Preventing type 2 diabetes microvascular complications: Exploring the interplay of racial/ethnic disparities and primary therapeutic interventions

Type 2 Diabetes Mellitus (T2DM) persists as a major public health issue capable of producing a variety of adverse complications. The prevalence of T2DM microvascular complications, such as kidney, nerve, and eye problems, is higher in the U.S. than macrovascular complications such as heart disease. Racial/ethnic disparities in the prevalence of T2DM microvascular complications has been reported by prior studies. Because treatment for T2DM microvascular complications is still in the developmental phase, it is critical to prevent the development of T2DM complications in at-risk populations to reduce disparities. Diet, physical activity, and drug (i.e., metformin) are often prescribed to treat T2DM. These T2DM interventions may lower risk of microvascular complications over time; however, findings from clinical and epidemiologic studies have been inconsistent. Furthermore, the effects of these interventions on risk may vary by race/ethnicity, but information in the scientific literature on this topic is scarce. The overarching aim of this dissertation project is to examine longitudinal associations between basic preventive interventions and risk of microvascular complications at the intersection of race/ethnicity. Using data from the National Heart Lung and Blood Institute, this dissertation project will address three specific aims. The first aim will analyze longitudinal trajectories of T2DM microvascular complications across racial/ethnic groups over a period of seven years. The second aim will investigate the individual and combined effects of lifestyle interventions (i.e., diet and physical activity) and metformin on risk of T2DM microvascular complications over a four-year period to identify the best preventive intervention. And finally, the third aim will examine racial/ethnic differences in the effects of the best intervention derived from aim two to determine if this intervention equitably reduces risk of microvascular complications for racial/ethnic groups. Overall, this project will identify racial/ethnic groups at increased risk for T2DM microvascular complications and the role of basic preventive intervention in reducing racial/ethnic disparities. The estimated timeline of completion is spring 2023. A detailed summary of the background and methods for each specific aim are provided below.

Name thesis:degree_name

Ph.D.

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Community Health

Grantor

University of Illinois at Urbana-Champaign

Year dc:date

2024

Author dc:creator

• Parab, Kaustubh Vijay

Contributors dc:contributor

• Singleton, Chelsea R
• Mahajan, Harshal P
• Gao, Xiaotian
• Gothe, Neha
• Wilund, Kenneth

• Type 2 Diabetes
• Race/ethnicity
• Microvascular Complications

Statement dc:rights

• Copyright 2024 Kaustubh Vijay Parab

Language dc:language

eng, en

Handle dc:identifier

https://hdl.handle.net/2142/124668

OAI identifier oai:identifier

oai:www.ideals.illinois.edu:2142/124668