Personalizing Sleep Interventions to Prevent Type 2 Diabetes in Community Dwelling Adults with Pre-Diabetes

对患有糖尿病前期的社区居民进行个性化睡眠干预以预防 2 型糖尿病

• 批准号: 10027336
• 负责人: Susan Kohl Malone
• 金额: $ 24.9万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-01-21 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10027336
• 关键词: Accelerometer; Address; Adult; American; Award; Beds; Behavior; Behavior Therapy; Behavioral; Body mass index; Caloric Restriction; Circadian Rhythms; Communities; Data; Data Collection; Data Set; Diabetes Mellitus; Diet; Dietary Intervention; Dimensions; Disease; Eating; Epidemic; Exclusion; Glucose; Glycosylated hemoglobin A; Goals; Health; Health Promotion; Hour; Impairment; Individual; Individual Differences; Insulin Resistance; Intervention; Life Style Modification; Light; Measures; Mentorship; Metabolic; Metabolism; Mission; Modeling; National Health and Nutrition Examination Survey; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Outcome Measure; Pathway interactions; Persons; Pharmaceutical Preparations; Pharmacology; Phase; Physical activity; Populations at Risk; Prediabetes syndrome; Randomized; Randomized Clinical Trials; Reporting; Research; Resistance; Risk; Role; Sample Size; Sampling; Schedule; Self Management; Sleep; Sleep Starts; Structure; Sum; Testing; Therapeutic Intervention; Time; Training; Work; Writing; actigraphy; arm; base; blood glucose regulation; bridge program; career; cohort; community intervention; community setting; design; diabetes risk; diet and exercise; dietary restriction; eligible participant; exercise intervention; glucose monitor; improved; innovation; insulin sensitivity; intervention effect; prevent; primary outcome; programs; racial and ethnic; recruit; research study; resilience; response; skills; sleep behavior; sleep pattern; sociodemographics; socioeconomics; stem; success; trend; wearable sensor technology

PROJECT SUMMARY Diet and exercise interventions have made great strides in preventing and delaying T2D onset: benefits that surpass pharmacological interventions in some persons. Yet, variable responses from less intense, more affordable interventions and waning benefits over time are significant limitations. Identifying additional modifiable factors that can expand intervention options, beyond diet and exercise, are needed to reach heretofore resistant groups and to sustain metabolic benefits. One viable option is improving sleep. Multiple dimensions of sleep have been independently associated with T2D risk and poor glucose control in persons with T2D. Improved insulin sensitivity has been reported in a small community based daily sleep extension study (N= 16), as well as in a 2-day lab based sleep extension study using a personalized “catch up” sleep intervention in healthy adults (N = 19,). Limited by small sample sizes, controlled lab conditions, and the exclusion of persons at greatest risk for T2D, the role of sleep in mitigating T2D risk remains uncertain. An important but unanswered question for tailoring sleep interventions is whether regular sleep timing should be prioritized. Given that irregular sleep-wake timing is widely prevalent, identifying the metabolic benefits or burdens of this sleep habit is critical. The proposed project in this K99/R00 award is a step toward independence in a program of research bridging circadian rhythms and metabolism to chrono-therapeutic interventions that mitigate type 2 diabetes (T2D) risk. Research: The study proposed in the K99 phase will leverage an existing data set to quantify the effects of irregular sleep timing on glucose regulation in persons with diabetes, prediabetes, and normoglycemia. This will elucidate individual differences in resiliency against or vulnerability to irregular sleep timing. Primary outcome measures will be hemoglobin A1c (for persons with diabetes and prediabetes) or insulin resistance (for persons with normoglycemia). The study proposed during the R00 phase will test the effects of a daily sleep extension intervention versus habitual sleep patterns on the percentage of time glucose is  140 mg/dL (n = 75 per group) in sleep restricted community-dwelling adults with pre-diabetes. Wearable sensor technologies (continuous glucose monitoring and accelerometry) will be used. This study will inform person- specific sleep interventions that improve glycemic responses, thus providing treatment for the prediabetic state. Training: To achieve overall career goals, the training plan will build upon the candidate's background in diabetes by affording her in-depth training in designing sleep interventions, wearable sensor technologies (specifically continuous glucose monitoring), and the analysis of large amounts of real time data. This training will also incorporate advancing her skills in writing and presenting scientific findings, as well as the skills to become a leader in the scientific community. A variety of approaches will be used to achieve these goals including formal coursework and structured one-on-one mentorship.

项目摘要 饮食和运动干预措施在预防和延迟T2D发作方面取得了长足的进步：好处 在某些人中超越药理干预措施。然而，来自较不强度，更多的响应 负担得起的干预措施和随着时间的流逝减弱是重大局限性。确定其他 需要扩大干预选择的可修改因素（除了饮食和运动之外）才能达到 迄今抗性群体并维持代谢益处。一个可行的选择是改善睡眠。多种的 睡眠的尺寸与T2D风险和人的葡萄糖控制不佳有关 与T2D。据报道，在小型社区的每日睡眠延期中，已经报道了胰岛素敏感性的提高 研究（n = 16），以及使用个性化“赶上”睡眠的为期2天的基于实验室的睡眠扩展研究 干预健康成年人（n = 19，）。受小样本量，受控的实验室条件和限制 排除T2D风险最大的人，睡眠在减轻T2D风险中的作用仍然不确定。一个 为调整睡眠干预措施的重要但未解决的问题是定期睡眠时机是否应该是 优先。鉴于不规则的睡眠觉醒时机广泛普遍，因此确定了代谢益处或 这种睡眠习惯的负担至关重要。该K99/R00奖中的拟议项目是迈向的一步 独立于研究培养昼夜节律和代谢的计划中的独立性 减轻2型糖尿病（T2D）风险的干预措施。 研究：在K99阶段提出的研究将利用现有数据集来量化 患有糖尿病，前糖尿病和正常血糖患者的葡萄糖调节的不规则睡眠时间。这 将阐明针对不规则睡眠时间的弹性或脆弱性的个体差异。基本的 结果指标将是血红蛋白A1C（对于糖尿病和糖尿病前患者）或胰岛素抵抗 （对于患有正常血糖的人）。在R00阶段提出的研究将测试每日的影响 时间葡萄糖百分比为140mg/dl，睡眠延长干预与惯常的睡眠模式 （每组n = 75个）在睡眠限制的社区居民中，患有糖尿病前期。可穿戴传感器 将使用技术（连续葡萄糖监测和加速度计）。这项研究将通知人 - 特定的睡眠干预措施可以改善血糖反应，从而为糖尿病前期提供治疗。 培训：为了实现整体职业目标，培训计划将以候选人的背景为基础 糖尿病通过在设计睡眠干预措施，可穿戴传感器技术方面提供深入的培训。 （特别是连续的葡萄糖监测），以及大量实时数据的分析。这个培训 还将结合她在写作和提出科学发现以及技能的技能以及 成为科学界的领导者。各种方法将用于实现这些目标 包括正式的课程和结构化的一对一思想。