• Cheryl Ritenbaugh, Nicolette I Teufel-Shone, Mikel G Aickin, Jennie R Joe, Steven Poirier, D Clay Dillingham, David Johnson, Susanne Henning, Suzanne M Cole, and David Cockerham.
• Kaiser Permanente Center for Health Research, Portland, OR 97227, USA. cheryl.ritenbaugh@kpchr.org
• Prev Med. 2003 Mar 1; 36 (3): 309-19.

BackgroundWorldwide, type 2 diabetes prevalence is increasing, with Native American populations particularly at risk. The Zuni Pueblo, with a history of wellness activities, volunteered to test the feasibility and efficacy of a high school-based diabetes prevention intervention.MethodsThis school-based intervention used a multiple cross-sectional design to evaluate outcome measures at 0, 1.5, and 3 years against an Anglo comparison group. The Zuni high school diabetes prevention program included an educational component targeting decreased consumption of sugared beverages, knowledge of diabetes risk factors, and a youth-oriented fitness center. Main outcome measures were plasma glucose and insulin measured fasting and 30 min after a 75-g glucose challenge.ResultsPlasma glucose levels were normal at baseline for Zuni (n = 72) and Anglo (n = 37) youth and did not significantly change throughout the study. At baseline, fasting and 30-min plasma insulin levels were significantly elevated for Zuni youth; they showed significant steady declines for both males and females throughout the study (P = 0.06 to P = 0.000 for trends using quantile regression). By Year 3, values for Zuni males (n = 29) equaled Anglo comparison values, while Zuni female (n = 26) values had declined but were still higher than Anglo comparison values.ConclusionsAmong at-risk youth, an environmentally based lifestyle intervention may significantly suppress markers of type 2 diabetes risk.

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