Medicine and Health Sciences Commons^™

Perceptions Of Diabetes Distress And Counseling During The Pandemic - Rural Provider Perspectives, Ranjita Misra, Brenna O. Kirk, William D. Lewis

Marshall Journal of Medicine

Introduction

West Virginia is an Appalachian rural state that ranks highest in the nation in the prevalence of diabetes (16.2%). The COVID-19 pandemic impacted routine diabetes care. As a result, individuals experienced diabetes distress over the physical and psychological burdens of diabetes management. In rural and medically underserved counties (71%), diabetes care is often provided by primary care physicians. However, healthcare providers’ perspectives on diabetes distress and related counseling to address them are unclear. This cross-sectional study’s objective was to explore healthcare providers’ (HCP) perspectives regarding their patient’s diabetes distress and how it guided their counseling for diabetes self-care during …

Cellular Senescence And Their Role In Liver Metabolism In Health And Disease: Overview And Future Directions, Matthew Schade, Jacqueline A. Sanabria, Rodrigo Aguilar, Milad Modarresi, Brad Gillon, Zach Hunter, Jacqueline Fannin, Amrita Mallick, Henri Brunengraber, Juan Sanabria

Surgery

Chronic liver disease has globally risen mainly due to a prevalent Hepatitis C Virus (HCV) infection rate and an epidemic of obesity. It is estimated by the year 2030, 2.2 billion people around the world will be overweight and 1.1 billion people will be obese. Diabetes and obesity are the main risk factors for the development of the metabolic syndrome and in the liver of Non-Alcoholic Fatty Liver Disease (NAFLD) which could progress to NASH related cirrhosis and liver malignancy. At present there is not effective therapy for NASH besides loss of weight and exercise. Furthermore, optimal management of HCC …

Role Of N-Acetyl-Seryl-Aspartyl-Lysyl-Proline (Ac-Sdkp) And Renal Hemodynamics On Obesity Related Renal Damage, Mani Maheshwari

Theses, Dissertations and Capstones

Obesity is a public health problem and is associated with salt-sensitive hypertension, kidney inflammation and fibrosis. N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP) is a tetra-peptide with anti-inflammatory and anti-fibrotic properties but its effect on kidney damage in obesity is unknown. We hypothesized that high salt fed Zucker obese (ZO) rats develop renal damage, inflammation and fibrosis and that Ac-SDKP prevents these changes. Zucker lean (ZL) rats served as controls. Animals were treated with Ac-SDKP while maintained on either a normal-salt or HS diet for 8 weeks. Systolic blood pressure (SBP), albuminuria, renal inflammation and fibrosis were evaluated. HS diet increased macrophage infiltration in the …

Effect Of Empagliflozin On Insulin Sensitivity In The Lean And Obese Zucker Rat: A Model Of Metabolic Syndrome, Veda Gayatri Sushma Penta

Theses, Dissertations and Capstones

Metabolic syndrome is one of the fastest growing health problems in the world. The medical costs associated with treating this disorder are staggering. Allowed to proceed untreated, metabolic syndrome can lead to a markedly decreased quality of life and a variety of medical conditions including heart and kidney failure. Whether the sodium glucose co-transporter-2 (SGLT-2) inhibitor Empagliflozin can be used to prevent the development of metabolic syndrome is not well understood. This proposal is specifically designed to address this gap in our knowledge. The expected outcomes of this work will identify the time course and degree of interrelatedness between changes …

Optimizing Heart Failure Outcomes Through Diet: A Review, Farley B. Neasman Iii

Marshall Journal of Medicine

Heart failure is a growing epidemic that will add significant monetary and human costs to an already overtaxed health-care system. Though promising new medications have recently been approved, this complex condition is largely preventable through aggressive risk factor modification, with diet being shown to have a greater effect than exercise. An underrated component of a healthy diet is the simple addition of nuts – the anti-inflammatory fatty acids, healthy proteins, and general availability have been shown to improve survival and reduce the primary risk factors contributing to heart failure, making the addition of nuts and legumes to the diet an …

Uric Acid-Induced Adipocyte Dysfunction Is Attenuated By Ho-1 Upregulation: Potential Role Of Antioxidant Therapy To Target Obesity, Komal Sodhi, Jordan Hilgefort, George Banks, Chelsea Gilliam, Sarah Stevens, Hayden A. Ansinelli, Morghan Getty, Nader G. Abraham, Joseph I. Shapiro, Zeid J. Khitan

Internal Medicine

Increased uric acid levels have been implicated in the pathogenesis of metabolic syndrome. To examine the mechanisms by which this occurs, we hypothesized that an increase in heme oxygenase 1, a potent antioxidant gene, will decrease uric acid levels and adipocyte dysfunction via suppression of ROS and xanthine oxidase (XO) levels.We examined the effect of uric acid on adipogenesis in human mesenchymal stem cells (MSCs) in the presence and absence of cobalt protoporphyrin (CoPP), an HO-1 inducer, and tin mesoporphyrin (SnMP), an HO activity inhibitor. Uric acid increased adipogenesis by increasing NADPH oxidase expression and elevation in the adipogenesis markers …

Alkali Therapy In Lactic Acidosis, Zeid J. Khitan, Md, Deepak Malhotra, Md, Dominic S. Raj, Md, Antonios H. Tzamaloukas, Md, Joseph I. Shapiro, Md

Marshall Journal of Medicine

This report attempts to frame the debate about clinical administration of sodium bicarbonate in the setting of lactic acidosis in terms of simple questions. Specifically, we address why we develop lactic acidosis in some circumstances, how acute lactic acidosis impairs cardiovascular function and why sodium bicarbonate may have deleterious effects which limit its utility. We also attempt to explore treatment alternatives to sodium bicarbonate.

Age At Diagnosis Of Diabetes In Appalachia, Lawrence Barker, Robert Gerzoff, Richard Crespo, Molly Shrewsberry

Family and Community Health

Background

Appalachia is a region of the United States noted for the poverty and poor health outcomes of its residents. Residents of the poorest Appalachian counties have a high prevalence of diabetes and risk factors (obesity, low income, low education, etc.) for type 2 diabetes. However, diabetes prevalence exceeds what these risk factors alone explain. Based on this, the history of poor health outcomes in Appalachia, and personally observed high rates of childhood obesity and lack of concern about prediabetes, we speculated that people in Appalachia with diagnosed diabetes might tend to be diagnosed younger than their non-Appalachian counterparts.

Methods …

Appalachian Regional Model For Organizing And Sustaining County-Level Diabetes Coalitions, Richard Crespo, Molly Shrewsberry, Darrlyn Cornelius-Averhart, Henry B. King Jr.

Family and Community Health

This article describes a model for developing diabetes coalitions in rural Appalachian counties and presents evidence of their sustainability. The rural Appalachian coalition model was developed through a partnership between two federal agencies and a regional university. Coalitions go through a competitive application process to apply for one-time $10,000 grants. The project has funded 7 to 9 coalitions annually since 2001, reaching 66 total coalitions in 2008. Sustainability of the coalitions is defined by the number of coalitions that voluntarily report on their programs and services. In 2008, 58 of 66 (87%) coalitions in the Appalachian region continue to function …

Residence In A Distressed County In Appalachia As A Risk Factor For Diabetes, Behavioral Risk Factor Surveillance System, 2006-2007, Lawrence Barker, Richard Crespo, Robert B. Gerzoff, Sharon Denham, Molly Shrewsberry, Darrlyn Cornelius-Averhart

Family and Community Health

Introduction

We compared the risk of diabetes for residents of Appalachian counties to that of residents of non-Appalachian counties after controlling for selected risk factors in states containing at least 1 Appalachian county.

Methods

We combined Behavioral Risk Factor Surveillance System data from 2006 and 2007 and conducted a logistic regression analysis, with self-reported diabetes as the dependent variable. We considered county of residence (5 classifications for Appalachian counties, based on economic development, and 1 for non-Appalachian counties), age, sex, race/ethnicity, education, household income, smoking status, physical activity level, and obesity to be independent variables. The classification “distressed” refers to …

Diabetes Alters Contraction-Induced Mitogen Activated Protein Kinase Activation In The Rat Soleus And Plantaris, Anjaiah Katta, Deborah L. Preston, Sunil K. Kakarla, Shinichi Asano, Sarath Meduru, Sriram P. Mupparaju, Ellie Yokochi, Kevin M. Rice, Devashish H. Desai, Eric R. Blough

MIIR Faculty Research

The prescription of anaerobic exercise has recently been advocated for the management of diabetes; however exercise-induced signaling in diabetic muscle remains largely unexplored. Evidence from exercise studies in nondiabetics suggests that the extracellular-signal-regulated kinases (Erk1/2), p38, and c-JUN NH2-terminal kinase (Jnk) mitogen-activated protein kinases (MAPKs) are important regulators of muscle adaptation. Here, we compare the basal and the in situ contraction-induced phosphorylation of Erk1/2- p38- and Jnk-MAPK and their downstream targets (p90rsk and MAPKAP-K2) in the plantaris and soleus muscles of normal and obese (fa/fa) Zucker rats. Compared to lean animals, the time course and magnitude of Erk1/2, p90rsk and …

Diabetes Alters Vascular Mechanotransduction: Pressure-Induced Regulation Of Mitogen Activated Protein Kinases In The Rat Inferior Vena Cava, Kevin M. Rice, Devashish H. Desai, Sunil K. Kakarla, Anjaiah Katta, Deborah L. Preston, Paulette Wehner, Eric R. Blough

MIIR Faculty Research

Background

Diabetes mellitus is an important risk factor for increased vein graft failure after bypass surgery. However, the cellular and molecular mechanism(s) underlying vessel attrition in this population remain largely unexplored. Recent reports have suggested that the pathological remodeling of vein grafts may be mediated by mechanically-induced activation of the mitogen activated protein kinase (MAPK) signaling pathways and the MAPK-related induction of caspase-3 activity. On the basis of these findings, we hypothesized that diabetes may be associated with alterations in how veins "sense" and "respond" to altered mechanical loading.

Methods

Inferior venae cavae (IVC) from the non-diabetic lean (LNZ) and …

The Zucker Rat As A Model Of Obesity-Hypertension, Ryan Morrison

Theses, Dissertations and Capstones

Hypertension is a serious health problem that affects approximately 1 in 4 American adults. Most cases are diagnosed as essential hypertension, meaning that the exact cause is unknown. In most patients, however, excess weight is a major contributory factor to the development of essential hypertension. The role of obesity in promoting hypertension is now well documented and has become the foundation for an entire field of research known alternately as obesity-hypertension, obesity-induced hypertension, or obesity-associated hypertension. In this field, rapid advances are being made in our understanding of how obesity and hypertension are linked. A plethora of related risk factors, …

West Virginia Registered Dietitians' Knowledge And Attitudes Of Diabetes Care, Marie R. Gravely

Theses, Dissertations and Capstones

This study addresses diabetes knowledge and attitudes of West Virginia dietitians as they relate to Medicare certified provider guidelines. A questionnaire was developed using the Diabetes Attitude Scale, questions from A CORE Curriculum for Diabetes Education, and demographic questions addressing length and type of practice, route to registration, and specialty credentials. Responses were analyzed to determine overall knowledge and attitude as well as how demographic information affects knowledge and attitude. Results indicated demographic information (except for specialty credentials and hours working with diabetes) did not have a significant effect on the dietitian’s diabetes knowledge and attitude. Specialty credentials did have …