Population Heterogeneity of Diabetes in Indigenous Peoples of the Americas: A Systematic Scoping Review of the Existing Literature

<b>Background:</b> In the Americas, the number of people living with diabetes is expected to rise from 92 million in 2024 to 120 million by 2050. Indigenous populations may experience distinct biological, environmental, and sociocultural risk factors; however, they are often treated as a homogeneous group in epidemiological research, and consolidated evidence on diabetes prevalence across diverse Indigenous populations remains limited. This scoping review examines the prevalence of diabetes among Indigenous populations in the Americas. <b>Methods:</b> Following PRISMA-ScR guidelines, we conducted a systematic scoping review of population-based studies reporting the prevalence of diabetes among Indigenous adult populations in the Americas. Searches were performed in PubMed and Scopus. Collected data included study location, Indigenous group, population characteristics, diagnostic criteria, and test used and reported prevalence estimates. <b>Results:</b> Sixty documents encompassing 73 studies met the inclusion criteria, representing 45,503 individuals from 16 countries between 1975 and 2025. The total number of ethnic groups represented was 111, and 12 studies did not identify a specific ethnic group. Fasting blood glucose (FBG) was the most frequently used diagnostic method, followed by the oral glucose tolerance test (OGTT). Estimates of the prevalence of diabetes varied widely across populations, regions, and time periods. Five studies-from Brazil, Chile, Colombia, Mexico, and Paraguay-did not identify any cases of diabetes. Among studies reporting cases, prevalence ranged from 1 to 70% in North America, 5 to 14% in Central America, and 1 to 29% in South America. <b>Conclusions:</b> The prevalence of diabetes among Indigenous populations varied widely across the region, with substantially higher estimates reported in North America than in Central and South America. The decline in published studies in recent years suggests reduced research attention to this topic. The marked heterogeneity identified in this review underscores the need for standardized measurement approaches to support population-specific strategies aligned with personalized care and precision public health.