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Enhancing Appropriate Statin Therapy In Type 2 Diabetic Patients Aged Between 40-75 Years At Graduate Medical Education (Gme) Internal Medicine Clinic, Adriana Betancourth Alvarenga, Ans Albustamy, Ayesha Khan, Steffi Sathiyaraj, Nghia Nguyen, Martha Solis, Rodolfo Garza-Morales, Oscar Lopez, Yilen Karen Ng-Wong, Hector Arredondo, Andres R. Suarez Parraga

Research Symposium

Background: The prevalence of type 2 diabetes mellitus (T2DM) is significantly higher in Rio Grande Valley than the rest of the United States. T2DM patients have an elevated risk of Atherosclerotic cardiovascular disease (ASCVD), and clinical trials have demonstrated the beneficial effects of statin therapy on ASCVD. A quality-improvement project was implemented in the GME Internal Medicine (IM) Clinic at Doctors Hospital at Renaissance to improve statin therapy appropriateness.

Methods: T2DM patients aged 40-75 were selected from the GME IM Clinic visits from July 2021 to October 2021 for baseline data and from January 2022 to April 2022 after implementing …

Metabolic Adaptation Of Staphylococcus Aureus Pathogenesis And Therapeutic Approach In Diabetic Foot Ulcers., Carol L. Baker

Theses and Dissertations

37.3 million Americans (11.2% of the US population) currently have Type 2 diabetes mellitus (T2DM) with over 1.5 million new cases being diagnosed each year. The multifactorial etiology of the patient having neuropathy, overweight/obesity, foot deformities, ischemia, and infection leads to a condition called diabetic foot ulcer (DFU). One in six patients with a DFU will require amputation with infected DFUs have a 155-fold increased risk of amputation. Staphylococcus aureus is the most common bacteria isolated from severe DFU infections that require amputation. Interestingly, diabetics are more heavily colonized with S. aureus compared to non-diabetics suggesting a unique advantageous adaptation …

Effectiveness Of Intervention Studies Based On Diet And/Or Physical Activity In Treatment, Prevention, And Management Of Diabetes Among South Asians: A Systematic Review, Ishaan Arora

Theses and Dissertations

The purpose of this study was to describe diet and/or physical activity-based interventions and their control in cardiometabolic risk factors of diabetes for the South Asian (SA) population. A systematic review was conducted in accordance with the PRISMA guidelines. Seventeen randomized control trials meeting the inclusion criteria were included for analysis. Interventions with type-2 diabetic SA showed significant improvements in HbA1c% (4/5 studies), fasting blood glucose (3/4 studies), and postprandial glucose (2/2 studies). Interventions with at-risk/prediabetic and non-diabetic SA showed a modest change in overall outcomes, with significant change reported for post-prandial insulin (3/4 studies), BMI and weight (2/4 studies), …

Spatial Epidemiology Of Prediabetes And Diabetes In Florida, Md Marufuzzaman Khan

Doctoral Dissertations

The burden of diabetes and diabetes-related Emergency Department (ED) visits has increased in Florida. However, Diabetes Self-management Education (DSME) Program participation remained considerably low. Little is known about disparities of DSME participation, diabetes complications, and ED use by diabetes patients in Florida and yet this information is important for guiding health programs aimed at reducing diabetes burden. Therefore, the objectives of this study were to investigate: (a) disparities of diabetes prevalence and DSME participation; (b) disparities of diabetes-related ED visit risks; and (c) prevalence and predictors of stroke among persons with prediabetes and diabetes.

Behavioral Risk Factor Surveillance System and …

In Vitro And In Vivo Diabetic Models For Assessment Of Tissue Engineered Vascular Grafts, Juan Carlos Carrillo Garcia

All Dissertations

Diabetes has become one of the leading causes of lower-limb loss worldwide. Every 30 seconds, a person loses a limb due to diabetic-related vascular complications. About one-third of patients needing lower-limb bypass surgery have debilitated autologous vessels unsuitable for use, and no other good long-term options are available. These detrimental effects on the vasculature are caused mainly by the hyperglycemic and hyperlipidemic conditions derived from diabetes. Under these conditions, an increase in advanced glycation end products (AGEs) and reactive oxygen species leads to irreversible crosslinks of extracellular matrix proteins, accelerating vascular pathology through vascular stiffening, endothelial dysfunction, inflammation, atherosclerosis, fibrosis, …

Respecting Tribal Voices In The Development Of A Gestational Diabetes Risk Reduction Preconception Counseling Program For American Indian/Alaska Native Adolescent Females: A Qualitative Study, Kelly R. Moore, Sarah Stotz, Martha Ann Terry, Ellen Seely, Kelly Gonzales, Gale Marshall, Jay Nadeau, Aletha Akers, Yesenia Garcia-Reyes, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background American Indians and Alaska Natives (AI/AN) are disproportionately affected by adolescent obesity, adolescent pregnancy and gestational diabetes mellitus (GDM). GDM is associated with increased risk for perinatal death, obesity, and subsequent type 2 diabetes (T2D) for the offspring. Moreover, mothers with GDM are also at increased risk for T2D post-partum. Yet few lifestyle interventions exist to reduce GDM risk prior to pregnancy. We describe the process of adapting an existing validated preconception counseling intervention for AI/AN adolescent girls at-risk for GDM and their mothers. Perspectives and recommendations were gathered from a diverse array of stakeholders to assure the new …

The Prevalence Of Diabetes In Juveniles, Tatyana Johnson

Graduate Student Dissertations, Theses, Capstones, and Portfolios

Diabetes mellitus, simply known as diabetes, is a metabolic disorder that impacts how the body makes use of glucose or blood sugar. Glucose is the primary supply of energy for the body’s cells, which is controlled by insulin, a pancreatic hormone. Diabetes results in high blood glucose levels (hyperglycemia), which are caused by either insufficient insulin production by the pancreas or ineffective insulin utilization by the body (Dean & McEntyre, 2004). Although there are several types of diabetes, the two main types are type 1 and type 2. Type 1, also known as juvenile diabetes, is an inflammatory condition in …

Diabetes Related Distress And Co-Occurrence With Depressive Symptoms In Urban Low-Income African American And Hispanic/Latinx Adults With Type 2 Diabetes, Laurie Ruggiero, Sarah Williams Leng, Mary De Groot, Ben S. Gerber, Rosalba Hernandez, Lauretta Quinn

Journal of Health Disparities Research and Practice

Introduction. Burden of diabetes in the U.S. is greater in racial-ethnic minority populations than non-Hispanic Whites. Depression and diabetes-related distress (DRD) are recognized as relatively common and important psychosocial areas to address in people living with diabetes. Limited research in the U.S. has focused on DRD in racial-ethnic minority populations. The purpose of this study is to describe patterns of DRD and co-occurrence with depressive symptoms in urban low-income African American and Hispanic/Latinx adults with type 2 Diabetes Mellitus (T2DM).

Method. We examined the baseline data collected for a randomized clinical trial (RCT) studying the impact of a culturally tailored …

The Impact Of Culture On Health Perceptions And Help-Seeking Behaviors Among Older Latinos With Co-Occurring Diabetes And Depression: A Literature Review, Alejandra M. Aguirre

McNair Research Journal SJSU

Diabetes is one of the most common health disparities in the United States today and disproportionately affects older Latino populations. Increased recognition of the bidirectional relationship between diabetes and mental health has led to more awareness and treatments for diabetes and depression. Despite high prevalence rates, diabetes and depression are commonly undiagnosed and untreated in older Latinos. Existing literature reports that factors including genetic and behavioral factors, low socioeconomic status (SES), limited healthcare access, and language barriers may prevent this population from seeking professional treatment. Prior research also suggests that culturally based stigma toward these conditions can negatively impact health …

Editorial: Physiology And Pathology Of Neuroglia, Daniel Reyes-Haro, Alejandro Lopez-Juarez, Adrián Rodríguez-Contreras

Health & Biomedical Sciences Faculty Publications and Presentations

Neuroglia is the largest population of cells in the brain and participates in formation, maintenance, and modulation of synaptic circuits. This heterogenous group includes macroglia (astroglia and oligodendroglia) and microglia. Neurons and neuroglia form assemblies that potentiate the cognitive capability of the brain. In this topic, nine articles highlight structural and functional roles of neuroglia in brain physiology, which is fundamental to better understand the biology of neurodevelopmental and neurodegenerative diseases.

Our understanding of brain connectivity evolves rapidly and the cytoarchitecture of underexplored brain regions such as the cerebellum need to be revisited (De Zeeuw et al., 2021). …

Editorial: Physiology And Pathology Of Neuroglia, Daniel Reyes-Haro, Alejandro Lopez-Juarez, Adrián Rodríguez-Contreras

Health & Biomedical Sciences Faculty Publications and Presentations

Neuroglia is the largest population of cells in the brain and participates in formation, maintenance, and modulation of synaptic circuits. This heterogenous group includes macroglia (astroglia and oligodendroglia) and microglia. Neurons and neuroglia form assemblies that potentiate the cognitive capability of the brain. In this topic, nine articles highlight structural and functional roles of neuroglia in brain physiology, which is fundamental to better understand the biology of neurodevelopmental and neurodegenerative diseases.

Our understanding of brain connectivity evolves rapidly and the cytoarchitecture of underexplored brain regions such as the cerebellum need to be revisited (De Zeeuw et al., 2021). …

High Glucose-Upregulated Pd-L1 Expression Through Ras Signaling-Driven Downregulation Of Ptrh1 Leads To Suppression Of T Cell Cytotoxic Function In Tumor Environment, Chenggang Gao, Jiaoshun Chen, Jianwei Bai, Haoxiang Zhang, Yanyi Tao, Shihong Wu, Hehe Li, Heshui Wu, Qiang Shen, Tao Yin

School of Graduate Studies Faculty Publications

Background: Nearly 80% of patients with pancreatic cancer suffer from glucose intolerance or diabetes. Pancreatic cancer complicated by diabetes has a more immunosuppressive tumor microenvironment (TME) and is associated with a worse prognosis. The relationship between glucose metabolism and programmed cell death-Ligand 1 (PD-L1) is close and complex. It is important to explore the regulation of high glucose on PD-L1 expression in pancreatic cancer and its effect on infiltrating immune effectors in the tumor microenvironment. Methods: Diabetic murine models (C57BL/6) were used to reveal different immune landscape in euglycemic and hyperglycemic pancreatic tumor microenvironment. Bioinformatics, WB, iRIP [Improved RNA Binding …

Implementation Of An Evidence-Based Diabetic Screening Tool In Rural Belizean Communities, Morgan Lee Taylor, Annelyse Caffrey

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Significance/Background: Type II Diabetes Mellitus (TIIDM) is a growing epidemic in Belize. The prevalence is increasing yearly, responsible for considerable health complications and deaths. Rates are much higher in Belize than in any other developing Central American country, and many rural citizens are undiagnosed and untreated. Access to healthcare is complex, and travel is often required in rural areas. Primary care visits in Belize are significantly less than in surrounding North and Central American countries. As a result, chronic illnesses such as TIIDM often go undiagnosed among children, adolescents, and adults- leaving TIIDM a leading cause of death in Belize. …

Unmet Needs And Coping Strategies Of Older Underserved Veterans During The Covid-19 Pandemic, Trenton M. Haltom, Joyce Tiong, Tracy L. Evans, Nipa Kamdar, Gala True, Mark E. Kunik

School of Medicine Faculty Publications

Introduction: The COVID-19 pandemic has had profound impacts on people with diabetes, a group with high morbidity and mortality. Factors like race, age, income, Veteran-status, and limited or interrupted resources early in the COVID-19 pandemic compounded risks for negative health outcomes. Our objective was to characterize the experiences and needs of under-resourced Veterans with type 2 diabetes during the COVID-19 pandemic. Methods: We conducted semi-structured qualitative interviews (March through September 2021) with U.S. military Veterans with diabetes. Transcripts were analyzed using a team-based, iterative process of summarizing and coding to identify key themes. Participants included Veterans (n = 25) who …

Functional Validation Of Human Multipotent Stromal Cell-Secreted Islet Regenerative Proteins, Xin Yue Xie

Electronic Thesis and Dissertation Repository

Diabetes affects ~537 million people worldwide. Although insulin can help manage blood glucose, 80% of patients suffer severe complications, prompting a need for novel therapies. Human bone marrow-derived multipotent stromal cells (MSC) expanded under Wnt-pathway stimulation secrete islet regenerative factors into conditioned media (Wnt+ CM). Proteomic analyses identified 8 secreted proteins (FAM3C, PSAP, SOD1, PPIA, GAL1, CTSB, TGM2, CALU) as top candidates; however, the islet regenerative functions of these proteins have not yet been functionally validated. We tested the islet regenerative capacity of these MSC-secreted proteins in vitro using human islet cultures and in vivo using streptozotocin-treated mice. Although the …

Early Postpartum Hba1c After Hyperglycemia First Detected In Pregnancy-Imperfect But Not Without Value, Ankia Coetzee, David R Hall, Mari Van De Vyver, Magda Conradie

Student and Faculty Publications

BACKGROUND: South African women of childbearing age are disproportionally affected by obesity and at significant risk of Type 2 Diabetes Mellitus (T2DM). Unless pregnant, they do not readily undergo screening for T2DM. With a local focus on improved antenatal care, hyperglycemia is often first detected in pregnancy (HFDP). This may erroneously be attributed to Gestational Diabetes Mellitus (GDM) in all without considering T2DM. Glucose evaluation following pregnancy is essential for early detection and management of women with T2DM in whom persistent hyperglycemia is to be expected. Conventional testing with an oral glucose tolerance test (OGTT) is cumbersome, prompting investigation for …

Diabetes Prevalence And Monitoring In Nonmetropolitan And Metropolitan Areas Within A Commercially Insured U.S. Population, Lindsey R. Hammerslag, Jeffery Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Enrollees living in nonmetropolitan areas had 22% higher likelihood of having diabetes, even after controlling for factors like age and region.
• The prevalence of diabetes in 2019-2020 was 7.9% in nonmetropolitan areas and 6.2% in metropolitan areas.
• Annual hemoglobin A1c (HbA1c) testing occurred for 85.1% of nonmetropolitan and 85.7% of metropolitan enrollees with diabetes. After controlling for other factors, we found significantly lower testing for those in nonmetropolitan areas.
• For diabetic enrollees, having an HbA1c test in 2019 was associated with an 8% decrease in the likelihood of non-cardiovascular complications related to diabetes and a 6% …

Implementation Of A Diabetes Education Program In The Correctional Setting: A Project Proposal, Raymond Lengel

Doctor of Nursing Practice Scholarly Projects

Diabetes is a chronic disease requiring patient responsibility to ensure good control and reduced morbidity and mortality. Incarcerated diabetic adults suffer from poor control and complications associated with their disease partly due to their limited health literacy. Arming diabetics with knowledge related to diabetes improves disease control and healthcare outcomes. The proposed final scholarly project involves the implementation of a diabetic education initiative to assess the effects of diabetic-specific education on self-care activities. The proposed quality improvement project will be framed with the Plan-Do-Study-Act and Nola Pender's Health Promotion Model. The proposed final scholarly project involves obtaining a baseline assessment, …

Mental Health Wellness In The Latino Population: Improving Phq-9 Scores In Depressed Patients With Comorbid Type Ii Diabetes, Amanda Cuellar

Doctor of Nursing Practice Final Manuscripts

Major depressive disorder is one of the most common mental health conditions. In the United States, 8.1% of the population have symptoms of depression. Patients with diabetes are 2–3 times more likely to experience symptoms of depression compared to the general population. Having these chronic conditions simultaneously can cause complications in both. The purpose of this study was to improve depression scores for patients who have comorbid type II diabetes. This project took place in a rural community with the Latino population. The nurse practitioner led an evidence-based practice project implementing treatment of depression with medication management, individual psychotherapy, and …

Shifting Gears: - The Expected Post-Transplant Survival (Epts) Usefulness In The Era Of Continuous Distribution- Examination Of The United Network Of Organ Sharing (Unos) Database 2000-2020, Vaughn Whittaker, Vaughn Easton Whittaker

NYMC Student Theses and Dissertations

The allocation of organs is a constantly evolving area of transplantation. The latest iteration of this process is a move toward continuous distribution of organs. This process considers dynamic factors instead of static constraints that box patients into certain categories. The expected post-transplant survival of patients is one of these dynamic factors that will be included in the assessment of patients' place in a continuous distribution allocation process. However, the predictive value of this construct is questionable, given that it uses only four factors (age, diabetes diagnosis, years on dialysis, and previous transplant) to represent complex patients who are on …

Gpr75 Deficiency Attenuates High Fat Diet-Driven Obesity And Glucose Intolerance, Sakib Hossain

NYMC Student Theses and Dissertations

Recently, a collaboration between Regeneron Pharmaceuticals and the Schwartzman-Garcia labs at New York Medical College published an exome sequencing study of individuals across the United Kingdom, United States, and Mexico which concluded that individuals possessing non-functioning, truncated mutations to the orphan g protein coupled receptor (GPCR), GPR75, had lower BMI and 54% reduced likelihood of obesity. The present study was undertaken to fully characterize the metabolic phenotype of Gpr75 deficient mice when fed a high fat diet (HFD) and explore potential mechanisms by which GPR75 activation links to increased adiposity and decreased glucose tolerance. After 14 weeks of HFD-feeding we …

Rutin Exerts Antidepressant Effect In A Rat Model Of Diabetes, Suzan A. Khodir, Eman A. Ali, Heba F. El-Domiaty

Menoufia Medical Journal

Objectives: to evaluate the potential antidepressant effect of rutin in diabetic rats and the assumed underlying mechanisms involved.

Background: Depression is a common behavioral disorder among diabetic patients. Oxidative stress and inflammation are strongly involved in pathophysiology of diabetes induced depression. Rutin is major flavonoid that is proved to have neuroprotective effect through antioxidant and anti-inflammatory effects.

Methods: Twenty four male Wistar rats were distributed (8/group) into control, diabetic and diabetic+Rutin groups. The depressive like behavior of the animals was conducted by forced swim test (FST). Fasting serum glucose, serum glycosylated hemoglobin A1c (Hb A1c), malondialdehyde (MDA), total antioxidant capacity, …

Establishing A Diabetes Self-Management Resource For The Self-Pay Client In A Rural Clinic, Emily Birkhead

Doctor of Nursing Practice Projects

Self-management of type 2 diabetes mellitus remains a prominent health concern across the United States. Adherence to treatment plans, medication, and glucose monitoring are often limited by out-of-pocket costs for the client. Diabetes Self-Management Education (DSME) is a set of domains that includes: medication adherence, glucose monitoring, nutrition, exercise, and effective coping mechanisms. DSME programs are provided across the United States helping those with Type 2 diabetes mellitus on their daily habits and management of the condition. DSME programs are largely unavailable to rural communities due to cost and distance barriers, resulting in diabetes education not being readily available in …

Understanding Veillonella Atypica As A Potential Metabolic Mediator In Diabetic Exercise, Anne Kelly

Undergraduate Theses and Capstone Projects

Diabetes is one of the leading health threats to Western society. While several treatmentoptions and preventative measures exist for diabetes, physicians routinely recommend exercise to improve glucose metabolism in diabetics. However, many patients still struggle with both excessglucose production and inefficient glucose uptake, despite adherence to an exercise regimen.This phenomenon, known as exercise resistance, means that exercise is either ineffective orharmful for diabetics. While some diabetics may not respond well to exercise due tomitochondrial limitations, other factors, such as gut microbiome dysbiosis and lactic acidosis,could be contributors. Lactate-metabolizing gut bacteria, like Veillonella atypica, couldameliorate exercise’s negative effects in diabetics byimproving …

Live Well, Eat Well, Be Active With Diabetes Curriculum Improves Type 2 Diabetes Management, Lauren Amaya, Dana Baldwin, Kathy Enyart, Arleen James, Tommie M. James, Penny R. King, Jan Maples, Lindy Peterman, Sara Randolph, Dea Rash, Kelsey Ratcliff, Joy Rhodes, Jessica Riggin, Janis Risley, Danette Russell, Janice Hermann

The Journal of Extension

Type 2 diabetes is a complex disease with several modifiable lifestyle factors. The Extension ‘Live well, Eat well, be Active with Diabetes’ curriculum provides four 90-minute lessons teaching individuals to live well, eat well, and be active with diabetes. Fourteen Extension educators implemented and evaluated the curriculum with 107 participants. Participants reported the program helped them feel better able to take care of their health. We observed significant differences in participants’ retrospective pre and post ‘Live well,’ ‘Eat well’ and ‘be Active’ total scores. Extension has a unique opportunity to educate individuals so they may better manage their diabetes.

Implementation Of A Comprehensive Diabetic Foot Care Program In Primary Care, Peguy Sylvain

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Diabetes Mellitus is a growing health problem in America. Uncontrolled diabetes can result in vascularcomplications. One of the most common complications of diabetes is diabetic peripheral neuropathy. Early foot carescreening can help prevent Diabetic peripheral neuropathy and other complications such as skin injuries, burns, falls,infection, lower- extremity amputations, and peripheral arterial disease. Interventions that have been shown to improve theidentification of diabetes foot complications include staff education, screening and assessment, use of monofilament,tuning fork for diabetic foot assessment, patient education/ self-care, standardization, and use of electronic medical records(EMR)/electronic reminders.

METHODS: The Plan Do Study Act method of quality improvement …

The Impact Of Maternal Diabetes On Birth To Placental Weight Ratio And Umbilical Cord Oxygen Values With Implications For Fetal-Placental Development, Sheryl Choo, Barbra De Vrijer, Timothy R H Regnault, Hilary K Brown, Larry Stitt, Bryan S Richardson

Obstetrics & Gynaecology Publications

Introduction

We determined the impact of gestational diabetes (GDM) and pre-existing diabetes (DM) on birth/placental weight and cord oxygen values with implications for placental efficiency and fetal-placental growth and development.

Methods

A hospital database was used to obtain birth/placental weight, cord PO₂ and other information on patients delivering between Jan 1, 1990 and Jun 15, 2011 with GA >34 weeks (N = 69,854). Oxygen saturation was calculated from the cord PO₂ and pH data, while fetal O₂ extraction was calculated from the oxygen saturation data. The effect of diabetic status on birth/placental weight and cord oxygen values …

Associations Between Demographic, Social Determinant, And Health Factors And Self-Management Measures Among Insured Individuals With Type 2 Diabetes, Shari Bowers-Dueker

Capstone Experience

Background: Ensuring that individuals with type 2 diabetes properly manage their chronic condition is a nation-wide challenge, even among individuals who have health insurance coverage and access to the treatment they need. There exist several literature sources that suggest various factors that may influence an individual’s lack of self-management of type 2 diabetes. This study investigated some of these factors by determining whether various demographic, social determinant, and health factors were associated with three self-management measures among individuals with type 2 diabetes.

Methods: The self-management measures of interest included (i) whether the annual recommended two primary care visits were attended …

Transforming Monterey Counties Food Environment, Geovanni Miron Solis

Capstone Projects and Master's Theses

The Blue Zones project was brought to Monterey County due to the high prevalence of type 2 diabetes. Nearly fifty percent of Monterey county are pre-diabetic or diabetic. The Blue Zones Project of Monterey County is a well being improvement initiative that works with local schools, worksites, restaurants and organizations to educate and promote healthier habits. The food sector of the project consists of individuals who work with restaurants and grocery stores here in Monterey County. The project serves Marina, Seaside, Monterey, Salinas, Pacific Grove, Gonzalez, King City, Soledad, Castroville, and Chular. A major issue the project wants to address …

Telehealth In Patients With Type 2 Diabetes Mellitus, Saghi Nassrouie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Description: Type 2 diabetes mellitus (DM2) is an epidemic that has many factors involved in its management to maintain control. Patients with DM2 require routine evaluations and blood work to provide comprehensive care. COVID-19 caused major shifts in traditional care which sparked an increase in the utilization of technology like telehealth. Telehealth can be an effective tool used to manage diabetes and help attain better glucose control, but its effectiveness during the COVID-19 pandemic warrants further investigation.Purpose: The purpose of this project was to determine if telehealth visits were more effective in reducing Hemoglobin A1c (HbA1c) in adult patients with …