Behavioral Intervention for Type 2 Diabetes in Youth

描述（由申请人提供）： 近年来，2型糖尿病的发病率显著增加，尤其是在青年人中。众所周知，2型糖尿病在成人中是一种严重且昂贵的疾病。因此，青年2型糖尿病患病率增加的影响在对公共卫生系统的影响方面是重大的。随着越来越多的人患有早发性糖尿病，增加的社会成本将是巨大的。尽管关于成人2型糖尿病的医学和行为管理的经验和知识积累巨大，但我们对儿童糖尿病及其管理知之甚少。研究表明，血糖水平的正常化降低了成人2型糖尿病健康并发症的频率。生活方式的改变是治疗的重要组成部分;在大多数情况下，减肥是一个重要的治疗目标。降低血糖水平的口服药物是治疗的另一个组成部分，尽管需要更多关于儿童药物疗效和安全性的信息。与1型糖尿病儿童和2型糖尿病成人的合作表明，糖尿病管理对许多患者及其家庭提出了相当大的挑战。坚持和代谢控制的困难是经常发生的，但对2型糖尿病儿童及其家庭面临的独特问题知之甚少。鉴于青年2型糖尿病的发病率仅在最近几年才急剧增加，很少有研究系统地研究这一人群的管理问题。因此，迫切需要进行研究，解决医疗干预以及行为和心理社会问题和干预措施，以管理2型糖尿病青年。拟议的研究将确定2型糖尿病青少年的重要治疗相关的心理和行为问题，并确定以家庭为基础的行为生活方式干预对2型糖尿病儿童和青少年的健康结果以及行为和心理功能的可行性和有效性。这项研究的结果将提供开发和提交后续R18应用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 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.