Spatial epidemiology of diabetes in the SEARCH for Diabetes in Youth Study

糖尿病是儿童和青少年的主要慢性病之一，发病率为 在全球范围内不断增加。糖尿病发病率的空间或地理差异是最大的 观察是否有任何非传染性疾病。人们对地球内部的地理变异知之甚少 美国。而在过去，儿童糖尿病主要被认为是1型，儿科2型 糖尿病(非自身免疫性和非胰岛素依赖型)最近出现。关于糖尿病的研究 青年研究是在2000年发起的，旨在从种族角度估计人口糖尿病患病率和发病率 美国20岁以下不同年龄、性别、种族/民族和糖尿病的年轻人 打字。该搜索辅助研究的目的是(1)描述和绘制事件的空间分布 种族和地理多样性搜索中的儿童糖尿病，包括1型和2型 来自南卡罗来纳州、俄亥俄州、科罗拉多州和华盛顿州的人口；(2)评估发病率与 1型和2型糖尿病的地理和社区特征(地理位置、城市化、 人口密度、社会经济特征)进行一系列统计、生态分析；(3)探索 综合地理和邻里特征对1型心脏病风险的影响程度 类型2，一旦确定，在多水平分析中考虑到个人水平的风险因素 将来自搜索的数据与搜索病例对照研究相结合。这一努力可能会为 儿童糖尿病的后续病因学研究，并将帮助卫生保健规划者确定 地理区域尤其需要卫生服务资源。

Diabetes mellitus is one of the leading chronic diseases of childhood and adolescence, and incidence is increasing worldwide. The spatial or geographic variation in incidence of diabetes is one of the largest observed for any non-communicable disease. Very little is known about geographic variation within the United States. While in the past pediatric diabetes has been thought of largely as Type 1, pediatric Type 2 diabetes (non-autoimmune and non-insulin-dependent) has recently emerged. The SEARCH for Diabetes in Youth Study was initiated in 2000 to estimate population prevalence and incidence of diabetes in ethnically- diverse youth under the age of 20 years in the United States by age, gender, race/ethnicity, and diabetes type. This ancillary study to SEARCH aims to (1) describe and map the spatial distribution of incident pediatric diabetes, including Type 1 and Type 2 in the ethnically and geographically diverse SEARCH populations from South Carolina, Ohio, Colorado, and Washington; (2) evaluate the association of incidence of Type 1 and Type 2 diabetes with geographic and neighborhood characteristics (location, urbanization, population density, socio-economic characteristics) in a series of statistical, ecologic analyses; (3) to explore the extent to which aggregate geographical and neighborhood characteristics influence risk of Type 1or Type 2, once established individual-level risk factors are taken into account, in a multi-level analysis combining data from SEARCH with the SEARCH Case Control study. This effort may provide novel leads for subsequent etiologic studies of pediatric diabetes and will assist health care planners in identifying geographic areas in particular need of health services resources.