Lifetime risk of diabetes among First Nations and non-First Nations people

• Published in: Canadian Medical Association journal (CMAJ) Vol. 188; no. 16; pp. 1147 - 1153
• Main Authors: Turin, Tanvir Chowdhury, Saad, Nathalie, Jun, Min, Tonelli, Marcello, Ma, Zhihai, Barnabe, Cheryl Carmelle Marie, Manns, Braden, Hemmelgarn, Brenda
• Format: Journal Article
• Language: English
• Published: Canada CMA Joule Inc 01.11.2016; CMA Impact, Inc; Joule Inc
• Subjects: Adolescent; Adult; Age; Age Distribution; Aged; Aged, 80 and over; Aging; Alberta - epidemiology; Canadian native peoples; Censuses; Classification; Cohort Studies; Comorbidity; Diabetes; Diabetes Mellitus - ethnology; Disease; Estimates; Female; Health aspects; Health risk assessment; Hospitals; Humans; Indians, North American; Life expectancy; Male; Mammography; Mens health; Methods; Middle Aged; Mortality; Native North Americans; Population; Registries; Risk Factors; Sex Distribution; Studies; Survival analysis; Womens health; Young Adult; Canada
• ISSN: 0820-3946; 1488-2329
• DOI: 10.1503/cmaj.150787

Lifetime risk is a relatively straightforward measure used to communicate disease burden, representing the cumulative risk of an outcome during the remainder of an individual's life starting from a disease-free index age. We estimated the lifetime risk of diabetes among men and women in both First Nations and non-First Nations populations using a cohort of adults in a single Canadian province. We used a population-based cohort consisting of Alberta residents from 1997 to 2008 who were free of diabetes at cohort entry to estimate the lifetime risk of diabetes among First Nations and non-First Nations people. We calculated age-specific incidence rates with the person-year method in 5-year bands. We estimated the sex- and index-age-specific lifetime risk of incident diabetes, after adjusting for the competing risk of death. The cohort included 70 631 First Nations and 2 732 214 non-First Nations people aged 18 years or older. The lifetime risk of diabetes at 20 years of age was 75.6% among men and 87.3% among women in the First Nations group, as compared with 55.6% among men and 46.5% among women in the non-First Nations group. The risk was higher among First Nations people than among non-First Nations people for all index ages and for both sexes. Among non-First Nations people, men had a higher lifetime risk of diabetes than women across all index ages. In contrast, among First Nations people, women had a higher lifetime risk than men across all index ages. About 8 in 10 First Nations people and about 5 in 10 non-First Nations people of young age will develop diabetes in their remaining lifetime. These population-based estimates may help health care planners and decision-makers set priorities and increase public awareness and interest in the prevention of diabetes.