The Prevalence of NIDDM and Associated Risk Factors in Native Canadians

Stewart B Harris; Joel Gittelsohn; Anthony Hanley; Annette Barnie; Thomas M S Wolever; Joe Gao; Alexander Logan; Bernard Zinman

doi:10.2337/diacare.20.2.185

Original Articles

The Prevalence of NIDDM and Associated Risk Factors in Native Canadians

Stewart B Harris, MD,
Joel Gittelsohn, PHD,
Anthony Hanley, MSC,
Annette Barnie, RN,
Thomas M S Wolever, MD,
Joe Gao, PHD,
Alexander Logan, MD and
Bernard Zinman, MD

Department of Family Medicine and the Department of Epidemiology, University of Western Ontario London, Ontario
Division of Human Nutrition, Department of International Health, School of Hygiene and Public Health, Johns Hopkins University Baltimore, Maryland
Department of Medicine, University of Toronto Ontario
Samuel Lunenfeld Research Institute, Mount Sinai Hospital Toronto, Ontario
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto Ontario, Canada

Address correspondence and reprint requests to Stewart B. Harris, MD, Centre for Studies in Family Medicine, University of Western Ontario, Thames Valley Family Practice Research Unit, 100 Collip Circle, Suite 241), UWO Research Park, London, Ontario N6G 4X8. E-mail: sharrisl{at}julian.uwo.ca

Diabetes Care 1997 Feb; 20(2): 185-187. https://doi.org/10.2337/diacare.20.2.185

Abstract

OBJECTIVE To determine the true prevalence of impaired glucose tolerance (IGT), NIDDM, and associated risk factors by age and sex in an isolated native community.

RESEARCH DESIGN AND METHODS A community-wide prevalence survey using a 75-g oral glucose tolerance test (OGTT) was undertaken in the remote native reserve of Sandy Lake, Ontario, Canada. Measurements for obesity included waist-to-hip circumference, BMI, and percentage body fat.

RESULTS A total of 728 individuals were enrolled, representing a community participation rate of 72%. The overall crude prevalence of NIDDM was 17.2% (18.1% females and 16.0% males) and increased to 26.1% overall (28.0% females and 24.2% males) when age-standardized. The prevalence of IGT was higher in females compared with males (age-standardized prevalence of 19.8 vs. 7.1%, respectively). Females had a higher prevalence of obesity, IGT, and NIDDM occurring at younger ages. Measures of obesity and fasting insulin levels were significantly associated with NIDDM in the 18–49 age-group.

CONCLUSIONS The prevalence rates of NIDDM in this study population are the highest reported to date in a Canadian native population and among the highest reported in the world. Females appear to be at much higher risk of developing obesity, IGT, and NIDDM and at a younger age. Due to the high prevalence rates of IGT and NIDDM in this young population, there is urgent need to develop culturally appropriate community-based public health intervention programs before the long-term complications of diabetes have a devastating effect on the residents.