COMMUNITY BASED NIDDM PREVENTION TARGETING ZUNI YOUTH

尽管对潜在的机制的理解取得了进展 NIDDM，以及治疗方面的一些进展，美洲印第安人的患病率 继续上升。癌症预防研究正在向前推进 正在开发针对风险升高的生物标记物的临床试验 已经处于高危状态的人群。高胰岛素血症可能提供这样一种 旨在预防NIDDM的研究的标记物。当然是美式的 印度社区为面临足够风险的人口提供足够的 试验设计。在过去，唯一的病因可能是 可以肯定的是，肥胖是一种臭名昭著的疾病 很难治疗。最近的研究表明，缺乏锻炼和 高蔗糖摄入量也可能独立导致风险，以及 这些为预防研究提供了更具体的行为目标。 据我们所知，这项拟议的研究完全代表了第一项 非胰岛素依赖型糖尿病一级预防干预研究评价。虽然这件事 项目只能研究对风险生物标记物(肥胖、胰岛素)的影响 )，该团队，包括祖尼的普韦布洛，致力于 在这一人群中继续进行研究，以跟踪 这些干预措施对妊娠期糖尿病和非胰岛素依赖型糖尿病的发病率有影响。 该项目是一项以社区为基础的干预研究，旨在 NIDDM的一级预防。目标群体是高中生。这个 干预措施将针对两个方面：增加体力活动 (一种可以持续整个成年期的类型)，并减少 在苏打水、糖果和烘焙食品等简单碳水化合物的消费中。 这些干预措施将得到课程投入、制定 青少年健康中心(Zuni Wellness的高中分部 中心)，以及一个青少年健康特别工作组。干预措施将是 使用开机自检前设计进行评估。将对以下项目进行评估： 通过纵向评估实施干预措施本身 有针对性的行为、态度和知识，使用自我报告、生物学 监测(心率监测)和不显眼的措施。评估 干预的生物影响将通过健身来实现 测量(如台阶试验)、身体成分和肥胖评估。全 01、02和04年级的大三和大四学生也将使用 A改良OGTT，检测30天前和30天前血糖和胰岛素水平 在摄入75克碳水化合物后几分钟。

In spite of advances in the understanding of the mechanisms underlying NIDDM, and some advances in treatment, prevalence among American Indians continues to rise. Cancer prevention research is moving forward by developing clinical trials which target biomarkers of elevated risk, in populations already at high risk. Hyperinsulinemia may provide such a marker for studies targeted to prevention of NIDDM. Certainly American Indian communities provide populations at sufficient risk for adequate trial design. In the past, the only etiologic factor which could be identified with certainty was obesity, a condition which is notoriously difficult to treat. Recent research suggests that lack of exercise and high sucrose consumption may also independently contribute to risk, and these provide more specific behaviors to target in prevention studies. The proposed research, to our knowledge, represents the first fully evaluated primary prevention intervention study for NIDDM. Although this project can only study impact on biomarkers of risk (obesity, insulin levels), the team, including the Pueblo of Zuni, is committed to continuing research in this population to track the long-term impact of these interventions on incidence of GDM and NIDDM. This project is a community-based intervention study directed toward the primary prevention of NIDDM. The target group is high school youth. The intervention will target two components: increases in physical activity (of a type which can be sustained throughout adulthood), and decreases in consumption of simple carbohydrates as sodas, candy, and baked goods. The interventions will be supported by curriculum inputs, development of a teen wellness center (a high school based branch of the Zuni Wellness Center), and a teen wellness task force. The intervention will be assessed using a pre-post design. Assessments will be made of the implementation of the intervention itself by longitudinal assessment of targeted behaviors, attitudes, and knowledge, using self-report, biologic monitoring (heart rate monitoring) and unobtrusive measures. Assessment of the biological impact of the intervention will be made using fitness measures (e.g. step test), body composition and obesity assessment. All juniors and seniors in years 01, 02, and 04 will also be examined using a modified OGTT, examining glucose and insulin levels before and 30 minutes after a 75 gm carbohydrate load.