542-P: Development and Baseline Characteristics of a Novel Community-Based Nutrition-Lifestyle Therapy for Pregnant Women with Diabetes

IF 7.5 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes Pub Date : 2025-06-13 DOI:10.2337/db25-542-p

RACHYL PINES, CEARA AXELROD, SARINTHA BELL, KRISTEN NELSON, ELIZABETH ROMERO GUTIERREZ, KATHERINE VICTORIA, KRISTIN N. CASTORINO

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引用次数: 0

Abstract

Introduction and Objective: Socioeconomically disadvantaged (SED) pregnant Latina women are disproportionately burdened by type 2 and gestational diabetes. While diet and lifestyle therapy can help maintain glycemic control in pregnancy and plant-forward interventions have been successful in Latino populations, there is little data in pregnancy. This study evaluates a culturally tailored, plant-forward, dietary-lifestyle intervention delivered by community health workers (CHWs). We hypothesize that it will improve glycemic control in pregnant Latina women with diabetes, including time in continuous glucose monitoring (CGM) pregnancy range (TIR) 63-140 mg/dL, average glucose and glycemic variability. Methods: We performed a baseline analysis in the 12 out of target 30 participants currently enrolled. Participants are randomized to either plant-forward dietary-lifestyle intervention or to standard of care. The intervention arm receives 12 CHW-led classes. Standard of care group receives their regular pregnancy care visits. Both groups wear CGM unblinded as best practice for diabetes in pregnancy. Results: Of the 12 participants mean age was 33.17 ± 6.27 years and mean gestational age at enrollment was 22.05 ± 5.73 weeks. 41.67% have food insecurity and 8.13% have housing insecurity. 50% are primarily Spanish speaking and 67.77% have a high school education or less. Average baseline A1c was 5.78 ± 1.25%, range 4.5-9.3%. Mean CGM TIR 63-140 mg/dL was 78.39 ± 24.28%. Conclusion: This baseline data suggests a need for an effective, culturally and linguistically tailored dietary-lifestyle intervention in SED pregnant Latina women with diabetes. While on average goal pregnancy TIR of >70% was met, there is significant variation and several participants are not meeting this goal. Overall, results of this pilot study will increase understanding of the effect of high-quality CHW-led education interventions on glycemic profiles, and maternal and fetal pregnancy outcomes of this vulnerable population. Disclosure R. Pines: None. C. Axelrod: None. S. Bell: None. K. Nelson: None. E. Romero Gutierrez: None. K. Victoria: None. K.N. Castorino: Research Support; Abbott, Medtronic, Dexcom, Inc., Lilly Diabetes, MannKind Corporation, Eli Lilly and Company, Insulet Corporation. Speaker's Bureau; Dexcom, Inc. Advisory Panel; MannKind Corporation. Speaker's Bureau; Insulet Corporation. Funding National Institutes of Health NIMHD (P50MD017344 subaward SCON-00003510)

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542-P：一种新的基于社区的营养生活方式治疗妊娠糖尿病的发展和基线特征

简介和目的：社会经济弱势（SED）怀孕的拉丁妇女是不成比例的负担2型和妊娠糖尿病。虽然饮食和生活方式治疗可以帮助维持怀孕期间的血糖控制，并且植物向前干预在拉丁裔人群中取得了成功，但在怀孕期间几乎没有数据。本研究评估了社区卫生工作者（CHWs）提供的文化量身定制，植物向前，饮食生活方式干预。我们假设它将改善拉丁裔糖尿病孕妇的血糖控制，包括持续血糖监测（CGM）妊娠范围（TIR） 63-140 mg/dL的时间，平均葡萄糖和血糖变异性。方法：我们对目前入组的30名目标参与者中的12名进行了基线分析。参与者被随机分为植物性饮食生活方式干预组和标准护理组。干预组接受了12个由chw领导的课程。标准护理组定期接受妊娠护理访问。两组均采用无盲CGM作为妊娠期糖尿病的最佳治疗方法。结果：12例患者的平均年龄为33.17±6.27岁，入组时的平均胎龄为22.05±5.73周。41.67%的人没有粮食保障，8.13%的人没有住房保障。50%的人主要说西班牙语，67.77%的人只受过高中或更低的教育。平均基线A1c为5.78±1.25%，范围为4.5-9.3%。平均CGM TIR 63 ~ 140 mg/dL为78.39±24.28%。结论：这一基线数据表明，需要一种有效的、文化和语言量身定制的饮食-生活方式干预SED怀孕的拉丁裔糖尿病妇女。虽然达到了70%的平均妊娠目标TIR，但存在显著差异，一些参与者没有达到这一目标。总的来说，这项试点研究的结果将增加对高质量chw主导的教育干预对这一弱势群体的血糖状况和母婴妊娠结局的影响的理解。R. Pines：没有。C.阿克塞尔罗德：没有。S.贝尔：没有。K. Nelson：没有。E. Romero Gutierrez：没有。维多利亚：没有。K.N. Castorino：研究支持；雅培、美敦力、Dexcom、礼来糖尿病、MannKind公司、礼来公司、胰岛素公司。演讲者的局;, Dexcom公司将公司。顾问小组;MannKind公司。演讲者的局;Insulet公司。资助美国国立卫生研究院NIMHD （P50MD017344分奖SCON-00003510）

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来源期刊

Diabetes 医学-内分泌学与代谢

CiteScore

12.50

自引率

2.60%

发文量

1968

审稿时长

1 months

期刊介绍： Diabetes is a scientific journal that publishes original research exploring the physiological and pathophysiological aspects of diabetes mellitus. We encourage submissions of manuscripts pertaining to laboratory, animal, or human research, covering a wide range of topics. Our primary focus is on investigative reports investigating various aspects such as the development and progression of diabetes, along with its associated complications. We also welcome studies delving into normal and pathological pancreatic islet function and intermediary metabolism, as well as exploring the mechanisms of drug and hormone action from a pharmacological perspective. Additionally, we encourage submissions that delve into the biochemical and molecular aspects of both normal and abnormal biological processes. However, it is important to note that we do not publish studies relating to diabetes education or the application of accepted therapeutic and diagnostic approaches to patients with diabetes mellitus. Our aim is to provide a platform for research that contributes to advancing our understanding of the underlying mechanisms and processes of diabetes.