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TRACKING RATES OF DIABETES AMONGST STATUS ABORIGINAL AND GENERAL POPULATION
YOUTH IN ALBERTA, CANADA
Richard OsterPhD Candidate
University of Alberta
CDPAC, OttawaFebruary 8th
2012
OUTLINE
Background
Methods
Results
Summary
BACKGROUND
CANADA’S ABORIGINAL PEOPLES
First Nations and Inuit (‘status’
and
‘non‐status’), as well as Métis
3.8% of total population
The contemporary Aboriginal
population is young, growing and
urbanizing
Canada Alberta
First Nations
696 310 97 130
Inuit 50 340 1 600
Métis 388 465 85 240
Total 1 135 115 183 970
Adapted from Statistics Canada, 2006
Introduction
Background
Methods
Results
Summary
DIABETES IN STATUS ABORIGINALS
Rapid emergence of type 2 diabetes
Prevalence 2‐5 times higher
Females have higher prevalence, but gap may be closing
Introduction
Background
Methods
Results
Summary
Oster et al, 2011
Prevalence and incidence of diabetes among people aged 20 years or more in Alberta
Introduction
Background
Methods
Results
Summary
DIABETES IN STATUS ABORIGINALS
Perhaps more alarming are reports of increasing obesity and emerging type 2
diabetes in Aboriginal youth
Those with early‐onset type 2 diabetes experience a longer duration of disease and
thus have an increased risk of developing complications
Introduction
Background
Methods
Results
Summary
Dyck et al, 2010
Age‐specific diabetes incident case counts and incidence by period in Saskatchewan
Introduction
Background
Methods
Results
Summary
Dean et al, 2003
Type 2 diabetes incidence from a tertiary care pediatric Diabetes Education Centre in
Manitoba
Introduction
Background
Methods
Results
Summary
Variable Clinical type 2 diabetes
N 66
% with A1c > 9.5 43.3%
% with waist circumference > 90th
percentile82.5%
% with hypertension 35.5%
% with hypertriglyceridemia 74.1%
% with low HDL 41.1%
% with microalbuminuria 31.5%
Adapted from Dabelea et al, 2009
Clinical, metabolic, behavioral, and sociodemographic risk factors for chronic complications among Navajo
youth with type 2 diabetes
Introduction
Background
Methods
Results
Summary
IN ALBERTA?
The epidemiology of diabetes in Aboriginal youth has not
been explored in Alberta The Alberta Diabetes
Surveillance System (ADSS) includes administrative data on
youth
Introduction
Background
Methods
Results
Summary
OBJECTIVE: To track and compare trends in diabetes rates from 1995 to 2007 for Status Aboriginal and general population youth
METHODS
DATA SOURCE
Data from 1995‐2007 for youth (< 20 years) was obtained: physician claims, vital
statistics, hospital discharge dataDiabetes cases were identified using the
National Diabetes Surveillance System algorithm
Does not differentiate between type 1 and type 2 diabetes
The Status Aboriginal identifier captures First Nations and Inuit peoples both on‐
and
off‐reserve with Treaty status
Introduction
Background
Methods
Results
Summary
DATA ANALYSES
Crude annual diabetes prevalence and incidence rates by ethnicity
Odds ratios (OR) were calculated to compare the likelihood of being a prevalent
case and incident case of diabetes for the two populations in 2007
Average Annual Percent Changes (AAPC) in prevalence and incidence from 1995 to 2007 were determined and compared
Introduction
Background
Methods
Results
Summary
RESULTS
CRUDE DIABETES RATES, 2007
Crude diabetes prevalence and incidence among Status Aboriginal and general population youth, 2007
Status Aboriginal General populationOdds ratio(95% CI)
Prevalence rate (per 100)
Combined 0.27 0.31 0.90 (0.76, 1.07)
Females 0.31 0.30 1.02 (0.81, 1.29)
Males 0.25 0.31 0.79 (0.61, 1.01)
Incidence rate (per 1000)
Combined 0.59 0.49 1.21 (0.83, 1.75)
Female 0.56 0.49 1.15 (0.67, 1.98)
Males 0.61 0.49 1.26 (0.76, 2.10)
Introduction
Background
Methods
Results
Summary
CRUDE PREVALENCE OVER TIME
Status AboriginalGeneral population
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Year
Rat
e pe
r 100
Introduction
Background
Methods
Results
Summary
CRUDE INCIDENCE OVER TIME
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Year
Rat
e pe
r 100
0
Status AboriginalGeneral population
Introduction
Background
Methods
Results
Summary
ETHNICITY COMPARISONS OVER TIME
Ethnicity comparisons of AAPC (Average annual percent change) in diabetes prevalence and incidence among Status Aboriginal and general population youth, 1995- 2007
AAPC Status Aboriginal AAPC General population
Prevalence
Combined 6.98*† 3.93*
Female 5.70*†§ 3.70*§
Male 9.18*† 4.15*
Incidence
Combined 8.92* 4.01*
Female 6.18*§ 3.36*§
Male 11.65*† 4.62** p < 0.05 for AAPC† p < 0.05 for AAPC ethnicity comparison§ p < 0.05 for AAPC sex comparison
Introduction
Background
Methods
Results
Summary
SUMMARY
TAKE HOME MESSAGES
Introduction
Background
Methods
Results
Summary
Diabetes prevalence and incidence has increased among all Alberta youth
Status Aboriginal youth, males in particular, experienced a disproportionate growth in
diabetes If unabated, increasing diabetes in youth
will likely only further perpetuate the diabetes epidemic in the Status Aboriginal
population
ACKNOWLEDGEMENTS
Dr. Ellen Toth
Sheri Pohar
ADSSDr. Jeff JohnsonStephanie BalkoGreg Hugel
Alberta Health and WellnessLarry Svenson
Introduction
Background
Methods
Results
Summary
REFERENCES
Dean HJ et al. Can J Diabetes. 2003;27(4):449‐54.
Dabelea D et al. Diabetes Care. 2009;32(Suppl
2):S141‐7.
Dyck R et al. CMAJ. 2010;182(3):249‐56.
Oster RT et a l. CMAJ. 2011;183(12):E803‐8.
Statistics Canada. 2006. Available online at:
http://www12.statcan.gc.ca/census‐ recensement/2006/as‐sa/97‐558/index‐eng.cfm
Introduction
Background
Methods
Results
Summary
QUESTIONS
Richard Oster
www.braiddm.ca
Introduction
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Summary