The objective of this project is to determine the feasibility of introducing CGMs to adolescent patients with obesity and pre-diabetes (Hemoglobin A1C: HbA1C between 5.7-6.5%) to determine whether their eating habits and subsequent glucose profiles are modified by the timely awareness of glucose excursions above the diabetes threshold of 200 mg/dl.
Inclusion Criteria:
Children aged 13-17 years.
BMI ≥ 95 percentile
BMI >85th and BMI < 95th percentile for age and sex (CDC growth charts) if the risk factors below are present: Family history of type 2 diabetes in first or second degree relative:
Receiving care through HCN for pediatric or family medicine clinics.
No structured nutritional intervention in the past 3 months.
Parent/guardian able to provide informed consent and child able to assent.
Family has access to a smartphone or is willing to use a study-provided device for CGM viewing and communication.
Willingness to comply with study visits, CGM wear, and laboratory testing.
Exclusion Criteria:
An individual who meets any of the following criteria will be excluded from participation:
Diabetes by history or HbA1c ≥ 6.5 % in the medical record or at screening.
Unable or unwilling to provide consent or participate fully in study activities.
Conditions predisposing to diabetes or altering normal pubertal development.
Current or planned use of medications affecting glucose dynamics, including:
o Insulin, glucagon-like peptide-1 (GLP-1) receptor agonists, metformin, or other glucose-lowering or weight-loss medications within 6 weeks prior to enrollment or planned during the study period.
Known syndromic or monogenic obesity.
Blood disorders that impact HbA1c interpretation (e.g., anemia, and hemoglobin variants).
Major systemic organ disease (renal, hepatic, or cardiac).
History or planned bariatric surgery.
Current pregnancy or plans for pregnancy during the study.
Use or planned use of GnRH agonists, estrogen, or testosterone.
Non-English- or non-Spanish-speaking individuals, as validated questionnaires are available only in these languages.
angelina@ufl.edu508-558-0475
Use of a continuous glucose monitor where the patient can see all of their blood glucose data
Standard of care treatment with no CGM use
sanzalone@healthcareswfl.org610-587-1010
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