Factors influencing time to case registration for youth with type 1 and type 2 diabetes: SEARCH for Diabetes in Youth Study

Abstract

Purpose The development of a sustainable pediatric diabetes surveillance system for the United States requires a better understanding of issues related to case ascertainment. Methods Using the SEARCH for Diabetes in Youth registry, we examined whether time from diabetes diagnosis to case registration differed by diabetes type, patient demographics, and the type of provider reporting the case to the study. Plots for time from diagnosis to registration were developed, and differences by key variables were examined using the log-rank test. Results Compared with time to registration for type 1 cases, it took 2.6 (95% confidence interval [CI], 2.5–2.6) times longer to register 50% of type 2 diabetes cases, and 2.3 (95% CI, 2.0–2.5) times longer to register 90% of type 2 cases. For type 1 diabetes cases, a longer time to registration was associated with older age, minority race/ethnicity, and cases, where the referring provider was not an endocrinologist. For type 2 diabetes cases, older age, non-Hispanic white race/ethnicity, and cases reported by providers other than an endocrinologist took longer to identify and register. Conclusions These findings highlight the need for continued childhood diabetes surveillance to identify future trends and influences on changes in prevalence and incidence.

In vivo Evaluation of Anti-Hyperglycemic, Anti-hyperlipidemic and Anti-Oxidant Status of Liver and Kidney of Thymol in STZ-Induced Diabetic Rats

“…Generally, two main factors are respon-sible for the causes of diabetic disorders: (1) poor insulin secretion (2) insulin resistance or both of them at the same time [2]. As previous reports, three types of diabetes have high level prevalence in the world including type I, type II and gestational [3]. Type I diabetes is also well-known as insulin-dependent diabetes mellitus streptozotocin induced diabetic and normal rats (overall 42 males) were tested through various biochemical and histopathological factors such as: serum glucose, insulin, creatinine, lipids, lipoproteins, liver function-related enzymes, and antioxidant status in liver and kidney.…”

Youth-Onset Type 2 Diabetes Consensus Report: Current Status, Challenges, and Priorities

“…As an example of the challenges in recruitment in youth-onset type 2 diabetes, the SEARCH study aimed to register pediatric patients with both type 1 and type 2 diabetes. Yet, despite the same well-funded, full-time, dedicated research staff, the case ascertainment time from diagnosis was two times longer in youth-onset type 2 diabetes than in type 1 diabetes ( 62 ). Similarly, the duration of the TODAY study recruitment had to be extended substantially, and although the well-funded, full-time TODAY research staff were ultimately successful in randomizing 699 youth, recruitment took 5.5 years ( 18 ).…”

An efficient approach for surveillance of childhood diabetes by type derived from electronic health record data: the SEARCH for Diabetes in Youth Study

“…1,2,[4][5][6] However, such surveillance systems are resource intensive and are associated with considerable delays in reporting results. 7 A more efficient surveillance system is needed for sustained monitoring of the incidence and prevalence of childhood diabetes, so as to inform health care needs for this growing population.…”