Advertisement

Canadian Journal of Public Health

, Volume 98, Issue 6, pp 438–443 | Cite as

Incidence and Prevalence of Type 2 Diabetes in the First Nation Community of Kahnawá:ke, Quebec, Canada, 1986–2003

  • Ojistoh Kahnawahere HornEmail author
  • Heather Jacobs-Whyte
  • Amy Ing
  • Amanda Bruegl
  • Gilles Paradis
  • Ann C. Macaulay
Article

Abstract

Background

Type 2 diabetes is an increasing global health concern, most notably for Aboriginal peoples living in Canada among whom prevalence rates are 3 to 5 times those of the general population. The objective of this study is to determine the incidence and prevalence of type 2 diabetes among adults living in a First Nation community from 1986 to 2003.

Methods

Kahnawá:ke is a Kanien’kehá:ka (Mohawk) community in Quebec, Canada. Numerators for incident and prevalent cases were derived from the community hospital Diabetes Registry. Denominators were derived from population distributions provided to Kahnawá:ke by Indian and Northern Affairs Canada. Rates were standardized to 2000/01 Canadian population.

Results

From 1986–88 to 2001–03, incidence rates per 1000 for those 18 years and over decreased from 8.8 to 7.0 in males, and 8.8 to 5.2 in females. Prevalence rates increased from 6.0% to 8.4% in males and 6.4% to 7.1% in females. The prevalence rate among Kahnawá:ke men aged 45–64 years was 14%, twice the corresponding rate among Canadian men. Male to female ratios for both incidence and prevalence rates were above 1.0.

Discussion

Kahnawá:ke incidence rates are much lower than those of First Nation peoples of Manitoba. Kahnawá:ke prevalence rates are midway between national Aboriginal and general Canadian populations. Kahnawá:ke incidence rates and gender ratios are closer to those of the Canadian population. The results highlight the variations of type 2 diabetes between individual communities, and may reflect Kahnawá:ke’s socio-economic status, ongoing diabetes education, clinical care and diabetes primary prevention efforts.

MeSH terms

Type 2 diabetes mellitus incidence prevalence Indians: North American 

Résumé

Contexte

Le diabète de type II est une préoccupation croissante partout dans le monde, mais surtout pour les Autochtones du Canada, qui affichent des taux de prévalence trois à cinq fois supérieurs à ceux de la population générale. Nous avons voulu déterminer l’incidence et la prévalence du diabète de type II chez les résidents adultes d’une communauté des Premières nations entre 1986 et 2003.

Méthode

Kahnawá:ke est une communauté kanien’kehá:ka (mohawk) du Québec, au Canada. Les numérateurs des taux d’incidence et de prévalence proviennent du registre des cas de diabète de l’hôpital communautaire. Les dénominateurs proviennent des chiffres sur la répartition de la population fournis à Kahnawá:ke par le ministère canadien des Affaires indiennes et du Nord. Les taux ont été normalisés selon la population canadienne de 2000–2001.

Résultats

De 1986–1988 à 2001–2003, les taux d’incidence pour 1 000 habitants chez les 18 ans et plus ont diminué (de 8,8 à 7 ‰ chez les hommes et de 8,8 à 5,2 ‰ chez les femmes). Les taux de prévalence ont augmenté (de 6 à 8,4 % chez les hommes et de 6,4 à 7,1 % chez les femmes). Le taux de prévalence chez les hommes de Kahnawá:ke âgés de 45 à 64 ans était de 14 %, soit le double du taux correspondant chez les hommes canadiens. Le rapport homme/femme était supérieur à 1, tant pour les taux d’incidence que pour les taux de prévalence.

Discussion

Les taux d’incidence du diabète de type II à Kahnawá:ke sont beaucoup plus faibles que chez les membres des Premières nations du Manitoba. Les taux de prévalence à Kahnawá:ke se situent à mi-chemin entre les taux nationaux pour les Autochtones et les taux dans l’ensemble de la population canadienne. Les taux d’incidence et le rapport homme/femme à Kahnawá:ke sont plus proches de ceux de la population canadienne. Ces résultats soulignent les écarts entre les taux de diabète de type II d’une communauté à l’autre et pourraient s’expliquer par le statut socioéconomique, la formation et l’information continues sur le diabète, les soins cliniques et les efforts de prévention primaire du diabète à Kahnawá:ke.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    King H, Aubert R, Herman W. Global burden of diabetes, 1995–2025. Prevalence, numerical estimates, and projections. Diabetes Care 1998; 21(9):1414–31.PubMedCrossRefGoogle Scholar
  2. 2.
    Boyle JP, Honeycutt AA, Narayan KM, Hoerger TJ, Geiss LS, Chen H, et al. Projection of diabetes burden through 2050: Impact of changing demography and disease prevalence in the U. S. Diabetes Care 2001; 24(11):1936–40.PubMedCrossRefGoogle Scholar
  3. 3.
    Millar WJ, Young, TK. Tracking diabetes: Prevalence, incidence and risk factors. Health Reports 2003; 14(3):35–47.PubMedGoogle Scholar
  4. 4.
    Koopman RJ, Mainous AG III, Diaz VA, Geesy ME. Changes in age at diagnosis in the United States, 1998–2000. Ann Fam Med 2005; 3:60–63.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Fox CS, Pencina MJ, Meigs JB, Ramachandran SV, Levitzky YS, D’Agostino RB Sr. Trends in the incidence of Type 2 diabetes mellitus from the 1970s to the 1990s: The Framingham Heart Study. Circulation 2006; 113:2914–18.PubMedCrossRefGoogle Scholar
  6. 6.
    Bobet E. Diabetes among First Nations people. Aboriginal Peoples Survey 1991. Ottawa: Minister of Public Works and Government Services, 1998.Google Scholar
  7. 7.
    Young KT, Reading J, Elias B, O’Neil, JD. Type 2 Diabetes mellitus in Canada’s First Nations: Status of an epidemic in progress. CMAJ 2000; 163(5):561–66.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Green C, Blanchard JF, Young TK, Griffith J. The epidemiology of diabetes in the Manitobaregistered First Nation population: Current patterns and comparative trends. Diabetes Care 2003; 26(7):1993–98.PubMedCrossRefGoogle Scholar
  9. 9.
    Montour LT, Macaulay, AC. High prevalence rates of diabetes mellitus and hypertension on a North American Indian reservation. CMAJ 1985; 132(10):1110–11.Google Scholar
  10. 10.
    Macaulay AC, Montour LT, Adelson N. Prevalence of diabetic and atherosclerotic complications among Mohawk Indians of Kahnawake, PQ. CMAJ 1988; 139(3):221–24.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Montour LT, Macaulay AC, Adelson N. Diabetes mellitus in Mohawks of Kahnawake, PQ: A clinical and epidemiologic description. CMAJ 1989; 141(6):549–52.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Montour LT, Macaulay, AC. Diabetes mellitus and atherosclerosis: Returning research results to the Mohawk community. CMAJ 1988; 139(3): 201–2.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Bisset S, Cargo M, Delormier T, Macaulay AC, Potvin L. Legitimizing diabetes as a community health issue: A case analysis of an Aboriginal community in Canada. Health Promot Int 2004; 19(3):317–26.PubMedCrossRefGoogle Scholar
  14. 14.
    Macaulay AC, Hanusaik N, Delisle-Diabo D. Diabetic education program in the Mohawk community of Kahnawake, Quebec. Can Fam Phys 1988; 34:1591–93.Google Scholar
  15. 15.
    Macaulay A, Paradis G, Potvin L, Cross E, Saad-Haddad C, McComber A, et al. The Kahnawake Schools Diabetes Prevention Project: A diabetes primary prevention program in a native community in Canada: Intervention and baseline results. Prev Med 1997; 26:779–90.PubMedCrossRefGoogle Scholar
  16. 16.
    Far MP, Feuer, EJ. Confidence intervals for directly standardized rates: A method based on the gamma distribution. Statistics Med 1997; 16(7):791–801.CrossRefGoogle Scholar
  17. 17.
    Meltzer S, Leiter L, Daneman D, Gerstein HC, Lau D, Ludwig S, et al. 1998 clinical practice guidelines for the management of diabetes in Canada. Canadian Diabetes Association.[see comment]. CMAJ 1998; 159(Suppl 8):S1–S29.PubMedGoogle Scholar
  18. 18.
    Macaulay AC, Cargo M, Delormier T, Levesque L, Bisset S, Potvin L. Kanien’keha:ka (Mohawk) ways for the Primary Prevention of Type 2 diabetes: The Kahnawake Schools Diabetes Prevention Project. In: iFerreira ML, Lang GC (Eds.), Indigenous Peoples and Diabetes: Community Empowerment and Wellness. Durham, NC: Carolina Academic Press, 2006; 407–33.Google Scholar
  19. 19.
    Chandler MJ, Lalonde C. Cultural continuity as a hedge against suicide in Canada’s First Nations. Transcultural Psych 1998; 35(2):191–219.CrossRefGoogle Scholar
  20. 20.
    Minister of Public Works and Government Services Canada. Diabetes in Canada: National Statistics and Opportunities for Improved Surveillance, Prevention, and Control. Ottawa, ON, 1999.Google Scholar
  21. 21.
    Clinical practice guidelines for treatment of diabetes mellitus. Expert Committee of the Canadian Diabetes Advisory Board. CMAJ 1992; 147(5):697–712.Google Scholar
  22. 22.
    Young TK, Mustard, CA. Undiagnosed diabetes: Does it matter? CMAJ 2001; 164(1):24–28.PubMedPubMedCentralGoogle Scholar
  23. 23.
    Blanchard JF, Ludwig S, Wajda A, Dean H, Anderson K, Kendall O, et al. Incidence and prevalence of diabetes in Manitoba, 1986–1991.[see comment] Diabetes Care 1996; 19(8):807–11.PubMedCrossRefGoogle Scholar
  24. 24.
    Brassard P, Robinson E, Lavallee C. Prevalence of diabetes mellitus among the James Bay Cree of northern Quebec.[see comment] CMAJ 1993; 149(3):303–7.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Fox C, Harris SB, Whalen-Brough E. Diabetes among Native Canadians in northwestern Ontario. Chron Dis Can 1994; 15(3):92–96.Google Scholar
  26. 26.
    Pioro MP, Dyck RF, Gillis, DC. Diabetes prevalence rates among First Nations adults on Saskatchewan reserves in 1990: Comparison by tribal grouping, Geography and with non-First Nations people. Can J Public Health 1996; 87(5):325–28.Google Scholar
  27. 27.
    First Nations Regional Longitudinal Health Survey (RHS) 2002/2003: First Nations Centre. ISBN 0-9736623, 2005. Available online at: https://doi.org/www.naho.ca/firstnations/english/regional_health.php pages 69–76 (Accessed December 15, 2006).
  28. 28.
    Kelly C, Booth G. Diabetes in Canadian women. BMC Women’s Health 2004; 4(Suppl 1):S16.PubMedPubMedCentralCrossRefGoogle Scholar
  29. 29.
    Young TK, Szathmary EJ, Evers S, Wheatley B. Geographical distribution of diabetes among the native population of Canada: A national survey. Soc Sci Med 1990; 31(2):129–39.PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Hegele RA, Hanley AJ, Zinman B, Harris SB, Anderson, CM. Youth-onset type 2 diabetes (Y2DM) associated with HNF1A S319 in aboriginal Canadians. Diabetes Care 1999; 22(12):2095–96.PubMedCrossRefGoogle Scholar
  31. 31.
    Young TK, McIntyre LL, Dooley J, Rodriguez J. Epidemiologic features of diabetes mellitus among Indians in northwestern Ontario and northeastern Manitoba. CMAJ 1985; 132(7):793–97.Google Scholar
  32. 32.
    Dannenbaum D, Torrie J, Noel F, Cheezo J, Sutherland L. Undiagnosed diabetes in 2 Eeyou Istchee (Eastern James Bay Cree) communities: A population-based screening project. Can J Diabetes 2005; 29(4):397–402.Google Scholar
  33. 33.
    Institute of Aboriginal Peoples’ Health. Available online at: https://doi.org/www.cihr-irsc.gc.ca/e/27062.html (Accessed December 15, 2006).
  34. 34.
    Canadian Medical Association. The Health of Aboriginal Peoples 2002. Available online at: https://doi.org/policybase.cma.ca/PolicyPDF/PD03-02.pdf (Accessed December 15, 2006).
  35. 35.
    Evers S, McCracken E, Antone I, Deagle G. The prevalence of diabetes in Indians and Caucasians living in southwestern Ontario. Can J Public Health 1987; 78(4):240–43.PubMedGoogle Scholar
  36. 36.
    Delisle HF, Ekoe, JM. Prevalence of non-insulin dependent diabetes mellitus and impaired glucose tolerance in two Algonquin communities in Quebec. Diabetes Care 1995; 18:1255–59.PubMedCrossRefGoogle Scholar
  37. 37.
    Harris SB, Gittelsohn J, Hanley A, Barnie A, Wolever TM, Gao J, et al. The prevalence of NIDDM and associated risk factors in native Canadians. Diabetes Care 1997; 20(2):185–87.PubMedCrossRefGoogle Scholar
  38. 38.
    Maberley D, King W, Cruess, AF. The prevalence of diabetes in the Cree of Western James Bay. Chron Dis Can 2000; 21(3):128–33.Google Scholar

Copyright information

© The Canadian Public Health Association 2007

Authors and Affiliations

  • Ojistoh Kahnawahere Horn
    • 1
    Email author
  • Heather Jacobs-Whyte
    • 2
  • Amy Ing
    • 3
  • Amanda Bruegl
    • 4
  • Gilles Paradis
    • 5
  • Ann C. Macaulay
    • 6
  1. 1.Schools Diabetes Prevention ProjectMohawk Nation, Kahnawá:ke TerritoryCanada
  2. 2.Mohawk Nation, Kahnawá:ke TerritoryCanada
  3. 3.Kahnawá:ke Schools Diabetes Prevention ProjectCanada
  4. 4.Native American Center of ExcellenceUniversity of Washington School of MedicineSeattleUSA
  5. 5.Department of Epidemiology, Biostatistics, and Occupational HealthMcGill UniversityMontrealCanada
  6. 6.Kahnawá:ke Schools Diabetes Prevention ProjectMcGill UniversityCanada

Personalised recommendations