OU College of Medicine Launches Study to Tackle Type 2 Diabetes in Youth

Recruitment is underway for a University of Oklahoma College of Medicine study that seeks to better understand the factors driving Type 2 diabetes in youth, with the aim of determining who is at highest risk for developing the disease. OU is part of a nationwide consortium funded by the National Institutes of Health to address the dramatic rise of youth diagnosed with Type 2 diabetes over the past two decades, a trend that is expected to continue.

The OU College of Medicine was awarded a six-year, $3.1 million grant from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) for the study, which is led by associate professor of pediatrics and OU Health pediatric endocrinologist Jeanie Tryggestad, M.D. She is also a research member of OU Health Harold Hamm Diabetes Center.

“It is important that we are a part of this study because Oklahoma is particularly burdened by Type 2 diabetes. If we can predict who will develop the condition, then we can intervene early and hopefully improve overall health in Oklahoma,” Tryggestad said.

The research builds on a previous NIDDK-funded study, Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY), showing that youth-onset Type 2 diabetes is more challenging to treat and progresses more aggressively compared to adult-onset Type 2 diabetes. In youth with Type 2 diabetes, good blood glucose control is harder to achieve, and the ability of the pancreas to secrete insulin declines much more rapidly. In many young people with Type 2 diabetes, the condition cannot be controlled solely with metformin, the drug most commonly used as the first-line treatment for diabetes in adults. In addition, youth-onset Type 2 diabetes is associated with earlier development of diabetes-related complications, such as damage to the eyes, kidneys and nerves. 

The OU College of Medicine is among 15 study sites nationwide. Collectively, the sites will recruit 3,600 participants, ages 9 to 14, who are considered at risk for developing Type 2 diabetes. They must have started puberty, be considered overweight or obese, and have high-normal to above-normal hemoglobin A1c (HbA1c) levels but not high enough for a diagnosis of diabetes. The participants will reflect the U.S. population of youth with Type 2 diabetes, including people from diverse racial and ethnic, socioeconomically disadvantaged and underserved rural populations.

In addition to looking at biological factors, the study team will gather comprehensive data from participants and their families to understand what social and environmental factors may be adversely contributing 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 shaping health outcomes. For example, people without access to healthy food and safe places to engage in physical activity may be more likely to develop obesity, which is associated with Type 2 diabetes.

“Most children we currently consider ‘at-risk’ for developing Type 2 diabetes will not actually do so, so we need to better understand what factors define who is at risk and would benefit from targeted prevention strategies,” said Barbara Linder, M.D., Ph.D., NIDDK program director who is overseeing the study. “These efforts are critical to lessen the immense burden, not just on young people and their families, but also the U.S. health care system, arising from the growing numbers of youth living with this disease and its debilitating complications.”

The OU College of Medicine played a foundational role in the previous TODAY study that laid the groundwork for this new consortium. The college was the largest of 15 clinical sites in the TODAY trial, which compared treatments for Type 2 diabetes in children. OU also participated in TODAY2, a follow-up study of the same youth, that demonstrated the high number of complications in youth 15 years after diagnosis – while they were still in young adulthood. Approximately 60% percent of participants had at least one complication and a third had two or more complications, including high blood pressure, kidney disease and eye disease.

“The complications with youth-onset Type 2 diabetes are actually greater than in those with Type 1 diabetes,” Tryggestad said. “Youth with Type 2 diabetes require aggressive management of their disease. Most of them fail therapy within the first four or five years after diagnosis, requiring insulin or some other intensive treatment in the hopes of preventing complications later on.”

“That’s why this new study is so important,” Tryggestad added. “It will allow us to better understand not only the biological factors contributing to youth-onset Type 2 diabetes, but also the social and environmental factors, such as access to healthy foods. That knowledge will help us identify Type 2 diabetes earlier, and ultimately we hope it will allow us to prevent the disease.”

For more information about the study, known as DISCOVERY of Risk Factors for Type 2 Diabetes in Youth, please visit discovery.bsc.gwu.edu. To learn more about about OU’s participation in the study, call (405) 271-7554 or email discoverystudy@ou.edu.

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About the project

DISCOVERY is funded through NIH grants DK134971, DK134984, DK134975, DK134996, DK134958, DK134967, DK135002, DK134982, DK135007, DK134988, DK134978, DK134981, DK135012, DK135015, DK134976, and DK134966.