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Improving Management Of Inpatient Blood Glucose, Rachael K. Misitano

Master's Projects and Capstones

Epidemiologic studies indicate blood glucose management in the hospitalized patient population is not adequate; with approximately 30% of patients reporting values >180mg/dl. Patients with increased blood glucose levels pose a higher mortality risk as well as increased risks for dehydration, hypotension, renal injury, decreased wound healing, immunosuppression, and an overall increase in hospital length of stay (AACE, 2015). This project aims to improve inpatient management of blood glucose levels by facilitating MD-RN communication through a reduction in the current reportable blood glucose level. This project took place on a 17 bed adult medical-surgical unit at a large academic hospital in …

Genetic Modification Of Human Mesenchymal Stem Cells Helps To Reduce Adiposity And Improve Glucose Tolerance In An Obese Diabetic Mouse Model., Sabyasachi Sen, Cleyton C Domingues, Carol Rouphael, Cyril Chou, Chul Kim, Nagendra Yadava

Medicine Faculty Publications

INTRODUCTION: Human mesenchymal stem cells (MSCs) are multipotent cells that can differentiate into fat, muscle, bone and cartilage cells. Exposure of subcutaneous abdominal adipose tissue derived AD-MSCs to high glucose (HG) leads to superoxide accumulation and up-regulation of inflammatory molecules. Our aim was to inquire how HG exposure affects MSCs differentiation and whether the mechanism is reversible.

METHODS: We exposed human adipose tissue derived MSCs to HG (25 mM) and compared it to normal glucose (NG, 5.5 mM) exposed cells at 7, 10 and 14 days. We examined mitochondrial superoxide accumulation (Mitosox-Red), cellular oxygen consumption rate (OCR, Seahorse) and gene …

Characterization And Diurnal Measurement Of Oral Inflammation In Association With Glycemic Control, Periodontal Status, & Glucose Stimulation, Melanie N. Kuehl

USF Tampa Graduate Theses and Dissertations

Diabetes has afflicted 8.3%, approximately 25.8 million, of the United States population and is the seventh leading cause of death [1]. Type I diabetes (T1D) accounts for 5 to 10% of all diagnosed cases of diabetes in the United States [2]. If present trends continue, the rate of T1D incidence among children under the age of 14 will increase by 3% globally [3]. T1D is an autoimmune disorder in which the β-cells of the pancreatic islets are destroyed, leading to high blood sugar. Hyperglycemia and loss of immunological tolerance to self-antigens are common associations of T1D [4]. Periodontal disease impacts …

Alagebrium Inhibits Neointimal Hyperplasia And Restores Distributions Of Wall Shear Stress By Reducing Downstream Vascular Resistance In Obese And Diabetic Rats, Hongfeng Wang, Dorothee Weihrauch, Judy R. Kersten, Jeffrey M. Toth, Anthony G. Passerini, Anita Rajamani, Sonja Schrepfer, John F. Ladisa Jr.

Biomedical Engineering Faculty Research and Publications

Mechanisms of restenosis in type 2 diabetes mellitus (T2DM) are incompletely elucidated, but advanced glycation end-products (AGEs)-induced vascular remodeling likely contributes. We tested the hypothesis that AGEs-related collagen cross-linking (ARCC) leads to increased downstream vascular resistance (DVR), and altered in-stent hemodynamics, thereby promoting neointimal hyperplasia (NH) in T2DM. We proposed that decreasing ARCC with ALT-711 (Alagebrium) would mitigate this response. Abdominal aortic stents were implanted in Zucker lean (ZL), obese (ZO), and diabetic (ZD) rats. Blood flow, vessel diameter, and wall shear stress (WSS) were calculated after 21 days, and NH was quantified. Arterial segments (aorta, carotid, iliac, femoral, arterioles) …

Influence Of Low Shear And Cyclic Strain On Hyperglycemic Rat Aortic Smooth Muscle Cells: An In Vitro Dynamic Disease Model, Varun Chawla

All Theses

Vascular complications are the leading cause of morbidity and mortality amongst diabetic patients which represent a major proportion of patients undergoing coronary artery revascularization. Major advances in drug eluting stent technologies have reduced the overall rates of restenosis in general however diabetic patients still remain at a high risk thus requiring target lesion revascularization more commonly as compared to non-diabetic cohort. Phenotypic modulation demonstrated by smooth muscle cells is essential for normal wound healing response however is also contributive to initiation and development of various vascular complications including neointimal hyperplasia which ultimately leads to the lumen re-narrowing or restenosis. Hyperglycemia …

Prevalence Of Steroid-Induced Hyperglycemia In Patients With Mantle Cell Lymphoma Receiving High Dose Steroids, Veronica Brady

Dissertations & Theses (Open Access)

Background

Hyperglycemia as a result of glucocorticoid administration (steroid-induced hyperglycemia [SIH]) occurs in 32-37% of adult patients with cancer both with and without previous history of diabetes. Patients diagnosed with mantle cell lymphoma (MCL) are often treated with chemotherapy regimens that include high dose steroids as first line therapy. Little is known about the prevalence of steroid-induced hyperglycemia in patients with MCL receiving high dose steroids. Moreover it is not known if how the resulting hyperglycemia is managed impacts time to relapse or death.

Purpose

The primary aim of this study was to determine the prevalence of SIH in MCL …

Insulin Resistance Due To Obesity, Chasity Crist

Nursing Student Class Projects (Formerly MSN)

Diabetes is defined as a common metabolic disorder where hyperglycemia or elevated glucose levels are prevalent (Shah & Vella, 2014). The most common form of diabetes is type two diabetes (T2DM) and effects around 9.3% of the population in the United States (Cornell, 2015, p. 631). The pathophysiology of this disease includes involvement from the pancreas, liver, skeletal muscle, adipose tissue, gastrointestinal tract, brain, and kidneys. Hyperglycemia is high blood sugar levels that effects multiple organs (Rymaszewski & Breakwell, 2013). Protocols are developed to allow nurses to identify and treat hyper/hypoglycemia. Patient education is a direct impact of the long …

Diabetic Ketoacidosis, Mario Bianconi

Nursing Student Class Projects (Formerly MSN)

According to “Statistics About Diabetes” (2014), in 2012, 29.1 million Americans, or 9.3% of the population, had diabetes. Additionally, of the 29.1 million, 21 million of the population were diagnosed, and 8.1 million were undiagnosed. With such a high prevalence, it is imperative that the hospital nurse is aware not only how to treat diabetes, but also how to look for complications of diabetes. One of the severe complications of diabetes is Diabetic Ketoacidosis, or DKA. DKA occurs as a result of prolonged untreated diabetes. It is the result of the body not being able to produce, or use, insulin …

Long Non-Coding Rna Malat1 Regulates Hyperglycaemia Induced Inflammatory Process In The Endothelial Cells., Prasanth Puthanveetil, Shali Chen, Biao Feng, Anirudh Gautam, Subrata Chakrabarti

Pathology Publications

To examine whether the long non-coding RNA (lncRNA) metastasis associated lung adenocarcinoma transcript 1 (MALAT1) is altered in the endothelial cells in response to glucose and the significance of such alteration. We incubated human umbilical vein endothelial cells with media containing various glucose levels. We found an increase in MALAT1 expression peaking after 12 hrs of incubation in high glucose. This increase was associated with parallel increase in serum amyloid antigen 3 (SAA3), an inflammatory ligand and target of MALAT1 and was further accompanied by increase in mRNAs and proteins of inflammatory mediators, tumour necrosis factor alpha (TNF-α) and interleukin …

Effects Of Acute And Chronic Hypoxia On Respiratory Physiology Of Paddlefish (Polyodon Spathula), Daniel Larbi Aboagye

Theses and Dissertations

Among the basal bony fishes, the American paddlefish (Polyodon spathula) has a unique respiratory strategy of ram-ventilation. However, despite the increasing problems caused by hypoxia in natural habitats occupied by this species, little information exists about their response to hypoxia. Four studies were conducted to examine the physiological and biochemical responses of juvenile paddlefish (150-181 g) to acute and chronic hypoxia. Acute hypoxia tolerance, aerobic metabolic rates and swimming capabilities of paddlefish in an intermittent respirometer or swim flume were evaluated under normoxic (partial pressures of oxygen [pO2] =140 mm Hg) and hypoxic (pO2 =62 mm Hg) conditions at 18 …

Obesity Indicators By Race/Ethnicity For Diagnosis Of Cardiometabolic Diseases For A Us Representative Sample Of Adults, Joan A. Vaccaro, Fatma G. Huffman

Joan A. Vaccaro

Background: Obesity, a growing epidemic, is a preventable risk factor for cardiometabolic diseases. Obesity and cardiometabolic diseases affect Hispanics and African Americans more than non-Hispanic Caucasians. This study examined the relationship among race/ethnicity, obesity diagnostic measures (body mass index, waist circumference, subscapular and triceps skinfold thickness), and cardiometabolic risk factors (hyperglycemia, high, non-high-density lipoprotein cholesterol, low, high-density lipoprotein cholesterol, and hypertension) for adults across the United States.

Methods: Using data from two-cycles of the National Health and Examination Survey (NHANES) 2007-2010, and accounting for the complex sample design, logistic regression models were conducted comparing obesity indicators in Mexican Americans, other …

C.Elegans As A Diabetes & Ischemia Model: Identification Of Genetic And Cellular Changes That Modulate The Survival Of Hyperglycemia And Oxygen-Deprivation, Anastacia M. Garcia, Mary L. Ladage, Brian K. Mcfarlin, Rajeev K. Azad, Pamela A. Padilla

International Journal of Exercise Science: Conference Proceedings

Diet represents an exogenous influence that often yields colossal effects on an individual’s phenotype, physiology, long-term health and disease risk. The overconsumption of dietary sugars for example, has contributed to significant increases in obesity and type 2 diabetes, health issues that are costly both in terms of dollars and human life. Additionally, individuals with these conditions have compromised oxygen delivery and thus, an increased vulnerability to other oxygen-deprivation related disease states, including cardiovascular disease, ischemic strokes, vascular and coronary diseases and myocardial infarction. While human and other mammalian studies have shown that individuals with type 2 diabetes have a worse …

Screening And Intervention For Women With Hyperglycemia During Pregnancy, Ladonna Lynn Williams

Walden Dissertations and Doctoral Studies

Gestational diabetes mellitus occurs in up to 10% of pregnancies and often leads to labor and delivery complications for both the mother and the baby. Early identification of gestational diabetes and educational intervention are needed to improve the self-management and knowledge among pregnant women. The purpose of the project was to implement newly established national guidelines to ensure that women with gestational diabetes are identified during the first trimester of pregnancy and begin diabetes education early in gestation. Lewin's planned change theory was selected as the theoretical framework, and the six sigma approach was used to facilitate the change process. …

Hyperglycemia And Inhibition Of The Monocarboxylate Transporter 1 (Mct1) Enhances Growth Arrest In Cancer Cells, Aleksandra I. Pivovarova

Theses

Many cancer cells rely predominately on glycolysis for their energy production, even in the presence of oxygen. They proceed further and reduce the glycolysis product pyruvate to lactate, by means of fermentation, for continued ATP production. This phenomenon is called the Warburg effect, and is associated with an upregulation of glycolysis and increased lactate production. A persistent increase in glycolysis and ATP turnover leads to an intracellular proton accumulation, which could eventually lead to cell damage and death by cytosolic acidification. However, cancer cells avoid acidification and maintain an appropriate intracellular pH by employing monocarboxylate transporters for the coupled export …

Mechanisms Of Hyperglycemia-Induced Ros Production In Osmotically Swollen Glial Cells, Augusta K. Eduafo

Browse all Theses and Dissertations

Cerebral edema is a potentially fatal complication of diabetes. There is evidence for increased Reactive Oxidative Species (ROS) production during cerebral edema in diabetics. This can lead to oxidative stress, thought to contribute to the onset and progression of diabetes and can cause cell injury and cell death. ROS, in moderate amounts, are involved in physiological processes within the body that produce favorable cellular responses. Unfortunately, high levels of ROS can lead to cellular damage of lipids, membranes, proteins and DNA. Hyperglycemia can cause an increase in ROS production due to activation of NADPH oxidases. The purpose of this study …

Deleterious Effects Of Hyperglycemia On Cognitive Functioning In The Cardia Study Cohort, Michele Holland Talley

All ETDs from UAB

DELETERIOUS EFFECTS OF HYPERGLYCEMIA ON COGNITIVE FUNCTIONING IN THE CARDIA STUDY COHORT MICHELE LYN HOLLAND TALLEY SCHOOL OF NURSING ABSTRACT With an aging society, maintaining cognitive functioning into older age is becoming more important. Because of the impact cognitive functioning has on daily activities, any disruption may inhibit the ability to perform such daily activities successfully. To prevent disruptions, determinants of cognitive functioning must be considered. Such determinants may or may not be modifiable. Some predictors may be demographic, metabolic, or inflammatory in nature. In addition, predictors or determinants may differ based on genetic predisposition to Alzheimer’s disease. As part …

Frequency And Mortality Associated With Hyperglycemia In Critically Ill Children, Sabeen Abid Khan, Mohsina Noor Ibrahim, Anwarul Haque

Department of Paediatrics and Child Health

Objective: To determine the frequency of hyperglycemia in critically ill children admitted in PICU of a tertiary care hospital of Karachi and to compare the mortality of critically ill children with and without hyperglycemia.

Study Design: Cross-sectional study.

Place and Duration of Study: Paediatrics Intensive Care Unit (PICU) of National Institute of Child Health (NICH), Karachi, from November 2011 to April 2012.

Methodology: One hundred fifty critically ill children admitted to PICU were included. Patients who had fasting blood sugar levels more than 126 mg/dl within 48 hours of admission were included in the hyperglycemic group. The normoglycemic and hyperglycemic …