Sioux Lookout First, Nations Health Authority, Ontario, Canada.
Division of Nephrology, U of T Associate Scientist, Institute of Medical Science, University of Toronto; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
Can J Rural Med. 2020 Oct-Dec;25(4):139-144. doi: 10.4103/CJRM.CJRM_99_19.
First Nations communities are known to have high rates of diabetes. The rural First Nations communities in northwest (NW) Ontario are particularly affected. Regional studies in 1985 and 1994 found a high prevalence of diabetes. More recently, they are estimated to have the highest prevalence in Ontario at 19%, double the provincial norm. The purpose of this study is to examine the epidemiology and prevalence of diabetes in the total population and cardiovascular comorbidities in the adult population of 25 First Nations communities in NW Ontario.
This retrospective diabetes prevalence study used primary care electronic medical record data for a 3-year period, 1 August 2014-31 July 2017. Diabetes prevalence was calculated for both the total and the adult (18+) populations and comorbid hypertension and dyslipidaemia were identified in adults.
The age-adjusted diabetes prevalence for the total population was 15.1% versus a Canadian prevalence of 8.8%. The age-adjusted adult prevalence was 14.1%, double Canada's average of 7.1%. The average age of adults with diabetes was 52 years (±14.9); 57% were female. Comorbid hypertension (58%) and dyslipidaemia (73%) were common. Metformin was the most commonly used medication (58%), followed by insulin/analogues (23%) and sulphonylureas (13%).
The diabetes prevalence in the First Nations population of NW Ontario is double Canada's norm. Addressing it will require addressing relevant social determinants of health, including poverty and food security.
众所周知，第一民族社区的糖尿病发病率很高。安大略省西北部的农村第一民族社区尤其受到影响。1985 年和 1994 年的区域研究发现，糖尿病的患病率很高。最近，据估计，该地区的患病率在安大略省最高，为 19%，是全省平均水平的两倍。本研究旨在检查安大略省西北部 25 个第一民族社区的总人口中糖尿病的流行病学和患病率，以及成年人口中的心血管合并症。
这项回顾性糖尿病患病率研究使用了为期 3 年的初级保健电子病历数据，时间为 2014 年 8 月 1 日至 2017 年 7 月 31 日。计算了总人口和成年（18 岁以上）人群的糖尿病患病率，并在成年人群中确定了合并高血压和血脂异常。
总人口的年龄调整糖尿病患病率为 15.1%，而加拿大的患病率为 8.8%。年龄调整后的成年患病率为 14.1%，是加拿大平均水平 7.1%的两倍。患有糖尿病的成年人的平均年龄为 52 岁（±14.9）；57%为女性。常见的合并症有高血压（58%）和血脂异常（73%）。最常用的药物是二甲双胍（58%），其次是胰岛素/类似物（23%）和磺脲类药物（13%）。
安大略省西北部第一民族人口的糖尿病患病率是加拿大平均水平的两倍。要解决这个问题，需要解决相关的健康决定因素，包括贫困和食品安全。
