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Changing patterns of type 2 diabetes incidence among Pima Indians

Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona

mpavkov{at}phx.niddk.nih.gov

ABSTRACT

OBJECTIVE: The rising prevalence of obesity and high prevalence of diabetes among Pima Indians suggest that the incidence of diabetes has risen over time. We examined trends in the incidence rate of type 2 diabetes among Pima Indians between 1965 and 2003.

RESEARCH DESIGN AND METHODS: Incidence rates were computed independently in three 13-year time periods in Pima Indians aged 5 years old. Diabetes was defined by the presence of at least one of two criteria 1) 2-hour plasma glucose concentration 200 mg/dl (11.1 mmol/l), or 2) hypoglycemic treatment.

RESULTS: Among 8,236 subjects without diabetes at baseline, 1,005 incident cases occurred during follow-up. Age-sex-adjusted incidence rates of diabetes were 25.3 cases/1,000 pyrs (95%CI=22.5-28.0) in 1965-1977, 22.9 cases/1,000 pyrs (95%CI=20.0-25.8) in 1978-1990 and 23.5 cases/1,000 pyrs (95%CI=20.5-26.5) in 1991-2003 (p=0.3). The incidence rate in subjects aged 5-14 years was 5.7 (95%CI=1.9-17.4) times as high in the last as in the first period, but the rate declined in those 25-34 years old (incidence rate ratio=0.6, 95%CI=0.4-0.8). Sex-adjusted prevalence increased significantly over time only in those 5-24 years of age (p_trend<0.0001).

CONCLUSION: The overall incidence of diabetes among Pima Indians remained stable over the past four decades, with a significant rise occurring only in the youth.

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