Longtitudinal Diabetes Care

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DESCRIPTION (provided by applicant): The Candidate: Dr. Elasy is a tenured Associate Professor of Medicine at Vanderbilt University . Evidence of his success as a translational (T2) diabetes research mentor is primarily the productivity and external funding of his mentees (13 first authored publications by his mentees since 2004; one K23 funded application (2005) and one pending K23 application; one NIDDK minority supplement to his grant (R18 DK062258-03) and another minority supplement to the Vanderbilt Diabetes Research and Training Center (DRTC P60 DK020593-28). The Environment: The environment at Vanderbilt University is highly conducive to the conduct of POR and Vanderbilt has unequivocally committed to Dr. Elasy's career as both a translational diabetes researcher and mentor. Of note, Dr. Elasy's integration with the K30 program has given him access to mentees, especially minority faculty, outside of Endocrinology who have gone on to do focused research in Diabetes. The Research Plan: This proposal addresses a line of inquiry regarding an optimal "dose" of diabetes care required to sustain optimal longitudinal diabetes care. Employing a randomized clinical trial the study addresses four specific aims. 1)To assess the relative effectiveness of 3 management approaches, varying in intensity, for preventing glycemic relapse after acceptable glycemic control is achieved; 2)To determine patient characteristics and behaviors that are prospectively predictive of successful relapse prevention in order to better understand the target group most likely to respond to a given maintenance plan; 3)To determine prospectively the predictors of failure to prevent glycemic relapse so as to better identify subgroups in need of alternate maintenance strategies; 4)To determine the differences in activity cost between intervention arms using activity based accounting. The Mentoring Plan:ln addition to a weekly journal clubs that highlight the methodological aspects of research and two (one for medical students/residents/fellows and another for junior faculty) weekly work-in-progress sessions for translational diabetes investigators, Dr. Elasy outlines specific skills his mentees will acquire beyond the formal training that some will receive as a result of the MPH or MSCI degree that are available. Relevance to Public Health: This K24 accelerates and heightens our understanding of optimal strategies to control diabetes. It also provides mentorship support for those who will lead this effort in the future.