Diabetes and other glucose metabolism abnormalities in Mexican Zapotec and Mixe Indians

Abstract

Aboriginal populations are experiencing an explosive rise in the prevalence of Type 2 diabetes. The purpose of this study was to estimate the prevalence of diabetes and other glucose metabolism abnormalities in Mexican Zapotec and Mixe Indians and to determine their association with known risk factors. A cross-sectional study was conducted in the southern Mexican state of Oaxaca. Two communities of Zapotec population and three of Mixe population were randomly chosen. Mexican Indians>or=35 years old were invited to participate; 394 Zapotec and 730 Mixe Indians participated. Diabetes and other glucose metabolism abnormalities were diagnosed using standard World Health Organization criteria after an oral glucose tolerance test. Prevalence and odds ratio (OR) were estimated with 95% confidence intervals (95% CI). The crude prevalence of diabetes was 8.19% (95% CI 6.7-9.9%) and the age- and sex-adjusted prevalence was 8.27%, significantly higher among Zapotec (8.71%) than among Mixe Indians (6.90%). The prevalence of impaired glucose tolerance was 9.9% and 4.7% of the studied subjects had impaired fasting glucose. The main risk factors related to the occurrence of diabetes were a family history of diabetes (OR 4.1; 95% CI 1.9-8.8), obesity (OR 3.0; 95% CI 1.6-5.6), hypertension (OR 2.6; 95% CI 1.5-4.7) and a high-risk waist-hip ratio (4.6; 95% CI 1.2-17.7). The prevalence of diabetes is high in this population, the highest so far reported in Mexican Indians. Mexico's health system faces a huge challenge to avert the advanced spread of diabetes in this susceptible population.