Improving Glycemic Control with Electrical Stimulation in Mexican-Americans

项目摘要/摘要 在过去的几十年里，肥胖、胰岛素抵抗和2型糖尿病等代谢性疾病有所增加 达到了流行的程度，特别是在墨西哥裔美国人中，并导致了高昂的医疗费用 全国范围内。与此同时，坚持体育锻炼以预防这些代谢性疾病的比例有所下降。一个 大多数(80%)的美国成年人不符合ACSM-建议的150分钟中等或75分钟 每周几分钟的剧烈运动。墨西哥裔美国人缺乏体育活动的比例更高 与普通人群相比。因此，至关重要的是制定额外的战略，以增加 在这一高危人群中采用和坚持体育锻炼。我们研究的长期目标是 探索改善久坐状态下血糖控制、胰岛素敏感性和代谢健康的有效策略 人类，特别是那些不能运动或有患T2D风险的人。神经肌肉 电刺激(e-stim)是一种实用、非侵入性、经济有效的创新方法，可促进 不太可能从事常规运动的个体的肌肉收缩的替代模式 体力活动。在过去的十年里，我们已经开发和建立了使用e- STIM收缩人类初级肌肉细胞(肌管)以研究肌肉收缩的机制 对胰岛素敏感性和脂类代谢有积极影响。虽然e-stim在康复中被广泛使用 设置以防止肌肉损失，在文献中定义e-stim的有效性是一个空白 改善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 E-stim在改善高危人群血糖控制、胰岛素敏感性和代谢健康方面有希望的应用 久坐、超重或肥胖人群。根据我们的初步数据，我们建议进行一项 综合随机对照试验(n=30)，以确定8周的e-stim对血糖的影响 对照组采用连续血糖监测，胰岛素敏感性采用口服葡萄糖耐量试验，能量 代谢(静息代谢率、底物利用率、血脂和代谢谱)、身体成分、 以及高危、久坐、超重/肥胖的墨西哥裔美国人的肌肉力量。我们 假设e-stim会在24小时内改善。控制血糖，增加胰岛素敏感性，全面改善 这一人群的新陈代谢健康。这项研究将使我们能够评估将e-stim用作小说的可行性。 对久坐不动的人群进行胰岛素抵抗和代谢性疾病的预防性治疗，将为 为可能影响预防和治疗2型糖尿病的临床实践的更大规模的临床试验奠定基础。

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.