Evaluation of a weight management intervention program in adolescents with insulin-dependent diabetes mellitus

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)