Bright 1 Bodies Weight Management Program
Condition: Diabetes Mellitus, Type 1
MeSH terms: Diabetes Mellitus, Type 1; Body Weight
Study type: Interventional

Summary: 
      Physical inactivity occurs among 65% to 95% of youth with type 1 diabetes (T1D) and based
      upon limited evidence may contribute to the rapidly growing incidence of overweight among
      this population. The purpose of the present study is to pilot test a 12-week intensive
      lifestyle program for adolescents with overweight and T1D utilizing group exercise classes
      adapted for this population, supplemented with coping skills training and diabetes
      self-management education to address problem solving behaviors that limit their physical
      activity and weight control. Our primary aim is to evaluate the changes in physical activity
      adherence, anthropometrics, and self-management behaviors following this program among
      sedentary adolescents with T1D and overweight (n=25, OW) compared with sedentary adolescents
      with T1D and normal weight (n=25, NW). We hypothesize that the OW group will achieve improve
      physical activity adherence and anthropometrics to the same or greater extent as the NW group
      and previous Bright Bodies cohorts, and that these changes will correlate with improved
      exercise-related problem solving. Our secondary aim is to evaluate changes in adipocytokines
      and epigenetic factors related to the etiology of overweight/obesity following our physical
      activity intervention. We hypothesize changes in these biomarkers will correlate with changes
      in anthropometry variables and partially explain any differences in response between the
      groups and individuals should those occur.
    

Detailed description: 
      Prevalence of overweight among patients with type 1 diabetes (T1D) of all ages has grown at
      alarming rates since the 1980s. Physical inactivity occurs among 65% to 95% of youth with T1D
      and doubles their risk of overweight. A major factor limiting their physical activity appears
      to be self-managed problem solving around exercise such as adjustments to insulin and diet,
      which is practiced regularly by less than half of our adolescent patients with T1D and less
      frequently than any other self-management behavior. Our previous interventions applying
      coping skills training (ABCs of Diabetes and TeenCope) as well as diabetes self-management
      (Managing Diabetes) successfully improved problem-solving and other aspects of
      self-management along with health outcomes among adolescents with T1D, but did not focus on
      those who were overweight nor promotion of physical activity and weight loss. The Yale Bright
      Bodies intensive lifestyle program successfully promotes physical activity and weight loss,
      enrolling >100 overweight youth from greater New Haven annually but does not presently
      accommodate those with T1D.

      The purpose of the present study is to pilot test a 12-week intensive lifestyle program for
      adolescents with overweight and T1D utilizing group exercise classes from Bright Bodies
      adapted for this population, supplemented with coping skills training and diabetes
      self-management education to address problem solving behaviors that limit their physical
      activity and weight control. Our primary aim is to evaluate the changes in physical activity
      adherence, anthropometrics (body mass index percentile for age, body fat percentage), and
      self-management behaviors following this 12-week lifestyles program among sedentary
      adolescents with T1D and overweight (n=25, OW) compared with sedentary adolescents with T1D
      and normal weight (n=25, NW). We hypothesize that the OW group will achieve improve physical
      activity adherence and anthropometrics to the same or greater extent as the NW group and
      previous Bright Bodies cohorts, and that these changes will correlate with improved
      exercise-related problem solving.

      Although physical activity is recommended for weight loss, outcomes from increased physical
      activity have been heterogeneously distributed-not all overweight participants lose weight
      and some even gain weight. Furthermore the etiologies of overweight/obesity and T1D appear to
      interact, yet no study has tested the influence of physical activity upon biological pathways
      related to overweight/obesity for patients with T1D. Accordingly, our secondary aim is to
      evaluate changes in adipocytokines and epigenetic factors related to the etiology of
      overweight/obesity following our physical activity intervention. We hypothesize changes in
      these biomarkers will correlate with changes in anthropometry variables and partially explain
      any differences in response between the groups and individuals should those occur.
    

Intervention name(s): Bright 1 Bodies
Intervention type(s): Behavioral
Intervention description(s): A 12-week intensive lifestyle program utilizing group exercise classes adapted for this population, supplemented with coping skills training and diabetes self-management education.
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: exercise; physical activity; behavior modification; coping skills; self management; glycemic control; overweight; obesity; body composition; adherence