CMAJ • February 23, 2010; 182 (3). First published January 18, 2010; doi:10.1503/cmaj.090846
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Research

Epidemiology of diabetes mellitus among First Nations and non-First Nations adults

Roland Dyck, MD, Nathaniel Osgood, PhD, Ting Hsiang Lin, PhD, Amy Gao, BSc and Mary Rose Stang, PhD

From the Departments of Medicine (Dyck), Computer Science (Osgood, Gao) and Community Health and Epidemiology (Dyck, Osgood), University of Saskatchewan, Saskatoon, Sask.; the Department of Statistics (Lin), National Taipei University, Taiwan; and the Ministry of Health (Stang), Government of Saskatchewan, Regina, Sask.

Correspondence to: Dr. Roland F. Dyck, Department of Medicine, Royal University Hospital, 103 Hospital Dr., Saskatoon SK S7K 0P3; roland.dyck{at}usask.ca

Background: First Nations people in Canada experience a disproportionate burden of type 2 diabetes mellitus. To increase our understanding of this evolving epidemic, we compared the epidemiology of diabetes between First Nations and non-First Nations adults in Saskatchewan from 1980 to 2005.

Methods: We used administrative databases to perform a population-based study of diabetes frequency, incidence and prevalence in adults by ethnic background, year, age and sex.

Results: We identified 8275 First Nations and 82 306 non-First Nations people with diabetes from 1980 to 2005. Overall, the incidence and prevalence of diabetes were more than 4 times higher among First Nations women than among non-First Nations women and more than 2.5 times higher among First Nations men than among non-First Nations men. The number of incident cases of diabetes was highest among First Nations people aged 40–49, while the number among non-First Nations people was greatest in those aged 70 or more years. The prevalence of diabetes increased over the study period from 9.5% to 20.3% among First Nations women and from 4.9% to 16.0% among First Nations men. Among non-First Nations people, the prevalence increased from 2.0% to 5.5% among women and from 2.0% to 6.2% among men. By 2005, almost 50% of First Nations women and more than 40% of First Nations men aged 60 or older had diabetes, compared with less than 25% of non-First Nations men and less than 20% of non-First Nations women aged 80 or older.

Interpretation: First Nations adults are experiencing a diabetes epidemic that disproportionately affects women during their reproductive years. This ethnicity-based pattern suggests diverse underlying mechanisms that may include differences in the diabetogenic impact of gestational diabetes.


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Can. Med. Assoc. J. 2010 182: 221. [Full Text] [PDF]



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