Background: Latino youth are disproportionately impacted by type 2 diabetes (T2D) and youth onset T2D is more aggressive and resistant to conventional treatment. Early prevention efforts are warranted for high-risk pediatric populations, but little is known about the long-term effects of such interventions. The purpose of this study was to examine health trajectories following a diabetes prevention program for Latino adolescents with obesity who are now young adults.

Methods: Participants (N=61) completed a 3-month lifestyle intervention as adolescents (Mage = 15.4) and were re-contacted ~5 years post-intervention (Mage = 20.7 years). Measures included BMI and the Matsuda Index to estimate insulin sensitivity. Latent profile analysis was used to examine heterogeneity in changes in insulin sensitivity over time.

Results: Participants exhibited significant reductions in BMI post-intervention (from 34.8±4.7 to 34.1±4.7, p <.001); however, BMI increased at 5-year follow up (40.5±8.4, p <.001). Similarly, insulin sensitivity increased by 23.5% post-intervention (from 1.7±1.0 to 2.1±1.0, p <.001) but returned to baseline levels at 5-years (1.8±1.4). Latent profile analysis identified two distinct trajectories in insulin sensitivity. Profile 1 was characterized by lower baseline insulin sensitivity (1.4 [1.2, 1.7]) followed by a 36% increase post-intervention (1.9 [1.6, 2.2]) that remained above baseline at 5 years (1.7 [1.3, 2.1]). Profile 2 exhibited a 31% increase from baseline insulin sensitivity (2.9 [1.6, 4.2]) after the intervention (3.8 [2.8, 4.8]) that fell below baseline at 5 years (2.7 [0.6-4.8]) Female sex significantly differentiated the trajectories and was associated with profile 1.

Discussion: Despite improvements in diabetes-related health immediately following the intervention, weight gain and decreased insulin sensitivity persisted into young adulthood. The unique profiles suggest that there may be specific factors such as sex that can differentiate health trajectories over time.


M.Braxton: None. J.Jager: None. S.Ayers: None. M.Olson: Advisory Panel; Rhythm Pharmaceuticals, Inc. G.Q.Shaibi: None.


National Institute on Minority Health and Health Disparities (U54MD002316)

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