This application seeks funding to complete the current protocols being conducted by the Studies to Treat Or Prevent Pediatric Type 2 Diabetes (STOPP-T2D) consortium under the U01 cooperative agreement mechanism since 2002. Funding is requested for an additional 4 years to: (1) complete the current protocols and database quality control, (2) initiate analysis and report of outcome data and methods, and (3) archive and transfer the data to the NIDDK central repositories. The studies target minority youth. The treatment study group of 15 clinical centers is conducting two protocols. (1) TODAY is a multi-center, 3-arm, prospective, randomized, partially-blinded clinical trial. The primary object is to evaluate the safety and efficacy of 3 treatments to maintain glycemic control. Subjects (N=629 to date) aged 10-17 were recruited over a 4-year period, randomized within 2 years of diagnosis of T2D, and will be followed for 2-6 years. Recruitment is scheduled to end September 1, 2008, final randomization and baseline data collection on February 28, 2009, and final follow-up on February 28, 2011. (2) The TODAY genetics study protocol will enroll an additional 2500 participants who were diagnosed with T2D prior to their 18th birthday. The primary objective is to collect blood and phenotypic information to be used to explore relationships between candidate genes and type 2 diabetes, as well as obesity, insulin resistance, and cardiovascular complications of insulin resistance. Recruitment is expected to start in late summer 2008 and continue until February 28, 2011. The prevention study group is conducting the HEALTHY primary prevention trial in 42 middle schools. A series of pilot and feasibility studies helped to define and develop study objectives and intervention. The primary objective is to reduce risk factors, such as obesity, associated with the development of T2D in intervention compared to control schools. The intervention changes the nutrition and physical activity environment throughout the school and includes educational and promotional events. Over 6000 6th graders were measured at baseline (fall 2006);final data are collected at end of 8th grade (spring 2009).

Public Health Relevance

The recent and precipitous rises in rates of type 2 diabetes (T2D) and in obesity (the primary risk factor for T2D) in the pediatric population have important ramifications for our health care system. Previous research of treatment and prevention of T2D targeted mainly adults. The STOPP-T2D consortium represents one of the first large-scale federally-funded efforts to conduct studies to further our knowledge and understanding of these problems and their solution in children and adolescents.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project--Cooperative Agreements (U01)
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Study Section
Special Emphasis Panel (ZDK1-GRB-2 (J1))
Program Officer
Garfield, Sanford A
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George Washington University
Biostatistics & Other Math Sci
Schools of Arts and Sciences
United States
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Berkowitz, Robert I; Marcus, Marsha D; Anderson, Barbara J et al. (2017) Adherence to a lifestyle program for youth with type 2 diabetes and its association with treatment outcome in the TODAY clinical trial. Pediatr Diabetes :
Arslanian, Silva; El Ghormli, Laure; Bacha, Fida et al. (2017) Adiponectin, Insulin Sensitivity, ?-Cell Function, and Racial/Ethnic Disparity in Treatment Failure Rates in TODAY. Diabetes Care 40:85-93
Kriska, Andrea; El Ghormli, Laure; Copeland, Kenneth C et al. (2017) Impact of lifestyle behavior change on glycemic control in youth with type 2 diabetes. Pediatr Diabetes :
Rockette-Wagner, Bonny; Storti, Kristi L; Edelstein, Sharon et al. (2017) Measuring Physical Activity and Sedentary Behavior in Youth with Type 2 Diabetes. Child Obes 13:72-77
Chadwick, Jennifer Q; Van Buren, Dorothy J; Morales, Elisa et al. (2017) Structure to utilize interventionists' implementation experiences of a family-based behavioral weight management program to enhance the dissemination of the standardized intervention: The TODAY study. Clin Trials 14:406-412
Kelsey, Megan M; Geffner, Mitchell E; Guandalini, Cynthia et al. (2016) Presentation and effectiveness of early treatment of type 2 diabetes in youth: lessons from the TODAY study. Pediatr Diabetes 17:212-21
Gandica, Rachelle; Zeitler, Phil (2016) Update on Youth-Onset Type 2 Diabetes: Lessons Learned from the Treatment Options for Type 2 Diabetes in Adolescents and Youth Clinical Trial. Adv Pediatr 63:195-209
Walders-Abramson, Natalie; Anderson, Barbara; Larkin, Mary E et al. (2016) Benefits and barriers to participating in longitudinal research of youth-onset type 2 diabetes: Results from the TODAY retention survey. Clin Trials 13:240-3
Marcus, M D; Wilfley, D E; El Ghormli, L et al. (2016) Weight change in the management of youth-onset type 2 diabetes: the TODAY clinical trial experience. Pediatr Obes :
Klingensmith, Georgeanna J; Pyle, Laura; Nadeau, Kristen J et al. (2016) Pregnancy Outcomes in Youth With Type 2 Diabetes: The TODAY Study Experience. Diabetes Care 39:122-9

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