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COBRE-DIABETES

糖尿病

基本信息

批准号：
10395384
负责人：
MARIANA GERSCHENSON
金额：
$ 31.1万
依托单位：
UNIVERSITY OF HAWAII AT MANOA
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-01 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10395384
关键词：
Affect Age Ambulatory Care Facilities American Indians Anxiety Asians Assessment tool Body mass index Cardiometabolic Disease Cardiovascular Diseases Cause of Death Centers of Research Excellence Diabetes Mellitus Diagnostic Reagent Kits Diet Enrollment Epidemic Ethnic group Focus Groups Future Gestational Diabetes Glucose Glucose tolerance test Glycosylated Hemoglobin Glycosylated hemoglobin A Goals High Prevalence High Risk Woman Hour Intervention Knowledge Life Life Style Linear Regressions Literature Measures Medical center Native Hawaiian Non-Insulin-Dependent Diabetes Mellitus Outpatients Pacific Island Americans Participant Physical activity Pittsburgh Sleep Quality Index Population Population Heterogeneity Postpartum Period Postpartum Women Pregnancy Pregnancy Complications Pregnant Women Prevalence Prevention strategy Public Health Race Recording of previous events Reporting Risk Risk Factors Severities Sleep Sleep Deprivation Sleeplessness Time United States Woman base cardiometabolic risk cardiometabolism cardiovascular disorder risk caregiving diabetes risk ethnic diversity ethnic minority population evidence base health disparity high risk home test indexing insight mortality multi-ethnic novel physical inactivity programs racial and ethnic racial diversity recruit sleep quality

项目摘要

PROJECT SUMMARY/ABSTRACT Cardiovascular disease (CVD) is the leading cause of death in women in the U.S, and complications during pregnancy, including gestational diabetes (GDM), are associated with risk of CVD and type 2 diabetes mellitus (DM) later in life. Women with DM have increased risk of CVD, and women with a history of GDM have 7 times higher risk for DM post-delivery compared with women who had a normoglycemic pregnancy. An increasingly important risk factor for GDM and DM is sleep deficiency, and women appear to be more vulnerable to the effects of sleep deficiency on cardiometabolic risk and mortality. Pregnancy and postpartum offer a window of opportunity to mitigate DM1 risk in high risk women of diverse racial/ethnic background. Sleep deficiencies are commonly reported during pregnancy and about 50% of women with history of GDM develop DM, however little is known about sleep deficiency and glycemic status at postpartum. Furthermore, sleep deficiencies and associated risk of diabetes and CVD unequally affect racial/ethnic minorities. Our long-term goal is to identify and disseminate evidence-based, culturally sensitive interventions to reduce sleep deficiencies in women during pregnancy and postpartum, and thus reduce the risk of type 2 DM. The objectives of this study are to understand the association between sleep deficiencies and glycemic status in women with a history of GDM. We propose a study with 200 women with history of GDM in the A Sweeter Choice (ASC) program, an established outpatient diabetes program at Kapi`olani Medical Center, Honolulu, Hawai`i, started in 1995 that has recruited over 10,000 multi-ethnic women with GDM and/or preexisting DM. We will assess sleep deficiency - sleep duration, sleep quality, insomnia severity, and morning-evening sleep choronotype using validated assessment tools. Our first aim is to describe the underlying factors contributing to risk for sleep deficiency in a population of postpartum women from diverse race/ethnic backgrounds with a prior history of GDM. We will conduct a total of 4-8 focus groups with 5-10 participants in each focus group by recruiting women from the ASC program at 6 – 12 months postpartum. Our goal is to gain a deeper understanding of the perspectives of women with a prior pregnancy complicated by GDM on sleep deficiency during pregnancy and postpartum. Our second aim is to examine the association of sleep deficiencies and glycemic status in a population of women from diverse race/ethnic backgrounds with a history of GDM. Sleep deficiencies and HbA1c will be evaluated in 150 women from the ASC program at 6 – 12 months postpartum. Sleep deficiencies will be assessed using the Pittsburgh Sleep Quality Index (PSQI), insomnia severity index, and the morning-evening chronotype assessment, and glycemic status using an HbA1c home test kit. The association between sleep deficiencies and glycemic status will be estimated using linear regression of glycemic status on each measure of sleep deficiency and as a composite sleep deficiency score, adjusted for confounders.

项目总结/文摘