Type 2 Diabetes in High-risk Youth: Improving Identification and Interventions in Community Health with a Decade of Quality Improvement Efforts.

Introduction: This manuscript describes quality improvement interventions with aims (1) to increase identification and follow-up testing of youth with prediabetes and type 2 diabetes (T2D) and (2) to improve outcomes for youth with prediabetes and low-range T2D (HbA1c 6.5-6.9%).

Quality improvement efforts in a safety net institution: Increased diabetes screening is associated with lower HbA1c at diagnosis and improved HbA1c outcomes in youth with type 2 diabetes.

Objectives: Evaluate whether increased diabetes screening in youth is associated with lower HbA1c at T2D diagnosis and improved HbA1c outcomes in youth.

Research Design And Methods: Diabetes screening rates from 2009 to 2018 were calculated. Electronic medical records identified obese youth ages 8-18 with first HbA1c ≥6.

Weight Gain Patterns in Adolescent and Young Adult Women With the Etonogestrel Implant: Comparison by Weight Category.

Purpose: The purpose of this study was to determine if initiation and use of the etonogestrel implant was associated with differential weight gain in patients who were overweight or obese compared with normal-weight patients.

Methods: This is a cohort study of 1,024 patients between ages of 13 and 25 years seen in a Title X clinic who received the etonogestrel implant from 2007 to 2019 and had weight measurements at implant insertion and 6-18 months before (preinsertion) and after insertion (postinsertion).

Results: Patients, regardless of weight category (normal weight, overweight, and obese), increased weight in kilograms (kg) from preinsertion to insertion (1.

Longitudinal follow up of dysglycemia in overweight and obese pediatric patients.

Objective: To examine factors related to progression of dysglycemia in overweight and obese youth in a large primary care setting.

Research Design And Methods: 10- to 18-year-old youth with body mass index (BMI) > 85 percentile and first-time A1c 5.7%-7.

School-based health center-based treatment for obese adolescents: feasibility and body mass index effects.

Background: School-based health centers (SBHCs) may be an ideal setting to address obesity in adolescents because they provide increased access to a traditionally difficult-to-reach population. The study evaluated the feasibility of adding a health educator (HE) to SBHC teams to provide support and increase the delivery of preventive services for overweight or obese adolescents.

Methods: Adolescents with BMI ≥85% recruited from two SBHCs were randomized to a control group (CG) or an intervention group (IG).

An approach to obesity management in primary care: yes, we can make a difference.

Obesity is a problem encountered in primary care on a daily basis. The author reviews the literature in the area of adolescent obesity and discusses an approach to managing obesity in the office, including screening for comorbidities and motivating teenagers to make lifestyle changes. Medications used for the treatment of comorbidities are reviewed also.

Treatment of non-alcoholic fatty liver disease with metformin versus lifestyle intervention in insulin-resistant adolescents.

The presence of fatty liver per ultrasound and liver-associated enzymes were measured in a select cohort of youth with both obesity and insulin resistance, and the effect of metformin on these parameters evaluated. Fifty obese, multiethnic, insulin-resistant adolescents (mean age 15.1 yr, mean body mass index 39.

Addition of metformin to a lifestyle modification program in adolescents with insulin resistance.

Objective: To evaluate whether metformin, when added to a program of personal goal setting, improves weight loss and clinical status in obese adolescents.

Study Design: In a randomized double-blind placebo controlled trial, 85 adolescents with insulin resistance were randomized to receive metformin (70%) or placebo (30%), along with monthly goal setting for diet and exercise modification. Anthropometric measures, fasting blood analysis, and glucose tolerance tests were performed at baseline and 6 months.

Presence of the metabolic syndrome in obese adolescents predicts impaired glucose tolerance and nonalcoholic fatty liver disease.

Purpose: To evaluate whether the presence of metabolic syndrome (MS) in obese adolescents is associated with other comorbidities of obesity

Methods: A total of 85 obese teens (70% female and 30% male) with fasting insulin >25 microU/ml and family history of type 2 diabetes mellitus and/or acanthosis nigricans were studied. Mean age was 15.8 +/- 1.

Elevated fasting triglycerides predict impaired glucose tolerance in adolescents at risk for type 2 diabetes.

Objective: The aim of this study was to evaluate whether fasting laboratory values can predict impaired glucose tolerance (IGT) in adolescents who are at risk for developing type 2 diabetes mellitus (T2DM).

Hypothesis: Elevated fasting triglycerides, a marker for worsening insulin resistance, predict risk for IGT.

Design: Following a fast of at least 9 h, laboratory measures, body mass index (BMI), and demographic information were obtained.