Spatial epidemiology of diabetes in the SEARCH for Diabetes in Youth Study

糖尿病是儿童和青少年的主要慢性疾病之一， 在全球范围内增加。糖尿病发病率的空间或地理差异是最大的 观察任何非传染性疾病。关于地球内部的地理变化， 美国的虽然在过去，儿童糖尿病主要被认为是1型，但儿童2型糖尿病 最近出现了糖尿病（非自身免疫性和非胰岛素依赖性）。糖尿病的治疗方法 青年研究于2000年启动，以估计人口患病率和糖尿病的发病率，在种族- 按年龄、性别、种族/民族和糖尿病分列的美国20岁以下的多样化青年 类型.本研究的目的是：（1）描述和绘制事件的空间分布图 儿科糖尿病，包括种族和地理位置不同的SEARCH中的1型和2型 来自南卡罗来纳州、俄亥俄州、科罗拉多和华盛顿的人群;（2）评估发病率与 1型和2型糖尿病的地理和邻里特征（位置，城市化， 人口密度，社会经济特征）的一系列统计，生态分析;（3）探索 综合地理和邻近特征对第1类风险的影响程度，或 第2类，在多水平分析中，一旦确定了个人水平的风险因素， 将来自ESTA的数据与ESTA病例对照研究相结合。这一努力可能会提供新的线索， 随后的儿科糖尿病病因学研究，并将协助卫生保健规划者确定 特别需要卫生服务资源的地理区域。

Diabetes mellitus is one of the leading chronic diseases of childhood and adolescence, and incidence is increasing worldwide. The spatial or geographic variation in incidence of diabetes is one of the largest observed for any non-communicable disease. Very little is known about geographic variation within the United States. While in the past pediatric diabetes has been thought of largely as Type 1, pediatric Type 2 diabetes (non-autoimmune and non-insulin-dependent) has recently emerged. The SEARCH for Diabetes in Youth Study was initiated in 2000 to estimate population prevalence and incidence of diabetes in ethnically- diverse youth under the age of 20 years in the United States by age, gender, race/ethnicity, and diabetes type. This ancillary study to SEARCH aims to (1) describe and map the spatial distribution of incident pediatric diabetes, including Type 1 and Type 2 in the ethnically and geographically diverse SEARCH populations from South Carolina, Ohio, Colorado, and Washington; (2) evaluate the association of incidence of Type 1 and Type 2 diabetes with geographic and neighborhood characteristics (location, urbanization, population density, socio-economic characteristics) in a series of statistical, ecologic analyses; (3) to explore the extent to which aggregate geographical and neighborhood characteristics influence risk of Type 1or Type 2, once established individual-level risk factors are taken into account, in a multi-level analysis combining data from SEARCH with the SEARCH Case Control study. This effort may provide novel leads for subsequent etiologic studies of pediatric diabetes and will assist health care planners in identifying geographic areas in particular need of health services resources.