Prevalence of type 2 diabetes, obesity and the metabolic syndrome among Canadian First Nations children in a remote Pacific coast community

BACKGROUND: Type 2 diabetes mellitus (T2D) in children and adolescents is a growing public health concern. Although the prevalence of T2D in First Nations children has been documented to be as high as 1% in central Canada, no paediatric data are available for any Aboriginal community in British Columbia (BC). OBJECTIVE: To determine the prevalence of obesity, glucose intolerance and the metabolic syndrome in children living in a remote BC First Nations community. METHODS: Children who were six to 18 years of age and living in the community of Hartley Bay, BC, participated in the study. A medical history, a physical examination and a 2 h oral glucose tolerance test were completed. Overweight was defined as a body mass index between the 85th and 95th percentiles, and obese was defined as a body mass index greater than or equal to the 95th percentile, which were standardized for age and sex. RESULTS: Thirty of 34 children (88%) participated (mean +/- SD age 11.8+/-3.4 years). Ten children (33%) were obese, and five (17%) were overweight. There were seven children (23%) with abnormal glucose tolerance as per the 2007 American Diabetes Association criteria: five with only impaired fasting glucose ([IFG] 5.6 mmol/L to 6.9 mmol/L), one with both IFG and impaired glucose tolerance and one with T2D. However, using the 2008 Canadian Diabetes Association criteria, two children (6.7%) had abnormal glucose tolerance (one with IFG plus impaired glucose tolerance and one with T2D) because no child met the definition for IFG alone (6.1 mmol/L to 6.9 mmol/L). Four children (13%) met the criteria for the metabolic syndrome. CONCLUSIONS: There is a high prevalence of the components of the metabolic syndrome, including overweight, obesity and abnormal glucose tolerance, in the children of this community.