When Shelly Bointy stands in front of her class of 20 students at Haskell Indian Nations University she is lecturing. Really lecturing, as in the way your mom does when she tells you to go to the doctor.

“Write this down,” she tells them. “For those 18 and older, you need to get your blood sugar checked once a year.”

While it’s a fact that will likely end up on the test later in the semester, she’s more concerned about its real-life application.

During a recent class, Bointy was teaching the differences among type 1, type 2 and gestational diabetes and how to test for them. In between, she coached students on what to say when they go to the doctor, encouraged the women in the classroom to keep exercising and watching what they eat when pregnant and, of utmost importance for everyone, to regularly test their blood sugar.

“It’s up to you to make sure you know your blood sugar, and it’s up to you to be healthy. Don’t let that decision be up to somebody else,” she said.

Since 2007, Bointy has taught the twice-a-week, 75-minute class at Haskell called Diabetes and the Native American.

American Indians are at a higher risk for diabetes. That risk continues to climb among those who have family members with the disease (which is most) and who are overweight.

Minorities — including Hispanics, blacks and some Asians — have higher rates of diabetes than the average population. At the top are American Indians. Of the adults who use Indian Health Services, 16.5 percent have diabetes — a rate more than double the national average.

“It’s been a long-standing problem in Indian communities,” Bointy said.

Bointy points to a number of reasons.

American Indians have been far removed from their indigenous food sources and the ones they do have aren’t always safe. Those native diets have been replaced with unhealthy Western ones.

Another theory, Bointy says, is that American Indians have a “quick gene,” which in days of hunting and gathering allowed them to store fat quickly during times that food was scarce.

And there are plenty of socio-economic factors — high substance abuse, high school drop-out rates and unemployment — that put American Indians at greater risk for developing type 2 diabetes.

Earlier this month, Bointy spent 16 hours traveling to Oklahoma and sharing a similar message with teachers as part of the Diabetes Education in Tribal Schools program. Under the National Institute of Diabetes and Digestive and Kidney Disease, the program works with teachers to integrate diabetes education into the year-round curriculum.

The idea, Bointy said, is to start diabetes education early because by the time the students arrive in her Haskell classroom, their diet and exercise habits already are entrenched.