Specimen and Data Collection in South Carolina Medicaid-Enrolled Patients With Type 2 Diabetes (T2D) and Metabolically Healthy Controls

Diabetes, and in particular Type 2 Diabetes which accounts for roughly 90-95% of Diabetes patients, affects tens of millions of Americans. The state of South Carolina has one of the highest rates of diabetes patients affecting every 1 in 7 adults. In addition, diabetes patients have a very high risk of developing further complications like chronic kidney disease or cardiovascular disease, which besides further threatening the lives of these patients, is very expensive to manage and treat. South Carolina also has one of the highest population growth percentage rate across the US, but the growth of the healthcare workforce particularly in the rural areas of the state is not able to keep up.

To help mitigate this, the SC Department of Health and Human Services has developed a "Rural Health Initiative" to better meet underserved communities' medical needs. Spartanburg Regional Healthcare System and Guardian Research Network have been funded by SCDHHS to serve the first study in this Initiative targeting Type 2 Diabetes (T2D).

This study aims to collect multiple types of data from SC Medicaid-enrolled type 2 diabetes (T2D) patients and healthy patients, including data from biospecimens, questionnaires, cognitive "brain" games, clinical assessments, electronic health records, wearable devices and lifestyle/behavioral data to identify elements that may be related to Chronic Kidney Disease (CKD) diagnosis or T2D progression. The primary goal is for researchers and physicians to analyze the multi-dimensional data to significantly improve the prediction of and strategies to prevent disease progression in T2D patients.

Patients between ages 40 to 70 diagnosed with T2D and enrolled in SC Medicaid may be eligible, as well as a smaller healthy (control) cohort also enrolled in SC Medicaid. Patients will be asked to provide a blood, saliva and stool sample, answer questionnaires, complete online cognitive assessments ("brain games"), and wear a study-provided Fitbit device. Type 2 Diabetes participants will also have access to a Certified Diabetes Educator to assist with disease management and potential suggested lifestyle changes to help improve health.

Inclusion criteria

All Participants:

• 40 to 70 years of age (inclusive) at enrollment
• Enrolled as Medicaid recipients
• Ability to provide informed consent and authorization for release of relevant protected health information or personal data
• Ability to provide a blood sample(s) of up to 70 mL and other required biospecimens, including genetic samples.

T2D Group:

• Current diagnosis of Type 2 diabetes OR a blood level of hemoglobin A1c equal to or greater than 6.5% at any time within the past 12 months

Control Group:

• Blood level of hemoglobin A1c less than or equal to 5.6% at time of enrollment
• No diagnosis of Type 2 diabetes

Exclusion criteria

• Pregnancy at time of enrollment (by self-report of pregnancy status)
• Lack of fluency in spoken and written English
• Type 1 diabetes or any other type of diabetes besides Type 2 diabetes
• Active cancer diagnosis or cancer that achieved complete remission within three (3) years prior to enrollment, other than non-melanoma skin cancer (e.g. malignant basal cell neoplasm of skin and/or squamous cell carcinoma of skin)
• Major Adverse Cardiovascular Events within two (2) years prior to enrollment
• Chronic Obstructive Pulmonary Disease
• Cognitive impairment or neurodegenerative diseases (e.g., Alzheimer's disease, dementia, multiple sclerosis, Parkinson's disease, etc.)
• Pancreatitis or other diseases of the pancreas (besides diabetes)
• The participant is, in the opinion of the investigator, unlikely to be able to complete all study requirements