Preventing Diabetes in Latino Youth

项目摘要/摘要： 肥胖和相关的健康差距是一些最重大的公共卫生挑战 面向社会。特别是，肥胖的拉丁裔青少年受到胰岛素抵抗的影响不成比例。 和2型糖尿病。糖尿病前期是2型糖尿病发病机制的中间阶段， 代表着干预的关键机会。糖尿病预防计划确立了这种生活方式 干预可以预防或推迟患有糖尿病前期的成年人的2型糖尿病。到目前为止，还没有糖尿病预防措施 对患有糖尿病前期的肥胖拉美裔青年进行了研究，这是一种非常脆弱和服务不足的疾病。 一群人。因此，我们提出了一项随机对照试验来检验短期(6个月)和长期(12个月)。 1个月)与常规护理相比，以文化为基础的生活方式干预的改善效果 120名患有糖尿病前期肥胖的拉丁裔青少年的葡萄糖耐量和降低糖尿病风险。我们将进一步 测试干预对生活质量的影响，探索总体、区域、 和器官脂肪对改善糖耐量和提高胰岛素敏感性的作用，并初步估计 与改善血糖的常规护理相比，干预措施的增量成本-效果 宽容。总体方法被框定在一个多层次的生态发展模型中，该模型利用 青春期关键过渡期的社区、家庭、同伴和个人因素 健康行为和健康结果的变化与未来的健康轨迹有关。干预措施是 以社会认知理论为指导，采用关键行为矫正策略提高自我效能感 并为做出和维持健康的行为改变培养社会支持。这项建议是在现有的基础上提出的 一个跨学科的调查小组与当地社区机构合作 解决如何为肥胖的拉美裔青年制定糖尿病预防干预措施方面的严重差距， 实施和评估。这一创新方法是开发可伸缩、 在该人群和其他高危人群中预防2型糖尿病的具有成本效益的、面向解决方案的计划 青春年华。

Project Summary / Abstract: Obesity and related health disparities represent some of the most significant public health challenges facing society. In particular, obese Latino adolescents are disproportionately impacted by insulin resistance and type 2 diabetes. Prediabetes is an intermediate stage in the pathogenesis of type 2 diabetes and represents a critical opportunity for intervention. The Diabetes Prevention Program established that lifestyle intervention can prevent or delay type 2 diabetes in adults with prediabetes. To date, no diabetes prevention studies have been conducted in obese Latino youth with prediabetes, a highly vulnerable and underserved group. Therefore, we propose a randomized-controlled trial to test the short-term (6-month) and long-term (12- month) efficacy of a culturally-grounded, lifestyle intervention, as compared to usual care, for improving glucose tolerance and reducing diabetes risk in 120 obese Latino adolescents with prediabetes. We will further test intervention effects on quality of life, explore the potential mediating effects of changes in total, regional, and organ fat on improving glucose tolerance and increasing insulin sensitivity, and estimate the initial incremental cost-effectiveness of the intervention as compared with usual care for improving glucose tolerance. The overall approach is framed within a multilevel Ecodevelopmental model that leverages community, family, peer, and individual factors during the critical transition period of adolescence when changes in health behaviors and health outcomes are linked to future health trajectories. The intervention is guided by Social Cognitive Theory and employs key behavioral modification strategies to enhance self-efficacy and foster social support for making and sustaining healthy behavior changes. The proposal builds upon extant collaborations of a transdisciplinary team of investigators working in concert with local community agencies to address critical gaps in how diabetes prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution-oriented programs to prevent type 2 diabetes in this and other populations of high-risk youth.