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Journal of Nutrition and Metabolism
Volume 2012, Article ID 127452, 7 pages
Review Article

Developmental Origins of Type 2 Diabetes in Aboriginal Youth in Canada: It Is More Than Diet and Exercise

1Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada R3E 0Z2
2Section of Endocrinology and Metabolism, Department of Pediatrics, University of Manitoba, Winnipeg, MB, Canada R3E 0Z2

Received 4 July 2011; Accepted 15 November 2011

Academic Editor: Tommy Cederholm

Copyright © 2012 Kyle Millar and Heather J. Dean. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Type 2 diabetes mellitus (T2DM) is classically viewed as a disease of adults caused by poor nutrition, physical inactivity, and obesity. However, with increasing awareness of the heterogeneity of T2DM, new risk factors are being identified that add complexity. Some of these new risk factors have been identified in Canadian people with Aboriginal Oji-Cree heritage, a group that demonstrates one of the highest rates of T2DM in the world. This high prevalence may be due to the rapid change, over the past 50 years, away from their traditional way of life on the land. Another environmental change is the increased rate of pregnancies complicated by obesity, gestational diabetes, or T2DM, resulting in more children being exposed to an abnormal intrauterine environment. Furthermore, the Oji-Cree of central Canada possesses the unique HNF-1α G319S polymorphism associated with reduced insulin secretion. We propose that intrauterine exposure to maternal obesity and T2DM, associated with the HNF-1α G319S polymorphism, results in fetal programming that accelerates the progression of early-onset T2DM. This paper describes the evolution of T2DM in children with a focus on the Oji-Cree people over the past 25 years and the unique prenatal and postnatal gene-environment interaction causing early-onset T2DM.