Night Eating Among Latinos With Diabetes: Exploring Associations With Heart Rate Variability, Eating Patterns, and Sleep.

OBJECTIVES: We explored associations between night eating and health outcomes in Latinos with type 2 diabetes. METHODS: Participants (n = 85) completed surveys, were measured for anthropometrics, provided blood samples, and wore Holter monitors for 24 hours to assess heart rate variability. RESULTS: Participant mean age was 60.0 years, hemoglobin A1c was 8.7%, most preferred Spanish (92%), and had less than a high school education (76%). Compared with their counterparts who denied night eating, night eaters had lower heart rate variability in the low (Cohen's d = -0.55; P = 0.04) and very-low-frequency bands (d = -0.54, P = 0.05), and reported more emotional eating (d = 0.52, P = 0.04), and poorer sleep quality (Cohen's h = 0.64). They did not differ on beverage intake or depressive symptoms. In regression that included depressive symptoms, associations between night eating and outcomes became nonsignificant. CONCLUSIONS AND IMPLICATIONS: Night eaters demonstrated worse health outcomes. If results are replicated, nutrition education for this population might focus on night eating.

A randomized, controlled trial of a stress management intervention for Latinos with type 2 diabetes delivered by community health workers: Outcomes for psychological wellbeing, glycemic control, and cortisol.

AIMS: To test the efficacy of a community health worker (CHW) delivered stress management (SM) intervention on psychosocial, glycemic, and cortisol outcomes among U.S. Latinos with type 2 diabetes. METHODS: A randomized, controlled trial compared CHW-delivered diabetes education (DE; one group session) to DE plus CHW-delivered SM (DE+SM; 8 group sessions). Psychosocial variables and urinary cortisol were measured at baseline and posttreatment. HbA1c was measured at baseline, posttreatment, and 3-month follow-up. RESULTS: In intent to treat analysis, compared to DE (n=46), DE+SM (n=61) showed significantly improved symptoms of depression, anxiety, and self-reported health status. There were no significant group effects for HbA1c, diabetes distress, or urinary cortisol. However, there was a dose response effect for HbA1c and diabetes distress; increasing attendance at SM sessions was associated with greater improvements in HbA1c and diabetes distress. CONCLUSIONS: This is the first randomized, controlled trial demonstrating that CHWs can improve psychological symptoms and self-reported health among Latinos with type 2 diabetes. Efforts to increase intervention attendance may improve HbA1c and diabetes distress.

Evaluation of online instruction to improve medical and dental students' communication and counseling skills.

Online, interactive video modules were created to demonstrate good skills in history taking, counseling, and communication. The authors evaluated the effect of the modules on students' data gathering, counseling, and communication skills with standardized patients (SPs). A student cohort without the online modules (n = 76 medical students and n = 43 dental students) was compared to a cohort of different students who were assigned the modules (n = 88 medical students and n = 39 dental students). Students were evaluated by SPs using case-specific content checklists and the Master Interview Rating Scale (MIRS). Compared to their counterparts who did not use the modules, medical and dental students who used the modules showed significantly higher performance on several outcomes. The areas that showed benefit were those that were novel to students. Student accuracy in grading others was generally unrelated to their own performance. In conclusion, the online, interactive video modules were associated with improvements in a majority of clinical skills.

Accuracy of blood glucose estimation by children with diabetes: an investigation of repeated practice with growth curve modeling.

This study used growth curve modeling to explore whether practicing the task of estimating blood glucose levels would increase accuracy in children with type 1 diabetes. It was predicted that accuracy would improve with practice and that younger, anxious, poorly adjusted children would improve most. 43 attendees at a diabetes summer camp participated. Their mean age was 13.4 yr. (SD = 1.6). All were Euro-American, and 22 were girls. Change in accuracy was best represented by a quadratic function, and this model fit the data well. Overall, participants' accuracy improved initially and then deteriorated. Results indicate that older children were more likely to improve and then deteriorate. Younger children were more likely to improve and sustain those improvements. Results indicate that practicing the task of estimating is not an effective way to increase accuracy and may be contra-indicated. These results can help guide research and clinical use of glucose estimation in children.