Cognitive Training for Diabetes Self-Management

糖尿病自我管理的认知训练

基本信息

批准号：
10375550
负责人：
Heather Cuevas
金额：
$ 19.09万
依托单位：
UNIVERSITY OF TEXAS AT AUSTIN
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-03-19 至 2024-02-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10375550
关键词：
Address Affect Age American Area Assimilations Attention Awareness Biological Blood Glucose Blood Vessels Calories Cancer Survivor Carbohydrates Chronic Cognition Cognitive Cognitive aging Cognitive deficits Complex Control Groups Data Development Diabetes Mellitus Diagnosis Disease Disease Management Exhibits Feasibility Studies Functional disorder Glucose Goals Heart failure Home Hypoglycemia Hypoglycemic Agents Impaired cognition Impairment Individual Insulin Resistance Intake Intervention Knowledge Life Life Style Measures Mediating Medication Management Memory Mission Monitor Morbidity - disease rate Neurocognitive Neuropsychological Tests Non-Insulin-Dependent Diabetes Mellitus Outcome Participant Patient Self-Report Patients Pattern Performance Persons Pharmaceutical Preparations Physical activity Pilot Projects Prevalence Problem Solving Public Health Randomized Randomized Controlled Trials Research Risk Role Sampling Self Efficacy Self Management Short-Term Memory Technology Testing Translating United States active control base blood glucose regulation cognitive function cognitive performance cognitive process cognitive rehabilitation cognitive testing cognitive training design diabetes management diabetes self-management efficacy testing executive function follow-up glucose monitor glycemic control improved innovation insight mortality performance tests pilot test post intervention programs skills webinar

项目摘要

Abstract The prevalence of both cognitive dysfunction and diabetes is increasing. Research shows that diabetes increases the risk for cognitive impairment and the rate of cognitive decline doubles after diabetes is diagnosed. In turn, cognitive dysfunction can make diabetes self-management more difficult. Diabetes self- management, essential to good glycemic control, requires both the assimilation of knowledge regarding a complex disease and self-management activities such as glucose self-monitoring and medication management. The objective of this R21 application is to pilot test the Memory, Attention, and Problem-Solving Skills for Persons with Diabetes (MAPSS-DM) intervention, a comprehensive cognitive rehabilitation intervention, which will include examining patterns of glycemic variability using continuous glucose monitors (CGMS). The central hypothesis of this proposal is that persons who received the MAPSS-DM intervention will have improved memory and executive function, greater use of compensatory strategies, and improved self- management. We will also explore the role of glucose variability in those changes. The specific aims of this proposal are as follows: Aim 1. To test the efficacy of the MAPSS-DM intervention for improving cognitive function, A1C, and diabetes self-management. Sixty-six participants with cognitive concerns and diabetes will be randomly assigned to either the full MAPSS-DM intervention or an active control. This pilot study will provide estimates of effect size on the following outcomes: A1C, diabetes self-management, and cognitive function. Aim 2. To explore changes in glycemic variability and their association with changes in cognitive function and diabetes self-management. Participants will use continuous glucose monitors pre-, during, and post- intervention to identify changes in glycemic variability related to the intervention. This project is innovative because it will be the first study to test lifestyle-based online cognitive rehabilitation as an intervention in T2DM. Providing cognitive rehabilitation that incorporates a widely available and increasingly acceptable technology (CGMS) is an innovative way to measure the impact of the intervention. This study will fill an important gap by addressing cognitive function in the management of diabetes. The results will contribute to the development of the knowledge necessary to enact strategies to support cognitive function and diabetes self-management which is significant because diabetes is related to accelerated cognitive aging, cognitive deficits are related to poorer self-management, and improvements in cognitive performance as a result of cognitive rehabilitation can translate into improved performance in everyday life and potentially diabetes self-management. Furthermore, the proposed study will offer new mechanistic insights into cognitive function through use of CGMS.

抽象的认知功能障碍和糖尿病的患病率都在增加。研究表明，糖尿病增加认知障碍的风险，糖尿病后认知能力下降的速度加倍确诊。反过来，认知功能障碍会使糖尿病的自我管理变得更加困难。糖尿病自我血糖管理对于良好的血糖控制至关重要，需要吸收有关血糖的知识复杂的疾病和自我管理活动，例如血糖自我监测和药物治疗管理。此 R21 应用程序的目标是试点测试记忆力、注意力和问题解决能力糖尿病患者技能（MAPSS-DM）干预，全面的认知康复干预，其中包括使用连续血糖监测仪检查血糖变异模式（CGMS）。该提案的中心假设是接受 MAPSS-DM 干预的人将改善了记忆力和执行功能，更多地使用补偿策略，并提高了自我意识管理。我们还将探讨葡萄糖变异性在这些变化中的作用。该提案的具体目标如下：目标 1. 测试 MAPSS-DM 干预对于改善认知功能、A1C 和糖尿病自我管理。 66 名患有认知问题和糖尿病的参与者将被随机分配分配给完整的 MAPSS-DM 干预或主动控制。这项试点研究将提供估计对以下结果的影响大小：A1C、糖尿病自我管理和认知功能。目标 2. 探索血糖变异性的变化及其与认知变化的关系功能和糖尿病自我管理。参与者将在赛前、赛中和赛前使用连续血糖监测仪干预后以确定与干预相关的血糖变异性变化。该项目具有创新性，因为它将是第一个测试基于生活方式的在线认知的研究康复作为 T2DM 的干预措施。提供认知康复，其中包含广泛可用的越来越可接受的技术（CGMS）是衡量技术影响的创新方法干涉。这项研究将通过解决管理中的认知功能来填补一个重要的空白。糖尿病。研究结果将有助于发展制定战略所需的知识支持认知功能和糖尿病自我管理，这很重要，因为糖尿病与认知老化加速，认知缺陷与自我管理较差以及认知能力的改善有关认知康复带来的认知表现可以转化为改善的表现日常生活和潜在的糖尿病自我管理。此外，拟议的研究将提供新的通过使用 CGMS 对认知功能进行机械洞察。