Accelerating Solutions to Optimize Glycemic Control and Weight Management In Young Adults with Type 1 Diabetes

加速优化 1 型糖尿病年轻成人血糖控制和体重管理的解决方案

• 批准号: 9302074
• 负责人: David Matthew Maahs
• 金额: $ 191.18万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-05 至 2022-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9302074
• 关键词: Achievement; Address; Adult; Age; Behavior Therapy; Behavioral; Bioenergetics; Biological; Blood Glucose; Blood Pressure; Body Composition; Body Weight decreased; Calories; Caring; Central obesity; Childhood; Clinical; Clinical Trials; Clinical Trials Design; Clinical effectiveness; Complex; Counseling; Data; Diabetes Mellitus; Diet; Dietary Carbohydrates; Dietary intake; Dyslipidemias; Endocrinology; Energy Metabolism; Enrollment; Ensure; Epidemiology; Feasibility Studies; Florida; Foundations; Funding; Future; General Population; Glycosylated hemoglobin A; Goals; High Prevalence; Hospitals; Hour; Hyperglycemia; Hypoglycemia; Individual; Institution; Insulin Resistance; Insulin-Dependent Diabetes Mellitus; Intervention; Intervention Trial; Lead; Macronutrients Nutrition; Metabolic; Metabolism; Modeling; North Carolina; Obesity; Outcome; Overweight; Participant; Phase; Physiology; Pilot Projects; Prevalence; Psychology; Reproducibility; Research; Research Design; Research Institute; Research Personnel; Role; Scientist; Seasons; Series; Specific qualifier value; Statistical Data Interpretation; Statistical Methods; Testing; Thinness; Translational Research; Universities; Validation; Weight; Weight maintenance regimen; Work; behavioral response; cardiovascular disorder risk; clinical care; clinical practice; design; efficacy testing; efficacy trial; energy balance; flexibility; glucose monitor; glycemic control; improved; innovation; metabolic phenotype; non-diabetic; nutrition; phase 1 study; pilot trial; primary outcome; programs; randomized trial; response; sex; therapy design; trial design; young adult

Young adults with type 1 diabetes (T1D) commonly struggle with both glycemic control and weight. The prevalence of overweight and obesity in T1D parallels that of the general population. There is a compelling need to develop interventions to optimize two key outcomes – glycemic control and weight status – that address underlying metabolic processes and behavioral challenges unique to T1D. Accordingly, our main objective is to develop a rigorous adaptive design to test the efficacy of behavioral interventions to simultaneously optimize glycemic control and facilitate weight management among overweight young adults with T1D. In June 2015, we established a transdisciplinary consortium, ACT1ON: Advancing Care for Type 1 Diabetes and Obesity Network, at three institutions: University of North Carolina (UNC), Florida Hospital Translational Research Institute for Metabolism and Diabetes (TRI), and the Division of Pediatric Endocrinology and Diabetes at Stanford University. Together, we propose Specific Aims in three phases: Aim 1: Phase One (18 months): To establish a rigorous scientific foundation for this work. Study One: The Influence of Glycemic Control and Obesity on Energy Balance and Metabolic Flexibility in Type 1 Diabetes. Goal: To develop a comprehensive model of energy balance and metabolic flexibility in T1D that accounts for hyperglycemia and body composition. We will enroll 33 individuals at TRI (8 lean T1D, 8 overweight T1D, 8 obese T1D; with three age-, sex-, and weight-matched non-diabetic controls per group). Study Two: Dietary Response to Non-Severe Hypoglycemia. Goal: To explore the role of non-severe hypoglycemia on weight status and dietary intake, using data from a funded study (UC4DK101132 MPIs, Mayer-Davis, Maahs, Seid). Aim 2: Phase Two (24 months): To conduct a pilot and feasibility study (n=72, 3 experimental diets, 9 months) using a sequential, multiple assignment, randomized trial (SMART) design to identify acceptable and effective dietary strategies to optimize both glycemic control and weight management in young T1D adults. Aim 3: Phase Three (6 months): To incorporate findings from Aims 1 and 2 to finalize the intervention strategy and SMART design of a fully-powered efficacy trial of behavioral interventions that will be acceptable and feasible to optimize glycemic control and weight management in young adults with T1D. We are uniquely qualified with expertise including clinical care, energy metabolism, nutrition, psychology, clinical trial design and statistical analyses, all with a focus on T1D. The proposed research is innovative, with state-of-the-art bioenergetic modeling, trial design, and statistical methods. Achievement of our objective would be highly significant and will ultimately lead to changes in clinical practice with an effective, acceptable approach to co-manage glycemia and weight in young adults with T1D.

患有1型糖尿病（T1D）的年轻人通常在血糖控制和体重上挣扎。这 T1D中超重和肥胖的患病率与普通人群的平行相似。有一个引人注目的 需要制定干预措施，以优化两个关键结果 - 血糖控制和体重状况 - 解决T1D独有的基本代谢过程和行为挑战。根据我们的主要 目的是开发严格的自适应设计，以测试行为干预措施的效率 同样优化血糖控制并促进超重年轻人的体重管理 T1D的成年人。 2015年6月，我们建立了一个跨学科财团，ACT1ON：推进护理 1型糖尿病和肥胖网络，三个机构：北卡罗来纳大学（UNC），佛罗里达州 医院转化研究所代谢和糖尿病研究所（TRI）和小儿分工 斯坦福大学的内分泌学和糖尿病。我们共同提出了三个阶段的特定目标： 目标1：第一阶段（18个月）：为这项工作建立严格的科学基础。研究一： 血糖控制和肥胖对1型糖尿病的能量平衡和代谢柔韧性的影响。 目标：在T1D中建立一个全面的能量平衡和代谢灵活性模型 高血糖和身体组成。我们将在TRI上注册33个人（8 Lean T1D，8超重T1D，8 肥胖T1D;每组具有三个年龄，性别和体重匹配的非糖尿病控制）。研究第二：饮食 对非重度低血糖的反应。目标：探索非重度低血糖对体重的作用 使用资助研究的数据（UC4DK101132 MPI，Mayer-Davis，Maahs，SEID）的数据和饮食摄入量。 AIM 2：第二阶段（24个月）：进行飞行员和可行性研究（n = 72，3实验饮食，9 几个月）使用顺序，多个分配，随机试验（智能）设计来识别可接受的和 有效的饮食策略，以优化年轻T1D成年人的血糖控制和体重管理。 AIM 3：第三阶段（6个月）：将目标1和2的发现结合起来以最终确定干预措施 行为干预措施的全力效率试验的策略和智能设计将是可以接受的 可行的T1D年轻人的血糖控制和体重管理。 我们具有独特的资格，具有临床护理，能源代谢，营养，包括临床护理， 心理学，临床试验设计和统计分析都重点是T1D。拟议的研究是 创新，具有最先进的生物能建模，试验设计和统计方法。实现我们的成就 目标将非常重要，并最终会通过有效的，有效的 T1D年轻人的共同管理血糖和体重的可接受方法。

项目成果

Relationship Between Moderate-to-Vigorous Physical Activity and Glycemia Among Young Adults with Type 1 Diabetes and Overweight or Obesity: Results from the Advancing Care for Type 1 Diabetes and Obesity Network (ACT1ON) Study.

患有 1 型糖尿病且超重或肥胖的年轻成人中中度至剧烈体力活动与血糖之间的关系：来自 1 型糖尿病和肥胖促进护理网络 (ACT1ON) 研究的结果。

• DOI: 10.1089/dia.2022.0253
• 发表时间: 2022
• 期刊: Diabetes technology & therapeutics
• 影响因子: 5.4
• 作者: Muntis,FranklinR;Igudesman,Daria;Sarteau,AngelicaCristello;Thomas,Joan;Arrizon-Ruiz,Nora;Hooper,Julie;Addala,Ananta;Crandell,JamieL;Riddell,MichaelC;Maahs,DavidM;Pratley,RichardE;Corbin,Karen;Mayer-Davis,ElizabethJ;Zaharie
• 通讯作者: Zaharie

An Overview of Diet and Physical Activity for Healthy Weight in Adolescents and Young Adults with Type 1 Diabetes: Lessons Learned from the ACT1ON Consortium.

• DOI: 10.3390/nu15112500
• 发表时间: 2023-05-27
• 期刊: Nutrients
• 影响因子: 5.9
• 作者: Bishop FK;Addala A;Corbin KD;Muntis FR;Pratley RE;Riddell MC;Mayer-Davis EJ;Maahs DM;Zaharieva DP
• 通讯作者: Zaharieva DP

Management of Neonatal Diabetes due to a KCNJ11 Mutation with Automated Insulin Delivery System and Remote Patient Monitoring.

• DOI: 10.1155/2023/8825724
• 发表时间: 2023
• 期刊: CASE REPORTS IN ENDOCRINOLOGY
• 影响因子: 1.1
• 作者: Lee, Ming Yeh;Gloyn, Anna L.;Maahs, David M.;Prahalad, Priya
• 通讯作者: Prahalad, Priya