The ENCOURAGE healthy families study: A comparative effectiveness trial to reduce risk for type 2 diabetes in mothers and children

Abstract

Introduction: Trials in adults have demonstrated that interventions targeting lifestyle are effective in preventing or delaying type 2 diabetes (T2D). To address this need in youth, we developed ENCOURAGE Healthy Families (ENCOURAGE), based on the US Diabetes Prevention Program (DPP).

Study design: Here, we present results of the ENCOURAGE randomized, comparative effectiveness trial in which we evaluated ENCOURAGE delivered to (1) mothers only, and (2) mothers with added content delivered to their children.

Participants: The study was performed in Indianapolis, IN, at an academic medical center and the YMCA; December 2012 to April 2016. Women with a history of gestational diabetes mellitus (GDM) or prediabetes with children aged 8 to 15 years enrolled (n = 128).

Outcome measures: Outcomes were collected at baseline, postintervention (3 months), 6 and 12 months. The primary outcome was weight change at 3 months in adults; secondary outcomes included glycosylated hemoglobin (HbA1c), lipids, and blood pressure.

Results: In neither program did mothers' weight change. HbA1c decreased at 3 months in both groups (mothers only=-0.09%, P = .019; mothers and children=-0.11%, P = .003). Participating children had a reduction in body mass index (BMI) percentile at 3 (-1.77, P = .014), 6 (-3.0, P = .002), and 12 months (-2.91, P = .004). HbA1c decreased in children in both groups (mothers only = -0.12% at 3 months [P < .0001], -0.13% at 6 months [P < .001], and -0.07% at 12 months [P = .001]; mothers and children = -0.08% at 3 months (P < .0001), -0.07% at 6 months (P = .0004), and -0.04% at 12 months (P = .03).

Conclusion: ENCOURAGE was beneficial for reducing BMI percentile in participating children.

Keywords: obesity; pediatric; prediabetes; prevention; weight.