(P28-031-23) The Effects of Health Coaching on Glycemic Management and Dietary Intake Among Adolescents With Prediabetes

Objectives: Early development of type 2 diabetes (T2D) in adolescents represents a critical public health issue, as disease complications emerge more rapidly for youth with T2D than their adult counterparts. Studies of prevention interventions are important to determine how to delay comorbid conditions associated with insulin resistance, including hyperglycemia, and to reduce morbidity and mortality from T2D. In this study, we assessed the effectiveness of health coaching – tailored programming to encourage dietary and physical activity behaviors – to improve glycemia in adolescents with overweight/obesity and prediabetes.

Methods: Prediabetes was established by 2-hour oral glucose tolerance test (OGTT). Eligible participants (n = 19, ages 10-17, 36.8% female) were randomized to receive from a clinical dietitian either personalized health coaching for 6 months or a single dietary consultation, the current model-of-care in many healthcare centers. Anthropometric, dietary, and metabolic data were collected at baseline, after 6 months treatment, and at 12 months to evaluate treatment durability. To assess longitudinal changes in glycated hemoglobin (HbA1c), we employed a generalized estimating equation regression model with an autoregressive covariance structure.

Results: Baseline HbA1c values did not differ between the health coaching (5.62%) and standard-of-care (5.65%) groups (Welch’s t = 0.2, P = 0.90). After adjusting for age, biological sex, race, and body-mass index (BMI), the mean HbA1c of participants in the health coaching group significantly decreased compared to those receiving a single dietary consultation (β = -0.03, SE = 0.01, P = 0.004). Post-hoc multiple comparisons indicated that the health coaching group exhibited lower HbA1c levels compared to dietary consult at 12 months (z = -3.23, P < 0.01).

Conclusions: Health coaching was associated with reduced HbA1c during the 6-month intervention, with superior treatment durability at 12 months compared with standard-of-care. Health coaching represents an effective and durable treatment option for adolescents with prediabetes.

Funding Sources: Indiana Clinical and Translational Sciences Institute, McKinley Education Foundation, Showalter Research Trust