Evaluating Diabetes Interventions in American Indian Populations, A Systematic Review

Abstract

Specific Aims: Conduct a comprehensive and systematic review to identify and describe studies from October 2010 to May 2012 that have addressed diabetes interventions in American Indian populations and assess the impact those interventions had on improving humanistic and therapeutic outcomes in preventing or treating diabetes in American Indians. Methods: Studies published between 5 October 2010 and 30 May 2012 that described diabetes interventions or programs in American Indian populations were identified via electronic searches of PubMed, CINAHL, IPA, Cochrane, PsychINFO, Web of Science, and ERIC using key search terms related to (and MeSH terms where applicable) diabetes, interventions, medication adherence, diet, exercise, blood glucose, cholesterol, blood pressure, North American Indians, American Indians, Native Americans, and Alaska Natives. Articles were reviewed and were excluded if the study had no comparison group, was not interventional or programmatic in nature, took place outside the US, study population was < 50% American Indian, or did not report on patient-related outcomes. Data on study characteristics, patient characteristics, and study outcomes were extracted. Main Results: A total of five studies were included. Positive, significant effects were reported on A1c in 40% (n=2), cholesterol in 40% (n=2), blood pressure in 40% (n=2), weight/BMI in 20% (n=1), blood glucose monitoring in 20% (n=1), diet in 20% (n=1), and diabetes knowledge and health literacy in 20% (n=1). Conclusion: The literature review had minimal results. Of those included, the majority of diabetes interventions were educational-related, observational in design, assessed only adults, and study populations were primarily female. Few of the included studies interventions demonstrated significant improvements in diabetic outcomes. Continued research and efforts to further improve diabetes management within the American Indian community is needed.