Lifestyle-Related Health Outcomes in Prediabetes and Diabetes

This study aims to do the following:

1. To evaluate whether a health education and coaching strategy in overweight and obese
adolescents (≥85th percentile) with high risk for type 2 diabetes is superior to usual
care (single nutrition consultation) for weight management, clinical health outcomes
(measures of glucose tolerance), lifestyle behavior outcomes (diet and physical
activity) and outcomes of importance to patients such as satisfaction with the health
care team, treatment goals, and psychosocial functioning.

2. To evaluate whether a health education and coaching strategy in obese adolescents with
diabetes (type 1 or type 2) is superior to usual care (single nutrition consultation)
for weight management, clinical health outcomes (measures of diabetes control),
lifestyle behavior outcomes (diet and physical activity) and outcomes of importance to
patients such as satisfaction with the health care team, treatment goals, and
psychosocial functioning.

3. At baseline, before the interventions described in Aims 1 and 2, to identify key diet
and physical activity factors, patient characteristics, or biomarkers which are
predictive of diabetes risk.

4. At baseline, before the interventions described in Aims 1 and 2, can associations
between glycemia, cardiometabolic risk factors, and diet and physical activity behaviors
in overweight and obese adolescents who are at risk for type 2 diabetes be identified
using the Bright Futures questionnaire, a survey for lifestyle behavior which is
normally used in the clinic setting.

Inclusion Criteria:

1. male and female adolescents/young adults,

2. age 10-21,

3. Tanner stage II-V,

4. overweight or obese (body mass index ≥85th percentile for age and sex).

Exclusion Criteria:

1. pregnancy,

2. use of medications that adversely affect glucose metabolism (such as
glucocorticoid-containing medications or atypical antipsychotics), and

3. syndromic obesity (such as Prader Willi, hypothalamic obesity, or Laurence-
Moon-Biedl).