Indian Health Service: Changing the Course of Diabetes in Indian Country

Tim Giago: A disease that ravages Indian Country and America

Notes from Indian Country
A disease that ravages Indian Country and America

Many years ago I knew a nutritionist named Linda Biel. Her mantra was, “You are what you eat.”

When one is young and healthy that mantra makes no sense. Young men and women eat anything, for the most part, that you put in front of them if it doesn’t eat them first. And then there comes that day when you are told you have Type 2 diabetes.

Diabetes is a disease that became epidemic on many Indian reservations. For instance, on the Gila River Reservation in Arizona it was determined that 50 percent of the population had diabetes. In the year 2020 this is not just a disease that impacts the Indian people. It is spreading rapidly around the country.

Tim Giago. Photo courtesy Native Sun News Today

But let me take you back to the days in Indian Country when the tremendous herds of buffalo where decimated with one purpose; to take away the main food source of the Plains Indians. The buffalo was the provider of food, shelter, tools and spirituality. It was all things to the Lakota, Dakota and Nakota. When the herds were nearly extinguished the people of the Sioux Nation were faced with starvation. The U. S. Government, for reasons most of us will never understand, decided to save the Indians from starvation by providing monthly rations to the tribes.

On Pine Ridge the rations came in the form of cattle driven all of the way to South Dakota from the herds in Texas, and were a part of the rations. Mostly the rations were made up of foods totally foreign to the indigenous people; food such as flour, beans, and lard led off the rations, but the government also sent large quantities of salt pork. The Pine Ridge Natives turned up their noses at the pork and often left it behind while taking their other rations away in their wagons. The local white settlers knew when “ration day” came to Wakpamni and watched as the rations were handed out because they knew the Natives would not take the salt pork. They took the pork the Indians left to their own homes, The Lakota people observed this and named the settlers “wacicu: Takers of the fat.” To this day the Lakota still refer to the white people as “wasicu.”

But most of the rations handed out to the Lakota was not healthy. The Lakota had never used flour and beans for instance. The lard handed out with the rations was terribly high in cholesterol, as was most of the rations. So in the short span of a few years, the Lakota, a people that thrived on buffalo meat, timpsilas (tuberous roots), wild onions, and berries had a healthy diet of centuries turned into one of the unhealthiest.

The Lakota women made a buffalo soup containing the roots, wild onions and other ingredients that they had used for centuries. This was a healthy, mostly non-fat diet that came to a screeching halt after the buffalo was gone. The starches and high cholesterols started to take their toll on the people who had never eaten this kind of food. This is when the first stages of diabetes began to appear. Prior to that it was a disease not known to the Lakota.

In the tribe there were people known as wicasa and winyan wakan, or holy men and women who also served the people as healers. They knew the plants and herbs needed to heal a sick person. My great grandmother’s name was Winyan Wakan, or Holy Woman. She was a medicine woman serving the people of Pejuta Haka (Medicine Root; or Kyle now). She also knew how to keep her own family healthy. Mary Tyler Moore, the actress, had Type 1 diabetes, a disease that begins at birth or early childhood. There are still many folks with Type 1, but there has been an extreme surge in Type 2 diabetes. Moore was a strong advocate for finding a cure to the disease, but it ended up taking her life.

The words of Linda Biel ring true. You are what you eat. What you eat has an immediate impact upon the blood sugars in your body. It wreaks havoc on one’s kidneys, heart and liver. So much so that many diabetics lose their limbs to it.

My brother-in-law Delmar Brewer tried to keep his sense of humor even though he had lost part of an arm and leg to it. One day I stopped to visit him in Pine Ridge and noticed the good looking pickup, the kind we used to call cherry, sitting in his driveway. I said, “Wow, great looking truck,” and he retorted, “Cost me an arm and a leg.” Fudd, as we called him, passed away in his thirties.

I have Type 2 diabetes and I lost two sisters to the disease. It cannot be cured, but it can be controlled if you remember, “You are what you eat.”

Tim Giago is the author of 4 books. He as the founder of the Native American Journalists Association and a Nieman Fellow at Harvard. Contact him at

Note: Content © Tim Giago

Join the Conversation