Dealing with diabetes

Toni Moran, M.D., is on the front lines of an epidemic—skyrocketing rates of diabetes in children.

There are two types of diabetes, a disease that disrupts the conversion of food to energy. Moran, a professor in the Department of Pediatrics, says both types are becoming more common in kids. She estimates that 1 in 300 children has type 1 diabetes, while type 2 diabetes, once rare in kids, now constitutes about 1 in 5 cases she sees.

"Type 1 diabetes and other autoimmune disorders are increasing, but we don't know why," Moran says.

The rise in type 2 is less mysterious. "It is clearly tied to obesity," she says. "Absolutely, no doubt."

Tackling type 1

Type 1 diabetes can be treated with insulin injections, but they're imperfect tools. Imperfect control of blood sugar levels can lead to numerous problems, including blindness and kidney failure.

Moran, who is regional director for a series of studies through a worldwide research network called TrialNet, has been looking for ways to prevent type 1 diabetes—or at least minimize its impact.

Because type 1 diabetes has both genetic and environmental components, is caused by immune system malfunction, and develops gradually, Moran believes there could be a spectrum of strategies for preventing or stalling its progression.

A complex problem

University of Minnesota researchers have been tracking key measures of health in nearly 400 Minneapolis schoolchildren since 1995. They hope to understand the development and consequences of metabolic syndrome, a cluster of conditions associated with type 2 diabetes that includes obesity, high blood pressure, high cholesterol, and insulin resistance.

"Some people have thought childhood and adolescence are periods of relative safety from the metabolic complications of diabetes," Moran says. "We're finding that belief is wrong. It's very important that we identify at-risk kids and try to change those risk factors as early as possible."

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