12/16 Action for Health in Diabetes Extension Study Research Project

12/16 糖尿病健康行动推广研究项目

• 批准号: 9226048
• 负责人: Rena R Wing
• 金额: $ 39.16万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2021-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9226048
• 关键词: Address; Adult; Age; Age-Years; Aging; Aging-Related Process; Ancillary Study; Biochemical; Body Weight decreased; Bone Density; Cardiovascular Diseases; Caring; Clinic Visits; Clinical; Clinical Trials; Comorbidity; Complications of Diabetes Mellitus; Control Groups; Data; Data Analyses; Diabetes Mellitus; Dimensions; Disease; Education; Elderly; Event; Face; Fatty acid glycerol esters; Genetic; Goals; Guidelines; Health; Health Care Costs; Healthcare; Healthy Eating; Incidence; Independent Living; Individual; Intervention; Kidney Diseases; Lead; Life; Long-Term Effects; Longevity; Measures; Microvascular Dysfunction; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Overweight; Participant; Pathway interactions; Patient-Focused Outcomes; Persons; Phase; Phonation; Physical Function; Physical activity; Population; Public Health; Publications; Quality of life; Randomized; Randomized Controlled Clinical Trials; Recording of previous events; Reporting; Research Infrastructure; Research Project Grants; Subgroup; Telephone; Testing; Thinness; Uncontrolled Study; Weight; Weight Gain; cohort; cost; cost effective; diabetic; follow-up; frailty; functional disability; group intervention; health care service utilization; healthy aging; improved; lifestyle intervention; medical complication; middle age; mortality; outcome prediction; post intervention; primary outcome; programs; public health relevance; randomized trial; research study; resilience; secondary outcome; trial comparing

 DESCRIPTION (provided by applicant): Over 25% of the US population >65 years of age have type 2 diabetes and 80% of these individuals are overweight or obese. These individuals face shortened lifespans, increased health care needs, greater medical complications, and lower quality of life relative to those of similar age without these conditions. Lifestyle interventions focused on weight loss are recommended for overweight and obese individuals with type 2 diabetes, but whether these interventions meaningfully improve the lives of older individuals with diabetes over extended follow-up is unknown. Look AHEAD is a randomized trial comparing the effects of intensive lifestyle intervention (ILI) focused on weight loss achieved through healthy eating and increased physical activity versus a control group given Diabetes Support and Education (DSE) in overweight and obese individuals with type 2 diabetes. Although ILI did not produce beneficial effects on the primary and secondary outcomes related to cardiovascular disease, it did produce beneficial effects on a broad spectrum of health parameters during the period of the intervention. The LA Extension (LA-E) will examine whether ILI, provided for 10 years during mid- life, has enduring benefits that persist beyond the period of the intervention for older individuals with diabetes. We propose to follow approximately 3,800 participants (current ages 58-89 years) for 4.5 additional years with biennial clinic visits and 6-month outcomes phone calls. The primary aims of LA-E are to test whether ILI relative to DSE has long term legacy effects on 1) increased lifespan and 2) reduced health care costs. Secondary aims test whether ILI relative to DSE has long-term effects on key dimensions of healthy aging: less frailty, reduced diabetic microvascular complications, and improved quality of life. LA-E will also compare long- term trajectories of weight, physical activity, fat and lean mass, and bone density and examine how these are related to outcomes. LA-E focuses on the clinical outcomes that are most relevant to healthy aging and resilience and will provide the long-term data needed to frame guidelines related to lifestyle intervention in the care of older overweight or obese individuals with type 2 diabetes.

 描述（由适用提供）：超过25％的美国人口> 65岁以上的2型糖尿病，其中80％的人超重或肥胖。这些人面临寿命缩短，增加医疗保健需求，更大的医疗并发症以及相对于没有这些条件的年龄相似的生活质量。建议为超重和肥胖的2型糖尿病患者进行重量减轻的生活方式干预措施，但是这些干预措施是否有意义地改善了糖尿病年龄较大的人的生活，而不是扩展随访。展望未来是一项随机试验，比较了针对通过健康饮食和增加体育锻炼来实现体重减轻的强化生活方式干预（ILI）的影响，而对照组则在超重和肥胖的2型糖尿病患者中，糖尿病支持和教育（DSE）。尽管ILI并未在与心血管疾病有关的主要和继发结果上产生益处，但在干预期间，它确实会在广泛的健康参数中产生益处。 LA扩展（LA-E）将检查在中年期间提供10年的ILI是否具有持久的益处，超出了老年糖尿病患者的干预时期。我们建议通过每两年一次的诊所访问和6个月的电话打电话来跟随大约3,800名参与者（当前年龄在58-89岁）中，再加上4。5年。 LA-E的主要目的是测试ILI相对于DSE是否具有长期遗产对1）寿命增加和2）降低医疗保健成本的影响。次要的目的是ILI相对于DSE是否对健康衰老的关键维度有长期影响：较小的脆弱，减少糖尿病微血管并发症和改善的生活质量。 LA-E还将比较体重，体育锻炼，脂肪和瘦质量的长期轨迹，以及骨密度和检查与结果的相关性。 LA-E专注于与健康衰老和韧性最相关的临床结果，并将提供与生活方式干预有关的指南所需的长期数据 护理年龄较大的超重或肥胖的患有2型糖尿病的人。