Looking Earlier: Searching for the First Signs of Diabetes Risk in Children

Researchers at the University of Tennessee Health Sciences are launching a study to investigate whether changes in children’s immune cells could reveal early signs of the processes leading to type 2 diabetes. Shannon Rose, an associate professor in the College of Nursing, received a **two-year, $423,500 grant** from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The project will examine blood samples from **30 children aged six and seven**, focusing on how individual immune cells generate energy and how those patterns relate to insulin resistance.

The team will compare three groups: children with healthy weight and normal insulin sensitivity, children with obesity but normal insulin sensitivity, and children with obesity and insulin resistance. Single-cell sequencing will help identify differences in T-cell populations and their metabolic pathways. Participants will also undergo a body-composition scan and complete assessments of diet and physical activity. Studying children before puberty helps reduce the influence of the temporary insulin resistance that can accompany normal adolescent development.

The research addresses a central question: why do some children with obesity develop insulin resistance while others do not? Rose’s collaborators include pediatric endocrinology practitioner Jamila Smith-Young, endocrinologist Sam Dagogo-Jack and biostatistician Xueyuan Cao. Identifying relevant immune-cell patterns could eventually inform earlier detection or research into targeted interventions. However, **this is a newly funded exploratory study, not a report of completed findings**. It has not established an early-warning test or demonstrated that changing these immune pathways prevents diabetes; its immediate purpose is to clarify the biology at an early stage.