Diabetes Prevention in Hispanics: Report From a Randomized Controlled Trial
Diabetes Prevention in Hispanics: Report From a Randomized Controlled Trial
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DOI：
10.5888/pcd11.130119
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发表时间：
2014-02-01
影响因子：
5.5
通讯作者：
Thompson, Beti
中科院分区：
文献类型：
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作者：
Duggan, Catherine;Carosso, Elizabeth;Thompson, Beti
西班牙裔美国人罹患2型糖尿病的风险增加。生活方式干预在预防糖尿病和恢复血糖调节方面是有效的。方法我们招募了居住在华盛顿州下亚基马谷的西班牙裔男性和女性(N=320)，年龄在18岁或以上，HbAtc水平高于6%，参加了2008至2012年间进行的平行两组随机对照试验。这项试验将接受即时教育课程的干预组参与者(n=166)与接受延迟教育课程的对照组参与者(n=154)进行了比较。以家庭为基础的课程包括由社区卫生工作者领导的5个课程，旨在向参与者介绍糖尿病、糖尿病治疗以及健康的饮食和体力活动行为。参与者被随机分配到干预组和控制组，分析人员对参与者组视而不见。我们评估了干预对糖化血红蛋白水平、水果和蔬菜消费频率(每周次数)以及轻度、中度和剧烈休闲体育活动频率(每周次数)的影响。在随机抽样后的基线、3个月和6个月，参与者完成了一份问卷并提供了血样。结果即时干预组HbAtc评分(-0.64%[标准差(SE)0.10])较延迟干预组(-0.44%)显著改善(-37.5%，P=0.04)。饮食终点或体力活动没有明显变化。我们确实观察到即时干预组与延迟干预组相比，中度和剧烈体力活动频率的增加更多，而轻度体力活动的增加更小。结论在HbAtc水平高于6%的西班牙裔成年人中，这种由CHWS提供的居家干预与HbAtc水平的临床和统计学显著降低有关。
Introduction Hispanics are at increased risk of developing type 2 diabetes. Lifestyle interventions are effective in preventing diabetes and restoring glucose regulation.Methods We recruited Hispanic men and women (N = 320) who were residents of the Lower Yakima Valley, Washington, aged 18 years or older with hemoglobin Ate (HbAtc) levels higher than 6% to a parallel 2-arm randomized-controlled trial conducted from 2008 through 2012. The trial compared participants in the intervention arm, who received an immediate educational curriculum (n = 166), to participants in the control arm, who received a delayed educational curriculum (n = 154). The home-based curriculum consisted of 5 sessions led by community health workers and was designed to inform participants about diabetes, diabetes treatment, and healthy dietary and physical activity behaviors. Participants were randomly assigned to the intervention and control arms, and analysts were blinded as to participant arm. We evaluated intervention effects on HbAtc levels; frequency (times per week) of fruit and vegetable consumption; and frequency (times per week) of mild, moderate, and strenuous leisure-time physical activity. At baseline, 3 months, and 6 months after randomization, participants completed a questionnaire and provided a blood sample. Analysts were blinded to intervention arm.Results The immediate intervention group (-0.64% [standard error (SE) 0.10]) showed a significant improvement in HbAtc scores (-37.5%, P =.04) compared with the delayed intervention group (-0.44%, P =.14). No significant changes were seen for dietary end points or changes in physical activity. We did observe a trend of greater increases in frequency of moderate and vigorous physical activity and a smaller increase in mild physical activity in the immediate intervention group than in the delayed intervention group.Conclusion This home-based intervention delivered by CHWs was associated with a clinically and statistically significant reduction in HbAtc levels in Hispanic adults with HbAtc levels higher than 6%.