Interventions for Type 2 Diabetes Prevention and Management Among Indigenous Children and Youth: A Systematic Review

Introduction: Indigenous populations experience a disproportionately higher burden of early onset of type 2 diabetes mellitus (T2DM). To contribute towards addressing this health disparity, evidence-based culturally appropriate interventions are urgently needed. This systematic review examines interventions designed to improve the prevention and management of T2DM among Indigenous children and youth.

Methods: A comprehensive search of five electronic databases was carried out in February 2023 to identify relevant studies published in English. We included studies of all designs involving Indigenous children and youth under 25 years of age. An adapted version of the National Institute of Health (NIH) quality assessment tool for pre-post intervention studies was used for quality assessment. Due to the heterogeneity of methods used by reviewed publications, the convergent integrated approach developed by Joanna Briggs Institute (JBI) for mixed-method systematic reviews was employed in the analysis. Prospero registration ID: CRD42023423671.

Results: The search identified 1127 publications, and 25 studies with a total of 4594 participants from four countries were eligible after screening. Notably, most (80%) originated from North America. Most interventions involved < 100 participants and lasted 6 months or less (58%). While knowledge and behaviours improved for most interventions, longer and culturally responsive interventions, often combining both community and school-based elements, demonstrated a greater effect on key anthropometrics and biomarkers associated with the risk of T2DM.

Conclusion: This review highlights the urgent need for more research to address T2DM among Indigenous youth. Future research should prioritise culturally appropriate, long-term interventions that engage communities and empower Indigenous youth to make healthy choices.