Diabetes Risk Assessment and Intervention Proposal

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Diabetes is a challenging disease whose lifelong repercussions and maintenance make identifying and treating it before its onset a critical aim of health sciences. In the present research proposal, a sample with a high-risk factor for diabetes will be targeted and aided through the establishment of an intervention that will help them to monitor and control for diabetes before it develops. In so doing, this research project will be of critical use to the population in perspective, Hispanic people with lower SES. 

Target Population

The American Diabetes Association states that Hispanic and Latino origin people possess some of the highest risks in the U.S. developing type 2 diabetes which is a preventable disease (Diabetes Among Hispanics, 2014). Within this population, there are demographics more at risk than others, namely those with lower socioeconomic status (SES). The risks of lowered SES in the onset of diabetes are extremely well documented throughout the literature. In Kivimäki et al., (2015), a meta-analysis, drawing upon 19 cohort studies, revealed that socioeconomic status is a prevailing risk factor for the onset of diabetes even when diverse characteristics such as sex, age, obesity, and physical activity were adjusted for. A complementary study from Stringhini (2013), unveils a similarly concerning finding for those with socioeconomic adversity; that its experience in early life has the possibility of programming a vulnerable phenotype that contributes to exaggerated inflammatory responses and, in turn, the onset of type 2 diabetes in adulthood. The demographic risks associated with SES, combined with the already high risks for diabetes within Hispanic/Latino people, make research and applied interventions for this population a serious need within the field of medicine at this time. 

Proposed Intervention

In addition to identifying risk factors for diabetes, treatment for these factors is required as well. To this end, the proposed research study puts forth the treatment of lifestyle intervention, which is an efficacious and enduring method for reducing diabetes incidence in research populations (Lindstrom et al., 2006). Lifestyle intervention consists of a participant visiting half a dozen times with a study nutritionist over the course of a year and then in regular intervals thereafter for the purpose of counseling which will aid them in reaching helpful lifestyle goals. In addition to nutritional advice, subjects in lifestyle intervention treatments are recommended to increase their physical activity with complimentary access to services to do so such as free of charge moderate-intensity circuit-type resistance training (Lindstrom et al., 2006). The benefit of lifestyle intervention is that it actually helps to reduce lastingly the risk of diabetes in vulnerable populations. This endurance is confirmed by the findings of Aroda by et al. (2015), a study that used a 10-year follow up analysis for women at risk for diabetes after participating in an intensive lifestyle intervention. 

Targeted Sample

A middle-aged sample of this demographic with a history of challenge from lower SES will be enrolled in an intensive lifestyle intervention for a period of 2 years and a control intervention. Like Aroda et al., (2015), this population will be followed up on for 10 years to determine if the onset of diabetes can be controlled for by the use of the proposed intervention. 

Outcomes

In order to test the success of this intervention, several outcomes need to be monitored. The most relevant outcomes will concern the individual’s health. For example, measures such as nutrient intake, blood pressure, weight, body fat percentage, hours slept, etc. need to be taken before the subjects enrolled in the intervention program. A successful intervention will result in these measurements becoming healthier for the targeted group, thus reducing the impact of SES on one’s likelihood of developing type II diabetes.  Overall, I expect the outcome of an overall improvement in health among these measurements.

References

Aroda, V. R., Christophi, C. A., Edelstein, S. L., Zhang, P., Herman, W. H., Barrett-Connor, E., ... & Knowler, W. C. (2015). The effect of lifestyle intervention and metformin on preventing or delaying diabetes among women with and without gestational diabetes: The Diabetes Prevention Program outcomes study 10-year follow-up. The Journal of Clinical Endocrinology & Metabolism, 100(4), 1646-1653.

Diabetes among Hispanics: All are not equal. (2014). American Diabetes Association. Retrieved from http://www.diabetes.org/newsroom/press-releases/2014/diabetes-among-hispanics-all-are-not-equal.html. 

Kivimäki, M., Virtanen, M., Kawachi, I., Nyberg, S. T., Alfredsson, L., Batty, G. D., ... & Dragano, N. (2015). Long working hours, socioeconomic status, and the risk of incident type 2 diabetes: a meta-analysis of published and unpublished data from 222 120 individuals. The Lancet Diabetes & Endocrinology, 3(1), 27-34.

Lindström, J., Ilanne-Parikka, P., Peltonen, M., Aunola, S., Eriksson, J. G., Hemiö, K., ... & Louheranta, A. (2006). Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. The Lancet, 368(9548), 1673-1679.

Stringhini, S., Batty, G. D., Bovet, P., Shipley, M. J., Marmot, M. G., Kumari, M., & Kivimäki, M. (2013). Association of life course socioeconomic status with chronic inflammation and type 2 diabetes risk: The Whitehall II prospective cohort study. PLoS Medicine, 10(7), e1001479.