期刊
PEDIATRIC OBESITY
卷 12, 期 4, 页码 337-345出版社
WILEY
DOI: 10.1111/ijpo.12148
关键词
type 2 diabetes; lifestyle; cardiometabolic risk; behavioral weight control
类别
资金
- National Institute of Diabetes and Digestive and Kidney Diseases/National Institutes of Health [U01-DK-061212, U01-DK-061230, U01-DK061239, U01-DK-061242, U01-DK-061254]
- National Center for Research Resources General Clinical Research Centers Program [M01-RR-000036, M01-RR-000043-45, M01-RR-000069, M01-RR-000084, M01-RR-001066, M01RR- 000125, M01-RR-014467]
- National Center for Research Resources Clinical and Translational Science Awards [UL1-RR-024134, UL1-RR-024139, UL1-RR-024153, UL1-RR-024989, UL1-RR-024992, UL1-RR-025758, UL1-RR-025780]
Background: The Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) clinical trial documented that metformin plus rosiglitazone, but not metformin plus lifestyle intervention, provided superior durability of glycemic control relative to metformin monotherapy. Objectives: We examined weight changes among TODAY participants that completed at least 6 months of treatment, evaluated predictors of lifestyle outcome, and examined whether weight changes were related to cardiometabolic outcomes across treatment arms. Methods: The 595 youth with type 2 diabetes, (85.1% of randomized participants aged 11-17 years) completed assessments of weight-related and cardiometabolic measures at months 0, 6, 12 and 24. Repeated measures models were used to investigate associations over time. Results: Lifestyle intervention did not enhance outcome relative to metformin alone and no predictors of response to lifestyle treatment were identified. However, changes in percent overweight across treatment arms were associated with changes in multiple cardiometabolic risk factors, and decreases of >= 7% in overweight were associated with significant benefits over 24 months. Conclusions: Although adjunctive intensive lifestyle intervention did not improve weight-related outcomes, weight changes in the full TODAY sample were associated with small, but significant improvements in cardiometabolic status, highlighting the importance of optimizing weight management in youth with T2DM.
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