First Nations kids with diabetes have high rates of mood and anxiety disorders, new study shows

First Nations children are experiencing a double burden of physical and mental illnesses, according to new research from the Manitoba Centre for Health Policy.

The study shows that the rate of Type 2 diabetes among young people rising dramatically in Manitoba and the majority of children with the disease are of First Nations heritage.

First Nations children were 25 per cent more likely to be diagnosed with Type 2 diabetes compared to all other children, said Dr. Liz Sellers, one of the authors of the study. 

Sellers, a pediatric diabetes specialist, treats children from Manitoba and from First Nations in the Sioux Lookout zone in northwestern Ontario, where she said many of the health concerns are the same, as families are connected across the provincial boundary.

In both areas, Sellers said Type 2 diabetes is an "intergenerational family disease."

Research in Ontario, published in February in the Canadian Medical Association Journal, showed that between 1995 and 2014, both the prevalence and incidence of all types of diabetes were "substantially higher" among First Nations people than among other people in Ontario.

In particular, First Nations women had higher prevalence of diabetes than other women, and First Nations people were more likely to die from diabetes complications than other people in Ontario.

"The kids we see with diabetes have high rates of other co-morbidities — liver disease, kidney disease, they have high rates of obesity," Sellers said. "They don't just have Type 2 diabetes."

Beyond the physical ailments, the Manitoba research also discovered that young First Nations people with Type 2 diabetes have high rates of mental health disorders, "and in particular high rates of mood and anxiety disorders and high rates of suicide and suicide attempts," she said.

'Chicken and egg'

It's an association that has been made in adults, but it's not known if there is a causal link.

Further research will be required to determine "the chicken and the egg" of the diagnosis, Seller said.

Right now it's not known if having a mood or anxiety disorder makes you more likely to develop Type 2 diabetes or if living with Type 2 diabetes makes you more likely to struggle with a mood and anxiety disorder.

But Sellers said enough is known now for governments and policy makers to take into account the physical and mental health needs of children and families with Type 2 diabetes.

"We can't deal with them separately," she said.

First Nations children living in remote communities also have trouble accessing the Canadian standard of care for Type 2 diabetes, Sellers said, because there are few health care resources close to their homes.

'Colonization and systemic impact of racism'

"I think that there are many historical issues that have also increased the risk [of Type 2 diabetes] for First Nations population including colonization and the systemic impact of racism in terms of access to healthy foods, access to adequate housing, access to safe drinking water," Sellers said. "We know all of those things affect health."

Meanwhile, the earlier onset of Type 2 diabetes could produce a "snowball effect with more and more people at younger and younger ages and suffering the complications," she said.

That's because women under 30, (i.e. in their child-bearing years), are developing the disease at the highest rate and the highest-risk factor of developing Type 2 diabetes is exposure to diabetes in utero, according to the research.

Sellers urges governments, health care providers, First Nations and families affected by Type 2 diabetes to work together to design programs to treat all aspects of the disease.

"It's not simply an issue of genetic risk or being more active and eating more healthy, there are some systemic issues that need to change if we're going to make a difference in Type 2 diabetes," she said.