DISCOVERY of Risk Factors for Type 2 Diabetes in Youth
Project Goals: Type 2 diabetes used to be known as “adult-onset” diabetes and was thought to mostly affect people later in life. Now, more children are being diagnosed with type 2 diabetes. Rates of type 2 diabetes among children and adolescents are increasing rapidly over time. Currently, we do not understand why rates of type 2 diabetes is increasing in children. The DISCOVERY Study seeks to understand what factors cause some children to develop type 2 diabetes while others don’t.
DISCOVERY is a study for children 9-14 years old who may be at higher risk of developing type 2 diabetes. This study does not involve medications and there is no cost to you. You will be compensated for your time in this study. Join families across the US to help us make a difference for all children and young people!
Visit the study web site.
Type 2 Diabetes and Bone Health in Youth
Project Goals: This study aims to investigate prospectively the effect of hyperglycemia on bone accrual, quality and strength in youth onset type 2 diabetes (T2D) compared with obese controls with normal glucose tolerance; and to identify the hormonal and biochemical determinants of bone accrual and strength in youth onset T2D.
Bone Health and Metabolism in Youth with Obesity
Project 1 Goals: This study evaluates the effects of childhood obesity on bone formation and strength (bone microarchitecture) and the relationship of bone hormones to insulin sensitivity and vascular function.
Project 2 Goals: Investigate the interaction between childhood adiposity, insulin resistance and adipokine imbalance on bone health in Hispanic youth across pubertal stages and the modifying effect of physical activity.
Advanced glycation endproducts (AGEs), oxidation products and the soluble receptor for AGE (sRAGE): Cardiovascular Disease Risk Biomarkers in Youth with Type 2 Diabetes.
Project Goals: This study aims to investigate the role of the advanced glycation endproducts (AGEs), oxidation products, and the soluble receptor for AGEs (sRAGE) as biomarkers of microvascular and macrovascular disease in youth with type 2 diabetes.
Understanding and Targeting the Pathophysiology of Youth-onset Type 2 Diabetes
Project Goals: 1) To develop more precise prediction of risk of youth-onset type 2 diabetes (T2D); and 2) To understand of the physiologic drivers of youth T2D, to guide development of more effective therapeutic and prevention strategies.
Lab Studies
IRB Number: H-55870
Study Title: DISCOVERY of Risk Factors for Type 2 Diabetes in Youth
Study Description: DISCOVERY will extensively phenotype a large cohort of youth at-risk for type 2 diabetes (T2D), as they transition through puberty, and characterize the course of dysfunction in pathophysiological indicators that lead to T2D.
Jesus Cazares, RC II: 713-798-7132 | jesus.cazares@bcm.edu| discovery@bcm.edu
IRB Number: H-45986
Study Title: Bone Health and Metabolism in Youth
Study Description: This study evaluates the effect of obesity and childhood onset diabetes and their associated adverse metabolic milieu on bone density, microarchitecture and bone biomarkers. In turn, the effect of these biomarkers on vascular function in youth will be assessed.
Victoria Sollock, RN, BSN; 713-798-6721 | Victoria.Sollock@bcm.edu
IRB Number: H-50574
Study Title: Type 2 diabetes and bone health in youth; A longitudinal study
Study Description: This study investigates the effect of childhood onset diabetes on bone accrual, density, microarchitecture and bone biomarkers longitudinally over 12 months.
Victoria Sollock, RN, BSN; 713-798-6721 | Victoria.Sollock@bcm.edu
IRB Number: H-30665
Study Title: Determinants of subclinical coronary atherosclerosis and endothelial dysfunction in youth with and without type 2 diabetes
Status: Not currently enrolling
About The Lab
Glucose and Insulin Metabolism- Prediabetes and Type 2 Diabetes in Youth
Earlier work by Dr. Bacha focused on understanding the relationship of adiposity to insulin resistance and characterizing the risk factors for type 2 diabetes in youth. Her work on the pathophysiological mechanisms of prediabetes and type 2 diabetes contributed to the current understanding of the pathophysiology of the disease in children, and the importance of the defect in beta cell function to the pathogenesis and the rapid progression of type 2 diabetes and its complications in childhood. Dr. Bacha has been a long-term investigator in the TODAY study and its long-term post-intervention follow-up TODAY 2. This project investigated the natural history of type 2 diabetes in children, therapeutic options and longitudinal follow-up post participation in the study.
Currently Dr. Bacha’s laboratory is pursuing the use metabolomics to uncover biomarkers of beta cell function and cardiovascular disease in youth with type 2 diabetes.
A new study aims to characterize the pathogenesis of youth-onset prediabetes and type 2 diabetes to better identify youth at risk for the disease.
Endothelial Dysfunction and Subclinical Atherosclerosis
Dr Bacha’s work aimed to delineate the cardiovascular complications related to childhood obesity, insulin resistance and type 2 diabetes, and to identify adequate biomarkers of subclinical atherosclerosis in youth, and their determining factors. She utilized different methodologies to measure vascular function including pulse wave velocity and intima media thickness, and coronary artery calcifications (CAC), as early biomarkers of subclinical atherosclerosis. Her work demonstrated that different aspects of subclinical atherosclerosis appear to be differentially modulated, adiposity being the major determinant of CAC, hyperglycemia for intima media thickness, and leptin and insulin sensitivity for arterial stiffness. She also demonstrated that peripheral endothelial function is a biomarker of vascular health modulated by insulin sensitivity in youth. In addition, work in her lab showed that non-alcoholic fatty liver disease in youth is associated with multi-organ insulin resistance and significant endothelial dysfunction directly related to the hepatic fat content. This was independent of visceral adiposity or glycemia. Ongoing work is focusing on understanding thee determinants of cardiac autonomic dysfunction in youth across the glycemic spectrum.
In the TODAY study, she also described evidence of early cardiac injury in relation to obesity and high blood pressure in youth-onset type 2 diabetes and contributed to work showing rapid progression of cardiovascular disease risk in youth with type 2 diabetes.
A recent project aims to understand the role of the advanced glycation endproducts (AGEs), and their receptor as biomarkers of microvascular and macrovascular disease in youth-onset type 2 diabetes.
Sleep, Circadian Dysregulation and Energy Metabolism
Her work included evaluation of the perturbations in energy metabolism related to obesity across the glycemia spectrum in youth, and the relationship of sleep dysfunction and circadian dysregulation to energy homeostasis and glucose metabolism in children. She showed reduced metabolic flexibility in the setting of severe insulin resistance in youth across the glycemic spectrum (JCI Insights 2021). She also investigated the relationship of sleep parameters (actigraphy) to physical activity and energy metabolism. These studies showed that delayed sleep timing is an important factor in determining physical activity in children. Reduced sleep duration was related to increased sedentary behaviors and less time spent in light physical activity. Moreover, she utilized indirect calorimetry and the doubly labeled water measures of energy expenditure, and showed that shorter sleep duration was associated with lower basal metabolic rate after accounting for age, sex, fat mass and lean mass.
Bone Health
A new area of investigation in the Bacha laboratory focuses on Bone Health in Children. She is utilizing high resolution peripheral quantitative computed tomography (HRpQCT) to measure bone micro-architecture and strength, along with assessment of body composition, glucose metabolism, physical activity and nutrition to better understand the factors that may interfere with adequate bone formation in childhood and adolescence, a critical time for bone growth and lifelong bone health.