Prediabetes: Adherence to Nutrition Visits Decreases HbA1c in Children and Adolescents
BackgroundPrediabetes, the precursor of type 2 diabetes (T2D), is on the rise in the US, but the determinants of its progression are poorly characterized in youth.ObjectiveTo determine the impact of nutrition visits, as a surrogate marker of lifestyle modification, on the trajectory of prediabetes o...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.916785/full |
| _version_ | 1818251356861890560 |
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| author | Sadichchha Parajuli Gabrielle Jasmin Hannan Sirak Austin F. Lee Benjamin Udoka Nwosu Benjamin Udoka Nwosu |
| author_facet | Sadichchha Parajuli Gabrielle Jasmin Hannan Sirak Austin F. Lee Benjamin Udoka Nwosu Benjamin Udoka Nwosu |
| author_sort | Sadichchha Parajuli |
| collection | DOAJ |
| description | BackgroundPrediabetes, the precursor of type 2 diabetes (T2D), is on the rise in the US, but the determinants of its progression are poorly characterized in youth.ObjectiveTo determine the impact of nutrition visits, as a surrogate marker of lifestyle modification, on the trajectory of prediabetes over a 4-year period.HypothesisAdherence to nutrition visits could reduce BMI and lower HbA1c.MethodsA 4-year retrospective study of 108 youth with prediabetes who were recommended to receive medical nutrition therapy every 3 months following their diagnosis. Subjects were divided into 2 groups: the non-adherent group who had ≤1 nutrition visit/year, and the adherent group with ≥2 nutrition visits/year.ResultsThere were 46 male subjects, mean age 12.4 ± 3.6y; and 62 female subjects, mean age, 13.3 ± 3.0y, p=0.2. The adherent group (n=44, 41.5%) had higher BMI z-scores, but similar values for HbA1c, metformin use, and racial/ethnic composition compared to the non-adherent group. Overall, 18(17.0%) subjects progressed to T2D in 4y and consisted of 14(22.6%) of the 62 non-adherent subjects and 4(9.1%) of the 44 adherent subjects. The non-adherent subjects progressed to T2D at a mean duration of 25.8 ± 12.6 months while the adherent subjects progressed at a mean duration of 34.9 ± 11.8 months. The hazard ratio of progression from prediabetes to T2D for the non-adherent versus adherent group was 3.88 (95%CI 1.26-11.98, p=0.02). The results remained significant after adjusting for age, sex, race/ethnicity, BMI, and metformin use.ConclusionAdherence to nutrition visits was associated with a 4-fold reduction in the likelihood to progress from prediabetes to T2D in US youth. |
| first_indexed | 2024-12-12T16:06:59Z |
| format | Article |
| id | doaj.art-007404457850499dbda20479a254417a |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-12T16:06:59Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-007404457850499dbda20479a254417a2022-12-22T00:19:17ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-06-011310.3389/fendo.2022.916785916785Prediabetes: Adherence to Nutrition Visits Decreases HbA1c in Children and AdolescentsSadichchha Parajuli0Gabrielle Jasmin1Hannan Sirak2Austin F. Lee3Benjamin Udoka Nwosu4Benjamin Udoka Nwosu5Division of Pediatric Endocrinology, Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, United StatesDivision of Pediatric Endocrinology, Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, United StatesDivision of Pediatric Endocrinology, Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, United StatesDepartment of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United StatesDivision of Pediatric Endocrinology, Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, United StatesDivision of Pediatric Endocrinology, Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, United StatesBackgroundPrediabetes, the precursor of type 2 diabetes (T2D), is on the rise in the US, but the determinants of its progression are poorly characterized in youth.ObjectiveTo determine the impact of nutrition visits, as a surrogate marker of lifestyle modification, on the trajectory of prediabetes over a 4-year period.HypothesisAdherence to nutrition visits could reduce BMI and lower HbA1c.MethodsA 4-year retrospective study of 108 youth with prediabetes who were recommended to receive medical nutrition therapy every 3 months following their diagnosis. Subjects were divided into 2 groups: the non-adherent group who had ≤1 nutrition visit/year, and the adherent group with ≥2 nutrition visits/year.ResultsThere were 46 male subjects, mean age 12.4 ± 3.6y; and 62 female subjects, mean age, 13.3 ± 3.0y, p=0.2. The adherent group (n=44, 41.5%) had higher BMI z-scores, but similar values for HbA1c, metformin use, and racial/ethnic composition compared to the non-adherent group. Overall, 18(17.0%) subjects progressed to T2D in 4y and consisted of 14(22.6%) of the 62 non-adherent subjects and 4(9.1%) of the 44 adherent subjects. The non-adherent subjects progressed to T2D at a mean duration of 25.8 ± 12.6 months while the adherent subjects progressed at a mean duration of 34.9 ± 11.8 months. The hazard ratio of progression from prediabetes to T2D for the non-adherent versus adherent group was 3.88 (95%CI 1.26-11.98, p=0.02). The results remained significant after adjusting for age, sex, race/ethnicity, BMI, and metformin use.ConclusionAdherence to nutrition visits was associated with a 4-fold reduction in the likelihood to progress from prediabetes to T2D in US youth.https://www.frontiersin.org/articles/10.3389/fendo.2022.916785/fullprediabetestype 2 diabetesobesitychildrenmedical nutrition therapy |
| spellingShingle | Sadichchha Parajuli Gabrielle Jasmin Hannan Sirak Austin F. Lee Benjamin Udoka Nwosu Benjamin Udoka Nwosu Prediabetes: Adherence to Nutrition Visits Decreases HbA1c in Children and Adolescents Frontiers in Endocrinology prediabetes type 2 diabetes obesity children medical nutrition therapy |
| title | Prediabetes: Adherence to Nutrition Visits Decreases HbA1c in Children and Adolescents |
| title_full | Prediabetes: Adherence to Nutrition Visits Decreases HbA1c in Children and Adolescents |
| title_fullStr | Prediabetes: Adherence to Nutrition Visits Decreases HbA1c in Children and Adolescents |
| title_full_unstemmed | Prediabetes: Adherence to Nutrition Visits Decreases HbA1c in Children and Adolescents |
| title_short | Prediabetes: Adherence to Nutrition Visits Decreases HbA1c in Children and Adolescents |
| title_sort | prediabetes adherence to nutrition visits decreases hba1c in children and adolescents |
| topic | prediabetes type 2 diabetes obesity children medical nutrition therapy |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.916785/full |
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