Medicine and Health Sciences Commons^™

Diabetes Health Education For South Jersey Communities, Heaven Chu, Sarah Tamous, Ashhabal Kavvi, Amin Khan

Rowan-Virtua Research Day

Diabetes is a chronic health condition that hinders the body’s metabolic process using insulin to maintain glycemic homeostasis. It is prevalent worldwide, with about 10% of the global adult population affected. Socio-economic and cultural factors and determinants make diabetes and diabetes management more of a health risk for certain populations rather than others. The prevalence of diabetes in the United States is higher than the global average and the risk factors disproportionately affect disadvantaged communities.

This study was designed to investigate health disparities in diabetes among a diverse population sample. The study included researching the disparities of diabetes patients in …

Impact Of Diabetic Education On Reducing Hospital Readmission Rates: A Literature Review Of Adults With Diabetes, Frank Camarda

Rowan-Virtua Research Day

According to 2018 data from the Diabetes Institute Foundation, adults in the U.S. diagnosed with diabetes accounted for 17 million emergency department visits. The readmission rate for patients with diabetes far exceeds the general readmission rates for hospitalized patients. While there is recognition of the need for diabetic education to reduce hospital readmissions, optimizing long-term self-management of diabetics remains a focus of ongoing research.

Exploring Geriatric Self Management Of Type 2 Dm: A Systematic Review, Ahmed Gawash, David F. Lo, Kunal P. Shah, Jasmine Emanuel, Brandon Goodwin, Don D. Shamilov, Gaurav Kumar, Nathan Jean, Christian P. White

Rowan-Virtua Research Day

This review explores diabetic self-management in geriatric individuals, focusing on positive attitudes and support from family/friends as crucial for self-care optimization. A comprehensive search in health databases was conducted, which involved screening 248 participants across eight qualitative research studies. Themes emphasizing the importance of listening to one’s body, acknowledging hidden issues, and recognizing the impact of various factors on diabetes self-care were established. A holistic approach to self management, emphasizing the significance of positive attitudes, cultural sensitivity, and individual values in healthcare practices is recommended. Embracing cultural diversity and addressing barriers can enhance self-management and quality of life for geriatric …

Immigration Status And Household Income As Predictors Of Childhood Obesity, Bhaumik Patel, Jeffery Powers

Rowan-Virtua Research Day

Childhood obesity rates have been on a remarkably steep rise in recent years. According to recent literature, the rate in the United States alone has more than doubled compared to other regions in the world such as Australia, Canada and Europe1,2 . Especially in the African immigrant community, there has been speculation of a higher prevalence of childhood obesity in the United States3 . This warranted further investigation into demographic factors impacting childhood obesity rates and their subsequent consequences with other clinical diseases such as diabetes and heart disease. The CDC reports that in 2011-2014, among individuals ages 2 to …

Clinical Practice Workflow Implementation For The Improvement Of Diabetic Metric Compliance, Sugosh Anur, Sohil Khanna, Alison Mancuso, Alexander Kowalski

Rowan-Virtua Research Day

Recent guidance suggests the management of screen-detected diabetes can be optimized using multifactorial interventions to improve overall disease burden, patient outcomes, and cost-savings. We explored preventive diabetic care and implemented interventions to increase recommended testing compliance among patients with Type II Diabetes Mellitus. This study employed a multi-faceted approach beginning with the distribution of surveys to patients in the Stratford Family Medicine Office in order to gauge their health literacy level pertaining to Diabetes management. Patient electronic medical records were evaluated to determine baseline levels for all laboratory values. Data analysis was completed using Statistical Package for the Social Sciences …

Outcomes In Type Ii Diabetes Patients Through The Covid 19 Pandemic A Retrospective Chart Review, Zurwa Nishat, Tara Pellegrino, Robert Steer

Rowan-Virtua Research Day

Context: The COVID-19 pandemic provided a unique opportunity for urgent expansion of telemedicine services as providers continued to supply longitudinal care to patients. Patients with type II diabetes were vulnerable to serious infection with COVID-19 as well as disruption in management of their chronic disease.

Objective: To delineate the outcomes in type II diabetes patients through the COVID-19 pandemic by a retrospective chart review in which disease management was evaluated through HbA1c levels and BMI.

Methods: This retrospective chart review included adult T2DM patients receiving care from five university family medicine offices in NJ. HbA1c levels and BMI values were …

Improving Diabetic Retinopathy Screening Practices With Qi Methodology In Family Medicine Offices, Rea Isaac, Anne Jones

Rowan-Virtua Research Day

Early detection and treatment of diabetic retinopathy (DR) is crucial in preventing vision loss and blindness in vulnerable diabetics. With around 7.7 million patients having DR, and the target population being 20 -75 years old, the potential for improving their quality of life is substantial (WHO, 2022). Despite the importance of timely and routine eye exams, 45% of diabetic patients do not complete an exam despite physicians recommendations (Lu, 2014). This project aims to standardize eye exams, improve process flow, and improve patient understanding of the urgency of timely and comprehensive eye exams for DR. Multiple PDSA cycles and QI …

The Effects Of Obesity And Diabetes On The Pediatric Population, Keyur Patel, Vrushank Shah, Zachary Harris, Kanad Mukherjee

Rowan-Virtua Research Day

The World Health Organization has declared diabetes (DM) and Obesity to be epidemics due to their rising prevalence. Obesity plays a role in the aetiopathogenesis of type 2 diabetes, the most common type of diabetes in the world, as well as the development of its complications. Obesity and overweight play a growing role in type 1 diabetes. Weight gain is often thought of as a side effect of insulin therapy, but it also has a significant pathophysiological impact at different stages of the disease. (1) In the United States and other nations across the world, childhood obesity has become a …

Pregnancy Outcome With In Vitro Fertilization-Embryo Transfer According To Age In Women With Diminished Oocyte Reserve (Dor) Using A Follicle Stimulating Hormone Receptor Up-Regulation Technique, Brooke Neumann, Jerome Check, Carrie Wilson, Michael Sobel, Jung Choe

Rowan-Virtua Research Day

Objective: About 18 years ago, one of the top IVF centers published a study and found that women with DOR did not have any live deliveries at any age in women with a day 3 serum FSH exceeding 18 mIU/mL. The failure to achieve a live delivery may have been related to the ovarian hyperstimulation regimen with possible down regulation of the FSH receptor needed to produce a key enzyme needed for successful implantation. The purpose of this 25-year retrospective review was to evaluate the efficacy of a specific type of mild stimulation referred to as the FSH receptor up-take …

Evaluation Of Outcome Following Oocyte Retrieval In Women With Marked Diminished Oocyte Reserve (Dor) Where The Only Oocyte Retrieved Was In A Metaphase I State, Brooke Neumann, Jerome Check, Carrie Wilson, Donna Summers, Kathleen Hollahan

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OBJECTIVE: To determine if there is value in culturing a metaphase I oocyte to metaphase II followed by intracytoplasmic sperm injection (ICSI), fertilization, then embryo transfer (ET) in women with marked DOR. MATERIALS AND METHODS: A follicle stimulating hormone (FSH) receptor up-regulation technique was used in women whose day 3 serum FSH levels were >12 mIU/mL and/or the serum anti-mullerian (AMH) level was <1ng/mL to mature antral follicle(s) to the dominant follicle stage (average diameter >18) and serum estradiol (E2) >200pg/mL when 10,000 IU human chorionic gonadotropin (hCG) would be given followed by oocyte retrieval 32 hours later. The basic tenet of this follicle maturation technique is to 1) use very little …

A Case Of Diabulimia In A 23-Year-Old Woman With Extensive Comorbidities, Stephen Poos, Kaitlin Mcgowan, Ashaki Martin

Rowan-Virtua Research Day

Diabulimia is defined as intentionally withholding insulin injections for the purpose of weight loss in the setting of type 1 diabetes mellitus (T1D).

It is characterized as an eating disorder (ED), although it does not yet have DSM diagnosis status.

Recognition of the condition among medical professionals is limited but growing.

Case Report: Thyrotoxic Hypokalemic Periodic Paralysis, Kelly Schuitema, Wayne Tamaska, Robin Lahr

Rowan-Virtua Research Day

Thyrotoxic crisis, or thyroid storm, is an acute, life threatening event caused by hyperthyroidism with mortality up to 8-25% that can present with multi-system organ involvement. It is a rare, but well studied complication in the emergency department but can lead to further, less common complications. In this study we will discuss a case of thyrotoxic hypokalemic periodic paralysis. Thyrotoxic hypokalemic periodic paralysis (TPP) most commonly affects Asian men. The key features of the syndrome include acute onset of hypokalemia and paralysis. The hypokalemic aspect of the disorder is secondary to the shift intracellularly by thyroid hormones’ sensitization of Na+/K+-ATPase …

Case Report: Octreotide Associated Hyperkalemia, Darren Finn, Eric Maddock, James Espinosa, Andrew Caravello, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

78-year-old female with past medical history of acromegaly status post pituitary adenoma status post resection presents to the emergency department with abdominal pain. ED workup was not significant for any acute intra-abdominal abnormalities; however, incidental finding of hyperkalemia was pertinent to the visit. Patient was treated in the ED for her condition but her potassium levels remained elevated despite repeated saline infusions. Patient was ultimately admitted to the hospital where it was discovered that she had recently been switched from octreotide injections to an oral somatostatin analogue Mycapssa. We believe that this patient’s hyperkalemia was caused by octreotide-induced insulin suppression …

Case Study Of Metformin-Induced Lactic Acidosis, Kajel Patel, Kishan Patel

Rowan-Virtua Research Day

Metformin induced lactic acidosis is when high levels of metformin cause dangerously high levels of lactic acid. Here is a case report of a 72-year-old female who came in for nausea, vomiting, and diarrhea found to have a high suspicion for metformin induced lactic acidosis. She stabilized in the emergency department, nephrology and ICU was contacted, and she went for emergent dialysis. For many patients the prognosis of metformin induced lactic acidosis is poor. This patient was made comfort care by her family.

Triad Of Acute Pancreatitis Coexisting With Diabetic Ketoacidosis And Very Severe Hypertriglyceridemia Successfully Resolved With Insulin Therapy Alone, Akash Patel, Monica Patel, Yvette Wang

Rowan-Virtua Research Day

Diabetic ketoacidosis (DKA) is known to cause mild elevations in triglyceride levels.

Severe hypertriglyceridemia (HTG) is a well-known cause of acute pancreatitis; however, in unique cases, DKA has been shown to cause severe HTG leading to the development of acute pancreatitis (AP).

HTG causing AP only accounts for 1-4% of cases of AP

From the few cases in literature that have reported this triad of DKA, HTG, and AP, even fewer have shown to be successfully treated with insulin therapy alone with the severe degree of HTG that we discuss.

In our case, we have treated a triad of DKA, …

Lipid Profile And Admission/Discharge Locations As Predictors Of 60 Day Readmission In Adults 65 Or Older With Type 2 Diabetes Mellitus, Zac Dalton, Terrie Ginsberg, Matthew Mclaughlin

Rowan-Virtua Research Day

Introduction: Reducing 30 and 60 day hospital readmissions is critical to our healthcare systems. Older folks with type 2 diabetes mellitus (T2DM) account for a disproportionate amount of readmissions. Through recognizing factors that correlate to readmissions, patients at risk may be identified.

Objective: To conduct a retrospective review of electronic medical records (EMR) to determine if there is an association between the lipid profile and admission and discharge locations of hospitalized older adults and whether they were rehospitalized 60-days post discharge.

Methods: EMRs were reviewed of 86 randomly selected consenting participants who were admitted to a community hospital and were …

The Relationship Of Creatinine, Sodium, Hematocrit And Hemoglobin A1c To 30-Day Hospital Readmission Among Older Adults With Type 2 Diabetes, Shmilah Choudhary, Meet Shah, Sanath Shetty, Terri Ginsberg, Matthew H. Mclaughlin

Rowan-Virtua Research Day

Introduction:Reducing thirty-day hospital readmissions is a top healthcare priority. However, there is little research describing the risk factors of readmission among patients with diabetes, especially for older adults. Understanding what the risk factors are for 30-day hospital readmission for older adults with type 2 diabetes would help identify patients at risk of rehospitalization.

Objective:The aim of this study was to identify factors associated with 30-day unplanned hospital readmissions among older adults with T2DM. Factors to be investigated are: patient demographics and three admission laboratory values.

Methods:Participants were older adult s>65 years old with T2DM, admitted to a community hospital …

The Relationship Of Risk Of Falls And Activities Of Daily Living To 30-Day Hospital Readmission Among Older Adults With Type 2 Diabetes, Sanath Shetty, Shmilah Choudhary, Meet Shah, Terrie Ginsberg D.O., Matthew H. Mclaughlin

Rowan-Virtua Research Day

Introduction: Reducing thirty-day hospital readmissions is a top healthcare priority. However, there is little research describing the risk factors of readmission among patients with diabetes, especially for older adults. Understanding what the risk factors are for 30-day hospital readmission for older adults with type 2 diabetes (T2DM) would help identify patients at risk of rehospitalization.

Objective: The aim of this study was to identify factors associated with 30-day unplanned hospital readmissions among older adults with T2DM. Factors to be investigated are: patient demographics, whether patients were at risk for falling, and patients’ activities of daily living (ADL) at discharge.

Methods: …

The Relationship Of Cardiovascular Disease To 30-Day Hospital Readmission Among Older Adults With Type 2 Diabetes Mellitus, Meet Shah, Shmilah Choudhary, Sanath Shetty, Terrie Ginsberg D.O., Matthew H. Mclaughlin

Rowan-Virtua Research Day

Reducing thirty-day hospital readmissions is a top healthcare priority. However, there is little research describing the risk factors of readmission among patients with diabetes, especially for older adults. Understanding what the risk factors are for 30-day hospital readmission for older adults with type 2 diabetes (T2DM) would help identify patients at risk of rehospitalization. The aim of this study was to identify factors associated with 30-day unplanned hospital readmissions among older adults with T2DM.Factors to be investigated are: patient demographics and whether the patient was hospitalized for cardiovascular disease. Participants were older adults>65 years old with T2DM, admitted to …

A Rare Case Of A Non- Functioning Pancreatic Neuroendocrine Tumor, Yaser Khalid, Neethi Dasu, Richard Gordon

Rowan-Virtua Research Day

Pancreatic neuroendocrine tumors (PNET) are very rare and represent about 1–2% of all pancreatic tumors. Non-functional PNET (NF-PNET) is incidentally discovered in most cases. Most NF-PNETs are found at an advanced stage because patients are mostly asymptomatic. We present a case of 32-yr-old female who initially presented with increasing abdominal girth, decreased mobility, and lower extremity swelling up to the hip and was found to have an advanced NF-PNET with metastatic disease to the pelvis and liver. There have been few studies directed toward early detection and management; Computed tomography (CT) is the imaging modality of choice as well as …