Prevalence of gestational diabetes mellitus among James Bay Cree women in northern Quebec

Background: The prevalence of gestational diabetes mellitus has been report ed to vary widely in aboriginal populations. Most of the data have come fro m the United States. To help determine the extent of gestational diabetes i n Canada's aboriginal population, the authors assessed the prevalence in a population of Cree women in northern Quebec. Methods: A cross-sectional study was conducted using the National Diabetes Data Group (NDDG) criteria. Information was obtained from patient charts on pregnancies between January 1995 and December 1996 among women residing in 9 Cree communities in the eastern lames Bay region of northern Quebec. Wom en who were not Cree, had pre-existing diabetes, had spontaneous abortion o r were receiving glucocorticoid treatment were excluded. Results: Data on 654 pregnancies that met the inclusion criteria were avail able. Results of the screening oral glucose challenge test were available f or 579 of the pregnancies; the remaining 75 were excluded. The mean gestati onal age at screening was 28.3 (standard deviation 2.6) weeks. The prevalen ce of gestational diabetes was 12.8% (74/579) (95% confidence interval [CI] 10.1%-15.5%). The prevalence in the inland communities was twice as high a s that in the coastal communities (18.0% v. 9.3%, p = 0.002). Women with ge stational diabetes or impaired glucose tolerance tended to be older, have h ad more pregnancies, weigh more before pregnancy and have heavier babies th an those with a normal glycemic status. Interpretation: The prevalence of gestational diabetes among lames Bay Cree women in northern Quebec is twice as high as that among women in the gener al North American population and the second highest reported in an aborigin al group worldwide.