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Type 2 Diabetes Mellitus in Children
Prenatal and Early Infancy Risk Factors Among Native Canadians
T. Kue Young, MD, PhD;
Patricia J. Martens, MSc, PhD;
Shayne P. Taback, MD;
Elizabeth A. C. Sellers, MD;
Heather J. Dean, MD;
Mary Cheang, MMath;
Bertha Flett, RN
Arch Pediatr Adolesc Med. 2002;156:651-655.
Background Type 2 diabetes mellitus is increasingly being observed among children
and youth, including the Native population of Canada. Only one study has investigated
prenatal and early infancy risk factors for the disease.
Methods A case-control study was conducted; 46 patients younger than 18 years
were recruited from the only clinical center for the treatment of diabetes
serving the province of Manitoba, and 92 age- and sex-matched controls were
recruited from a pediatric ambulatory clinic serving a large Native population
in Winnipeg, Manitoba. Information on exposure to prenatal and early infancy
risk factors was obtained through questionnaires administered by a Native
nurse-interviewer.
Results Multiple logistic regression modeling identified preexisting diabetes
(odds ratio [OR], 14.4; 95% confidence interval [CI], 2.86-72.5), gestational
diabetes (OR, 4.40; 95% CI, 1.38-14.1), and breastfeeding longer than 12 months
(OR, 0.24; 95% CI, 0.13-0.99) as significant independent predictors of diabetic
status. Other factors, such as low (<2500 g) and high (>4000 g) birth weight
and maternal obesity, were also associated with diabetes in our population,
but the elevated risks were not statistically significant.
Conclusion Breastfeeding reduces the risk of type 2 diabetes among Native Canadian
children and should be promoted as a potential intervention to control the
disease.
From the Departments of Community Health Sciences (Drs Young, Martens,
and Taback and Mss Cheang and Flett) and Pediatrics and Child Health (Drs
Taback, Sellers, and Dean), Faculty of Medicine, University of Manitoba and
the Health Sciences Centre, Winnipeg; and the Department of Public Health
Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario (Dr
Young).
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