Non-insulin dependent diabetes mellitus (NIDDM) is a major source of morbidity and mortality in the United States, affecting 13-16 million Americans. Women appear to be dis-proportionately affected, with particularly high prevalence and associated morbidity among African- American women. Obesity has been implicated as a primary factor in the etiology of NIDDM and weight loss is recommended as a principal intervention for obese diabetic individuals. Although behavioral obesity treatments produce weight losses and improve glycemic control, they have achieved only modest long-term success, particularly among African- American women. Our pilot data indicate that the addition of motivational interviewing methods to a behavioral weight control program enhanced the short-term treatment efficacy of in achieving glycemic control for older women with NIDDM. Thus, the overall objective for this proposed 5-year project is to determine whether the addition of motivational interviewing to a behavioral weight control program for NIDDM produces significantly greater long-term improvements in glycemic control and weight loss than a standard behavioral weight control program in a sample of black and white women. We propose to recruit a total of 218 women (84 African-American women) aged 40 or older with NIDDM who are overweight (body mass index between 27 and 45). Participants will randomized to one of two treatment conditions within race: l) behavioral weight control with motivational interviewing (BT+MI); or 2) behavioral weight control with health education attention control (BT+HE). Primary outcome measures to evaluate treatment efficacy will be glycemic control (HbA1c and weight loss at 6-, 12- and 18-month follow-up. Secondary measures obtained at each assessment point will include: 1) treatment adherence (e.g., group attendance, self-monitoring, dietary' change, physical activity, and medication adherence); 2) change in cardiovascular disease (CVD) risk factors (e.g., insulin resistance, fat distribution, lipids, and blood pressure); 3) mood and attitudinal measures; and 4) quality of life.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK054041-02
Application #
6177624
Study Section
Behavioral Medicine Study Section (BEM)
Program Officer
Yanovski, Susan Z
Project Start
1999-04-15
Project End
2004-03-31
Budget Start
2000-04-01
Budget End
2001-03-31
Support Year
2
Fiscal Year
2000
Total Cost
$521,559
Indirect Cost
Name
University of Alabama Birmingham
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
004514360
City
Birmingham
State
AL
Country
United States
Zip Code
35294
White, Della B; Bursac, Zoran; Dilillo, Vicki et al. (2011) Weight loss goals among African-American women with type 2 diabetes in a behavioral weight control program. Obesity (Silver Spring) 19:2283-5
Kim, Karen Hye-cheon; Bursac, Zoran; DiLillo, Vicki et al. (2009) Stress, race, and body weight. Health Psychol 28:131-5
West, Delia Smith; DiLillo, Vicki; Bursac, Zoran et al. (2007) Motivational interviewing improves weight loss in women with type 2 diabetes. Diabetes Care 30:1081-7