Cohort Registry of Type 1 Diabetes

描述（由申请人提供）：威斯康星糖尿病登记研究（WDRS）是美国为数不多的以人群为基础的1型糖尿病队列之一。该队列的独特之处在于从1987-1992年诊断到现在，在血糖控制、糖尿病护理和并发症方面进行了全面的描述。因此，WDRS适合于：(1)确定人群向更强化的胰岛素治疗和糖尿病管理的转变如何影响微血管预后。(2)研究青春期血糖控制、糖尿病护理、胰岛素抵抗等因素的发展及对后期结局的影响。这些目标将通过对1型糖尿病患者20年的观察来实现，在此期间微血管并发症的增加预计会发生，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，在相隔7-10年诊断的个体中，并发症的潜在下降。WSDR队列的参与情况非常好。标准化的检查方案，包括眼底照片和访谈，已在整个后续行动中实施，并将在这一额外的数据收集期间使用。临床检查将为18-20年1型糖尿病患者视网膜病变、肾功能障碍和高血压的发病率、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的影响，胰岛素抵抗，身体组成，心血管风险的标志和肾损伤的指标在关键的青春期和以后。这些指标的模式将作为结果的预测因素加以研究。具体来说，胱抑素C将被用作肾脏功能和心血管风险的纵向测量，而IGF-1和脂联素将被用于检查青春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才被认识到，但其发展尚未得到全面的研究。血浆脂质、身体成分、胰岛素治疗和胰岛素抵抗在青春期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.