Research Agenda: The overall goal of my research is to understand the risk factors and social implications of diabetes, with particular reference to minorities and children. Our major project has been a population-based incidence registry of diabetes in Chicago children ages 0-17, which has launched further studies of the genetic, social and clinical features distinguishing early-onset Type 2 from more typical Type 1 diabetes in children and young adults, its complications and diabetes- related mortality. I have for many years been involved in collaborative research on the cultural & psychological determinants of obesity and physical inactivity in the varied ethnic populations in Chicago, as well as in general epidemiologic questions related to chronic diseases of children and their sequelae.
The Chicago Childhood Diabetes Registry, an NIH-funded project since 1992, is ascertaining cases of diabetes occurring in Chicago residents aged 0-17. It represents the largest collection of children with diabetes of African American origin, and the largest group of Latino children with diabetes in the continental US. The public health importance of the impact of childhood diabetes cannot be overstated. An ancillary mortality study to the Registry documented a nine-fold excess risk for death in young African Americans with diabetes, compared with Caucasian Chicagoans. This effort has led to additional studies as follows:
A Family Study is in progress, where all family members of probands diagnosed with diabetes as children are examined for the presence of diabetes and cardiovascular risk factors. This work specifically addresses the questions: a) What are the determinants of type 1 and non-type 1 diabetes among youth-onset patients, and what can they tell us about the etiology of diabetes? Specifically, what is the role of type 2- and obesity-related genetic variation? b) What is the role of insulin resistance and diabetic phenotype in the sequence of events leading to the development of the Insulin Resistance Syndrome (IRS) and chronic diabetes complications in young patients and their relatives?
I and my colleagues recently completed Diabetes STYLE (Self-management Training in Youth for Lifelong Effectiveness), a pilot/feasibility study in preparation for a comprehensive psychosocial/educational intervention to assist older adolescents in making the transition to adulthood. This effort will measure the effects of education and peer support on disease management and quality of life in youth aged 18-25 living with diabetes.
The city-wide registry of childhood diabetes is based upon examining medical records at hospitals throughout Cook County. Pediatricians and endocrinologists from 38 institutions have been involved in the registry being able to obtain the needed data. The project has also allowed the opportunity for strong research collaborations to be formed with local clinicians and scientists, including research teams at the University of Illinois – Chicago and Northwestern University/Children’s Memorial Hospital. Current research in progress involves investigators from the University of Washington and the University of Florida. Dr. Lipton has been a collaborator on other projects with investigators from the Chicago Department of Public Health, the Illinois Department of Public Health, the Chicago Nutrition Education Center, the Woodlawn Adult Health Clinic, Illinois Masonic Hospital, Cook County Hospital and the Rush-Prudential health Plans.
Internationally, the Registry data have contributed to the DiaMond Project, a worldwide effort to understand the determinants of childhood diabetes. Our study had been represented in two papers (2000, 2006) on incidence and a recent publication on the risk factors for early diabetes complications (2006).