Discussion
Despite already increased health risks, a subset of youth with
T2D in our sample reported engaging in activities that
further increase the likelihood of life-threatening morbidities.
The prevalence of trying smoking was lower than in a
sample of youth with T2D participating in the SEARCH for
Diabetes in Youth study.9 In it, Reynolds et al9 found that
35.9% (n = 579) of 10- to 22-year-old subjects with T2D reported
ever trying smoking compared with approximately
14%-22% in our slightly younger sample. Our prevalence estimates
are generally in line with the CDC’s 2009 Youth Risk
Behavior Survey of high school students for which 19.5% had
smoked cigarettes in the past 30 days, even though the CDC
survey was conducted with an older sample and characterized
current use rather than ever just trying smoking.23 For ever
trying alcohol, our prevalence estimates (28%-44%) are close
to the CDC current use data, with 41.8% reporting that they
had drank alcohol in the past 30 days.23 In general, prevalence
for at least trying smoking or drinking in this sample of youth
with T2D is at the lower end of estimates that vary from
19.5% to 90%, depending on age, race, and operationalization
of health behavior.9,23,24 To our knowledge, no prevalence
data exist for alcohol consumption in youth with
T2D. Our study is unique in characterizing health risk behaviors
for youth with T2D enrolled in a longitudinal research
trial.
Many predictions based on findings from the prior literature
were confirmed, including from school- and
community-based studies as well as studies of youth with
T1D.9-14 In multivariate modeling at each assessment point
(ie, cross-sectional adjusted analyses), demographic factors
related to increased risk for at least trying health risk behaviors
are older age, male sex, and non-Hispanic white race-ethnicity
for the composite health risk behaviors and non-Hispanic