Type 2 Diabetes Risk Reduction for Minority Youth

描述（由申请人提供）： 近年来，2型糖尿病的发病率在青年中显著增加，特别是少数民族青年。部分原因可能是少数民族儿童肥胖率上升。即使在儿童中，肥胖也明显增加了2型糖尿病的代谢风险因素，包括胰岛素升高和葡萄糖耐量异常，以及血压升高。鉴于儿童期肥胖与成年后持续肥胖的可能性很高，预防2型糖尿病应该从干预儿童期肥胖开始。这项研究旨在验证一个假设，即对高危儿童的生活方式干预将降低他们以后患2型糖尿病的风险。高风险儿童被认为是肥胖和有2型糖尿病家族史的儿童。我们将以文化上适当的方式制定一个以家庭为基础的行为体重控制计划，在儿童学校制定多家庭小组计划，在儿童之家制定个性化计划。将进行焦点小组，以完善文化适当性的干预措施，然后在其他焦点小组中对干预措施进行预先测试。然后将进行一项小规模的试点研究，其中50名8-9岁的少数民族儿童将随机接受最初12个月的干预或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。这项研究的结果将为儿童2型糖尿病的风险因素提供新的信息，并为降低少数民族儿童2型糖尿病风险提供创新方法。这些发现将为后续R18应用的开发和提交提供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.