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  • Centers for Behavioral and Preventive Medicine

  • Diabetes Research

  • 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