Personal and Social-Built Environmental Factors of Glucose Variability Among Multiethnic Groups of Adults With Type 2 Diabetes: Research Protocol Using Ecological Momentary Assessment, Continuous Glucose Monitoring, and Actigraphy.

Publisher: Wiley Country of Publication: United States NLM ID: 7806136 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1098-240X (Electronic) Linking ISSN: 01606891 NLM ISO Abbreviation: Res Nurs Health Subsets: MEDLINE

Original Publication: New York, Wiley.

Diabetes Mellitus, Type 2*/blood ; Diabetes Mellitus, Type 2*/psychology ; Actigraphy* ; Ecological Momentary Assessment* ; Blood Glucose Self-Monitoring*; Humans ; Female ; Male ; Middle Aged ; Prospective Studies ; Adult ; Aged ; Blood Glucose/analysis ; Life Style ; Ethnicity/statistics & numerical data ; Continuous Glucose Monitoring

Glucose variability (GV)-the degree of fluctuation in glucose levels over a certain period of time-is emerging as an important parameter of dynamic glycemic control. Repeated glycemic oscillations have been reported to be the link to diabetes complications. This prospective observational study aims to: (1) identify multilevel risk factors (personal and social-built environmental factors) associated with high GV; (2) identify "within-person predictors" of high GV leveraging the intra-person data to inform future personalized diabetes interventions; and (3) examine which lifestyle factors either mediate or moderate the relationship between emotional well-being and GV among diverse adults with type 2 diabetes (T2D). We will recruit 200 adults with T2D from the community. All participants will complete baseline surveys assessing demographics, lifestyle, social-built environmental, and clinical factors. Real-time dynamic glucose levels will be measured using continuous glucose monitoring (CGM). Sleep, physical activity, diet/eating, and emotional well-being will be measured with an actigraphy device and a real-time self-report tool (ecological momentary assessment [EMA]) across 14 days. Two 24-h dietary recall data will be collected by online video calls. Generalized linear models, multilevel models, and structural equation models will be developed to achieve the study aims. The findings from the study will identify high-risk groups of high GV who would benefit from CGM to improve diabetes outcomes and inform the future development of personalized just-in-time interventions targeting lifestyle behaviors with an increased understanding of GV and by supporting healthcare providers' clinical decisions.
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This research is supported by National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases (R01DK132069).

Keywords: continuous glucose monitoring; ecological momentary assessment; glucose variability, lifestyle; type 2 diabetes

0 (Blood Glucose)

Date Created: 20240907 Date Completed: 20241113 Latest Revision: 20241121

20241122

10.1002/nur.22420

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