“Barbara Linder has led the federal effort to address type 2 diabetes in children,” said Dr. Judith Fradkin of the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “Her accomplishments in advancing research to prevent and treat type 2 diabetes in youth have far-reaching benefits for children, their families and the broader public health.”
Diabetes, the seventh leading cause of death in the United States, is a chronic disease in which blood glucose (sugar) levels are above normal due to defects in insulin production or in the body’s ability to use insulin. Long-term complications include heart disease, stroke, blindness, kidney failure, nerve disease, gum disease and amputation of the foot or leg.
According to the Centers for Disease Control and Prevention (CDC), almost 26 million Americans have diabetes, including 215,000 people younger than 20 with type 1 or type 2 diabetes. A study funded by the CDC and NIH found that about 4,000 new cases of type 2 diabetes are now diagnosed nationally every year in those under age 20.
One of the studies overseen by Linder, known as HEALTHY, demonstrated that a middle school-based program to improve nutrition and increase physical activity could successfully reduce the children’s risk for type 2 diabetes.
The HEALTHY trial involved more than 4,000 students at 42 middle schools with predominantly Hispanic and African-American children from low-income households, most of whom were eligible for free or reduced-price lunches. Some schools pushed back on HEALTHY’s efforts to reform nutrition. Vending machines with unhealthy snacks and sodas were very profitable for schools with tight budgets. Other schools faced pressure to improve test scores and were wary of sacrificing classroom time for more time in physical education classes.
Linder oversaw scientists who negotiated with test schools to ensure they made substantial changes in food offerings and provided expanded opportunities for exercise. She also oversaw an agreement for the researchers to collect routine medical data, such as blood pressure and body mass index, and to carry out tests related to diabetes risk factors.
“The research findings from this study can inform future school-based efforts to reduce the escalating problems of overweight and obese American children,” said Fradkin. “U.S. research and health care efforts can build on HEALTHY’s wealth of information.”
A second clinical trial led by Linder compared the safety and efficacy of three treatment strategies for 699 overweight children with type 2 diabetes. One group in the study took a single drug, a second group took two medicines and a third group took one medication and engaged in an intensive lifestyle intervention. Up to this point, physicians treating youth with type 2 had been guided by evidence of therapeutic regimens tested only in adults.