Type 2 Diabetes Risk Reduction for Minority Youth

描述(由申请人提供)： 近年来，2型糖尿病在青年中的发病率显著增加，特别是在少数民族青年中。这可能部分是由于少数民族儿童肥胖率的增加。即使在儿童中，肥胖显然也会增加2型糖尿病的代谢风险因素，包括胰岛素升高和糖耐量异常，此外还有高血压。鉴于儿童期肥胖与成年后肥胖持续的可能性高相关，预防2型糖尿病应从干预儿童期肥胖症开始。这项研究旨在检验这样一种假设，即对高危儿童进行生活方式干预将降低他们未来患2型糖尿病的风险。高危儿童被认为是那些肥胖和有2型糖尿病家族史的人。因地制宜地制定以家庭为基础的行为体重控制方案，在儿童学校开展多家庭集体活动，在儿童之家开展个性化活动。将进行重点小组，以完善干预的文化适当性，然后将在更多的重点小组中对干预进行预先测试。然后将进行一项小规模的试点研究，将50名8-9岁的少数族裔儿童随机分为两组，要么接受最初12个月的干预，要么接受由健康风险反馈和教育材料组成的对照条件。主要结果是肥胖和代谢风险的测量，包括对胰岛素抵抗的估计。次要结果包括饮食摄入量和体力活动的测量。本研究的结果将有助于提供有关儿童2型糖尿病危险因素的新信息，以及降低少数民族儿童2型糖尿病高危发展风险的创新方法。这些调查结果将提供开发和提交后续R18申请所需的初步可行性和有效性数据。

DESCRIPTION (provided by applicant): The incidence of type 2 diabetes has increased markedly among youth in recent years, particularly minority youth. This is likely due in part to the increased rate of obesity among ethnic minority children. Even in children, obesity apparently increases metabolic risk factors for type 2 diabetes, including elevated insulin and abnormal glucose tolerance, in addition to higher blood pressure. Given the fact that obesity in childhood is associated with high probability of continued obesity into adulthood, prevention of type 2 diabetes should begin by intervening with obesity in childhood. This study is designed to test the hypothesis that a lifestyle intervention for high-risk children will reduce their risk for later development of type 2 diabetes. High-risk children are considered to be those who are obese and who have a family history of type 2 diabetes. We will develop a family-based behavioral weight control program in a culturally appropriate manner, with multi-family group programming at children's schools and individually tailored programs at children's homes. Focus groups will be conducted to refine the intervention for cultural appropriateness and then the intervention will be pre-tested in additional focus groups. A small-scale pilot study will then be conducted in which 50 8-9 year-old minority children will be randomized to either receive the initial 12 months of the intervention or receive a control condition consisting of health risk feedback and educational materials. Primary outcomes are measures of obesity and metabolic risk, including estimates of insulin resistance. Secondary outcomes include measures of dietary intake and physical activity. The results of this study will contribute new information concerning risk factors for type 2 diabetes in children, and innovative methods to reduce type 2 diabetes risk in minority children at high risk for its development. These findings will provide the preliminary feasibility and efficacy data needed for the development and submission of a subsequent R18 application.