Assessing the Burden of Diabetes by Type in Children, Adolescents and Young Adults (DiCAYA) - Component B (18 to < 45 yrs)

按类型评估儿童、青少年和年轻人的糖尿病负担 (DiCAYA) - B 部分（18 岁至 < 45 岁）

• 批准号: 10636654
• 负责人: Kristi Reynolds
• 金额: $ 25万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2025-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10636654
• 关键词: Assessing; Burden; Diabetes; Type; Children

Project Summary Diabetes, a spectrum of metabolic diseases caused by deficits in insulin secretion, insulin action, or both, is one of the most common chronic diseases among adults, effecting over 30 million people in the United States in 2017. Using data from the National Health Interview Survey (NHIS), the CDC estimated that young adults ages 18-44 years account for ~ 3 million diagnosed diabetes cases and 1.6 million undiagnosed cases in the US in 2015, with 3.1/1,000 individuals in this age group developing diabetes each year. NHIS results are based on self-report of diagnosis date, insulin use, and diabetes type, which may not accurately assess diabetes status and type. In 2017, the Diabetes in Young Adult (DiYA) study estimated that the age- and sex- standardized diabetes incidence rate was 3.8/1,000 using information in electronic health records (EHR) of a racially/ethnically diverse population of over 2.1 million health plan members 18-44 years in California. Given that the incidence and prevalence of diabetes in US children and adolescents < 18 years continues to increase and there is minimal mortality among this age group, these increases will in part drive increases in prevalence of diabetes in young adults. A major challenge of diabetes surveillance in this age group is that most reported estimates of incidence and prevalence are not type-specific. Use of electronic health records (EHRs) allow for the assessment of type based on clinicians' determination and provides other clinical and demographic information such as pharmacological treatment, body mass index, age and race/ethnicity. The Aims of this study are: Aim 1: To ascertain prevalent diabetes cases in calendar years 2020-2024 among young adults ages 18-44 years at diagnosis, using cost-efficient approaches that maximize use of information in the electronic health records (EHRs) and administrative databases. Aim 2: To ascertain newly diagnosed (incident 2020-2024) diabetes cases in young adults ages 18-44 years, using cost-efficient approaches that maximize use of EHRs and administrative data. Aim 3: To describe selected clinical characteristics at diagnosis and determine if these characteristics have changed over time. This study will be conducted in Kaiser Permanente Southern California (KPSC), an integrated health care system that has ~1.4 million members age 18-44 years in an 8-county area including Los Angeles county, the largest county in California. The racial/ethnic diversity of the membership, the wealth of clinical information in the EHR including diagnosis codes from inpatient, outpatient, and virtual care encounters; laboratory test results including diabetes autoantibodies (when ordered); dispensed prescriptions, height, weight, blood pressure, and patient reported outcomes that can be linked to demographic and membership data including health plan enrollment start and end dates, creates a robust platform for diabetes surveillance activities.

项目概要 糖尿病是由胰岛素分泌缺陷、胰岛素作用缺陷或两者兼而有之引起的一系列代谢疾病， 成年人中最常见的慢性疾病之一，影响美国超过 3000 万人 2017 年。根据国家健康访谈调查 (NHIS) 的数据，疾病预防控制中心估计年轻人 年龄在 18-44 岁之间的糖尿病患者约有 300 万例，未确诊病例有 160 万例 2015 年，美国这个年龄段的人每年有 3.1/1,000 人患上糖尿病。 NHIS 结果基于 自我报告诊断日期、胰岛素使用情况和糖尿病类型，这可能无法准确评估糖尿病 状态和类型。 2017 年，年轻人糖尿病 (DiYA) 研究估计，年龄和性别 根据电子健康记录 (EHR) 中的信息，标准化糖尿病发病率为 3.8/1,000 加利福尼亚州有超过 210 万 18-44 岁的健康计划成员，其中种族/族裔多样化。给定 美国 18 岁以下儿童和青少年的糖尿病发病率和患病率持续增加 而且这个年龄组的死亡率最低，这些增加将部分推动患病率的增加 年轻人的糖尿病。该年龄段糖尿病监测的一个主要挑战是，大多数报告 发病率和患病率的估计值不针对具体类型。使用电子健康记录 (EHR) 可以 根据临床医生的决定进行类型评估，并提供其他临床和人口统计信息 药物治疗、体重指数、年龄和种族/民族等信息。本次活动的目的 研究目标： 目标 1：确定 2020-2024 日历年年轻人中糖尿病患病率 诊断时年龄为 18-44 岁，采用具有成本效益的方法，最大限度地利用信息 电子健康记录 (EHR) 和管理数据库。目标 2：确定新确诊病例 （事件 2020-2024）18-44 岁年轻人的糖尿病病例，采用具有成本效益的方法， 最大限度地利用电子病历和管理数据。目标 3：描述选定的临床特征 诊断并确定这些特征是否随时间变化。这项研究将在 南加州凯撒医疗机构 (KPSC)，一个综合医疗保健系统，拥有约 140 万人 会员年龄在18-44岁之间，分布在8个县地区，其中包括加州最大的县洛杉矶县。 会员的种族/民族多样性，EHR 中丰富的临床信息（包括诊断） 住院、门诊和虚拟护理经历的代码；实验室检查结果，包括糖尿病 自身抗体（订购时）；处方、身高、体重、血压和患者报告 可以与人口统计和会员数据相关联的结果，包括健康计划注册开始和 结束日期，为糖尿病监测活动创建了一个强大的平台。