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Press release
Wednesday October 9, 2024
Effort to identify risk factors for type 2 diabetes in young people in order to improve prevention and treatment.
The National Institutes of Health has launched a national consortium to address the dramatic increase in the number of young people diagnosed with type 2 diabetes over the past two decades, a trend that is expected to continue. The effort aims to advance understanding of the biological, social, and environmental factors that drive type 2 diabetes in young people, with the goal of determining which children are at greatest risk of developing the disease and how to better prevent, detect, and manage type 2 diabetes in young people.
“Our overweight and obese children are at risk, but we don’t know how best to identify which children will progress to type 2 diabetes,” said Rose Gubitosi-Klug, MD, PhD, study leader and chief of pediatric endocrinology at Case Western Reserve University/Rainbow Babies and Children’s Hospital in Cleveland. “This study will bring us closer to our goal of preventing type 2 diabetes in future generations of young people.”
The observational study is funded by the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and builds on previous NIDDK-funded research indicating that type 2 diabetes in adolescence is more difficult to treat and progresses more aggressively than type 2 diabetes in adulthood. In youth with type 2 diabetes, good blood sugar control is more difficult to achieve and the ability of the pancreas to secrete insulin declines much more rapidly. Many youth with type 2 diabetes do not respond well to metformin, the most commonly used first-line treatment for diabetes in adults. Additionally, type 2 diabetes in adolescence is associated with earlier development of diabetes-related complications, such as eye, kidney and nerve damage.
“All of these factors create a picture of a disease that is much more aggressive in young people than in adults, but we don’t understand what’s driving these differences,” said Barbara Linder, MD, PhD, the NIDDK program director who is overseeing the study. “As a result, young people are developing devastating complications from the disease during what should be the most productive years of their lives.”
The study will aim to identify unique factors in early-onset type 2 diabetes, distinguishing it from adult-onset disease, which will help clinicians better understand which children will develop the disease and guide more effective and targeted prevention and intervention strategies. Study sites across the country will enroll 3,600 participants, ages 9 to 14, who are considered at risk for developing type 2 diabetes. They must have entered puberty, be overweight or obese, and have hemoglobin A1c (HbA1c) levels that are normal or above normal but not high enough to be diagnosed with diabetes. Participants will be representative of the U.S. population of youth with type 2 diabetes, including individuals from diverse races and ethnic groups, socioeconomic disadvantage, and underserved rural populations.
The research team is also seeking extensive input from youth, young adults and parents with lived experience of type 2 diabetes on the design and conduct of the study, including how best to recruit and retain participants, how often participants should be seen during the study, what questionnaires to use to collect data, etc.
In addition to examining biological factors, the study team will collect comprehensive data from participants and their families to understand what social and environmental factors may negatively contribute to health disparities and poor outcomes among youth with type 2 diabetes. Research has suggested that these social determinants of health—the conditions in which people are born, grow, work, live, and age—have a powerful influence on health outcomes. For example, people who lack access to healthy food and safe places to exercise may be more likely to develop obesity, which is associated with type 2 diabetes.
“Most children we currently consider to be ‘at risk’ for developing type 2 diabetes will not actually develop it. We need to better understand what factors define who is at risk and who would benefit from targeted prevention strategies,” said Dr. Linder. “These efforts are critical to reducing the immense burden, not only on youth and their families, but also on the U.S. health care system, resulting from the increasing number of young people living with this disease and its debilitating complications.”
For more information about the study, titled DISCOVERY of Risk Factors for Type 2 Diabetes in Youth, please visit discovery.bsc.gwu.edu.
Funding: DISCOVERY is funded by NIH grants DK134971, DK134984, DK134975, DK134996, DK134958, DK134967, DK135002, DK134982, DK135007, DK134988, DK134978, DK134981, DK135012, DK135015, DK134976, and DK134966.
The NIDDK, a component of the NIH, conducts and supports research in diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and renal, urologic, and hematologic diseases. These diseases, which span the spectrum of medicine and affect people of all ages and ethnicities, encompass some of the most common, serious, and debilitating conditions affecting Americans. For more information about the NIDDK and its programs, visit https://www.niddk.nih.gov.
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, comprises 27 institutes and centers and is part of the U.S. Department of Health and Human Services. NIH is the primary federal agency that conducts and supports basic, clinical, and translational medical research, and studies the causes, treatments, and cures for common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
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