Medicine and Health Sciences Commons^™

Diabetes Related Distress And Co-Occurrence With Depressive Symptoms In Urban Low-Income African American And Hispanic/Latinx Adults With Type 2 Diabetes, Laurie Ruggiero, Sarah Williams Leng, Mary De Groot, Ben S. Gerber, Rosalba Hernandez, Lauretta Quinn

Journal of Health Disparities Research and Practice

Introduction. Burden of diabetes in the U.S. is greater in racial-ethnic minority populations than non-Hispanic Whites. Depression and diabetes-related distress (DRD) are recognized as relatively common and important psychosocial areas to address in people living with diabetes. Limited research in the U.S. has focused on DRD in racial-ethnic minority populations. The purpose of this study is to describe patterns of DRD and co-occurrence with depressive symptoms in urban low-income African American and Hispanic/Latinx adults with type 2 Diabetes Mellitus (T2DM).

Method. We examined the baseline data collected for a randomized clinical trial (RCT) studying the impact of a culturally tailored …

Telehealth In Patients With Type 2 Diabetes Mellitus, Saghi Nassrouie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Description: Type 2 diabetes mellitus (DM2) is an epidemic that has many factors involved in its management to maintain control. Patients with DM2 require routine evaluations and blood work to provide comprehensive care. COVID-19 caused major shifts in traditional care which sparked an increase in the utilization of technology like telehealth. Telehealth can be an effective tool used to manage diabetes and help attain better glucose control, but its effectiveness during the COVID-19 pandemic warrants further investigation.Purpose: The purpose of this project was to determine if telehealth visits were more effective in reducing Hemoglobin A1c (HbA1c) in adult patients with …

Preoperative Maximization To Reduce Complications In Spinal Surgery, Sukanta Maitra, Christopher Mikhail, Samuel K. Cho, Michael D. Daubs

School of Medicine Faculty Publications

Study design: Invited narrative review. Objectives: The aim of this review was to summarize current literature regarding risk factors that surgeons can optimize in the preoperative setting in the spinal surgery patient, in order to reduce complications and improve patient-reported outcomes. Methods: Review of the relevant literature by the authors. Results: Modifiable risk factors identified relative to the patient include obesity, malnutrition/nutrient deficiency, diabetes/hyperglycemia, preoperative anemia, vitamin D/DEXA (dual-energy radiograph absorptiometry), nicotine use/smoking, and opioid use/psychosocial factors. Conclusion: By maximizing a patient's physiological and psychological status prior to elective spine surgery, we may move closer to achieving the goals of …

An Evaluation Of Factors Associated With The Perceptions Of Diabetes In A Filipino American Sample Residing In Clark County, Nevada, Lawrence Nartatez Sagadraca

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study assessed beliefs about the contribution of the Filipino diet and genetics to diabetes burden and its ability to control it without medical interventions. The data from a need’s assessment survey of 200 Filipino Americans residing in Clark County, Nevada, were analyzed by using the logistic regression model. A significant proportion of the participants believed that diabetes is a problem in the Filipino community (79%) and is related to the Filipino diet (75%) and genetics (69.0%), and that it can be controlled without medical intervention (52.4%). In univariate analyses, age (Odds ratio [OR]: 1.03, 95% confidence interval [CI]: 1.01 …

Home Base Care Approach To Reduce Disparity In Diabetes Care In Zuni Indians, Eun Hee Choi, Donica Ghahate, Jeannette Bobelu, Vernon Pankratz, Vallabh Shah

Journal of Health Disparities Research and Practice

Purpose/Background: We conducted a randomized clinical intervention trial of a home-based kidney care program to examine its efficacy in adult Zuni Indians with Chronic Kidney Disease (CKD). We evaluated the results of the study in the subset of participants with type 2 diabetes (T2DM) to determine the degree to which this intervention influenced the engagement of those with T2DM in the management of their own health circumstances.

Materials & Methods: We randomized participants by household to receive usual care or home-based care. After initial lifestyle coaching, the intervention group received frequent additional reinforcement by community health representatives (CHRs) about adherence …

Assessment Of Childhood Obesity Prevalence And Prevention Efforts In A Wisconsin Tribal Community, Simone Tucker, Lauren Lamers, Mph, Phd

Journal of Health Disparities Research and Practice

American Indian children experience disproportionately high rates of obesity, yet tribal communities often lack capacity to utilize local obesity data to guide prevention efforts. It is estimated the prevalence of childhood obesity in a Wisconsin tribal community and identified local school-based obesity prevention initiatives. Height and weight data were collected for children ages 2-19 years through routine screenings at local Head Start centers and schools. Weight status was determined based on BMI percentile according to year 2000 CDC growth charts.

Summary statistics and chi-square tests were generated to examine differences in obesity prevalence by age and gender. An environmental scan …

Depression In Those With Diabetes, Jaidyn Probst, Darin Prescott, Dnp, Mba, Rn, Stacy Hammer, Rdn, Ld

Journal of Health Disparities Research and Practice

In the United States, depression and diabetes collide with greater frequencies in American Indian/Alaskan Native communities, with 15% of those with diabetes suffering from depression. Often, providers cannot describe the emotional effects of being diagnosed with a chronic illness, such as diabetes, to the patient. Diabetes bingo is a place of information and support for those with diabetes in the Lower Sioux Indian Community (LSIC). The group was given surveys during their once-monthly bingo session held by the Lower Sioux Health Care Center Dietitian. We hypothesize that the social and emotional support from peers is what drives members of the …

Exploring Vanadium Chemical Transferrin Mimetic Compounds For Insulin Enhancement, Amanda Feliciano, Arthur D. Tinoco, Ph.D., Sergio A. Loza

Journal of Health Disparities Research and Practice

Diabetes Mellitus (DM) is caused by a lack of insulin production (Type 1) or the body’s cells’ inability to properly receive it, also known as insulin resistance (Type 2), resulting in greatly elevated levels of blood glucose. Vanadium(IV) and vanadium(V) ions are believed to enhance insulin activity by inhibition of protein tyrosine phosphatase 1B (PTP1B). PTP1B is normally responsible for downregulating the insulin signaling, but in DM type 2, PTP1B activity is overexpressed leading to the insulin signaling blocking. The most promising V(IV) compounds are designed for oral delivery: they are absorbed into the gut and delivered into the bloodstream …

Predictors And Missed Opportunities For Blood Glucose Screening Among African Americans: Implications For Church-Based Populations, Alexandria G. Bauer, Jannette Berkley-Patton, Carole Bowe Thompson, Kelsey Christensen

Journal of Health Disparities Research and Practice

African Americans (AAs) are disproportionately diagnosed with prediabetes, diabetes, and related complications. Guidelines for prediabetes/diabetes screening emphasize reaching at-risk adults. The AA church has potential to increase reach of BGS with AA church members and community members. The current study identified predictors of blood glucose screening (BGS) and individuals with missed opportunities for BGS among church-affiliated AA adults. Participants were drawn from a previous pilot study (Project Faith Influencing Transformation) conducted in six AA churches over eight months. Eligibility criteria included self-identifying as AA and being aged 18 or older. Participants who had previously been diagnosed with diabetes were excluded, …

Cardio-Metabolic Disease Risk Factors Among South Asian Labour Migrants To The Middle East: A Scoping Review And Policy Analysis, Shiva Raj Mishra, Saruna Ghimire, Chandni Joshi, Bishal Gyawali, Archana Shrestha, Dinesh Neupane, Sudesh Raj Sharma, Yashashwi Pokharel, Salim S. Virani

Public Health Faculty Publications

This paper aims to explore the burgeoning burden of cardiovascular and metabolic disease (CMD) risk factors among South Asian labor migrants to the Middle East. We conducted a qualitative synthesis of literature using PubMed/Medline and grey literature searches, supplemented by a policy review of policies from the South Asian countries. We found a high burden of cardio-metabolic risk factors among the migrants as well as among the populations in the home and the host countries. For example, two studies reported the prevalence of diabetes mellitus (DM) ranging between 9 and 17% among South Asian migrants. Overweight and obesity were highly …

Examining The Impact Of Race And Rurality On Health Differences Among Overweight Youth Accessing Pediatric Endocrinology Care, Kelsee Halpin, Janelle R. Noel-Macdonnell, Yun Yan

Journal of Health Disparities Research and Practice

Methods: This study examines the impact of race and rurality on health differences, including prevalence of prediabetes and type 2 diabetes (T2D), among overweight children accessing pediatric endocrine specialty care. Cross-sectional analysis of overweight/obese youth 10 to 18 years of age receiving pediatric endocrinology consultation for weight gain, hyperglycemia, and/or T2D from 2013 to 2016 at a Midwest tertiary pediatric center.

Results: The 722 patients were 42% white, 25% black, 22% Hispanic; 88% lived in urban areas and 12% in rural areas. Rurality was determined using zip code approximation of Rural-Urban Commuting Area (RUCA) codes. After adjusting for confounders, black …

Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu

Journal of Health Disparities Research and Practice

Background: In the US, the percentage of adults with diagnosed diabetes are higher in members of racial and ethnic minority groups compared to non-Latino Whites. Understanding why such disparities exist has been less forthcoming.

Methods: Secondary data analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) 1999-2000 cross-sectional data.

Results: H.pylori seropositivity was highest in Mexican Americans (43.7%), lowest in non-Hispanic Whites (18.1%). Diabetes was highest in non-Hispanic Blacks (5.9%); lowest in non-Hispanic whites (4.3%). H.pylori seropositivity was associated with greater likelihood of having type 2 diabetes (1.927, 95% CI 1.142, 3.257) compared to H.pylori negative in …

The Role Of Pre-Existing Type 2 Diabetes Mellitus In Colorectal Cancer Stage And Survival In Elderly Americans: A Seer-Medicare Population-Based Study 2002-~2011, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Diabetes is a common comorbid condition among colorectal cancer (CRC) patients, yet its effects in CRC outcomes, particularly stage at diagnosis, risk of death and variations by diabetes severity (complications vs no complications) and Hispanic ethnicity have not been adequately studied. The purpose of this study was to investigate the association between pre-existing T2DM and advanced stage at diagnosis in elderly patients with CRC; to examine whether diabetes is an independent predictor of poor survival from all-cause and CRC-specific mortality; to assess whether variations exist by diabetes severity and to analyze the outcomes for the Hispanic group.

The Surveillance Epidemiology …

An Evaluation Of Gabab Receptors On Modulating Neuroinflammation In A Non-Transgenic Animal Model Of Alzheimer's Disease, Monica Bolton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by progressive memory loss and distinct neuropathological hallmarks, including amyloid beta plaques and neurofibrillary tau tangles (NFT). Although the etiology remains to be discovered, several risk factors exist that significantly contribute to developing AD. Diabetes is one of the major risk factors associated with AD and is characterized by disrupted insulin signaling that may contribute to or exacerbate AD pathologies. Furthermore, both disorders result in increased neuroinflammation. Considerable evidence has demonstrated that a chronic inflammatory response, in particular chronic microglia activation, promotes A production as well as the hyperphosphorylation of tau through …

The Effects Of An Acute Bout Of Exercise On Hunger Hormones In Individuals At Risk For Type 2 Diabetes, Sydney Spoon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Hunger hormone levels are typically dysregulated in obese and diabetic

populations, however; postprandial exercise has been shown to influence hunger hormone levels. Purpose: To determine if hunger hormones including acylated ghrelin and GLP-1 levels are altered in response to an acute bout (15 minutes) of walking in individuals at risk for type 2 diabetes mellitus (T2DM).

Methods: Ten subjects at risk for prediabetes (fasting blood glucose 100–125mg/dL) participated in this randomized crossover design trial. Subjects arrived at the laboratory following an overnight fast and underwent one of two conditions: 1) Test meal with no walking (CON) or 2) Test …

Acceptability And Feasibility Of Web-Based Diabetes Instruction For Latinos With Limited Education And Computer Experience, Sharon A. Fitzgerald, Victor E. Martinez-Zavala, Kenia Yazmin Reyna Blanco, A Paula Cupertino, Mugur V. Geana, Edward F. Ellerbeck

Journal of Health Disparities Research and Practice

Introduction: The internet offers an important avenue for developing diabetes self-management skills, but many Latinos have limited experience with computer-based instruction.

Objective: To evaluate the feasibility and acceptability of delivering a web-based diabetes education program in a computer classroom for Spanish-speaking Latinos.

Methods: Spanish-speaking Latinos (n=26) attended two classroom sessions to learn computer skills while navigating a web-based diabetes education platform. Diabetes knowledge was assessed before and after the intervention; structured interviews were completed to assess program acceptability.

Results: Half of participants (50%) had not previously used a computer. Post-intervention, diabetes knowledge improved significantly (p=.001). The majority of participants (86%) …

Addressing Diabetes Prevention At The American Indian Summer Medical Wellness Camp, Mahpiya Vanderbilt, Francine Gachupin, Phd, Mph

Journal of Health Disparities Research and Practice

American Indian youth ages 10-19 are nine times more likely of being diagnosed with type 2 diabetes compared to non-Hispanic whites. A family history of diabetes, being overweight, and being inactive are the main risk factors for type 2 diabetes. The American Indian Summer Medical Wellness Camp is a six day camp for American Indian youth where they are taught about nutrition and fitness in an effort to prevent diabetes. What I looked at is if students who have attended the camp in previous years make different choices than the youth who have never attended camp. I hypothesize that if …

An Intervention To Promote Navajo Gardening, Nutrition, And Community Wellness, Sonia Avitia, Mark C. Bauer, Phd, Linda Garcia

Journal of Health Disparities Research and Practice

The rates of diabetes and obesity in Navajo communities are higher than national rates. A healthy diet of fresh fruits and vegetables will help to prevent and reduce such rates. So the project focuses on promoting gardening to make vegetables and fruits more accessible at the comfort of one’s own home. Previous research in this area shows that gardeners consume 2 more servings of fruits and vegetables than nongardeners. Thirty participants were recruited by flyer distribution at chapter houses, senior centers, and community centers, from four Navajo targeted areas: Shiprock, NM; Tsaile, AZ; Lukachukai, AZ, and Hogback, NM. With the …

Prescription Drug Costs: Does Neighborhood Matter?, Abigayle Alexander, Lisa M. Lapeyrouse, Phd

Journal of Health Disparities Research and Practice

The price of pharmaceuticals can impact one’s ability to purchase needed medication(s). If one cannot afford necessary prescriptions the resulting medication noncompliance can lead to further health complications, increasing the risk of disability, disease progression, and mortality (Mojtabai & Olfson, 2003; Sherbourne, Hays, Ordway, DiMatteo, & Kravitz, 2010).

In this research study we aim to answer two questions: (1) Is there a relationship between neighborhood characteristics (population size, race/ethnic composition, median income, and crime) and access to pharmacies?; and (2) Is there a relationship between neighborhood characteristics and pharmaceutical prices? Using 2009-2013 American Community Survey Data, Census block group data …

Traditional Medicine As A Treatment For Type Ii Diabetes Mellitus, Ronalei Ronny, Christopher U. Kitalong, Phd

Journal of Health Disparities Research and Practice

Diabetes is a common life-long health condition. It is a serious and costly metabolic disease which is now one of a growing concern in the whole world including the Republic of Palau. There are two main types of diabetes: Type I diabetes and type II diabetes mellitus (T2DM). People living with diabetes may have to deal with short-term or long-term complications as a result of their condition. Short-term complications include hypoglycaemia diabetic ketoacidosis (DKA), and hyperosmolar hyperglycaemic state (HHS). Long-term complications include how diabetes affects your eyes (retinopathy), heart (cardiovascular disease), kidneys (nephropathy), and nerves and feet (neuropathy). In the …

Effectiveness Of Traditional Treatments Of Diabetes In Pohnpei, Federated States Of Micronesia, Sonsha Padock, Nacanieli Tuivavalagi, Phd, Fredson Ardos, As, Jackson Philip, Bs, Paul Dacanay, Md

Journal of Health Disparities Research and Practice

Diabetes is the second leading cause of death in Pohnpei – next only to heart disease. However, households in Pohnpei are struggling to make ends meet and find it difficult to afford hospital treatments. The objective of this study is to assess the effectiveness of selected traditional treatment methods for diabetes using local plant products. We hypothesize that the traditional treatment methods of diabetes could also be effective.

Data was collected through interviews and discussions with 17 diabetic patients who have undergone different forms of treatments, and with five medical practitioners. Effects of five treatments were explored: lime and lemon …

Unhealthy Eating Habits In The Marshall Islands Result From Deteriorating Reef Systems, Josephine Lalita, Lyla Lemari, Aa

Journal of Health Disparities Research and Practice

Small Island nations such as the Marshall Islands (RMI) have limited resources. In order to provide food to its population of about 60,000, the Marshallese have had to replace traditional food with foreign imports. A result of this is the prevalence of obesity and non-communicable diseases (NCDs). The most common NCD is diabetes. Diabetic patients are encouraged to follow strict diets that include mostly traditional, local food such as fish; however, because of environmental factors, fish populations are threatened.

The objective of this study was to understand the relationship between healthy reefs, healthy fish populations and the health of communities …

Aspartame: An Investigation Of The Use Of Artificial Sweeteners, Carlson John, Alvin Page, Bsc

Journal of Health Disparities Research and Practice

Aspartame is an artificial, non-saccharide sweetener used as a sugar substitute in many foods and beverages. Aspartame is two hundred times sweeter than regular sugar. Many people prefer to use artificial sweeteners like aspartame as it does not affect blood sugar in the same way as natural sweeteners, does not promote tooth decay, and has been shown to be beneficial in weight control. However, it has also been linked with the development or aggravation of diabetes mellitus, convulsions, headaches, depression, hypertension, arthritis, and other medical conditions. We hypothesize that natural sweeteners are healthier than artificial sweeteners, like Splenda.

Artificial sweeteners …

Developing Registered Nurse Competency In Diabetes Care, Elizabeth Ortiz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: As the cost of health care continues to climb in the United States, hospitals are seeing longer lengths of stay and associated costs resulting from the complications of diabetes mellitus (DM). Registered nurses (RNs) play a critical role in caring for patients with DM. Rapid changes in the care of DM require continuing education on the current trends and the use of evidence-based practices to prevent hypoglycemia as a serious complication of lowering blood glucose levels. This doctoral project assessed the knowledge levels of RNs caring for patients with DM in the hospital setting.

Methods: Eighty-five RNs …

Facilitators And Barriers To Type 2 Diabetes Self-Management Among Rural African American Adults, Dina Byers, Katy Garth, Dana Manley, Diane Chlebowy

Journal of Health Disparities Research and Practice

Purpose: The purpose of this study was to identify facilitators and barriers to self-management of type 2 diabetes mellitus (T2DM) among African American adults living in rural communities. Research indicates that African Americans experience higher rates of T2DM and diabetes-related complications than other ethnic groups. In Kentucky, diabetes is now the fourth leading cause of death by disease among African Americans.

Methods: Twenty-two African American adults with T2DM were recruited from three churches in rural communities in Kentucky. Three focus groups were conducted to identify factors that made managing diabetes easier (facilitators) and factors that made managing diabetes more …

The Impact Of Shift Work On Diabetes Self-Management Activities, Daniel Navarro

UNLV Theses, Dissertations, Professional Papers, and Capstones

In the United States 26 million people are affected by diabetes, which can result in microvascular and macrovascular complications. As a consequence, once a person is diagnosed with diabetes, aggressive clinical management is imperative to minimize poor glycemic control’s devastating outcomes. However, for some patients reaching optimum blood glucose levels is challenging due to the complexity of diabetes’ care. In order for patients with diabetes to achieve good blood glucose control, they must engage in self-care activities that include routine blood glucose checks, dietary control, physical activity, and routine medical provider visits, simultaneously with their medication regimen. Diabetes associated self-care …

Effective Smoking Cessation Methods Among Smokers With Diabetes In Nv, Salome Kapella-Mshigeni, Eunice Kimunai, Peter Anderson, Elizabeth Fildes, Tam Villar

Nevada Journal of Public Health

Smoking and diabetes could both be prevented if individuals would abstain from smoking, eat healthy, and exercise regularly. Smokers with diabetes have an increased risk of serious health outcomes, hence effective smoking cessation interventions are critical. The transtheoretical model was used in this quantitative study analyzing secondary data from the state of Nevada Quitline to examine the relationships between smoking cessation method (counseling versus counseling and medication) and quitting smoking for 720 smokers with/without diabetes. Participants were Nevada residents, ages 18+, men and women, English or Spanish speakers. Descriptive statistics, logistic regression, and a test of two proportions were conducted. …

The Effect Of Acute Lps-Induced Immune Activation And Brain Insulin Signaling Disruption In A Diabetic Model Of Alzheimer's Disease, Andrew Scott Murtishaw

UNLV Theses, Dissertations, Professional Papers, and Capstones

Alzheimer's disease (AD) is a neurodegenerative disorder marked by progressive cognitive impairments and pathological hallmarks that include amyloid plaques, neurofibrillary tangles, and neuronal loss. Several well-known mutations exist that lead to early-onset familial AD (fAD). However, these cases only account for a small percentage of total AD cases. The vast majority of AD cases are sporadic in origin (sAD) and are less clearly influenced by a single mutation but rather some combination of genetic and environmental risk.

The etiology of sAD remains unclear but numerous risk factors have been identified that increase the chance of developing AD. Among these risk …

Healthcare Access And Health Outcomes In Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

In a publication from the Robert Woods Johnson Foundation, it was recognized that a person’s zip code was a more important predictor of health than their genetic code. Where we live influences not only our access to health care, but other health indicators as well. Clark County has a low primary care physician to population ratio compared to other counties in Nevada and in the US. Clark County also has highest rates of uninsured in the Mountain West and among the highest in the nation.

Southern Nevada fared worse than other Mountain West Metropolitan areas in health indicators and preventative …

Effects Of Anti-Inflammatory Foods On Hyperglycemia In Type-1 Diabetics, Primrose Martin, Michelle Chino

McNair Poster Presentations

Based on a case study administered by Dr. Charlotte Gerson, an IDDM patient referred to as R.H. reversed hyperglycemic symptoms within ten weeks while adhering to a diet of mainly vegetables and some low-glycemic index fruits. R.H. also ingested mineral supplements and underwent multiple coffee enemas each day (Gerson & Bishop, 2007, p. 56). This self-study hypothesizes that diet alone has a positive correlation coefficient with hyperglycemic blood glucose levels in type-1 diabetics (IDDM). Conducting this self-study contributes information to the limited research and database of alternative methods for managing IDDM hyperglycemia, and provides candid documentation of the effects that …