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

项目摘要：在世纪末，我们对人类的理解存在重大差距。 青年糖尿病发病率和负担。2000年发起的青年糖尿病研究所教授了 1型糖尿病（T1 D）的发病率为100%，而T1 D的发病率为100%。 20岁以下青年中的2型糖尿病（T2 D）分别增加了21%和30.5%， 2001年和2009年。在大多数种族/民族和年龄组中，T1 D的负担不断增加， 在10-14岁和15-19岁的西班牙裔、非西班牙裔白色和非西班牙裔中观察到T2 D负担的趋势。 西班牙裔黑人青年同样，在美国，T1和T2 D的发病率也在增加（1.4%和4.2%）。 2002年至2012年期间，分别。T1 D在少数民族青年中不再罕见， 在西班牙裔青年中观察到的发病率趋势。T2 D的发病率在所有人群中呈上升趋势， 种族/族裔群体，除了非西班牙裔白人。 持续、及时和有效地监测青年诊断的糖尿病对于确定健康状况至关重要。 差异，并告知卫生保健系统和公共卫生界，以确定和优先考虑战略 预防糖尿病及其并发症。虽然非正式监督方法澄清了我们的许多差距， 了解青年糖尿病，需要成本较低，时间和劳动密集型的方法， 利用电子病历和其他临床数据集中的大量数据， 维持在联合国开发计划署期间发展的关键基础设施和专门知识。科罗拉多迪卡雅 监督小组处于理想的位置，以解决利用现有电子数据源的关键挑战 及时准确地估计青年人糖尿病的发病率和流行率，按年龄、性别、 和种族/民族亚组。为响应RFA-DP-20-001-组分A，我们建议确定 科罗拉多州18岁以下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， 社区诊所和医院网络在科罗拉多。我们简单而创新的集成监控 该方法将利用算法和有针对性的图表审查相结合，以确定患有糖尿病的青年， 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）-确定按年龄、种族/族裔分列的18岁以下青年糖尿病患病率 目的2：监测（发病率）-确定新诊断的糖尿病病例， 按年龄、种族和糖尿病类型分列的诊断时年龄< 18岁的青年;目标3：增进公共卫生 监测方法-评估我们综合监测的优势和挑战 通过确定有效性确定18岁以下青年糖尿病负担和发病率的方法， 案例确定方法的完整性和代表性。

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.