Diabetes and Wellness
Diabetes and wellness outcomes research for the Republic of the Marshall Islands
This study is designed to determine the effectiveness of intensive lifestyle intervention programs conducted by properly trained indigenous health workers in the Republic of the Marshall Islands (RMI). In the 1950s there were only three elderly people in the Marshall Islands known to have type-2 diabetes mellitus. Currently it is estimated that between 20 and 30 percent of the population have developed this chronic disease. It is the number one health concern in the region.
This wellness study aims to leverage methods proven effective from an already established wellness program that has been conducted by Canvasback Missions in the RMI. These methods will be applied to a vulnerable population--those with type-2 diabetes with poor glucose control and increased risk of complications. A randomized parallel group design will be utilized for the study. Participants will be randomly assigned to receive either a 24-week intensive lifestyle intervention or standard diabetes education. The lifestyle intervention will consist of diet, exercise, and stress-management health behavior modifications administered in a group setting with decreasing frequency over a period of 24 weeks. Biological and behavioral measurements as well as demographic variables will be recorded. Outcome measures between the treatment group and the control group will be compared to determine any difference in effect of lifestyle intervention.
It is expected that culturally sensitive intensive lifestyle interventions conducted by properly trained indigenous staff will produce clinically significant improvements in the management and treatment of type-2 diabetes. It is further expected that program participants will make sufficient lifestyle changes to lower serum glucose and reduce cardiac risk factors as measured by fasting serum glucose glycosylated hemoglobin, BMI, waist-hip ratio, total, low density and high density cholesterol, blood pressure, insulin resistance, and high-sensitivity C-reactive protein compared to controls receiving standard diabetes education. This study has the potential to add important approaches to minimizing the incidence and complications of type-2 diabetes in the Pacific Islands and elsewhere.
This study is funded by the US Congress through the US Army Medical Research Acquisition Agency.
