Medicine and Health Sciences Commons^™

Genetic Vulnerability To Diabetes And Obesity: Does Education Offset The Risk?, Sze Yan Liu, Stefan Walter, Jessica Daniel, David H. Rehkopf, Laura E. Kubzansky, M Maria Glymour

Sze Yan Liu

The prevalence of type 2 diabetes (T2D) and obesity has recently increased dramatically. These common diseases are likely to arise from the interaction of multiple genetic, socio-demographic and environmental risk factors. While previous research has found genetic risk and education to be strong predictors of these diseases, few studies to date have examined their joint effects. This study investigates whether education modifies the association between genetic background and risk for type 2 diabetes (T2D) and obesity. Using data from non-Hispanic Whites in the Health and Retirement Study (HRS, n = 8398), we tested whether education modifies genetic risk for obesity …

The Lifestyle Initiative: An Innovative Coaching-Based Quality Improvement Study To Improve The Health Of Aurora Health Care Caregivers And Family Members, Tiffany A. Mullen, Jessica J.F. Kram, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

Background: Self-management support has been shown to improve clinical outcomes. Health coaching, one form of self-management support, empowers patients within the health care system by providing information and through collaboratively developed care plans.

Purpose: Assess the impact of The Lifestyle Initiative, a coaching-based health program utilized by Aurora Health Care caregivers or family members.

Methods: The Lifestyle Initiative is a coaching-based approach for Aurora caregivers or family members enrolled in Aurora’s health insurance network. Individuals were recruited from the care management database, and all participants had an Aurora primary care provider. Participation was limited to those ≥ 18 years of …

Vitamin D Status And Demographic And Lifestyle Determinants Among Adults In The United States (Nhanes 2001-2006), Yan Cao, Katie L. Callahan, Sreenivas P. Veeranki, Yang Chen, Ying Liu, Shimin Zheng

Shimin Zheng

This study looked at risk factors associated with vitamin D levels in the body among a representative sample of adults in the U.S., NHANES III (2001-2006) data were used to assess the relationship between several demographic and health risk factors and vitamin D levels in the body. The Baseline-Category Logit Model was used to test the association between vitamin D level and the potential risk factors age, education, ethnicity, poverty status, physical activity, smoking, alcohol, obesity, diabetes and total cholesterol with both genders. Vitamin D insufficiency and deficiency were significantly associated with age, race, education, physical activity, obesity, diabetes and …

Decade-Long Trends (1999-2009) In The Characteristics, Management, And Hospital Outcomes Of Patients Hospitalized With Acute Myocardial Infarction With Prior Diabetes And Chronic Kidney Disease, Mayra Tisminetzky, David D. Mcmanus, Alon Dor, Ruben Miozzo, Jorge L. Yarzebski, Joel M. Gore, Robert J. Goldberg

Jorge L. Yarzebski

BACKGROUND: Despite the increasing magnitude and impact, there are limited data available on the clinical management and in-hospital outcomes of patients who have diabetes mellitus (DM) and chronic kidney disease (CKD) at the time of hospitalization for acute myocardial infarction (AMI). The objectives of our population-based observational study in residents of central Massachusetts were to describe decade-long trends (1999-2009) in the characteristics, in-hospital management, and hospital outcomes of AMI patients with and without these comorbidities.

METHODS: We reviewed the medical records of 6,018 persons who were hospitalized for AMI on a biennial basis between 1999 and 2009 at all eleven …

Impact Of The Heart Watch Program On Patients At Risk Of Developing Metabolic Syndrome, Prediabetes Or Cardiovascular Disease, Jennifer T. Fink, Kathryn K. Havens, Julia A. Schumacher, Renee E. Walker, George L. Morris Iii, David A. Nelson, Maharaj Singh, Ron A. Cisler

Maharaj Singh

Purpose

Metabolic syndrome is a set of metabolic risk factors associated with increased risk of developing cardiovascular disease and type 2 diabetes mellitus. We retrospectively evaluated the effectiveness of a lifestyle modification program (Heart WATCH) geared toward reducing development of chronic disease in women deemed at risk for metabolic syndrome, prediabetes and/or cardiovascular disease.

Methods

Our institution’s Heart WATCH program consists of screening sessions with a multidisciplinary team (physician/nurse, nutritionist and psychologist), a minimum of three visits with a nurse practitioner and weekly follow-up phone calls for a 14-week period. Sociodemographic variables were obtained at initial visit. Biometric testing indices …

Racial Disparities In Outcomes Following Kidney Transplantation: A Single-Center Experience, Vani Nilakantan, Maharaj Singh, Ruth M. Perez, Yang Shi, Ahmed Dalmar, Brittany T. Last, Ajay Sahajpal

Ahmed Dalmar, MD

Purpose

Kidney transplantation remains the best treatment option for end-stage renal disease. However, despite overall improvements in patient and graft survival rates after kidney transplantation, differences in outcomes still exist among different racial and ethnic groups, with African-Americans having lower graft survival. Gaps continue to exist in the understanding of how demographic factors contribute to the varying outcomes among racial/ethnic groups.

Methods

We retrospectively evaluated kidney transplant outcomes in four racial/ethnic groups over a 12-year period at a large tertiary care center. Primary and secondary study outcomes were patient and graft survival across groups. To determine factors that might predict …

Knowledge, Attitudes, Beliefs And Behaviors (Kabb) Of Diabetes Among Afro-Caribbeans Near Brooklyn, New York, Sophia Allen

Sophia I. Allen, Ph.D.

Diabetes is an epidemic in the U.S. that unduly affects minority groups. African Americans are more than two times as likely to die from diabetes than whites. Literature previously established that some population groups have a negative perception toward medical professionals and visiting a doctor's office and/or hospital when a health problem occurs. In New York City, where a large group of Afro-Caribbeans live, diabetes prevalence more than doubled over the past 10 years with over half a million adults diagnosed. Due to a gap in literature in the U.S. on type 2 diabetes among English-speaking Afro-Caribbeans, this study recruited …

Television Watching, Diet Quality, And Physical Activity And Diabetes Among Three Ethnicities In The United States, Fatma G. Huffman, Joan A. Vaccaro, Joel C. Exebio, Gustavo C. Zarini, Timothy Katz, Zisca Dixon

Joan A. Vaccaro

Diabetes is a world-wide epidemic associated with multiple environmental factors. Prolonged television viewing (TV) time has been related to increased risk of obesity and type 2 diabetes in several studies. TV viewing has been positively associated with cardiovascular disease risk factors, lower energy expenditure, over-eating high-calorie and high-fat foods. The objective of this study was to assess the associations of hours of TV viewing with dietary quality, obesity and physical activity for three ethnic minorities with and without type 2 diabetes. Diet quality and physical activity were inversely related to prolonged TV viewing. African Americans and participants with type 2 …

Healthy Eating Index And Alternate Healthy Eating Index Among Haitian Americans And African Americans With And Without Type 2 Diabetes, Fatma G. Huffman, Mauricio De La Cera, Joan A. Vaccaro, Gustavo C. Zarini, Joel C. Exebio, Deva Gundupalli, Lamya Shaban

Joan A. Vaccaro

Ethnicities within Black populations have not been distinguished in most nutrition studies. We sought to examine dietary differences between African Americans (AA) and Haitian Americans (HA) with and without type 2 diabetes using the Healthy Eating Index, 2005 (HEI-05), and the Alternate Healthy Eating Index (AHEI). The design was cross-sectional (225 AA, 246 HA) and recruitment was by community outreach. The eating indices were calculated from data collected with the Harvard food-frequency questionnaire. African Americans had lower HEI-05 scores (−8.67, 13.1); , than HA. Haitian American females and AA males had higher AHEI than AA females and HA males, respectively, …

Medical Advice And Diabetes Self-Management Reported By Mexican-American, Black- And White-Non-Hispanic Adults Across The United States, Joan A. Vaccaro, Daniel J. Feaster, Sandra L. Lobar, Marianna K. Baum, Marcia Magnus, Fatma G. Huffman

Joan A. Vaccaro

Background

Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and …

Postpartum Screening For Diabetes Among Medicaid-Eligible South Carolina Women With Gestational Diabetes, Nathan Hale, Janice Probst, Jihong Liu, Amy Martin, Kevin Bennett, Saundra Glover

Jihong Liu

No abstract provided.

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

Richard Crespo

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 …

The Relationship Between Coping Styles In Response To Unfair Treatment And Understanding Of Diabetes Self-Care, Michelle Dyke, Yendelela Cuffee, Jewell Halanych, Richard Mcmanus, Carol Curtin, Jeroan Allison

Richard H. McManus

Purpose This study examined the relationship between coping style and understanding of diabetes self-care among African American and white elders in a southern Medicare-managed care plan. Methods Participants were identified through a diabetes-related pharmacy claim or ICD-9 code and completed a computer-assisted telephone survey in 2006-2007. Understanding of diabetes self-care was assessed using the Diabetes Care Profile Understanding (DCP-U) scale. Coping styles were classified as active (talk about it/take action) or passive (keep it to yourself). Linear regression was used to estimate the associations between coping style with the DCP-U, adjusting for age, sex, education, and comorbidities. Based on the …

Are Podcasts Effective At Educating African American Men About Diabetes, Jarrett Johnson, Levi Ross, Walter Iwanenko, Judith Schiffert, Arup Sen

Levi Ross

Education is a critical component of the National Blueprint to eliminate racial disparities in diabetes. Research indicates that traditional methods of diabetes education has had limited effectiveness with minority populations and suggests that different educational approaches be explored. The purpose of the research was to explore the effectiveness of an emergent technology (podcast) for use in educating inner-city, African American men about diabetes prevention. Thirty African American men participated in self-administered, pretest-posttest surveys in August 2009. Surveys collected information on demographic characteristics, perceptions of diabetes, and diabetes knowledge. Paired samples t test was computed to evaluate pretest-posttest changes in overall …

Race-Ethnicity As An Effect Modifier Of The Association Between Hbalc And Mortality In U.S. Adults Without Diagnosed Diabetes, Katharina G. Kehl, Hannes M. Findeisen, David W. Fardo, Dennis Bruemmer, David M. Mannino, Wayne T. Sanderson

David M. Mannino

Objective

HbAlc is increasingly appreciated as a risk factor for all-cause and cardiovascular disease (CVD) mortality in the non-diabetic population. In this study, we investigated the association between HbAlc and mortality with a particular focus on the impact of race–ethnicity.

Design

Cohort study.

Methods

We analyzed the association between HbAlc and all-cause and CVD mortality in 12 698 non-diabetic adults 20 years or older from the Third National Health and Nutrition Examination Survey using separate models for people of different race–ethnicity.

Results

In our stratified analyses, higher non-diabetic HbAlc levels were associated with all-cause and CVD mortality in non-Hispanic whites …

Using Multiple Sources Of Data To Assess The Prevalence Of Diabetes At The Subcounty Level, Duval County, Florida, 2007, William C. Livingood, Luminita Razaila, Elena Reuter, Rebecca Filipowicz, Ryan C. Butterfield, Katryne Lukens-Bull, Linda Edwards, Carlos Palacio, David L. Wood

David L. Wood

Event Rates, Hospital Utilization, And Costs Associated With Major Complications Of Diabetes: A Multicountry Comparative Analysis, Philip M. Clarke, Paul Glasziou, Anushka Patel, John Chalmers, Mark Woodward, Stephen B. Harrap, Joshua A. Salomon

Paul Glasziou

Background: Diabetes imposes a substantial burden globally in terms of premature mortality, morbidity, and health care costs. Estimates of economic outcomes associated with diabetes are essential inputs to policy analyses aimed at prevention and treatment of diabetes. Our objective was to estimate and compare event rates, hospital utilization, and costs associated with major diabetes-related complications in high-, middle-, and low-income countries.

Methods and Findings: Incidence and history of diabetes-related complications, hospital admissions, and length of stay were recorded in 11,140 patients with type 2 diabetes participating in the Action in Diabetes and Vascular Disease (ADVANCE) study (mean age at entry …

Estudo Longitudinal De Saúde Do Adulto -Elsa-Brasil [English], Paulo A. Lotufo

Paulo A Lotufo

Presentation update on September, 2011.

The Role Of Body Mass Index And Diabetes In The Development Of Acute Organ Failure And Subsequent Mortality In An Observational Cohort, Katarina Slynkova, David M. Mannino, Greg S. Martin, Richard S. Morehead, Dennis E. Doherty

David M. Mannino

Introduction

Several studies have shown a correlation between body mass index (BMI) and both the development of critical illness and adverse outcomes in critically ill patients. The goal of our study was to examine this relationship prospectively with particular attention to the influence of concomitant diabetes mellitus (DM).

Methods

We analyzed data from 15,408 participants in the Atherosclerosis Risk in Communities (ARIC) study for this analysis. BMI and the presence of DM were defined at baseline. We defined 'acute organ failure' as those subjects who met a standard definition with diagnostic codes abstracted from hospitalization records. Outcomes assessed included the …

Screening At Worksite Applying The Framingham Heart Study Score., Paulo A. Lotufo

Paulo A Lotufo

The first evaluation of class of occupation and cardiovascular risk factors in a Brazilian sample of civil servants. 1) context: Cardiovascular diseases are the main causes of death in Brazil. The high-risk approach to cardiovascular risk factors by screening test at worksite is one possible strategy of prevention. 2) objective: to verify the impact of a risk factors screening according to occupational levels. 3) type of study: cross-sectional 4) setting: occupational division of University of Sao Paulo 5) participants: 6,587 employees aged 20 to 69 years-old classified according three occupational grades (non-skilled, both manual and non-manual jobs; technical; faculty). 6) …

Diabetes And All-Cause And Coronary Heart Disease Mortality Among Us Male Physicians, Paulo A. Lotufo, Joann E. Manson

Paulo A Lotufo

Background: While diabetes has long been associated

with increased risk of coronary heart disease (CHD), the

magnitude of risk of diabetes-related CHD is uncertain.

Objective: To evaluate the impact of diabetes and prior

CHD on all-cause and CHD mortality.

Methods: In a prospective cohort study of 91 285 US

male physicians aged 40 to 84 years, participants were

divided into 4 groups: (1) a reference group of 82 247

men free of both diabetes and CHD (previous myocardial

infarction and/or angina) at baseline, (2) 2317 men

with a history of diabetes but not CHD, (3) 5906 men

with a history …

Alcohol Consumption And Risk Of Coronary Heart Disease By Diabetes Status, Paulo A. Lotufo

Paulo A Lotufo

Background—An inverse association between moderate alcohol consumption and coronary heart disease (CHD) has been observed in several epidemiological studies. To assess whether a similar association exists among diabetics, we examined the relation between light to moderate alcohol consumption and CHD in men with and without diabetes mellitus in a prospective cohort study. Methods and Results—A total of 87 938 US physicians (2790 with diagnosed diabetes mellitus) who were invited to participate in the Physicians’ Health Study and were free of myocardial infarction, stroke, cancer, or liver disease at baseline were followed for an average of 5.5 years for death with …