Ancient Voices

A Museum to honor the least known people in North America, the Original Tribal Women

Diabetes and Ceremony
Including Powwows and Potlucks

Diabetes affects both women and men so on this page I have not concentrated on only the female aspects. I hope that this will be acceptable because of the severity of the disease in Indian Country.

However because this site is about Native American women I would like to give some statistics of the disease on the women before the rest of the information is given:

Type 2 diabetes is a serious chronic health problems facing Native American women. Approximately one third of American Indians aged 45 or older have diabetes. (1)
Native American women suffer from the second highest rate of being overweight, which places them at a higher risk for diabetes. (2)
Native American women have the highest age-adjusted death rates for diabetes, one that is 3.5 times greater than the overall population. (3)
American Indian/ Alaska Natives are almost 3 times as likely to have diabetes as non-Hispanic whites. (3)
The mortality rate for American Indian women living in New Mexico has increased 550% over a 30-year period. (4)
Rates of end-stage-renal-disease, a complication of diabetes, are increasing at a rate of 10% per year for American Indian/ Alaska Natives compared to 6% per year for whites. (5)
1. Making the Grade on Women's Health: A National and State-by-State Report Card: National Women's Law Center; August 2000.
2. Ross H. Lifting the Unequal Burden of Cancer on Minorities and the Underserved: NCI Develops Strategic Plan to Reduce Cancer Related Health Disparities. Washington, DC: Office of Minority Health, U.S. Department of Health and Human Services; August 2000.
3. National diabetes statistics fact sheet: general information and national estimates on diabetes in the United States, 2000. Department of Health and Human Services, National Institutes of Health, Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases; 2002.
4. Carter JS, Wiggins CL, Becker TM, Key CR, Samet JM. Diabetes mortality among New Mexico's American Indian, Hispanic, and non-Hispanic white populations, 1958-1987. Diabetes Care. 1993;16(1):306-309.
5. Healthy People 2010, 2nd ed. Washington, DC: U.S. Department of Health and Human Services, U.S. Government Printing Office; November 2000

the above statistics are from:

The Porcupine Clinic in Porcupine South Dakota (Pine Ridge Reservation) has developed guides for people who have diabetes and wish to take part in Lakota Ceremonies. The guides are now being adapted to the ceremonies of the Dakota and Ojibwa Tribes in South Dakota and Minnesota. The guides have been found useful for a number of people who advise diabetic Native Americans.

Diabetes is a new disease for Native Americans. However the lifestyle changes required for the management of diabetes can be supported by many of the older Native American traditions. Often the losses that come with the diagnosis of diabetes can be dealt with by drawing on the Native American traditions that emphasize personal strength and courage along with the connections with family and the world.

Unfortunately some of the Native American ceremonies pose special challenges to a person with diabetes. For example; the heat and hot rocks of the Sweat Lodge, the fasting of the Vision Quest, and the lacerations of the Sun Dance need to be considered and planned for by a diabetic. Successfully dealing with these challenges requires insight into an individual's response to stress, medication and diet. This understanding combined with other native traditions can go a long way to managing diabetes.

The guides were written drawing first from published information and then from interviews with Native Americans who have diabetes yet regularly participate in their ceremonies. Leaders of the ceremonies were also consulted. The guides are written for specific ceremonies and the participants are referred to ceremonial leaders who have experience in working with diabetics.

It is our experience that with proper planning, people with diabetes can participate fully in all Native American Ceremonies.

The following information has been taken from the cards written and published by the Porcupine Clinic in Porcupine South Dakota. I know for a fact that diabetes is a big problem for many Native American people it has grown disproportionately compared with other racial/ethnic populations. Often people come into the Little Feather Center asking about how they can continue going to Sun Dance or do sweats now that they are diabetic. When we were shown these cards we were very impressed because by using the tips on them the diabetic person can continue with their social or ceremonial lifestyle. All thanks have to go to the Porcupine Clinic on Pine Ridge for publishing these wonderful cards.

I am using every word that is on the cards, so copyright belongs to the Porcupine Clinic. If you would like a set of these cards please contact us and we will send you the address of the person who has them (dragonfly_dezignz at hotmail dot com)

Powwows and Potlucks

Nothing beats getting together, having fun and eating with friends; that is what powwows and potlucks are all about. The happiness and laughter are all good medicine for you. They lower your stress and lift your spirits. But all that food and all that great tasting fat can pose a challenge to someone with diabetes. Here are some suggestions on how to eat right at powwows and potlucks.

Have a snack before going to take the edge off your appetite, spread out the food and decrease the resistance to sugar uptake.
Bring your own water or diet pop. Drinking them will help reduce your appetite
Take the opportunity to try low fat foods prepared in new ways. Take small servings and try more dishes. You can get chips and dip anytime.
Use smaller plates that hold less food. Pace yourself between trips. It takes the stomach 15 - 20 minutes to know it's full.
Bring a dish to the potluck that shows how great a low fat dish can taste.
Look for interesting salads, fresh fruits and vegetables.
For the dishes you like, go back for the recipe not seconds.
If you take something that isn't worth the calories, don't finish it. If your auntie made it, eat a polite amount and compliment her.
Plan to walk or dance off some of the extra calories.
If you plan to deal with overeating by skimping during the days before and after, make sure to adjust your medications, and check your blood sugars.

Remember to have fun and enjoy the company.


The drum has been called the heartbeat of mother earth and dancing is a way of experiencing that heartbeat. Dancing can help you feel the connection to your ancestors and their strength and courage. It also helps you feel connected with your children, grandchildren and the others at the powwow. It is for them you are managing your diabetes. Some have found dancing lowers their stress and helps control their blood sugar long after the dance. To get the most from your dancing, consider the following:

If your dancing is quite strenuous, and you are taking diabetic medications such as insulin or oral drugs that stimulate insulin production you may need to add some carbohydrates to avoid low blood sugars.
The low blood sugar effect may be delayed several hours; test and eat after dancing.
Very strenuous exercise can dehydrate you, resulting in elevated blood sugar. If your blood sugar is already above 300 (250 if ketones are present), you should get your blood sugar under better control before dancing.
If your blood sugar is below 100 take a snack to get it up before dancing.
Regardless of your blood sugar drink plenty of water; regalia can get very hot. If you are going to do a sweat before or after dancing, drink extra water to avoid dehydration and high blood sugars.
Have someone at the dance be aware of your diabetes; someone you would be comfortable asking to help if you have symptoms of high or low blood sugar. Wear a medical alert ID and carry a fast acting source of sugar.
Make sure your shoes are comfortable. Wear moccasins with hard soles or insoles or padding along with thick socks. Chesk your feet after dancing.
If you have retinopathy check with your ophthalmologist before starting strenuous dancing.
Finally, check your cardiovascular health with your health provider especially if you are new to dancing. Diabetes dramatically increases the chances of you having a heart attack or stroke so make sure you know their warning signs and symptoms.

Talk with others who have diabetes and dance. Don't stop dancing just because you have diabetes; it may be just the medicine you need.

Sweat Lodge

You sweat a lot in a sweat lodge, and the sweat gives you a sense of special cleaning and renewal, from the inside out. The sweat lodge is used for purification by itself or as preparation for other ceremonies, for example the Sun Dance, and the Vision Quest. The sweat lodge can strengthen your spirituality. For a person with diabetes, a sweat lodge can reduce the stress in their lives and renew their determination to manage their disease. Some have found that sweats bring their blood sugars back to normal. Here are some suggestions that will help make a successful Sweat Lodge experience.

Drink enough water before a sweat; the excess sweating can dehydrate you and increase your blood sugar. If your blood sugar is already above 300 (250 if ketones are present), you should get your blood sugar under better control before before doing a sweat.
Sweating in sweat lodge is not the same as sweating from exercise but it can still drop your blood sugars. Check your blood sugar after a sweat if it is your first time or if you are medicating your diabetes with insulin or oral drugs that stimulate insulin production.
If you are going to a sweat before or after a Vision Quest or during a Sun Dance, drink extra liquids to avoid dehydration. Take liquids if they are offered between doors.
Do not go into a sweat lodge alone; have someone in the sweat be aware of your diabetes. The Sweat Lodge is such an intense experience that you cannot rely on your feelings that normally indicate high or low blood sugar.
Make sure you don't burn your feet on the rocks, the hot coals or the hot spray. Sit as far away from the rocks as practical. Check the position of your legs before the door is closed and between doors. Protect your feet with a towel.
Finally, since diabetes dramatically increases the chances of you having a heart attack or stroke, make sure you know their warning signs and symptoms.

Sweat Lodges are an important way to connect with yourself, your spirituality and your tribe and heritage. Talk with others who have diabetes and have done sweats. Your health care provider can help you contact leaders who have experience accommodating people with diabetes. Do not stop going to sweat lodges just because you have diabetes, they may be just the medicine you need.

Vision Quest

The vision comes during isolation, but the understanding comes by going back to the community. It is this dual nature of the Vision Quest that has made it a powerful ritual with Native Americans. A Vision Quest is where a person withdraws to an isolated area (often a hill) and fasts and prays for the spirits to give a dream or vision through which he or she can achieve a better life or a better life for his or her family and community. As a result, a Vision Quest can be a critical element in a person's ability to manage their diabetes. However a Vision Quest for a person with diabetes poses some medical challenges but with proper preparation they can participate. Most diabetic treatment plans are focused on utilizing food properly; it may take some effort to develop a plan for fasting.

It is important to control your blood sugar while fasting. Out of control blood sugar can affect your senses and hide any visions from the spirits.

These are some suggestions:

With your health care provider develop a treatment plan that can be used with fasting. Be patient, it may take several weeks before you will know how your body responds to fasting.
Drink plenty of water before starting the Quest. If you are going to do a sweat before or after a Quest, drink extra water to avoid dehydration.
Start by fasting for only one day and test your blood sugar several times. It is important to have experience with fasting before undertaking even a one-day Vision Quest.
Arrange to have one or two friends observe you unseen during your Quest. Arrange to go through a routine that will allow the observers to judge how you are feeling.
Longer fasts require more elaborate preparations and treatment plans. Remember to check your blood sugar often.
Finally, since diabetes dramatically increases the chances of you having a heart attack or stroke, make sure you know their warning signs and symptoms.

Talk with other people who have diabetes and have undertaken Vision Quests. Talk with the spiritual leaders. Your health care provider can help you contact leaders who have experience accommodating people with diabetes. They can help you avoid the potential problems and gain the benefits of one of the most profound experiences in Native American life.

Sun Dance

The Sundance Ceremony is one of the most dramatic of Native American ceremonies but it is still fundamentally spiritual to the people who take part. Four days of outdoor dancing and visiting with friends and relatives from across the country is very spiritual. For those who choose to undergo the piercing and tearing of their flesh, the pain and its release can put the everyday challenges of managing diabetes in a new perspective. A number of Native Americans with diabetes have used the Sundance to develop the deep spirituality needed for managing their diabetes. The Sundance can make living with diabetes seem easy.

Use the pledge year before the Sundance to minimize your medications through diet and exercise while maintaining good sugar control. Both traditional and western medicines can help you do this.
Test your blood sugar regularly throughout the Sundance. If you are going to fast during the Sundance, develop a treatment plan with your health care provider that can be used with fasting
If you are going to do a sweat during the Sundance, drink plenty of liquids to avoid dehydration and high blood sugars.
New wounds should be treated as soon as practical to speed the healing.
Finally, since diabetes dramatically increases the chances of you having a heart attack or stroke, it is important that you know their warning signs and symptoms.

Talk with other diabetics who have gone through a Sundance. Talk with the leaders. Your health care provider can help you contact leaders who have offered to guide those who truly want to undertake a Sundance but are concerned about their diabetes. They can help you avoid the potential problems and gain the benefits of one of the most profound spiritual experiences in Native American religion.

© all the above writing on the ceremonies and diabetes - Porcupine Clinic, Porcupine SD

In my own experience of going to Sundance for 8 years, I wish to add that the leader allowed those with diabetes to wear moccasins and drink sage tea to help them - GH

Links that could help

American Diabetes Association -
specifically about Native Americans on this page

Native American Diabetes Project
Diabetes Wellness Connection

Indian Health Service
Division of Diabetes Treatment and Prevention

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Museum Research & Curator Gloria Hazell
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©August, 2006