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Objective: This study estimated the screening prevalence of prediabetes and diabetes using a lower BMI cutoff of 23 kg/m(2) in Asians in the U.S. using the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2012.Research Design and Methods: A cross-sectional analysis was conducted of non-Hispanic Asians, aged 45 years and older, with available BMI, HbA1c, and fasting glucose data. These overall criteria were met by 341 participants.Results: Lowering the screening BMI to 23 kg/m(2) increased the sensitivity of screening for prediabetes and diabetes from 50.2 to 74.1% (P < 0.0001) but decreased the specificity from 62.9 to 38.7% (P < 0.0001).Conclusions: Although this will add additional health care costs resulting from more widespread screening, early identification of these conditions may be beneficial for primary and secondary prevention in this unique population that develops prediabetes and diabetes at lower BMI levels. [ABSTRACT FROM AUTHOR]

The National Institutes of Health's Environmental Influences on Child Health Outcomes (ECHO) program aims to study high-priority and high-impact pediatric conditions. This broad-based health initiative is unique in the National Institutes of Health research portfolio and involves 2 research components: (1) a large group of established centers with pediatric cohorts combining data to support longitudinal studies (ECHO cohorts) and (2) pediatric trials program for institutions within Institutional Development Awards states, known as the ECHO Institutional Development Awards States Pediatric Clinical Trials Network (ISPCTN). In the current presentation, we provide a broad overview of the ISPCTN and, particularly, its importance in enhancing clinical trials capabilities of pediatrician scientists through the support of research infrastructure, while at the same time implementing clinical trials that inform future health care for children. The ISPCTN research mission is aligned with the health priority conditions emphasized in the ECHO program, with a commitment to bringing state-of-the-science trials to children residing in underserved and rural communities. ISPCTN site infrastructure is critical to successful trial implementation and includes research training for pediatric faculty and coordinators. Network sites exist in settings that have historically had limited National Institutes of Health funding success and lacked pediatric research infrastructure, with the initial funding directed to considerable efforts in professional development, implementation of regulatory procedures, and engagement of communities and families. The Network has made considerable headway with these objectives, opening two large research studies during its initial 18 months as well as producing findings that serve as markers of success that will optimize sustainability., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2020 by the American Academy of Pediatrics.)