Assistant Professor Icahn School of Medicine at Mount Sinai Icahn School of Medicine at Mount Sinai New York, New York, United States
Background: Rates of type 2 diabetes in youth are projected to quadruple by the year 2050 without new interventions. However, few prevention programs have been developed and tested among at-risk youth.
Objective: 1) Modify an effective adult diabetes prevention program for youth from East Harlem, NY; 2) Screen at-risk youth for prediabetes and related lifestyle and biological measures; 3) Pilot and evaluate the intervention with 90 prediabetic youth.
Design/Methods: We screened 148 youth (ages 13-19) with BMI>85th percentile for prediabetes using oral glucose tolerance testing and obtained other clinical measurements and administered a health and lifestyle survey. Prediabetic youth were randomized into intervention (n=41) and waitlist control groups (n=49). Intervention participants were asked to attend a 12-week peer education program, and both groups completed 5- and 12-month follow-up evaluations. We compared baseline and follow-up measures within intervention and control groups using the Wilcoxon signed rank test. We used generalized linear models to test the intervention effect (with p<0.05 for statistical significance).
Results: Demographic characteristics are presented in Table 1 and clinical outcomes are presented in Table 2. BMI percentile and % body fat were stable in both groups and there was a smaller increase in median waist circumference in the intervention group than the control group from baseline to 12 months (2 cm vs 6 cm, p<0.05 and p<0.001, respectively). Fasting glucose and hemoglobin A1c decreased significantly in the intervention group at both time points (also decreased in the control group at 12 months). Total cholesterol and LDL decreased in the intervention group, while HDL decreased in the control group. There were also changes in several behavioral outcomes from baseline to 12 months in the intervention group: those who ate <2 snacks per day increased from 39% to 59% (p=0.007); those who ate readymade meals >3 times per week decreased from 17% to 3% (p=0.029); and those who ate foods purchased from food stands and fast-food restaurants <once a week increased from 51% to 72% (p=0.013) and from 68% to 86% (p=0.016), respectively. There were no significant differences between intervention and control groups from baseline to follow up for any outcome. Conclusion(s): Our pilot diabetes prevention program resulted in several changes in clinical and behavioral outcomes with trends favoring the intervention group. Future work aims to increase youth access and engagement by incorporating mHealth and delivering the program virtually.
Authors/Institutions: Nita Vangeepuram, Icahn School of Medicine at Mount Sinai, New York, New York, United States; Cordelia R. Elaiho, Icahn School of Medicine at Mount Sinai, New York, New York, United States; Yannan Li, Icahn School of Medicine at Mount Sinai, New York, New York, United States; Bian Liu, Icahn School of Medicine at Mount Sinai, New York, New York, United States; Carol Horowitz, Icahn School of Medicine at Mount Sinai, New York City, New York, United States