TY - JOUR
T1 - Physician-directed primary care intervention to reduce risk factors for type 2 diabetes in high-risk youth
AU - Cotton, Byron
AU - Smith, Alice
AU - Hansen, Inger
AU - Davis, Catherine
AU - Doyle, Andrew
AU - Walsh, Ann
PY - 2006/9
Y1 - 2006/9
N2 - BACKGROUND: The incidence of type 2 diabetes in youth is increasing at an alarming rate. The purpose of this pilot study was to determine whether a nutrition and physical activity intervention in an urban primary care office is feasible and effective in decreasing risk factors for type 2 diabetes in high-risk youth. METHODS: A one-group pretest/post-test design was used. Participants were recruited from existing patients in a primary care facility serving low-income children. Inclusion criteria included body mass index (BMI) over the 85th percentile for age and a fasting glucose-insulin ratio (FGIR) less than 6. Thirty-six African-American patients, 9 males, 27 females, average age 12.4 years (range, 8-18) participated in a 12-week nutrition and physical activity program. Measurements included fasting glucose, insulin, FGIR, lipid profile, blood pressure, and BMI. BMI and laboratory values were tested for significant differences before and after intervention using paired t-tests. A P-value of <.05 was considered statistically significant. RESULTS: On average, patients attended 8.3 of 24 physical activity sessions, 2 of 3 nutrition sessions and 1.5 of 3 planned clinical sessions. Twenty-six of 36 patients completed follow-up laboratory tests. Mean FGIR improved significantly from baseline (3.6 ± 1.2 to 4.6 ± 2.8; P = .043). CONCLUSIONS: A nutrition and physical activity intervention for overweight children can be conducted in an urban primary care setting and may decrease laboratory evidence of insulin resistance, a risk factor for type 2 diabetes. Making the program accessible by public transit and scheduling the sessions at convenient times were important factors.
AB - BACKGROUND: The incidence of type 2 diabetes in youth is increasing at an alarming rate. The purpose of this pilot study was to determine whether a nutrition and physical activity intervention in an urban primary care office is feasible and effective in decreasing risk factors for type 2 diabetes in high-risk youth. METHODS: A one-group pretest/post-test design was used. Participants were recruited from existing patients in a primary care facility serving low-income children. Inclusion criteria included body mass index (BMI) over the 85th percentile for age and a fasting glucose-insulin ratio (FGIR) less than 6. Thirty-six African-American patients, 9 males, 27 females, average age 12.4 years (range, 8-18) participated in a 12-week nutrition and physical activity program. Measurements included fasting glucose, insulin, FGIR, lipid profile, blood pressure, and BMI. BMI and laboratory values were tested for significant differences before and after intervention using paired t-tests. A P-value of <.05 was considered statistically significant. RESULTS: On average, patients attended 8.3 of 24 physical activity sessions, 2 of 3 nutrition sessions and 1.5 of 3 planned clinical sessions. Twenty-six of 36 patients completed follow-up laboratory tests. Mean FGIR improved significantly from baseline (3.6 ± 1.2 to 4.6 ± 2.8; P = .043). CONCLUSIONS: A nutrition and physical activity intervention for overweight children can be conducted in an urban primary care setting and may decrease laboratory evidence of insulin resistance, a risk factor for type 2 diabetes. Making the program accessible by public transit and scheduling the sessions at convenient times were important factors.
KW - Fasting glucose to insulin ratio (FGIR)
KW - Hyperinsulinemia
KW - Overweight adolescents
KW - Physical activity intervention
KW - Primary care based intervention
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U2 - 10.1097/00000441-200609000-00002
DO - 10.1097/00000441-200609000-00002
M3 - Article
C2 - 16969138
AN - SCOPUS:33748741174
SN - 0002-9629
VL - 332
SP - 108
EP - 111
JO - American Journal of the Medical Sciences
JF - American Journal of the Medical Sciences
IS - 3
ER -