Looking more closely at the developmental origins of pediatric obesity and diabetes will help researchers and clinicians not only develop better ways to treat obesity and diabetes, but perhaps stave off their onset, according to Dana Dabelea, MD, PhD, this year’s recipient of the Kelly West Award for Outstanding Achievement in Epidemiology.
Dr. Dabelea, the Conrad Riley Endowed Professor and Director of the LEAD Center at the Colorado School of Public Health, will deliver her award lecture, “Diabetes in Youth—Looking Backwards to Inform the Future,” at 2:15 p.m. Sunday in room 28.
“Data from the SEARCH study I will be presenting suggests that after a relatively short period of time, adolescents with type 1 and type 2 diabetes have a heavy burden of diabetes-related complications and comorbidity,” said Dr. Dabelea, a site investigator for the SEARCH for Diabetes in Youth study.
Research shows one in three youths with type 1 diabetes and three in four youths with type 2 have at least one diabetes complication, she explained. But clinicians often think that adolescence is too early for patients to suffer from severe diabetes complications, she added.
“Some of the data I am going to present show it’s not and that we should be alert and screen these adolescents and young adults to control their risk factors very tightly so that we prevent further morbidity and mortality,” she said.
Dr. Dabelea will explore what she calls the “transgenerational vicious cycle of diabetes and obesity in children.” She will discuss the exposome, a totality of environmental exposures that increase the risk of obesity and diabetes early in life.
There’s a significant need to leverage and support existing studies and fund new studies, Dr. Dabelea said, including cohort studies that start before birth and follow children throughout their in utero development and postnatal life to better understand the exposome and how it predisposes children to obesity and diabetes.
“We need to continue surveillance of pediatric diabetes so that we understand what’s happening with today’s children in terms of their burden and risk for diabetes, and the effect of the programs that we put in place on these trends. Without strong surveillance systems, we cannot monitor these,” Dr. Dabelea said.
“Obviously, we also need randomized clinical trials and translational programs,” she continued. “Inspired by the successes with diabetes prevention in adults, the DPP [Diabetes Prevention Program] study, we need to now break the vicious cycle of diabetes and obesity by acting much earlier than in older adults with what we call primordial prevention—prevention of risk factors for diabetes, not just prevention of diabetes in high-risk individuals. We need to do that at various points throughout this vicious cycle—during pregnancy, in early life, and as these children grow up before they reach adulthood.”
Just as critically, clinicians must understand the burden of diabetes in children and its aggressive nature, she said.
“Even after a short period of time, adolescents and young adults display complications, which means that we need to more aggressively control blood glucose, obesity, blood pressure, dyslipidemia—all the risk factors that predispose these adolescents to morbidity and mortality,” Dr. Dabelea said.