Cohort Registry of Type 1 Diabetes

描述(由申请人提供)：威斯康星州糖尿病登记研究(WDRS)正在跟踪美国极少数以人群为基础的1型糖尿病队列之一。该队列的独特之处在于，从1987-1992年的诊断时间到现在，关于血糖控制、糖尿病护理和并发症的全面描述是独一无二的。因此，WDRS非常适合于：(1)确定整个人群向更密集的胰岛素治疗和糖尿病治疗的变化如何影响微血管结果。(2)调查青春期的血糖控制、糖尿病护理、胰岛素抵抗和其他因素是如何发展起来的，并影响以后的结果。这些目标将通过将观察延长到1型糖尿病的第20年来实现，在这段时间内，预计微血管并发症将会增加。与威斯康星州糖尿病视网膜病变流行病学研究(WESDR)合作，可以直接检查在同一地理区域糖尿病护理疑似改善的背景下，相隔7-10年的糖尿病患者并发症的潜在下降。参与世界特别提款权的队列是非常好的。检查的标准化方案，包括眼底照片和面谈，已在整个后续行动中执行，并将在这一额外的数据收集期间使用。临床检查将为1型糖尿病18-20年期间视网膜病变、肾功能障碍和高血压的发生率、患病率和进展建立准确的预后信息。广泛的纵向数据和现有的血浆库将用于检查糖尿病管理、胰岛素抵抗、身体成分、心血管风险标记物和关键青春期和过去几年肾脏损害指标的影响。将调查这些指标中的模式，将其作为结果的预测因素。具体地说，胱抑素C将被用来作为肾功能和心血管风险的纵向测量，IGF-1和脂联素将被用来研究青少年时期胰岛素敏感性的发展和作用。胰岛素敏感性在1型糖尿病中的重要性最近已经被认识到，但它的发展还没有得到全面的研究。关于青春期血脂、身体成分、胰岛素治疗和胰岛素抵抗的预测作用的研究结果可能对预防糖尿病并发症具有重要意义。

DESCRIPTION (provided by applicant): The Wisconsin Diabetes Registry Study (WDRS) is following one of very few population-based cohorts with type 1 diabetes in the United States. The cohort is unique in being comprehensively described from the time of diagnosis during 1987-1992 until now, with respect to glycemic control, diabetes care and complications. Hence, the WDRS is well situated to: (1) Determine how population wide changes toward more intensive insulin therapy and diabetes management have affected microvascular outcomes. (2) Investigate how glycemic control, diabetes care, insulin resistance and other factors across adolescence develop and affect later outcomes. These goals will be achieved by extending the observations through the twentieth year of type 1 diabetes, a duration over which an increase in microvascular complications is expected to occur Collaboration with the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR), makes it possible to directly examine the potential decline in complications in the context of suspected improvements in diabetes care in the same geographic region overtime in individuals diagnosed 7-10 years apart. Participation in the WSDR cohort is excellent. Standardized protocols for examinations, including fundus photographs and interviews, have been implemented throughout follow-up and will be used during this additional period of data collection. Clinical examinations will establish accurate prognostic information for the incidence, prevalence, and progression of retinopathy, kidney dysfunction and hypertension at 18-20 years duration of type 1 diabetes. Extensive longitudinal data and an existing plasma bank will be used to examine the effects of diabetes management, insulin resistance, body composition, markers of cardiovascular risk and indicators of kidney damage across and past the critical adolescent years. Patterns in these indicators will be investigated as predictors of outcomes. Specifically, cystatin C will be used as a longitudinal measure of kidney function and cardiovascular risk, and IGF-1 and adiponectin will be used to examine the development and role of insulin sensitivity across adolescence. The importance of insulin sensitivity in type 1 diabetes has recently been realized, but its development has not been comprehensively studied. Findings on the predictive role of plasma lipids, body composition, insulin therapy and insulin resistance during adolescence could have important implications for prevention of diabetes complications.