This study is currently recruiting participants.
Type 2 diabetes is a disease that affects blood sugar levels. Complications can include heart and blood vessel (vascular) diseases. Rates of type 2 diabetes have tripled in children and young adults over the last 40 years. Vascular diseases are also increasing in young people.
To learn more about factors, including type 2 diabetes, that may cause vascular disease in young people.
People aged 12 to 25 years who (1) have type 2 diabetes; (2) are overweight but not diabetic; (3) or are lean and healthy. Biological parents are also needed.
Young participants will visit the NIH clinic once a year for up to 25 years. Each visit will take 4 days. Before each visit, participants will wear devices to track their sleep, activity, and blood sugar levels for 7 to 10 days.
Samples: They will provide blood, urine, and stool samples.
Heart: They will ride a stationary bike for 6 minutes with stickers applied to their chest.
Scans: They will lie on a bed that slides into a tube; the machine will take pictures of the inside of their body.
Energy: They will wear a hood over their head to measure the air they breathe.
Social stress: They will give a speech for 10 minutes to show their body s response to stress.
Glucose: They will drink a sweet drink to see how their blood sugar changes.
Biological parents will have 1 study visit. They will have blood tests. They will fill in questionnaires about their lifestyle and stress.
INCLUSION CRITERIA:
To be eligible to participate in this study, an individual must meet the following criteria according to their group:
Four categories of participants will be included in this study and the inclusion criteria for each group are given below:
-Participants with Y-T2DM
--Age 12-25 years
--Type 2 diabetes mellitus as defined by fasting blood glucose >= 126 mg/dL OR postprandial blood sugar >= 200 mg/dL OR Hemoglobin A1c >= 6.5 percent per American Diabetes Association Criteria OR documentation of type 2 diabetes diagnosed at <=25 years of age
-Youth with overweight/ obesity (Y-OW)
--Age 12-25 years
--For participants < 18 years of age, BMI >= 85th percentile (overweight) and >= 95th percentile (obesity) for age and sex OR
--For participants >= 18 years of age, BMI >=25<30 kg/m^2 (overweight) or >=30 kg/m^2 (obesity)
--Participants with obesity may have a diagnosis of prediabetes, defined as fasting blood glucose 100-125 mg/dL OR postprandial blood sugar 140-199 mg/dL OR HbA1c 5.7-6.4 percent (either during testing at NIH or as previously documented on outside medical record).
-Healthy control lean participants (Y-Lean)
--Age 12-25 years
--For participants < 18 years of age, BMI <= 85th percentile for age and sex OR
--For participants >=18 years of age, BMI 18-24.99 kg/m^2.
--HbA1c <5.7 percent (either during testing at NIH or as previously documented on outside medical record).
-Biological parents of Y-T2DM, Y-OW and Y-Lean participants
--Biological parent of enrolled Y-T2DM, Y-OW and Y-Lean by self-report.
EXCLUSION CRITERIA:
An individual who meets any of the following criteria for their specific group will be excluded from participation in this study:
-Y-T2DM, Y-OW and Y-Lean Participants:
--Type 1 diabetes or the presence of >2 diabetes auto-antibodies (e.g., GAD-65, IA-2 antigen, Zinc transporter 8 autoantibodies).
--Medical, psychiatric or cognitive disorders that will, in the opinion of the investigators, limit the subject s ability to comply with study procedures (specific obesity-related comorbidities are explicitly permitted, including hypertension, hyperlipidemia, obstructive sleep apnea and non-alcoholic steatohepatitis).
--Serious medical illnesses or diseases thought to alter metabolism (including moderate to severe renal disease (< 30 mL/min/1.73m^2), congenital heart disease, Cushing s syndrome, cancer, or other metabolic diseases associated with diabetes or excess weight).
--For participants enrolled at the NIH, dietary allergies, intolerances or eating patterns that would preclude them from consuming metabolic meals.
--Unwilling to comply with all study procedures or to adhere to Lifestyle Considerations throughout study duration.
--Pregnancy at the time of the screening visit.
--Clinically significant anemia OR Hematocrit below the lower limit of normal for age and sex cutoffs.
-Y-Lean participants:
In addition to the above exclusion criteria, any Y-Lean participant who meets any of the following additional criteria will be excluded from the study:
--Current use of prescription or non-prescription medication. Certain exceptions are permitted, including topical medications, vitamins, and hormonal contraceptives. Other medications may be permitted at the discretion of the investigators.
--Recent (past 2 months) use of drugs or supplements that alter glucose or lipid metabolism (e.g., niacin, fish oil, red yeast rice)
--History of diabetes or abnormal glucose tolerance
--Abnormal screening labs, including the following:
---ALT or AST >2 times the upper limit of normal
---Glycosuria
---Low eGFR (<90 mL/min/1.73m^2)Any other abnormality that, in the opinion of the investigator, will increase risk to the subject from participation, or interfere with interpretation of study data
-Biological Parents
--No Exclusion Criteria