Objectives To characterize, during a 2-year period, the proportion of youth with type 2 diabetes (T2D) enrolled in
the Treatment Options for Type 2 Diabetes in Adolescents and Youth study that reported ever at least trying smoking
cigarettes and/or drinking alcohol.
Study design Longitudinal data were examined for participants with T2D ages 10-18 years at baseline. Youth
psychosocial, parent/family, environmental, and biological correlates of trying health risk behaviors were tested
via cross-sectional multivariate models at each time point. Longitudinal models were explored for selected factors.
Results Data were obtained from the Treatment Options for Type 2 Diabetes in Adolescents and Youth study’s
ethnically diverse participants at baseline (N = 644), 6-month (N = 616), and 24-month (N = 543) assessments.
The percentage of youth ever trying only smoking remained stable at 4%; only drinking alcohol increased from
17% to 26%, and both smoking and drinking increased from 10% to 18% during the 2-year period. Factors related
to trying health risk behaviors were older age, male sex, non-Hispanic white race-ethnicity, lower grades, more
depressive symptoms, and stressful life events. Depressive symptoms, stressful life events, and body mass index
Z-score (the latter with smoking only) were related to engagement in health risk behaviors over time.
Conclusions Youth with T2D who are already at risk for health complications and who reported engaging in activities
that further increase the likelihood of life-threatening morbidities were characterized. Although most correlates
of trying these risk behaviors are nonmodifiable, intervention efforts may need to focus on potentially
modifiable factors, such as depressive symptoms and lower grades