The Improving Renal Complications in Adolescents With Type 2 Diabetes Through the REsearch (iCARE) Cohort Study: Rationale and Protocol

Dart, Allison; Wicklow, Brandy; Sellers, Elizabeth; Dean, Heather; Malik, Sayma; Walker, John R.; Château, Dan; Blydt-Hansen, Tom; McGavock, Jonathan; investigators, iCARE

doi:10.1016/j.jcjd.2014.07.224

Cited by 27 publications

(30 citation statements)

References 58 publications

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“…This cross‐sectional study was embedded within the Improving Renal Complications in Adolescents with Type 2 Diabetes through REsearch (iCARE) cohort study . The iCARE cohort study is designed to identify the biopsychosocial determinants of albuminuria and the progression of chronic kidney disease in adolescents with T2D.…”

Section: Methodsmentioning

confidence: 99%

Determinants of Readiness for Adopting Healthy Lifestyle Behaviors Among Indigenous Adolescents with Type 2 Diabetes in Manitoba, Canada: A Cross‐Sectional Study

McGavock

Durksen

Wicklow

et al. 2018

Obesity

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Section: Methodsmentioning

confidence: 99%

Determinants of Readiness for Adopting Healthy Lifestyle Behaviors Among Indigenous Adolescents with Type 2 Diabetes in Manitoba, Canada: A Cross‐Sectional Study

McGavock

Durksen

Wicklow

et al. 2018

Obesity

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“…To test these study hypotheses, we conducted a series of cross‐sectional analyses comparing cardiovascular structure and function as well as metabolites among Indigenous adolescents with type 2 diabetes in the iCARE cohort study and Indigenous controls without type 2 diabetes (Clinical trials registry: #NCT02818192). The STROBE guidelines for reporting observational studies were followed for this manuscript .…”

Section: Methodsmentioning

confidence: 99%

“…Adolescents aged 10 to 18 years with a diagnosis of type 2 diabetes (according to clinical criteria, in absence of diabetes‐related autoantibodies) were invited to participate in the iCARE cohort study during their routine clinical visit to the Pediatric subspecialty diabetes clinic in Manitoba. The iCARE cohort is a prospective study of the biopsychosocial determinants of proteinuria among youth diagnosed with type 2 diabetes before 18 years of age . The design and methods for the cohort and primary analyses have been published previously .…”

Section: Methodsmentioning

confidence: 99%

“…The iCARE cohort is a prospective study of the biopsychosocial determinants of proteinuria among youth diagnosed with type 2 diabetes before 18 years of age . The design and methods for the cohort and primary analyses have been published previously . Recruitment started in November 2011 and is ongoing until the target sample size of 400 youth and young adults aged 10 to 25 years is achieved.…”

Section: Methodsmentioning

confidence: 99%

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Cardiac structure and function in youth with type 2 diabetes in the iCARE cohort study: Cross‐sectional associations with prenatal exposure to diabetes and metabolomic profiles

et al. 2019

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Objective: This study aimed to determine the degree of left ventricular (LV) dysfunction and its determinants in adolescents with type 2 diabetes (T2D). We hypothesized that adolescents with T2D would display impaired LV diastolic function and that these cardiovascular complications would be exacerbated in youth exposed to maternal diabetes in utero.Methods: Left ventricular structure and function, carotid artery intima media thickness and strain, and serum metabolomic profiles were compared between adolescents with T2D (n = 121) and controls (n = 34). Sub-group analyses examined the role of exposure to maternal diabetes as a determinant of LV or carotid artery structure and function among adolescents with T2D.Results: Adolescents with T2D were 15.1 ± 2.5 years old, (65% female, 99% Indigenous), had lived with diabetes for 2.7 ± 2.2 years, had suboptimal glycemic control (HbA1c = 9.4 ± 2.6%) and 58% (n = 69) were exposed to diabetes in utero. Compared to controls, adolescents with T2D displayed lower LV diastolic filling (early diastole/ atrial filling rate ratio [E/A] = 1.9 ± 0.6 vs 2.2 ± 0.6, P = 0.012), lower LV relaxation and carotid strain (0.12 ± 0.05 vs 0.17 ± 0.05, P = .03) and elevated levels of leucine,

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“…First Nation children also often have an earlier onset of risk factors for CKD including high rates of obesity, hypertension, and metabolic syndrome [ 18 ]. They often live in poverty and are faced with food insecurity, inter-generational trauma, poor housing, have high levels of stress and emotional distress [ 19 , 20 ] and have low educational attainment [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Mass Screening for Chronic Kidney Disease in Rural and Remote Canadian First Nations People: Methodology and Demographic Characteristics

Lavallee

Chartrand

McLeod

et al. 2015

Can J Kidney Health Dis

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BackgroundScreening the general population for Chronic Kidney Disease is not currently recommended.. Rural and remote Canadian First Nations people suffer a disproportionate burden of Kidney Failure. The First Nations Community Based Screening to Improve Kidney Health and Prevent Dialysis (FINISHED) project intends to test the hypothesis that a mobile, mass screening initiative available to all First Nations people 10 years of age and older residing in rural and/or remote communities, is feasible, will improve health outcomes and is cost effective.ObjectivesThe objective of this manuscript is to describe the key elements required to design, implement and evaluate such a program and describe key characteristics of our screened cohort.DesignMethods and cohort description.Setting11 First Nations communities within 2 Tribal Councils in Manitoba, Canada.PatientsAll First Nations individuals between the ages of 10–80 living in the 11communities were eligible for the screening initiative.MeasurementsScreening Rates achieved within communities.MethodsAn interdisciplinary team partnership was established between the Diabetes Integration Project and the Manitoba Renal Program. Stakeholder consultation was obtained and protocols developed to mass screen community members using point of care testing equipment. All people screened were risk stratified, counselled and referred to nephrologists as required in real time, based on risk.ResultsAs of August 31, 2014, 1480 people in 11 communities over 2 Tribal Councils have been successfully screened. A mean screening rate of 21% of all community members eligible (aged 10–80) has been achieved. All patients at intermediate or high risk of kidney failure have been seen by nephrologists within 1 month of screening.LimitationsLong term outcomes of kidney failure rates not assessed for at least 5 years. Alternative public health initiatives to reduce kidney failure not investigated.ConclusionsPoint of care mass screening, real time risk prediction and counselling of First Nations people at high risk of Kidney Failure is feasible in rural and remote communities. Further analysis of this cohort will describe theepidemiology of CKD in these communities, and test the cost effectiveness of this strategy.Electronic supplementary materialThe online version of this article (doi:10.1186/s40697-015-0046-9) contains supplementary material, which is available to authorized users.

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The Improving Renal Complications in Adolescents With Type 2 Diabetes Through the REsearch (iCARE) Cohort Study: Rationale and Protocol

Cited by 27 publications

References 58 publications

Determinants of Readiness for Adopting Healthy Lifestyle Behaviors Among Indigenous Adolescents with Type 2 Diabetes in Manitoba, Canada: A Cross‐Sectional Study

Determinants of Readiness for Adopting Healthy Lifestyle Behaviors Among Indigenous Adolescents with Type 2 Diabetes in Manitoba, Canada: A Cross‐Sectional Study

Cardiac structure and function in youth with type 2 diabetes in the iCARE cohort study: Cross‐sectional associations with prenatal exposure to diabetes and metabolomic profiles

Mass Screening for Chronic Kidney Disease in Rural and Remote Canadian First Nations People: Methodology and Demographic Characteristics

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