The U.S. government has launched the largest study ever of diabetes in children. The five-year program, SEARCH for Diabetes in Youth, involves more than 5 million, or 6 percent, of Americans from infancy to age 19.

The main goals of SEARCH:

• Classify all types and variations of childhood diabetes
• Estimate the number of cases by type, race, sex and age
• Note the causes and characteristics of each type
• Detail the complications of the disease
• Describe the quality of life of children with diabetes

Scientists with SEARCH reported in 2006 that obesity, long known to be a major risk factor for type 2 diabetes, can also speed the development of type 1 diabetes in children who already have severe damage to the pancreas. Childhood obesity may help explain why type 1 diabetes is being seen at earlier ages, the researchers reported.

The U.S. government has also begun the TODAY Study (Treatment Options for type 2 Diabetes in Adolescents in Youth). TODAY is comparing the effectiveness of three treatments for type 2 diabetes:

• The glucose-controlling drugs biguanides alone
• Biguanides with rosiglitazone (a thiazolidinedione)
• Biguanides with exercise and weight loss

Federal health officials in 2006 announced the largest-ever long-term of children’s health. The goal of the National Children’s Study is to follow at least 100,000 American children from birth through adulthood, in an effort to find the causes of diseases ranging from diabetes to autism. The project is to begin in 2007, with the first results released about 2010.

A new international effort called TEDDY (The Environmental Determinants of Diabetes in the Young) is testing more than 200,000 babies for several genes known to increase the risk of type 1 diabetes. This four-year genetic screening is expected to identify 13,000 high-risk babies. Half of them will be followed for 15 years in an effort to determine which environmental factors contribute to type 1 diabetes.

A similar study, PANDA (Prospective Assessment in Newborns for Diabetes Autoimmunity), is using a blood sample to identify infants at high genetic risk of type 1 diabetes and following them for five years.

Other topics being studied include the relationship of obesity to childhood diabetes, prenatal causes of diabetes, whether type 1 diabetes is on the rise in the United States as it is in Europe, and the genetic, racial, ethnic and gender differences in childhood diabetes. Scientists and public health authorities hope that such research will help stem the rising tide of diabetes in children.