Effects of a Diabetes Prevention Program on Type 2 Diabetes Risk Factors and Quality of Life Among Latino Youths With Prediabetes

Abstract

IMPORTANCELatino youths are disproportionately impacted by prediabetes and type 2 diabetes (T2D). Lifestyle intervention is the first-line approach for preventing or delaying T2D among adults with prediabetes. OBJECTIVE To assess the efficacy of a diabetes prevention program among Latino youths aged 12 to 16 years with prediabetes. DESIGN, SETTING, AND PARTICIPANTS This 2-group parallel randomized clinical trial with 2:1 randomization assessed a lifestyle intervention against usual care among Latino youths with prediabetes and obesity with 6-and 12-month follow-up. The study was conducted at YMCA facilities in Phoenix, Arizona from May 2016 to March 2020. INTERVENTION Participants were randomized to lifestyle intervention (INT) or usual care control (UCC). The 6-month INT included 1 d/wk of nutrition and health education and 3 d/wk of physical activity. UCC included 2 visits with a pediatric endocrinologist and a bilingual, bicultural registered dietitian to discuss diabetes risks and healthy lifestyle changes. MAIN OUTCOMES AND MEASURES Insulin sensitivity, glucose tolerance, and weight-specific quality of life (YQOL-W) at 6-and 12-month follow-up. RESULTS A total of 117 Latino youths (mean [SD] age, 14 [1] years; 47 [40.1%] girls) were included in the analysis. Overall, 79 were randomized to INT and 38 to UCC. At 6 months, the INT led to significant decreases in mean (SE) 2-hour glucose (baseline: 144 [3] mg/dL; 6 months: 132 [3] mg/dL; P = .002) and increases in mean (SE) insulin sensitivity (baseline

Family systems approaches in pediatric obesity management: a scoping review

“…Support may include emotional, motivational, physical, financial and types of support and resources, as well as fostering a sense of community and solidarity for the individual 13 Families Improving Together (FIT) : Aimed to foster social support within families through take-home bonding activities, and between families through group activities [ 35 , 37 ] Multifamily Therapy plus Psychoeducation : Promoted enlisting social support; e.g., determining the type of support needed, who can provide it, and how to ask for it [ 60 ] SHINE : Emphasized the importance of peer relationships during adolescence and the role parents play in managing peer relationships and healthy lifestyle behaviours. Adolescents were encourage to bring a friend to [one] session, and friends were integrated into the activities [ 71 ] [ 29 , 33 , 35 – 40 , 42 , 43 , 47 , 49 , 50 , 56 , 60 – 63 , 70 – 72 ] The Youth Quality of Life (YQOL) Inventory, including a social relationship subscale [ 49 ] The Support for Exercise Scale (revised version) [ 56 ] The Social Support for Eating Habits and Exercise Scale [ 61 ] Parent Relationship with Peer Group Scale [ 33 ] Family Functioning Family member roles and interactions that affect day-to-day living within the home environment, including acceptance and understanding of one another, family decision-making and problem-solving processes, and general communication among family members. Simply described as the overall healthiness of a family unit 10 Multidisciplinary FBBT : Nutrition-related topics and systemic interventions to facilitate family functioning by reinforcing family resources and improving the emotional climate for adolescents with obesity [ 57 ] [ 30 , 31 , 33 , 35 – 40 , ...…”

Pros and Cons of Current Diagnostic Tools for Risk-Based Screening of Prediabetes and Type 2 Diabetes in Children and Adolescents with Overweight or Obesity

“…The decision to screen should also be guided by clinical judgment, as some youth with obesity may have earlier onset of puberty and therefore need earlier screening, but also depending on the prevalence of diabetes in different parts of the world [9]. Noteworthy is that risk-based screening for prediabetes or T2D in children and adolescents allows early diagnosis of alterations in glucose metabolism that enable early and targeted preventive and therapeutic interventions that could prevent or delay progression to T2D, so fast in early ages [10, 11]. Moreover, the early diagnosis and intensive treatment of T2D during youth is important to maintain good glycemic control and prevent T2D complications [12].…”

Diabetes Patients’ Acceptance of Injectable Treatment, a Scientometric Analysis

“…Therefore, they must accept this injectable treatment. For adults with type 2 diabetes, first-line treatment depends on comorbidities, patient-centered treatment factors, and management needs, but will generally include metformin and a comprehensive lifestyle modification [4,5]. Other medications can be used as diabetes therapy, such as sulfonylureas or insulin glargine, in those with an increased risk of cardiovascular or renal side effects [6,7].…”