DiCAYA: South Carolina Youth (Component A)

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PROJECT SUMMARY Between 2001 and 2009, the multi-site SEARCH for Diabetes in Youth study documented marked increases in the incidence and prevalence of type 1 diabetes (T1D) and type 2 diabetes (T2D) among youth. These trends were largely driven by increased incidence rates in racial and ethnic minorities. Ongoing surveillance of diabetes diagnosed in youth is essential to inform health care systems and generate testable hypotheses related to the natural history of diabetes in youth, but it cannot be accomplished through existing national survey-based surveillance efforts because of the rarity of diabetes in youth. Therefore, in response to RFA-DP- 20-001, Component A, we propose the South Carolina DiCAYA Youth study, which will ascertain newly- diagnosed incident diabetes cases statewide throughout the study period. Our approach is informed by almost 20 years of experience in South Carolina that allows us to conduct diabetes surveillance work in youth in a highly efficient manner, relying on a novel 2-step approach developed by our team which builds on electronic health record (EHR) data. Our specific aims are: Aim 1: To ascertain newly-diagnosed cases of incident diabetes in youth < 18 years of age in 2020 - 2024 in order to describe diabetes incidence in South Carolina, by age, sex, race/ethnicity, and diabetes type. Aim 2: To provide annual estimates of the prevalence of diabetes in youth < 18 years, by age, sex, race/ethnicity, and diabetes type, using mathematical modeling and the ascertained incidence data. South Carolina is uniquely positioned to contribute to the DiCAYA surveillance effort by employing our well-established surveillance infrastructure that has been refined for optimal efficiency while maintaining our exceptional levels of scientific rigor and ascertainment completeness. Moreover, we are comprised of a highly-experienced, collaborative and multi-disciplinary investigative team. Last but not least, South Carolina’s location in the South Atlantic census division and high proportion of non- Hispanic black residents will be critical to guaranteeing the representativeness of the overall DiCAYA surveillance effort, as South Carolina has contributed 21% of all incident T1D cases (48% of non-Hispanic black T1D) and 32% of all incident T2D cases (70% of non-Hispanic black T2D) to surveillance conducted by SEARCH. Thus, the well- established and highly- productive South Carolina team is uniquely positioned to provide critical information on the prevalence and incidence of diabetes in youth.