MINORITY TYPE 1 DIABETES REGISTRY

描述：（改编自研究者摘要）本申请 要求继续进行大规模的人口登记， 非裔美国人中胰岛素依赖型糖尿病（IDDM）， 芝加哥的西班牙裔儿童。 书记官处项目平均包括49个 非洲裔美国人的案件和20西班牙裔事件案件每年。 这 非洲裔病例的数量是非洲裔病例的三倍多， 世界上任何其他登记处，以及西班牙裔病例数量最多的国家， 美国大陆。 调查人员将利用登记册进行调查 以下是两个直接相关的问题。 1. 胰岛素依赖型糖尿病自然史中的种族差异：最近的关注 关注的是一些年轻人最初被诊断为 胰岛素依赖型糖尿病实际上是糖尿病的一种变体。 迄今为止，没有基于人口的 关于美国青年糖尿病疾病谱的数据是可用的。 考虑到非裔美国人和 西班牙裔，很可能有独特的遗传和/或病理生理 在接受胰岛素治疗的少数民族儿童中起作用的过程。 调查人员 假设临床上非典型疾病将被描述为 相当大比例（5-15%）接受胰岛素治疗的少数患者，以及 它可以在家族基础上与自身免疫性糖尿病区分开来， 病史发病特征和遗传标记 2. 少数民族中的胰岛素依赖型糖尿病结局：研究人员最近证实， 在芝加哥， 非洲裔美国人比非西班牙裔白色患者在24岁之前， 也是发病率差异的证据 他们假设 如果控制持续时间， 登记的少数民族患者的并发症将大大超过 其他地方报道的非西班牙裔白色患者。 他们将 调查非裔美国人的死亡率 超过了芝加哥的西班牙裔患者，如果两者的死亡率 非洲裔美国人和西班牙裔患者超过其他地方公布的比率。 他们将完成以下具体任务：1）继续 芝加哥市少数民族儿童胰岛素依赖型糖尿病发病率登记; 2)确定这些人中非典型糖尿病的患病率 胰岛素治疗的青年发病患者; 3）构建一个评分来预测 年轻少数民族患者非典型糖尿病后续临床病程; 描述糖尿病并发症和死亡率的自然史 在患有胰岛素依赖型糖尿病的少数年轻人中。

DESCRIPTION: (Adapted from Investigator's Abstract) This application requests continuation of the large population-based registry of insulin-dependent diabetes mellitus (IDDM) among African-American and Hispanic children in Chicago. The Registry project includes on average 49 African-American cases and 20 Hispanic incident cases per year. This represents more than three times the number of African-origin cases than in any other registry worldwide, and the largest number of Hispanic cases in the continental US. The investigators will use the Registry to investigate two questions of immediate relevance, as follow. 1. Ethnic differences in the natural history of IDDM: Recent attention has focused on the possibility that some young people initially diagnosed with IDDM actually have a variant form of diabetes. To date, no population-based data are available on the spectrum of diabetic disease in U.S. youth. Considering the high risk of NIDDM among both African-American and Hispanics, there may well be unique genetic and/or pathophysiologic processes at work in insulin-treated minority children. The investigators hypothesize that clinically atypical disease will be described in a substantial proportion (5-15%) of insulin-treated minority patients, and that it can be distinguished from autoimmune diabetes on the basis of family history, onset characteristics, and genetic markers. 2. IDDM outcomes among minorities: The investigators recently demonstrated that the case-fatality rate for IDDM in Chicago is nine times greater among African-American than non-Hispanic white patients through age 24, and there is some evidence of disparities in morbidity as well. They hypothesize that, controlled for duration, the rates of early signs of developing complications in registered minority patients will significantly exceed those reported elsewhere among non-Hispanic white patients. They will investigate whether the mortality rate among African-American patients exceeds that among Hispanic patients in Chicago, and if mortality among both African-American and Hispanic patients exceed published rates elsewhere. They will accomplish the following specific tasks: 1) continue the incidence registry of IDDM among minority children in the City of Chicago; 2) determine the prevalence of atypical diabetes among these insulin-treated, youth onset patients; 3) construct a score to predict the subsequent clinical course of atypical diabetes in young minority patients; and 4) describe the natural history of diabetes complications and mortality in minority young people with IDDM.