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May 21, 2004|Volume 32, Number 30|Two-Week Issue



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Study will compare treatments
for children with type 2 diabetes

A clinical study comparing three treatments of type 2 diabetes in children and teens has begun at Yale and 11 other medical centers and their affiliated sites around the country.

The Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study is the first clinical trial sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), one of the National Institutes of Health under the Department of Health and Human Services, to focus on type 2 diabetes in youth. It is also the first to look at the effects of intensive lifestyle change aimed at lowering weight by cutting calories and increasing physical activity in young people with type 2 diabetes.

The principal investigator at the Yale center is Dr. Sonia Caprio, associate professor of pediatric endocrinology at the School of Medicine and associate clinical professor at the School of Nursing.

Many drugs are available to treat type 2 diabetes in adults. Metformin, which lowers the liver's production of glucose, is the only oral drug approved by the Food and Drug Administration to treat type 2 diabetes in children. Rosiglitazone, the other oral medicine used in the TODAY study, belongs to a class of insulin-sensitizing drugs called the thiazolidinediones. It helps fat, muscle and liver cells respond to insulin and use glucose more efficiently.

The TODAY study's main goal is to determine how well and for how long each treatment approach controls blood glucose levels. The study will also evaluate the safety of the treatments, the effects of the treatments on insulin production, insulin resistance (a hallmark of type 2 diabetes in which cells do not effectively use insulin), body composition, nutrition, physical fitness and risk factors for disease. It will also evaluate quality of life and psychological outcomes, the influence of individual and family behaviors on treatment response and the cost-effectiveness of the treatments.

"Researchers have learned a great deal about treating type 2 diabetes in adults, but much less is known about how best to treat this increasingly common form of diabetes in youth," says Tommy G. Thompson, secretary of health and human services. "This study will answer urgent questions about which therapy is most effective for the early stage of type 2 diabetes in young people."

Researchers plan to enroll 750 children and teens 10 to 17 years old diagnosed with type 2 diabetes in the past two years. The trial is expected to last five years.

Another NIDDK-funded prevention study will seek to develop cost-effective interventions that can be widely applied in schools across the country.

The TODAY study chair is Dr. Francine R. Kaufman at Children's Hospital of Los Angeles. The coordinating center is at George Washington University, and the study centers include University of Colorado Health Sciences Center; Massachusetts General Hospital; Washington University School of Medicine and the Saint Louis University School of Medicine; State University of New York Upstate Medical University; Case Western Reserve University School of Medicine; University of Oklahoma Health Sciences Center; The Children's Hospital of Philadelphia; Children's Hospital of Pittsburgh; Baylor College of Medicine; and University of Texas Health Science Center at San Antonio.

The study is supported by the American Diabetes Association, LifeScan, GlaxoSmithKline and Eli Lilly and Company.

For more information about the Yale trial, call Cindy Guandalini at (203) 764-6652. To learn more about the national study, contact Joan Chamberlain or Jane DeMouy at NIDDK, (301) 496-3583 or visit the TODAY Study Q&A at www.niddk.nih.gov/patient/TODAY/QA.htm or the study's website at www.TODAYstudy.org.


T H I SW E E K ' SS T O R I E S

Eight Yale professors elected fellows . . .

Undergraduates create prize to honor faculty advisers

Fake patients helping medical students to develop real-world skills

Site offers special challenges to young architects

Summertime at Yale

SOM center wins grant for study of behavioral finance

FOUR FACULTY GET ENDOWED POSTS

Gallery acquires collection of Mediterranean coins

Alumni return to campus to celebrate reunions

AYA honors five for outstanding service with Yale Medals

Graduate School presents alumni with its highest honor

Three faculty members are hailed by graduate students . . .

Researchers solve riddle of what makes some mammals . . .

Study will compare treatments for children with type 2 diabetes

Susan Greenberg named the first Goldsmith Assistant Curator

Prize-winning series of articles cites Yale research

Athletics department staff go to bat for a worthy cause

Scientist Michel Devoret is honored . . .

Campus Notes

Concert to feature undergraduate musicians

2004 Commencement Information


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