Diabetes in the Northwest Territories

Abstract

An estimated 2.7 million (7.6%) Canadians were living with diabetes in 2012.1 Internationally, Canada has the fourth highest rate of diabetes, behind Mexico, the United States and Portugal.2 The prevalence of diabetes in Canada has doubled since 2000, and is expected to keep increasing.2 The Northwest Territories (NWT) is one of three territories located in the most Northern part of Canada. In the NWT, the prevalence of diabetes was estimated to be 5.5% in 2008/2009.3 Approximately 200 new cases of diabetes are diagnosed each year in the NWT, contributing to the increasing prevalence of diabetes across the territory.3 Aboriginal populations are at a disproportionately higher risk of developing diabetes, post adoption of a more Westernized culture.4 With 51% of NWT’s population of 43623 identifying as Aboriginal, coupled with an aging population, the burden of diabetes in the NWT is expected to increase in the coming years.5 To help combat the anticipated growth in the burden of disease in the NWT, specific screening and diagnosis clinical practice guidelines for type 2 diabetes were developed in 2014 in consultation with the Canadian Diabetes Association (CDA).6 According to the guidelines, a diagnosis of diabetes is made if any one of three tests for diabetes has a positive result: Fasting Plasma Glucose (FPG), two hour 75 g Oral Glucose Tolerance Test (OGTT) and Glycated hemoglobin (A1C) (Table 1). Screening for diabetes is implemented based on risk for developing diabetes, established from an NWT adapted Canadian Diabetes Risk Questionnaire (CANRISK) assessment.7 These adapted guidelines recommend annual screening starting at age 30 for those at high risk, every two years starting at age 30 for those at moderate risk, and every three years starting at age 40 for those at low risk.