Preeclampsia in American Indian women with Type 2 Diabetes

History of Tribal Partnership to Address Preeclampsia

As in Type 1 diabetes, preeclampsia (PE) is increased in women with Type 2 diabetes. Again, many studies of PE have excluded women with Type 2 diabetes, particularly those from minority groups and American Indians are experiencing a particularly severe “epidemic” of Type 2 diabetes. To address these issues, Dr. Lyons and his colleagues, while working at the University of Oklahoma, created a partnership with two Oklahoma tribes, the Choctaw Nation and the Chickasaw Nation. Together they initiated a multi-center prospective study of pregnant women with Type 2 diabetes and American Indian ancestry.

The clinical sample collection phase is now complete. From these tribal sites, 309 participants were enrolled for prospective study. Detailed clinical assessments were recorded throughout the pregnancies, and blood and urine samples were collected at ~12, ~22, and ~32 weeks’ gestation and at term. We will use these samples to perform detailed lipoprotein analysis, measures of oxidative stress, inflammation, endothelial dysfunction, and factors in the blood that may affect vessel growth. We expect that this study will identify markers to identify diabetic patients at highest risk for PE, clarify disease mechanisms, and eventually find measures to prevent PE. The Choctaw and Chickasaw Nations’ Institutional Review Boards have requested that the samples collected in this study (requiring five ultra-low temperature freezers) be transferred to the Lyons Lab at MUSC to begin the next phase of study.