This research study collects health-related information and blood samples to better understand how body composition, lifestyle habits, and diet influence meta-inflammatory monocytes (MiMos) in adolescents. The hypothesis of this study is that adolescents at risk for metabolic disease have enhanced MiMo related activities leading to insulin resistance.

Inclusion Criteria:

• Between 14 and 18 years of age
• Tanner stage 4 or 5 (mature adult stage of puberty)
• Normal weight (BMI ≥ 5th percentile & < 85th percentile), overweight (BMI > 86th percentile) & < 94th percentile), obese weight (BMI percentile ≥ 95th percentile), and/or pre-diabetes (HbA1c > 5.7%)
• For Type 2 Diabetes cohort, diagnosis of Type 2 Diabetes

Exclusion Criteria:

• Currently pregnant
• Use medications known to affect glucose metabolism (immunosuppressive medications, cancer medications, or high dose steroids), unless prescribed for Type 2 Diabetes management
• Prior diagnosis of autoimmune disease, cancer, or a cognitive or perceptual disability that would inhibit following directions of study staff
• Allergies or intolerance to milk, soy, or palm oil

Participants may be recruited from a variety of sites including University of Michigan clinical sites, non-University of Michigan clinical sites, local communities and schools throughout Southeast Michigan, and the University of Michigan campus.

Genomic and associated phenotypic data will be shared through NIH-designated data repositories.

Genotype/sequencing and phenotype data will be submitted after the genotyping/sequencing data have been cleaned. Following submission, data will be released within six months.

In regards to genomic data, individual-level data will be deidentified and made available through controlled-access.