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Diabetes Prevention Program

Diabetes Prevention Program
糖尿病预防计划
批准号:
7189079
负责人:
TREVOR J. ORCHARD
金额:
$34.95万
依托单位国家:
美国
项目类别:
财政年份:
1994
资助国家:
美国
项目状态:
已结题
起止时间:
1994-08-15 至 2009-01-31
关键词:
2,4-thiazolidinedioneAccountingAddressAdoptedAdultAdvisory CommitteesAffectAfricanAfrican AmericanAgeAge-YearsAgingAlbuminsAmericanAnkleAnthropometryAntioxidantsAnxietyAppearanceAppendixArterial Fatty StreakAsiansAsorbicapAtherosclerosisAutopsyBehavior TherapyBeta CellBiochemicalBiochemistryBlood GlucoseBlood PressureBody Weight decreasedBudgetsCalendarCaliberCardiovascular DiseasesCardiovascular systemCategoriesCaucasiansCaucasoid RaceCell physiologyCenters for Disease Control and Prevention (U.S.)CharacteristicsCholesterolChronicChronic DiseaseClassificationClinicalClinical ResearchClinical TrialsClosureCohort EffectCollaborationsCollectionCombined Modality TherapyComplicationComplications of Diabetes MellitusConceptionsConditionConsensusControl GroupsControlled Clinical TrialsControlled StudyCoronaryCoronary ArteriosclerosisCosts and BenefitsCox ModelsCreatinineCross-Sectional StudiesCystatinsDataData AnalysesDevelopmentDiabetes MellitusDiabetes preventionDiabetic AngiopathiesDiabetic MicroangiopathiesDiabetic NephropathyDiabetic RetinopathyDiagnosisDiagnosticDietary intakeDiseaseDisease OutcomeDisease regressionDistalDropoutDyslipidemiasEconomic ModelsEconomicsEffectivenessEffectiveness of InterventionsElectrocardiogramEnd PointEnrollmentEpidemiologic StudiesEpidemiologyErythrocytesEthnic OriginEvaluationEventEvolutionExcretory functionExerciseExposure toFailureFastingFibrinogenFollow-Up StudiesFrequenciesFunctional disorderFundingFundusFundus photographyGenderGeneral PopulationGlucoseGlucose IntoleranceGlucose tolerance testGoalsGrantGraphGroup MeetingsHazard ControlsHealthHealth BenefitHealth Care CostsHealth PersonnelHealth ProfessionalHealthcareHeart DiseasesHemoglobinHemoglobin concentration resultHemostatic AgentsHeterogeneityHigh Blood PressureHigh Density Lipoprotein CholesterolHigh Pressure Liquid ChromatographyHigh PrevalenceHip region structureHispanicsHomocysteineHomocystineHourHyperglycemiaHyperlipidemiaHypertensionHypotensionImpaired fasting glycaemiaIncidenceIndividualInstitutesInsulinInsulin ResistanceInsulin-Dependent Diabetes MellitusIntakeIntentionInterventionIntervention StudiesInvestigationKidneyKidney DiseasesKnowledgeLDL Cholesterol LipoproteinsLaboratoriesLifeLife StyleLife Table AnalysesLife Table EstimateLife Table MethodLife TablesLightLinear ModelsLinkLipidsLipoproteinsLiving CostsLogistic ModelsLong-Term EffectsLongitudinal StudiesLow-Level Laser TherapyMasksMatched-Pair AnalysisMeasurementMeasuresMedialMedical HistoryMedicineMental DepressionMetabolicMetforminMethodsMichiganMicroalbuminuriaMicroaneurysmMindMinorityModelingModificationMonitorMorbidity - disease rateMulticenter StudiesMyocardial InfarctionNational Eye InstituteNational Health and Nutrition Examination SurveyNational Institute of Diabetes and Digestive and Kidney DiseasesNatural HistoryNatureNeurologicNeuropathyNewly DiagnosedNicotinic AcidsNon-Insulin-Dependent Diabetes MellitusNot Hispanic or LatinoNumbersNutrientOGTTObesityObservational StudyOphthalmologistOrganOther FindingOutcomeOutcome MeasurePaired ComparisonPaperParticipantParticle SizePathogenesisPatientsPeripheral Nervous System DiseasesPersonal SatisfactionPersonsPharmaceutical PreparationsPhasePhotographyPhysical ExaminationPhysical activityPima IndianPlacebosPlasmaPlasminogen Activator Inhibitor 1PlayPopulationPopulation StudyPopulations at RiskPre-studyPredispositionPremenopausePrevalencePreventionPrimary PreventionPrincipal InvestigatorProceduresProcessProcess MeasureProspective StudiesProteinsProtocols documentationPsychological reinforcementPublic HealthPublishingPurposeQuality of lifeQuality-Adjusted Life YearsQuestionnairesRaceRandom AllocationRandomizedRangeRateReadingRecommendationRecording of previous eventsReflex actionRelative (related person)Relative RisksReportingResearchResearch DesignResearch PersonnelResearch TrainingResistanceResourcesRetinal DiseasesRiskRisk EstimateRisk FactorsRisk ReductionRoleSF-36Sample SizeSamplingScanningScheduleScreening procedureSelection BiasSelf-AdministeredSideSignificance LevelSodium ChlorideSomatomedinsSpecific qualifier valueSpottingsStagingStandards of Weights and MeasuresStatistically SignificantStratificationStrokeSubgroupSuggestionSurveysSymptomsTNF geneTechniquesTest ResultTestingThiazolidinedionesThickThinkingTicksTimeTissuesTouch sensationTranslatingTranslationsTreatment EffectivenessTriglyceridesUltrasonographyUnited KingdomUnited States Public Health ServiceUpper armUric AcidUrineVascular DiseasesVisitVisualWeekWeightWisconsinWomanWorld Health Organizationadjudicateautonomic neuropathybasecardiovascular disorder riskcardiovascular risk factorclinical Diagnosiscohortcomparison groupcostcost effectivenesscysteine rich proteindemographicsdesigndiabetes prevention programdiabetes riskdiabeticearly onsetepidemiology studyexperiencefollow-upglucose toleranceglycationglycemic controlhazardillness lengthimpaired glucose toleranceimprovedindexinginsightinstrumentinterestintervention programlife time costlifestyle interventionmembermenmortalitynon-diabeticoral glucose tolerancepre-clinicalpreventprognosticprogramsprospectiveprotocol developmentracial and ethnicsexsizestereoscopictooltreatment durationtreatment effecttype I diabeticurinaryvolunteeryoung adult

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中文摘要
翻译
描述(由申请人提供): 糖尿病预防计划是一项多中心对照临床试验,旨在检查强化生活方式干预或二甲双胍预防或延迟因存在糖耐量受损(IGT)而被选为高风险人群的糖尿病发展的疗效。根据1997年ADA标准定义的糖尿病发展是主要结局, 心血管疾病及其危险因素是重要的次要结局。检察长办公室于1996年年中开始征聘。在本申请时,3组研究中3,234名志愿者的总研究暴露平均约为3年(范围2 - 5),总计约为10,000患者年。基于生活方式干预在糖尿病发展方面的统计学显著性和临床上令人信服的减少, 与安慰剂治疗组相比,二甲双胍治疗组(分别减少58%和31%),DPP数据监测委员会和NIDDK于2001年5月结束了研究的盲态治疗阶段,比原计划提前一年。本申请旨在进一步利用具有科学和临床价值的DPP志愿者队列以及研究期间收集的大量数据。高度依从的DPP队列,包括45%的少数民族,是有史以来研究的最大IGT人群。此外,子队列 已经发展为糖尿病的患者(n约700)从糖尿病发作的确切时间开始跟踪。临床上重要的研究问题仍然在DPP之后。在这个队列中仔细收集,集中测量和分级的数据应该有助于回答,明确,一些重要的问题,关于IGT和早发2型糖尿病的临床过程。具体目标包括:1.检查既往DPP干预对主要DPP结局的长期影响和持久性,包括糖尿病、临床心血管疾病、动脉粥样硬化、CVD风险因素、生活质量和成本效益; 2.确定新发2型糖尿病和IGT的临床病程,特别是关于微血管和神经系统 并发症; 3.确定新发2型糖尿病和IGT患者的心血管疾病(CVD)、CVD危险因素和动脉粥样硬化的发病率;检查少数民族人群中的主题1-3,男性与女性,以及DPP中的老年受试者。目前的申请是5年的资金,虽然所描述的项目的一些目标将需要10年 study.
英文摘要
DESCRIPTION (provided by applicant): The Diabetes Prevention Program is a multicenter controlled clinical trial examining the efficacy of an intensive life-style intervention or metformin to prevent or delay the development of diabetes in a population selected to be at high risk due to the presence of impaired glucose tolerance (IGT). Development of diabetes, defined by 1997 ADA criteria, is the primary outcome while cardiovascular disease and its risk factors are important secondary outcomes. The DPP began recruitment in mid-1996. At the time of this application, total study exposure is a mean of approximately 3 years (range 2 to 5) with a total of approximately 10,000 patient years in the 3,234 volunteers in the 3-arm study. On the basis of a statistically significant and clinically compelling decrease in the development of diabetes in the life-style intervention and metformin-treated groups (58% and 31% reductions, respectively) compared with the placebo treated group, the DPP Data Monitoring Board and NIDDK ended the masked treatment phase of the study in May, 2001, one year earlier than originally planned. This application is designed to take further advantage of the scientifically and clinically valuable cohort of DPP volunteers and the large volume of data collected during the study. The highly compliant DPP cohort, including 45% minorities, is the largest IGT population ever studied. Moreover, the subcohort that has developed diabetes (n approximately 700) has been followed from near the exact time of diabetes onset. Clinically important research questions remain in the wake of the DPP. The carefully collected, centrally measured and graded data in this cohort should help to answer, definitively, a number of important questions regarding the clinical course of IGT and early onset type 2 diabetes. Specific aims include: 1. Examine the long-term effects and durability of prior DPP intervention on the major DPP outcomes including diabetes, clinical cardiovascular disease, atherosclerosis, CVD risk factors, quality of life and cost-benefit; 2. Determine the clinical course of new onset type 2 diabetes and IGT, in particular regarding microvascular and neurologic complications; 3. Determine the incidence of cardiovascular disease (CVD), CVD risk factors and atherosclerosis in new onset type 2 diabetes and IGT; and 4. Examine topics 1-3 in minority populations, men vs. women, and in older subjects in the DPP. The current application is for 5 years of funding, although the some of the goals of the projects described will require a 10-year study.
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