Risk of clinical diabetes in a northern Native Canadian cohort

A cohort of 630 non-diabetic adult Cree and Ojibwa Indians aged 20-64 from 6 remote communities in northern Manitoba and Ontario were followed for 46-63 months. During this period, 22 new cases of clinical diabetes were registered, an incidence density of 8.0/1000 person-years (95% confidence interval 5.8-10.3). Compared to the few published incidence studies, the rate in this population is slightly higher than the "general" North American population but still far below that of the extremely high risk groups such as Pima Indians and Nauruans. On multivariate analyses, fasting plasma glucose (FPG) level and body mass index (BMI) at baseline were significant independent predictors in a multiple logistic regression model that also contained age, sex, total cholesterol, HDL-cholesterol, triglycerides, hypertensive status, waist/hip ratio and subscapular/triceps skin-fold ratio. These associations are in accordance with current knowledge of the pathogenesis of non-insulin-dependent diabetes. This study indicates that a longitudinal follow-up study of a cohort of non-diabetic Native Canadians in remote communities is feasible. Useful data on the etiologic role of various risk factors can be generated which may be used in the planning of intervention programs in the control of this emerging health problem.