A Mindfulness-Based Approach to the Treatment of Obesity and Diabetes

描述(申请人提供)：糖尿病患病率的上升与美国肥胖症的上升同步。需要在糖尿病患者中使用新的方法来预防体重增加和促进减肥，以降低与肥胖相关的发病率和死亡率。肥胖和糖尿病在双向互动中包含了几种身心关系，高血糖可能会对情绪产生不利影响，而情绪低落可能会导致不良的饮食习惯、缺乏运动和体重进一步增加。增强正念自我意识的干预技术可以改善心理和身体健康，并可能改善糖尿病的自我管理和体重控制。因此，这项研究的目的是评估基于正念冥想的干预与标准糖尿病教育干预在35-65岁患有2型糖尿病的超重/肥胖成年人中为期1年(n=70)的影响。参与者将被随机分配到为期10周的以小组为基础的正念治疗方法，重点是正念冥想、正念饮食和正念练习身体意识和饱腹感线索，或者接受为期10周的标准团体干预，以满足糖尿病患者的营养护理标准。在干预后10周、1个月和3个月的随访中，测定和比较干预对体重、血糖控制(HbA1c和空腹血糖)、胰岛素敏感性、饮食摄入量、体力活动、抑郁、焦虑和自我效能的影响。本课程将探讨冥想在调节结果变化中的作用。这项研究的发现将使教育工作者和临床医生能够确定肥胖的潜在可改变决定因素，以及在不断增长的美国人口中加强体重控制的更有效的技术。与公共健康相关：正念状态可能有助于改善成年糖尿病患者的体重和血糖控制，因为压力会导致高血糖和不良饮食习惯。以正念为基础的教育计划与标准营养教育计划的效果将进行比较和评估。这项研究的发现将使教育工作者和临床医生能够在临床和社区环境中为成年糖尿病患者制定更有效的教育计划。

DESCRIPTION (provided by applicant): The rising prevalence of diabetes parallels the rise in obesity in the U.S. The prevention of weight gain and promotion of weight loss using novel approaches among people with diabetes is needed to reduce the morbidity and mortality associated with obesity. Obesity and diabetes encompass several body-mind relationships in bidirectional interactions such that hyperglycemia may adversely affect mood, and depressed mood may contribute to poor eating habits, physical inactivity, and further weight gain. Intervention techniques that enhance mindful self-awareness improve mental and physical well being and may improve diabetes self- management and weight control. Therefore, the purpose of this study is to evaluate the impact of a mindfulness meditation-based intervention compared to a standard diabetes education intervention among overweight/obese adults aged 35-65 years with type 2 diabetes for e 1 year (n=70). Participants will be randomly assigned to either a 10-week group-based mindful approach to treatment that focuses on mindful meditation, mindful eating, and mindful practice of body awareness and satiety cues or to a standard 10-week, group-based intervention that meets the nutritional standards of care for people with diabetes. The impact of the interventions on weight, glycemic control (HbA1c and fasting plasma glucose), insulin sensitivity, dietary intake, physical activity, depression, anxiety and self-efficacy will be determined and compared at 10-weeks post-intervention and at 1-month and 3-month follow-up. The role of mindful meditation in mediating changes in outcomes will be explored. The findings from this study will enable educators and clinicians to determine potentially modifiable determinants of obesity and more effective techniques for enhancing weight control in a growing segment of the U.S. population. PUBLIC HEALTH RELEVANCE: A state of mindfulness may be beneficial in improving weight and glycemic control in adults with diabetes, since stress can contribute to high blood glucose and poor eating habits. The effect of a mindfulness-based education program compared to a standard nutrition education program will be compared and evaluated. The findings from this study will enable educators and clinicians to develop more effective education programs for adults with diabetes in both clinical and community settings.