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Study projects high lifetime diabetes risks in Canada, especially for First Nations

A new Canadian study found alarmingly high lifetime risk levels for diabetes, especially in First Nations people. For young people (age 20), the study projected that eight in 10 First Nations people will develop diabetes in their lifetime, and five in 10 non-First Nations people will develop the condition.

The study identified several differences in diabetes risks between First Nations people and non-First Nations people. Many of these differences reflect the long-established higher diabetes risks in First Nations people.

  • While lifetime diabetes risks increased over time in all groups, First Nations people had higher risks than non-First Nations people in every age group, and reached higher risk levels at an earlier age. For example, at age 20, First Nations women have a 19 per cent risk of developing diabetes before their 50th birthday, compared to a seven per cent risk in 20-year-old non-First Nations Women.
  • In First Nations people, women had higher risk of diabetes than men, with 87 per cent lifetime risk in women compared to 76 per cent in men. This was pattern was reversed in non-First Nations women and men: women had 47 per cent overall lifetime risks, compared to 56 per cent in men.
  • First Nations people living in rural areas had higher risks than those in urban areas, especially for women. Rural First Nations women had a lifetime diabetes risk of 94 per cent, compared to 80 per cent for urban women. In non-First Nations people, lifetime risk was slightly higher in urban areas than in rural locations.

The study lists some of the reasons why First Nations people are particularly vulnerable to diabetes. These include genetic factors and dietary acculturation, as well as increases in obesity rates and adoption of sedentary lifestyles. Socioeconomic factors also play a role. The authors cite research showing the influence of social, cultural, historical and political inequities, as well as lack of access to healthy nutrition and healthcare, on diabetes risks in indigenous populations.

Researchers from the University of Calgary used Alberta Health Registry data on over 2,800,000 Albertans, ages 20 and older, who did not have diabetes at the beginning of the study. The study group included 70,631 were First Nations people. Over an average followup time of almost nine years, 160,549 people developed diabetes. The study did not differentiate between Type 1, Type 2, and gestational diabetes, but the vast majority of diabetes cases in Canada are Type 2.

The study highlights the very high lifetime risks identified in young First Nations people, and points out that more than half of Alberta’s First Nations population is under age 25. The researchers stress the need for primary prevention programs to help lower diabetes risks.    

The researchers note that the lifetime risks outlined in the study were estimated for populations, based on average people. For individuals, personal risk factors – such as  affect lifetime risk of diabetes.

The lifetime risks projected in the study were estimated for populations, based on average people. The study authors note that for individuals, personal risk factors will affect the likelihood of developing diabetes. The authors also note that data from Alberta might not be generalizable to other parts of Canada.

The study was led by Tanvir Chowdhury Turin, PhD, at the University of Calgary. It was published online in CMAJ on Sept. 19, 2016.

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  • A publication of:
  • Women's College Hospital