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Background: Type 2 diabetes is an increasing global health concern, most notably for Aboriginal peoples living in Canada among whom prevalence rates are 3 to 5 times those of the general population. The objective of this study is to determine the incidence and prevalence of type 2 diabetes among adults living in a First Nation community from 1986 to 2003. Methods: Kahnawá:ke is a Kanien'kehá:ka (Mohawk) community in Quebec, Canada. Numerators for incident and prevalent cases were derived from the community hospital Diabetes Registry. Denominators were derived from population distributions provided to Kahnawá:ke by Indian and Northern Affairs Canada. Rates were standardized to 2000/01 Canadian population. Results: From 1986-88 to 2001-03, incidence rates per 1000 for those 18 years and over decreased from 8.8 to 7.0 in males, and 8.8 to 5.2 in females. Prevalence rates increased from 6.0% to 8.4% in males and 6.4% to 7.1% in females. The prevalence rate among Kahnawá:ke men aged 45-64 years was 14%, twice the corresponding rate among Canadian men. Male to female ratios for both incidence and prevalence rates were above 1.0. Discussion: Kahnawá:ke incidence rates are much lower than those of First Nation peoples of Manitoba. Kahnawá:ke prevalence rates are midway between national Aboriginal and general Canadian populations. Kahnawá:ke incidence rates and gender ratios are closer to those of the Canadian population. The results highlight the variations of type 2 diabetes between individual communities, and may reflect Kahnawá:ke's socioeconomic status, ongoing diabetes education, clinical care and diabetes primary prevention efforts.

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