Prevalence of Diabetes, Prediabetes, and Obesity in the Indigenous Kuna Population of Panamá



Diabetes is a burgeoning disease affecting more than 8% of the world population. Indigenous communities are disproportionately impacted by diabetes; however, limited data is available on prevalence and correlates of diabetes.


Data was collected from 211 Indigenous Kuna adults off the coast of Panamá in the San Blas region of the Caribbean. Diabetes and prediabetes were measured by HbA1c. Obesity was defined using the US BMI categories as well as categories defined by the WHO to assess obesity among Asian populations. Univariate analyses (chi2 tests) were used to investigate diabetes status and obesity by demographic factors. Logistic regression was used to examine the correlates of diabetes and obesity.


Of the 211 adults, 13% had diabetes, 35% had prediabetes, and approximately 39% were obese. Using the Asian cut point for obesity, this number increased to 61%. Income was statistically significantly related to an HbA1c cut point of 6.5 (p = 0.005). Individuals who reported a monthly income of greater than $250 had increased odds of prediabetes and diabetes nearly sixfold for HbA1c of > 6.5 (OR 6.3; CI 1.43–28.45) and HbA1c of > 5.7 (OR 5.1; CI 1.03–26.14).


These findings represent one of the first studies examining diabetes and prediabetes in indigenous Kuna of the San Blas region. Our findings suggest Kuna Indians may be at an increased risk for diabetes and prediabetes. Current national estimates for diabetes is considered low in this population. Greater understanding of determinants of diabetes and obesity are needed in order to address diabetes in this indigenous community.

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We would like to acknowledge the support and participation of the Ustupu and Ogobsucum communities and the partnership with the Panama Ministry of Health that made this study possible.


This study was supported by Indigenous Health International (IHI), an approved 501(c)(3) non-profit organization in the USA. The study sponsor had no role in the analysis, interpretation, or writing of the manuscript.

Author information




LEE designed and obtained funding for the study. LEE, RJW, and JAC acquired the data. LEE analyzed the data. LEE, RJW, JAC, and AZD drafted the article and critically revised the manuscript for intellectual content. All the authors approved the final manuscript.

Corresponding author

Correspondence to Leonard E. Egede.

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This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects/patients were approved by the Western Institutional Review Board (WIRB), USA. Informed consent was obtained from all subjects/patients.

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Campbell, J.A., Walker, R.J., Dawson, A.Z. et al. Prevalence of Diabetes, Prediabetes, and Obesity in the Indigenous Kuna Population of Panamá. J. Racial and Ethnic Health Disparities 6, 743–751 (2019).

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  • Diabetes
  • Prediabetes
  • Obesity
  • Indigenous
  • Kuna
  • Panama