Obesity and type 2 diabetes mellitus in a birth cohort of First Nation children born to mothers with pediatric-onset type 2 diabetes

Abstract

The prevalence of type 2 diabetes in this cohort of offspring of First Nation women with pediatric-onset type 2 diabetes is the highest ever reported. Obesity is an important postnatal risk factor for type 2 diabetes in this population and may result from a unique gene-environment interaction.

Differential mortality and the excess burden of end-stage renal disease among First Nations people with diabetes mellitus: a competing-risks analysis

“…6 Among First Nations children, the prevalence of diabetes tripled between 1980 and 2005, 28 and the offspring of these individuals are in turn experiencing an even higher risk of childhood type 2 diabetes. 29 These demographic trends suggest that steadily increasing numbers of young First Nations individuals will face prolonged exposure to the metabolic consequences of type 2 diabetes. Without substantial improvements in the prevention and treatment of this disease, this pattern will likely translate into increasing numbers of First Nations people with diabetes-related end-stage renal disease and possibly other chronic diabetic complications.…”

Emerging diabetes and metabolic conditions among Aboriginal and Torres Strait Islander young people

“…This contributes to greater concern regarding the future health of young people, as youth onset diabetes (defined as that diagnosed before the age of 25 years) appears to progress more rapidly, be more difficult to treat, have more comorbidities, and have a higher risk of complications. There is also a greater risk of mental health concerns, and the diagnosis of diabetes appears to worsen any pre‐existing comorbidities, which is of great concern in an already very vulnerable population. Type 2 diabetes is known to carry a burden of stigma, potentially further isolating young people, and there has been a lack of research focusing on strengths or resilience factors that would enhance engagement and self‐management …”

Developmental Origins of Type 2 Diabetes in Aboriginal Youth in Canada: It Is More Than Diet and Exercise

“…In the First Nations people of Saskatchewan, a neighbouring province to Manitoba, 19% to 30% of cases of T2DM may be due to maternal GDM [44]. In the mothers with preexisting T2DM in the Manitoba Oji-Cree, 25% of their children eligible for blood glucose screening (>7 years old) had T2DM and 43% of those >10 years old had T2DM [3]. Every child with T2DM in this birth cohort had at least 1 copy of the HNF-1 α G319S polymorphism [3].…”

“…In the mothers with preexisting T2DM in the Manitoba Oji-Cree, 25% of their children eligible for blood glucose screening (>7 years old) had T2DM and 43% of those >10 years old had T2DM [3]. Every child with T2DM in this birth cohort had at least 1 copy of the HNF-1 α G319S polymorphism [3]. Interestingly, in individuals with monogenic diabetes due to known, severe mutations in the HNF-1 α gene, a significantly reduced age at diagnosis is also associated with exposure to diabetes in utero .…”

“…In a unique birth cohort started in 2003, roughly 50% of the children born to mothers who were diagnosed with T2DM in adolescence, and followed at the DER-CA, have developed T2DM before the age of 18 years old [3]. This unique observation and others related to the evolution of T2DM in youth in Manitoba over the past 25 years provide strong evidence to support the developmental origins of health and disease (DOHaD) theory [4].…”