Reducing risk of Type 2 diabetes inHIV: a mixed-methods investigation of theSTOP-Diabetes diet and physical activity intervention
Reducing risk of Type 2 diabetes inHIV: a mixed-methods investigation of theSTOP-Diabetes diet and physical activity intervention
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DOI：
10.1111/dme.13927
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发表时间：
2020-10-01
影响因子：
3.5
通讯作者：
Goff, L. M.
中科院分区：
文献类型：
--
作者：
Duncan, A. D.;Peters, B. S.;Goff, L. M.
目的进行一项混合方法的可行性研究，研究旨在降低HIV感染者患2型糖尿病风险的个体化饮食和体力活动干预的有效性和可接受性。方法对空腹血糖受损的HIV感染者进行为期6个月的饮食和体力活动干预。每月提供实现10个生活方式目标的个性化建议。糖尿病风险评估前和干预后通过测量血糖和胰岛素对3小时餐耐量试验的反应。使用配对检验分析6个月变化。研究访谈，探索干预措施的可接受性和影响行为改变的因素进行了与那些谁参加了干预措施，和那些谁拒绝参与。结果干预组（n=28）显著降低了以下指标：空腹和餐后血糖和胰岛素曲线下面积（分别为血糖7.9%和17.6%;胰岛素22.7%和31.4%）;体重（4.6%）;腰围（6.2%）;收缩压（7.4%）;甘油三酯（36.7%）。访谈数据证明了干预的可接受性。然而，与会者表示担心，故意减肥可能会导致披露艾滋病毒状况或与艾滋病有关的疾病。认为抗逆转录病毒药物会增加糖尿病风险的观点与研究参与率下降或实现目标较少有关。结论：我们已经证明了生活方式干预在减轻HIV相关的2型糖尿病风险增加方面的有益作用。未来的干预措施应旨在进一步减少阻止该队列成功结局的独特障碍。
Aim To conduct a mixed-methods feasibility study of the effectiveness and acceptability of an individualized diet and physical activity intervention designed to reduce the risk of Type 2 diabetes experienced by people living withHIV. Methods Participants with impaired fasting glucose andHIVwere invited to take part in a 6-month diet and physical activity intervention. Individualized advice to achieve 10 lifestyle goals was delivered monthly. Diabetes risk was assessed pre- and post-intervention by measurement of the glucose and insulin response to a 3-h meal tolerance test. Six-month change was analysed using pairedt-tests. Research interviews exploring the acceptability of the intervention and factors influencing behaviour change were conducted with those who participated in the intervention, and those who declined participation. Results The intervention (n=28) significantly reduced the following: glucose and insulin, both fasting and postprandial incremental area under the curve (glucose 7.9% and 17.6%; insulin 22.7% and 31.4%, respectively); weight (4.6%); waist circumference (6.2%); systolic blood pressure (7.4%); and triglycerides (36.7%). Interview data demonstrated the acceptability of the intervention. However, participants expressed concern that deliberate weight loss might lead to disclosure ofHIVstatus or association withAIDS-related illness. The belief that antiretroviral medications drove diabetes risk was associated with declining study participation or achieving fewer goals. Conclusions We have demonstrated the beneficial effects of a lifestyle intervention in mitigating the increased risk of Type 2 diabetes associated withHIV. Future interventions should be designed to further reduce the unique barriers that prevent successful outcomes in this cohort.