Chapter 6: Diabetes in Aboriginal Communities

Prevalence

Many surveys have been conducted at the national level since the 1990's but only two of them give an estimation of the prevalence of diabetes (self-reported) in each of the Aboriginal sub-populations.

The Aboriginal Peoples Survey (APS 1991) is the most recent comprehensive survey across Canada. According to this survey (Figure 6-1), the prevalence of diabetes among native groups in Canada is as follows: 8.5 % of North American Indian peoples on Indian reserves and settlements; 5.3% of North American Indian peoples off reserves; 5.5% of Métis people and 1.9% of Inuit people. Of the Aboriginal population represented in this survey, approximately 783,980 identified as North American Indian, 212,650 as Métis and 49,255 as Inuit. Approximately two-thirds of the First Nations people with a diagnosis of diabetes are women, which is different from the overall trend of the general population².

The prevalence rate for all age groups from the First Nations and Inuit Regional Health Survey (FNIRHS 1997) are 20% greater than the Aboriginal Peoples Survey (APS). Among First Nations on reserve, the overall prevalence is 12% and one in four individuals who are over the age of 45 have diabetes. The age-standardized prevalence of diabetes for First Nations people is 3 to 5 times that of the general population⁵.

Various local studies on the prevalence of diabetes among Aboriginal people in Canada have also been conducted in the last two decades. They have shown extremely high rates of diabetes, especially among some specific First Nations communities. For instance, rates among women age 35+ were between 22% and 48% in two Algonquin communities in Quebec and in Haida Gwaii (B.C), 17% of adults over age 35 had type 2 diabetes^3,4. However, the methodologies used in these studies varied considerably and no single set of diagnostic criteria was identical.

Gestational diabetes is also an issue in the Aboriginal communities. According to the First Nations and Inuit Regional Health Survey, about 30% of women with diabetes reported that their diabetes was first diagnosed during pregnancy⁵.

Overall, diabetes among Aboriginal people at least three times that of the population. Prevalence is expected to increase over time as a function of incidence, survival of people with diabetes, and aging of the population⁵. Inuit people are the only exception and their prevalence rates are below the national average. However, the latest indications are showing an increase of diabetes rates among this group⁶.

Due to the self-reported nature of diabetes (respondents were asked if they have been diagnosed with diabetes by a health physician) and the non-inclusions of some reserves in the current surveys, the existing numbers probably understate the true prevalence of diabetes.

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