Kahnawake is an Aboriginal Kanien'kehá:ka (Mohawk) community of 7200 people located 9 miles outside of Montreal, Quebec. Recent surveys in Canada have shown that the incidence and prevalence of type 2 diabetes is three to five times higher in Aboriginal peoples than compared to the general Canadian population. The purpose of this study was to investigate the incidence and prevalence of type 2 diabetes among the Kanien'kehá:ka living in Kahnawake, aged 18 and older, and compare rates to the trends in the general Canadian population. Increased community awareness of diabetes in Kahnawake resulted in the development of a Diabetes Education Program in 1984 at the community-owned Kateri Memorial Hospital Centre (KMHC), which offers individualized counseling and education to patients. Patients who accept referral to this program (diagnosed according to the Canadian Diabetes Association clinical guidelines) meet with the Diabetes Nurse Educator, and have been prospectively added to the KMHC Diabetes List. This list was used to create the coded database used in this study; a total of 630 (310 males and 320 females) individuals were included. Age-adjusted prevalence and incidence rates (adjusted to the 2001 Canadian population) were calculated for total population (18 years and older), males, and females for 3-year intervals beginning in 1986. These data show that the incidence and prevalence of type 2 diabetes among the Kanien'kehá:ka of Kahnawake is greater than that of the general Canadian population and parallels the overall increasing trends in Canada. The overall prevalence rate in 2001-2003 for Kahnawake was 15% compared to 4.5% in 2000/2001 for Canada. It also shows that type 2 diabetes is affecting younger age groups (ages 45-64) in Kahnawake compared to the general Canadian population (greater than 65 years). The prevalence of diabetes in Kahnawake females decreased after 1998, despite the more stringent change in guidelines in 1998. These results underestimate the true rates as diagnosis is made by case finding and not all patients accept referral to the Diabetes Education Program.
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