Epidemiology of diabetes mellitus among First Nations and non-First Nations adults.
BACKGROUND
First Nations people in Canada experience a disproportionate burden of type 2 diabetes mellitus. To increase our understanding of this evolving epidemic, we compared the epidemiology of diabetes between First Nations and non-First Nations adults in Saskatchewan from 1980 to 2005.


METHODS
We used administrative databases to perform a population-based study of diabetes frequency, incidence and prevalence in adults by ethnic background, year, age and sex.


RESULTS
We identified 8275 First Nations and 82,306 non-First Nations people with diabetes from 1980 to 2005. Overall, the incidence and prevalence of diabetes were more than 4 times higher among First Nations women than among non-First Nations women and more than 2.5 times higher among First Nations men than among non-First Nations men. The number of incident cases of diabetes was highest among First Nations people aged 40-49, while the number among non-First Nations people was greatest in those aged 70 or more years. The prevalence of diabetes increased over the study period from 9.5% to 20.3% among First Nations women and from 4.9% to 16.0% among First Nations men. Among non-First Nations people, the prevalence increased from 2.0% to 5.5% among women and from 2.0% to 6.2% among men. By 2005, almost 50% of First Nations women and more than 40% of First Nations men aged 60 or older had diabetes, compared with less than 25% of non-First Nations men and less than 20% of non-First Nations women aged 80 or older.


CONCLUSIONS
First Nations adults are experiencing a diabetes epidemic that disproportionately affects women during their reproductive years. This ethnicity-based pattern suggests diverse underlying mechanisms that may include differences in the diabetogenic impact of gestational diabetes.
Dyck
Roland
R
Department of Medicine, University of Saskatchewan, Royal University Hospital, Saskatoon, Saskatchewan. roland.dyck@usask.ca
Osgood
Nathaniel
N
Lin
Ting Hsiang
TH
Gao
Amy
A
Stang
Mary Rose
MR
D000328:Adult; D002170:Canada / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D012525:Saskatchewan / Q000208:ethnology