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Research

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Diabetes, Insulin Resistance & Metabolic Syndrome

According to the National Institutes of Health, an estimated 23.6 million people in the United States--7.8 percent of the population--have diabetes, a serious, lifelong condition. Of those, 17.9 million have been diagnosed, and 5.7 million have not yet been diagnosed. Through a number of studies, including the Diabetes and Aging study and the Diabetes Study of Northern California, the Division of Research has done considerable work to better understand the complexities of this condition and how best to treat it.  

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Effective Care of Latinos with Diabetes and Limited English Proficiency

This study focuses on respondents from DISTANCE to determine if there is a differential impact of language concordant care on the outcomes of Latino patients with diabetes and limited English proficiency.
Funder: Nat. Inst.of Diabetes & Digestive & Kidney Disease
Principal Investigator: Karter, Andrew

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Lactation and Incidence of Type 2 Diabetes in CARDIA Women

The goals of our study are to prospectively examine whether longer duration of lactation is associated with development of type 2 DM in women of reproductive age during the 25-year CARDIA study period (1986-2011) and assess changes in risk factors.
Funder: Nat. Inst.of Diabetes & Digestive & Kidney Disease
Principal Investigator: Gunderson, Erica

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Pharmacogenomics of Membrane Transporters

As part of Pharmacogenomics of Membrane Transporters Research Network we will collaborate with UCSF on a multi-site study of the genetic determinants of response to Metformin in African Americans. The aim of the study is to collect biospecimens and phenotypic measurements from a cohort of African American diabetic patients on Metformin monotherapy.  Aim 2 will be to undertake a two-stage genomewide association study to identify loci associated with glycemic response to metformin. 
Funder: National Institute of General Medical Sciences
Principal Investigator: Hedderson, Monique

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Learnings in Diabetes Prevention from an Integrated Delivery System

Includes evaluation studies of a health plan employer partnership that identifies employees at high risk for diabetes on intervenes using outreach and communication, feedback, incentives, and health coaching to change behaviors and reduce risk; a broader evaluation of a new telephone health coaching program that will ultimately be available to all adult members; and the Regional Perinatal Service Centers region-wide program for reducing risk among women who have had gestational diabetes mellitus.
Funder: Centers for Disease Control and Prevention
Principal Investigator: Selby, Joe

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Protein and Lipid Biomarkers for Prospective Prediction of Type 2 Diabetes: a CARDIA Ancillary Study

The overall goal of this proposal is to investigate the ability of a panel of protein and lipid biomarkers to predict the future incidence of diabetes in a population based study which includes both Caucasians and African Americans. 
Funder: Tethys Bioscience
Principal Investigator: Iribarren, Carlos

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Multi-institutional Consortium for CER in Diabetes Treatment and Prevention

To build a standardized diabetes registry (including children and adults) across participating HMORN sites, to be used for comparative effectiveness studies of diabetes prevention and CVD risk reduction.
Funder: Agency for Healthcare Research and Quality
Principal Investigator: Selby, Joe

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To examine the relationship between three prevalent mental health disorders (depression, anxiety disorders, and ADHD), their associated therapies, and outcomes for hypertension, atrial fibrillation and venous thromboembolic disease within the NHLBI-sponsored Cardiovascular Research Network (CVRN). These outcomes will include intermediate markers such as medication adherence and surrogate outcomes (e.g., systolic blood pressure and percentage of time spent at a therapeutic INR), as well as long-term clinical outcomes such as thromboembolic events (e.g., acute myocardial infarction, ischemic stroke, recurrent venous thromboembolism) and major bleeding.

The goal of this project is to compare the risk of cancer among users of glargine insulin to risk among users of other insulin (primary comparator drug will be NPH).  The cohort study will be conducted among Kaiser health plan members who are in the KP Diabetes Registry.  Information on medication use and covariates will be obtained from electronic records.  The KP tumor registry will be used to capture information on cancer diagnoses. Cox proportional hazards modeling to compare risk of cancer at specific sites (10 most common) among glargine users to risk in users of NPH insulin, while adjusting for confounding variables.
Funder: Sanofi Pasteur
Principal Investigator: Habel, Laurel

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The Impact of Intensive Versus Usual Glucose Control and Multiple Risk Factor Intervention Approaches in Individuals With Type 2 Diabetes

This study will address the question of whether intensive glycemic control in adult patients with type 2 diabetes leads to improved short- and longer-term outcomes compared with less intensive therapy, and to determine whether its benefit varies as a function of age, prior cardiovascular disease, blood pressure, or LDL-cholesterol control.
Funder: Agency for Healthcare Research and Quality
Principal Investigator: Selby, Joe

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Impact of Integrated Health IT on Quality and Resource Use for Diabetic Patients

Quasi-experimental study of effect of Health IT use on quality and efficiency of outpatient care for patients with multiple chronic diseases.
Funder: Nat. Inst.of Diabetes & Digestive & Kidney Disease
Principal Investigator: Reed, Mary

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Lactation and Glucose Tolerance after GDM Pregnancy – SWIFT, Study of Women, Infant Feeding and Type 2 Diabetes

This study examines whether lactation prevents or delays the development of type 2 diabetes in a large, population-based sample of women with a recent pregnancy complicated by GDM in Kaiser Permanente Northern California.
Funder: Nat. Inst. of Child Health and Human Dev.
Principal Investigator: Gunderson, Erica

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Neighborhood Effects on Weight and Diabetes Complications

We propose to evaluate hypothesized relationships between neighborhood-level influences on diabetes self-care, cardiometabolic markers of disease and health outcomes by studying patients with diabetes and uniform access to health care.  
Funder: Nat. Inst.of Diabetes & Digestive & Kidney Disease
Principal Investigator: Karter, Andrew

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Failure to Utilize Diabetes Health Services Following a Referral

This study will utilize the new electronic referral system to evaluate social disparities in the patterns and predictors of failure of patients to utilize preventive health services which have been referred by their providers.
Funder: Nat. Inst.of Diabetes & Digestive & Kidney Disease
Principal Investigator: Karter, Andrew

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Medication Adherence and Social Disparities in Diabetes

This study will evaluate whether diabetes, blood pressure, and cholesterol medications are taken by patients with diabetes as prescribed (“adherence”), emphasizing social patterns in adherence, clinical consequences, and reasons for differences in therapy initiation, maintenance, and discontinuation.
Funder: Nat. Inst.of Diabetes & Digestive & Kidney Disease
Principal Investigator: Karter, Andrew

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The Impact of Language Concordance on the Health Care of Patients with Limited English Proficiency

This study characterize patient-provider language concordance/discordance, quality of care and health outcomes in diabetic patients with limited English proficiency.  We will also survey providers regarding their language fluency.
Funder: California Program on Access to Care
Principal Investigator: Karter, Andrew

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Stakeholder Support for the Diabetes Multicenter Research Consortium

This study aims to prioritize comparative effectiveness research needs in the area of diabetes and to conduct original research to address high priority comparative effectiveness questions.
Funder: Agency for Healthcare Research and Quality
Principal Investigator: Selby, Joe

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Antipsychotic Medication Use Among Children and Risk of Diabetes Mellitus

Andrade, S. E.; Lo, J. C.; Roblin, D.; Fouayzi, H.; Connor, D. F.; Penfold, R. B.; Chandra, M.; Reed, G.; Gurwitz, J. H.;
Pediatrics  
Nov 21 2011
PubMed abstract  »

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Ethnic Differences in Appointment-Keeping and Implications for the Patient-Centered Medical Home-Findings from the Diabetes Study of Northern California (DISTANCE)

Parker, M. M.; Moffet, H. H.; Schillinger, D.; Adler, N.; Fernandez, A.; Ciechanowski, P.; Karter, A. J.;
 
Oct 27 2011
PubMed abstract  »

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Ethnic differences in the development of albuminuria: the DISTANCE study

Choi, A. I.; Karter, A. J.; Liu, J. Y.; Young, B. A.; Go, A. S.; Schillinger, D.;
  17 (11): 737-745
Nov 2011
PubMed abstract  »

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Patient-Reported Racial/Ethnic Healthcare Provider Discrimination and Medication Intensification in the Diabetes Study of Northern California (DISTANCE)

Lyles, C. R.; Karter, A. J.; Young, B. A.; Spigner, C.; Grembowski, D.; Schillinger, D.; Adler, N.;
Journal of general internal medicine  26 (10): 1138-44
Oct 2011
PubMed abstract  »

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Patient-Reported Racial/Ethnic Healthcare Provider Discrimination and Medication Intensification in the Diabetes Study of Northern California (DISTANCE)

Lyles, C. R.; Karter, A. J.; Young, B. A.; Spigner, C.; Grembowski, D.; Schillinger, D.; Adler, N.;
  26 (10): 1138-44
Oct 2011
PubMed abstract  »

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Association of Increased Upper Trunk and Decreased Leg Fat With 2-h Glucose in Controls and HIV-Infected Persons

Kosmiski, L. A.; Scherzer, R.; Heymsfield, S. B.; Rimland, D.; Simberkoff, M. S.; Sidney, S.; Shlipak, M. G.; Bacchetti, P.; Biggs, M. L.; Grunfeld, C.;
Diabetes Care  
Sep 16 2011
PubMed abstract  »

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Association of Increased Upper Trunk and Decreased Leg Fat With 2-h Glucose in Controls and HIV-Infected Persons

Kosmiski, L. A.; Scherzer, R.; Heymsfield, S. B.; Rimland, D.; Simberkoff, M. S.; Sidney, S.; Shlipak, M. G.; Bacchetti, P.; Biggs, M. L.; Grunfeld, C.;
Diabetes Care 
Sep 16 2011
PubMed abstract  »

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Provision of Contraceptive Services to Women with Diabetes Mellitus

Schwarz, E. B.; Postlethwaite, D.; Hung, Y. Y.; Lantzman, E.; Armstrong, M. A.; Horberg, M. A.;
 
Sep 16 2011
PubMed abstract  »

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Provision of Contraceptive Services to Women with Diabetes Mellitus

Schwarz, E. B.; Postlethwaite, D.; Hung, Y. Y.; Lantzman, E.; Armstrong, M. A.; Horberg, M. A.;
Journal of general internal medicine 
Sep 16 2011
PubMed abstract  »

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Is Diabetes Mellitus an Independent Risk Factor for Colon Cancer and Rectal Cancer?

Yuhara, H.; Steinmaus, C.; Cohen, S. E.; Corley, D. A.; Tei, Y.; Buffler, P. A.;
 
Sep 13 2011
PubMed abstract  »

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Patient reported interpersonal processes of care and perceived social position: The Diabetes Study of Northern California (DISTANCE)

Moskowitz, D.; Lyles, C. R.; Karter, A. J.; Adler, N.; Moffet, H. H.; Schillinger, D.;
Patient Educ Couns  
Aug 18 2011
PubMed abstract  »

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Cross-sectional and longitudinal changes of glucose effectiveness in relation to glucose tolerance: the insulin resistance atherosclerosis study

Lorenzo, C.; Wagenknecht, L. E.; Karter, A. J.; Hanley, A. J.; Rewers, M. J.; Haffner, S. M.;
Diabetes Care  34 (9): 1959-64
Sep 2011
PubMed abstract  »

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Cross-sectional and longitudinal changes of glucose effectiveness in relation to glucose tolerance: the insulin resistance atherosclerosis study

Lorenzo, C.; Wagenknecht, L. E.; Karter, A. J.; Hanley, A. J.; Rewers, M. J.; Haffner, S. M.;
Diabetes Care   34 (9): 1959-64
Sep 2011
PubMed abstract  »

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Adherence to laboratory test requests by patients with diabetes: the Diabetes Study of Northern California (DISTANCE)

Moffet, H. H.; Parker, M. M.; Sarkar, U.; Schillinger, D.; Fernandez, A.; Adler, N. E.; Adams, A. S.; Karter, A. J.;
  17 (5): 339-44
May 2011
PubMed abstract  »

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Diabetes performance measures: current status and future directions

O'Connor, P. J.; Bodkin, N. L.; Fradkin, J.; Glasgow, R. E.; Greenfield, S.; Gregg, E.; Kerr, E. A.; Pawlson, L. G.; Selby, J. V.; Sutherland, J. E.; Taylor, M. L.; Wysham, C. H.;
Diabetes Care  34 (7): 1651-9
Jul 2011
PubMed abstract  »