title: Evaluation of a weight management intervention program in adolescents with insulin-dependent diabetes mellitus.
abstract: This study evaluated the effectiveness of a family-based, multidisciplinary, behavior-modification program (SHAPEDOWN) adapted for obese adolescents with insulin-dependent diabetes mellitus (IDDM), a unique and understudied population. Eleven test subjects participated in the SHAPEDOWN program, and 9 comparison subjects received standard nutrition care for subjects with IDDM. Mean age of the experimental and control subjects was 13.9 and 15.2 years, respectively, and the two groups were 121% and 126% overweight, respectively. The program comprised 14 weekly sessions in which subject and parents participated in separate groups taught by a dietitian, a psychologist, and a child health associate. Data were collected at baseline, at 3 months, and at 15 months. Compared with standard treatment, the intervention significantly increased body image. Self-esteem improved clinically in four subjects in the experimental group but in only one subject in the standard treatment group. Change in percent overweight at 15 months was -3% for the experimental group and +0.9% for the standard treatment group; however, the difference was not statistically significant. This mean loss in percent overweight of subjects is comparable with that reported in a nondiabetic group in which age and percent overweight were similar. The change in percent overweight from baseline to 15 months in the two groups combined shows a positive correlation with triceps skinfold thickness and a negative correlation with obesity-related behavior. Changes in glycated hemoglobin were not significantly different. We conclude that this program proved effective in improving body image and self-esteem in obese adolescents with IDDM.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Denver 80262.
authors.forename: D A
authors.initials: DA
authors.lastname: Thomas-Dobersen
authors.forename: N
authors.initials: N
authors.lastname: Butler-Simon
authors.forename: M
authors.initials: M
authors.lastname: Fleshner
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D000704:Analysis of Variance; D000886:Anthropometry; D001521:Behavior Therapy; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000178:diet therapy*; D004435:Eating; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D009765:Obesity / Q000178:diet therapy*; D015397:Program Evaluation; D015431:Weight Loss
chemical_list: D006442:Glycated Hemoglobin; D007328:Insulin