Project 446664

"Clinical research should improve patient care," but it does not happen quickly taking up to 16 years, which does not help patients. Implementation Science is a new research that helps advance research findings into clinical care to help doctors help patients. ADMIRE will use implementation science to help improve the care and lives of young people living with diabetes. The start of puberty is an important time in the lives of teenagers with Type I Diabetes as many teens have high blood sugars and start to show early signs of kidney problems. Albuminuria or abnormally high levels of protein in the urine is an early sign of kidney problems, which can lead to kidney damage in adulthood. Checking for albuminuria in clinic has challenges. The test result may come back false positive for many reasons including time of day the urine was collected, exercise and in girls having their period. Because of this, young people with diabetes are asked to repeat the urine test in clinic many times to make sure the result of albuminuria is truly positive. The research study, Adolescent Type I Diabetes Cardio-Renal Intervention Trial (AdDIT), used a better way to test for albuminuria. It identified teenagers with diabetes at high risk for albuminuria by collecting early morning urine over three days at home, which were later kept in the fridge and then mailed to clinic. This way of testing for albuminuria was found to be more accurate so AdDIT then looked to see whether early treatment could reduce high protein levels in the urine. ADMIRE will implement AdDIT albuminuria testing in diabetes clinics and see how it compares with clinical practice. We will partner with patients and their families as well as doctors and diabetes clinic staff to learn whether this research test is suitable in diabetes clinic. If suitable, we aim to identify teenagers with diabetes at high risk for kidney and heart problems, so we can offer early treatment to prevent problems in adulthood.