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Review

Type 2 diabetes mellitus in Canada‚s First Nations: status of an epidemic in progress

T. Kue Young, Jeff Reading, Brenda Elias and John D. O‚Neil
CMAJ September 05, 2000 163 (5) 561-566;
T. Kue Young
Dr. Young is Professor and Head, Dr. Reading is Assistant Professor, Ms. Elias is Research Associate and Dr. O‚Neil is Professor and Director, Northern Health Research Unit, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Man.
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Jeff Reading
Dr. Young is Professor and Head, Dr. Reading is Assistant Professor, Ms. Elias is Research Associate and Dr. O‚Neil is Professor and Director, Northern Health Research Unit, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Man.
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Brenda Elias
Dr. Young is Professor and Head, Dr. Reading is Assistant Professor, Ms. Elias is Research Associate and Dr. O‚Neil is Professor and Director, Northern Health Research Unit, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Man.
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John D. O‚Neil
Dr. Young is Professor and Head, Dr. Reading is Assistant Professor, Ms. Elias is Research Associate and Dr. O‚Neil is Professor and Director, Northern Health Research Unit, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Man.
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  • Microalbuminuria and Diabetes Mellitus: a primary predictor.
    Sergio Stagnaro
    Posted on: 22 August 2002
  • Posted on: (22 August 2002)
    Microalbuminuria and Diabetes Mellitus: a primary predictor.
    • Sergio Stagnaro, Specialist in Blood, Gastroenterology, and Metabolic Diseases. Researcher in Biophysical Semeiotics

    Sir, excretion of urinary albumin above 20 mg/min (microalbuminuria1) is strongly prognostic of disease and death in diabetes mellitus.2, 3 The association between albumin excretion and the risk of death is also present when other risk factors such as male sex, age, obesity, ischaemic heart disease, hypertension, smoking and raised blood lipid concentrations are taken into account1. Although the association between microalbum...

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    Sir, excretion of urinary albumin above 20 mg/min (microalbuminuria1) is strongly prognostic of disease and death in diabetes mellitus.2, 3 The association between albumin excretion and the risk of death is also present when other risk factors such as male sex, age, obesity, ischaemic heart disease, hypertension, smoking and raised blood lipid concentrations are taken into account1. Although the association between microalbuminuria and cardiovascular disease was initially described in individuals with diabetes, it is now well established that microalbuminuria is associated with a 1,5- to 4- fold increased risk of cardiovascular disease among individuals with and without diabetes. In fact, microalbuminuria is also associated with hypertension4 and increased cardiovascular morbidity in people who are not diabetic5.

    However, the pathophysiological mechanism linking microalbuminuria to cardiovascular disease is unknown. It is important to stress that the association between microalbuminuria and cardiovascular disease is unlikely to reflect a direct, causal pathway, because there is no plausible mechanism that can directly link the quantitatively trivial urinary loss of albumin (15-300 mg per 24 hours) to atherothrombosis, as states Coen D.A. Stehouwer, MD PhD, (Why is (micro)albuminuria associated with risk of cardiovascular disease?.In: ATHERO ORG. 3 July 2002), who concludes his paper: For the present, microalbuminuria is a clinically useful marker of increased cardiovascular disease risk, even though the pathophysiological explanation of the association remains enigmatic. To recognize in a quantitative way the real arteriosclerotic risk of an individual, it is interesting to highlight the nature of link between microalbuminuria and cardiovascular diseases, but of primary importance, as regards arteriosclerosis prevention, is to go beyond microalbuminuria, in my opinion (See www.katamed.it, the Page Semeiotica Biofisica, in press). As a matter of fact, microalbuminuria takes part in most, but not all, cases of arteriosclerotic constitution. It, therefore, when present, indicates the microcirculatory abnormalities, different in location and seriousness, at the base of arteriosclerotic constitution (See my site HONCode N0 23736, http://digilander.libero.it/semeioticabiofisica: Biophysical Semeiotic Constitutions)

    References

    1) Mogensen CE, Chacati A Christensen CK, et al. Microalbuminuria: an early marker of renal involvement in diabetes. Uremia Investigation. 9, 85-95, 1985-6. 2) Mogensen CE. Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes. N.Engl.J.Med. 310, 356-60, 1984. 3) Mogensen CE, Scmitz A, Christensen CK. Comparative renal pathophysiology relevant to IDDM and NIDDM patients. Diabetes/Metabolism Reviews. 4, 453-83, 1988. 4) Damsgaard EM, Mogensen CE. Microalbuminuria in elderly hyperglicaemic patients and controls.Diabetic Med. 3, 430-5, 1986. 5)Yudkin JS, Forrest RD, Jakson CA. Microalbuminuria as predictor of vascular disease in non diabetic subjects. Lancet.ii, 530-33, 1988.

    Show Less
    Competing Interests: None declared.
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Vol. 163, Issue 5
5 Sep 2000
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Type 2 diabetes mellitus in Canada‚s First Nations: status of an epidemic in progress
T. Kue Young, Jeff Reading, Brenda Elias, John D. O‚Neil
CMAJ Sep 2000, 163 (5) 561-566;

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Type 2 diabetes mellitus in Canada‚s First Nations: status of an epidemic in progress
T. Kue Young, Jeff Reading, Brenda Elias, John D. O‚Neil
CMAJ Sep 2000, 163 (5) 561-566;
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  • Global Burden of Disease Study trends for Canada from 1990 to 2016
  • Elder women's perceptions around optimal perinatal health: a constructivist grounded-theory study with an Indigenous community in southern Ontario
  • Lifetime risk of diabetes among First Nations and non-First Nations people
  • Differential mortality and the excess burden of end-stage renal disease among First Nations people with diabetes mellitus: a competing-risks analysis
  • Association between First Nations ethnicity and progression to kidney failure by presence and severity of albuminuria
  • Metabolic Consequences of Hepatic Steatosis in Overweight and Obese Adolescents
  • Recent epidemiologic trends of diabetes mellitus among status Aboriginal adults
  • AN INTERNATIONAL PERSPECTIVE ON PERITONEAL DIALYSIS AMONG INDIGENOUS PATIENTS
  • Hypertriglyceridemic-waist phenotype and glucose intolerance among Canadian Inuit: the International Polar Year Inuit Health Survey for Adults 2007-2008
  • Age- and sex-related prevalence of diabetes mellitus among immigrants to Ontario, Canada
  • Epidemiology of diabetes mellitus among First Nations and non-First Nations adults
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  • La recherche d'une amelioration de la sante des Autochtones.
  • The quest to improve Aboriginal health.
  • Cigarette smoking and cardiovascular risk factors among Aboriginal Canadian youths
  • Complications of Type 2 Diabetes Among Aboriginal Canadians: Prevalence and associated risk factors
  • Canadian guidelines for body weight classification in adults: application in clinical practice to screen for overweight and obesity and to assess disease risk
  • Arctic Indigenous Peoples Experience the Nutrition Transition with Changing Dietary Patterns and Obesity
  • Adiponectin in a Native Canadian Population Experiencing Rapid Epidemiological Transition
  • Review of research on aboriginal populations in Canada: relevance to their health needs
  • The Epidemiology of Diabetes in the Manitoba-Registered First Nation Population: Current patterns and comparative trends
  • High birth weight does not guarantee protection from type 2 diabetes
  • Microalbuminuria in diabetes mellitus
  • A Comparison of Rates, Risk Factors, and Outcomes of Gestational Diabetes Between Aboriginal and Non-Aboriginal Women in the Saskatoon Health District
  • Diabetes in Ontario: Determination of prevalence and incidence using a validated administrative data algorithm
  • Racial stereotyping and medicine: the need for cultural competence
  • Diabetes in Canada's First Nations
  • Diabetes in Canada's First Nations
  • Diabetes in Canada's First Nations
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