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

The development of a sustainable pediatric diabetes surveillance system for the United States requires a better understanding of issues related to case ascertainment

The impact of diabetes on one-year health status outcomes following acute coronary syndromes

Abstract Background Diabetes is an important predictor of mortality patients with ACS. However, little is known about the association between diabetes and health status after ACS. The objective of this study was to examine the association between diabetes and patients' health status outcomes one year after an acute coronary syndrome (ACS). Methods This was a prospective cohort study of patients hospitalized with ACS. Patients were evaluated at baseline and one year with the Seattle Angina Questionnaire (SAQ). Socio-demographic and clinical characteristics were ascertained during index ACS hospitalization. One year SAQ Angina Frequency, Physical Limitation, and Health-Related Quality of Life (HRQoL) scales were the primary outcomes of the study. Results Of 1199 patients, 326 (37%) had diabetes. Patients with diabetes were more likely to present with unstable angina (52% vs. 40%; p < 0.001), less likely to present with STEMI (20% vs. 31%; p < 0.001), and less likely to undergo coronary angiography (68% vs. 82%; p < 0.001). In multivariable analyses, the presence of diabetes was associated with significantly more angina (OR 1.36; 95% CI 1.01–1.38), cardiac-related physical limitation (OR 1.94; 95% CI 1.57–3.24) and HRQoL deficits (OR 1.43; 95% CI 1.01–2.04) at one year. Conclusion Diabetes is associated with more angina, worse physical limitation, and worse HRQoL one year after an ACS. Future studies should assess whether health status outcomes of patients with diabetes could be improved through more aggressive ACS treatment or post-discharge surveillance and angina management.Peer Reviewe

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

Objective To develop an efficient surveillance approach for childhood diabetes by type across 2 large US health care systems, using phenotyping algorithms derived from electronic health record (EHR) data

The Association of Arsenic Exposure and Metabolism With Type 1 and Type 2 Diabetes in Youth: The SEARCH Case-Control Study

Little is known about arsenic and diabetes in youth. We examined the association of arsenic with type 1 and type 2 diabetes in the SEARCH for Diabetes in Youth Case-Control (SEARCH-CC) study. Because one-carbon metabolism can influence arsenic metabolism, we also evaluated the potential interaction of folate and vitamin B12 with arsenic metabolism on the odds of diabetes

A Survey of z>5.8 Quasars in the Sloan Digital Sky Survey I: Discovery of Three New Quasars and the Spatial Density of Luminous Quasars at z~6

We present the results from a survey of i-dropout objects selected from ~1550 deg^2 of multicolor imaging data from the Sloan Digital Sky Survey, to search for luminous quasars at z>5.8. Objects with i*-z*>2.2 and z*<20.2 are selected, and follow-up J band photometry is used to separate L and T type cool dwarfs from high-redshift quasars. We describe the discovery of three new quasars, at z=5.82, 5.99 and 6.28, respectively. Their spectra show strong and broad Ly alpha+NV emission lines, and very strong Ly alpha absorption, with a mean continuum decrement D_A > 0.90. The ARC 3.5m spectrum of the z=6.28 quasar shows that over a range of 300 A immediately blueward of the Ly alpha emission, the average transmitted flux is only 0.003 +/-0.020 times that of the continuum level, consistent with zero flux, and suggesting a tentative detection of the complete Gunn-Peterson trough. The existence of strong metal lines suggests early chemical enrichment in the quasar enviornment. The three new objects, together with the previously published z=5.8 quasar form a complete color-selected flux-limited sample at z>5.8. We estimate that at $z=6$, the comoving density of luminous quasars at M_1450 < -26.89 (h=0.5, Omega=1)is 1.1x10^-9 Mpc^-3. This is a factor of ~2 lower than that at z~5, and is consistent with an extrapolation of the observed quasar evolution at low-z. We discuss the contribution of quasars to the ionizing background at z~6. The luminous quasars discussed in the paper have central black hole masses of several times 10^9 M_sun by the Eddington argument. Their observed space density provides a sensitive test of models of quasar and galaxy formation at high redshift. (Abridged)Comment: AJ in press (Dec 2001), 40 pages, 10 figures. Updated following referee report; minor change

The SEARCH for Diabetes in Youth Study: Rationale, Findings, and Future Directions

The SEARCH for Diabetes in Youth (SEARCH) study was initiated in 2000, with funding from the Centers for Disease Control and Prevention and support from the National Institute of Diabetes and Digestive and Kidney Diseases, to address major knowledge gaps in the understanding of childhood diabetes. SEARCH is being conducted at five sites across the U.S. and represents the largest, most diverse study of diabetes among U.S. youth. An active registry of youth diagnosed with diabetes at age <20 years allows the assessment of prevalence (in 2001 and 2009), annual incidence (since 2002), and trends by age, race/ethnicity, sex, and diabetes type. Prevalence increased significantly from 2001 to 2009 for both type 1 and type 2 diabetes in most age, sex, and race/ethnic groups. SEARCH has also established a longitudinal cohort to assess the natural history and risk factors for acute and chronic diabetes-related complications as well as the quality of care and quality of life of persons with diabetes from diagnosis into young adulthood. Many youth with diabetes, particularly those from low-resourced racial/ethnic minority populations, are not meeting recommended guidelines for diabetes care. Markers of micro- and macrovascular complications are evident in youth with either diabetes type, highlighting the seriousness of diabetes in this contemporary cohort. This review summarizes the study methods, describes key registry and cohort findings and their clinical and public health implications, and discusses future directions

Evaluating geographic variation in type 1 and type 2 diabetes mellitus incidence in youth in four US regions

We evaluated geographic variation of Type 1 and Type 2 diabetes mellitus (T1DM, T2DM) in four regions of the United States