Microsoft Word search phase 3 Title Page Amendment

Aim 2:  Assess the incidence of, and risk factors for, serious acute complications of 
diabetes including severe hypoglycemia and diabetic ketoacidosis (DKA). 

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Section 4B - Study Objectives/Background and Significance (Phase 3 - 12/2010) 
Section 4B - Page 2 
 Cohort 
Study
 
 
Research Question 2.1:  Does the incidence of serious acute complications differ 
according to biochemical dimensions of diabetes type (autoimmunity, insulin 
sensitivity score, residual insulin secretion), glycemic control or diabetes treatment 
regimen? 
Research Question 2.2:  Does the incidence of serious acute complications differ 
according to race/ethnicity or other socio-cultural factors (e.g., family structure, 
household income, or parental education)? 
Aim 3:  Determine the degree to which barriers to care, quality of care, and the process 
of transition from pediatric to adult health care impact disease factors, including 
dimensions of diabetes type, and diabetes-related outcomes (acute and chronic 
complications, quality of life, diabetes-related mortality). 
Research Question 3.1:  Do specific barriers to care and quality of care assessed early 
in the course of their diabetes effect a) the evolution of key dimensions of diabetes 
type; b) metabolic status (e.g., A1c, lipid profile, weight status); c) markers of acute 
and chronic complications of diabetes; or d) quality of life? 
Research Question 3.2:  Do specific barriers to care and quality of care explain 
differences in health outcomes experienced by minority youth, compared to their non-
Hispanic white counterparts with the same type of diabetes (T1D or T2D)?  Health 
outcomes will include dimensions of diabetes type, metabolic status, markers of acute 
and chronic complications, quality of life, and mortality. 
Research Question 3.3:  What are the specific barriers to care that emerge as youth 
with diabetes move into early adulthood (e.g., loss of or change in insurance; change 
in health care provider)?  Do these barriers affect metabolic status and co-
morbidities?  Are these barriers more common among persons of minority 
race/ethnicity compared to NHW individuals, independent of other socio-cultural 
factors (e.g., family structure, household income, or parental education)? 
Aim 4:  Maintain and supplement the SEARCH repository for biological specimens, and 
promote access to SEARCH for conduct of scientifically and logistically 
appropriate ancillary studies. 
4.1.2.
 
Research Strategy 
The SEARCH Cohort Study is a highly interdisciplinary effort, inclusive of experts in 
diabetes-related physiology and epidemiology, clinical researchers, and health services 
researchers.  Together, we have developed a conceptual framework to ensure realization 
of our overarching vision to improve the health and well-being of individuals diagnosed 
with diabetes in youth.  Our framework is shown Figure 3, in which socio-cultural 
factors, biological risk factors and mediators including health care access and quality 
together drive diabetes-related health outcomes.  The core content of the present 

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Section 4B - Study Objectives/Background and Significance (Phase 3 - 12/2010) 
Section 4B - Page 3 
 Cohort 
Study
 
 
application was assembled collaboratively by the SEARCH team, and represents the 
scientific accomplishments and vision for the SEARCH Cohort Study, by consensus of 
all current SEARCH centers and central units.