SEARCH FOR DIABETES IN YOUTH

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 糖尿病是导致肾病、视网膜病变、神经病变以及冠状动脉和外周血管疾病的主要原因，在美国儿童时期是第三大最常见的严重慢性病。在20岁之前确诊的糖尿病患者的预期寿命比非糖尿病患者短15-27岁。 直到最近，儿童和青少年被诊断出的糖尿病几乎完全被认为是1型糖尿病，这通常是由于胰腺的β细胞被破坏导致胰岛素绝对不足。儿童和青少年糖尿病现在被认为是一种复杂的疾病，在其发病机制、临床表现和临床结果方面具有异质性。然而，由于对儿童和青少年糖尿病范围更广的认识是最近才出现的，因此没有区分这一年龄段糖尿病类型的金标准定义。 最近也有儿童出现具有2型糖尿病临床特征的糖尿病的报道，在此之前，2型糖尿病被认为是成年人的疾病。青少年中的2型糖尿病发病率，特别是少数族裔青少年，似乎正在以惊人的速度增加，但这种增加的幅度尚不清楚。 最后，有关儿童和青年糖尿病，特别是2型糖尿病的临床病程和演变的信息有限。 这项名为“在青年中寻找糖尿病”的研究将确定20岁以下人群中糖尿病的流行和发病病例，以便： A)按年龄和种族估计人群1型、2型和其他类型(或混合型)糖尿病的患病率和发病率。 B)制定有效和实用的方法，对糖尿病流行病例和发病病例进行分类。 C)描述和比较1型、2型和其他类型(或混合型)糖尿病的临床表现和病程。 其次，这项研究将： A)描述选定的微血管和大血管疾病并发症的风险因素的分布，以及糖尿病类型在流行和发病病例中的不同之处。 B)说明选定的急性和慢性并发症的分布情况，以及糖尿病类型在流行和发病病例中的不同。 C)分别描述流行病例和发病病例的卫生保健利用情况、护理过程和生活质量。 最后，搜索将建立与研究参与者保持联系的系统(S)，以促进辅助研究和长期跟踪，并将建立一个储存库，长期储存作为搜索的一部分获得的生物标本，并建立获取这些标本的程序。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Diabetes Mellitus, a leading cause of nephropathy, retinopathy, neuropathy, and coronary and peripheral vascular disease, is the third most prevalent severe chronic disease of childhood in the United States. People with diabetes diagnosed before age 20 have a life expectancy that is 15-27 years shorter than non-diabetic people. Until recently, diabetes diagnosed in children and adolescents was almost entirely considered to be type 1, which is usually due to the destruction of the beta cells of the pancreas leading to an absolute deficiency of insulin. Diabetes in children and adolescents is now acknowledged to be a complex disorder with heterogeneity in its pathogenesis, clinical presentation, and clinical outcome. However, because recognition of the broader spectrum of diabetes in children and adolescents is recent, there are no gold standard definitions for differentiating the types of diabetes in this age group. Also recent are reports of children who present with diabetes that has the clinical characteristics of type 2 diabetes, which was heretofore considered a disease of adults. The incidence of type 2 diabetes in adolescents, especially minority adolescents, appear to be increasing at alarming rates, but the magnitude of this increase is not known. Finally, information about the clinical course and evolution of diabetes in children and youth, particularly type 2 diabetes, is limited. The study "SEARCH for Diabetes in Youth" will identify prevalent and incident cases of diabetes among individuals under age 20 years in order to: a) Estimate the population prevalence and incidence of type 1, type 2, and other type (or hybrids) of diabetes rates overall and by age and ethnicity. b) Develop efficient and practical approaches to classification of diabetes type for prevalent and incident cases. c) Describe and compare clinical presentation and course of type 1, type 2 and other types (or hybrids) of diabetes. Secondarily, the study will: a) Describe the distribution of risk factors for selected micro- and macrovascular disease complications and how they differ by diabetes type separately for prevalent and incidence cases. b) Describe the distributions of selected acute and chronic complications and how they differ by diabetes types for prevalent and incident cases. c) Describe the health care utilization, processes of care, and quality of life separately for prevalent and incidence cases. Finally, the SEARCH will develop system (s) to maintain contact with study participants in order to facilitate the ancillary studies and long term follow-up, and it will establish a repository for long-term storage of biologic specimens obtained as a part of SEARCH and establish processes for access to these specimens.