Diabetes, pre-diabetes and insulin resistance screening in Native American children and youth

P. A. Nsiah-Kumi, S. Lasley, M. Whiting, C. Brushbreaker, J. M. Erickson, F. Qiu, F. Yu, J. L. Larsen

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Objectives:Early identification of pre-diabetes and insulin resistance (IR) provides an important window of opportunity for diabetes prevention. Little is known about the prevalence of pre-diabetes and IR in Native American (NA) youth. We designed a cross-sectional, community-based study of NA children to estimate the prevalence of diabetes, pre-diabetes and IR and their association with other diabetes risk factors.Study Design:NA children (5-18 years) were screened with body mass index (BMI), blood pressure, oral glucose tolerance test (OGTT), lipids, insulin and highly sensitive C-reactive protein (hsCRP), and calculated homeostatic model assessment of IR (HOMA-IR).Results:Mean age of the cohort (n=201) was 10.8±3.8 years (±s.d.; 94/107 M/F). BMI percentile for age and sex (BMI%) was elevated (≥85th percentile) in 58.6% of 5-11 years and 51.1% of 12-18 years, and positively correlated with HOMA-IR, blood pressure, triglycerides and hsCRP (P<0.05). The prevalence rate for pre-diabetes and diabetes were 6.5% (3.5-10.8%) and 1.0% (0.1-3.6%), respectively. Mean HOMA-IR was greater in the older than younger age group while prevalence of pre-diabetes was the same. Those with pre-diabetes and diabetes had a greater HOMA-IR, abdominal circumference and BMI% than normal youth.Conclusion:In the first prospective, community-based screening for pre-diabetes, IR and diabetes in United States NA youth using OGTT, while the number of diabetes cases was low, pre-diabetes was found in a significant number of youth, particularly in those with BMI ≥95th%. As proportions of pre-diabetes were similar in 5-11 and 12-18 year olds, diabetes risk begins early in NA youth.

Original languageEnglish (US)
Pages (from-to)540-545
Number of pages6
JournalInternational Journal of Obesity
Issue number4
StatePublished - Apr 2013


  • community-based participatory research
  • diabetes in childhood
  • epidemiology
  • insulin sensitivity and resistance
  • prevention of type 2 diabetes
  • weight regulation and obesity

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics


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