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

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.