Type 2 diabetes (T2D) is extremely prevalent in Native communities across america. While the variety of individuals with T2D varies between tribal nations, there are a couple of aspects which have increased the variety of individuals with T2D in these communities: colonization and its impact on traditional diets, food insecurity and discrimination and racism. 

Colonization, food insecurity and health discrimination

Adversarial events akin to forced relocation, pandemics and discrimination have affected the diets of Native communities. They’ve been required to abandon the natural resources utilized in their diets, which has contributed to a rise in malnutrition, a greater dependence on Western foods and a decrease in agriculture. Those that eat a Western food plan are 2.5 times more prone to develop diabetes than Natives who follow a conventional food plan. 

Food insecurity also plays a job in the event of diabetes. This happens when people don’t have access to enough food with the intention to live an lively, healthy life. While 59 percent of the US population in 2014 lived inside one mile of a food market, only 26 percent of individuals on tribal reservations did. 

Food insecurity is connected to the high rates of diabetes in Native communities; people who find themselves food insecure are two times more prone to live with obesity and diabetes than those that should not. Being food insecure also makes it more difficult to administer diabetes as a result of the dearth of nutritious foods. 

Discrimination and racism are also involved in impacting the health of individuals in Native communities. In 2019, a survey found that 23 percent of participants reported being discriminated against in US healthcare settings, while one other 15 percent avoided healthcare visits due to possible discrimination. 

Avoiding care from healthcare professionals can result in more cases of undiagnosed diabetes and make diabetes harder to administer. 

Diabetes in Indigenous communities

The International Diabetes Federation (IDF) recently hosted a webinar covering the impact of diabetes on Indigenous communities. The goals of the event were to advertise the IDF’s Atlas Report on Diabetes and Indigenous Populations, recognize the challenges that folks in Indigenous communities face when living with diabetes and supply recommendations in response to the increasing cases of diabetes in these populations. 

Featuring experts in the sector akin to an Indigenous Health PhD candidate, the vice chair of the UN Everlasting Forum on Indigenous Issues and an individual from Nepal who lives with diabetes, the event discussed the IDF’s Atlas Report, resources for use for advocacy and the difficulties of providing diabetes care to Indigenous Peoples in Brazil and Nepal. 

The IDF’s 2022 Atlas Report found a consistent increase in diabetes amongst Indigenous populations world wide, and it’s estimated that the prevalence of diabetes is over ten percent. 

Recommendations for addressing the high variety of diabetes cases in Indigenous communities include:

• the successful practices utilized in countries which have low diabetes prevalence
• Applying traditional Indigenous foods and practices for prevention
• Exploring the upper prevalence of diabetes amongst women versus men
• Increasing the reporting of the age-specific prevalence of T2D to find out physiological changes
• Conducting future research by and with Indigenous Peoples

Advice from a Navajo dietitian

Though traditional food is commonly demonized and said to be unhealthy, Denee Bex, a Navajo Dietitian and Certified Diabetes Care and Education Specialist, has a message for her fellow Indigenous Peoples. 

When asked what she wishes Indigenous and Native communities knew about their cultural food and diabetes, she said, “I wish my community knew that we don’t must let go of our traditional and Native foods to administer diabetes. … Incorporating these foods can still help us manage our blood sugars. … [T]hey should not just nutritious, but in addition they honor our history of resilience and pride in our heritage.”

She emphasized that food is greater than just nutrition; additionally it is love, our heritage and connection to the community. 

Bex also shared that she wishes more people in her community knew there isn’t a shame in developing diabetes or other chronic conditions. Due to stigma around diabetes, many individuals don’t seek medical care until it’s too late. 

Diabetes also isn’t so simple as what you eat and should you exercise or not. In point of fact there are various aspects that go into its development including stress levels, sleep patterns, family history, age, genetics and even intergenerational and historical trauma.

As well as, Bex shared that Native communities are thrice more prone to be in poverty than non-Natives, and there is commonly limited access to grocery stores, basic utilities, clean water and inclusive healthcare services. 

While it’s vital to debate challenges these communities face, she said we also must brainstorm solutions to them. She recommends offering non-judgmental nutrition and diabetes education, creating handouts with pictures and supporting indigenous farmers. 

Teaching basic cooking and diabetes management skills, providing transportation to medical appointments or health events, specializing in budget-friendly recipes and dealing closely with mental health professionals to handle trauma were other suggestions from Bex.

Resources for Native communities

There are a selection of resources available to assist mitigate problems with food access and improve the treatment of diabetes.

The Alaska Native Tribal Health Consortium runs the Food Distribution Program through which eligible households can receive a month’s value of food akin to produce, meat, grains and dairy products. 

Native Health in Phoenix offers the Native Health Diabetes Prevention program, which provides counseling and education to individuals with pre-diabetes and diabetes.

The Special Diabetes Program for Indians (SDPI) provides grants to 301 programs in 35 states to assist decrease the number of individuals that suffer from diabetes and its complications. 

As well as, the Navajo Nation Special Diabetes Project promotes healthy lifestyles while decreasing and stopping the number of people that have diabetes within the Navajo community. 

Learn more

Taking a customized approach to diabetes management makes it easier to stick with your treatment plan. Personalizing your approach must also include taking cultural considerations under consideration. Discover more about why diabetes care needs to be tailored to every person’s culture here!

Editor’s Note: This content was made possible with support from Lilly, an lively partner of Beyond Type 2 on the time of publication.