April 24 2001
Dear Ms.Clark:
In the context of pregnancy there is some work in the area of your interest. Although the whole business of soi-disant gestational diabetes and screening for it is controversial (on that see A Guide to Effective Care in Pregnancy and Childbirth 3rd ed. OUP 2000, Enkin M et al eds) there is:
(a) correlation between perinatal mortality and body mass index (for example see Naeye RL Maternal body weight and pregnancy outcome Am J Clin Nutr 1990;52:273-9)
(b) correlation between diabetes in pregnancy and BMI (for example and subject to caution about what is and what is not pathology see Engelau MM et al The epidemiology of diabetes and pregnancy in the US, 1988 Diabetes Care;18:1029-33)
(c) excellent evidence for existence of genes in humans and other animals which affect both diabetes predisposition and tendency to become obese, at least four having been identified (proposed initially by genetecist James V.Neel as the possibility of a "thrifty gene" in the early 1960's, before the real ones had been discovered)
(d) considerable and growing evidence that the type 2 diabetes epidemic in aboriginal populations in Canada and elsewhere has its roots in genetic predisposition, dietary change, obesity and sedenterism (the references are extensive but see Kopelman PG and Hitman GA Exploding type II Lancet 1998;352: suppl IV/5 and if you want more on this <www.cma.ca/cmaj/vol-160/issue-9/1315.htm> for the references).
I realize that this information does not answer your question directly but the point of relevance from the aboriginal issues is that obesity was uncommon and diabetes unheard of in Canadian aboriginal populations half a century ago. The incidence of diabetes in Manitoba aboriginal citizens age 15 and up is now 20% in women and only slightly less than that in men, with direct correspondance to BMI in such groups.
I hope this is relevant and useful to your search.
Sincerely,
Philip F. Hall, MD BScMed FRCSC
Director, Fetal Assessment, Provincial Obstetric Outreach and Maternal-Fetal Medicine Programs
St.Boniface General Hospital, 409 Tache Avenue D2044
Winnipeg, Manitoba, Canada R2H 2A6
ph 204-237-2547 FAX 204-233-1751
(Chair, Obs & Gyn Specialty Committee,
Royal College of Physicians & Surgeons of Canada)
Professor, Faculty of Medicine, University of Manitoba
<www.umanitoba.ca/womens_health>
>>> Julie Clark <[log in to unmask]> 04/24/01 03:07am >>>
Dear Collegues,
Does anyone know of any research looking at what impact the rise in obesity will have on levels of diabetes type 2? I'm looking for something along the lines of a % rise in obesity correlates with a % rise in diabetes type 2, in order to adjust diabetes projections.
Many thanks,
Julie Clark
Senior Public Health Researcher
Lothian Health Board...Edinburgh
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