Diabetes Care in American Samoa
As type 2 diabetes prevalence increases in the United States, the burden
of diabetes falls more on groups with greater barriers to care, such as
language and cultural differences, and lower economic resources. These
disparities extend to the US Territory of American Samoa, where the
proportion of adults over 18 with diabetes was 19.6 percent in 2002,
compared to 6.4 percent of US adults. This project will translate recent
advances in diabetes care into clinical practice for the American Samoan
community by improving methods of health care delivery and methods of
diabetes self management. We will conduct a randomized clinical trial to
test the effectiveness of a community health worker and primary-care
coordinated intervention to provide outreach, education and support to
type 2 diabetes patients and their families. The outcomes at a one-year
follow-up will include glycosolated hemoglobin (HbA1c), cardiovascular
disease risk factors, diet and exercise behaviors, and adherence to
diabetes care guidelines.
Principal Investigators: Judith
DePue, EdD (Subcontract) and Stephen McGarvey, PhD (Project PI)
Co-Investigators: Michael Goldstein, MD and Rochelle Rosen, PhD
Funding Agency: National Institute of Diabetes and
Digestive and Kidney Diseases
Dates: 2006 - 2011
A Lifestyle Intervention to Prevent Recurrent Gestational Diabetes Mellitus
This study will test the ability of an exercise intervention to prevent recurrent gestational diabetes mellitus. This intervention can readily be translated into clinical practice in underserved and minority populations.
Principal Investigators: Bess Marcus, PhD (Subcontract) and Lisa Chasan-Taber, ScD(Project PI)
Co-Investigator: Charles Neighbors, PhD
Funding Agency: National Institute of Diabetes and Digestive Kidney Diseases
Dates: 2007 - 2011
The Look AHEAD Continuation: Action for Health in Diabetes
Look AHEAD is a randomized clinical trial examining the long-term health effects of an intensive weight loss intervention in approximately 5,145 overweight volunteers with type 2 diabetes. Participants are randomized to an intensive lifestyle intervention designed to achieve and maintain weight loss by decreased caloric intake and increased physical activity, or to a control program of diabetes support and education. The primary outcome of Look AHEAD is the aggregate occurrence of severe cardiovascular events (fatal and non-fatal Ml and stroke and cardiovascular deaths) over a planned follow-up of 11.5 years. The continuation of this project allows for completion of follow up outcome assessments and the continued administration of the lifestyle intervention. These procedures will enable us to analyze the effects of the intervention on serious cardiovascular- related factors and complications, and cost-effectiveness of the intervention. (5U01DK056992-11)
Principal Investigator: Rena R. Wing, PhD
Co-Investigators: Vincent Pera, MD; Jeanne McCaffery, PhD
Funding Agency: National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute of Nursing Research
Dates: 1999 - 2013
Gene x Behavioral Interaction in the Look AHEAD Study
Obesity is a major public health problem, with millions of Americans
suffering from weight-related health complications, including Type 2
diabetes, coronary heart disease, hypertension, and osteoarthritis.
Behavioral weight loss intervention has emerged as a key strategy in
combating obesity and the associated health consequences. However,
individuals differ in their degree of success in these programs and
genetic factors are known to play a role. We propose to identify
specific genes that predict individual differences in weight loss in
response to behavioral intervention to help identify individuals who
struggle with weight loss despite behavioral efforts. Genotype data from
the IBC chip, including over 4,000 markers within genes previously
associated with obesity, will allow us to test our central hypothesis
that genes that predispose to obesity interact with lifestyle treatment
to influence weight loss following intensive lifestyle intervention.
Principal Investigators: Rena
Wing, PhD; Jeanne
McCaffery, PhD
Funding Agency: National Institute of Diabetes
and Digestive and Kidney Diseases
Dates: 2009-2013
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