The complications of diabetes continue to be a major source of morbidity and mortality. The Epidemiology of Diabetes Complications Study has examined the prevalence and incidence of and risk factors contributing to diabetes complications for 14 years. This renewal proposes to continue examining these issues as they relate to population subgroups and specific complications. The study population is a well-defined cohort of type 1 diabetic patients identified from Children's Hospital of Pittsburgh Registry. All 658 examined subjects at baseline (1986-1988) were diagnosed between 1950-80. Subjects have been seen biennially since and are now in their 14th year of follow-up. During the proposed renewal period, we plan to conduct an annual general survey follow-up of the entire cohort (including the 658 examined at baseline who are still active and the 130 who provided only baseline questionnaires to further determine the presence of diabetes complications and associated risk factors. At 18 years a repeat exam will be done on those previously examined. Specifically we aim to: examine the role of Electron Beam Computed Tomography (EBT) determined coronary calcification (and of its rate of progression) and arterial to venous ratio on the prediction of coronary artery disease, determine risk factors for the progression of nephropathy (decline of renal function determined by standard clinical and serum cystatin-C measures), identify the predictors of clinically significant distal neuropathy by examination of the temporal relationship of risk factors, particularly inflammatory markers, to neuropathy presentation and progression), and to conduct further statistical, and temporal trend analyses of diabetes complications using the 18-20 year follow-up data set that will become available during this renewal period. Finally, we will collaborate with 4 other investigators, to increase our analytical power for EBT analyses, and permitting valuable comparisons, including use of the non-diabetic control subjects being examined in these studies. This study will continue to advance our knowledge of diabetes complications and lead to appropriate preventive strategies.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project (R01)
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Epidemiology of Chronic Diseases Study Section (ECD)
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Jones, Teresa L Z
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University of Pittsburgh
Public Health & Prev Medicine
Schools of Public Health
United States
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Williams, Katherine V; Cristaldi, Christina L; Miller, Rachel G et al. (2018) Celiac Autoimmunity Is Associated With Lower Blood Pressure and Renal Risk in Type 1 Diabetes. J Clin Endocrinol Metab 103:3828-3836
Ghai, Vikas; Wu, Xiaogang; Bheda-Malge, Anjalei et al. (2018) Genome-wide Profiling of Urinary Extracellular Vesicle microRNAs Associated With Diabetic Nephropathy in Type 1 Diabetes. Kidney Int Rep 3:555-572
Miller, Rachel G; Anderson, Stewart J; Costacou, Tina et al. (2018) Hemoglobin A1c Level and Cardiovascular Disease Incidence in Persons With Type 1 Diabetes: An Application of Joint Modeling of Longitudinal and Time-to-Event Data in the Pittsburgh Epidemiology of Diabetes Complications Study. Am J Epidemiol 187:1520-1529
Guo, Jingchuan; Miller, Rachel G; Costacou, Tina et al. (2018) Left ventricular systolic dysfunction predicts long-term major microvascular complication outcomes in type 1 diabetes. The Pittsburgh Epidemiology of Diabetes Complications (EDC) study of childhood onset diabetes. J Diabetes Complications 32:298-304
Ray, Evan C; Miller, Rachel G; Demko, John E et al. (2018) Urinary Plasmin(ogen) as a Prognostic Factor for Hypertension. Kidney Int Rep 3:1434-1442
Costacou, Tina; Orchard, Trevor J (2018) Cumulative Kidney Complication Risk by 50 Years of Type 1 Diabetes: The Effects of Sex, Age, and Calendar Year at Onset. Diabetes Care 41:426-433
Swasey, Krystal K; Orchard, Trevor J; Costacou, Tina (2018) Trends in cardiovascular risk factor management in type 1 diabetes by sex. J Diabetes Complications 32:411-417
Guo, Jingchuan; Erqou, Sebhat A; Miller, Rachel G et al. (2018) The role of coronary artery calcification testing in incident coronary artery disease risk prediction in type 1 diabetes. Diabetologia :
Bjornstad, P; Costacou, T; Miller, R G et al. (2017) Predictors of early renal function decline in adults with Type 1 diabetes: the Coronary Artery Calcification in Type 1 Diabetes and the Pittsburgh Epidemiology of Diabetes Complications studies. Diabet Med 34:1532-1540
Nunley, Karen A; Ryan, Christopher M; Aizenstein, Howard J et al. (2017) Regional Gray Matter Volumes as Related to Psychomotor Slowing in Adults with Type 1 Diabetes. Psychosom Med 79:533-540

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