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Diabetes and behavior: American Indian issues.

Diabetes is one of the leading health problems in the United States. It has recently attained the dubious distinction of becoming the fifth leading cause of disease-related death (Hamburg, Elliott, & Parron, 1982). Diabetes is generally characterized as existing in two major forms: (a) insulin-dependent (Type n. and (b) noninsulin-dependent (Type JD. The latter appears to be the more common, accounting for 80% of all diabetic cases (Hamburg et al., 1982). Types I and II diabetes differ in regard to several factors. Knowler, Pettitt, Bennett, and Williams (1983) describe Type I, or insulin-dependent diabetes, as a condition in which the administration of exogenous insulin is needed in order to keep the diabetic patient from developing ketoacidosis and eventually dying. They describe other factors associated with Type I diabetes as being the presence of pancreatic islet cell antibodies and acute symptom onset. Type II diabetes, according to Knowler et al. (1983), shows a resistance to ketosis, absence of pancreatic islet cell antibodies, and either the lack or slow development of overt symptoms. From an etiological perspective, Knowler et al. (1983) further address the differences between Types I and II diabetes: