A Culturally-Relevant Perspective on This Issue
Diabetes is a chronic illness characterized by the body’s inability to produce insulin needed to break down sugar. Type 1 diabetes occurs when the body produces little or no insulin, and Type 2 diabetes occurs when the body cannot use insulin to break down sugar. The Public Health Agency of Canada has identified diabetes as a major health concern for the Aboriginal population. Aboriginal ancestry is a risk factor for the disease . As well, Aboriginal populations experience earlier onset, greater severity at diagnosis, lack of accessible services, and greater complications from diabetes . Aboriginal women are twice as likely than Aboriginal men to develop diabetes. Gestational diabetes can increase the risk for developing diabetes, birth complications, infant morbidity, and mortality [3,4]. Gestational diabetes can also increase the risk of obesity and diabetes in the offspring .
There is a lack of data about diabetes in First Nations, Métis, and Inuit populations and available survey data likely underestimates the true prevalence [6,7]. Further research using administrative and screening data is needed to better understand diabetes epidemiology among Aboriginal peoples, including Aboriginal women.
The prevalence of diabetes in First Nations people is 20% and it is most prevalent among middle-aged men and older women. First Nations women make up two-thirds of First Nations people with diabetes [3,8]. Among the First Nations population, women aged 65+ have the highest rate of 40%, followed by 37% for women aged 55-64, both of which are higher than men’s rates of 36% and 30%, respectively. The diabetes prevalence is higher among those living in isolated communities and those that speak or understand a First Nations language . Additionally, First Nations people are more likely to have Type 2 diabetes and are often develop it at a younger age than the general population .
According to the 2006 Aboriginal People’s survey, the rate of diabetes among Métis women and men in Canada is 7%. Similar to First Nation people, the Métis population are also more likely to have Type 2 diabetes, and experience the disease at a younger age than the general population. Diabetes data in the Métis population, particularly in women, is limited .
The prevalence of diabetes among Inuit people is 4%, which is comparatively lower than Métis and First Nations, however there is evidence that the rates are rising [11-14]. Currently, there is limited data on diabetes in the Inuit population, though research is ongoing. Due to recent changes in dietary, physical exercise and lifestyle practices, continual data collection about diabetes is needed to detect future increases in diabetes among the Inuit population .