Applied Research and Surveillance

Applied research includes observational and clinical epidemiologic studies, health services research, and economic studies designed to:

• Identify modifiable risk factors.
• Determine the effectiveness of interventions at individual, health care system, community, and policy levels.
• Prioritize the value of successful interventions.

Surveillance involves the development and use of systems to collect and analyze data to:

• Identify the burden and magnitude of diabetes and its related conditions.
• Guide decision making.
• Prioritize national public health objectives.
• Evaluate the impact of diabetes prevention programs.

Applied Research Projects

Longitudinal Epidemiologic Assessment of Diabetes Risk (LEADR)

Overall Objective: This project uses electronic health records from DARTnet, a collaboration of practice-based research networks, to assess risk factors and incidence of type 2 diabetes. It will also examine how often people at high risk of developing type 2 diabetes receive counseling and are referred to diabetes prevention programs. Other objectives of this project include the following:

• Establish a population-based cohort using electronic records to identify traditional and emerging risk factors for type 2 diabetes.
• Assess the availability, delivery, and impact of type 2 diabetes preventive care.
• Develop and test strategies for identifying people at risk of developing type 2 diabetes.

Funding Agencies:

• CDC, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), DDT

Period of Funding: 09/29/2015–09/28/2020

Contractors:

• Westat (contract # HHSD200201587699) and its subcontractor
• DARTnet Institute

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Population-based Diabetes in Youth Registry, the SEARCH for Diabetes in Youth Study

Overall Objective: This project monitors how many children and adolescents in the United States are affected by diabetes and whether the occurrence of the disease is increasing over time. Each year, SEARCH (the SEARCH for Diabetes in Youth study) conducts surveillance on about 5 million children to estimate the number of new cases of diabetes. This study also collects data on diabetes complications, risk factors for diabetes complications, and the quality of care and the quality of life of children and adolescents with diabetes.

In 2009, SEARCH estimated that 167,000 youth (younger than 20 years) in the United States had type 1 diabetes, an increase of over 21% from 2001. From 2002 through 2009, the annual rate of new cases among non-Hispanic white youth increased by 2.7% each year. SEARCH also estimated that 20,300 US youth had type 2 diabetes in 2009, an increase of over 30% from 2001. This study has also shown that diabetes complications are present at an early age, and complications are more common among minority youth, and those with type 2 diabetes.

Funding Agencies:

• CDC, NCCDPHP, DDT
• National Institutes of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases

Period of Funding: 09/30/15–09/29/20

Grantees:

• Clinical Sites:
  • University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
  • Children’s Hospital Medical Center, Cincinnati, Ohio
  • University of Colorado, Denver, Colorado School of Public Health, Aurora, Colorado
  • Kaiser Permanente Southern California, Pasadena, California
  • University of Washington School of Medicine, Seattle, Washington
• Coordinating Center: Wake Forest University School of Medicine, Winston Salem, North Carolina
• External Study Website: http://www.searchfordiabetes.org/dspHome.cfm

Selected Publications:

1. Hamman RF, Bell RA, Dabelea D, et al. The SEARCH for Diabetes in Youth study: rationale, findings, and future directions. Diabetes Care. 2014;37(12):3336–3344. doi: 10.2337/dc14-0574.
2. Lawrence JM, Imperatore G, Dabelea D, et al. Trends in incidence of type 1 diabetes among non-Hispanic white youth in the U.S., 2002-2009. Diabetes. 2014;63(11):3938–3945. doi: 10.2337/db13-1891.
3. Dabelea D, Mayer-Davis EJ, Saydah S, et al. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA. 2014;311(17):1778–1786. doi: 10.1001/jama.2014.3201.
4. Dabelea D, Rewers A, Stafford JM, et al. Trends in the prevalence of ketoacidosis at diabetes diagnosis: the SEARCH for Diabetes in Youth Study. Pediatrics. 2014;133(4):e938–e45. doi: 10.1542/peds.2013-2795.
5. Pettitt DJ, Talton J, Dabelea D, et al. Prevalence of diabetes in U.S. youth in 2009: the SEARCH for Diabetes in Youth study. Diabetes Care. 2014;37(2):402–408. doi: 10.2337/dc13-1838.
6. Imperatore G, Boyle JP, Thompson TJ, et al. Projections of type 1 and type 2 diabetes burden in the U.S. population aged <20 years through 2050: dynamic modeling of incidence, mortality, and population growth. Diabetes Care. 2012;35(12):2515–2520. doi: 10.2337/dc12-0669.
7. Rodriguez BL, Dabelea D, Liese AD, et al. Prevalence and correlates of elevated blood pressure in youth with diabetes mellitus: the SEARCH for Diabetes in Youth Study. J Pediatr. 2010;157(2):245–251.e1. doi: 10.1016/j.jpeds.2010.02.021.
8. Petitti DB, Klingensmith GJ, Bell RA, et al. Glycemic control in youth with diabetes: the SEARCH for Diabetes in Youth Study. J Pediatr. 2009;155(5):668–672.e1–e3. doi: 10.1016/j.jpeds.2009.05.025.
9. Mayer-Davis EJ, Bell RA, Dabelea D, et al. The many faces of diabetes in American youth: type 1 and type 2 diabetes in five race and ethnic populations: the SEARCH for Diabetes in Youth Study. Diabetes Care. 2009;32(suppl 2):S99–S101. doi: 10.2337/dc09-S201.

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