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Evaluating Acceptability, Feasibility And Efficacy Of A Diabetes Care Support Program Facilitated By Cellular-Enabled Glucose Meters: A Dissertation, Daniel J. Amante Oct 2016

Evaluating Acceptability, Feasibility And Efficacy Of A Diabetes Care Support Program Facilitated By Cellular-Enabled Glucose Meters: A Dissertation, Daniel J. Amante

GSBS Dissertations and Theses

Background. Diabetes requires significant disease management, patient-provider communication, and interaction between patients, family members, caregivers, and care teams. Emerging patient-facing technologies, such as cellular-enabled glucose meters, can facilitate additional care support and improve diabetes self-management. This study evaluated patient acceptability, feasibility, and efficacy of a diabetes care support program facilitated by cellular-enabled glucose meters.

Methods. A two-phase study approach was taken. Get In Touch – Phase 1 (GIT-1) was a 1-month pilot involving patients with type 1 and type 2 diabetes. Get In Touch – Phase 2 (GIT-2) was a 12-month randomized controlled crossover trial involving patients with poorly-controlled type 2 diabetes ...


Long-Term Survival And Prognostic Factors In Patients With Acute Decompensated Heart Failure According To Ejection Fraction Findings: A Population-Based Perspective: A Master Thesis, Andrew H. Coles Aug 2014

Long-Term Survival And Prognostic Factors In Patients With Acute Decompensated Heart Failure According To Ejection Fraction Findings: A Population-Based Perspective: A Master Thesis, Andrew H. Coles

GSBS Dissertations and Theses

Limited data exists describing the long-term prognosis of patients with acute decompensated heart failure (ADHF) further stratified according to currently recommended ejection fraction (EF) findings. In addition, little is known about the magnitude of, and factors associated with, long-term prognosis for these patients. Based on previously validated and clinically relevant criteria, we defined HF-REF as patients with an EF value ≤40%, HF-PEF was defined as an EF value > 50%, and HF-BREF was defined as patients with an EF value during their index hospitalization between 41 and 49%. The hospital medical records of residents of the Worcester (MA) metropolitan area who ...


Local Macrophage Proliferation In Adipose Tissue Is A Characteristic Of Obesity-Associated Inflammation: A Dissertation, Shinya U. Amano Mar 2013

Local Macrophage Proliferation In Adipose Tissue Is A Characteristic Of Obesity-Associated Inflammation: A Dissertation, Shinya U. Amano

GSBS Dissertations and Theses

Obesity and diabetes are major public health problems facing the world today. Extending our understanding of adipose tissue biology, and how it changes in obesity, will hopefully better equip our society in dealing with the obesity epidemic. Macrophages and other immune cells accumulate in the adipose tissue in obesity and secrete cytokines that can promote insulin resistance. Adipose tissue macrophages (ATMs) are thought to originate from bone marrow-derived monocytes, which infiltrate the tissue from the circulation. Much work has been done to demonstrate that inhibition of monocyte recruitment to the adipose tissue can ameliorate insulin resistance. While monocytes can enter ...


Txnip Is A Mediator Of Er Stress-Induced Β-Cell Inflammation And Apoptosis: A Dissertation, Christine M. Oslowski May 2012

Txnip Is A Mediator Of Er Stress-Induced Β-Cell Inflammation And Apoptosis: A Dissertation, Christine M. Oslowski

GSBS Dissertations and Theses

Diabetes mellitus is a group of metabolic disorders characterized by hyperglycemia. The pathogenesis of these diseases involves β-cell dysfunction and death. The primary function of β-cells is to tightly regulate the secretion, production, and storage of insulin in response to blood glucose levels. In order to manage insulin biosynthesis, β-cells have an elaborate endoplasmic reticulum (ER).

The ER is an essential organelle for the proper processing and folding of proteins such as proinsulin. Proteins fold properly when the ER protein load balances with the ER folding capacity that handles this load. Disruption of this ER homeostasis by genetic and environmental ...


Contribution Of Wfs1 To Pancreatic Beta Cell Survival And Adaptive Alterations In Wfs1 Deficiency: A Dissertation, Bryan M. O'Sullivan-Murphy Apr 2012

Contribution Of Wfs1 To Pancreatic Beta Cell Survival And Adaptive Alterations In Wfs1 Deficiency: A Dissertation, Bryan M. O'Sullivan-Murphy

GSBS Dissertations and Theses

Diabetes mellitus comprises a cohort of genetic and metabolic diseases which are characterized by the hallmark symptom of hyperglycemia. Diabetic subtypes are based on their pathogenetic origins: the most prevalent subtypes are the autoimmune-mediated type 1 diabetes mellitus (T1DM) and the metabolic disease of type 2 diabetes mellitus (T2DM). Genetic factors are major contributory aspects to diabetes development, particularly in T2DM where there is close to 80% concordance rates between monozygotic twins. However, the functional state of the pancreatic β cell is of paramount importance to the development of diabetes. Perturbations that lead to β cell dysfunction impair insulin production ...


The Effect Of Glycemic Index And Glycemic Load On Glucose Control, Lipid Profiles And Anthropometrics Among Low-Income Latinos With Type 2 Diabetes: A Dissertation, Lauren A. Gellar Mar 2011

The Effect Of Glycemic Index And Glycemic Load On Glucose Control, Lipid Profiles And Anthropometrics Among Low-Income Latinos With Type 2 Diabetes: A Dissertation, Lauren A. Gellar

GSBS Dissertations and Theses

Background The incidence of type 2 diabetes has increased dramatically, particularly among Latinos. While several studies suggest the beneficial effect of lowering glycemic index and glycemic load in patients with type 2 diabetes, no data exists regarding this issue in the Latino population. The purpose of this study was to determine the effect of lowering glycemic index and glycemic load on diabetes control, lipid profiles and anthropometrics among Latinos with type 2 diabetes.

Methods Subjects participated in a 12 month randomized clinical trial. The intervention targeted diabetes knowledge, attitudes and behavioral capabilities related to diabetes self management with content including ...


Behavioral Health Disorders And The Quality Of Diabetes Care: A Dissertation, Yat (Gary) Hung Leung Mar 2010

Behavioral Health Disorders And The Quality Of Diabetes Care: A Dissertation, Yat (Gary) Hung Leung

GSBS Dissertations and Theses

Both diabetes and behavioral health disorders (mental and substance use disorders) are significant health issues in the United States. While previous studies have shown worse health outcomes in people with diabetes and co-occurring behavioral health disorders (BHDs) than those with diabetes alone, it is unclear whether the quality of diabetes care was poorer in the presence of co-occurring BHDs. Although previous research has observed a trend of positive outcomes in people with comprehensive diabetes care, there is a lack of evidence about whether that mode of care delivery can improve outcomes in people with co-occurring BHDs. Therefore, further studies are ...


Prediction, Prevention And Treatment Of Virally Induced Type 1 Diabetes: A Dissertation, Annie J. Kruger Apr 2009

Prediction, Prevention And Treatment Of Virally Induced Type 1 Diabetes: A Dissertation, Annie J. Kruger

GSBS Dissertations and Theses

Several viral infections have been associated with human type 1 diabetes (T1D), although it has proven difficult to unequivocally establish them as causative agents. In rodent models, however, viruses have definitely been established to cause T1D. The treatment of weanling BBDR rats with the combination of a TLR3 ligand, pIC, and an ssDNA parvovirus, KRV, precipitates T1D in nearly 100% of rats within a short, predictable timeframe. In this dissertation, we utilized the BBDR rat model to (1) identify early serum biomarkers that could predict T1D precipitated by viral induction and (2) test the efficacy of leptin, a therapeutic agent ...


Innate Immunity In Type 2 Diabetes Pathogenesis: Role Of The Lipopolysaccharide Signaling Cascade: A Dissertation, James L. Young Jul 2008

Innate Immunity In Type 2 Diabetes Pathogenesis: Role Of The Lipopolysaccharide Signaling Cascade: A Dissertation, James L. Young

GSBS Dissertations and Theses

Once seen as a disease of wealthy nations, type 2 diabetes mellitus is now showing unprecedented growth throughout the world, fueling increases in microvascular and macrovascular complications. A compelling and growing body of evidence suggests that glucose intolerance and insulin resistance, hallmarks of the diabetic patient, may be driven by chronic inflammation. In particular, a predominance of visceral fat has been associated with enhanced inflammatory cytokine secretion that may contribute to enhanced risk of diabetes and comorbid cardiovascular disease in these individuals. As a function of its potency and wide environmental and biological distribution, we hypothesized that bacterial lipopolysaccharide (LPS ...


The Role Of Endoplasmic Reticulum Stress Signaling In Pancreatic Beta Cells: A Dissertation, Kathryn L. Lipson May 2008

The Role Of Endoplasmic Reticulum Stress Signaling In Pancreatic Beta Cells: A Dissertation, Kathryn L. Lipson

GSBS Dissertations and Theses

Protein folding in the endoplasmic reticulum (ER) is essential for proper cellular function. However, the sensitive environment in the ER can be perturbed by both pathological processes as well as by physiological processes such as a large biosynthetic load placed on the ER. ER stress is a specific type of intracellular stress caused by the accumulation of immature or abnormal misfolded or unfolded proteins in the ER. Simply defined, ER stress is a disequilibrium between ER load and folding capacity. Cells have an adaptive response that counteracts ER stress called the "Unfolded Protein Response” (UPR). The ability to adapt to ...


Egr-2 And Pd-1 Are Required For Induction And Maintenance Of T Cell Anergy: A Dissertation, Kenneth D. Bishop Jul 2005

Egr-2 And Pd-1 Are Required For Induction And Maintenance Of T Cell Anergy: A Dissertation, Kenneth D. Bishop

GSBS Dissertations and Theses

The prevalence of diabetes is approaching epidemic proportions worldwide. There is currently no cure for type 1 diabetes, and successful treatment requires constant monitoring of blood sugars and use of exogenous insulin to prevent hyperglycemia. Diabetes will be curable when pancreatic β-islet cells can be transplanted into diabetes patients without requiring long-term immunosuppression. This will require learning more about the induction of functional tolerance, a state that maintains the competence of the immune system to most antigens but protects graft-specific antigens from immune rejection, permitting transplantation. One known mechanism of peripheral tolerance is T cell anergy, a phenotype of hypo-reponsiveness ...


Poly(Adp)-Ribose Polymerase Activity In The Eukaryotic Mono-Adp-Ribosyl Transferase, Art2: A Dissertation, Alan R. Morrison Sep 2003

Poly(Adp)-Ribose Polymerase Activity In The Eukaryotic Mono-Adp-Ribosyl Transferase, Art2: A Dissertation, Alan R. Morrison

GSBS Dissertations and Theses

The glycophosphatidylinositol(GPI)-linked membrane protein ART2 is an antigenic determinant for T lymphocytes that regulate the expression of diabetes in the BB/W rat model. Though little is understood of the physiologic role of ART2 on T lymphocytes, ART2 is a member of the mono-ADP-ribosyl transferase subgroup ofthe ADP-ribosyl transferase (ART) protein family. The ART protein family, which traditionally has been divided into mono-ADP-ribosyl transferases (mono-ARTs), poly(ADP)-ribose polymerases (PARPs), and ADP-ribosyl cyclases, influences various aspects of cellular physiology including: apoptosis, DNA damage repair, chromatin remodeling, telomere replication, cellular transport, immune regulation, neuronal function, and bacterial virulence. A ...


Role Of The Intestinal Immune System In The Pathogenesis Of Autoimmune Diabetes In The Bb Rat Model Of Type 1 Diabetes Mellitus, Derrick James Todd Jun 2001

Role Of The Intestinal Immune System In The Pathogenesis Of Autoimmune Diabetes In The Bb Rat Model Of Type 1 Diabetes Mellitus, Derrick James Todd

GSBS Dissertations and Theses

The intestine is the largest lymphoid organ in the body, challenged constantly by an enonnous quantity and diversity of antigens. Distinct from peripheral lymphocytes, intestinal lymphocytes have evolved unique mechanisms of tolerance and appear to govern mucosal processes such as "chronic physiologic inflammation" and oral tolerance. Failure of mucosal tolerance has been implicated in the pathogenesis of several diseases, including inflammatory bowel disease, celiac disease, and even autoimmune diabetes. One population of intestinal lymphocytes, intraepithelial lymphocytes (IELs), exists within the intestinal epithelium itself and remains poorly characterized. IELs respond to unique activation signals and appear to be in part responsible ...


Characterization Of The Hypersensitive Response Of Glycogen Phosphorylase To Catecholamine Stimulation In Primary Culture Diabetic Cardiomyocytes: A Thesis, Jo Ann Buczek-Thomas Aug 1992

Characterization Of The Hypersensitive Response Of Glycogen Phosphorylase To Catecholamine Stimulation In Primary Culture Diabetic Cardiomyocytes: A Thesis, Jo Ann Buczek-Thomas

GSBS Dissertations and Theses

The primary goal of my thesis research was to characterize the basis for the hypersensitive response of glycogen phosphorylase to catecholamine stimulation in primary culture diabetic cardiomyocytes. Toward this goal, I have investigated several key regulatory sites in this signaling pathway which could promote the hypersensitive activation of phosphorylase. Specifically, I investigated (1) which adrenergic receptors are involved in mediating the hypersensitive response of glycogen phosphorylase to epinephrine stimulation; (2) whether the presence of fatty acid metabolites affects phosphorylase activation; (3) whether the hypersensitive response of phosphorylase results from altered signal transduction through the β-adrenergic receptor system or from a ...