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: 10320470
• 负责人: Susan Kohl Malone
• 金额: $ 23.89万
• 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 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10320470
• 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; Sleep disturbances; 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 饮食和运动干预在预防和延迟T2 D发作方面取得了很大进展： 对某些人来说超过了药物干预。然而，不同的反应，从较低的强度， 负担得起的干预措施和随着时间的推移而减少的效益是重大的限制。找出更多 除了饮食和锻炼之外，还需要一些可以扩大干预选择的可变因素， 迄今为止的耐药群体和维持代谢益处。一个可行的选择是改善睡眠。多 睡眠维度与T2 D风险和血糖控制不良独立相关 关于T2 D据报道，在一个小型社区的日常睡眠延长中，胰岛素敏感性得到了改善 研究（N= 16），以及在2天的实验室为基础的睡眠延长研究，使用个性化的“追赶”睡眠 健康成人（N = 19）。受样本量小、实验室条件受控以及 尽管排除了T2 D风险最高的人，但睡眠在减轻T2 D风险中的作用仍然不确定。一个 对于定制睡眠干预来说，一个重要但尚未回答的问题是，是否应该 优先。鉴于不规则的睡眠-觉醒时间普遍存在，确定代谢益处或 这种睡眠习惯的负担是至关重要的。在这个K99/R 00奖项中提出的项目是朝着 在一个研究项目中的独立性，将昼夜节律和新陈代谢与时间治疗联系起来 降低2型糖尿病（T2 D）风险的干预措施。 研究：K99阶段提出的研究将利用现有的数据集来量化 不规则的睡眠时间对糖尿病、糖尿病前期和血糖正常者血糖调节的影响。这 将阐明对不规则睡眠时间的弹性或脆弱性的个体差异。初级 结果测量将是血红蛋白A1 c（对于糖尿病和前驱糖尿病患者）或胰岛素抵抗 (for正常人）。R 00阶段拟议的研究将测试每日 睡眠延长干预与习惯性睡眠模式对血糖≥ 140 mg/dL时间百分比的影响 （每组n = 75）在睡眠受限的社区居住的糖尿病前期成人。可穿戴传感器 将使用技术（连续葡萄糖监测和加速度计）。这项研究将告知人们- 改善血糖反应的特定睡眠干预，从而为糖尿病前期状态提供治疗。 培训：为了实现总体职业目标，培训计划将建立在候选人的背景上， 通过为她提供设计睡眠干预措施、可穿戴传感器技术 （特别是连续葡萄糖监测）以及大量真实的时间数据的分析。本次培训 还将包括提高她在写作和展示科学发现方面的技能，以及 成为科学界的领导者。为实现这些目标，将采用各种方法 包括正式的课程和结构化的一对一指导。

项目成果

Self-care in People with Type 2 Diabetes Mellitus Research Protocol of a Multicenter Mixed Methods Study (SCUDO)

2 型糖尿病患者的自我护理多中心混合方法研究方案 (SCUDO)

• DOI: 10.7429/pi.2019.723203
• 发表时间: 2019
• 期刊: Professioni infermieristiche
• 作者: Luciani,Michela;Fabrizi,Diletta;Rebora,Paola;Rossi,Emanuela;DiMauro,Stefania;KohlMalone,Susan;Ausili,Davide
• 通讯作者: Ausili,Davide