Design of a family-based lifestyle intervention for youth with type 2 diabetes: the TODAY study

Nwosu, Benjamin Udoka

doi:10.1038/ijo.2009.195

Cited by 69 publications

(35 citation statements)

References 63 publications

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“…The lifestyle program has been described in detail (6). TODAY staff members delivered the program to youth participants and a family support person, most of whom were parents.…”

Section: Methodsmentioning

confidence: 99%

Weight change in the management of youth‐onset type 2 diabetes: the TODAY clinical trial experience

et al. 2016

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Summary Background The Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) clinical trial documented that metformin plus rosiglitazone, but not metformin plus lifestyle intervention, provided superior durability of glycemic control relative to metformin monotherapy. Objectives We examined weight changes among TODAY participants that completed at least 6 months of treatment, evaluated predictors of lifestyle outcome, and examined whether weight changes were related to cardiometabolic outcomes across treatment arms. Methods The 595 youth with type 2 diabetes, (85.1% of randomized participants aged 11–17 years) completed assessments of weight-related and cardiometabolic measures at months 0, 6, 12 and 24. Repeated measures models were used to investigate associations over time. Results Lifestyle intervention did not enhance outcome relative to metformin alone and no predictors of response to lifestyle treatment were identified. However, changes in percent overweight across treatment arms were associated with changes in multiple cardiometabolic risk factors, and decreases of ≥7% in overweight were associated with significant benefits over 24 months. Conclusions Although adjunctive intensive lifestyle intervention did not improve weight-related outcomes, weight changes in the full TODAY sample were associated with small, but significant improvements in cardiometabolic status, highlighting the importance of optimizing weight management in youth with T2DM.

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“…The lifestyle program has been described in detail (6). TODAY staff members delivered the program to youth participants and a family support person, most of whom were parents.…”

Section: Methodsmentioning

confidence: 99%

Weight change in the management of youth‐onset type 2 diabetes: the TODAY clinical trial experience

et al. 2016

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“…WC was recorded with an anthropometric tape measure -the median of three measurements was used. The impact of 10% change in weight or WC was initially explored, as this was regarded as 'moderate' weight loss in previous studies (28,29). Participants were classified as having either none or R1 comorbidity at each visit (1).…”

Section: Other Measurements and Data Collectionmentioning

confidence: 99%

Age-associated changes in hypothalamic–pituitary–testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing Study

Camacho

Huhtaniemi

O'Neill

et al. 2013

European Journal of Endocrinology

327

232

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Objective: Health and lifestyle factors are associated with variations in serum testosterone levels in ageing men. However, it remains unclear how age-related changes in testosterone may be attenuated by lifestyle modifications. The objective was to investigate the longitudinal relationships between changes in health and lifestyle factors with changes in hormones of the reproductive endocrine axis in ageing men. Design: A longitudinal survey of 2736 community-dwelling men aged 40-79 years at baseline recruited from eight centres across Europe. Follow-up assessment occurred mean (GS.D.) 4.4G0.3 years later. Results: Paired testosterone results were available for 2395 men. Mean (GS.D.) annualised hormone changes were as follows: testosterone K0.1G0.95 nmol/l; free testosterone (FT) K3.83 G16.8 pmol/l; sex hormone-binding globulin (SHBG) 0.56G2.5 nmol/l and LH 0.08G0.57 U/l. Weight loss was associated with a proportional increase, and weight gain a proportional decrease, in testosterone and SHBG. FT showed a curvilinear relationship to weight change; only those who gained or lost R15% of weight showed a significant change (in the same direction as testosterone). Smoking cessation was associated with a greater decline in testosterone than being a non-smoker, which was unrelated to weight change. Changes in number of comorbid conditions or physical activity were not associated with significant alterations in hypothalamic-pituitary-testicular (HPT) axis function. Conclusions: Body weight and lifestyle factors influence HPT axis function in ageing. Weight loss was associated with a rise, and weight gain a fall, in testosterone, FT and SHBG. Weight management appears to be important in maintaining circulating testosterone in ageing men, and obesity-associated changes in HPT axis hormones are reversible following weight reduction.

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“…The TODAY study design has been previously described (7–9). Presence of MetS was determined using adult ATP III criteria without modification (12) since many youth during the study became ≥18 years of age.…”

Section: Methods and Proceduresmentioning

confidence: 99%

“…This multicenter multiethnic trial randomized youth (n=699, ages 10–17 years) with recent onset of diabetes to receive metformin, metformin + intensive lifestyle intervention or metformin + rosiglitazone (7–9). The intensive lifestyle approach did not result in superior glycemic control or weight loss compared to metformin alone (8).…”

Section: Introductionmentioning

confidence: 99%

Metabolic syndrome is common and persistent in youth-onset type 2 diabetes: Results from the TODAY clinical trial

Drews

Caprio

Leibel

et al. 2015

Obesity

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Objective To examine the prevalence of metabolic syndrome (MetS) in youth-onset type 2 diabetes in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study. Methods Prevalence of MetS (ATP III definition) was compared at baseline (n=679), 6 (n=625) and 24 months (n=545) using chi-square tests. Laboratory data were examined between MetS classifications at each time point using ANOVA. Results Baseline prevalence of MetS was 75.8% and did not differ by treatment group or change over time. MetS was more common in females (83.1%) than males (62.3%; p<0.0001) at baseline; this difference persisted over 24 months. Prevalence of MetS was similar between ethnic groups at baseline, but greater in Hispanics (82.7%) vs non-Hispanic Whites (67.5%; p=0.0017) and non-Hispanic Blacks (72.7%;p=0.0164) at 24 months. Although MetS was common in participants with A1c <7.0% (74.4% at baseline; no significant change over 24 months), it was more common in those who did not maintain glycemic control at 6 months (80.3%; p=0.0081). Elevated c-reactive protein, ALT, IL6 and PAI-1 levels were more frequent with MetS. Conclusions Persistent high prevalence of MetS in youth-onset diabetes, even with excellent glycemic control, is of concern given the associated increased cardiovascular risk.

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Design of a family-based lifestyle intervention for youth with type 2 diabetes: the TODAY study

Cited by 69 publications

References 63 publications

Weight change in the management of youth‐onset type 2 diabetes: the TODAY clinical trial experience

Weight change in the management of youth‐onset type 2 diabetes: the TODAY clinical trial experience

Age-associated changes in hypothalamic–pituitary–testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing Study

Metabolic syndrome is common and persistent in youth-onset type 2 diabetes: Results from the TODAY clinical trial

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