title: Parental Characteristics Associated With Outcomes in Youth With Type 2 Diabetes: Results From the TODAY Clinical Trial.
abstract: OBJECTIVE
  This study examined parental factors associated with outcomes of youth in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) clinical trial.
  
  
  METHODS
  Of 699 youth with type 2 diabetes in the TODAY cohort, 623 (89.1%) had a parent participate and provide data at baseline, including weight, HbA1c, blood pressure, symptoms of depression, binge eating (BE), and medical history. Youth were followed 2-6.5 years. Data were analyzed using regression models and survival curve methods.
  
  
  RESULTS
  Parental diabetes (43.6% of parents) was associated with higher baseline HbA1c (P < 0.0001) and failure of youths to maintain glycemic control on study treatment (53.6% vs. 38.2% failure rate among those without a diabetic parent, P = 0.0002). Parental hypertension (40.6% of parents) was associated with hypertension in youth during TODAY (40.4% vs. 27.4% of youth with and without parental hypertension had hypertension, P = 0.0008) and with higher youth baseline BMI z scores (P = 0.0038). Parents had a mean baseline BMI of 33.6 kg/m(2). Parental obesity (BMI >30 kg/m(2)) was associated with higher baseline BMI z scores in the youth (P < 0.0001). Depressive symptoms in parents (20.6% of parents) were related to youth depressive symptoms at baseline only (P = 0.0430); subclinical BE in parents was related to the presence of subclinical BE (P = 0.0354) and depressive symptoms (P = 0.0326) in youth throughout the study period.
  
  
  CONCLUSIONS
  Parental diabetes and hypertension were associated with lack of glycemic control, hypertension, and higher BMI z scores in youth. Further research is needed to better understand and address parental biological and behavioral factors to improve youth health outcomes.
authors.affiliation: State University of New York Upstate Medical University, Syracuse, NY.
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Weinstock
authors.affiliation: State University of New York Upstate Medical University, Syracuse, NY.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Trief
authors.affiliation: George Washington University Biostatistics Center, Rockville, MD elghorml@bsc.gwu.edu.
authors.forename: Laure
authors.initials: L
authors.lastname: El Ghormli
authors.affiliation: Columbia University, New York, NY.
authors.forename: Robin
authors.initials: R
authors.lastname: Goland
authors.affiliation: Baylor College of Medicine, Houston, TX.
authors.forename: Siripoom
authors.initials: S
authors.lastname: McKay
authors.affiliation: Joslin Diabetes Center, Boston, MA.
authors.forename: Kerry
authors.initials: K
authors.lastname: Milaszewski
authors.affiliation: University of Oklahoma Health Sciences Center, Oklahoma City, OK.
authors.forename: Jeff
authors.initials: J
authors.lastname: Preske
authors.affiliation: Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: Steven
authors.initials: S
authors.lastname: Willi
authors.affiliation: Children's Hospital Los Angeles and Keck School of Medicine at the University of Southern California, Los Angeles, CA.
authors.forename: Patrice M
authors.initials: PM
authors.lastname: Yasuda
mesh_terms: D000293:Adolescent; D000328:Adult; D056912:Binge-Eating Disorder / Q000150:complications; D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight; D003863:Depression / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000150:complications; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D009765:Obesity / Q000150:complications; D010290:Parents; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents