Clinical Epidemiology Division
The Clinical Epidemiology program at the Barbara Davis Center encompasses a group of prospective observational research studies focused on the etiology and complications of type 1 diabetes, as well as other autoimmune diseases. Currently the Clinical Epidemiology Program includes the efforts of 5 Barbara Davis Center faculty investigators and over 40 research staff, adult and pediatric research clinics, and a shared research laboratory.
PROMISE
PRenatal and Obstetric Maternal Exposures and ISlet Autoantibodies in Early Life
The purpose of this study is to find out more about how health and exposures during pregnancy, such as having an infection, diet and growth may impact later risk of islet autoimmunity in the child. We are also interested in finding out more about why having a father or sibling with type 1 diabetes increases risk of autoimmunity in the child than having a mother with type 1 diabetes.
ASK
The Autoimmunity Screening for Kids (ASK) program (Dr. Rewers, PI) launched a large scale screening initiative to identify children who have pre-symptomatic T1D or celiac disease. Following the initial planning phase, the program received funding to conduct a 3-year mass screening of 50,000 Denver metro children ages 1-17 with the long term goal of providing strong evidence for adding screening for T1D and celiac disease to routine pediatric practice. ASK participants are enrolling in clinical trials aimed at preventing progression from pre-symptomatic to symptomatic T1D.
TEDDY
The multi-center The Environmental Determinants of Diabetes in the Young (TEDDY) study was funded in 2003, with a clinical center in Colorado (Dr. Rewers, PI). To identify the environmental triggers of type 1 diabetes, TEDDY screened 423,000 newborns and is following 8,676 high-risk children at six centers in the U.S., Sweden, Finland and Germany. A follow-up of TEDDY subjects who have been diagnosed with T1D has been funded by JDRF (Dr. Steck, PI).
DAISY
The Diabetes Autoimmunity Study in the Young (DAISY) study was the first Clinical Epidemiology project at the BDC. Funded in 1993 and continuously supported through 2020 by the National Institutes of Health (Dr. Rewers, PI), the DAISY study strives to find the cause of type 1 diabetes by observing the natural history of islet-cell autoimmunity and progression to diabetes in children at high genetic risk. Building from the DAISY cohort, other studies have been funded including the C-peptide in the Young PREServation Study (CYPRESS), (Dr. Steck, PI) and the Infant Vitamins in the Young (IVY) and IVY’omics studies (Dr. Norris, PI). The CEliac Disease Autoimmunity Research (CEDAR) study began in 1995 to examine celiac disease occurrence in patients with type 1 diabetes, their relatives and the public (Dr. Rewers, PI.)
Complications of Type 1 Diabetes
The Clinical Epidemiology program has a robust research program investigating predictors of complications of type 1 diabetes. The Coronary Artery Calcification in Type 1 Diabetes (CACTI) study examined risk factors and incidence of cardiovascular complications (Dr. Rewers, PI). CACTI has since added assessments for other complications, including diabetic nephropathy, retinopathy and neuropathy (Dr. Snell-Bergeon, PI). In addition, several ancillary studies related to the CACTI cohort are ongoing. Dr. Snell-Bergeon is examining cardiovascular risk protection during the premenopausal years, as well as novel proteomic, metabolomic and lipidomic markers of diabetic kidney disease, HDL function in cardiovascular disease risk among adults with type 1 diabetes, and how reproductive hormones affect vascular and bone health in women with type 1 diabetes.