Behavioral Intervention for Type 2 Diabetes in Youth

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DESCRIPTION (provided by applicant): The incidence of type 2 diabetes has increased significantly in recent years, especially in youth. It is well known that type 2 diabetes is a serious and costly disease in adults. Thus, the implications of the increased prevalence of type 2 diabetes in youth are significant in terms of the impact on the public health system. With many more individuals experiencing diabetes with early onset, the increased cost to society will be large. Although there is an enormous accumulation of experience and knowledge concerning the medical and behavioral management of type 2 diabetes in adults, we know little about the disease or its management in children. Research indicates that normalization of blood glucose levels decreases the frequency of health complications of type 2 diabetes in adults. Changes in lifestyle are an important component of treatment; with obesity in the majority of cases, weight loss is an important treatment goal. Oral medications that lower glucose levels are another component of treatment, although more information about the efficacy and safety of the medications in children is needed. Work with children with type 1 diabetes and adults with type 2 diabetes indicates that diabetes management presents considerable challenges for many patients and their families. Difficulties with adherence and metabolic control are frequent, but little is known about the unique issues faced by children with type 2 diabetes and their families. Given that the incidence of type 2 diabetes in youth has increased dramatically only in recent years, few research studies have systematically examined management issues for this population. Thus, there is an urgent need for studies that address medical interventions as well as behavioral and psychosocial issues and interventions for management in youth with type 2 diabetes. The proposed research will identify important treatment-relevant psychosocial and behavioral issues for youth with type 2 diabetes and determine the feasibility and efficacy of a family-based behavioral lifestyle intervention on health outcomes and behavioral and psychosocial functioning of children and adolescents with type 2 diabetes. The results from this research will provide the preliminary feasibility and efficacy data needed for the development and submission of a subsequent R18 application.