Welcome to The Ohio State University Diabetes and Metabolism Research Center

Diabetes Registry!

Researcher: Kathleen Dungan, MD, MPH

Completion of this survey will serve as your consent for participation in this registry.

Your participation is voluntary.

Purpose: The Diabetes Research Registry will help us to determine whether participants who may be eligible for existing or future clinical trials involving both Type 1 and Type 2 Diabetes. These studies vary in time commitment and complexity and may involve completion of questionnaires, disease prevention studies, and clinical treatment studies.

Procedures: If you agree to join this Registry, a center investigator or member of our research staff will contact you if you are potentially eligible for any research studies. We will also contact you annually (via email) to ask you to update your information online.

Duration: This survey should take less than 10 minutes to complete. If we do not obtain updates from you, we will discard your information within 5 years. You may choose to leave this registry at any time by contacting us directly.

Risks and Benefits: Joining this registry may not benefit you personally, even if we find that you may qualify for a clinical trial. You will not be paid for completing this survey. However, completion of the survey may provide benefit to society by allowing us to more quickly and efficiently identify potential participants, complete the research, and implement the research findings in every day practice.

Confidentiality: We will work to make sure that no one sees your survey responses without approval. But, because we are using the Internet, there is a chance that someone could access your online responses without permission. In some cases, this information could be used to identify you. Your data will be protected with a code to reduce the risk that other people can view the responses. Also, your records may be reviewed by the following groups for legal, regulatory or quality assurance purposes:

  • Office for Human Research Protections or other federal, state, or international regulatory agencies

  • The Ohio State University Institutional Review Board or Office of Responsible Research Practices

Participant Rights: If you choose to not to participate, your relationship with The Ohio State University will not be affected. Participation in this study does not alter your personal or legal rights. You may discontinue participation at any time without penalty or loss of benefits. By joining this registry you are NOT obligated to participate in any of our studies.

An Institutional Review Board responsible for human subjects research at The Ohio State University reviewed this research project and found it to be acceptable, according to applicable state and federal regulations and University policies designed to protect the rights and welfare of participants in research.

Contacts and Questions:

If you have any questions about your rights as a participant in this study or to discuss other study-related concerns or complaints with someone who is not part of the research team you may contact Ms. Sandra Meadows in the Office of Responsible Research Practices at 1-800-678-6251.

If you have any questions or need assistance or you feel you have been harmed as a result of research study participation please contact Kathleen Dungan, MD, MPH at Ohio State University Medical Center, 5th Floor McCampbell Hall; 1581 Dodd Drive, Columbus, OH, 43210 or you may call 614-685-3333.

Thank you!

May we have your permission to use the information you provide, including personal health information, and to contact you now and in the future to describe our research studies and invite you to participate in a study?

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