# Metabolic Health during Puberty: the Healthy Start Study

> **NIH NIH R01** · UNIVERSITY OF COLORADO DENVER · 2022 · $699,478

## Abstract

PROJECT SUMMARY/ABSTRACT
Type 2 Diabetes (T2D) has been increasing worldwide, in both adults and youth. Youth-onset T2D is strongly
associated with obesity, characterized by rapid β-cell failure, early morbidity and mortality, and it almost
universally presents in mid-puberty, a period of physiologic insulin resistance.
However, our knowledge of the pathophysiology of youth-onset T2D is limited as it is primarily derived from
cross-sectional studies, and longitudinal studies do not span the entire pubertal transition or only include youth
with obesity. Such studies are not able to provide an understanding of the physiologic changes in glucose-insulin
homeostasis during puberty, and of how prior metabolic health influences them. We also know of several risk
factors for youth-onset T2D, but we do not know how they operate. These gaps prevent us from accurately
predicting and preventing youth-onset T2D.
The overarching goal of this proposal is to improve our understanding of metabolic health and dysregulation
during puberty, and their determinants. To address this goal we propose to extend the longitudinal follow-up of
the Healthy Start (HS) Cohort, a maternal-offspring community-based cohort study that enrolled 1418 pregnant
women and conducted detailed characterization of mothers during pregnancy, of offspring through age ~7 years
(R01DK076648), and ongoing at ages 8-10 years (through the Environmental Influences on Child Health
Outcomes –ECHO- Consortium, UH3OD023248). This cohort is now transitioning through puberty.
We will follow up 500 youth age 10-15 years throughout puberty to address specific aims: Aim 1: Describe
glycemic trajectories [A1c, fasting and postload glucose, area under the glucose curve, time to peak during an
oral glucose tolerance test-OGTT], and their metabolic correlates, during puberty; Aim 2: Explore the sequence
of metabolic changes linking early life exposures to pubertal glucose-insulin homeostasis; Aim 3: Assess the
importance of established genetic risk factors and characterize gene-environment interactions on pubertal
glucose-insulin homeostasis.
An improved understanding of the physiological changes in glucose-insulin homeostasis as youth transition
through puberty will provide foundational knowledge to better predict future youth-onset T2D risk. An improved
knowledge of the sequence of metabolic changes resulting from early life exposures and influencing adiposity
and glucose-insulin metabolism, in the context of genetic susceptibility to T2D, will inform potential prevention
approaches.

## Key facts

- **NIH application ID:** 10499864
- **Project number:** 1R01DK133235-01
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Dana Dabelea
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $699,478
- **Award type:** 1
- **Project period:** 2022-07-01 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10499864

## Citation

> US National Institutes of Health, RePORTER application 10499864, Metabolic Health during Puberty: the Healthy Start Study (1R01DK133235-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10499864. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*