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 socio-cultural 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. In collaboration with the other SEARCH clinical centers, the Ohio site will collect the data described in this proposal from all eligible cases. We expect approximately 646 Ohio subjects will be eligible to participate. For Incident 2002-2005 cases, 85% of the Ohio participants have returned for at least one follow-up visit, which is the highest study-wide response rate. The Ohio team also has the highest rate for completeness of laboratory core samples. For Incident 2006 cases, Ohio had 99% completeness, and 100% completeness for Incident 2008 cases. In this proposal the Ohio site will employ the same approach and techniques used in SEARCH 1 and 2 to maintain high subject retention rates. Thus, the Ohio site has a very high likelihood of meeting the recruitment goals in this proposal contributing significantly to the success of the SEARCH Cohort Study. 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 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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Darling, Natalie
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Cincinnati Children's Hospital Medical Center
United States
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Dabelea, Dana; Stafford, Jeanette M; Mayer-Davis, Elizabeth J et al. (2017) Association of Type 1 Diabetes vs Type 2 Diabetes Diagnosed During Childhood and Adolescence With Complications During Teenage Years and Young Adulthood. JAMA 317:825-835
Jaiswal, Mamta; Divers, Jasmin; Dabelea, Dana et al. (2017) Prevalence of and Risk Factors for Diabetic Peripheral Neuropathy in Youth With Type 1 and Type 2 Diabetes: SEARCH for Diabetes in Youth Study. Diabetes Care 40:1226-1232
Nandi-Munshi, Debika; Afkarian, Maryam; Whitlock, Kathryn B et al. (2017) Vitamin D and Albuminuria in Youth with and without Type 1 Diabetes. Horm Res Paediatr 87:385-395
Kanakatti Shankar, Roopa; Dolan, Lawrence M; Isom, Scott et al. (2017) Serum cystatin C in youth with diabetes: The SEARCH for diabetes in youth study. Diabetes Res Clin Pract 130:258-265
Mayer-Davis, Elizabeth J; Lawrence, Jean M; Dabelea, Dana et al. (2017) Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002-2012. N Engl J Med 376:1419-1429
Couch, Sarah C; Crandell, Jamie; King, Irena et al. (2017) Associations between long chain polyunsaturated fatty acids and cardiovascular lipid risk factors in youth with type 1 diabetes: SEARCH Nutrition Ancillary Study. J Diabetes Complications 31:67-73
Shah, Amy S; Maahs, David M; Stafford, Jeanette M et al. (2017) Predictors of Dyslipidemia Over Time in Youth With Type 1 Diabetes: For the SEARCH for Diabetes in Youth Study. Diabetes Care 40:607-613
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
Crume, Tessa L; Hamman, Richard F; Isom, Scott et al. (2016) Factors influencing time to case registration for youth with type 1 and type 2 diabetes: SEARCH for Diabetes in Youth Study. Ann Epidemiol 26:631-7
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

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