TODAY Helps Teen Look Forward to Prom

Teresa Witten, MS-MPH, RD, Bocanegra's
physical activity leader, meets with her
once every other week to discuss
diabetes-specific weight loss information
and provide guidance and support.

Jessica Bocanegra has the “perfect” black-and-white prom dress. Now her goal is to be able to fit into the dress. 

Bocanegra, 17, is a participant in the TODAY study (Treatment Options for Type 2 Diabetes in Adolescents and Youth). The Children’s Hospital, Denver , is one of 15 sites participating in the nationwide study that is being funded by the National Institutes of Health to study treatment of type 2 diabetes in children and adolescents. The study plans to enroll a total of 750 participants, and follow them for at least two years.

“Type 2 diabetes was almost unheard of in children until the early 1980s, when it began to increase, going from 2 percent of all new cases of diabetes in the pediatric population, to about 15 percent now; and it is about 40 percent of all new adolescent cases of diabetes,” said Philip Zeitler, MD, PhD, pediatric endocrinologist at Children’s and associate professor of pediatrics at the University of Colorado Denver. “It is increasing with increasing obesity and decreasing routine activity in the adolescent population."

The TODAY study is the first to examine the treatment of type 2 diabetes in adolescents.

“All current management is based on extrapolation of adult studies,” Dr. Zeitler said. “Therefore, this will provide the first large-scale clinical trial data regarding effective treatments. We will also obtain a lot of information about the natural history of diabetes, and complications of diabetes, such as hypertension and lipid abnormalities. We're also learning a lot about how to work with these kids and their families to promote lifestyle change.”

To be eligible for the study, patients must meet a number of criteria, including: confirmed diagnosis of type 2 diabetes less than two years ago; body mass index above the 85th percentile; 10 to 17 years of age; and have an adult caregiver who agrees to participate with the child.

All study participants take metformin, the only oral medication that is approved for the treatment of type 2 diabetes in youth and adolescents; it decreases the amount of sugar made by the liver. Participants are randomized into one of three type 2 diabetes treatment plans: metformin alone; metformin plus rosiglitazone, a medication currently used to treat type 2 diabetes in adults; metformin plus an intensive lifestyle intervention called the TODAY Lifestyle Program (TLP).

Jessica started the TODAY program in July 2007, and was pleased to be assigned to the metformin plus TLP treatment.

Teresa Witten, MS-MPH, RD, is a TODAY team member, and is Jessica’s physical activity leader (PAL); she provides diabetes-specific weight loss information, guidance and support. They started out meeting once a week for six months; now they meet once every other week, with an off-week phone call. Jessica’s mom, Brenda, and brother, Mario, attend each meeting with Jessica.

Witten has taught Jessica and her family many ways to make healthier food and activity choices, including pre-planning before going to a restaurant; going grocery shopping together to find healthy food options; and going on walks together while using a pedometer.

“I think she’s amazing,” Witten said. “I’m excited to meet with her each week. She’s so motivated. I just gave her the tools.”

With prom just around the corner, her goal of fitting into her dress is within reach: Jessica has lost 40 pounds in the seven months since she started the study. She is sharing what she’s learned with other friends and family members, and is helping them to lose weight.

“It’s so wonderful,” she said. “It’s made me look at life differently.”

For more information on TODAY, (720) 777-3212.