Greg Hugel

Urban and Rural Differences in Prevalence and Incidence of Diabetes in Alberta, 1995–2006.

Increasing Incidence and Prevalence of Diabetes between 1995 and 2006 in Young Children and Adolescents in Alberta, Canada. JEFFREY A. JOHNSON, STEPHANIE U. VERMEULEN, ROBERT M. COUCH,SETH D. MARKS, DANIELE PACAUD, GREG HUGEL. School of Public Health, University of Alberta, Edmonton, AB. Institute of Health Economics, Edmonton, AB, Department of Pediatrics, University of Alberta, Edmonton, AB. Diabetes is largely a disease of older adults, but increasing incidence has been reported for children and adolescents in many countries. We analyzed epidemiologic trends of diabetes in children and adolescents over the past decade in the province of Alberta. Administrative databases from Alberta Health and Wellness were used to identify cases of diabetes among Albertans aged 1 to 19 years. The Canadian National Diabetes Surveillance System (NDSS) algorithm was used to identify cases. Annual incidence and prevalence rates were compared across time (1995-2006) using multivariable logistic regression, adjusting for age, sex and First Nations status. Among 2301 prevalent cases of diabetes in the Alberta population under 20 years of age in 2006, 49% were female and 5.5% were First Nations. Nearly one-half (45%) of prevalent cases were 15-19 years old; 33% were 10-14 years, 16% were 5-9 years and 6% were 1-4 years. Prevalence increased 47%, from 18.7 per 10,000 in 1995 to 27.5 per 10,000 in 2006. Prevalence increased 94% for 1-4 years, 51% for 5-9 years, 43% for 10-14 years and 29% for 15-19 years (p=0.005). The annual incidence rate increased from 2.2 per 10,000 in 1995 to 3.1 per 10,000 in 2006. Incidence rates increased 68% for 1-4 years, 68% for 5-9 years, 43% for 10-14 years, and 3.0% for 1519 years (p=0.034). Prevalence was 23% (95%CI: 15-31%; p<0.001) higher for First Nations, although incidence rates were not different (p=0.314), compared to non-First Nations. Over the last decade, diabetes rates have increased significantly in all pediatric age groups in Alberta. The largest increases occurred in the younger age groups, who are most likely to have type 1 diabetes. ABSTRACT #39

Increasing Incidence and Prevalence of Diabetes between 1995 and 2006 in Young Children and Adolescents in Alberta, Canada.

Increasing Incidence and Prevalence of Diabetes between 1995 and 2006 in Young Children and Adolescents in Alberta, Canada. JEFFREY A. JOHNSON, STEPHANIE U. VERMEULEN, ROBERT M. COUCH,SETH D. MARKS, DANIELE PACAUD, GREG HUGEL. School of Public Health, University of Alberta, Edmonton, AB. Institute of Health Economics, Edmonton, AB, Department of Pediatrics, University of Alberta, Edmonton, AB. Diabetes is largely a disease of older adults, but increasing incidence has been reported for children and adolescents in many countries. We analyzed epidemiologic trends of diabetes in children and adolescents over the past decade in the province of Alberta. Administrative databases from Alberta Health and Wellness were used to identify cases of diabetes among Albertans aged 1 to 19 years. The Canadian National Diabetes Surveillance System (NDSS) algorithm was used to identify cases. Annual incidence and prevalence rates were compared across time (1995-2006) using multivariable logistic regression, adjusting for age, sex and First Nations status. Among 2301 prevalent cases of diabetes in the Alberta population under 20 years of age in 2006, 49% were female and 5.5% were First Nations. Nearly one-half (45%) of prevalent cases were 15-19 years old; 33% were 10-14 years, 16% were 5-9 years and 6% were 1-4 years. Prevalence increased 47%, from 18.7 per 10,000 in 1995 to 27.5 per 10,000 in 2006. Prevalence increased 94% for 1-4 years, 51% for 5-9 years, 43% for 10-14 years and 29% for 15-19 years (p=0.005). The annual incidence rate increased from 2.2 per 10,000 in 1995 to 3.1 per 10,000 in 2006. Incidence rates increased 68% for 1-4 years, 68% for 5-9 years, 43% for 10-14 years, and 3.0% for 1519 years (p=0.034). Prevalence was 23% (95%CI: 15-31%; p<0.001) higher for First Nations, although incidence rates were not different (p=0.314), compared to non-First Nations. Over the last decade, diabetes rates have increased significantly in all pediatric age groups in Alberta. The largest increases occurred in the younger age groups, who are most likely to have type 1 diabetes. ABSTRACT #39

Active Dissemination of the Alberta Diabetes Surveillance System: Local Information for Local Planning.

Increasing Incidence and Prevalence of Diabetes Among Status Aboriginal Men in Rural and Urban Alberta, 1995 to 2006. JEFFREY A. JOHNSON, STEPHANIE U. VERMEULEN, GREG HUGEL, ELLEN TOTH, BRENDA R. HEMMELGARN, KELLI RALPH-CAMPBELL, MALCOLM KING. School of Public Health, University of Alberta, Edmonton, AB. Institute of Health Economics, Edmonton, AB, Department of Medicine, University of Alberta, Edmonton, AB, Department of Medicine, University of Calgary, Calgary, AB. The increase in diabetes rates among Status Aboriginal (SA) Canadians is well documented. Less is known about the epidemiology of diabetes for this population by location of residence. Trends of diabetes incidence and prevalence between SA men and women living in urban and rural areas of Alberta were compared. The Alberta Diabetes Surveillance System (ADSS) tracks diabetes population trends using diagnostic codes from administrative records from Alberta Health and Wellness (AHW) (1995 to 2006 in adults aged >20 years). Aboriginal Status was identified as registered Indians in the AHW Stakeholder Registry. Location of residence was defined by postal code. Multivariable logistic regression was used to compare prevalence and incidence rates over time, by sex and location of residence. Age-sex adjusted diabetes prevalence increased 35%, from 10.9% (10.4-11.5) in 1995 to 14.7% (14.2-15.2) in 2006 in rural SA and 22%, from 9.4% (8.5-10.3) in 1995 to 11.5% (10.9-12.1) in 2006 among urban SA. The greatest increases were for men, at 40% and 43% compared to 12% and 30% for women (p<0.0001), in urban and rural settings, respectively. SA men with urban residences had the greatest increase in diabetes incidence at 45%, from 7.4 (4.9-10.6) per 1000 in 1995 to 10.7 (8.3-13.5) per 1000 in 2006. Incidence increased 25% for SA women in urban locations, but did not significantly change for women in rural locations (p=0.109). Significant increases in incidence and prevalence of diabetes over the past decade were observed amongst the SA population in Alberta. Prevalence and incidence were highest in SA women, but these rates have increased faster in men over the past decade, regardless of where they lived. ABSTRACT #29

Increasing Incidence and Prevalence of Diabetes Among Status Aboriginal Men in Rural and Urban Alberta 1995 to 2006

Increasing Incidence and Prevalence of Diabetes Among Status Aboriginal Men in Rural and Urban Alberta, 1995 to 2006. JEFFREY A. JOHNSON, STEPHANIE U. VERMEULEN, GREG HUGEL, ELLEN TOTH, BRENDA R. HEMMELGARN, KELLI RALPH-CAMPBELL, MALCOLM KING. School of Public Health, University of Alberta, Edmonton, AB. Institute of Health Economics, Edmonton, AB, Department of Medicine, University of Alberta, Edmonton, AB, Department of Medicine, University of Calgary, Calgary, AB. The increase in diabetes rates among Status Aboriginal (SA) Canadians is well documented. Less is known about the epidemiology of diabetes for this population by location of residence. Trends of diabetes incidence and prevalence between SA men and women living in urban and rural areas of Alberta were compared. The Alberta Diabetes Surveillance System (ADSS) tracks diabetes population trends using diagnostic codes from administrative records from Alberta Health and Wellness (AHW) (1995 to 2006 in adults aged >20 years). Aboriginal Status was identified as registered Indians in the AHW Stakeholder Registry. Location of residence was defined by postal code. Multivariable logistic regression was used to compare prevalence and incidence rates over time, by sex and location of residence. Age-sex adjusted diabetes prevalence increased 35%, from 10.9% (10.4-11.5) in 1995 to 14.7% (14.2-15.2) in 2006 in rural SA and 22%, from 9.4% (8.5-10.3) in 1995 to 11.5% (10.9-12.1) in 2006 among urban SA. The greatest increases were for men, at 40% and 43% compared to 12% and 30% for women (p<0.0001), in urban and rural settings, respectively. SA men with urban residences had the greatest increase in diabetes incidence at 45%, from 7.4 (4.9-10.6) per 1000 in 1995 to 10.7 (8.3-13.5) per 1000 in 2006. Incidence increased 25% for SA women in urban locations, but did not significantly change for women in rural locations (p=0.109). Significant increases in incidence and prevalence of diabetes over the past decade were observed amongst the SA population in Alberta. Prevalence and incidence were highest in SA women, but these rates have increased faster in men over the past decade, regardless of where they lived. ABSTRACT #29