SEARCH for Diabetes in Youth 2: Hawaii Center

这项建议建立在一个为期五年的研究项目，青年糖尿病，其标准化的 数据收集工作，经验丰富的研究者团队，建立的病例确定基础设施，以及 种族多样的人口基础。这是一个常见的，集成的应用程序，从六个临床 建议继续并扩大联合国难民事务高级专员办事处开展的工作， 具体研究目标： 目的1：初步确定2006-2008年新诊断的20岁以下发病病例，以便 估计青年糖尿病（DM）发病率的时间趋势; 目标2：对2002-2005年已被招募到卫生部的事件进行纵向跟踪， 根据临床和生化因素记录新诊断的DM的演变; 目标3：完成在项目前五年启动的分析，并扩大项目的质量范围。 护理评估应包括更广泛定义的概念和质量衡量标准; 目的4：开发和验证青年DM类型的简单和低成本病例定义和分类 可以用于公共卫生监测。 这项建议的新奇包括它的全面性，它将主要和及时的方面结合在一起， 儿童期糖尿病研究：一项流行病学研究，在美国是独一无二的， 青年糖尿病发病率;青年糖尿病自然史的病理生理学组成部分; 护理过程和生活质量的研究;以及对糖尿病病例分类的公共卫生观点， 青年这项研究对公共卫生至关重要，因为它将提供有关是否和 在美国不同种族/民族的年轻人中，DM增加了多少，DM如何影响 身体健康，包括并发症，以及有关护理质量和医疗质量的宝贵数据。 这些年轻人的生活。 在夏威夷进行的健康保险研究是以人口为基础的，三个健康保险计划参与了 该研究包括在其成员近80%的国家的人口。大约80%的 在夏威夷注册的青年属于少数民族，主要是亚洲/太平洋地区的青年 岛民（API）。在这项研究中，夏威夷中心对亲自访问的回应率最高， 约占全国研究中纳入的API病例的一半。数据显示， 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，包括低比例的未投保居民和低 此外，由于人口移徙，以及地理位置偏远，糖尿病护理几乎完全在国内接受。

This 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; 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 US, 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.