TY - JOUR
T1 - Weight change in the management of youth-onset type 2 diabetes
T2 - the TODAY clinical trial experience
AU - For the TODAY Study Group
AU - Marcus, M. D.
AU - Wilfley, D. E.
AU - El ghormli, L.
AU - Zeitler, P.
AU - Linder, B.
AU - Hirst, K.
AU - Ievers-Landis, C. E.
AU - van Buren, D. J.
AU - Walders-Abramson, N.
N1 - Funding Information:
The TODAY Study Group gratefully acknowledges the participation and guidance of the American Indian partners associated with the clinical center located at the University of Oklahoma Health Sciences Center, including members of the Absentee Shawnee Tribe, Cherokee Nation, Chickasaw Nation, Choctaw Nation of Oklahoma and Oklahoma City Area Indian Health Service. The opinions expressed in this paper are those of the authors and do not necessarily reflect the views of the respective Tribal and Indian Health Service Institution Review Boards or their members. Materials developed and used for the TODAY standard diabetes education program and the intensive lifestyle intervention program are available to the public at https://today.bsc.gwu.edu/.
Publisher Copyright:
© 2016 World Obesity Federation
PY - 2017/8
Y1 - 2017/8
N2 - 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.
AB - 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.
KW - behavioral weight control
KW - cardiometabolic risk
KW - lifestyle
KW - type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=84968690706&partnerID=8YFLogxK
U2 - 10.1111/ijpo.12148
DO - 10.1111/ijpo.12148
M3 - Article
C2 - 27161901
AN - SCOPUS:84968690706
SN - 2047-6302
VL - 12
SP - 337
EP - 345
JO - Pediatric Obesity
JF - Pediatric Obesity
IS - 4
ER -