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April 22, 2026PEDIATRICS1 citations

Prevalence of Obesity and Diabetes for American Indian Children on the Northern Great Plains

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VKValborg L. KvigneCBChad BirgerJEJared Eagle

Key Points

  • This research aims to assess the prevalence of obesity, prediabetes, and diabetes in American Indian children living on a reservation.
  • Screened American Indian students in grades K-11 for BMI percentiles and HbA1c levels from 2019-2023.
  • Utilized χ2 tests to analyze differences in obesity levels and HbA1c across sexes and time.
  • Overweight or obesity prevalence from 60.9% to 68.6% among students.
  • HbA1c levels showed a significant increase from 4.7% to 9.9% over the study period.
  • 70% of students with elevated HbA1c levels were male, with 81.2% diagnosed with type 2 diabetes.

Abstract

INTRODUCTION In 2015, the Indian Health Service reported an obesity prevalence rate of 29.7% for American Indian/Alaska Native children aged 2 to 19 years. The purpose of these annual evaluations is to describe the prevalence of obesity, prediabetes, and diabetes for American Indian children living on one reservation in the Northern Great Plains. METHODS From 2019–2020 through 2022–2023, American Indian students in grades kindergarten through 11, with parental consent, were screened for height, weight, body mass index (BMI) percentiles, and hemoglobin A1c (HbA1c) levels. χ2 tests were used to determine differences in BMI percentiles, HbA1c levels, sexes, and changes over time. RESULTS In school years 2019–2020 through 2022–2023, students with overweight or class I, II or III obesity ranged from 60.9% to 68.6%. The percentage of students with any class of obesity ranged from 41.8% to 50.3%. Students in every grade (kindergarten-11) and every age (6–17 years) had overweight and classes I, II, and III obesity; every age from 5 to 17 years had prediabetes. The percentage of students with a hemoglobin A1c level from 5.7% to 6.4% significantly increased from 4.7% to 9.9% (P = .001) in 2019–2020 through 2022–2023. Of students with a hemoglobin A1c level of at least 6.5%, 70% were male, 18.8% were diagnosed type 1 diabetes, and 81.2% were diagnosed with type 2 diabetes. CONCLUSIONS Prevalence of obesity among these American Indian students is higher than 2015 rates. Prediabetes rates suggest an increase in the incidence and prevalence of diabetes is possible for these children. Interventions are needed to decrease the disease burden.

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Cite This Study

Kvigne et al. (2026) studied this question.

synapsesocial.com/papers/69e864c46e0dea528dde97c0https://doi.org/10.1542/peds.2025-072559
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