Surveillance of Diabetes in Children and Adolescents between 0-17 Years of Age (DiCAYA) - Component A

项目摘要：在20世纪末，我们对 青少年糖尿病的发病率和负担。在青年中寻找糖尿病，于2000年发起，告诉我们 美国年轻人中糖尿病的发病率在美国呈上升趋势1型糖尿病(T1D)的患病率 青年和20岁年龄段的2型糖尿病分别增加了21%和30.5%。 2001年和2009年。T1D的负担在大多数种族/民族和年龄组中都在增加，同时也在增加 T2D负担的趋势在10-14岁和15-19岁的西班牙裔、非西班牙裔白人和非 西班牙裔黑人青年。同样，T1和T2D在美国的发病率都在增加(1.4%和4.2% 分别在2002-2012年期间每年)。T1D在少数族裔年轻人中不再罕见，最陡峭的 在西班牙裔青年中观察到的发病率趋势。其中T2D的发病率呈上升趋势。 种族/民族，非西班牙裔白人除外。 对青少年确诊的糖尿病进行持续、及时和有效的监测对确定健康状况至关重要 并告知卫生保健系统和公共卫生界确定战略并确定其优先顺序 预防糖尿病及其并发症。虽然搜索监视方法澄清了我们在 在年轻人中了解糖尿病，需要成本更低、时间和劳动力密集型的方法 利用电子病历和其他临床数据集中的大量数据，同时 维护在搜索过程中形成的关键基础设施和专业知识。科罗拉多州的迪卡亚 监控团队是解决利用现有电子数据源的关键挑战的理想选择 按年龄、性别、年龄、年龄、性别、年龄 和种族/民族亚群。针对RFA-DP-20-001-组件A，我们建议确定 科罗拉多州18岁青年糖尿病年患病率和发病率 从2020年开始，从完善的儿科内分泌诊所网络搜索开始， 科罗拉多州的社区诊所和医院网络。我们简单但创新的集成监控 该方法将利用算法和有针对性的图表审查相结合的方式来识别患有糖尿病的年轻人， 区分糖尿病类型和估计发病日期。我们的具体目标是：目标1：监督 (患病率)-按年龄、种族/族裔确定18岁以下青年中糖尿病的流行病例 和糖尿病类型；目标2：监测(发病率)--确定#年新诊断的糖尿病病例 青年确诊时年龄&18岁，按年龄、种族和糖尿病类型分列；目标3：评估公共卫生 监测方法-评估我们综合监测的优势和挑战 通过确定效度确定18岁青年糖尿病负担和发病率的方法 案例确定方法的完备性和代表性。

PROJECT SUMMARY: Significant gaps existed at the end of the 20th century in our understanding of the incidence and burden of diabetes in youth. The SEARCH for Diabetes in Youth, initiated in 2000, has taught us that diabetes among youth is frequent and increasing in the U.S. The prevalence of type 1 diabetes (T1D) and type 2 diabetes (T2D) among youth <20 years of age increased by 21% and 30.5%, respectively between 2001 and 2009. The increasing burden of T1D is seen in most racial/ethnic and age groups while increasing trends in the burden on T2D are noted in 10-14 and 15-19 year old Hispanic, non-Hispanic white and non- Hispanic black youth. Similarly, the incidence of both T1 and T2D is increasing in the U.S (1.4% and 4.2% annually between 2002-2012, respectively). T1D is no longer a rarity among minority youth, with the steepest trend in incidence observed among Hispanic youths. The incidence of T2D has increasing among all race/ethnic groups except non-Hispanic whites. Ongoing, timely and efficient surveillance of diabetes diagnosed in youth is essential to identify health disparities and inform health care systems and the public health community to identify and prioritize strategies to prevent diabetes and its complications. While the SEARCH surveillance approach clarified many gaps in our understanding of diabetes among youth, less costly, time- and labor-intensive approaches are needed that utilize the enormous wealth of data in the electronic medical record and other clinical datasets, while maintaining the critical infrastructure and expertise developed during SEARCH. The Colorado DiCAYA surveillance team is ideally situated to address the critical challenge of utilizing existing electronic data sources to generate accurate, timely estimates of the incidence and prevalence of diabetes among youth, by age, sex, and race/ethnicity subgroups. In response to RFA-DP-20-001- Component A, we propose to ascertain the annual prevalence and incidence of diabetes among youth <18 years of age in the state of Colorado starting with year 2020 from the well-established SEARCH, network of pediatric endocrinology clinics, community clinics and hospital networks in Colorado. Our simple, yet innovative integrated surveillance approach will utilize a combination of algorithms and targeted chart review to identify youth with diabetes, distinguish diabetes type and estimate onset date. Our specific aims are: Aim 1: SURVEILLANCE (Prevalence)- To ascertain cases of prevalent diabetes among youth age < 18 years, by age, race/ethnicity and diabetes type ; Aim 2: SURVEILLANCE (Incidence)- To ascertain newly diagnosed diabetes cases in youth age < 18 years at diagnosis, by age, race and diabetes type; Aim 3: EVALUATE PUBLIC HEALTH SURVEILLANCE METHODS - To evaluate the strengths and challenges of our integrated surveillance approach to determine the burden and incidence of diabetes among youth < 18 years by ascertaining validity, completeness and representativeness of case ascertainment methods.