TREATMENT OPTIONS FOR TYPE 2 DIABETES IN ADOLESCENTS AND YOUTH (TODAY)

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 在过去的二十年里，儿童和青少年2型糖尿病患者数量的增加被贴上了流行病的标签。到1999年，根据年龄和种族的不同，2型糖尿病新发病例的百分比在8%-45%之间。儿童2型糖尿病的流行与超重或有超重风险的儿童数量的增加和青少年体力活动模式的减少是一致的。此外，T2 DM与青春期的开始、T2 DM阳性家族史以及代谢综合征的因素，如黑棘皮病和多囊卵巢综合征(PCOS)有很强的相关性。尽管儿童T2 DM的病例数量急剧增加，但还没有大规模的研究调查儿童和青年T2 DM的病理生理、治疗和并发症。与T2 DM相关的潜在长期并发症和成本，特别是在如此年轻的年龄出现，使得此类研究势在必行。因此，NIDDK/NIH正在赞助一项为期4年的青少年和青年2型糖尿病治疗选择的多中心试验(今天)。丹佛儿童医院是这项全国性治疗试验的12个地点之一。此外，当地的PI(Zeitler博士)被选为今天研究小组的主席。这项试验将研究三种治疗方案在血糖控制方面的安全性和有效性：(1)单独使用二甲双胍，(2)二甲双胍+强化生活方式干预，(3)二甲双胍+使用噻唑烷二酮(TZD)的早期侵入性药物治疗。除了治疗武器对血糖控制的影响外，还将研究多种次要结果，以提供有关治疗武器的作用机制和相关益处的信息。应该指出的是，Zeitler博士是这项研究的组织、实施和监督的国家研究主席。

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. Over the last two decades, the increase in the number children and adolescents with T2DM has been labeled an epidemic. By 1999, the percent of new cases of diabetes due to T2DM was between 8-45%, depending on age and ethnicity. The epidemic of pediatric T2DM is coincident with the rise in the number of children who are overweight or at risk for overweight and with a decrease in the physical activity pattern of youth. In addition, there has been a strong association between T2DM and the onset of puberty, a positive family history of T2DM, and elements of the metabolic syndrome, such as acanthosis nigricans and polycystic ovarian syndrome (PCOS). Despite the dramatic increase in the number of cases of T2DM in childhood, there have been no large-scale studies investigating the pathopysiology, treatment, and complications of T2DM in children and youth. The potential long-term complications and costs associated with T2DM, particularly when appearing at such a young age, make such studies imperative. Therefore, the NIDDK/NIH is sponsoring a 4-year Multi-center trial, Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY). The Children's Hospital of Denver is one of twelve sites included in this national treatment trial. In addition, the local PI (Dr. Zeitler) has been chosen as the Chair of the TODAY Study Group. The trial will study the safety and efficacy of three treatment arms on glycemic control: (1) metformin alone, (2) metformin plus an intensive lifestyle intervention, (3) metformin plus early aggressive pharmacologic therapy using a thiazolidinedione (TZD). In addition to the effect of the treatment arms on glycemic control, multiple secondary outcomes will be studied to provide information regarding mechanism of action and associated benefits of the treatment arms. It should be pointed out that Dr. Zeitler is the National Study Chair for the organization, conduct and oversight of this study.