Preventing
type 2 diabetes in high risk youth
Background: Type 2 diabetes (T2DM) is
epidemic among youth, with minority youth at the highest risk. New Haven, CT is
a high-risk community where up to 30% of middle school youth are significantly
overweight.
Purpose: The purpose of this pilot
study was to test the feasibility of a school-based program of nutrition,
exercise and coping skills training in youth to prevent T2DM.
Methods: Of 45 youth who met the criteria (Body Mass Index BMI > 85th
percentile, acanthosis nigricans, family history of T2DM), 41 agreed to
participate (age 12.6+- 1.07, 63% female, 51% African American, 44% Hispanic,
5% Caucasian). Data were collected on BMI, adiposity, insulin sensitivity,
intake (Eating habits questionnaire), self-efficacy (Health Behavior
Questionnaire) and activity (Revised Godin-Shepard Activity Survey).
Results: At baseline, BMI range from
26-53 (36.2+- 6.0). The Oral Glucose Tolerance Test demonstrated that 1 youth
had T2DM, 5 met American Diabetes Association Criteria for Impaired Glucose
Tolerance, 1 was normal, and the remainder demonstrated hyperinsulinemia
between 30 and 120 minutes. At 12 months trends supported improvement in
Parental and Teacher Reinforcement for diet (p=.2), dietary self-efficacy
(p=.2). The BMI in the control group increased whereas the experimental group
held constant (p=.3) at 12 months. At baseline the experimental group
demonstrated higher glucose levels, but at 12 months trended lower than the
control group (p=.43). At baseline the experimental group demonstrated lower
insulin levels and they remained lower at 12 months (p=.43), whereas the
control group increased dramatically.
Conclusions: The data suggest that a
school-based program tailored to multi-ethnic youth at risk for T2DM can be
successful in assisting these youth to control their weight, increase physical
activity, improve nutritional status and improve glucose and insulin
metabolism.