Determinants of plasma glucose level and diabetic status in a northern Canadian Indian population

We conducted a cross-sectional survey of 704 Indians aged 20 to 64 years in six remote communities in northern Ontario and Manitoba to determine the factors associated with the fasting plasma glucose and glycosylated hemoglobin levels and diabetic status, defined by past history and current fasting plasma glucose level. Multivariate analyses for the 671 subjects with complete data showed that triglyceride level, age and body mass index (BMI) were significant predictors of the log fasting plasma glucose level and the log glycosylated hemoglobin level; for the latter, waist/hip ratio, history of diabetes mellitus among first-degree relatives and low level of education were additional predictors. Significant risk factors for diabetes as a dichotomous variable included triglyceride level, age, BMI and family history of diabetes. Although energy intake per unit of body weight was lower among subjects with diabetes than those without diabetes, possibly reflecting the lower physical activity level of diabetic subjects, the former consumed significantly more "calorie-adjusted" protein and less carbohydrate than the latter. The findings are consistent with studies in other populations. Further study is needed to determine the natural history of diabetes and its metabolic consequences and to assess the effect of dietary alteration and promotion of physical activity on the incidence of the disease.