Non-insulin-dependent diabetes mellitus among First Nations children - New entity among First Nations people of northwestern Ontario

OBJECTIVE To describe the emergence of a new clinical form of non-insulin-dependent diabetes mellitus (NIDDM) among First Nations children. DESIGN Case series developed through retrospective review of a computerized diabetes registry and of records from a hospital and clinic. SETTING Sioux Lookout Zone Hospital, a secondary care referral hospital for 28 remote First Nations communities in northwestern Ontario, affiliated with the University of Toronto's Sioux Lookout Program. PARTICIPANTS Eighteen First Nations youths younger than 16 years identified via the Sioux Lookout Diabetes Program registry and via hospital discharge records from 1978 to 1994. Three of the 18 subjects were excluded because data essential to the study were missing from their records. MAIN OUTCOME MEASURES Prevalence of NIDDM in this population, clinical presentation at diagnosis, and associated risk factors (including family history, obesity, and clinical management). RESULTS Age-adjusted prevalence was 2.5/1000 in this population, the highest yet reported for NIDDM in this age group. Ratio of female to male subjects was 6:1. Typical patients were asymptomatic, obese adolescents who were not prone to ketosis and whose families had a strong history of NIDDM. CONCLUSIONS Non-insulin-dependent diabetes mellitus can occur during childhood, particularly among First Nations people.