Diabetes rates high in Canadian Aboriginal adults

Oster RT. CMAJ. 2011;doi:10.1503/cmaj.101882.

Estimated rates of type 2 diabetes and its complications are two to five times higher among Aboriginal adults than the general Canadian population, according to researchers. However, over time, the increase in diabetes incidence and prevalence for status Aboriginals was less than that of the general population.

A search of the Alberta Health and Wellness administrative databases by Richard T. Oster, MSc, of the University of Alberta, and colleagues yielded 161,268 total cases of diagnosed diabetes among more than 2.5 million adults aged 20 years and older living in Alberta between 1995 and 2007. Of the 72,725 Aboriginal adults identified, 7,055 had diabetes.

The average relative change per year in prevalence of diabetes for Aboriginal adults was lower than that of the general population (2.39% vs. 4.09%). Data were similar for the incidence of diabetes (1.21% vs. 4.55%). Aboriginal men experienced greater average relative change per year in prevalence and incidence compared with Aboriginal women (3.13% vs. 1.88% and 2.6% vs. 0.02%, respectively). Despite these findings, the researchers said the prevalence of diabetes among Aboriginal adults was lower in Alberta when compared with other Canadian provinces, including Saskatchewan, Manitoba and Ontario.

During the same period, mortality rates in all people with diabetes decreased, and the rates of decrease were not different between Aboriginal adults and the general population. However, mortality rates for Aboriginal adults were 1.5 to two times higher than that of the general population, and in those without diabetes, the mortality rate gap was increasing. Among those without diabetes, mortality increased in the general population but remained unchanged in the Aboriginal population.

“The decreases in mortality observed among status Aboriginal adults with diabetes over the study period are consistent with findings from a recent study of ours showing improved diabetes-related health among status Aboriginal adults in Alberta,” Ellen Toth, MD, also of the University of Alberta, said in a press release. “The growing divergence in mortality observed between status Aboriginals and the general population without diabetes is sadly in contrast to national trends from 1980 to 2001, which showed an improvement in life expectancy among registered Indians from 60.9 to 70.4 years among men and from 68 to 75.5 years among women.”

The researchers encouraged further research on why diabetes prevalence was lower in Alberta compared with other provinces and why mortality remained higher among Aboriginal adults.

Disclosure: The researchers report no relevant financial disclosures.

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