title: Type 2 diabetes mellitus in children: prenatal and early infancy risk factors among native canadians.
abstract: BACKGROUND
  Type 2 diabetes mellitus is increasingly being observed among children and youth, including the Native population of Canada. Only one study has investigated prenatal and early infancy risk factors for the disease.
  
  
  METHODS
  A case-control study was conducted; 46 patients younger than 18 years were recruited from the only clinical center for the treatment of diabetes serving the province of Manitoba, and 92 age- and sex-matched controls were recruited from a pediatric ambulatory clinic serving a large Native population in Winnipeg, Manitoba. Information on exposure to prenatal and early infancy risk factors was obtained through questionnaires administered by a Native nurse-interviewer.
  
  
  RESULTS
  Multiple logistic regression modeling identified preexisting diabetes (odds ratio [OR], 14.4; 95% confidence interval [CI], 2.86-72.5), gestational diabetes (OR, 4.40; 95% CI, 1.38-14.1), and breastfeeding longer than 12 months (OR, 0.24; 95% CI, 0.13-0.99) as significant independent predictors of diabetic status. Other factors, such as low (<2500 g) and high (>4000 g) birth weight and maternal obesity, were also associated with diabetes in our population, but the elevated risks were not statistically significant.
  
  
  CONCLUSIONS
  Breastfeeding reduces the risk of type 2 diabetes among Native Canadian children and should be promoted as a potential intervention to control the disease.
authors.affiliation: Department of Community Health Sciences, University of Manitoba, 750 Bannatyne Ave, Winnipeg, Manitoba, Canada R3E 0W3. tkyoung@ms.umanitoba.ca
authors.forename: T Kue
authors.initials: TK
authors.lastname: Young
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Martens
authors.forename: Shayne P
authors.initials: SP
authors.lastname: Taback
authors.forename: Elizabeth A C
authors.initials: EA
authors.lastname: Sellers
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Dean
authors.forename: Mary
authors.initials: M
authors.lastname: Cheang
authors.forename: Bertha
authors.initials: B
authors.lastname: Flett
mesh_terms: D000293:Adolescent; D001942:Breast Feeding / Q000208:ethnology; D016022:Case-Control Studies; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006293:Health Promotion; D006801:Humans; D007198:Indians, North American; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008350:Manitoba / Q000453:epidemiology / Q000208:ethnology; D008425:Maternal Behavior / Q000208:ethnology*; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000208:ethnology; D011295:Prenatal Care / Q000379:methods / Q000592:standards*; D012307:Risk Factors; D011795:Surveys and Questionnaires