Metformin for Preventing Frailty in High-risk Older Adults.

本研究副刊旨在促进健康相关研究的多样性，旨在了解 导致糖尿病和虚弱发病的因素以及确定虚弱和虚弱之间的时间关系 老年人的糖尿病发病率。这项研究还将支持马里兰州蒂凡尼·科特斯的职业发展， 与亲本试验(埃斯皮诺莎)的PI一起工作的内分泌学家和临床调查员。在这项研究中，我们 将利用正在进行的临床试验，在这项试验中，我们正在检查老年、非虚弱的糖尿病前期患者 用两年的时间测试二甲双胍对胰岛素敏感性的增加是否会改变脆弱的发病。我们还将进行一次 更大规模的队列研究，以检查使用退伍军人的老年人中糖尿病和虚弱的发生率 管理(VA)临床/管理数据。 简而言之，我们的具体目标是： (1)确定增加从糖尿病前期转化为糖尿病的风险的因素，以及糖尿病的预测因素 在我们未来的临床试验中是脆弱的。 (2)检查与老年退伍军人中糖尿病和虚弱的发病相关的因素。 通过实现这些目标，这项研究将阐明老年人虚弱和糖尿病发病的危险因素 以及它们之间的时间关系。这一数据也将为今后更大范围的务实提供基础 研究的重点是预防老年人的虚弱。

The purpose of this Research Supplement to Promote Diversity in Health-Related Research is to understand the factors that lead to onset of diabetes and frailty and to determine the temporal relationship between frailty and diabetes incidence in older adults. This research will also support the career development of Tiffany Cortes, MD, an endocrinologist and clinical investigator working with the PI of the parent trial (Espinoza). For this study, we will take advantage of the ongoing clinical trial where we are examining older, non-frail prediabetic patients over two years to test whether increased insulin sensitivity with metformin alters frailty onset. We will also conduct a larger cohort study in order to examine the incidence of diabetes and frailty in older adults using Veterans Administration (VA) clinical/administrative data. Briefly, our specific aims are: (1) Identify factors that increase the risk of conversion from prediabetes to diabetes, and predictors of diabetes and frailty in our prospective clinical trial. (2) Examine factors related to the onset of diabetes and frailty in an older veteran population. By accomplishing these aims, this study will shed light on risk factors for frailty and diabetes onset in older adults and the temporal relationship of these. This data will also provide the foundation for a future larger pragmatic study focused on prevention of frailty in older adults.