SEARCH for Diabetes in Youth 3: Washington Site, Part B

描述(由申请者提供)：搜索青年糖尿病(SEARCH)是一项正在进行的多中心研究，包含了美国有史以来研究过的最大规模和最具种族多样性的青年糖尿病人群。针对RFA-DP10-001，B部分，搜索队列研究将利用这一独特资源，继续对选定的搜索参与者进行研究，以达到下列目标：1)评估糖尿病慢性微血管病变(视网膜病变、肾病和自主神经病变)和大血管并发症(高血压、动脉僵硬)的特定标记物的患病率、发病率和风险因素；2)评估糖尿病急性并发症的发病率和风险因素，包括严重的低血糖和糖尿病酮症酸中毒；3)对死亡率进行监测；以及4)确定护理障碍、护理质量和过渡到成人护理对糖尿病相关健康结局，包括生活质量的影响程度。在这些目标的基础上，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物化学维度对糖尿病相关健康结果的影响。搜索队列研究将对2002年或以后的搜索参与者进行面对面的研究访问，访问时间为5年，并完成基线数据(预计n=3699)。在这项研究中，将收集和分析医学史、人体测量学、生化、生理学和调查数据。华盛顿搜索网站包括西雅图和塔科马周围的5个普吉特湾县(金、基特萨普、皮尔斯、瑟斯顿和斯诺霍米什)。我们已经成功注册了3700多名参与者，就完成的调查和基线访问总数而言，我们是第二大搜索网站。凭借对后续访问的高应答率，以及华盛顿研究人员在糖尿病及其并发症方面的重要专业知识，我们处于强有力的地位，能够实现这项研究的目标。这项研究将利用研究人群的规模和种族多样性，根据传统的临床糖尿病类型、美国的主要种族/民族以及采用一种新的方法按病理生理维度区分传统的临床糖尿病类型，来确定护理过程和健康结果的差异。因此，SEARCH队列研究很有可能对美国所有主要种族的青少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 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 Washington SEARCH site includes 5 Puget Sound counties (King, Kitsap, Pierce, Thurston, and Snohomish) surrounding Seattle and Tacoma. We have successfully registered over 3,700 participants, and we are the second largest SEARCH site in terms of total number of surveys and baseline visits completed. With a high response rate to follow-up visits, and the significant expertise of Washington investigators in diabetes and its complications, we are strongly positioned to meet the aims of this study. 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.