Objective-To evaluate the impact of a multifaceted, school-based intervention on inner city youth at high risk for type 2 diabetes mellitus (T2DM) and to determine whether the addition of coping skills training (CST) and health coaching improves outcomes.Method-198 students in New Haven, CT at risk for T2DM (BMI > 85 th percentile and family history of diabetes) were randomized by school to an educational intervention with or without the addition of CST and health coaching. Students were enrolled from 2004-2007 and followed for 12 months.Results-Students in both groups showed some improvement in anthropometric measures, lipids, and depressive symptoms over 12 months. BMI was not improved by the intervention. Students who received CST showed greater improvement on some indicators of metabolic risk than students who received education only.Conclusion-A multifaceted, school-based intervention may hold promise for reducing metabolic risk in urban, minority youth.

Because depressive symptoms may affect ability to engage in healthy behavior changes, evaluation and treatment of depressive symptoms should be considered in preventive interventions for youth at risk for T2DM.

Introduction-The purpose of this paper is to describe components of a health coaching intervention based on coping skills training delivered via telephone. This intervention was provided to urban adolescents at risk for type 2 diabetes mellitus (T2DM), reinforcing a schoolbased curriculum designed to promote a healthy lifestyle and prevent T2DM.

The effects of sucrose ingestion on the excretion of urinary calcium, zinc, phosphorus, sodium and potassium have been investigated and compared among 13 individuals to the magnitude of their postprandial serum insulin response. Fasted subjects consumed a beverage containing 2 g sucrose/kg, and urine and blood samples were taken at intervals during the next 3 h. As a result of sucrose consumption there were significant increases in serum insulin and decreases in serum phosphorus, but no change in serum total or filterable calcium, zinc, sodium or potassium. Urine calcium peaked at 1.5 h and was significantly increased from 10 through 2.5 h. Sucrose-induced increases in serum insulin and urine calcium were highly variable among subjects, and within the group were significantly correlated (r = 0.82, P less than 0.01). Urine calcium excretion was correlated with serum phosphorus (r = 0.41, P less than 0.05) and urine zinc (r = 0.80, P less than 0.01). Sucrose consumption also increased the urinary excretion of zinc and sodium, although renal reabsorption was not impaired. The effects of sucrose on urinary calcium are consistent with the hypothesis that insulin inhibits renal calcium reabsorption.

OBJECTIVEThe purpose of this study was to determine the impact of sex and race/ethnicity on metabolic risk and health behaviors in minority youth.RESEARCH DESIGN AND METHODSA total of 173 seventh graders (46% male and 54% female; 49% Hispanic and 51% African American) with BMI ≥85th percentile and a family history of diabetes were assessed with weight, height, BMI, percent body fat, and waist circumference measures. Laboratory indexes included 2-h oral glucose tolerance tests with insulin levels at 0 and 2 h, fasting A1C, and lipids. Insulin resistance was estimated by homeostasis model assessment (HOMA-IR). Youth also completed questionnaires evaluating health behaviors.RESULTSAverage BMI (31.6 ± 6.4 kg/m2) and percent body fat (39.5 ± 10.6%) were high. All participants demonstrated insulin resistance with elevated HOMA-IR values (8.5 ± 5.2). Compared with African American youth, Hispanic youth had higher triglycerides and lower HDL cholesterol despite similar BMI. Hispanic youth reported lower self-efficacy for diet, less physical activity, and higher total fat intake. Male youth had higher glucose (0 and 2 h) and reported more physical activity, more healthy food choices, and higher calcium intake than female youth.CONCLUSIONSScreening high-risk youth for insulin resistance and lipid abnormalities is recommended. Promoting acceptable physical activities and healthy food choices may be especially important for Hispanic and female youth.