Diabetes incidence in an Australian aboriginal population: An 8-year follow-up study

Mark Daniel, Kevin G. Rowley, Robyn Mcdermott, Arul Mylvaganam, Kerin O'Dea

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Abstract

OBJECTIVE - To examine prospectively the association between age, BMI, and subsequent incidence of type 2 diabetes in Australian aboriginal people. RESEARCH DESIGN AND METHODS - We performed a stratified analysis of incidence data from a community-based longitudinal study. Measures included fasting and 2-h postload glucose concentrations, and BMI, stratified into four categories. Subjects were 882 male and female participants in diabetes screening initiatives in two remote Australian aboriginal communities, free from diabetes at baseline, ages 15-77 years. RESULTS - There were 46 incident cases of diabetes over 2,808 person-years of follow-up. BMI modified strongly the sex- and community-adjusted association between age and diabetes incidence (P < 0.001). Adjusted for age, sex, and community, the population diabetes incidence rate was 20.3 cases/1,000 person-years, with BMI-specific rates of 10.7-47.2 cases/1,000 person-years, and relative risks (95% CI) for BMI strata beyond the reference category (<25 kg/m2) of 3.3 (1.5-7.0), 2.7 (1.1-6.8), and 4.4 (1.7-11.6), respectively. The population's attributable risk (95% CI) associated with BMI beyond the reference category was 70.1% (58.1-82.4). CONCLUSIONS - BMI-specific diabetes incidence rates in Australian aboriginal people are among the highest in the world. Diabetes incidence in the lowest BMI category (10.7 cases/1,000 person-years) is two to five times greater than corresponding rates for non-aboriginal populations. An urgent need exists to prevent weight gain associated with diabetes. Further study is required to determine for aboriginal people an optimal range of BMI, likely lower than that suggested for non-aboriginal populations.

Original languageEnglish
Pages (from-to)1993-1998
Number of pages6
JournalDiabetes Care
Volume22
Issue number12
DOIs
Publication statusPublished - 1999
Externally publishedYes

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Incidence
Population
Type 2 Diabetes Mellitus
Weight Gain
Longitudinal Studies
Fasting
Research Design
Glucose

Cite this

Daniel, Mark ; Rowley, Kevin G. ; Mcdermott, Robyn ; Mylvaganam, Arul ; O'Dea, Kerin. / Diabetes incidence in an Australian aboriginal population: An 8-year follow-up study. In: Diabetes Care. 1999 ; Vol. 22, No. 12. pp. 1993-1998.
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abstract = "OBJECTIVE - To examine prospectively the association between age, BMI, and subsequent incidence of type 2 diabetes in Australian aboriginal people. RESEARCH DESIGN AND METHODS - We performed a stratified analysis of incidence data from a community-based longitudinal study. Measures included fasting and 2-h postload glucose concentrations, and BMI, stratified into four categories. Subjects were 882 male and female participants in diabetes screening initiatives in two remote Australian aboriginal communities, free from diabetes at baseline, ages 15-77 years. RESULTS - There were 46 incident cases of diabetes over 2,808 person-years of follow-up. BMI modified strongly the sex- and community-adjusted association between age and diabetes incidence (P < 0.001). Adjusted for age, sex, and community, the population diabetes incidence rate was 20.3 cases/1,000 person-years, with BMI-specific rates of 10.7-47.2 cases/1,000 person-years, and relative risks (95{\%} CI) for BMI strata beyond the reference category (<25 kg/m2) of 3.3 (1.5-7.0), 2.7 (1.1-6.8), and 4.4 (1.7-11.6), respectively. The population's attributable risk (95{\%} CI) associated with BMI beyond the reference category was 70.1{\%} (58.1-82.4). CONCLUSIONS - BMI-specific diabetes incidence rates in Australian aboriginal people are among the highest in the world. Diabetes incidence in the lowest BMI category (10.7 cases/1,000 person-years) is two to five times greater than corresponding rates for non-aboriginal populations. An urgent need exists to prevent weight gain associated with diabetes. Further study is required to determine for aboriginal people an optimal range of BMI, likely lower than that suggested for non-aboriginal populations.",
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Diabetes incidence in an Australian aboriginal population: An 8-year follow-up study. / Daniel, Mark; Rowley, Kevin G.; Mcdermott, Robyn; Mylvaganam, Arul; O'Dea, Kerin.

In: Diabetes Care, Vol. 22, No. 12, 1999, p. 1993-1998.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Diabetes incidence in an Australian aboriginal population: An 8-year follow-up study

AU - Daniel, Mark

AU - Rowley, Kevin G.

AU - Mcdermott, Robyn

AU - Mylvaganam, Arul

AU - O'Dea, Kerin

PY - 1999

Y1 - 1999

N2 - OBJECTIVE - To examine prospectively the association between age, BMI, and subsequent incidence of type 2 diabetes in Australian aboriginal people. RESEARCH DESIGN AND METHODS - We performed a stratified analysis of incidence data from a community-based longitudinal study. Measures included fasting and 2-h postload glucose concentrations, and BMI, stratified into four categories. Subjects were 882 male and female participants in diabetes screening initiatives in two remote Australian aboriginal communities, free from diabetes at baseline, ages 15-77 years. RESULTS - There were 46 incident cases of diabetes over 2,808 person-years of follow-up. BMI modified strongly the sex- and community-adjusted association between age and diabetes incidence (P < 0.001). Adjusted for age, sex, and community, the population diabetes incidence rate was 20.3 cases/1,000 person-years, with BMI-specific rates of 10.7-47.2 cases/1,000 person-years, and relative risks (95% CI) for BMI strata beyond the reference category (<25 kg/m2) of 3.3 (1.5-7.0), 2.7 (1.1-6.8), and 4.4 (1.7-11.6), respectively. The population's attributable risk (95% CI) associated with BMI beyond the reference category was 70.1% (58.1-82.4). CONCLUSIONS - BMI-specific diabetes incidence rates in Australian aboriginal people are among the highest in the world. Diabetes incidence in the lowest BMI category (10.7 cases/1,000 person-years) is two to five times greater than corresponding rates for non-aboriginal populations. An urgent need exists to prevent weight gain associated with diabetes. Further study is required to determine for aboriginal people an optimal range of BMI, likely lower than that suggested for non-aboriginal populations.

AB - OBJECTIVE - To examine prospectively the association between age, BMI, and subsequent incidence of type 2 diabetes in Australian aboriginal people. RESEARCH DESIGN AND METHODS - We performed a stratified analysis of incidence data from a community-based longitudinal study. Measures included fasting and 2-h postload glucose concentrations, and BMI, stratified into four categories. Subjects were 882 male and female participants in diabetes screening initiatives in two remote Australian aboriginal communities, free from diabetes at baseline, ages 15-77 years. RESULTS - There were 46 incident cases of diabetes over 2,808 person-years of follow-up. BMI modified strongly the sex- and community-adjusted association between age and diabetes incidence (P < 0.001). Adjusted for age, sex, and community, the population diabetes incidence rate was 20.3 cases/1,000 person-years, with BMI-specific rates of 10.7-47.2 cases/1,000 person-years, and relative risks (95% CI) for BMI strata beyond the reference category (<25 kg/m2) of 3.3 (1.5-7.0), 2.7 (1.1-6.8), and 4.4 (1.7-11.6), respectively. The population's attributable risk (95% CI) associated with BMI beyond the reference category was 70.1% (58.1-82.4). CONCLUSIONS - BMI-specific diabetes incidence rates in Australian aboriginal people are among the highest in the world. Diabetes incidence in the lowest BMI category (10.7 cases/1,000 person-years) is two to five times greater than corresponding rates for non-aboriginal populations. An urgent need exists to prevent weight gain associated with diabetes. Further study is required to determine for aboriginal people an optimal range of BMI, likely lower than that suggested for non-aboriginal populations.

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KW - adolescent

KW - adult

KW - aged

KW - body mass

KW - non insulin dependent diabetes mellitus

KW - Statistical analysis

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DO - 10.2337/diacare.22.12.1993

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VL - 22

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EP - 1998

JO - Diabetes Reviews

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SN - 0149-5992

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