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  • Pediatric Original Article
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Diabetes, pre-diabetes and insulin resistance screening in Native American children and youth

International Journal of Obesity volume 37, pages 540–545 (2013)Cite this article

Subjects

Abstract

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.

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Acknowledgements

This study was supported by the National Institutes of Health through a Native American Research Center for Health (NARCH IV) grant with funding from the National Institute of Diabetes, Digestive and Kidney Diseases (#U26IHS300002). Dr Nsiah-Kumi was supported by the National Institute of Minority Health and Health Disparities’ Loan Repayment Program.

Special thanks to the Rosebud Tribal Health Board, Aberdeen Area Tribal Chairman’s Health Board, Rosebud Diabetes Prevention Program (specifically Marlene Schafer, Tina Martinez, Duane Lamb), Rita Broken Leg and Claudia Borgeson for their invaluable assistance with this work. Thanks also to Pamela S Welch, Teishetta B Daniel, Kimberly Gazaryan and Jacqueline Barrera for their assistance with the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA

    P A Nsiah-Kumi, S Lasley, M Whiting, J M Erickson & J L Larsen

  2. Rosebud Sioux Tribe, Rosebud, SD, USA

    C Brushbreaker

  3. Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA

    F Qiu & F Yu

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  1. P A Nsiah-Kumi
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Correspondence to P A Nsiah-Kumi.

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Nsiah-Kumi, P., Lasley, S., Whiting, M. et al. Diabetes, pre-diabetes and insulin resistance screening in Native American children and youth. Int J Obes 37, 540–545 (2013). https://doi.org/10.1038/ijo.2012.199

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