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Diabetes Study of Northern California


The Diabetes Study of Northern California (DISTANCE) is a long-term study funded by the National Institutes of Health. DISTANCE conducts epidemiological and health services research in diabetes​​ among a large, multiethnic cohort of patients in a large, integrated health care delivery system.

DISTANCE began in 2003 as a study of social disparities in diabetes-related health outcomes. Its original aims were to identify potentially modifiable factors, such as patient health literacy or provider communication, which might explain social disparities in the most common diabetes-related complications, including myocardial infarction, stroke, congestive heart failure, end-stage renal disease, lower-extremity amputation, proliferative retinopathy, acute metabolic events, and death. Today, DISTANCE includes these broad areas of inquiry:

  • Social disparities
  • Aging
  • Medication adherence
  • Health information technology
  • Health communications, health literacy and language barriers​​​​​