This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. (1) Participants receiving either insulin or repaglinide will increase their BMI compared to control participants. (2) Insulin will be more effective than repaglinide at increasing BMI. (3) The increase in BMI will be primarily due to increased muscle mass. (4) The increase in BMI will be accomplished without significant changes in dietary macronutrient or calorie composition. (5) Insulin or repaglinide therapy will prevent pulmonary function decline compared to both control subjects and to their own baseline as measured the previous year. This will be associated with improvement in NIH clinical score and will be directly related to weight gain and increase in thigh muscle volume. (6) Participants receiving insulin or repaglinide will improve hand grip strength, and this will be directly related to weight gain and increase in thigh muscle volume.
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