The rapidly changing epidemiology of type 2 diabetes and its frequent companion obesity, doubling in thelast two decades, have disproportionately impacted Mexican Americans; a minority with already markedhealth disparity in these conditions owing to higher initial frequencies. Recognizing these disparities, theproposed Center of Excellence on Diabetes in Americans of Mexican Descent aims to conduct research onthe physiologic progression to diabetes and its complications among Mexican Americans, and to developdiabetes prevention strategies and test innovative approaches to effective interventions in a minoritypopulation severely affected by type 2 diabetes. This Center proposes an administrative core, a researchcore including three research projects and two pilot studies, a training core and a community engagementcore. The Center of Excellence Research Core is addressing this interaction in type 2 diabetes through threecoordinated projects with the goal of understanding and implementing interventions to slow the current rateof increase in the disease and its complications.This is one of the three projects of the research core and will focus on the transitions in glucose status fromnormal to pre-diabetes to overt diabetes. In 2001, we initiated the establishment of the Cameron CountyHispanic (Mexican American) Cohort as a complement to our two decades of work in Starr County, Texas.Prior to the start of this project we will have completed detailed physical evaluations on some 1,500individuals living in Brownsville located the US/Mexico border.
Our first aim i s to document changesproximal to the development of overt diabetes. While metabolic and inflammatory risk factors are known topredict the development of type 2 diabetes in the long term, little is known regarding these profiles at thetime of and immediately preceding the transition to overt disease. We will assess the impact of metabolicand inflammatory profiles and their regulation at the time of conversion and 3 and 6 months earlier byintensively following 300 individuals with pre-diabetes from our established cohort.
The second aim i s todetermine the consequences of transitions in glucose status on the mental health of individuals with diabetesand its interaction with socioeconomic status. As with the onset of diabetes, inflammatory processes are alsoassociated with deterioration in cognitive function. Further, stress and mental health can be affected bychanges in glucose control. Currently, there are inadequate data in these regards for Hispanics, in general,and specifically for Hispanics with type 2 diabetes. Changes in mental health are likely slower to develop, butby examining the full Cameron County Hispanic Cohort we will determine the contribution of diabetes statusto cognitive health
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