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Diabetes Res Clin Pract. 2015 Jun;108(3):423-31. doi: 10.1016/j.diabres.2015.03.001. Epub 2015 Mar 11.

Cardiometabolic correlates of low type 2 diabetes incidence in western Alaska Native people - The WATCH study.

Author information

1
Alaska Native Tribal Health Consortium, Division of Community Health Services, Anchorage, AK, United States. Electronic address: kkoller@anthc.org.
2
University of Alaska Anchorage, Anchorage, AK, United States.
3
Cleveland Clinic Medicine Institute, Cleveland, OH, United States.
4
MedStar Health Research Institute, Hyattsville, MD, United States; Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, United States.
5
University of Alaska Fairbanks, Center for Alaska Native Health Research, Fairbanks, AK, United States.
6
Alaska Native Tribal Health Consortium, Division of Community Health Services, Anchorage, AK, United States.
7
Norton Sound Health Corporation, Nome, AK, United States.
8
University of Washington, Seattle, WA, United States.

Abstract

AIMS:

Previously rare among Alaska Native (AN) people, type 2 diabetes (DM2) prevalence as indicated by registry data has increased by as much as 300% in some western Alaska regions. We sought to determine prevalence and incidence of DM2 and analyze associated cardiometabolic risk factors in western AN people.

METHODS:

DM2 and prediabetes prevalence and incidence were determined by the Western Alaska Tribal Collaborative for Health using consolidated data from cohort studies conducted during 2000-2010. Crude and age-adjusted incidence for DM2 and prediabetes were calculated using 2010 American Diabetes Association criteria. Effects of covariates on DM2 and prediabetes were determined using univariate and multivariate Cox proportional hazards analyses, adjusted for age and sex.

RESULTS:

Excluding baseline diabetes (n=124, 4.5%), 53 cases of new DM2 were identified among 2630 participants. Age- and sex-adjusted DM2 incidence was 4.3/1000 (95% CI 2.9, 5.0) person-years over an average 5.9-year follow up. After excluding baseline prediabetes, 387 new cases of prediabetes were identified among 1841 participants; adjusted prediabetes incidence was 44.5/1000 (95% CI 39.5, 49.5) person years. Independent predictors for DM2 included age, impaired fasting glucose, and metabolic syndrome; family history of diabetes and obesity were additional independent predictors for prediabetes.

CONCLUSIONS:

DM2 incidence in western AN people is substantially lower than that for U.S. whites; however, incidence of prediabetes is more than 10-fold higher than western AN DM2 incidence and more closely aligned with U.S. rates. Interventions aimed at achieving healthy lifestyles are needed to minimize risk factors and maximize protective factors for DM2 in this population.

KEYWORDS:

Alaska Native (AN); DM2; Metabolic syndrome; Prediabetes; Risk factors; Western Alaska Tribal Collaborative for Health

PMID:
25805711
PMCID:
PMC4442716
DOI:
10.1016/j.diabres.2015.03.001
[Indexed for MEDLINE]
Free PMC Article

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