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. Type 2 Diabetes Mellitus is on the rise in the pediatric population in the United States. In certain ethnic groups such as, African Americans, Asian Americans, Hispanics, and Native Americans, the incidence may be as high as 45% of new cases of pediatric diabetes. This rise in type 2 diabetes may partly be explained by the increase in obseity; however, genetic predisposition is another contributing factor. The relationship between obesity, insulin resistance, diet and physical activity int he development of type 2 diabetes remains to be investigated.
The specific aims of this project are to :1) assess insulin sensitivityin obeses African-American adolescents with and without a family history of diabetes, 2) to compare insulin sensitivity wiht leptin, body fat distribution, lean body mass, and body mass index, 3) to assess the relationship of diet and physical activity with insulin sensitivity, and 4) provide dietary and excercise counseling and longitudinally follow these adolescents to observe for any changes in insulin sensitivity with time and development of diabetes. This project will be accomplished by determining body composition, nutritional and physical activity histories, and insulin sensitivity using the homestasis model assessment (HOMA) and the whole-body insulin sensitivity (WBIS) in obese African American adolescents with and without a family history of diabetes. These adolescents will be assessed on a yearly basis to determine if there is any deterioration of glucose tolerance and development of diabetes. The results obtained from this study will be evaluated using multiple regression analysis to determine which factors are significant in impaired glucose homeostasis and intervention improves metabolic derangements.
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