Cha EunSeok, Kim Kevin H, Umpierrez Guillermo, Dawkins Colleen R, Bello Morenike K, Lerner Hannah M, Narayan K M Venkat, Dunbar Sandra B
Emory University, Atlanta, Georgia (Dr Cha, Dr Umpierrez, Ms Dawkins, Ms Bello, Dr Venkat Narayan, Dr Dunbar)
University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Kim)
Diabetes Educ. 2014 Sep-Oct;40(5):626-37. doi: 10.1177/0145721714539736. Epub 2014 Jun 20.
The purpose of this pilot study was to examine the feasibility and preliminary efficacy of an age-specific diabetes prevention program in young adults with prediabetes.
A one-group pretest-posttest design was used. The inclusion criteria were age 18 to 29 years and the presence of prediabetes (either impaired fasting glucose of 100-125 mg/dL [5.55-6.94 mmol/L] or A1C of 5.7%-6.4%). Fifteen participants were enrolled in the study. A technology-based lifestyle coaching program focused on diet and physical activity and incorporating a handheld device and digital platforms was developed and tested. Psychosocial factors (health literacy, illness perception, self-efficacy, therapeutic efficacy) based on social cognitive theory, changes in diet and physical activity, and cardiometabolic risk factors were assessed at baseline and week 12 after the intervention. A paired-samples t test was performed to examine changes between baseline and postintervention on each psychosocial and physical variable.
Participants' (n = 13 completers) mean age was 24.4 ± 2.2 years, 23.1% were male, and 53.8% were African American. Overall, the participants were satisfied with the intervention (mean score, 4.15 on a 5-point, Likert-type scale). Between pre- and posttesting, mean body mass index and mean A1C decreased from 41.0 ± 7.3 kg/m(2) and 6.0 ± 0.5% to 40.1 ± 7.0 kg/m(2) and 5.6 ± 0.5%, respectively, whereas mean fasting glucose did not significantly change (from 92.6 ± 11 to 97.6 ± 14.3 mg/dL [5.14 ± 0.61 to 5.42 ± 0.79 mmol/L]).
The intervention resulted in reduced A1C and a trend toward decreased body mass index in obese sedentary young adults with prediabetes after 12 weeks. Further study through a randomized clinical trial with a longer intervention period is warranted.
本试点研究旨在检验一项针对糖尿病前期年轻成年人的特定年龄糖尿病预防计划的可行性和初步疗效。
采用单组前后测设计。纳入标准为年龄在18至29岁之间且患有糖尿病前期（空腹血糖受损为100 - 125 mg/dL [5.55 - 6.94 mmol/L] 或糖化血红蛋白为5.7% - 6.4%）。15名参与者被纳入该研究。开发并测试了一项基于技术的生活方式指导计划，该计划侧重于饮食和体育活动，并结合了手持设备和数字平台。基于社会认知理论评估心理社会因素（健康素养、疾病认知、自我效能感、治疗效果）、饮食和体育活动的变化以及心血管代谢危险因素，在干预前的基线和干预后第12周进行评估。进行配对样本t检验以检查每个心理社会和身体变量在基线和干预后之间的变化。
参与者（n = 13名完成者）的平均年龄为24.4 ± 2.2岁，23.1%为男性，53.8%为非裔美国人。总体而言，参与者对干预感到满意（在5分制李克特量表上的平均得分为4.15）。在前后测试之间，平均体重指数和平均糖化血红蛋白分别从41.0 ± 7.3 kg/m²和6.0 ± 0.5%降至40.1 ± 7.0 kg/m²和5.6 ± 0.5%，而平均空腹血糖没有显著变化（从92.6 ± 11降至97.6 ± 14.3 mg/dL [5.14 ± 0.61降至5.42 ± 0.79 mmol/L]）。
干预导致患有糖尿病前期的肥胖久坐年轻成年人在12周后糖化血红蛋白降低且体重指数有下降趋势。有必要通过干预期更长的随机临床试验进行进一步研究。
