ObjectiveTo assess the risk factors for a group of children at high risk for type 2 diabetes using a proven medical model and incorporating a community-friendly standardized fitness assessment tool.DesignAll children in school (kindergarten to grade eight) in an isolated First Nation community were enrolled to be screened for diabetes, risk factors, and fitness level.SettingBeausoleil First Nation community is an Ojibway community situated on Christian Island in Georgian Bay, Ontario, Canada.ParticipantsAll children attending Christian Island Elementary School, a total of 101 students from kindergarten to grade eight.InterventionsCapillary blood glucose fasting and 2 hours after 75-g simple carbohydrate meal, height and weight (calculated BMI), blood pressure, aerobic capacity, abdominal strength and endurance, upper body strength, trunk extensor strength and flexibility, and upper body flexibility.Outcome MeasurementsApplicability of tests to assess disease, risk factors, and fitness level.ResultsEight children were found to have abnormal capillary blood glucose and required further laboratory investigations. Significant risk factors for type 2 diabetes were identified. The screening exercise assessment identified specific areas below that considered a healthy fitness zone.ConclusionsThe screening assessment identified medical areas of concern in capillary blood glucose, blood pressure, and body mass index. The fitness testing identified areas of concern in aerobic capacity, upper body strength, abdominal strength and endurance, and flexibility. The fitness testing was First Nation community-friendly.