SEARCH for Diabetes in Youth (SEARCH) is an on-going, multi-center study containing the largest and most ethnically diverse population of youth with diabetes ever studied in the US. In response to RFA-DP10-001, Component B, the SEARCH Cohort Study will utilize this unique resource by continuing the study of selected SEARCH participants to address the following Aims: 1) assess the prevalence, incidence, and risk factors for selected markers of chronic microvascular (retinopathy, nephropathy, and autonomic neuropathy) and macrovascular complications (hypertension, arterial stiffness) of diabetes;2) assess the incidence and risk factors for acute complications of diabetes including serious hypoglycemia and diabetic ketoacidosis;3) conduct surveillance of mortality;and 4) determine the degree to which barriers of care, quality of care, and transition to adult care impact diabetes-related health outcomes including quality of life. Overlaid across these Aims, we will focus on the impact of race/ethnicity and other sociocultural factors, and biochemical dimensions of diabetes type, on diabetes-related health outcomes. The SEARCH Cohort Study will conduct an in-person research study visit on SEARCH participants incident in 2002 or later, with duration of diabetes >5 years and with baseline data completed (expected n=3699). During this study medical history, anthropometric, biochemical, physiologic, and survey data will be collected and analyzed. With the Dr Mayer-Davis as PI and the national chairperson for SEARCH 2, and as we have done throughout SEARCH, the Carolina Clinical Center will provide substantial scientific leadership. For the Cohort Study we bring new leadership in the areas of diabetic retinopathy and diabetic nephropathy. Importantly, the Carolina population comprises the lowest socioeconomic status among the current SEARCH sites, and over half of the African American youth in SEARCH are from the Carolina Center. Additionally, and a substantial proportion of youth with type 2 diabetes are from this Center. This study will exploit the size and ethnic diversity of the study population to identify differences in both processes of care and health outcomes by traditional, clinical diabetes type;by the major race/ethnic groups in the US;and by employing a novel approach to segregate traditional clinical diabetes types by pathophysiologic dimensions. Thus, the SEARCH cohort study has a high likelihood of making a significant impact on the clinical care of youth with diabetes from all the major ethnic groups in the US and on national public health policy.

Public Health Relevance

The SEARCH Cohort Study will provide important, new information regarding the frequency of acute and chronic complications of diabetes and the degree to which barriers to health care, the type and quality of care of health care, and moving from a pediatric to adult health care provider impact diabetes-related health outcomes. Since these data will be collected in the largest, most ethnically diverse population of youth with diabetes that is also representative of the ethnic diversity of the US, the SEARCH Cohort Study has a high likelihood of making a significant impact on the clinical care of youth with diabetes from all the major ethnic groups in the US and on national public health policy.

National Institute of Health (NIH)
National Center for Chronic Disease Prev and Health Promo (NCCDPHP)
Research Demonstration--Cooperative Agreements (U18)
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Special Emphasis Panel (ZDP1-DYB (09))
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University of North Carolina Chapel Hill
Chapel Hill
United States
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Yi-Frazier, Joyce P; Hilliard, Marisa E; Fino, Nora F et al. (2016) Whose quality of life is it anyway? Discrepancies between youth and parent health-related quality of life ratings in type 1 and type 2 diabetes. Qual Life Res 25:1113-21
Mottl, Amy K; Divers, Jasmin; Dabelea, Dana et al. (2016) The dose-response effect of insulin sensitivity on albuminuria in children according to diabetes type. Pediatr Nephrol 31:933-40
Li, Chao; Beech, Bettina; Crume, Tessa et al. (2015) Longitudinal association between television watching and computer use and risk markers in diabetes in the SEARCH for Diabetes in Youth Study. Pediatr Diabetes 16:382-91
Liese, Angela D; Crandell, Jamie L; Tooze, Janet A et al. (2015) Sugar-sweetened beverage intake and cardiovascular risk factor profile in youth with type 1 diabetes: application of measurement error methodology in the SEARCH Nutrition Ancillary Study. Br J Nutr 114:430-8
Shah, Amy S; Dolan, Lawrence M; Dabelea, Dana et al. (2015) Change in adiposity minimally affects the lipid profile in youth with recent onset type 1 diabetes. Pediatr Diabetes 16:280-6
Saydah, Sharon H; Imperatore, Giuseppina; Henkin, Leora et al. (2015) Trends and characteristics of self-reported case presentation of diabetes diagnosis among youth from 2002 to 2010: findings from the SEARCH for diabetes in youth study. Diabetes Care 38:e84-5
Liese, Angela D; Crandell, Jamie L; Tooze, Janet A et al. (2015) Relative validity and reliability of an FFQ in youth with type 1 diabetes. Public Health Nutr 18:428-37
Law, Jennifer R; Stafford, Jeanette M; D'Agostino Jr, Ralph B et al. (2015) Association of parental history of diabetes with cardiovascular disease risk factors in children with type 2 diabetes. J Diabetes Complications 29:534-9
Tomer, Yaron; Dolan, Lawrence M; Kahaly, George et al. (2015) Genome wide identification of new genes and pathways in patients with both autoimmune thyroiditis and type 1 diabetes. J Autoimmun 60:32-9
Jaacks, Lindsay M; Bell, Ronny A; Dabelea, Dana et al. (2014) Diabetes self-management education patterns in a US population-based cohort of youth with type 1 diabetes. Diabetes Educ 40:29-39

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