Alfreda White, 46, has battled depression and cried for entire days since being diagnosed a diabetic. She now struggles daily with fear and self-esteem issues from having an incurable disease, she says.

White and Vernon Medicine Cloud, Karen's son, both work with the Willow Glen-based Indian Health Center of Santa Clara Valley to spread the message that diabetes rates among Native Americans could be reduced if people were educated about it sooner.

"If I would've known about screenings I would've gone," White says. "I would've done something about it. If I would've been more alert, maybe I wouldn't be like this."

Some at high risk will soon receive education about it as the Diabetes Prevention Program gets under way at the center on Meridian Avenue.

The program is scheduled to open this month with its first 16 participants, who will learn how to prevent diabetes through cooking, exercise and regular checkups.

The center will deliver what it calls a "culturally competent" program, such as talking circles, to new groups each year over a three-year period.

"If health professionals deliver the message in a paternalistic way, then American Indians will tune out. When you present it in a positive way saying, 'You can do something about this,' and it comes from our tribal leaders, there's respect and trust," says Valarie Jernigan, director of the center's diabetes program.

The center is one of only two urban Native American health facilities in the nation to receive a $1.65 million grant from Indian Health Services for the prevention program. San Jose and Los Angeles were chosen over Seattle, Arizona, Minneapolis and New Mexico, says Medicine Cloud, who coordinates the Indian Health Center's program.

"This is the first time the National Diabetes Prevention Program has been implemented here," Jernigan says. "What we want to do with diabetes is create a community where it can't thrive."

Treatment at the center has helped White realize the disease can be prevented, she says.

Before she got diabetes, White says she thought Native Americans inevitably got the disease as they aged, as did most of the population on her South Dakota reservation.

The most common form of diabetes, Type 2, occurs in all ethnic groups, but Native Americans have the highest rates in the country, according to the National Institutes of Health. The organization's statistics show this population is more than twice as likely to have been diagnosed with diabetes than its Caucasian counterparts.

Health experts have different explanations for the disproportionate numbers.

Jernigan says the rates are attributable to remote reservations' distance from quality health care and to Native Americans making a rapid transition from traditional diets to modern processed foods.

Ann Albright, chief of the California Department of Health Services' diabetes program, says likely causes are similar for all populations: excess calorie intake and lack of exercise. There could also be a genetic contribution, she says.

Medicine Cloud says whatever the reason, the number of people coming to the Indian Health Center due to diabetes is increasing.

Almost 7,000 Native Americans live in San Jose, and more make their home in California than any other state, according to U.S. Census Bureau figures. Health officials estimate that diabetes affects at least 15 percent of each tribal community.

White said more people would likely maintain their health if they knew the consequences of the disease.

Now that White has the disease, she has to be strict about what she eats, take pills twice a day, and give herself insulin shots.

"I used to just get up and go and not have to be home at a certain time. I have to take insulin morning and evening. I don't wish that on even my worst enemy," she says

But White says she is willing to do whatever it takes to live. She's motivated by the desire to be with her children and grandchildren.

"I want my grandchildren to know me," she says. "I want to tell kids that it can be prevented."

For more information contact the Indian Health Center of Santa Clara Valley, 1333 Meridian Ave., at 408. 445.3400.