SEARCH for Diabetes in Youth, Phase 3: Cohort Study - California Center

描述（由申请人提供）：青年糖尿病研究是一项正在进行的多中心研究，包含美国有史以来研究的最大和最具种族多样性的青年糖尿病人群。作为对RFA-DP 10 -001组件B的响应，研究队列研究将通过继续对选定的研究队列参与者进行研究来利用这一独特资源，以实现以下研究目的：1）评估慢性微血管疾病选定标志物的患病率、发生率和风险因素，（视网膜病变、肾病和自主神经病变）和大血管并发症（2）评估糖尿病急性并发症（包括严重低血糖和糖尿病酮症酸中毒）的发生率和危险因素;（3）监测死亡率;以及4）确定护理障碍、护理质量以及向成人护理的过渡对糖尿病相关健康结果（包括生活质量）的影响程度。在这些目标的覆盖下，我们将重点关注种族/民族和其他社会文化因素以及糖尿病类型的生化方面对糖尿病相关健康结果的影响。该队列研究将对2002年或以后发生的糖尿病事件的糖尿病参与者进行面对面研究访问，糖尿病持续时间> 5年，基线数据已完成（预期n=3699）。在本研究期间，将收集并分析病史、人体测量、生化、生理和调查数据。凯萨加州中心位于加州帕萨迪纳市凯萨医疗机构的研究和评估部。将纳入本队列研究的来自加州研究中心的青年（n=424）在种族/人种上非常多样化，包括118名非西班牙裔白色青年（110名1型糖尿病患者和8名2型糖尿病患者）和306名少数民族青年（209名1型糖尿病患者和97名2型糖尿病患者）。该中心看到的所有年轻人中有一半是西班牙裔，其中大多数是墨西哥裔美国人;而大约15%是非洲裔美国人，5%是亚洲/太平洋岛民。本研究将利用研究人群的规模和种族多样性，通过传统临床糖尿病类型、美国主要种族/种族群体以及采用新方法按病理生理学维度分离传统临床糖尿病类型，确定护理过程和健康结局的差异。因此，该队列研究很有可能对美国所有主要种族的青年糖尿病患者的临床护理和国家公共卫生政策产生重大影响。

DESCRIPTION (provided by applicant): SEARCH for Diabetes in Youth (SEARCH) is an on-going, multi-center study containing the largest and most ethnically diverse population of youth with diabetes ever studied in the US. In response to RFA-DP10-001, Component B, the SEARCH Cohort Study will utilize this unique resource by continuing the study of selected SEARCH participants to address the following research Aims: 1) assess the prevalence, incidence, and risk factors for selected markers of chronic microvascular (retinopathy, nephropathy, and autonomic neuropathy) and macrovascular complications (hypertension, arterial stiffness) of diabetes; 2) assess the incidence and risk factors for acute complications of diabetes including serious hypoglycemia and diabetic ketoacidosis ; 3) conduct surveillance of mortality; and 4) determine the degree to which barriers of care, quality of care, and transition to adult care impact diabetes-related health outcomes including quality of life. Overlaid across these Aims, we will focus on the impact of race/ethnicity and other sociocultural factors, and biochemical dimensions of diabetes type, on diabetes-related health outcomes. The SEARCH Cohort Study will conduct an in-person research study visit on SEARCH participants incident in 2002 or later, with duration of diabetes > 5 years and with baseline data completed (expected n=3699). During this study medical history, anthropometric, biochemical, physiologic, and survey data will be collected and analyzed. The SEARCH California Center is located within Kaiser Permanente's Department of Research and Evaluation in Pasadena California. Youth from the California SEARCH Center that will be included in this Cohort Study (n=424) are very racially/ethnically diverse and include 118 non-Hispanic White youth (110 with type 1 diabetes and 8 with type 2 diabetes) and 306 minority youth (209 with type 1 diabetes and 97 with type 2 diabetes). Half of all youth seen by this SEARCH center are Hispanic, the majority of which are Mexican American; while about 15% are African American and 5% are Asian/Pacific Islander. This study will exploit the size and ethnic diversity of the study population to identify differences in both processes of care and health outcomes by traditional, clinical diabetes type; by the major race/ethnic groups in the US; and by employing a novel approach to segregate traditional clinical diabetes types by pathophysiologic dimensions. Thus, the SEARCH cohort study has a high likelihood of making a significant impact on the clinical care of youth with diabetes from all the major ethnic groups in the US and on national public health policy.