Type 2 Diabetes Mellitus (T2DM) prevalence is increasing globally with roughly 2.4 million people currently living with this condition in Canada. T2DM occurs more commonly in non-European ethnoracial groups, however the distribution of risk by age, sex, ethnicity and immigration status in Canada are not completely understood.
The purpose of this thesis is to investigate the epidemiology of diabetes in an immigrant, multi-ethnic population using linked immigration and health data for the province of Ontario. The ultimate goal of this work is to generate information that can be used to design appropriate and effective targeted programs for diabetes prevention, management and control in order to reduce inequities in health.
The principal findings of this work indicate that:
1) South Asians had a three-fold higher risk for developing diabetes as compared with people of European ethnicity and this disparity in risk was evident at a very young age;
2) The young age at diabetes onset experienced by many of our high-risk ethnic groups, including South Asians and people of African and Middle Eastern descent, suggest that in order to capture an equivalent risk of disease, screening may be recommended up to 15 years earlier in these groups – which is not reflected in current screening guidelines;
3) Contrary to patterns seen in Western European populations, women belonging to many high–risk ethnicities had equivalent or, in some cases, higher risk than men;
4) Risk varied substantially across country and region of birth making broad definitions of race or ethnicity (eg. ‘Asian’ or ‘Black’) inappropriate.
These findings emphasize the heterogeneity of risk experienced by different ethnoracial populations in Canada and suggest that targeted primary prevention programs aimed at young adults and adolescents belonging to high-risk ethnic groups may be warranted. In addition, screening guidelines may need to be updated to reflect the younger age at onset in these populations. Further research is necessary to identify culturally appropriate and effective programs to reduce diabetes risk and associated health problems in these populations.
| Identifer | oai:union.ndltd.org:TORONTO/oai:tspace.library.utoronto.ca:1807/35797 |
| Date | 02 August 2013 |
| Creators | Creatore, Maria Isabella |
| Contributors | Glazier, Richard H. |
| Source Sets | University of Toronto |
| Language | en_ca |
| Detected Language | English |
| Type | Thesis |
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