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Determining Early Life Factors for Type 2 Diabetes in Childhood: The Next Generation Study
Abstracts / Can J Diabetes 38 (2014) S2eS24
categories at diagnosis appear to have the largest increases in BMIZ while those presenting as overweight or obese at diagnosis show little or no significant changes. Implications: If this study (as shown by initial results) finds a significant association between post-diagnosis weight gain and longer-term obesity, then clinical practice may need to be modified to monitor weight gain associated with initiation of insulin therapy.
54 Prevalence of Obesity in Linguistic and/or Visible Minority Mothers and Their School-Aged Children: Preliminary Results ROSANNE BLANCHETy*, DIA SANOUy, MALEK BATALy, ISABELLE GIROUXy* Ottawa, ON; Montréal, QC Background: Canadian adults living in a minority situation, such as francophones living outside Québec and immigrants, face higher rates of obesity, type 2 diabetes (T2DM) and cardiovascular disease. Obesity is a known risk factor for T2DM and has several life-long health impacts if developed during childhood. However, little is known about the prevalence of obesity amongst minority children, particularly those in double minority situations (linguistic and visible). Objective: To evaluate the weight status of minority mothers (black immigrant women either Francophone or Anglophone, and Canadian-born Francophone women), and that of their 6- to 12year old child. Methods: Ninety-six mother-child dyads living in minority situation were recruited in JanuaryeApril 2014. Weight and height were measured, and body mass index (BMI) calculated for each mother and child. BMI-for-age and sex percentiles based on World Health Organization (WHO) growth charts were assessed with AnthroPlus v.1.0.4 software. Overweight was defined as a BMI-for-age percentile >85th, obesity >97th and severe obesity as >99.9th. For adults, WHO BMI cutoffs were used. Results: Women and children were aged 40.34.8 (mean SD) and 9.30.6 years old respectively. About half of children were boys (48.9%). More than three-quarters of mothers were overweight (77.9%) and 45.3% were obese. In children, 39.6% were overweight, 25.3% obese and 5.5% severely obese. Conclusions: A high prevalence of overweight and obesity was observed in those minority women and school-aged children. These preliminary results may indicate a need to develop interventions targeting minorities to reduce health inequity affecting them.
55 Determining Early Life Factors for Type 2 Diabetes in Childhood: The Next Generation Study JENNIFER SCHNEIDER*y, HEATHER DEAN, ELIZABETH SELLERS, JON MCGAVOCK, CATHERINE MACDONALD, ERIKA BLOOMFIELD, BRANDY WICKLOW Winnipeg, MB Children born to parents with childhood-onset type 2 diabetes (T2D) are at increased risk of developing T2D. The goal of this longitudinal birth cohort study (2003e2014) is to determine risk factors for childhood-onset T2D and translate this knowledge into prevention and treatment strategies. Annual assessments, including anthropometric and biochemical phenotyping, were performed on offspring of mothers and/or fathers with indigenous heritage who were diagnosed with T2D before 18 years of age. In April 2014, there were 150 offspring (78 females, 72 males; age 0e24, mean 8.8 years) of 67 parents (58 females; 9 males). Twentyfour offspring (16 females; 8 males) born to mothers with childhoodonset T2D have been diagnosed with T2D at a mean age of 11.7 years, younger than the average age of diagnosis of the overall
S21
clinical population (13 years). The offspring with T2D had GS (n¼16, 67%), SS (n¼7, 29%) or GG (n¼1, 4%) genotype of the HNF1-a G319S polymorphism, compared to prevalent frequencies of the GS/SS/GG genotype of 39%/13%/48% in the T2D clinic population, respectively. The small number of fathers with T2D limit conclusions about exposure to maternal T2D in pregnancy. We observed a high rate of T2D in offspring born to mothers with childhood-onset T2D and a disproportionate frequency of the S allele of the HNF1-a G319S polymorphism. This suggests that intrauterine exposure to maternal T2D presents a unique environment-gene interaction manifesting in early expression of T2D. This longitudinal birth cohort provides a unique opportunity to explore new hypotheses in the fetal origins of T2D.
56 Cultural Continuity is Protective Against Diabetes in Alberta First Nations RICHARD T. OSTER*, ANGELA GRIER, RICK LIGHTNING, MARIA J. MAYAN, ELLEN L. TOTH Edmonton, AB; Brocket, AB; Maskwacis, AB Background: We sought to examine the association between cultural continuity, self-determination and diabetes prevalence in First Nations in Alberta. Methods: We used an exploratory sequential mixed-methods approach. First we conducted a qualitative descriptive study with 10 Cree and Blackfoot leaders (members of Chief and Council) from across the province to understand cultural continuity and selfdetermination in the Alberta First Nations context. Interviews were recorded, transcribed and subject to qualitative content analysis. We shared the findings with interested participants for feedback, interpretation, clarity, validity and other concerns. Participants also had the opportunity to be involved in data analysis and dissemination. We then conducted a cross-sectional quantitative study using provincial administrative data and publically available data for 31 First Nations to examine any relationship with diabetes prevalence. Results: Qualitative: Cultural continuity, or “being who we are”, is foundational to healthy and successful First Nations. Selfdetermination, or “being a self-sufficient Nation”, stems from cultural continuity and is seriously compromised in today’s Alberta Cree and Blackfoot Nations. Sadly, First Nations are in a continuous battle against government policy and the intergenerational effects of colonization to rehabilitate their culture and achieve selfdetermination. Quantitative: Crude diabetes prevalence varied dramatically among Nations with values as low as 1.2% and as high as 18.3%. Those Nations that appeared to have more cultural continuity (measured by traditional indigenous language knowledge) had significantly lower diabetes prevalence after adjustment for socioeconomic factors (p¼0.007). Conclusions: We conclude that cultural continuity is protective against diabetes in Alberta First Nations.
57 The Association of Income with Health Behaviour Change and Disease Monitoring Among Patients with Chronic Disease DAVID JT. CAMPBELL*, PAUL E. RONKSLEY, BRADEN J. MANNS, MARCELLO TONELLI, CLAUDIA SANMARTIN, ROBERT G. WEAVER, DEIRDRE HENNESSY, KATHRYN KING-SHIER, TAVIS CAMPBELL, BRENDA HEMMELGARN Calgary, AB; Ottawa, ON; Edmonton, AB Management of chronic disease requires adherence to recommended health behaviour change and completion of tests for disease monitoring. While studies have shown an association between low income and lack of adherence, the reasons why people with low income may be less likely to adhere are unclear. We sought to
categories at diagnosis appear to have the largest increases in BMIZ while those presenting as overweight or obese at diagnosis show little or no significant changes. Implications: If this study (as shown by initial results) finds a significant association between post-diagnosis weight gain and longer-term obesity, then clinical practice may need to be modified to monitor weight gain associated with initiation of insulin therapy.
54 Prevalence of Obesity in Linguistic and/or Visible Minority Mothers and Their School-Aged Children: Preliminary Results ROSANNE BLANCHETy*, DIA SANOUy, MALEK BATALy, ISABELLE GIROUXy* Ottawa, ON; Montréal, QC Background: Canadian adults living in a minority situation, such as francophones living outside Québec and immigrants, face higher rates of obesity, type 2 diabetes (T2DM) and cardiovascular disease. Obesity is a known risk factor for T2DM and has several life-long health impacts if developed during childhood. However, little is known about the prevalence of obesity amongst minority children, particularly those in double minority situations (linguistic and visible). Objective: To evaluate the weight status of minority mothers (black immigrant women either Francophone or Anglophone, and Canadian-born Francophone women), and that of their 6- to 12year old child. Methods: Ninety-six mother-child dyads living in minority situation were recruited in JanuaryeApril 2014. Weight and height were measured, and body mass index (BMI) calculated for each mother and child. BMI-for-age and sex percentiles based on World Health Organization (WHO) growth charts were assessed with AnthroPlus v.1.0.4 software. Overweight was defined as a BMI-for-age percentile >85th, obesity >97th and severe obesity as >99.9th. For adults, WHO BMI cutoffs were used. Results: Women and children were aged 40.34.8 (mean SD) and 9.30.6 years old respectively. About half of children were boys (48.9%). More than three-quarters of mothers were overweight (77.9%) and 45.3% were obese. In children, 39.6% were overweight, 25.3% obese and 5.5% severely obese. Conclusions: A high prevalence of overweight and obesity was observed in those minority women and school-aged children. These preliminary results may indicate a need to develop interventions targeting minorities to reduce health inequity affecting them.
55 Determining Early Life Factors for Type 2 Diabetes in Childhood: The Next Generation Study JENNIFER SCHNEIDER*y, HEATHER DEAN, ELIZABETH SELLERS, JON MCGAVOCK, CATHERINE MACDONALD, ERIKA BLOOMFIELD, BRANDY WICKLOW Winnipeg, MB Children born to parents with childhood-onset type 2 diabetes (T2D) are at increased risk of developing T2D. The goal of this longitudinal birth cohort study (2003e2014) is to determine risk factors for childhood-onset T2D and translate this knowledge into prevention and treatment strategies. Annual assessments, including anthropometric and biochemical phenotyping, were performed on offspring of mothers and/or fathers with indigenous heritage who were diagnosed with T2D before 18 years of age. In April 2014, there were 150 offspring (78 females, 72 males; age 0e24, mean 8.8 years) of 67 parents (58 females; 9 males). Twentyfour offspring (16 females; 8 males) born to mothers with childhoodonset T2D have been diagnosed with T2D at a mean age of 11.7 years, younger than the average age of diagnosis of the overall
S21
clinical population (13 years). The offspring with T2D had GS (n¼16, 67%), SS (n¼7, 29%) or GG (n¼1, 4%) genotype of the HNF1-a G319S polymorphism, compared to prevalent frequencies of the GS/SS/GG genotype of 39%/13%/48% in the T2D clinic population, respectively. The small number of fathers with T2D limit conclusions about exposure to maternal T2D in pregnancy. We observed a high rate of T2D in offspring born to mothers with childhood-onset T2D and a disproportionate frequency of the S allele of the HNF1-a G319S polymorphism. This suggests that intrauterine exposure to maternal T2D presents a unique environment-gene interaction manifesting in early expression of T2D. This longitudinal birth cohort provides a unique opportunity to explore new hypotheses in the fetal origins of T2D.
56 Cultural Continuity is Protective Against Diabetes in Alberta First Nations RICHARD T. OSTER*, ANGELA GRIER, RICK LIGHTNING, MARIA J. MAYAN, ELLEN L. TOTH Edmonton, AB; Brocket, AB; Maskwacis, AB Background: We sought to examine the association between cultural continuity, self-determination and diabetes prevalence in First Nations in Alberta. Methods: We used an exploratory sequential mixed-methods approach. First we conducted a qualitative descriptive study with 10 Cree and Blackfoot leaders (members of Chief and Council) from across the province to understand cultural continuity and selfdetermination in the Alberta First Nations context. Interviews were recorded, transcribed and subject to qualitative content analysis. We shared the findings with interested participants for feedback, interpretation, clarity, validity and other concerns. Participants also had the opportunity to be involved in data analysis and dissemination. We then conducted a cross-sectional quantitative study using provincial administrative data and publically available data for 31 First Nations to examine any relationship with diabetes prevalence. Results: Qualitative: Cultural continuity, or “being who we are”, is foundational to healthy and successful First Nations. Selfdetermination, or “being a self-sufficient Nation”, stems from cultural continuity and is seriously compromised in today’s Alberta Cree and Blackfoot Nations. Sadly, First Nations are in a continuous battle against government policy and the intergenerational effects of colonization to rehabilitate their culture and achieve selfdetermination. Quantitative: Crude diabetes prevalence varied dramatically among Nations with values as low as 1.2% and as high as 18.3%. Those Nations that appeared to have more cultural continuity (measured by traditional indigenous language knowledge) had significantly lower diabetes prevalence after adjustment for socioeconomic factors (p¼0.007). Conclusions: We conclude that cultural continuity is protective against diabetes in Alberta First Nations.
57 The Association of Income with Health Behaviour Change and Disease Monitoring Among Patients with Chronic Disease DAVID JT. CAMPBELL*, PAUL E. RONKSLEY, BRADEN J. MANNS, MARCELLO TONELLI, CLAUDIA SANMARTIN, ROBERT G. WEAVER, DEIRDRE HENNESSY, KATHRYN KING-SHIER, TAVIS CAMPBELL, BRENDA HEMMELGARN Calgary, AB; Ottawa, ON; Edmonton, AB Management of chronic disease requires adherence to recommended health behaviour change and completion of tests for disease monitoring. While studies have shown an association between low income and lack of adherence, the reasons why people with low income may be less likely to adhere are unclear. We sought to