American Indian Culture and Research Journal

THE NATURE OF THE PROBLEM Diabetes mellitus among American Indians is not only a major health problem and a challenge to physicians and epidemiologists but represents an opportunity for anthropologists and population geneticists to help in understanding why such a detrimental disease has persisted in human populations and increased its incidence dramatically during the past fifty years. For a variety of reasons, susceptibility appears to be uniquely high among selected North American Indian groups, despite the fact that early in this century diabetes was virtually unknown among these populations. At the same time, other Indians exhibit rates of diabetes that are lower than the average rates for Caucasians. These variations lead to questions concerning both the factors that contribute to the onset of diabetes as well as to more fundamental issues involving Indian origins and their adaptations to different environments. The purpose of this paper is to examine what is known about the problem and suggest general directions for further inquiry.