Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study.
BACKGROUND
Diabetes is an important contributor to the health inequity between Aboriginal and non-Aboriginal Australians. This study aims to estimate incidence rates of diabetes and to assess its associations with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) among Aboriginal participants in a remote community.


METHODS
Six hundred and eighty six (686) Aboriginal Australians aged 20 to 74 years free from diabetes at baseline were followed for a median of 11 years. During the follow-up period, new diabetes cases were identified through hospital records. Cox proportional hazards models were used to assess relationships of the incidence rates of diabetes with IFG, IGT and body mass index (BMI).


RESULTS
One hundred and twenty four (124) new diabetes cases were diagnosed during the follow up period. Incidence rates increased with increasing age, from 2.2 per 1000 person-years for those younger than 25 years to 39.9 per 1000 person-years for those 45-54 years. By age of 60 years, cumulative incidence rates were 49% for Aboriginal men and 70% for Aboriginal women. The rate ratio for developing diabetes in the presence of either IFG or IGT at baseline was 2.2 (95% CI: 1.5, 3.3), adjusting for age, sex and BMI. Rate ratios for developing diabetes were 2.2 (95% CI: 1.4, 3.5) for people who were overweight and 4.7 (95% CI: 3.0, 7.4) for people who were obese at baseline, with adjustment of age, sex and the presence of IFG/IGT.


CONCLUSIONS
Diabetes incidence rates are high in Aboriginal people. The lifetime risk of developing diabetes among Aboriginal men is one in two, and among Aboriginal women is two in three. Baseline IFG, IGT and obesity are important predictors of diabetes.
Wang
Zhiqiang
Z
Centre for Chronic Disease, School of Medicine, University of Queensland, Herston, 4029 QLD, Australia.
Hoy
Wendy E
WE
Si
Damin
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D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D005215:Fasting / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000208:ethnology*; D005951:Glucose Tolerance Test; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015876:Northern Territory / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D020379:Risk Adjustment; D012737:Sex Factors
D001786:Blood Glucose