Kathrine: Contributing to Research on Type 2 Diabetes in Youth

Thirty-year-old Kathrine works for a non-profit organization whose mission is to create opportunities for people to live in affordable homes, improve lives, and strengthen communities. She grew up in Cleveland under the guardianship of her grandparents. Kathrine’s grandparents both have type 2 diabetes, and as a child she was used to seeing them treat themselves with medication. She describes herself as having been an overweight child, but nonetheless very active. “I never felt limited by my physical health,” she says.

"These medical problems happen more often in marginalized communities because we experience the health care system differently. If my grandparents hadn’t been paying attention, I could have become another statistic," says Kathrine, explaining how her grandparents noticed she was having diabetes symptoms at age 11.

However, her grandmother noticed that Kathrine appeared thirstier and more tired than normal and recognized there might be a problem. So, she took Kathrine to the hospital to have her tested—she was diagnosed with type 2 diabetes at age 11. Shortly thereafter, Kathrine and her family were informed of a new clinical trial that was about to begin that would test treatment approaches for type 2 diabetes in youth—the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study. As it turned out, a study site was located at Rainbow Babies & Children’s Hospital right there in Cleveland. “These medical problems happen more often in marginalized communities because we experience the health care system differently. If my grandparents hadn’t been paying attention, I could have become another statistic. But they jumped into action to make the conversation easier. It became a no-brainer for me to participate in the study,” remembers Kathrine. And so, her journey began.

Kathrine became the first participant to be placed in the TODAY study’s metformin and intensive lifestyle group. (Each of the participants was randomly assigned to receive either metformin alone or metformin in combination with another treatment strategy.)

The doctors and nurses involved in the study explained to Kathrine that she could make lifestyle changes such as incorporating healthy eating habits and increasing her physical activity to help control her blood sugar. This was appealing to her because she knew she did not want the burden of being dependent upon injected insulin to control her blood sugar. She thought the lifestyle changes would be helpful to achieving her many goals in life, including attending a prestigious private high school and going to college.

"I knew this was going to change my life," says Kathrine about meeting her TODAY lifestyle coach—a Black woman from her local Cleveland neighborhood.

Kathrine was determined to take these measures to regain control of her own health, a resolution strengthened by meeting her TODAY lifestyle coach—a Black woman who happened to be from the same neighborhood in Cleveland. “I knew this was going to change my life because I have this Black woman I can relate to, looking out for me." Her coach turned her on to cooking; Kathrine had never cooked healthy foods before, and she grew to enjoy it. Learning new skills in the kitchen, Kathrine was well on her way to improving her health. She lost 15 pounds and saw her blood sugar levels improve. “So much of the education I got from TODAY was about nutrition and that I can make the choice to eat well.”

After graduating from an elite private high school in Cleveland, Kathrine was accepted into and attended a university in Atlanta. The TODAY study team ensured she would have continuity of care in the trial and arranged for quarterly visits in Cleveland. As for many college students, Kathrine faced challenges during this time. She was no longer able to cook for herself in this setting—grabbing a bag of chips on the go was cheap and easy. There were also the additional stressors of college studies. Her weight fluctuated and her blood sugar spiked. Kathrine realized that she was neglecting her health during this time and needed to regain control. “Twenty-year-old me didn’t realize that this is a journey, not a destination,” she recalls.

Kathrine graduated with degrees in psychology and sociology and continued in the TODAY2 follow-up study. She returned for a time to Cleveland to work in grassroots community development, establishing farmers’ markets and community gardens in the neighborhood where she grew up, before ultimately returning to Atlanta for work and to pursue graduate studies. Through the years, Kathrine has relied upon the lifestyle education she received in the TODAY study to help guide her choices. She joined a running club, runs several miles per day now, and cooks healthful meals for herself daily. Today, Kathrine maintains a healthy weight and, quite impressively, her blood sugar levels are below that of even being considered to have prediabetes. This, along with the fact that she no longer requires diabetes medication, is a testament to her incredible determination and dedication. This past August, Kathrine received her master’s degree in communications and public policy, and she’s excited to continue her career in community development and confident her future is bright and healthy.

Reflecting upon her experience in the TODAY trial, Kathrine expresses extreme gratitude: "TODAY didn’t complete me. It complemented me. It gave me the tools to be a better me."

Reflecting upon her experience in the TODAY study, Kathrine expresses extreme gratitude. She says the study team watched her grow up, tracked her progress, and provided continuity of care. “TODAY didn’t complete me. It complemented me. It gave me the tools to be a better me.”

Diabetes does not define Kathrine. She knows now that she is in control of her own health. She’s not Kathrine, the person with diabetes. She is Kathrine, the student, the professional, the runner, the home cook, the community activist—who happens to be managing risk for type 2 diabetes. She exclaims proudly: “I am not one thing. I am everything!”