Research and Mentoring in the Clinical Epidemiology of Type 2 Diabetes

 描述(由申请人提供)：2型糖尿病是一个主要的公共卫生问题，特别是在老年人中。我们对老年人糖尿病的了解存在很大差距。在老年人中，关于与糖尿病相关的总风险负担、最佳治疗目标以及如何最好地降低心血管风险和预防认知和身体损害存在争议。糖尿病和心血管疾病的新生物标志物反映了急性和慢性发病率的总和，可能有助于指导治疗决策，但它们尚未在社区老年人中得到严格评估。为了解决这些问题，我们需要初级的以患者为导向的研究人员，他们需要在临床流行病学、转化性研究方法以及包括随机临床试验在内的大型临床研究的进行方面的严格培训和指导。候选人伊丽莎白·塞尔文，博士，公共卫生硕士，致力于2型糖尿病临床流行病学的研究和该领域实习生的指导。这一职业生涯中期奖将保护候选人进行研究和指导的时间。该项目的目标是描述老年人糖尿病的发病率和进展，评估糖尿病意识以及自我护理和治疗依从性的障碍，并检查新的生物标记物对风险分层的预后价值。我们还将在一项针对2型糖尿病患者的随机临床试验中，评估传统和新型心脏代谢生物标记物对降糖干预的比较反应。这些项目将为学员提供丰富的培训基础和新的研究机会。塞尔文博士在该领域和指导初级科学家方面有着良好的成功记录。在K24的支持下，塞尔文博士将能够扩大她的指导活动，加强她的研究组合，并招募和培训该领域的下一代领导者。

 DESCRIPTION (provided by applicant): Type 2 diabetes is a major public health concern, particularly in older adults. There are major gaps in our knowledge about diabetes in the elderly. In older adults, there is controversy regarding the total burden of risk associated with diabetes, optimal treatment targets, and how best to reduce cardiovascular risk and prevent cognitive and physical impairment. Novel biomarkers of diabetes and cardiovascular disease reflect the summation of acute and chronic morbidity and may have utility for informing treatment decisions but they have not been rigorously evaluated in older adults in the community. To address these issues we need junior patient-oriented investigators who will need rigorous training and mentorship in the areas of clinical epidemiology, translational research methods, and the conduct of large clinical studies including randomized clinical trials. The candidate, Elizabeth Selvin, PhD, MPH, has devoted her career to the study of the clinical epidemiology of type 2diabetes and the mentorship of trainees in this field. This midcareer award will protect the time of the candidate for research and mentoring. The goals of the project are to characterize diabetes incidence and progression in older adults, evaluate diabetes awareness and barriers to self-care and treatment adherence, and to examine the prognostic value of novel biomarkers for risk stratification. We will also evaluate the comparative response of traditional and novel cardiometabolic biomarkers to a glucose-lowering intervention in a randomized clinical trial of persons with type 2 diabetes. These projects will provide a rich substrate for training and new research opportunities for mentees. Dr. Selvin has a strong track record of success in the field and in mentoring junior scientists. With support from this K24, Dr. Selvin will be able to expand her mentorship activities, strengthen her research portfolio, and recruit and train the next generation of leaders in the field.