Wagner, Julie A., PhD
Autonomic balance, glycemia, and mental stress in Latinos with type 2
General Research Subject: Type 2 Diabetes
Focus: Complications, Complications\ Macrovascular-Atherosclerotic CVD and Human Diabetes, Complications\Neuropathy, Psychosocial Behavioral Medicine
Type of Grant: Translational Science
Project Start Date: July 1, 2013
Project End Date: June 30, 2016
Diabetes Type: Type 2 diabetes
The autonomic nervous system regulates involuntary bodily functions. It is divided into two branches. The parasympathetic branch conserves energy by lowering heart rate and blood pressure and conserving energy. The sympathetic branch helps the body deal with challenges by increasing heart rate and blood pressure and releasing energy. Autonomic tone is the net balance of sympathetic and parasympathetic forces. When the autonomic system is out of balance, it increases risk of heart attacks and death. Mental stress and poor glycemic control impairs autonomic tone. Latinos have worse glycemic control and more mental stressors, such as immigration and English as a second language, than non-Latino Whites.
As part of a larger study on stress management in Latinos with type 2 diabetes, this study will test the effects of stress management on autonomic function. 250 Latinos with type 2 diabetes will have their autonomic function measured. Half will get diabetes education only, and half will get diabetes education plus 9 group sessions of stress management. Then they will all have their autonomic function measured again. It is expected that the group that receives stress management will have more improved autonomic function than the group that only receives diabetes education. The study will also use continuous glucose monitoring to study how hour-to-hour changes in glucose relate to hour-to-hour changes in parasympathetic tone. It is expected that as glucose increases, parasympathetic tone will decrease. If these hypotheses are correct, this study will produce a new, non-pharmacological treatment to improve autonomic function.
What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?
This project is a randomized controlled trial of a behavioral stress management program, delivered by a community health worker, to poor, urban Latinos with type 2 diabetes. We want to know if the treatment improves glycemic control. ADA funding will help determine whether the intervention also improves autonomic nervous system functioning, and to investigate the relationship between glucose levels and autonomic nervous system functioning.
If a person with diabetes were to ask you how your project will help them in the future,
how would you respond?
Dysfunction of the autonomic nervous system is involved many long-term diabetes complications and increases risk for mortality. This project may produce a new, lifestyle based treatment to improve autonomic function in persons with diabetes. If successful, this treatment may eventually decrease risk for some long-term complications. It may also show that this treatment can be delivered to hard-to-reach patients by community health workers. Community health workers are effective bridges between disenfranchised communities and the healthcare team, and are also less expensive to the healthcare system than healthcare professionals.
Why is it important for you, personally, to become involved in diabetes research? What role will this award play in your research efforts?
Diabetes is a serious disease that disproportionately affects women and communities of color. My diabetes research is informed by a concern about social justice. I hope that my work contributes to the elimination of health disparities, and progress toward a more equitable society that understands and values the highest attainable standard of health as a human right.
In what direction do you see the future of diabetes research going?
My sincere hope is that we can incorporate hard science - the search for better treatment, prevention, and a cure - with translational science that will make those scientific discoveries equally available to all people who need them.
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