Self-Management, Insomnia, and Glucose Control in Adults with Diabetes

成人糖尿病患者的自我管理、失眠和血糖控制

• 批准号: 9313038
• 负责人: Eileen R Chasens
• 金额: $ 12.36万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-04-14 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9313038
• 关键词: Adult; Affect; American; Area; Behavior; Behavior Control; Behavior Therapy; Behavioral; Chronic Disease; Cognitive Therapy; Continuous Positive Airway Pressure; Control Groups; Counseling; Data; Development; Diabetes Mellitus; Diet; Distress; Dose; Drowsiness; Education; Enrollment; Faculty; Fatigue; Generic Drugs; Goals; Health; Impaired health; Impairment; Individual; Internet; Intervention; Knowledge; Link; Medical; Medicine; Mentors; Mission; Modeling; Moods; Non-Insulin-Dependent Diabetes Mellitus; Nurses; Obstructive Sleep Apnea; Online Systems; Parents; Participant; Patients; Persons; Physical activity; Physiological; Pilot Projects; Population; Population Heterogeneity; Postdoctoral Fellow; Quality of life; Randomized; Randomized Clinical Trials; Recruitment Activity; Research; Research Personnel; Research Project Grants; Risk; Role; Sampling; Science; Scientist; Self Care; Self Management; Severities; Sleep; Sleep Disorders; Sleep Fragmentations; Sleeplessness; Symptoms; Testing; Time; actigraphy; blood glucose regulation; career development; diabetes control; diabetes education; doctoral student; empowerment; glycemic control; improved; improved outcome; innovation; parent grant; post intervention; prevent; programs; randomized trial; skills; sleep regulation; symptom management; symptom science; symptom self management; symptomatic improvement; treatment effect; treatment program

ABSTRACT Research Goals: To examine the role of treatment of insomnia on diabetes self-management behavior, symptom management (i. e. sleepiness and fatigue), and glucose control in adults with type 2 diabetes. Data from this study will help inform a randomized clinical trial that will test a behavioral sleep intervention in this population. The long-term goal of this program of research is determine the effect of sleep disorders as a barrier to self-management and quality of life in populations with at risk for impaired health and well being and to develop behavioral interventions to improve symptoms and self-management. Career Development Goals: There are two career development goals: 1) to increase the applicant's knowledge and expertise in behavioral sleep medicine and 2) to provide sufficient time and increase skills as an effective mentor of doctoral students, postdoctoral fellows, and junior faculty. Research Project: Recent evidence supports that insomnia is a prevalent problem among persons with type 2 diabetes that may be associated with increased daytime sleepiness and fatigue, increased diabetes-related distress, decreased self-management behavior, and worse glycemic control. The main hypothesis of the current application is that a web-based cognitive behavioral treatment of insomnia (SHUTi) in persons with T2DM will not only improve their nighttime sleep, but also improve their ability to integrate diabetes education into their daily behavior and positively affect their glucose control compared to a web-based Information Control group. The aims of this study are to 1) obtain preliminary data to facilitate further hypothesis development and enhance the feasibility of conducting a randomized clinical trial to examine if treatment of insomnia results in participant's being better able to integrate diabetes education into their self-management behavior and result in improved glucose control, 2) explore the associations among changes in insomnia severity, fatigue, daytime sleepiness, sleep quality, A1C and DSM behaviors, 3) explore average pre-intervention to post-intervention changes in insomnia severity, daytime symptoms (fatigue, sleepiness, mood) and DSM behaviors (diet and physical activity) in subjects treated with SHUTi + DSM compared to IC + DSM subjects at 3 months, and 4) explore sleep fragmentation as a potential physiological mechanism linking impaired glucose control (A1C) and sleep in subjects with insomnia and T2DM at baseline and 3 months. The proposed application is relevant to NINR's mission to: 1) support development of beginning and midcareer scientists, 2) to improve symptom science to reduce the effect of disordered sleep and prevent symptoms of illness and 3) improved the science of self- management by the development of innovative approaches to reduce barriers to the self-management of chronic disease.

摘要 研究目的：探讨失眠治疗对糖尿病自我管理行为的影响， 症状管理（i. e.嗜睡和疲劳）和2型糖尿病成人患者的血糖控制。数据 这项研究将有助于为一项随机临床试验提供信息，该试验将测试这种行为睡眠干预。 人口这项研究计划的长期目标是确定睡眠障碍的影响， 存在健康和福祉受损风险的人群的自我管理和生活质量障碍， 开发行为干预措施，以改善症状和自我管理。职业发展目标： 有两个职业发展目标：1）增加申请人在行为方面的知识和专业知识 睡眠医学和2）提供足够的时间并提高作为博士生有效导师的技能， 博士后研究员和初级教员。研究项目：最近的证据支持失眠是一种 2型糖尿病患者中普遍存在的问题可能与日间活动增加有关 嗜睡和疲劳，增加糖尿病相关的痛苦，减少自我管理行为，更糟的是， 血糖控制当前应用的主要假设是，基于网络的认知 行为治疗失眠（SHUTi）不仅可以改善T2 DM患者的夜间睡眠， 睡眠，而且还提高了他们将糖尿病教育融入日常行为的能力， 积极影响他们的血糖控制相比，基于网络的信息控制组。的目的 这项研究是为了1）获得初步数据，以促进进一步的假设发展，并加强 进行随机临床试验的可行性，以检查失眠治疗是否会导致参与者的 能够更好地将糖尿病教育融入他们的自我管理行为， 血糖控制，2）探索失眠严重程度，疲劳，白天嗜睡， 睡眠质量，A1 C和DSM行为，3）探索干预前后的平均变化， 失眠严重程度、日间症状（疲劳、嗜睡、情绪）和DSM行为（饮食和身体状况） 活性），以及4）探索 睡眠片段作为联系血糖控制受损（A1 C）和睡眠的潜在生理机制 在基线和3个月时失眠和T2 DM受试者中。建议的应用程序与NINR的 使命：1）支持职业生涯初期和中期科学家的发展，2）改善症状科学， 减少睡眠障碍的影响，预防疾病的症状; 3）提高了自我保健的科学性， 通过制定创新办法，减少自我管理的障碍， 慢性病