American Indians and Alaska Natives have these risk factors for type 2 diabetes:

• Genes. We still don’t know the specific genes responsible for the inheritance of type 2 diabetes. But scientists studying the Pima Indians have identified a gene called FABP2 that may play a role in insulin resistance. Other studies have shown that a variant in the PPPIR3 gene is more common in Pimas than Whites and is associated with type 2 diabetes and insulin resistance.
• Obesity. Increasing rates of obesity have been found in many American Indian and Alaska Native communities.
• Diet and physical activity. Both diet and physical activity have changed for many members of American Indian and Alaska Native groups over the past several decades. Diets are higher in fat and calories than traditional diets, and physical activity has decreased

Pregnant AI/AN women with type 2 diabetes are at an increased risk of having babies born with birth defects. Diabetes that shows up in pregnancy is called gestational diabetes. This form of diabetes is high among certain AI/AN groups. Gestational diabetes increases the baby's risk for problems such as macrosomia (large body size) and neonatal hypoglycemia (low blood sugar). Although the blood glucose levels of women with gestational diabetes usually return to normal after childbirth, these women have an increased risk of developing gestational diabetes in future pregnancies. In addition, studies show that many women with gestational diabetes will develop type 2 diabetes later in life.

Type 2 diabetes is becoming increasingly common in children and adolescents. Getting type 2 diabetes at this early age increases the likelihood of getting cardiovascular disease, eye problems, nerve problems, and kidney problems earlier. American Indian/Alaska Native children have a higher rate of type 2 diabetes compared to other ethnicities. In addition to the increase of type 2 diabetes in children and adolescents, it is also common among middle-age and older American Indians and Alaska Natives. Twenty percent of AI/AN between ages 45 and 64 have diabetes, and about 20 percent of AI/AN over age 64 have diabetes.

Serious complications of diabetes are increasing. The most concerning are kidney failure, heart disease, amputations, and blindness. Infections, including tuberculosis (TB), are of particular concern to both American Indians and Alaska Natives who have diabetes. A study of Sioux Indians showed that their rate of developing tuberculosis is higher if they had diabetes than if they did not.

People with diabetes have a higher chance of having problems with their skin, mouth, kidneys, heart, nerves, eyes, and feet. Although type 1 diabetes cannot be prevented, there are steps you can take to prevent and control type 2 diabetes and avoid harmful complications:

• See your doctors regularly. Don't forget about the dentist and eye doctor!
• Check your levels. Control your blood sugar and cholesterol levels, your blood pressure, and weight.
• Get moving! Get at least 30 minutes of physical activity on most days, if not all days, of the week.
• Check your feet every day for blisters, red spots, swelling, or cuts.
• Stay aware of how you feel. If you notice a problem, call your doctor or nurse right away.
• Don’t smoke. If you smoke, try to quit.

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