The epidemiology of diabetes in pregnant native Canadians - A risk profile

OBJECTIVE - The purpose of this study was to determine the prevalence of diabetes in pregnancy (gestational diabetes mellitus [GDM] and NIDDM) and to identify risk factors in the development of GDM in a native population in northwestern Ontario, Canada. RESEARCH DESIGN AND METHODS - A retrospective analysis of 1,305 singleton deliveries among Ojibwa-Cree women from northwestern Ontario, Canada, was conducted from 1990 to 1993 inclusive. GDM was diagnosed using a 3-h oral glucose tolerance test (OGTT) and defined according to standard guidelines. RESULTS - The overall prevalence of diabetes in pregnancy (NIDDM and GDM) was 11.6% (152 of 1,305) with a GDM prevalence of 8.4% (110 of 1,305). Among 741 women with complete data, prevalence rates increased with age, peaking at 46.9% in the age-group greater than or equal to 35 years. Significant risk factors for GDM included older maternal age, multiparity, prepregnancy obesity, a family history of diabetes, and a history of GDM in previous pregnancies. CONCLUSIONS - Diabetes in pregnancy among Ojibwa-Cree reported here represent the highest rates reported to date in a Canadian population. The high rates of maternal obesity and relative young age of this population further highlight the urgent need for diabetes screening and prevention in this population.