COBRE-DIABETES

糖尿病

基本信息

批准号：
10395384
负责人：
MARIANA GERSCHENSON
金额：
$ 31.1万
依托单位：
UNIVERSITY OF HAWAII AT MANOA
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-01 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10395384
关键词：
Affect Age Ambulatory Care Facilities American Indians Anxiety Asians Assessment tool Body mass index Cardiometabolic Disease Cardiovascular Diseases Cause of Death Centers of Research Excellence Diabetes Mellitus Diagnostic Reagent Kits Diet Enrollment Epidemic Ethnic group Focus Groups Future Gestational Diabetes Glucose Glucose tolerance test Glycosylated Hemoglobin Glycosylated hemoglobin A Goals High Prevalence High Risk Woman Hour Intervention Knowledge Life Life Style Linear Regressions Literature Measures Medical center Native Hawaiian Non-Insulin-Dependent Diabetes Mellitus Outpatients Pacific Island Americans Participant Physical activity Pittsburgh Sleep Quality Index Population Population Heterogeneity Postpartum Period Postpartum Women Pregnancy Pregnancy Complications Pregnant Women Prevalence Prevention strategy Public Health Race Recording of previous events Reporting Risk Risk Factors Severities Sleep Sleep Deprivation Sleeplessness Time United States Woman base cardiometabolic risk cardiometabolism cardiovascular disorder risk caregiving diabetes risk ethnic diversity ethnic minority population evidence base health disparity high risk home test indexing insight mortality multi-ethnic novel physical inactivity programs racial and ethnic racial diversity recruit sleep quality

项目摘要

PROJECT SUMMARY/ABSTRACT Cardiovascular disease (CVD) is the leading cause of death in women in the U.S, and complications during pregnancy, including gestational diabetes (GDM), are associated with risk of CVD and type 2 diabetes mellitus (DM) later in life. Women with DM have increased risk of CVD, and women with a history of GDM have 7 times higher risk for DM post-delivery compared with women who had a normoglycemic pregnancy. An increasingly important risk factor for GDM and DM is sleep deficiency, and women appear to be more vulnerable to the effects of sleep deficiency on cardiometabolic risk and mortality. Pregnancy and postpartum offer a window of opportunity to mitigate DM1 risk in high risk women of diverse racial/ethnic background. Sleep deficiencies are commonly reported during pregnancy and about 50% of women with history of GDM develop DM, however little is known about sleep deficiency and glycemic status at postpartum. Furthermore, sleep deficiencies and associated risk of diabetes and CVD unequally affect racial/ethnic minorities. Our long-term goal is to identify and disseminate evidence-based, culturally sensitive interventions to reduce sleep deficiencies in women during pregnancy and postpartum, and thus reduce the risk of type 2 DM. The objectives of this study are to understand the association between sleep deficiencies and glycemic status in women with a history of GDM. We propose a study with 200 women with history of GDM in the A Sweeter Choice (ASC) program, an established outpatient diabetes program at Kapi`olani Medical Center, Honolulu, Hawai`i, started in 1995 that has recruited over 10,000 multi-ethnic women with GDM and/or preexisting DM. We will assess sleep deficiency - sleep duration, sleep quality, insomnia severity, and morning-evening sleep choronotype using validated assessment tools. Our first aim is to describe the underlying factors contributing to risk for sleep deficiency in a population of postpartum women from diverse race/ethnic backgrounds with a prior history of GDM. We will conduct a total of 4-8 focus groups with 5-10 participants in each focus group by recruiting women from the ASC program at 6 – 12 months postpartum. Our goal is to gain a deeper understanding of the perspectives of women with a prior pregnancy complicated by GDM on sleep deficiency during pregnancy and postpartum. Our second aim is to examine the association of sleep deficiencies and glycemic status in a population of women from diverse race/ethnic backgrounds with a history of GDM. Sleep deficiencies and HbA1c will be evaluated in 150 women from the ASC program at 6 – 12 months postpartum. Sleep deficiencies will be assessed using the Pittsburgh Sleep Quality Index (PSQI), insomnia severity index, and the morning-evening chronotype assessment, and glycemic status using an HbA1c home test kit. The association between sleep deficiencies and glycemic status will be estimated using linear regression of glycemic status on each measure of sleep deficiency and as a composite sleep deficiency score, adjusted for confounders.

项目摘要/摘要心血管疾病（CVD）是美国女性死亡的主要原因，在怀孕，包括妊娠糖尿病（GDM），与CVD和2型糖尿病的风险有关（DM）生活中的后期。患有DM的妇女患CVD风险增加，具有GDM病史的妇女有7次与患有正常血糖妊娠的妇女相比，DM送货后的风险更高。越来越多 GDM和DM的重要危险因素是睡眠不足，女性似乎更容易受到影响睡眠不足对心脏代谢风险和死亡率的影响。怀孕和产后提供减轻DM1风险在高风险的妇女/种族背景的机会。睡眠不足是通常在怀孕期间报告，大约50％的GDM史发展DM的妇女关于产后的睡眠不足和血糖状态知之甚少。此外，睡眠不足和糖尿病和CVD的相关风险不平等地影响种族/族裔少数民族。我们的长期目标是确定和传播基于证据的文化敏感干预措施减少怀孕和产后妇女的睡眠不足，从而降低2型DM的风险。这项研究的目的是了解睡眠不足与血糖状态之间的关联在具有GDM史的女性中。我们建议对200名具有GDM历史的女性进行研究 Choice（ASC）计划是一个既定的门诊糖尿病计划夏威夷于1995年始于1995年，已招募了10,000多名具有GDM和/或先前存在的DM的多种族女性。我们将评估睡眠不足 - 睡眠持续时间，睡眠质量，失眠严重程度和早晨睡眠使用经过验证的评估工具的脉络膜型。我们的第一个目的是描述导致人群睡眠不足风险的根本因素来自潜水员种族/种族背景的产后妇女的先前历史。我们将进行通过招募ASC计划的女性，总共有4-8个焦点小组，每个焦点小组中有5-10名参与者产后6至12个月。我们的目标是更深入地了解具有在怀孕期间和产后，GDM对GDM的妊娠复杂化。我们的第二个目标是要研究来自潜水员的女性人口的睡眠不足和血糖状况的关联种族/种族背景具有GDM的历史。睡眠不足和HBA1C将在150名女性中进行评估从ASC计划产后6到12个月。睡眠不足将使用匹兹堡评估睡眠质量指数（PSQI），失眠严重程度指数和早晨的表型评估以及使用HBA1C家居测试套件的血糖状态。睡眠不足与血糖状态之间的关联将使用每种睡眠不足量度的血糖状态的线性回归来估计复合睡眠不足评分，针对混杂因素进行了调整。