SEARCH for Diabetes in Youth 2: Hawaii Center

描述(由申请人提供)：该提案建立在一个为期五年的研究项目--青年糖尿病研究项目的基础上，其标准化的数据收集工作、经验丰富的调查团队、已建立的病例查明基础设施以及不同种族的人口基础。这是六个搜索临床站点共同的综合应用，它建议继续和扩大Search进行的工作，以解决以下具体研究目标：目的1：前瞻性确定年龄在20岁以下的新诊断(2006-2008年)糖尿病(DM)病例，以估计青年糖尿病(DM)发病率的时间趋势；目标2：对2002-2005年已招募进行搜索的事件病例进行纵向跟踪，以根据临床和生化因素记录新诊断DM的演变；目标3：在搜索的头五年中启动的完整分析，并扩大护理质量评估的范围，以涵盖更广泛定义的质量概念和衡量标准；以及目标4：制定和验证可用于公共卫生监测的简单和低成本的青年糖尿病病例定义和分类。 这一建议的新颖性包括其综合性，汇集了儿童糖尿病研究的主要和及时的方面；一项在美国独一无二的关于青年糖尿病发病率时间趋势的流行病学研究；涉及青年糖尿病自然病史的病理生理学部分；关于护理过程和生活质量的研究；以及关于青年糖尿病病例分类的公共卫生观点。这项研究对公共卫生至关重要，因为它将提供有关糖尿病在美国不同种族/民族的青年中是否正在增加以及增加了多少的信息，糖尿病如何影响身体健康，包括并发症，以及关于这些青年的护理质量和生活质量的宝贵数据。 夏威夷的SEARCH研究是以人口为基础的，参与研究的三个医疗保险计划的成员包括该州近80%的人口。在夏威夷参加搜索的年轻人中，大约80%属于少数族裔群体，主要是亚洲/太平洋岛民(API)。夏威夷中心对研究中的面对面访问的应答率最高，约占全国纳入研究的API病例的一半。搜索数据表明，API中2型糖尿病的患病率是非西班牙裔白人的3倍。作为一个研究中心，夏威夷提供了许多优势，包括低未参保居民比率和低移民，而且由于地理上的隔绝，糖尿病治疗几乎只在该州得到。

DESCRIPTION (provided by applicant): The proposal builds upon a five year research project, SEARCH for Diabetes in Youth, and its standardized data collection effort, experienced investigator team, established case ascertainment infrastructure, and ethnically diverse population base. This is a common, integrated application from the six SEARCH clinical sites, which proposes to continue and expand the work performed by SEARCH in order to address the following specific research aims: AIM 1: Prospectively ascertain newly diagnosed (2006-2008) incident cases age less than 20 years in order to estimate temporal trends in incidence of diabetes mellitus (DM) in youth; AIM 2: Conduct longitudinal follow-up of incident cases already recruited to SEARCH in 2002-2005 in order to document the evolution of newly diagnosed DM according to clinical and biochemical factors; AIM 3: Complete analyses initiated in the first five years of SEARCH and expand the scope of quality of care assessment to encompass more broadly defined concepts and measures of quality; and AIM 4: Develop and validate simple and low-cost case definitions and classifications of DM types in youth that can be used for public health surveillance. The novelty of this proposal includes its comprehensive nature that brings together major and timely facets of childhood DM research; an epidemiologic study, unique in the United States, of temporal trends in the incidence of DM in youth; a pathophysiologic component addressing the natural history of DM in youth; a study of processes of care and quality of life; and a public health perspective on case classification of DM in youth. This research is critically important to public health as it will provide information about whether and how much DM is increasing among youth of different racial/ethnic groups in the U.S., how DM impacts physical health, including complications, as well as valuable data regarding the quality of care and quality of life of these youth. The SEARCH study in Hawaii is population-based, with the three health insurance plans participating in the study including in their membership nearly 80% of the population of the State. Approximately 80% of the youth enrolled in SEARCH in Hawaii belong to an ethnic minority group, primarily Asian/Pacific Islanders (API). The Hawaii Center had the highest response rate to in person visits in the study and accounts for approximately half of the API cases included in the study nationwide. SEARCH data indicates that the prevalence of Type 2 diabetes among API was 3 times higher compared to non-Hispanic whites. As a study center, Hawaii offers many advantages including a low rate of uninsured residents and low migration, and due to geographic isolation, diabetes care is received almost exclusively within the State.