ASU team part of nationwide study looking at Type 2 diabetes in youth
Professor Gabe Shaibi is leading a team that has been chosen to be part of a National Institutes of Health nationwide consortium seeking to address the rise of Type 2 diabetes among youth over the past two decades.
Near the end of an interview in which he talked about the work his team will be doing to tackle the rise in Type 2 diabetes among youth, Arizona State University Professor Gabe Shaibi answered why that work is so important.
“Because when a kid develops Type 2 diabetes in their adolescent years, it’s about a 15- or 16-year life decrease,” said Shaibi, a professor and Southwest Borderlands Scholar in the Edson College of Nursing and Health Innovation, where he directs the Center for Health Promotion and Disease Prevention.
“On top of that, they’re losing their quality of life because they get kidney disease or heart disease much, much earlier. So the morbidity associated with a youth onset Type 2 diabetes is immense.”
Shaibi is leading a team that has been chosen to be part of a National Institutes of Health nationwide consortium seeking to address the rise of Type 2 diabetes among youth over the past two decades.
Shaibi’s team, which includes ASU faculty and students, is one of 15 “clinical sites” across the country that will recruit 3,600 participants, ages 9 to 14, who are considered at risk for developing Type 2 diabetes.
The ASU-led team is partnering with Phoenix Children’s and will enroll 240 of the 3,600 youth in the study, which will take 10 years.
ASU News talked to Shaibi about the work his team will be doing.
Editor's note: Answers have been edited for length and/or clarity.
Question: What’s the overarching goal of the study?
Answer: Big picture, we’re trying to understand why certain kids who are at high risk go on to develop Type 2 diabetes early in life, and another group who are seemingly at high risk may not go on to develop diabetes. So we have this kind of bifurcation, but we really don’t know why certain kids do and certain kids don’t.
This study is to really kind of figure that out and look at the biology as well as things like social determinants of health. What is causing the difference in these kids to go on these two trajectories? And, then, most importantly, we can then kind of better define the types of prevention and intervention strategies that are needed.
Q: How will the partnership with Phoenix Children’s work?
A: All the kids that we recruit will come from the division of endocrinology and diabetes at Phoenix Children’s. The kids would then come to ASU, and we do all the comprehensive testing. So all the questions, but also the biology. We’ll do a head-to-toe evaluation, like body composition, how well their body uses sugar. ... Phoenix Children’s is not a research institution, so that’s why it’s a really cool partnership.
Q: You mentioned social and environmental factors. What are some of those factors that could be contributing to the rise in diabetes?
A: This is the unknown, right? This is the part we’re looking at. We think that where these kids live is a contributing factor, potentially some of their environmental exposures, not only in their homes but in their communities. Access to regular health care, access to healthy foods and being able to be physically active. These are all of the questions that we’re embedding in this project, along with biological differences, genetics, genomics, things that happened in utero. We’re really taking a comprehensive look.
Q: Is the look at social and environmental factors sort of a switch in thinking when it comes to the cause of diabetes?
A: It’s an absolute switch in thinking. We’ve spent a ton of energy on the genetics and genomics of diabetes. And although we’ve learned a lot about it, we know that when we look at the big pictures, the majority of diabetes is not explained by any of those factors. So either we’re not looking in the right place from a biological perspective, which I don’t think people would agree with, or we need to incorporate what are called upstream factors that might be contributing to the biology.
Those upstream factors represent what we call social determinants or root causes of chronic disease.
Q: The study will last 10 years?
A: We’re going to recruit and enroll for the first five years. That’s acquiring the cohort and monitoring the cohort. And then, at the five-year mark, we’ll know those kids who have gone on to develop diabetes and those who hadn’t. Then we can say, “OK, this is the group that has diabetes. Let’s look at how those kids differ.”
Q: Part of the grant with NIH is that you’re required to do local engagement, right?
A: Yes. They actually said you have to talk to community members and stakeholders early on, like before we even applied for the grant, to get their feedback. And then, throughout the grant, you have to get continual feedback from the community. Because we don’t want to just answer a scientific question. We want to make sure that any question we ask and answer also represents what the community is interested in.
So one of the cool pieces of engagement that we’re doing is around Access ASU. We know that people who have lower education and lower socioeconomic status are more likely to develop diabetes. So we’ve engaged with Access ASU to say, “What can we do with our families around ASU?”
One of the students is working on what type of information we can give kids — not about eating and exercise, because that’s part of the study — but about getting into college and saving for higher education.
We’re also partnering with the Watts College of Public Service and Community Solutions and the community advisory board in the School of Social Work, which is part of the Southwest Interdisciplinary Research Center. They’ve encouraged us to develop what’s called a youth advisory board. These youth ambassadors who are going to help us think about how you engage 9-, 10-, 11-year-old kids.
Q: In 10 years, what’s the hope?
A: Right now, we don’t know where and how and whom to intervene with. The goal would be, “Hey, if these are the kids we really need to worry about, then those are the kids we focus on."
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