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wicazo sa review: A Journal of Native American Studies 16.1 (2001) 9-15



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The Diabetic Plague in Indian Country: Legacy of Displacement

Lorelei De Cora


In the movie Outbreak, a small town in California is decimated by a new airborne virus that is spreading wildly despite efforts to halt it by the Centers for Disease Control and the U.S. Army. At least one member in every family is infected. Death strikes within hours.

The epidemic in Outbreak is strikingly similar to a disease sweeping Indian communities throughout the country, including the Winnebago reservation located in the state of Nebraska. Although it does not cause death within hours of onset nor is it viral in nature, it threatens a lifetime of ill health and an early death. When one family member is affected, others are likely to be as well. The disease is diabetes, and it can lead to blindness, amputations, heart attacks, kidney failure, and neurological breakdown--a syndrome familiar to all too many Native Americans.

Although diabetes strikes people of all races, 30% of Indians in the United States die of complications directly related to diabetes compared to 10% of non-Indians. Forty-eight percent of Indian children as young as six on one reservation show signs of being at risk for diabetes, and 80% of Indians over age 45 are already diagnosed with the disease.

Diabetes can blind, disable, or kill Indians who are currently diagnosed with the disease. Unchecked, it will devastate the Winnebago tribe. But there is reason for hope. When diabetes is diagnosed early, and when simple changes in diet and exercise are made, people can live long and healthy lives with diabetes. [End Page 9]

The Diagnosis of Diabetes

Wee-ha is a 42-year-old Winnebago Indian woman who works part-time and lives on the reservation with her three children. She takes care of her mother, who is blind from diabetes and needs kidney dialysis three time a week.

Over the past year, Wee-ha has felt increasingly weak and shaky during the day. She eats large meals to regain her strength and often snacks on quick-energy food like donuts or candy. Still, she continues to feel weak, and her weight is dropping steadily. Wee-ha is terribly thirsty and constantly drinks pop or lemonade. One day when she wakes up, her vision has become so blurry that she can't work. Finally, she goes to the local Indian Health Service health care clinic.

After checking her blood, the doctor diagnoses Wee-ha with type II diabetes. Her body is not absorbing insulin, he explains, and the overload of sugar in her bloodstream is compromising the tiny blood vessels in her eyes.

For the next several weeks, Wee-ha must check her blood sugar level four times a day and keep a log that includes the results of the tests, as well as what and when she ate between each test. She also has to give herself daily injections of insulin and visit the clinic so they can evaluate her progress.

At the clinic, the goals are first to lower Wee-ha's blood sugar level and then to help her maintain a safe blood sugar level. Type II diabetes can be controlled--if the patient exercises and changes his or her diet.

After four weeks, Wee-ha's blood sugar level has dropped to a safe level, and she can try to manage her diabetes by eating better food and exercising regularly. Between her job and caring for her mother and children, however, Wee-ha is overwhelmed. Now that she feels better, it is difficult to want to change her diet and exercise.

To all appearances, life goes on as before. But Wee-ha's body has become a time bomb. Without drastic changes in her lifestyle, it is only a matter of time before her diabetes worsens and she either loses her sight or requires amputation, beginning with her toes, then her feet, and then her legs. Her children are...

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