Type 2 Diabetes Risk Reduction for Minority Youth

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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.