Arnold School researchers continue to impact children's health through SEARCH for Diabetes in Youth study

Aug. 22, 2011


Dr. Angela Liese and Dr. Anwar Merchant are among the Arnold School researchers who have been an integral part of the SEARCH for Diabetes in Youth study.

A decade of studies on diabetes in youth by Arnold School of Public Health researchers has raised the visibility of the prevalence of the disease among youth and is expected to yield more information on its associated health problems.

Since the initial funding in 2000, Arnold School researchers have received more than $7.4 million as part of the nation's SEARCH for Diabetes in Youth study, which comprises six clinical sites, including South Carolina. Each site has collected data on type 1 and type 2 diabetes among youth under age 20.

Grant monies for SEARCH, the nation's largest and most comprehensive study to date on diabetes among youth, have come from the Centers for Disease Control and Prevention and the National Institute of Diabetes and Digestive and Kidney Diseases.

Dr. Anwar Merchant, associate professor in the department of epidemiology and biostatistics is the principal investigator of the Arnold School's portion of SEARCH, which includes Arnold School researchers Drs. Angela Liese and Robert Moran, and former Arnold School faculty member Dr. Elizabeth Mayer-Davis, who is at the University of North Carolina, Chapel Hill and principal investigator of the Carolina site and study co-chair.

"SEARCH has put diabetes in children on the map and has been critical to our understanding of the disease as it relates to our nation's youth," Merchant said. "We know the prevalence of the disease, and we have been able to track trends over time. This has been one of SEARCH's unique contributions to our knowledge of diabetes."

Because SEARCH is receiving federal funding through 2015, researchers also will have the opportunity to study complications that diabetes is having on the children who have been part of the study. Many of the participants who entered the study in its early years are adults now.

"We know diabetes causes cardiovascular, eye, neurological, dental, and other diseases over a person's life," Merchant said. "By tracking the SEARCH participants, we will have a better idea of the impact of diabetes as they age. This next phase of the study will give us the chance to develop methods for disease surveillance. We are learning."

In 2010, the CDC found that 215,000 youth under age 20 had type 1 or type 2 diabetes. Among adults, diabetes is the seventh leading cause of death in the United States.

To estimate prevalence and incidence of diabetes -- the registry part of the study -- SEARCH has identified more than 18,795 children and youth at the six clinical sites over the past 10 years.

"Our study staff is dedicated to working with a network of healthcare providers statewide in recruiting youth with diabetes," Liese said. "In South Carolina alone, about 3,150 youth have been identified, of which more than 1,141 have been participants in the in-person part of the study protocol been by our outstanding staff at clinic visit."

The Arnold School's research has been significant to the overall SEARCH program, Merchant said.

"South Carolina is a major contributor to this work," he said. "About half of the African Americans in the overall study are from South Carolina. Having their participation has had a major impact to the study of diabetes in different ethnic groups."

SEARCH has led to ancillary studies that have been instrumental in learning more about the impact of diabetes on health. At the Arnold School alone, SEARCH data has led to studies on the link between diabetes and nutrition, periodontal disease, depression, and a study on geographic variation in diabetes.

The SEARCH program has led to more than 50 studies published in journals, including at least 25 studies on which Arnold School faculty have been authors, said Liese, director of the Center for Research in Nutrition and Heath Disparities.

"The impact of the SEARCH program on the health of children and adolescents in the United States cannot be understated," she said. "Over the 10 years of research, we have learned about the increase in type 2 diabetes, clinical aspects of the disease, how diabetes affects quality of care and quality of life factors among youth. SEARCH is one of the longest running studies at USC and certainly one of the most prestigious."

SEARCH has studied diabetes in whites, African Americans, Hispanics, Asian/Pacific Islanders, and Native Americans/Navajo Nation. Clinical sites outside the Palmetto State include California, Colorado, Hawaii, Ohio, and Washington.

To learn more about SEARCH, visit

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