Class of 2007 Abstract / Objectives: To determine the effect of antihypertensive use on renal function and other diabetic complications in adults over the age of 18 with type 2 diabetes mellitus (DM). Methods: A retrospective secondary analysis of the NIH Pima epidemiologic data included 1,828 individuals with type 2 DM were evaluated for antihypertensive use and DM complications. Statistical analysis was done using general linear model regression (GLM) or logistic regression models controlling for age, sex and DM duration. Three groups were established to evaluate antihypertensive use Group 1 those taking antihypertensives to those not taking antihypertensives, Group 2 those taking more than one (multiple) antihypertensives to those only taking one and Group 3 those taking an angiotensin converting enzyme (ACE) inhibitor to those not taking an ACE. Results: Group 1 those taking antihypertensives were significantly worse for all outcome measures than those taking no antihypertensives as evident with: renal function (ACR 43 mg/mmol versus 15.9 mg/mmol (ρ=0.0003) and albuminuria 55.8% versus 37.6% (p=0.0039), retinopathy, neuropathy and CVD. Group 2 those taking multiple antihypertensives had significantly worse renal function (ACR 69.2 mg/mmol versus 34.5 mg/mmol (p=0.0329) and albuminuria 63% versus 52% (p=0.0396)), CVD while retinopathy and neuropathy were not significantly different. Group 3 those taking ACE had significantly worse renal function (ACR 43.8 mg/mmol versus 35.2 mg/mmol (p=0.0329)) while CVD was improved and no difference was observed in retinopathy and neuropathy. Conclusions: Antihypertensive use had little impact on preventing diabetic complications. This is contrary to well- documented literature that supports the use of antihypertensives to slow disease progression and protect renal function.

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Tissues (liver, spleen, pancreas, and aorta) and hair taken at autopsy from diabetic and non-diabetic southwestern Indians (mainly Pima) were analyzed for chromium (Cr) using flameless atomic absorption spectrophotometry. The Cr levels in both tissues and hair from diabetic subjects were consistently lower than in those from non-diabetic individuals. There were so few individuals in each group that it was not possible to accurately correlate a given tissue either with any other tissues or hair.

This study identifies the historical factors that impacted Pima agriculture, water use and water rights in south-central Arizona between 1848 and 1921. Federal land and resource policies, especially federal Indian policies, impacted the dynamics of Pima agriculture and water use during these crucial years when the federal government utilized economic liberalism to open the West to homesteading and facilitate the development of the region's vast resources.As an agricultural people, the Pima did not passively accept these policies and events. Rather, they proved adaptive, demonstrating their resourcefulness in important ways. In response to water deprivation and infringement of their water rights, the Pima reduced the amount of land they cultivated. While before 1880 they had increased their cultivated acreage and expanded their trade networks, in the years after they creatively found ways to keep land in production despite water shortages. As the water crisis deepened, the Pima abandoned their least productive lands. In the midst of great deprivation, they relocated (or abandoned) a number of villages and scores of fields in an attempt against great odds to maintain their agricultural economy. To make the most of their diminishing water resources, the Pima adapted by growing small grains such as wheat and barley, even when these crops no longer proved to be economically viable in Arizona. While not new to their crop rotation, the Pima relied almost exclusively upon these crops by the 1910s since they required considerably less water than others.Because the Pima had prior and paramount rights to the water and were wrongfully deprived of their rights to the use of water, their water rights struggle raised a metaphorical Damoclean sword above the heads of those non-Indian farmers who used the water. This study, therefore, focuses on the history of water use and agricultural production among the Pima Indians between 1848 and 1921 and argues that without infringement of their rights to water, the Pima would have equaled and perhaps surpassed the local agricultural economy.

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No description available.

The purpose of this research was to evaluate the impact of glycemic measures, and changes in identified risk factors (BMI, waist circumference, lipids, blood pressure) on follow-up glycemia, in Pima children at high risk for type two diabetes (type 2 DM).I computed incidence and cumulative incidence of type 2 DM in Pima children 5-19 years of age between 1983 and 2004. Cox proportional hazards rates for development of type 2 DM were calculated by glycemic measure (HbA1C, 20PG, FPG) controlling for confounding factors (age, sex, BMI, blood pressure, and cholesterol). Diabetes was defined by the presence of at least one of four criteria: 1) 20PG of >200 mg/dl, 2) FPG of >126 mg/dl, 3) HbA1C > 8.0%, or 4) hypoglycemic treatment. Linear regression models were computed to identify the impact of changes in risk factors on changes in HbA1C. Only exams performed in non-diabetic children during childhood were included in the regression models.Among 2658 non-diabetic children, 258 cases of diabetes occurred during mean 9.1 years of follow-up (1.5 - 21.7). The age-sex adjusted incident rate of diabetes was 19.0 cases per 1000 person-years, and cumulative incidence was 54% by age 40. Incidence rates increased with increasing baseline values of 20PG, and FPG, but not for HbA1C. For HbA1C the relationship was u-shaped with the lowest and highest quartiles having the highest DM rates. After adjustment for confounding risk factors using Cox proportional hazards analysis, the risk for diabetes increased 2-fold for every 10 mg/dl increase in FPG. Changes in waist circumference best predicted changes in HbA1C (R2 = 0.48, Ï <0.001). However, the ability of waist circumference to predict change is limited due to the powerful effect of regression to the mean, suggesting that these risk factors contribute very little to changes in HbA1C, at least in childhood.Childhood levels of glycemia predict development of type 2 DM later in life. While changes in waist circumference are associated with only moderate changes in HbA1C, this does not refute the significant contribution of adiposity in childhood to the development of type 2 DM.

The Mountain Pima of the Sierra Madre Occidental of Chihuahua, Mexico, utilize a variety of domesticated and nondomesticated resources. Part of their agricultural system consists of shifting, or swidden, cultivation on steep hillsides. Wild edible plants contribute significant amounts of vitamins and minerals to the diet on a seasonal basis. The drought of 1988 caused a decrease in the availability of many resources, but an increase in availability of roots of saraviqui (Prionosciadium townsendii). A dynamic, nonlinear optimization study of Mountain Pima diet included requirements for adequate amounts of energy, protein, calcium, and vitamins A and C. Oxalate content of several plant foods and seasonal variation in resource availability were incorporated into the study. Two methods were compared: time minimization and a nutrient indexing method minimizing the product of the absolute value of the natural logarithm of the ratio of recommended intake to actual intake rates. This method allowed simultaneous optimization of several different parameters. The nutrient indexing model matched the actual diet of the Mountain Pima somewhat better than the traditional energy minimization model. It predicted higher use of noncultivated plant species and of animal resources than the time minimization model. Analyses were conducted for years of adequate rainfall and for the drought year. A list of 612 plant species collected in the community of Nabogame is also included.

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No description available.