FAMILY STUDIES

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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. The purpose of this study is to investigate the determinants of diabetes and cardiovascular disease (CVD) risk in young people diagnosed with diabetes before age 18 and their family members. Recent increases in childhood diabetes herald a substantial jump in the CVD- and diabetes-related public health burden in years to come, unless effective prevention efforts are mounted. It is therefore essential to understand the mechanisms underlying the current epidemic among children and adolescents. The following hypotheses frame the research project: Hypothesis 1. Diabetes can develop in various ways, from autoimmunity leading to type 1, to obesity-related, insulin-resistant type 2 diabetes. A subset of children develop diabetes through a combination of the 2 major pathways, with autoimmune ¿-cell destruction aggravated by the presence of insulin resistance related to genetic susceptibility, obesity and/or physical inactivity. Hypothesis 2. A complex interplay of heritable, behavioral, and treatment factors can accelerate or delay the development of CVD and chronic diabetes complications. Familial clustering of these factors may itself play a role in determining risk for people with diabetes. It is particularly compelling to understand this process in young patients, those with the most years of productive life at stake. Data collection is carried out primarily during home visits, or for those who prefer, outpatient visits to the GCRC. Families gather, fasting, for glucose challenge tests, biochemical measures, anthropometrics, blood pressure and questionnaire administration. Samples are processed through the GCRC core laboratory. We estimate that up to 400 families will take part.