Grant: Project Grant

Youth onset type 2 diabetes (T2D) is increasing in children worldwide and especially in First Nation children in Canada. These youth develop early onset kidney disease that can lead to kidney failure in young adulthood despite receiving lifestyle and diabetes drugs. Current treatment approaches are failing. Youth have identified stress and lack of supports as critical barriers to managing their disease. We are proposing an extension of the iCARE cohort study to further evaluate the most relevant risk factors for worsening kidney disease using a wholistic approach in 350 existing and 150 new participants age 10-18 years with T2D from centres across Canada. Embedded within the study we will recruit 30 Manitoba children to study a new skills-based mental health intervention called Dialectical Behavioural Therapy (DBT) to help youth understand, manage and cope with their emotions. The program is 16 weeks long and runs once weekly for 2 hours/session (in person or virtual). We will evaluate DBT success (participation rates, retention and participation) and acceptability utilizing traditional and Indigenous Worldview interview techniques. In parallel, we will work with our Patient Advisory Group and Indigenous partners to determine how best to incorporate Traditional Medicine components into a modified DBT curriculum. We will then refine the DBT program and recruit an additional 30 Canadian children to evaluate the modified intervention. Our team has expertise in diabetes, kidney disease, Indigenous health, mental health, trials and interviewing. We are hopeful this study will provide new knowledge about how mental health and social factors impact kidney complication development and progression. At the same time, we are evaluating a new approach to help youth with T2D learn skills to manage their emotions and their disease. If our findings are promising this study will lead to a multi-centre International study to test DBT benefit more broadly.