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‘Insulin Superheroes’ program reduces HbA1c in children

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March 28, 2017

Children participating in a youth diabetes prevention program saw a reduction in HbA1c and other cardiometabolic parameters after 16 weeks of intensive lifestyle intervention, according to findings from a prospective pilot study.

“Culturally tailored and comprehensive prevention strategies are vital for addressing the epidemic of obesity and rising rates of type 2 diabetes, particularly among ethnic and racial minority youth,” Chantis Mantilla, PhD, assistant professor of pediatrics at the University of Tennessee Health Science Center in Memphis, and colleagues wrote. “The Diabetes Prevention Program (DPP) has demonstrated the efficacy of lifestyle modification in adults. However, studies on lifestyle programs for diabetes prevention in youth are limited, and none have reported comprehensive physical fitness outcomes.”

Mantilla and colleagues analyzed data from 33 children aged 7 to 15 years and a parent with impaired glucose tolerance enrolled in the Insulin Superheroes Club curriculum, a DPP designed for youths from culturally diverse, minority backgrounds (mean age, 11 years; 58% girls; 88% Hispanic; 25% with overweight; 39% with obesity). Over 12 months, participants attended 16 weekly sessions, followed by three biweekly sessions and six monthly sessions, all of which included 60 minutes of physical fitness and 30 minutes of education. The education portion included interactive teaching on nutrition, exercise, physiology, mindfulness and stress reduction, using cooking, crafts, games and role play. The physical fitness component included moderate-intensity exercises, such as pushups, yoga, basketball, tag and dancing. Researchers measured HbA1c, nonfasting lipid profile, blood pressure, body weight and physical fitness (walk test, handgrip strength, sit-and-reach and shuttle run) at baseline and 16 weeks.

At 16 weeks, mean HbA1c fell from a mean of 5.8% to 5.3% (P < .0017); BMI z score moderately improved from 1.23 to 1.13 (P < .003) and percent body fat decreased from 32.8% to 31.6% (P < .008). Diastolic BP also improved slightly (68 mm Hg to 64 mm Hg; P < .01), and physical fitness parameters showed slight improvements.

The percentage of children with an HbA1c less than 5.7% decreased from 61% to 15% during the program (P < .0001), according to the researchers.

“After 16 weeks of the phase 1 component of the [Insulin Superheroes Club], participants displayed significantly improved metabolic and physical fitness parameters,” the researchers wrote. “These beneficial outcomes suggest that a family-based program that involves lifestyle education, behavior modification and goal-driven exercise can be effective in a predominantly Latino, socioeconomically disadvantaged population.”

Researchers plan to conduct a 12-month follow-up study. – by Regina Schaffer

Disclosure: The Memphis Research Consortium and the Le Bonheur Children’s Foundation Research Institute funded this study. One of the researchers reports receiving an unrestricted research grant from Rhythm Pharmaceuticals.