Preventing Diabetes in Latino Youth
Condition: Obesity; Diabetes
MeSH terms: Diabetes Mellitus
Study type: Interventional

Summary: 
      Obesity and type 2 diabetes are critical public health issues in youth. This study will test
      the effects and estimate the cost-effectiveness of a culturally-grounded community-based
      lifestyle intervention on type 2 diabetes risk among obese Latino adolescents with
      prediabetes.
    

Detailed description: 
      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, investigators 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. Investigators will further test intervention
      effects on changes in 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.
    

Intervention name(s): Intensive Lifestyle Intervention; Usual Care Control
Intervention type(s): Behavioral; Other
Intervention description(s): 6-months of lifestyle education; Medical visit and dietary counseling
Other intervention name(s): Control
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention