Tracking ancient pathways to a modern epidemic: Diabetic end-stage renal disease in Saskatchewan aboriginal people

It is likely that diabetic pregnancies play a key role in the initiation, progression, and perpetuation of the T2DM epidemic among Canadian aboriginal peoples, and may additionally increase the risk for DESRD. We speculate that an ancient survival advantage that promoted caloric conservation in young women and their unborn children is now a risk factor for prepregnancy obesity, GDM, and excess fetal nutrition. Infants are often large and have an increased risk for T2DM and its complications (hefty fetal-type hypothesis).