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Correspondence: Gina Agarwal, Department of Family Medicine, McMaster University, Hamilton, ON L7N 1A3; Tel: 905-525-9140, ext. 28520;


Introduction: First Nations/Métis populations develop diabetes earlier and at higher rates than other Canadians. The Canadian diabetes risk questionnaire (CANRISK) was developed as a diabetes screening tool for Canadians aged 40 years or over. The primary aim of this paper is to assess the effectiveness of the existing CANRISK tool and risk scores in detecting dysglycemia in First Nations/Métis participants, including among those under the age of 40. A secondary aim was to determine whether alternative waist circumference (WC) and body mass index (BMI) cut-off points improved the predictive ability of logistic regression models using CANRISK variables to predict dysglycemia.


Methods: Information from a self-administered CANRISK questionnaire, anthropometric measurements, and results of a standard oral glucose tolerance test (OGTT) were collected from First Nations and Métis participants (n = 1479). Sensitivity and specificity of CANRISK scores using published risk score cut-off points were calculated. Logistic regression was conducted with alternative ethnicity-specific BMI and WC cut-off points to predict dysglycemia using CANRISK variables.


Results: Compared with OGTT results, using a CANRISK score cut-off point of 33, the sensitivity and specificity of CANRISK was 68% and 63% among individuals aged 40 or over; it was 27% and 87%, respectively among those under 40. Using a lower cut-off point of 21, the sensitivity for individuals under 40 improved to 77% with a specificity of 44%. Though specificity at this threshold was low, the higher level of sensitivity reflects the importance of the identification of high risk individuals in this population. Despite altered cut-off points of BMI and WC, logistic regression models demonstrated similar predictive ability.


Conclusion: CANRISK functioned well as a preliminary step for diabetes screening in a broad age range of First Nations and Métis in Canada, with an adjusted CANRISK cut-off point for individuals under 40, and with no incremental improvement from using alternative BMI/WC cut-off points.


Keywords: CANRISK, Type 2 Diabetes, First Nations and Métis, screening, sensitivity, specificity



From the 2011 National Household Survey, 4.3% of the Canadian population identified themselves as Aboriginal (First Nations, Inuit, or Métis), with 28% aged 14 years or under and 18.2% aged 15 to 24 years CHIARINI BOLOGNA Flip flops sale browse ZE34mxG
. Studies have demonstrated that the Canadian Aboriginal population is at a higher risk for developing diabetes due to many factors including lifestyle, environmental and genetic. Footnote 2

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Britain's Kennel Club declared the corgi, that most English of dog breeds, might be at risk of disappearing in the U.K. The little herders are still going strong in the United States, but there are many canine types whose numbers have dwindled. Here's a list of current and recent "vulnerable breeds" provided by Britain's Kennel Club.

Credit: TIMOTHY A. CLARY/AFP/Getty Images

It's hard to imagine that this police favorite ever dwindled in popularity, but back in 2013, the Kennel Club registered only 51 bloodhounds. The breed is now thought to be doing fine.

This tiny body needs a lot of exercise and stimulation. Sadly, new registrations have fluctuated betweenonly56 to 108 in recent years.

This well-coifed breed is thought to be named after a character in a novel. Only 105 were registered in 2013.

Sure, it looks like a small horse, but this big breed is relatively tiny in number these days.

Credit: Spencer Platt/Getty Images

Many other terrier breeds owe their existence to this ancestor, though Britain's Kennel Club says yearly registrations for the smooth fox terrier only number around 120.

Credit: STAN HONDA/AFP/Getty Images

Considered vulnerable only a few years ago, this gorgeous dog was originally bred to hunt gamebirds.

Credit: Christopher Furlong/Getty Images

Only 82 of these pretty dogs were registered by the Kennel Club in 2013, but determined breeders have kept the setters from going extinct so far.

Credit: Scott Barbour/Getty Images

One of the oldest of the spaniels, it is said to have a clown-like nature. Current registrations are only around 100 yearly.

Credit: ADRIAN DENNIS/AFP/Getty Images

This very tall dog is said to be at risk because of a "bottleneck" in the gene pool.

Credit: WILLIAM WEST/AFP/Getty Images

It's been described as an "unfashionable" breed, but not so endangered as some others in the terrier family.

Credit: Mario Tama/Getty Images

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