Improving Glycemic Control with Electrical Stimulation in Mexican-Americans

项目摘要/总结 几十年来，肥胖、胰岛素抵抗和2型糖尿病等代谢性疾病的发病率不断上升 流行病的比例，特别是在墨西哥裔美国人，并导致高医疗保健费用 全国范围与此同时，坚持体育活动以预防这些代谢性疾病的人数有所下降。一 大多数（80%）的美国成年人没有达到ACSM推荐的150分钟的中等或75分钟 每周5分钟的剧烈运动。墨西哥裔美国人身体不活动的患病率更高 与一般人群相比。因此，必须制定额外的战略， 在这一高危人群中采用和坚持体力活动。我们研究的长期目标是 探索有效的策略，以改善血糖控制，胰岛素敏感性和代谢健康的久坐 人类，特别是那些无法锻炼或有发展T2 D风险的人。神经肌肉 电刺激（e-stim）是一种实用，非侵入性，成本效益和创新的方法，以促进 不太可能从事传统运动的人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体外运动模型，使用电子- 刺激收缩人类初级肌肉细胞（肌管），以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被广泛用于康复治疗 设置，以防止肌肉损失，有一个差距，在文献中定义的有效性e-stim， 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在改善高危人群的血糖控制、胰岛素敏感性和代谢健康方面的应用前景广阔。 久坐、超重或肥胖人群。根据我们的初步数据，我们建议执行一个 一项综合随机对照试验（n=30），旨在确定8周e-stim对血糖的影响 通过连续葡萄糖监测测量的控制，通过口服葡萄糖耐量试验测量的胰岛素敏感性，能量 代谢（静息代谢率、底物利用、血脂和代谢特征），身体组成， 和肌肉力量的风险，久坐，超重/肥胖，墨西哥裔美国人的人口。我们 假设e-stim将在24小时内改善。血糖控制，增加胰岛素敏感性，并改善整体 代谢健康状况。这项研究将使我们能够评估使用e-stim作为一种新的可行性 预防性治疗胰岛素抵抗和代谢疾病的久坐人群，并将奠定 为更大规模的临床试验奠定了基础，有可能影响预防和治疗2型糖尿病的临床实践。

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.