A Comparison of Rates, Risk Factors, and Outcomes of Gestational Diabetes Between Aboriginal and Non-Aboriginal Women in the Saskatoon Health District

Abstract

OBJECTIVE -To determine possible differences in gestational diabetes mellitus (GDM) between aboriginal and non-aboriginal people in the Saskatoon Health District.RESEARCH DESIGN AND METHODS -This was a prospective survey of all women admitted for childbirth to the Saskatoon Royal University Hospital between January and July 1998. We compared prevalence rates, risk factors, and outcomes of GDM between aboriginal and non-aboriginal women.RESULTS -Information was obtained from 2,006 women, of whom 252 aboriginal and 1,360 non-aboriginal subjects had been tested for GDM. The overall rates of GDM were 3.5% for women in the general population and 11.5% for aboriginal women. For those living within the Saskatoon Health District, GDM rates were 3.7 and 6.4%, respectively. Multivariate analysis demonstrated that aboriginal ethnicity, most notably when combined with obesity, was an independent predictor for GDM. Pregravid BMI Ն27 kg/m 2 and maternal age Ն33 years were the most important risk factors for GDM in aboriginal women, whereas previous GDM, family history of diabetes, and maternal age Ն38 years were the strongest predictors for GDM in non-aboriginal women.CONCLUSIONS -There may be fundamental differences in GDM between aboriginal and non-aboriginal people. Because GDM contributes to an increased risk for type 2 diabetes in aboriginal women and their offspring, the impact of prevention and optimal treatment of GDM on the type 2 diabetes epidemic in susceptible populations are important areas for further investigation. Diabetes Care 25:487-493, 2002

Lifetime risk of diabetes among First Nations and non–First Nations people

“…Also, there are high rates of gestational diabetes among pregnant Aboriginal women who develop type 2 diabetes later in life. 26 Irrespective of urban or rural location of residence, we observed a higher lifetime risk of diabetes among First Nations people than among non-First nations people. However, in the First Nations group, the lifetime risk was higher among those living in rural communities than among those in urban areas.…”

The Increasing Prevalence of Diabetes in Pregnancy

“…In a Canadian study at the Saskatoon Royal University Hospital, using the NDDG criteria, the prevalence was 11.5% in the Aboriginal population and 3.5% in the non-Aboriginal population (92). In a study conducted at the University Hospital in Monterrey, Mexico which compared a number of diagnostic criteria the prevalence was 3.2%, 4.1%, and 8.7% based on NDDG, C & C and 1999 WHO diagnostic criteria, respectively (86).…”

Perinatal exercise improves glucose homeostasis in adult offspring

“…In humans, 5-yr-old children born to mothers who exercised regularly during pregnancy had improved intelligence scores and reduced body mass (7). Physical activity is already used as a treatment for gestational diabetes in humans, but long-term outcomes in offspring have not been fully investigated (10,28,41,49).Using a mouse model, we set out to explore maternal voluntary exercise as an intervention to improve offspring metabolic health. We hypothesized that voluntary exercise prior to and during pregnancy and nursing would benefit offspring metabolic health throughout their adult life.…”

“…In humans, 5-yr-old children born to mothers who exercised regularly during pregnancy had improved intelligence scores and reduced body mass (7). Physical activity is already used as a treatment for gestational diabetes in humans, but long-term outcomes in offspring have not been fully investigated (10,28,41,49).…”