SEARCH FOR DIABETES IN YOUTH

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 糖尿病是肾病、视网膜病、神经病以及冠状动脉和外周血管疾病的主要原因，是美国儿童期第三大流行的严重慢性疾病。 在20岁之前被诊断出患有糖尿病的人的预期寿命比非糖尿病患者短15-27年。 直到最近，在儿童和青少年中诊断出的糖尿病几乎完全被认为是1型，这通常是由于胰腺β细胞的破坏导致胰岛素的绝对缺乏。 儿童和青少年糖尿病现在被认为是一种复杂的疾病，其发病机制，临床表现和临床结局具有异质性。 然而，由于最近才认识到儿童和青少年糖尿病的范围更广，因此在这个年龄组中没有区分糖尿病类型的金标准定义。 此外，最近有报道称，儿童患有具有2型糖尿病临床特征的糖尿病，迄今为止，2型糖尿病被认为是成人疾病。 青少年，特别是少数民族青少年的2型糖尿病发病率似乎正在以惊人的速度增加，但这种增加的幅度尚不清楚。 最后，关于儿童和青少年糖尿病，特别是2型糖尿病的临床病程和演变的信息有限。 这项名为“青年糖尿病预防”的研究将确定20岁以下人群中糖尿病的流行和偶发病例，以便： a）、 估计1型、2型和其他类型（或混合型）糖尿病的总体和年龄及种族的人群患病率和发病率。 B） 为流行和偶发病例制定有效和实用的糖尿病类型分类方法。 c）、 描述和比较1型、2型和其他类型（或混合型）糖尿病的临床表现和病程。 其次，研究将： a）、 描述所选微血管和大血管疾病并发症的危险因素的分布，以及它们在糖尿病类型中的不同。 B） 描述所选的急性和慢性并发症的分布，以及它们在糖尿病类型中的流行和偶发病例的差异。 c）、 分别描述流行病例和发病病例的卫生保健利用、护理过程和生活质量。 最后，研究中心将开发与研究参与者保持联系的系统，以促进辅助研究和长期随访，并将建立一个长期储存作为研究中心一部分获得的生物标本的储存库，并建立获取这些标本的流程。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Diabetes Mellitus, a leading cause of nephropathy, retinopathy, neuropathy, and coronary and peripheral vascular disease, is the third most prevalent severe chronic disease of childhood in the United States. People with diabetes diagnosed before age 20 have a life expectancy that is 15-27 years shorter than non-diabetic people. Until recently, diabetes diagnosed in children and adolescents was almost entirely considered to be type 1, which is usually due to the destruction of the beta cells of the pancreas leading to an absolute deficiency of insulin. Diabetes in children and adolescents is now acknowledged to be a complex disorder with heterogeneity in its pathogenesis, clinical presentation, and clinical outcome. However, because recognition of the broader spectrum of diabetes in children and adolescents is recent, there are no gold standard definitions for differentiating the types of diabetes in this age group. Also recent are reports of children who present with diabetes that has the clinical characteristics of type 2 diabetes, which was heretofore considered a disease of adults. The incidence of type 2 diabetes in adolescents, especially minority adolescents, appear to be increasing at alarming rates, but the magnitude of this increase is not known. Finally, information about the clinical course and evolution of diabetes in children and youth, particularly type 2 diabetes, is limited. The study "SEARCH for Diabetes in Youth" will identify prevalent and incident cases of diabetes among individuals under age 20 years in order to: a) Estimate the population prevalence and incidence of type 1, type 2, and other type (or hybrids) of diabetes rates overall and by age and ethnicity. b) Develop efficient and practical approaches to classification of diabetes type for prevalent and incident cases. c) Describe and compare clinical presentation and course of type 1, type 2 and other types (or hybrids) of diabetes. Secondarily, the study will: a) Describe the distribution of risk factors for selected micro- and macrovascular disease complications and how they differ by diabetes type separately for prevalent and incidence cases. b) Describe the distributions of selected acute and chronic complications and how they differ by diabetes types for prevalent and incident cases. c) Describe the health care utilization, processes of care, and quality of life separately for prevalent and incidence cases. Finally, the SEARCH will develop system (s) to maintain contact with study participants in order to facilitate the ancillary studies and long term follow-up, and it will establish a repository for long-term storage of biologic specimens obtained as a part of SEARCH and establish processes for access to these specimens.