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.

Agency
National Institute of Health (NIH)
Institute
National Center for Chronic Disease Prev and Health Promo (NCCDPHP)
Type
Research Demonstration--Cooperative Agreements (U18)
Project #
5U18DP002708-04
Application #
8531691
Study Section
Special Emphasis Panel (ZDP1-DYB (09))
Project Start
2010-09-30
Project End
2015-09-29
Budget Start
2013-09-30
Budget End
2014-09-29
Support Year
4
Fiscal Year
2013
Total Cost
$698,437
Indirect Cost
$101,158
Name
University of North Carolina Chapel Hill
Department
Type
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Li, Chao; D'Agostino Jr, Ralph B; Dabelea, Dana et al. (2018) Longitudinal association between eating frequency and hemoglobin A1c and serum lipids in diabetes in the SEARCH for Diabetes in Youth study. Pediatr Diabetes :
Kahkoska, Anna R; Isom, Scott; Divers, Jasmin et al. (2018) The early natural history of albuminuria in young adults with youth-onset type 1 and type 2 diabetes. J Diabetes Complications 32:1160-1168
Costacou, Tina; Crandell, Jamie; Kahkoska, Anna R et al. (2018) Dietary Patterns Over Time and Microalbuminuria in Youth and Young Adults With Type 1 Diabetes: The SEARCH Nutrition Ancillary Study. Diabetes Care 41:1615-1622
Jaiswal, Mamta; Divers, Jasmin; Urbina, Elaine M et al. (2018) Cardiovascular autonomic neuropathy in adolescents and young adults with type 1 and type 2 diabetes: The SEARCH for Diabetes in Youth Cohort Study. Pediatr Diabetes 19:680-689
Reynolds, Kristi; Saydah, Sharon H; Isom, Scott et al. (2018) Mortality in youth-onset type 1 and type 2 diabetes: The SEARCH for Diabetes in Youth study. J Diabetes Complications 32:545-549
Liese, Angela D; Ma, Xiaonan; Ma, Xiaoguang et al. (2018) Dietary quality and markers of inflammation: No association in youth with type 1 diabetes. J Diabetes Complications 32:179-184
Kahkoska, Anna R; Shay, Christina M; Couch, Sarah C et al. (2018) Sociodemographic associations of longitudinal adiposity in youth with type 1 diabetes. Pediatr Diabetes 19:1429-1440
Mendoza, Jason A; Haaland, Wren; D'Agostino, Ralph B et al. (2018) Food insecurity is associated with high risk glycemic control and higher health care utilization among youth and young adults with type 1 diabetes. Diabetes Res Clin Pract 138:128-137
Kahkoska, Anna R; Shay, Christina M; Crandell, Jamie et al. (2018) Association of Race and Ethnicity With Glycemic Control and Hemoglobin A1c Levels in Youth With Type 1 Diabetes. JAMA Netw Open 1:
Pinto, Cathy A; Stafford, Jeanette M; Wang, Tongtong et al. (2018) Changes in diabetes medication regimens and glycemic control in adolescents and young adults with youth-onset type 2 diabetes: The SEARCH for diabetes in youth study. Pediatr Diabetes :

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