Energy Expenditure and Metabolic Control among T1D Youth

T1D 青少年的能量消耗和代谢控制

• 批准号: 8213981
• 负责人: RANDI STREISAND
• 金额: $ 8.44万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-19 至 2013-03-18
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8213981
• 关键词: Address; Adherence; Adolescent; Aerobic; Affect; Aftercare; American; Area; Attention; Back; Behavior Therapy; Behavioral; Behavioral Research; Biometry; Blood Glucose; Child; Childhood; Clinical; Clinical Research; Clinical Trials; Complex; Comprehensive Health Care; Data; Data Analyses; Diabetes Mellitus; Diabetes prevention; Diet; Disease; Disease Management; Energy Metabolism; Equilibrium; Exercise; Failure; Family; Female; Frequencies; Future; General Population; Goals; Health; Insulin; Insulin-Dependent Diabetes Mellitus; Intake; Intervention; Knowledge; Lead; Life; Light; Literature; Maximum Heart Rate; Measurement; Measures; Medical; Mentors; Metabolic; Metabolic Control; Methods; Monitor; National Children' s Study; Nature; Nutritional; Outcome; Parents; Patient Self-Report; Physical activity; Physiology; Positioning Attribute; Public Health; Public Health Practice; Quality of life; Recommendation; Regimen; Research; Risk; Role; Sampling; Science; Self Care; Teenagers; Time; Training; Universities; Ursidae Family; Washington; Youth; adverse outcome; base; biobehavior; blood glucose regulation; cardiovascular risk factor; diabetes control; diabetes management; epidemiologic data; evidence base; experience; fitness; follow-up; glucose monitor; knowledge base; meetings; nutrition; programs; protective effect; stem; tool

DESCRIPTION (provided by applicant): Type 1 diabetes is a lifelong illness that demands constant attention and management, requiring adhering to a complex, medically prescribed self-care regimen. Behavioral interventions to promote adherence in diabetes management in youth have largely focused on consistent blood glucose monitoring, and the role of physical activity has been inconsistently examined in relationship to metabolic outcomes. This is true despite regular physical activity being medically advised as part of comprehensive care planning, as supported by data from large, national studies of children's metabolic control. However, little is known about the specific nature and timing of the impact of levels on children's blood glucose regulation. Some indications of benefit include short- term changes in metabolic control and enhanced quality of life, balanced against the risks of low blood glucose levels that can accompany high energy expenditure. Though there are new and advanced measures and methods in exercise science that could be brought to bear in addressing these complex biobehavioral questions, this knowledge and expertise tends to reside outside of the clinical and behavioral research literature in childhood diabetes. By combining these tools for the assessment of physical activity and energy expenditure (i.e., the amount of energy used to perform a physical activity) with those that measure glycemic variability (i.e., excursions of blood glucose from low to high and back again), I plan to incorporate more informed physical activity recommendations into my behavioral interventions for youth with diabetes. I propose to do this by seeking mentored training experiences with Dr. Loretta DiPietro (an expert in exercise science) at The George Washington University, as well as by taking additional coursework at the University in exercise science methods and data analysis, biostatistics, and physiology. These are cornerstones of basic behavioral research in health, and hold promise in enriching my clinical research program and strengthening my capacity to meet the public health challenges associated with pediatric diabetes prevention and control. PUBLIC HEALTH RELEVANCE: The management of type 1 diabetes in children demands constant attention and careful adherence to a complex medical regimen, including monitoring of physical activity. However, behavioral interventions aimed to promote adherence in children with type 1 diabetes rarely include physical activity. By examining the relationship among energy expenditure and glycemic variability, we will gain a better understanding of the role of physical activity in diabetes management. Findings can lead to the inclusion of physical activity into future behaviorally based adherence promotion programs.

描述（由申请人提供）：1型糖尿病是一种终身疾病，需要持续关注和管理，需要遵守复杂的，医学处方的自我保健方案。促进青年糖尿病管理依从性的行为干预措施主要集中在一致的血糖监测上，并且在与代谢结果的关系中，体育锻炼的作用不一致。尽管经常在医学上为综合护理计划的一部分提供医学建议，但这是事实，这是由大型国家代谢控制的数据提供的支持。但是，对水平对儿童血糖调节的影响的特定性质和时机知之甚少。一些益处的迹象包括代谢控制的短期变化和增强的生活质量，与可能伴随高能量消耗的低血糖水平的风险保持平衡。尽管运动科学中有新的和高级的措施和方法可以在解决这些复杂的生物行为问题方面带来，但这种知识和专业知识倾向于居住在儿童糖尿病的临床和行为研究文献之外。通过将这些工具结合起来，以评估体育活动和能量消耗（即用于进行体育活动的能量的能量量）与测量血糖变异性的那些工具（即，从低到高和背部的血糖偏移），我计划将更知识的身体活动建议纳入我的糖尿病青年人的行为干预措施中。我建议通过在乔治华盛顿大学的洛雷塔·迪皮特罗（Loretta Dipietro）（运动科学专家）以及在运动科学方法和数据分析，生物统计学和生理学的大学课程中获得其他课程的培训经验来做到这一点。这些是健康中基本行为研究的基石，并且在丰富我的临床研究计划方面保持了希望，并增强了我应对与小儿糖尿病预防和控制相关的公共卫生挑战的能力。 公共卫生相关性：儿童中1型糖尿病的管理需要不断关注并仔细遵守复杂的医疗方案，包括监测体育锻炼。但是，旨在促进1型糖尿病儿童依从性的行为干预措施很少包括体育锻炼。通过研究能量消耗和血糖变异性之间的关系，我们将更好地了解体育活动在糖尿病管理中的作用。发现可能导致将体育活动纳入未来的基于行为的依从性促进计划中。