Prevalence of type 2 diabetes, obesity and the metabolic syndrome among Canadian First Nations children in a remote Pacific coast community.
BACKGROUND
Type 2 diabetes mellitus (T2D) in children and adolescents is a growing public health concern. Although the prevalence of T2D in First Nations children has been documented to be as high as 1% in central Canada, no paediatric data are available for any Aboriginal community in British Columbia (BC).


OBJECTIVE
To determine the prevalence of obesity, glucose intolerance and the metabolic syndrome in children living in a remote BC First Nations community.


METHODS
Children who were six to 18 years of age and living in the community of Hartley Bay, BC, participated in the study. A medical history, a physical examination and a 2 h oral glucose tolerance test were completed. Overweight was defined as a body mass index between the 85th and 95th percentiles, and obese was defined as a body mass index greater than or equal to the 95th percentile, which were standardized for age and sex.


RESULTS
Thirty of 34 children (88%) participated (mean +/- SD age 11.8+/-3.4 years). Ten children (33%) were obese, and five (17%) were overweight. There were seven children (23%) with abnormal glucose tolerance as per the 2007 American Diabetes Association criteria: five with only impaired fasting glucose ([IFG] 5.6 mmol/L to 6.9 mmol/L), one with both IFG and impaired glucose tolerance and one with T2D. However, using the 2008 Canadian Diabetes Association criteria, two children (6.7%) had abnormal glucose tolerance (one with IFG plus impaired glucose tolerance and one with T2D) because no child met the definition for IFG alone (6.1 mmol/L to 6.9 mmol/L). Four children (13%) met the criteria for the metabolic syndrome.


CONCLUSIONS
There is a high prevalence of the components of the metabolic syndrome, including overweight, obesity and abnormal glucose tolerance, in the children of this community.
Wahi
Gita
G
Department of Pediatrics, Endocrinology & Diabetes Unit, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia.
Zorzi
Alexandra
A
Macnab
Andrew
A
Panagiotopoulos
Constadina
C