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

Dec 12, 2012International journal of obesity (2005)

Screening for Diabetes and Insulin Resistance in Native American Children and Teens

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Abstract

The prevalence rate for pre-diabetes among Native American youth is 6.5%.

58.6% of children aged 5-11 years and 51.1% of those aged 12-18 years had elevated body mass index (BMI) for age and sex.
Elevated BMI was positively correlated with insulin resistance, blood pressure, triglycerides, and inflammation markers.
Mean insulin resistance was higher in older children compared to younger ones, although pre-diabetes prevalence was similar across age groups.
Youth with pre-diabetes and diabetes exhibited higher insulin resistance, abdominal circumference, and BMI than those without these conditions.
The findings indicate early diabetes risk among Native American youth, particularly in those with BMI at or above the 95th percentile.

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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 (≥ 85 th 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 ≥ 95 th%. 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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Diabetes, pre-diabetes and insulin resistance screening in Native American children and youth

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