Genetic Testing for Type 2 Diabetes in High-Risk Children: the Case for Primordial Prevention

Open science in practice: 300 published research ideas and outcomes illustrate how RIO Journal facilitates engagement with the research process

Since Research Ideas and Outcomes was launched in late 2015, it has stimulated experimentation around the publication of and engagement with research processes, especially those with a strong open science component. Here, we zoom in on the first 300 RIO articles that have been published and elucidate how they relate to the different stages and variants of the research cycle, how they help address societal challenges and what forms of engagement have evolved around these resources, most of which have a nature and scope that would prevent them from entering the scholarly record via more traditional journals. Building on these observations, we describe some changes we recently introduced in the policies and peer review process at RIO to further facilitate engagement with the research process, including the establishment of an article collections feature that allows us to bring together research ideas and outcomes from within one research cycle or across multiple ones, irrespective of where they have been published.

Feasibility and Acceptability of a Type 2 Diabetes Prevention Intervention for Mothers and Children at a Federally Qualified Healthcare Center

BACKGROUND

Maternal obesity and gestational diabetes mellitus (GDM) contribute to increased risk for type 2 diabetes mellitus (T2DM) among both mothers and their offspring. Randomized trials demonstrated T2DM risk reduction in adults following lifestyle behavior change and modest weight loss; the evidence base for at-risk children remains limited.

PURPOSE

Evaluate the feasibility, acceptability, and preliminary efficacy of a T2DM prevention intervention for mother-child dyads delivered by Federally Qualified Health Center staff.

METHODS

A group randomized design tested the effects of a behavioral lifestyle intervention on T2DM risk factors in women with a history of GDM and their 8- to 12-year-old children. Mother-child dyads were recruited and randomized to intervention or wait-listed control conditions. Intervention participants completed the 13-week intervention; control participants received standard of care. Baseline and 13-week measures assessed program acceptability and feasibility, and explored effects on body weight, waist circumference, hemoglobin A1c, and lifestyle behaviors.

RESULTS

Forty-two dyads were randomized and 35 (83%) completed pre-/post-measurements. Participants and program leaders positively rated content and engagement. Nearly all strongly agreed that activities were enjoyable (97%), applicable (96%), useful (97%), and motivational (96%). Attendance averaged 65% across 2 cohorts; delivery costs were approximately $225/dyad. There were no significant differences in body weight, BMI (or BMI z-score), waist circumference, hemoglobin A1c, diet quality, physical activity, sleep, or home environment changes between intervention and control groups.

CONCLUSIONS

A family T2DM prevention program was feasibly delivered by FQHC staff, and acceptable to mothers and children. Program efficacy will be evaluated in an adequately powered clinical trial.

The Continuing Evolution of Precision Health in Type 2 Diabetes: Achievements and Challenges

PURPOSE OF REVIEW

The purpose of this review was to summarize recent advances in the genomics of type 2 diabetes (T2D) and to highlight current initiatives to advance precision health.

RECENT FINDINGS

Generation of multi-omic data to measure each of the "biologic layers," developments in describing genomic function and annotation in T2D relevant tissue, along with the increasing recognition that T2D is a heterogeneous disease, and large-scale collaborations have all contributed to advancing our understanding of the molecular basis of T2D. Substantial advances have been made in understanding the molecular basis of T2D pathogenesis, such that precision health diabetes is increasingly becoming a reality. For precision diabetes to become a routine in clinical and public health, additional large-scale multi-omic initiatives are needed along with better assessment of our environment to delineate an individual's diabetes subtype for improved detection and management.