DYNAMO?Diabetes in Youth and Young Adults of the Pacific Northwest

About This Grant

Project summary Type 1 and type 2 diabetes mellitus (T1D, T2D) continue to rise in youth and young adults (YYA) worldwide, with disproportionately high rates of T2D among historically underserved populations. Young people with early-onset diabetes face decades of managing a complex chronic disease and are at heightened risk of complications. Despite advancements, key knowledge gaps persist regarding trends in early onset T1D and T2D incidence, disease management, and outcomes in real-world settings, particularly for young adults, rural communities, and those receiving care outside specialty centers. The transition to adulthood, which often involves changes in residence, employment, and insurance, complicates surveillance through traditional methods. To address these challenges, we have brought together a highly collaborative, multi-institutional team of endocrinologists, biostatisticians, epidemiologists, nephrologists and informaticists with experience in diabetes surveillance and electronic health record-based research. We have established a unique regional network of five major health systems across the Pacific Northwest (PNW) to conduct comprehensive diabetes surveillance in YYA. This network includes Seattle Children’s Hospital, University of Washington Medicine, Providence Health System, Virginia Mason Franciscan Health, and the Veterans Affairs VISN 20 region, collectively serving diverse urban and rural populations across Washington, Oregon, Idaho, Montana, and Alaska. By integrating EHR, claims data, and established research infrastructure, we will conduct systematic surveillance of diabetes incidence, prevalence, clinical management, and complications in YYA. Our central hypothesis is that tracking diverse demographics, including rural and Native populations, will uncover critical disparities in the diabetes burden, healthcare delivery, and outcomes amenable to targeted interventions. Data will be harmonized across the health systems in our network. We will contribute to and implement the shared protocol developed with other funded sites in this cooperative grant mechanism. This project will deliver the first large-scale, real-world surveillance system for YYA with diabetes in the PNW, capturing underrepresented populations and addressing a pressing need for timely data on evolving trends in care and outcomes. By systematically identifying disparities in disease burden and clinical management, results will inform interventions to prevent disease progression, reduce complications, and improve long-term quality of life. The focus on rural and Native populations ensures that our approach is inclusive, contextually relevant, and poised to directly influence public health efforts in regions often overlooked by surveillance studies.