Open Access Highly Accessed Original investigation

Cardiovascular disease risk profile and microvascular complications of diabetes: comparison of Indigenous cohorts with diabetes in Australia and Canada

Louise J Maple-Brown123*, Joan Cunningham1, Bernard Zinman34, Mary Mamakeesick5, Stewart B Harris6, Philip W Connelly78, Jonathan Shaw9, Kerin O'Dea10 and Anthony J Hanley1134

Author Affiliations

1 Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia

2 Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia

3 Leadership Sinai Centre for Diabetes, Mt Sinai Hospital, Toronto, Canada

4 Division of Endocrinology, University of Toronto, Toronto, Canada

5 Sandy Lake Health and Diabetes Project, Sandy Lake First Nation, London, ON, Canada

6 Centre for Studies in Family Medicine at The Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada

7 Keenan Research Centre in the Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Canada

8 Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada

9 Baker IDI Heart and Diabetes Institute, Melbourne, Australia

10 Sansom Institute for Health Research, University of South Australia, Adelaide, South, Australia

11 Department of Nutritional Sciences and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

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Cardiovascular Diabetology 2012, 11:30  doi:10.1186/1475-2840-11-30

Published: 28 March 2012

Abstract

Background

Indigenous populations of Australia and Canada experience disproportionately high rates of chronic disease. Our goal was to compare cardiovascular (CVD) risk profile and diabetes complications from three recent comprehensive studies of diabetes complications in different Indigenous populations in Australia and Canada.

Methods

We compared participants from three recent studies: remote Indigenous Australians (2002-2003, n = 37 known diabetes), urban Indigenous Australians (2003-2005, n = 99 known diabetes), and remote Aboriginal Canadians (2001-2002, n = 188 known diabetes).

Results

The three groups were similar for HbA1c, systolic BP, diabetes duration. Although leaner by body-mass-index criteria, remote Indigenous Australians displayed a more adverse CVD risk profile with respect to: waist-hip-ratio (1.03, 0.99, 0.94, remote Indigenous Australians, urban Indigenous Australians, remote Canadians, p < 0.001); HDL-cholesterol (0.82, 0.96, 1.17 mmol/L, p < 0.001); urine albumin-creatinine-ratio (10.3, 2.4, 4.5 mg/mmol); and C-reactive protein. With respect to diabetes complications, microalbuminuria (50%, 25%, 41%, p = 0.001) was more common among both remote groups than urban Indigenous Australians, but there were no differences for peripheral neuropathy, retinopathy or peripheral vascular disease.

Conclusions

Although there are many similarities in diabetes phenotype in Indigenous populations, this comparison demonstrates that CVD risk profiles and diabetes complications may differ among groups. Irrespective, management and intervention strategies are required from a young age in Indigenous populations and need to be designed in consultation with communities and tailored to community and individual needs.

Keywords:
Aboriginal; Retinopathy; Albuminuria; Peripheral neuropathy; Perhipheral vascular disease