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According to the 1997 study, "genetic susceptibility plays a significant role in some diseases, such as diabetes, while for others, the generally lower socioeconomic status, higher prevalence of certain health risk behaviors and lower utilization of preventative services in the Native American population are important determinants." [10] Also, before WWII, diabetes in Native American Communities was essentially non-existent

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As such, a doctor will perform imaging tests to confirm the diagnosis