Brief Alcohol Intervention to Reduce At-Risk Drinking Among Type 2 Diabetes

描述（由申请人提供）：高危饮酒在糖尿病患者中很常见，并与糖尿病治疗依从性和预后差有关。迄今为止，在这一人群中减少酒精使用的方法在很大程度上尚未被探索，但在其他患者群体中，减少高危饮酒的简短干预措施已经得到了很好的验证，并有望减少糖尿病患者的高危饮酒，从而改善糖尿病治疗的依从性和结果。我们假设，相对于普通健康教育，在标准糖尿病治疗中加入短暂的酒精干预，将减少高危糖尿病患者的总饮酒量和重度饮酒天数。此外，我们期望接受短暂酒精干预的参与者比接受普通健康教育的参与者有更好的糖尿病治疗依从性和结果。我们还期望减少饮酒量将介导短暂酒精干预对糖尿病治疗依从性和结果的影响。此外，我们将探讨潜在的治疗机制。该研究采用随机、两组设计，随时间重复测量，比较护士提供的短暂酒精干预加标准糖尿病治疗与普通健康教育。在这项研究中，我们将从一家大型城市初级保健诊所招募240名2型糖尿病患者作为样本。为了有资格参加这项研究，患者必须报告有饮酒风险和糖尿病治疗依从性差。这项研究有望为2型糖尿病患者建立一种有效的干预方法，这些患者是有风险的饮酒者，在没有改变其饮酒行为的情况下，可能维持较差的糖尿病治疗依从性和结果，导致糖尿病相关发病率和死亡率增加。本研究提出的干预措施代表了一种减少糖尿病患者高危饮酒的新方法，如果有效，可以很容易地整合到各种治疗环境中的糖尿病治疗中。此外，本研究将提供有关酒精使用与糖尿病治疗依从性和结果之间关系的有价值信息，以及关于2型糖尿病高危饮酒者酒精使用变化的机制。

DESCRIPTION (provided by applicant): At-risk drinking is common among diabetic patients and is associated with inferior diabetes treatment adherence and outcomes. While methods for reducing alcohol use in this population have been largely unexplored to date, brief interventions to reduce at-risk drinking have been well-validated in other patient populations and offer the promise to reduce at-risk drinking among diabetic patients, resulting in improved diabetes treatment adherence and outcomes. We hypothesize that adding a brief alcohol intervention to standard diabetes treatment, relative to general health education, will reduce overall drinking volume and heavy drinking days among diabetic patients who are at-risk drinkers. Furthermore, we expect participants who receive the brief alcohol intervention to have better diabetes treatment adherence and outcomes than the participants receiving general health education. We also expect that reduced alcohol consumption will mediate the effect of the brief alcohol intervention on diabetes treatment adherence and outcomes. In addition, we will explore potential treatment mechanisms. The proposed study is a randomized, two-group design with repeated measures over time, comparing a brief nurse-delivered alcohol intervention plus standard diabetes treatment to general health education. For this study, we will recruit a sample of 240 Type 2 diabetic patients from a large, urban primary care clinic. To be eligible for the study, patients must report at-risk drinking and poor diabetes treatment adherence. This study holds the promise of establishing an efficacious intervention approach for Type 2 diabetic patients who are at-risk drinkers and are likely to maintain poor diabetes treatment adherence and outcomes in the absence of a change in their drinking behavior, resulting in increased diabetes-related morbidity and mortality. The intervention proposed in this study represents a novel approach to reducing at-risk drinking among diabetic patients that, if efficacious, can be readily integrated into the treatment of diabetes in a variety of treatment settings. In addition, this study will provide valuable information regarding the relationship between alcohol use and diabetes treatment adherence and outcomes and about the mechanisms of change in alcohol use among Type 2 diabetic patients who are at-risk drinkers.