Arginine Metabolism in Youth with Type 2 Diabetes
Type 2 diabetes in youth has emerged as a major public health concern in recent decades. Arginine is a known stimulant of insulin secretion in pancreatic beta cells, and previous studies in adults demonstrate that arginine and its metabolite nitric oxide play important roles in the pathogenesis of type 2 diabetes. This study aims to investigate arginine metabolism and the effects of arginine administration in youth with type 2 diabetes compared to healthy controls.
Supported by the National Institutes of Health / National Institute of Diabetes and Digestive and Kidney Diseases.
Prediabetes Physical Activity and Stopping Evening Snacking Study (PASS Study)
Prediabetes is defined as blood glucose levels that are elevated above normal but below the diagnostic threshold for type 2 diabetes. This condition is particularly significant in children as it represents a critical window for intervention to prevent progression to type 2 diabetes and associated complications later in life. The PASS Study is an eight-week, randomized clinical trial that aims to explore the metabolic benefits of increasing physical activity and stopping evening snacks in youth with prediabetes.
Supported by United States Department of Agriculture, Agricultural Research Service.
Leveraging Artificial Intelligence for Precision Medicine in Youth-Onset Type 2 Diabetes
In collaboration with the Data Science Team at Texas Children’s Hospital, we are developing an AI foundation model that integrates both structured clinical data and unstructured physician notes from electronic medical records to predict key outcomes including glycemic control, treatment responses, and insulin independence over 2-5 years post-diagnosis. This research directly addresses the urgent need for personalized treatment strategies in youth T2D, a condition that has nearly doubled in incidence and disproportionately affects minority populations. By leveraging comprehensive EMR data from Texas Children's Hospital, our AI model aims to transform clinical decision-making and improve long-term outcomes for young patients with diabetes. This work builds on our lab's ongoing commitment to understanding diabetes heterogeneity and advancing precision medicine approaches for pediatric type 2 diabetes.
Supported by the National Institutes of Health / National Institute of Diabetes and Digestive and Kidney Diseases thru dkNET
The Monogenic Diabetes Center at Texas Children's Hospital and Baylor College of Medicine
Monogenic diabetes represents a diverse group of conditions caused by single genetic variants, such as maturity-onset diabetes of the young (MODY) and neonatal diabetes. These disorders exemplify the potential of precision medicine approaches in diabetes care. Leveraging our extensive clinical and genetic resources, we strive to expand our database and provide new insights into monogenic diabetes through our strong national and international collaborations.
For more information, please visit our center webpage.
Collaborations
Rare and Atypical Diabetes Network (RADIANT)
Dr. Tosur serves as a co-investigator in the RADIANT (Rare and Atypical Diabetes Network), an NIDDK-supported national collaborative network dedicated to discovering and defining rare and atypical forms of diabetes. Through this multi-institutional partnership, we contribute to the critical mission of identifying individuals with atypical diabetes who often remain undiagnosed and do not receive appropriate treatment. RADIANT focuses on developing accurate and efficient diagnostic methods to identify patients with rare diabetes forms, enabling precise genetic diagnosis that can lead to targeted therapy, improved quality of life, and facilitate diagnosis of diabetes in family members. As part of this network of universities, hospitals, and clinics across the United States, our lab collaborates with physicians and healthcare groups to advance understanding of diabetes heterogeneity and improve diagnostic approaches for these challenging cases. For further information, please visit RADIANT website.
Precision Diabetes Consortium (PREDICT)
Dr. Tosur serves as a site director and co-investigator in the Precision Diabetes Consortium (PREDICT), a collaborative network designed to advance monogenic diabetes research through structured data sharing and multi-institutional cooperation. As part of this consortium, we contribute to the identification and characterization of local monogenic diabetes cases, harmonize our data to the PREDICT standardized data model, and submit de-identified patient information to the centralized PREDICT data commons managed by Data for the Common Good. Through PREDICT, we collaborate on approved research projects and analyses that leverage pooled data from multiple sites, enhancing our ability to understand rare monogenic forms of diabetes that would be difficult to study at any single institution. Dr. Tosur serves on the Executive Committee, participating in monthly consortium meetings and helping guide the strategic direction of this important precision medicine initiative in diabetes research. For further information, please visit the PREDICT website.
Type 1 Diabetes TrialNet - Pathway to Prevention Study
Dr. Tosur serves as a site principal investigator for the TrialNet Affiliate Center, leading our participation in the internationally renowned Type 1 Diabetes TrialNet network. TrialNet is an international network dedicated to the study, prevention, and early treatment of type 1 diabetes, with the ultimate goal of creating a future without T1D. The Pathway to Prevention study serves as the foundation for all TrialNet prevention research, providing free risk screening for relatives of individuals with type 1 diabetes. Through this natural history study, we screen first-, second-, or third-degree relatives to understand disease progression and identify those at risk for developing type 1 diabetes. To date, TrialNet has screened over 250,000 relatives of individuals with type 1 diabetes for autoantibodies, making it one of the largest diabetes prevention research efforts worldwide. Our site contributes to innovative clinical studies testing interventions to slow disease progression and prevent diabetes onset in high-risk individuals, advancing the field's understanding of type 1 diabetes pathogenesis and bringing us closer to effective prevention strategies. For more information, please visit TrialNet website.