Building Infrastructure to Address Social, Cultural and Biological Determinants of Diabetes in Lebanon

建设基础设施以解决黎巴嫩糖尿病的社会、文化和生物决定因素

• 批准号: 10237378
• 负责人: Leonard E. Egede
• 金额: $ 18.97万
• 依托单位: AMERICAN UNIVERSITY OF BEIRUT
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10237378
• 关键词: Address; Adult; Affect; African; Aging; American; Attitude; Belief; Biological; Biological Factors; Biological Markers; Blood Glucose; Blood Pressure; Cardiovascular Diseases; Communities; Complications of Diabetes Mellitus; Cultural Backgrounds; Data; Developing Countries; Development; Diabetes Mellitus; Discipline; Disease; Disease Outcome; Disease Progression; Dyslipidemias; Economic Conditions; Economics; Education; Epigenetic Process; Etiology; Funding; Gender; Glycosylated hemoglobin A; Health; Health Status; High Prevalence; Home; Hunger; Hyperglycemia; Hypertension; Incidence; Income; Individual; Infrastructure; Institution; Interdisciplinary Study; Kidney Diseases; Knowledge; Lebanon; Life Expectancy; Life Style; Lipids; Marmota; Measures; Middle East; Non-Insulin-Dependent Diabetes Mellitus; Occupations; Outcome; Patients; Plant Roots; Plasma; Policies; Population; Population trends; Poverty; Prevalence; Prevention strategy; Prostate-Specific Antigen; Proteomics; Public Health; Research; Research Infrastructure; Resources; Retinal Diseases; Risk; Risk Factors; Role; Social Conditions; Social support; Socioeconomic Status; Surveys; Time trend; Transportation; Universities; Wisconsin; Work; base; burden of illness; cardiovascular disorder risk; cohort; connective tissue growth factor; diabetes education; evidence base; evidence based guidelines; health care availability; health care disparity; health management; macrovascular disease; medical schools; patient population; patient registry; productivity loss; proteomic signature; racism; response; social; social determinants; social factors; social health determinants; treatment strategy

ABSTRACT Diabetes is a major public health problem currently affecting over 40 million people living in the Middle East and North African (MENA) region. Lebanon is one of the MENA nations with a higher prevalence of diabetes than the regional average of 9.2%, estimated at 14.6% of adults in 2017. Despite this tremendous burden, the risk determinants that contribute to the development of diabetes and its serious microvascular (retinopathy and nephropathy) and macrovascular complications are not well understood. In response to the increasing impact of diabetes on the nation, Lebanon has created an operational policy for diabetes, however, there is no comprehensive Lebanese registry of patients with diabetes, no national survey in which blood glucose was measured, and only partial implementation of evidence-based guidelines for diabetes treatment. As a result, this patient population is largely uncharacterized, and the current preventative and treatment strategies remain sub- optimal. In addition, there is a paucity of information detailing the etiological factors of patients with type 2 diabetes, the status and determinants of their outcomes, or the time trends in incidence/prevalence of diabetes or disparities in care. While it is known that diabetes knowledge, attitudes, beliefs, social determinants, and biomarkers all have individual relationship with diabetes, the incremental influence of each of these factors on diabetes outcomes in the Lebanese adult population is unknown. Combining expertise across three institutions and multiple disciplines, we seek to understand the role of a variety of factors on diabetes outcomes, disease progression, and complications in Lebanese adults with type 2 diabetes through the following specific aims: (1) Build a multi-institutional and multi-disciplinary collaboration to address diabetes and cardiovascular disease (CVD) in the MENA region. (2) Identify the role of beliefs, knowledge and attitudes on diabetes and CVD risk factor control (HbA1c, blood pressure, lipid profile). (3) Determine the role of social determinants of health on diabetes and CVD risk factor control. (4) Identify biomarkers of disease progression and complications (such as CTGF and plasma prekallikrein) in individuals with diabetes and CVD risk factors. By investigating the role of cultural, social, and biological factors influencing diabetes outcomes in Lebanese adults, this study will provide an opportunity to build research infrastructure and capacity across multiple institutions and disciplines that will facilitate an application for R01 funding to investigate epigenetics and proteomics in Lebanese adults with diabetes.

抽象的 糖尿病是目前的一个重大公共卫生问题，目前影响居住在中东的4000万人和 北非（MENA）地区。黎巴嫩是糖尿病患病率更高的北非国家之一 区域平均水平为9.2％，估计2017年成年人的14.6％。尽管如此 有助于糖尿病及其严重的微血管的决定因素（视网膜病变和 肾病）和大血管并发症尚不清楚。回应日益增长的影响 黎巴嫩在国家糖尿病已经制定了糖尿病的运营政策，但是，没有 全面的糖尿病患者注册表，没有血糖的全国调查 测量，并且仅部分实施基于证据的糖尿病治疗指南。结果，这个 患者人群在很大程度上没有表征，目前的预防和治疗策略仍然是 最佳的。另外，信息很少，详细介绍了2型患者的病因因素 糖尿病，结果的状态和决定因素或糖尿病发病率/患病率的时间趋势 或护理上的差异。众所周知，糖尿病，态度，信念，社会决定因素和 生物标志物都与糖尿病有个人关系，这些因素中的每一个都对 黎巴嫩成年人口中的糖尿病结果尚不清楚。结合三个机构的专业知识 和多个学科，我们试图了解各种因素在糖尿病结果，疾病中的作用 通过以下特定目的，黎巴嫩2型糖尿病的黎巴嫩成年人的进展和并发症：（1） 建立多机构和多学科的合作，以解决糖尿病和心血管疾病 （CVD）在MENA地区。 （2）确定信念，知识和态度对糖尿病和CVD风险的作用 因子控制（HBA1C，血压，脂质剖面）。 （3）确定健康决定因素在 糖尿病和CVD风险因素控制。 （4）确定疾病进展和并发症的生物标志物（例如 患有糖尿病和CVD危险因素的患者的CTGF和血浆prekallikrein）。通过调查角色 这项研究将提供影响黎巴嫩成年人的文化，社会和生物学因素，该研究将提供 在多个机构和学科上建立研究基础设施和能力的机会 促进R01资金的申请，以调查黎巴嫩成年人的表观遗传学和蛋白质组学 糖尿病。