title: Buddy Study: Partners for better health in adolescents with type 2 diabetes.
abstract: OBJECTIVE
  To investigate whether assigning young, healthy and motivated lay volunteer partners ("buddies") to adolescents with type 2 diabetes improves hemoglobin A1c (HbA1c).
  
  
  METHODS
  Adolescents with type 2 diabetes were randomized to partnering with a "buddy" or to conventional treatment. During the initial screening visit, which coincided with a routine outpatient diabetes clinic visit, patients with type 2 diabetes underwent a physical examination, detailed medical history, laboratory measurement of HbA1c, and completed two questionnaires (Pediatric Quality of Life Inventory and Children's Depression Inventory) to assess their overall quality of life and the presence of depressive symptoms. Patients were then randomized to the intervention (the buddy system) or conventional treatment (standard care). All patients were scheduled to return for follow-up at 3- and 6-mo after their initial visit. HbA1c was determined at all visits (i.e., at screening and at the 3- and 6-mo follow-up visits) and quality of life and depressive symptoms were evaluated at the screening visit and were reassessed at the 6-mo visit.
  
  
  RESULTS
  Ten adolescents, recruited from a pool of approximately 200 adolescents, enrolled over a two-year time period, leading to premature termination of the study. In contrast, we easily recruited motivated lay volunteers. We found no change in HbA1c from the initial to the 6-mo visit in either group, yet our small sample size limited systematic assessment of this outcome. Participants repeatedly missed clinic appointments, failed to conduct self-glucose-monitoring and rarely brought their glucometers to clinic visits. Total quality of life scores (72.6 ± 6.06) at screening were similar to previously reported scores in adolescents with type 2 diabetes (75.7 ± 15.0) and lower than scores reported in normal-weight (81.2 ± 0.9), overweight (83.5 ± 1.8), and obese youths without diabetes (78.5 ± 1.8) or in adolescents with type 1 diabetes (80.5 ± 13.1). Among adolescents who returned for their 6-mo visit, there were no differences in total quality of life scores (70.2 ± 9.18) between screening and follow-up.
  
  
  CONCLUSIONS
  Our approach, effective in adults with type 2 diabetes, was unsuccessful among adolescents and emphasizes the need for innovative strategies for diabetes treatment in adolescent patients.
authors.affiliation: Allison C Sylvetsky, Radha Nandagopal, Tammy T Nguyen, Marisa R Abegg, Mahathi Nagarur, Kristina I Rother, Section on Pediatric Diabetes and Metabolism, NIDDK, National Institutes of Health, Bethesda, MD 20892, United States.
authors.forename: Allison C
authors.initials: AC
authors.lastname: Sylvetsky
authors.affiliation: Allison C Sylvetsky, Radha Nandagopal, Tammy T Nguyen, Marisa R Abegg, Mahathi Nagarur, Kristina I Rother, Section on Pediatric Diabetes and Metabolism, NIDDK, National Institutes of Health, Bethesda, MD 20892, United States.
authors.forename: Radha
authors.initials: R
authors.lastname: Nandagopal
authors.affiliation: Allison C Sylvetsky, Radha Nandagopal, Tammy T Nguyen, Marisa R Abegg, Mahathi Nagarur, Kristina I Rother, Section on Pediatric Diabetes and Metabolism, NIDDK, National Institutes of Health, Bethesda, MD 20892, United States.
authors.forename: Tammy T
authors.initials: TT
authors.lastname: Nguyen
authors.affiliation: Allison C Sylvetsky, Radha Nandagopal, Tammy T Nguyen, Marisa R Abegg, Mahathi Nagarur, Kristina I Rother, Section on Pediatric Diabetes and Metabolism, NIDDK, National Institutes of Health, Bethesda, MD 20892, United States.
authors.forename: Marisa R
authors.initials: MR
authors.lastname: Abegg
authors.affiliation: Allison C Sylvetsky, Radha Nandagopal, Tammy T Nguyen, Marisa R Abegg, Mahathi Nagarur, Kristina I Rother, Section on Pediatric Diabetes and Metabolism, NIDDK, National Institutes of Health, Bethesda, MD 20892, United States.
authors.forename: Mahathi
authors.initials: M
authors.lastname: Nagarur
authors.affiliation: Allison C Sylvetsky, Radha Nandagopal, Tammy T Nguyen, Marisa R Abegg, Mahathi Nagarur, Kristina I Rother, Section on Pediatric Diabetes and Metabolism, NIDDK, National Institutes of Health, Bethesda, MD 20892, United States.
authors.forename: Paul
authors.initials: P
authors.lastname: Kaplowitz
authors.affiliation: Allison C Sylvetsky, Radha Nandagopal, Tammy T Nguyen, Marisa R Abegg, Mahathi Nagarur, Kristina I Rother, Section on Pediatric Diabetes and Metabolism, NIDDK, National Institutes of Health, Bethesda, MD 20892, United States.
authors.forename: Kristina I
authors.initials: KI
authors.lastname: Rother
keywords: Adolescent; Diabetes mellitus type 2; Hemoglobin A1c; Quality of life; Social support