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.
Footnotes
Sources of Funding: This study was supported by the Kateri Memorial Hospital Centre, Kahnawá:ke, the National Health Research and Development Program, Health Canada (6605-4188-ND and 6605-4187-ND), and the Canadian Institutes of Health Research (CIHR # H43274). Funding sources for AB were Native American Center of Excellence, Native American Research Center for Health, and University of Washington, Department of Family Medicine, Washington, USA.
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