Incident diabetes, hypertension and dyslipidemia in a Manitoba First Nation

BACKGROUND: Diabetes and diabetes complications are substantially higher among Canadian First Nations populations compared with the general Canadian population. However, incidence data using detailed individual assessments from a population-based cohort have not been undertaken. OBJECTIVE: We sought to describe incident diabetes, hypertension and dyslipidemia in a population-based cohort from a Manitoba Ojibway First Nation community. DESIGN: Study data were from 2 diabetes screening studies in Sandy Bay First Nation in Manitoba, Canada, collected in 2002/2003 and 2011/2012. The cohort comprised of respondents to both screening studies (n=171). Health and demographic data were collected using a questionnaire. Fasting blood samples, blood pressure and anthropometric data were also collected objectively. Incident diabetes, hypertension and dyslipidemia were determined. Generalized linear models with Poisson distribution were used to estimate risk of incident diabetes and cardiometabolic conditions according to age and sex. RESULTS: There were 35 (95% CI: 26, 45) new cases of diabetes among 128 participants without diabetes at baseline (27 or 3.3% per year). While participants who were 50 years and older at baseline had a significantly higher risk of incident diabetes at follow-up compared with participants aged 18–29 at baseline (p=0.012), more than half of the incident cases of diabetes occurred among participants aged less than 40 at baseline. There were 28 (95% CI: 20, 37) new cases of dyslipidemia at follow-up among 112 without dyslipidemia at baseline (25%). There were 36 (95% CI: 31, 42) new cases of hypertension among 104 participants without hypertension at baseline (34.6%). Women had half the risk of developing hypertension compared with men (p=0.039). CONCLUSIONS: Diabetes incidence is very high, and the number of new cases among those younger than 40 is a concern. Additional public health and primary care efforts are needed to address the diabetes burden in this First Nation community.