Arginine Metabolism in Youth With Type 2 Diabetes

Type 2 diabetes (T2D), once considered only "a disease of older ages," is now a significant public health concern in youth. Although it is characterized by insulin resistance and impaired insulin secretion, its precise etiology and pathogenesis are not yet fully understood. This study aims to (1) explore arginine metabolism in youth with T2D via safe, minimally invasive kinetic experiments using stable isotope tracers and targeted metabolomics, and (2) determine the effect of exogenous arginine administration on β-cell function in youth with T2D, potentially supporting the use of this safe, low-cost, and readily available nutrient to improve pediatric diabetes outcomes.

Inclusion Criteria: 1. Youth with type 2 diabetes and healthy controls who meet other inclusion criteria outlined below. 2. Age and pubertal stage criteria (12- to 20-year-old girls who are postmenarchal, and 14- to 20-year-old boys who are at Tanner stage 5 genitalia), 3. Additional criteria for youth with diabetes: i. diagnosis of T2D, and ii. diabetes duration between 3 months and 10 years. Exclusion Criteria: 1. Previous history of diabetic ketoacidosis (DKA) 2. Poorly controlled diabetes defined as HbA1c \>7.5%, 3. Abnormal liver, thyroid, gonadal or adrenal functions, 4. Renal insufficiency defined by eGFR (estimated glomerular filtration rate) \