The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61870

Nancy E Fritz, MD¹, Christiane E. Stahl, MD², Nike Mourikes, MD¹, Shonta L. Corbin, BA¹, and Mary Driscoll, RN, MPH³. (1) Pediatrics/Adolescent Medicine, Cook County ACHN, 1900 w Polk Street, Rm 1114, Chicago, IL 60612, 312-572-4954, teendrnan@excite.com, (2) Department of Pediatrics, University of Illinois at Chicago, 840 S. Wood St., M/C 856, Chicago, IL 60612, (3) Cook County Ambulatory Health Network, Hektoen, 1835 W Harrison Street, Suite 2204, Chicag, IL 60612

Background: As the incidence of obesity and type 2 diabetes (DM) increases in adolescents, timely identification of a “pre-diabetic” stage in at-risk youth could create the opportunity for a focused intervention. Behavior change interventions have been successful in delaying or preventing the onset of DM in adults, but it is not clear whether they can reverse unhealthy eating and physical activity patterns in youth. Methods: To investigate the feasibility of identifying and intervening with “pre-diabetic” youth, students with at least 2 (ADA defined) risk factors for DM enrolled in a project conducted in 3 school based health centers (SBHCs), serving African-American or Mexican American students. Initial questionnaires on eating, exercise, and self-esteem were included, as well as labs for fasting insulin, lipids, glucose, and HbA1c. Regular appointments based on a standardized curriculum and stages-of-change motivational interviewing were then supplemented with weekly support/activity groups. Results: The program has enrolled 75 students who have the following risk factors: 91% obesity, 35% acanthosis nigricans, 85% family history DM, 10% menstrual disorders. Lab results for 52 students revealed 40% had elevated cholesterol, 27% elevated insulin levels; 3 students were diagnosed with DM, and 2 had borderline glucose results. Most students, some morbidly overweight, enrolled hoping to lose weight. Students and families who completed questionnaires displayed an array of nutritional misunderstandings and unhealthy life styles. Conclusions: A SBHC behavioral intervention program can identify and involve students at risk for developing DM. Screening high risk students can identify previously unsuspected adolescent diabetics.

Learning Objectives:

At the conclusion of this session, participants should:
• recognize the nutritional challenges faced by teens;
• understand the concept of “pre-diabetes” syndrome and its implications for adolescents; and
• understand the concept of motivational interviewing in behavior change and its application in this sample of teens.

Keywords: Adolescent Health, Diabetes

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.