Preventing Diabetes in Latino Youth

项目概要/摘要： 肥胖和相关的健康差距代表了一些最重大的公共卫生挑战 面对社会。尤其是肥胖的拉丁裔青少年更容易受到胰岛素抵抗的影响 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， 这是一个重要的干预机会。糖尿病预防计划确立了这种生活方式 干预可以预防或延迟患有前驱糖尿病的成年人的2型糖尿病。到目前为止，没有糖尿病预防 在患有糖尿病前期的肥胖拉丁裔青年中进行了研究， 组因此，我们提出了一个随机对照试验，以测试短期（6个月）和长期（12- 与常规护理相比，基于文化的生活方式干预对改善 在120名患有糖尿病前期的肥胖拉丁裔青少年中，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， 和器官脂肪对改善葡萄糖耐量和增加胰岛素敏感性的作用，并估计初始 与改善血糖的常规护理相比，干预的成本效益增加 宽容整体方法是在一个多层次的生态发展模型框架内， 社区，家庭，同伴和个人因素在青春期的关键过渡期， 健康行为和健康结果的变化与未来的健康轨迹有关。述干预 以社会认知理论为指导，采用关键的行为矫正策略来提高自我效能 并培养社会支持，使和维持健康的行为改变。该提案建立在现有的 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丁裔青年制定糖尿病预防干预措施的关键差距， 执行和评估。这种创新的方法是开发可扩展的， 具有成本效益的，以解决方案为导向的计划，以预防2型糖尿病在这一人群和其他高风险人群 青年

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.