Comprehensive Analysis, Surveillance, and Statistics Initiative for Diabetes in the Young (CASSIDY)

University Of Colorado Denver, Aurora CO

Investigators

Abstract

PROJECT SUMMARY People with diabetes are at high risk of developing a range of diverse microvascular, macrovascular and neuropathic complications that are associated with high morbidity and erode their quality of life. Diabetes is expected to take an increasingly large financial toll in in the United States (U.S.) in the future, particularly among working age adults. Ongoing, timely and efficient surveillance of incidents and prevalent type 1 and type 2 diabetes diagnosed among youth and young adults is essential to identify health disparities and inform health care systems and the public health community on prioritizing strategies to prevent diabetes and its complications. The Colorado CASSIDY surveillance team is ideally situated to generate timely and accurate estimates of the prevalence and incidence of diabetes in youth and young adults from a near complete representation of health systems throughout our state, established in SEARCH, expanded in the Assessing the Burden of Diabetes by Type in Children, Adolescents, and Young Adults (DiCAYA) and further enriched for CASSIDY to allow our state to function as a health system site with a demographically and geographically representative population under surveillance. Our longstanding leadership in diabetes surveillance and research, institutional and statewide healthcare system partner commitment and the opportunity to directly validate the coverage and representativeness of statewide, deduplicated utilization-based denominators make us a valuable partner for the CASSIDY project. Our integrated surveillance approach was honed during our participation in DiCAYA, utilizing a combination of algorithms, incremental record linkage and chart review to identify individuals with diabetes, distinguish diabetes type and estimate date of diagnosis. Our specific aims are: Aim 1: SURVEILLANCE (Prevalence)- To ascertain cases of prevalent diabetes among individuals aged <45, by age, sex, race/ethnicity, geography and diabetes type; Aim 2: SURVEILLANCE (Incidence)- To ascertain newly diagnosed diabetes cases in young adults age <45 years at diagnosis, by age, sex, race/ethnicity, geography and diabetes type; Aim 3: EVALUATE PUBLIC HEALTH SURVEILLANCE METHODS - To evaluate the strengths and challenges of our integrated surveillance approach to determine the burden and risk of diabetes among youth and young adults by assessing validity, completeness and representativeness of case ascertainment methods and the potential utility of utilization-based denominators.