title: A lifestyle intervention improves plasma insulin levels among Native American high school youth.
abstract: BACKGROUND
  Worldwide, 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.
  
  
  METHODS
  This 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.
  
  
  RESULTS
  Plasma 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.
  
  
  CONCLUSIONS
  Among at-risk youth, an environmentally based lifestyle intervention may significantly suppress markers of type 2 diabetes risk.
authors.affiliation: Kaiser Permanente Center for Health Research, Portland, OR 97227, USA. cheryl.ritenbaugh@kpchr.org
authors.forename: Cheryl
authors.initials: C
authors.lastname: Ritenbaugh
authors.forename: Nicolette I
authors.initials: NI
authors.lastname: Teufel-Shone
authors.forename: Mikel G
authors.initials: MG
authors.lastname: Aickin
authors.forename: Jennie R
authors.initials: JR
authors.lastname: Joe
authors.forename: Steven
authors.initials: S
authors.lastname: Poirier
authors.forename: D Clay
authors.initials: DC
authors.lastname: Dillingham
authors.forename: David
authors.initials: D
authors.lastname: Johnson
authors.forename: Susanne
authors.initials: S
authors.lastname: Henning
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Cole
authors.forename: David
authors.initials: D
authors.lastname: Cockerham
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000208:ethnology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000517:prevention & control*; D004032:Diet; D015444:Exercise; D005260:Female; D005951:Glucose Tolerance Test; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D006946:Hyperinsulinism / Q000517:prevention & control*; D007198:Indians, North American; D008019:Life Style; D008297:Male; D009765:Obesity; D018570:Risk Assessment; D012572:School Health Services; D012680:Sensitivity and Specificity; D013334:Students
chemical_list: D001786:Blood Glucose