Dr. Sharon Brown, associate dean for research and professor of nursing at The University of Texas at Austin, has received a four-year, $1.3 million National Institutes of Health grant to identify ways to achieve better glycemic control in persons with type 2 diabetes.
Brown is trying to find out why so few people with diabetes achieve glycemic control. To achieve it, individuals must change their dietary habits, increase their physical activity, adhere to prescribed medications and self-monitor glucose levels several times a day. Glycemic control refers to the typical levels of blood sugar (glucose) in a person with diabetes.
"Glycemic control improves health outcomes in persons with type 2 diabetes, but fewer than 30 percent of these individuals achieve glycemic goals," said Brown, adding that tight glucose control reduces diabetes complications by 50 to 75 percent. Only 10 percent achieve the three major health goals of controlling glycemia, blood pressure and lipids, primarily cholesterol.
"What we don't know is how to motivate individuals to make these critical behavioral changes," Brown said.
Past research has explored many intervening variables that may affect behavior change and health outcomes, but the studies have not been systematically reviewed nor synthesized. Brown's new research will analyze all the research that has been done in the past, examining possible mechanisms whereby behavioral change can be fostered, then test a series of predictive models using meta-analysis research methods.
"It is imperative to synthesize these studies to inform clinical guidelines so that health care providers can effectively address the growing global diabetes epidemic," said Brown, a specialist in health promotion and disease prevention in Mexican Americans with type 2 diabetes. Her diabetes research grants since 1992 now total more than $7 million. This new research employs meta-analytic methods to test a model explaining health outcomes in type 2 diabetes, an approach never before used in diabetes research.
Brown discusses her diabetes research at various speaking engagements, including a recent talk at the Joslin Diabetes Center, which is affiliated with Harvard University Medical School. She was invited there to consult with physicians, nurses, dietians and staff involved in the Latin Diabetes Initiative.
Type 2 diabetes affects more than 23.6 million Americans or 8 percent of the U.S. population. As a growing global epidemic, diabetes may be the No. 1 health problem of this generation, Brown said.
"Plausible explanations for low rates of glycemic control are depression, side effects of diabetes treatments, including medications, and the complexities of self-management--all of which may negatively impact one's quality of life," she said. "With the need to control health care costs associated with the rapidly growing worldwide diabetes epidemic, efficient approaches must be identified or the majority of persons with diabetes will remain in poor glycemic control."