INSULIN SENSITIVITY IN ADOLESCENTS WITH DIABETES

这个子项目是众多研究子项目之一

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. Insulin resistance is associated with cardiovascular disease among patients with metabolic syndrome and type 2 diabetes (T2D). However, there has been increasing interest in the role of insulin resistance in patients with type 1 diabetes (T1D), particularly as these children become more obese. However, research in this area has been limited by technical challenges. While it is possible to measure insulin sensitivity rigorously in T1D utilizing the hyperinsulinemic clamp, this is labor and time-intensive and not useful in large epidemiologic trials. Yet, surrogate estimates of insulin sensitivity used commonly in adults with metabolic syndrome and T2D assume intact insulin and c-peptide secretion. Therefore, the development of estimates of insulin sensitivity that do not rely on intact insulin and c-peptide secretion are fundamental to progress in the study of insulin sensitivity and cardiovascular risk in T1D. Development of surrogate estimates of insulin sensitivity is also important to the care of youth with T2D, as the indicies used in adults may not apply to younger patients, who also have superimposed insulin resistance of puberty, and other differences from adults. Indices derived from historical data, anthropometrics, and biomarkers other than insulin/c-peptide have been used to estimate insulin sensitivity in normal and diabetic adults with T1D and T2D. Therefore, it may be possible to develop similar indices for adolescents. In this proposal, we will utilize a previously characterized population of adolescents with diabetes to identify and validate such an index against rigorous measurements of insulin sensitivity obtained through hyperinsulinemic euglycemic clamp.