Improving Glycemic Control with Electrical Stimulation in Mexican-Americans

通过电刺激改善墨西哥裔美国人的血糖控制

• 批准号: 10421136
• 负责人: Sudip Bajpeyi
• 金额: $ 30.6万
• 依托单位: UNIVERSITY OF TEXAS EL PASO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10421136
• 关键词: 5' -AMP-activated protein kinase; Acute; Adherence; Adoption; Adult; Affect; Basal metabolic rate; Blood; Body Composition; Body measure procedure; Cell Culture Techniques; Centers for Disease Control and Prevention (U.S.); Cessation of life; Chronic; Clinical Trials; Contracts; Data; Defect; Diagnosis; Dual-Energy X-Ray Absorptiometry; Effectiveness; Electric Stimulation; Energy Metabolism; Epidemic; Exercise; Fatty acid glycerol esters; Foundations; General Population; Glucose Transporter; Goals; Guidelines; Health; Health Care Costs; Healthcare; Hour; Human; Immobilization; Impairment; In Vitro; Indirect Calorimetry; Individual; Insulin Resistance; Intervention; Knowledge; Limb structure; Lipids; Literature; Longitudinal Studies; Measures; Metabolic; Metabolic Diseases; Methods; Mexican Americans; Mexico; Minority Groups; Mitochondria; Modeling; Muscle Cells; Muscle Contraction; Muscle Fibers; Muscular Atrophy; Musculoskeletal Pain; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; OGTT; Obesity; Overweight; Peripheral Nervous System Diseases; Physical activity; Population; Populations at Risk; Prevalence; Prevention; Preventive treatment; Protocols documentation; Randomized; Randomized Controlled Trials; Rehabilitation therapy; Research; Risk; Risk Factors; Role; Skeletal Muscle; Strenuous Exercise; Testing; Texas; United States National Center for Health Statistics; base; blood lipid; cardiovascular risk factor; clinical practice; cost effective; effectiveness testing; exercise intensity; glucose monitor; glycemic control; human subject; improved; innovation; insulin sensitivity; lipid metabolism; longitudinal human study; metabolic profile; minority health; muscle form; muscle strength; neuromuscular; neuromuscular function; neuromuscular stimulation; novel; obese person; oxidation; physical inactivity; prevent; respiratory; sedentary; sedentary lifestyle; study population; vigorous intensity

PROJECT ABSTRACT/SUMMARY Over the few decades, metabolic diseases such as obesity, insulin resistance, and type 2 diabetes have risen to epidemic proportions, particularly among Mexican-Americans, and are leading to a high health care costs nationwide. Meanwhile, adherence to physical activity to prevent these metabolic diseases has declined. A majority (80%) of adults in the US do not meet the ACSM-recommended 150 minutes of moderate or 75 minutes of vigorous exercise per week. Mexican-Americans have greater prevalence of physical inactivity compared to the general population. Therefore, it is critical to develop additional strategies to increase adoption and adherence to physical activity in this at-risk population. The long-term goal of our research is to explore effective strategies to improve glycemic control, insulin sensitivity and metabolic health in sedentary humans, particularly those who are unable to exercise or are at risk for developing T2D. Neuromuscular Electrical Stimulation (e-stim) is a practical, non-invasive, cost-effective and innovative method to promote an alternative mode of muscle contraction among individuals who are less likely to engage in conventional physical activity. Over the past decade, we have developed and established in vitro exercise models using e- stim to contract human primary muscle cells (myotubes) to study the mechanisms by which muscle contraction positively influences insulin sensitivity and lipid metabolism. Although e-stim is widely used in rehabilitation settings to prevent muscle loss, there is a gap in the literature defining the effectiveness of e-stim to improve insulin sensitivity and metabolic health. Our preliminary data and existing literature indicate a promising application of e-stim to improve glycemic control, insulin sensitivity and metabolic health in an at-risk sedentary, overweight or obese population. Based on our preliminary data, we propose to perform a comprehensive randomized controlled trial (n=30) to determine the effects of 8 weeks of e-stim, on glycemic control as measured by continuous glucose monitoring, insulin sensitivity by oral glucose tolerance test, energy metabolism (resting metabolic rate, substrate utilization, blood lipid and metabolic profile), body composition, and muscle strength in an at-risk, sedentary, overweight/obese, Mexican-American population. We hypothesize that e-stim will improve 24 hour. glycemic control, increase insulin sensitivity, and improve overall metabolic health in this population. This study will allow us to evaluate the feasibility of using e-stim as a novel preventative treatment for insulin resistance and metabolic diseases in a sedentary population and will lay the foundation for a larger clinical trial with potential to impact clinical practice to prevent and treat type 2 diabetes.

项目摘要/摘要 在几十年中，肥胖，胰岛素抵抗和2型糖尿病等代谢疾病的增长 在流行病上，尤其是在墨西哥裔美国人中，并带来了高昂的医疗保健费用 全国。同时，遵守体育活动以防止这些代谢疾病。一个 美国大多数（80％）在美国不符合ACSM推荐的150分钟或75分钟 每周剧烈运动。墨西哥裔美国人的身体不活跃率更大 与普通人群相比。因此，制定其他策略来增加至关重要 在这种高危人群中，采用和遵守体育活动。我们研究的长期目标是 探索有效的策略，以改善久坐的血糖控制，胰岛素敏感性和代谢健康 人类，尤其是那些无法运动或有发展T2D的风险的人。神经肌肉 电刺激（E-stim）是一种实用，无创，成本效益和创新的方法，可促进 在传统的个人中，肌肉收缩的替代模式 体育锻炼。在过去的十年中，我们使用E-开发并建立了体外运动模型 刺激人类原代肌肉细胞（肌管）来研究肌肉收缩的机制 积极影响胰岛素敏感性和脂质代谢。虽然E-stim广泛用于康复 为防止肌肉损失的设置，文献中存在差距，以定义E stim的有效性 提高胰岛素敏感性和代谢健康。我们的初步数据和现有文献表明 有希望使用E-Stim在高风险中改善血糖控制，胰岛素敏感性和代谢健康 久坐，超重或肥胖人群。根据我们的初步数据，我们建议执行 全面的随机对照试验（n = 30）确定8周E-stim对血糖的影响 通过连续葡萄糖监测，口服葡萄糖耐受性测试的胰岛素敏感性，能量来测量的控制 代谢（静息代谢率，底物利用率，血脂和代谢谱），身体成分， 以及危险，久坐，超重/肥胖的墨西哥裔美国人人口中的肌肉力量。我们 假设E-stim将24小时改善。血糖控制，提高胰岛素敏感性并提高整体 该人群的代谢健康。这项研究将使我们能够评估使用E-stim作为新颖的可行性 预防性治疗胰岛素抵抗和代谢性疾病的久坐人群，并将放置 基础是一项更大的临床试验，潜力有可能影响临床实践，以预防和治疗2型糖尿病。