The diabetes project at Fort Totten, North Dakota, 1984-1988.

The purpose of this study was to characterize demographic, therapeutic, and complication features of patients in the Fort Totten Diabetes Project and to assess the longitudinal impact of intervention strategies. Individuals (n=215) of varying American Indian tribal origin and a mean age of 53 years (range 14-86), 62% women, with type II diabetes of 9 years average duration were studied. Annual chart audits of the complete diabetic population were conducted from 1984 to 1988. Obesity is a major problem complicating diabetes management (average body mass index [BMI] 32 +/-0.9), but BMI does not correlate with glucose control as assessed by total GHb (r=0.014, NS). Individuals lost an average of 3.7 kg (P < 0.025) during the interval, but no significant decline was evident when values for individuals were considered. Complication rates for retinopathy, nephropathy, and neuropathy paralleled those rates published for urban populations. Diabetes mellitus in American Indians living in a rural, socioeconomically deprived area can be identified and cared for with success similar to that published for urban populations.