Diabetes mellitus in the First Nations population of British Columbia, Canada.

This study is the continuation of diabetes mellitus surveillance in the First Nations population of British Columbia. In 1990, the authors reported on a 1987 study of 348 cases of diabetes mellitus in the on-reserve residents of 104 communities. That study showed that the overall prevalence of diabetes appeared to be lower than in the non-Native population and was one of the lowest for the First Nations in Canada. The surveillance was repeated in 1992 and in 1995. In 1992, results were obtained for 60 communities. The overall rate was 2.0% compared to 1.2% in 1987. For diabetics aged 35+, the overall rate was 5.9% compared to 4.5% in 1987. In 1995, the overall rate was 2.2%, and for those aged 35+ it was 6.3%. The First Nation rates continue to be low but have increased considerably from 1987. The higher rates are found in the coastal and southern areas of the province. A North-South gradient has been noted elsewhere in Canada with the lowest rates in the North. This has been attributed to acculturation, including the adoption of a non-traditional diet and a more sedentary lifestyle. It is not clear otherwise why the coastal communities are affected to this extent. In spite of low rates overall, those in the north-eastern interior region of the province have steadily and significantly increased over the period of the study. A significant proportion of First Nations diabetics are reliant on insulin for blood sugar control, and higher rates of mortality from diabetes and cardiovascular disease suggest that complication rates may be excessive in this population. Diabetes remains a significant health challenge for the First Nations in British Columbia.