| S. No |
Risk factors |
Points to consider |
| 1. |
Genetic and biological |
Higher obesity rates, higher gestational diabetes rates leading to increased risk of diabetes and increased risk of obesity in offspring, impaired glucose tolerance in females, and thrifty gene theory |
| 2. |
Environmental |
Less access to healthcare services, remote geographical location, reduced availability of healthy food supply, less education opportunities, and hunting and fishing restrictions leading to less traditional food |
| 3. |
Lifestyle |
Smoking, energy-dense westernized food leading to obesity and increased body mass index (BMI), and less physical activity - hunting restrictions |
| 4. |
Sociocultural |
Lack of culturally appropriate support, language barriers, mistrust of outsiders, political and historical factors such as the residential school system, and loss of native land |
| 5. |
Economic |
Lack of employment, cost of daily diabetes care, expensive healthy food options, and transportation costs to access healthcare |
