Zusammenfassung

PURPOSE: The purpose of the study was to: (1) characterize leptin in Mexican Americans with poorly-controlled T2DM; (2) examine relationships among leptin and indicators of diabetes status (BMI and A1C); and (3) explore the effects of a culturally-tailored DSME intervention on leptin. METHODS: In Starr County, an impoverished Texas-Mexico border community, 252 Mexican Americans with T2DM were recruited to test a DSME intervention culturally tailored in terms of language, dietary recommendations, social emphasis, family participation, and incorporation of cultural health beliefs. Groups of eight participants were randomized to experimental or wait-listed control conditions. Outcomes were measured at 3, 6, and 12 months; by 12 months, 109 had complete leptin data. RESULTS: Subjects were predominantly female and on average, 55 years of age, diagnosed with diabetes for 8 years, obese, and in poor glycemic control. Three variables — BMI, gender, A1C — explained 36% of the variance in baseline leptin; there were no intervention effects on leptin. Gender, time, and gender-by-time interaction effects on leptin were statistically significant; greater increases in leptin over time occurred in females compared to males. In females, baseline-to-12 month FBG changes significantly predicted baseline-to-12 month leptin changes; in males BMI changes predicted leptin change. CONCLUSIONS: With increasing obesity rates, further research is warranted to determine if leptin is a useful intervention target in T2DM.