This proposal for a Research Planning Grant describes our plans to automate, complete and analyze an existing database which will enable us to subsequently submit a proposal to study Noninsulin-dependent Diabetes Mellitus (NIDDM) in the Hispanic population of Southern California. We specifically wish to study Hispanic women who have been previously diagnosed as having gestational diabetes (GDM). These women represent a known high risk population for NIDDM which can be studied by epidemiological, genetic and pathophysiological approaches to determine specific risk factors that eventually may lead to early intervention and reduction of complications. In the Planning Grant stage, we intend to utilize information obtained from an existing clinical program at Harbor-UCLA Medical Center which follows women after GDM. A large amount of previously obtained clinical and biochemical (plasma glucose, insulin, C-peptide and serum lipids) measures will be entered into a database and analyzed to provide us with enough information to plan the research proposal. Data from hospital records and other sources will be added to complete the database. We will also document the rate at which patients are lost to follow-up. We will then field-test methods to increase the follow-up rate. In addition, we will establish links with clinics which will give us access to a more stable Hispanic population in order to facilitate successful long-term studies. Using the database we will describe the characteristics of the patient population and determine the potential for adequate follow-up. This will form the basis for our subsequent research proposal in which it is anticipated that a long-term, longitudinal investigation will be feasible. At that time broad screening for clinical, biochemical and genetic predictive markers of NIDDM will be carried out. We also intend to perform in-depth physiological studies to better understand the pathogenesis of NIDDM in these Hispanic women. We believe that this multidisciplinary approach, carried out at a center experienced in providing health care for minority populations, can eventually lead to a significant reduction in the burden of diabetes and its complications on the health status of the Hispanic population.
