Alternative approaches to public health surveillance of IDDM.

OBJECTIVE: To assess the appropriateness of national surveillance of IDDM. RESEARCH DESIGN AND METHODS: We reviewed the structure and function of national disease surveillance, the diverse goals of IDDM surveillance, and prior experience with IDDM as a reportable disease. RESULTS: Surveillance is the systematic and ongoing collection, analysis, interpretation, and dissemination of data linked to public health action. The potential goals of surveillance of IDDM are to understand the etiology and trends in incidence of IDDM, to measure the burden of IDDM and its complications, and to assess mortality. Problems associated with surveillance of IDDM include underreporting, delayed reporting, and lack of funding. CONCLUSIONS: To make IDDM a nationally reportable disease is neither warranted nor feasible at this time. Although surveillance is needed to understand diabetes better and for diabetes control, proposed initiatives, such as major expansions of IDDM reporting, should be developed to address specific questions, problems, and needs--still recognizing real-world issues of competing priorities and limited resources.