Medicine and Health Sciences Commons^™

Exercise/Physical Activity In Individuals With Type 2 Diabetes: A Consensus Statement From The American College Of Sports Medicine, Jill A. Kanaley, Sheri R. Colberg, Matthew H. Corcoran, Steven K. Malin, Nancy R. Rodriguez, Carlos J. Crespo, John P. Kirwan, Juleen R. Zierath

OHSU-PSU School of Public Health Faculty Publications and Presentations

This consensus statement is an update of the 2010 American College of Sports Medicine position stand on exercise and type 2 diabetes. Since then, a substantial amount of research on select topics in exercise in individuals of various ages with type 2 diabetes has been published while diabetes prevalence has continued to expand worldwide. This consensus statement provides a brief summary of the current evidence and extends and updates the prior recommendations. The document has been expanded to include physical activity, a broader, more comprehensive definition of human movement than planned exercise, and reducing sedentary time. Various types of physical …

Clinical Characteristics Of Peripheral Neuropathy In Kenyan Patients With Hiv Infection Compared With Patients With Concurrent Hiv Infection And Diabetes Mellitus, Pascal Kuka, Jasmit Shah, Uazman Alam, Reena Shah, Dilraj Sokhi

Internal Medicine, East Africa

Introduction: Persons living with human immunodeficiency virus (HIV) are living longer and at risk of non-communicable diseases, including diabetes mellitus (DM). Both HIV and DM place patients at risk of peripheral neuropathy (PN). Our aim was to demonstrate the prevalence and characteristics of PN in our population of patients with HIV infection compared with concomitant HIV and DM.

Methods: A prospective cross-sectional study was performed at the Aga Khan Hospital in Nairobi, Kenya. Data were collected on demographics and characteristics of DM and HIV. Symptoms and signs of PN were evaluated by Neuropathy Symptom Score, Neuropathy Disability Score, …

A Narrative Review Of The Evidence For Variations In Serum 25-Hydroxyvitamin D Concentration Thresholds For Optimal Health, William B. Grant, Fatme Al Anouti, Barbara J. Boucher, Erdinç Dursun, Duygu Gezen-Ak, Edward B. Jude, Tatiana Karonova, Pawel Pludowski

All Works

Vitamin D3 has many important health benefits. Unfortunately, these benefits are not widely known among health care personnel and the general public. As a result, most of the world’s population has serum 25-hydroxyvitamin D (25(OH)D) concentrations far below optimal values. This narrative review examines the evidence for the major causes of death including cardiovascular disease, hypertension, cancer, type 2 diabetes mellitus, and COVID-19 with regard to sub-optimal 25(OH)D concentrations. Evidence for the beneficial effects comes from a variety of approaches including ecological and observational studies, studies of mechanisms, and Mendelian randomization studies. Although randomized controlled trials (RCTs) are generally considered …

Diabetic Care Pathway, Shalini Bansal, Kayla Brockmeyer, Nick Kieran

Physician Executive Leadership-Plus (PEL-Plus)

Presentation Outline

• The Impact of Diabetes
• Problem Statement
• Solution
• Looking to the Future

“If I Were To Suffer A Stroke Right Now, The First Place That I Should Be Taken To Is The Traditional Healer”: Community Beliefs And Health-Seeking Practices For Noncommunicable Diseases In Rural Kwazulu-Natal, South Africa, Herbert Chikafu, Innocent Tinashe Mutero Dr., Moses John Chimbari Prof.

The Qualitative Report

T

The burden of chronic noncommunicable diseases in rural South Africa is exacerbated by delayed health-seeking. This study explored awareness, beliefs and health-seeking behaviour relating to diabetes, hypertension and cardiovascular diseases in Ingwavuma, a poor rural community in the uMkhanyakude district of KwaZulu-Natal, South Africa. Eight gender and age-stratified Focus Group Discussions (FGD) were conducted in isiZulu using a pre-tested FGD guide with seventy-six participants. Thematic analysis was done to discern views on access to care for noncommunicable diseases. Findings revealed limited awareness of hypertension, diabetes, and cardiovascular-related disease burden. The community practices medical plurality, and consultation with traditional healers …

Dia.Ries, Katherine A. Doyle

Theses and Dissertations

dia.ries is a pilot episode of an episodic series that offers insight into the lives of a few of the 500 million people around the world with diabetes—otherwise normal, everyday people who happen to be living each day with an “invisible illness.” Produced through video diaries and other user-generated content, the series tells stories from first-person points of view along thematic lines, using a collaborative approach rooted in Third Cinema.

Care Coordination And Empowerment In People With Type 2 Diabetes, Erik M. Wilson

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

1. Background: In 2018, approximately one in seven Americans had been diagnosed with Type 2 Diabetes, a number that is projected to increase to one in three by 2050. Approximately 40% of individuals with Type 2 diabetes develop long-term complications, accounting for one-in-four healthcare dollars spent in the United States. Current initiatives supported through Accountable Care Organizations place an emphasis on improving the quality of care delivered in chronic medical problems such as diabetes to optimize patient outcomes, moving away from the traditional fee-for-service. One cornerstone of improving quality of care is care coordination and education.

1. Methods: Utilizing the Plan-Do-Study-Act methodology …

Weight Management Clinical Practice Guidelines For The Obese, Pre-Diabetic, And Diabetic Population, Dawn Williams

Walden Dissertations and Doctoral Studies

AbstractDiabetes is among chronic or lifestyle-related illnesses posing health care challenges at epidemic proportions, pressuring health care systems infrastructure for positive outcome-driven practices and sustainable costs, as continued research suggests that obese people are up to 80 times more likely to develop type 2 diabetes. In June 2021, a weight-loss and wellness center serving this high-risk population established recommended guidelines for Hemoglobin A1C (HbA1C) screening and education. During the initial 3 months of implementation, data findings captured 37% in a total of 220 with elevated HbA1C levels. The gap in practice is that the Wellness Center did not have a …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

Diabetes Self-Management Education In The Urban Low Socioeconomic Status Senior Population, Heather Santa Barbara

Walden Dissertations and Doctoral Studies

This exploratory quantitative study used a survey design to address a gap in the literature concerning primary care team perceptions about diabetes care for urban low socioeconomic status seniors with diabetes. Diabetes is a chronic health problem that is often managed in primary care offices, and primary care teams are often the first source of education and support for patients. Standards of management for seniors with diabetes has changed to eliminate tight control of glucose levels, and primary care team members may have differing perceptions about diabetes care depending upon their role in the primary care team and years of …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

Culturally Sensitive Carbohydrate Sources For Nepalese With Diabetes Or Prediabetes, Rachel Bombardier

Family Medicine Clerkship Student Projects

Over 8,000 refugees have started new lives in Vermont since 1980. Many of these people utilize the Community Health Centers of Burlington, for some this may be their first time navigating America's healthcare system. This is a daunting task due to a multitude of barriers, including missing cultural competencies in various aspects of their care. This project focuses on dietary recommendations for Nepalese patients with prediabetes and type 2 diabetes, specifically carbohydrate sources based on fiber content. Type 2 diabetes is a very prevalent chronic disease that costs Vermont $520 million each year. Understanding healthy food options in a culturally …

Home Exercise For Patients With Limited Access And Resources, Justin L. Esteban

Family Medicine Clerkship Student Projects

Patients with limited resources and who are socioeconomically disadvantaged, don’t have the time or resources available to partake/pursue exercise. Having a home workout program may prove to be beneficial to patients who don't have access to a gym, equipment, or are otherwise constrained by time.

Accessibility Of Nutritious And Healthy Foods To Older Adults, Kristen Wright

Family Medicine Clerkship Student Projects

Food insecurity rates are high among older adults who have chronic conditions and/or are homebound. These patients have functional limitations, comorbidities limiting their mobility, and often are socially isolated or live alone, all of which impact their ability to access or make healthy meals. As food insecurity rises, so do the health care costs related to inaccessibility to healthy food, involving the increased risk or prevalence of chronic conditions like hypertension, diabetes, and cancer. This project aimed to understand the barriers older adults face in accessing and making healthy meals, and to educate health care providers and patients on recognizing …

A Preoperative Intervention To Improve Glycemic Control In Surgical Patients With Diabetes, Kelsey L. Boyd

Graduate Theses, Dissertations, and Problem Reports

Perioperative hyperglycemia is reported in 20-40% of patients undergoing general surgery and is an independent risk factor for negative surgical outcomes. Patients with diabetes presenting to a local community hospital are at risk for negative surgical outcomes due to the lack of strategies to prevent perioperative hyperglycemia. This project aimed to implement and evaluate the usefulness of succinct diabetes education for preoperative total joint surgical patients with diabetes. The intervention was a nurse-led, face-to-face diabetes education session provided to total joint surgical patients with diabetes during a preoperative evaluation appointment, compared to usual care (no preoperative diabetes education). This project …

Thinking Inside The Food Pantry Box, Elizabeth Shoaf

Doctor of Nursing Practice Projects

Background: Prior research has indicated a varying relationship between food security and obesity risk. Food insecurity is a known complication of men and women’s underlying health issues, such as hypertension and diabetes, because of altered food choices.

Objective: Provide healthier food options to the food insecure within the facility’s food distribution boxes, as available, for the two most common health issues (diabetes and high blood pressure).

Methods: Clients at a local food pantry were interviewed individually to learn more about food insecurity and complicating health issues, such as obesity, diabetes, and high blood pressure (hypertension) while simultaneously offering alternative food …

Impact Of Public Health Nurse Training On Their Perception To Provide Hypertension And Diabetes Care To Patients In Their Communities., Stephen Goggans, Jean O'Connor, Elena A. Wood, Elizabeth Sacksteder Laclair, Kathryn Martin, Paul Wallach

Journal of the Georgia Public Health Association

To evaluate the impact of protocol training by a medical school and public health department on nurses’ perceptions to deliver care to patients with hypertension and diabetes.

Training was delivered using the Georgia Diabetes and Hypertension Nurse protocols for public health nurses. A survey was developed and distributed post training to participants. The training included lectures, workshops, case discussions, simulation, and physical examination practice on standardized patients. Participants were asked about perceptions, both before and after training completion regarding frequency in changing practice and confidence in treating hypertension and diabetes for six items.

Perceived levels of confidence for all questionnaire …

Adverse Childhood Events And Protective Health Behaviors Among Adults With Diabetes Or Diabetes With Comorbid Heart Disease, Ciara Michelle Rukse

Walden Dissertations and Doctoral Studies

Diabetes is a prevalent and costly chronic condition that can lead to other comorbid conditions such as heart disease. Disease management is essential but can be stressful and complicated, especially for individuals who have developed maladaptive behaviors in response to exposure to adverse childhood events (ACEs), which are chronic stressors that impact physiological and psychological development. There is limited research on the potential relationship between childhood adversity and engagement in protective health behaviors among U.S. populations with diabetes or diabetes with comorbid heart disease. The ACEs pyramid was the theoretical framework of this quantitative cross-sectional study concerning morbidity and early …

Nursing Staff Education On The Use Of The American Diabetes Association Guidelines, Terrie Hattie Allen

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus is a complex chronic condition that requires continuous care and management. Approximately 34 million Americans are diagnosed with diabetes and around 90%–95% suffer from Type 2 diabetes. The problem identified in this project was the need to follow the American Diabetes Association guidelines in place at the study site clinic but are not adhered to by the staff. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, the purpose of this project was to plan, implement, and evaluate a nursing staff education program on the use of the American Diabetes Association Guidelines for diabetes. …

Intermittent Fasting And Reduction Of Cardiovascular Disease Risk, Ethan Dekam

Theses and Graduate Projects

Background: Cardiovascular disease remains one of the leading causes of death worldwide. Intermittent fasting is a unique intervention that is beginning to be studied more extensively for weight loss, positive alterations in serum lipid profile, and improvement of insulin resistance which are all modifiable risk factors for the development of cardiovascular disease.

Purpose: The research question at the center of this literature review is: does the addition of intermittent fasting reduce the risk of developing cardiovascular disease? The reduction of cardiovascular disease was studied through alterations in weight, cholesterol, and diabetic labs.

Methods: A comprehensive literature review …

Tracking Home Blood Glucose Through Mychart, Zachary T. Osborn

Family Medicine Clerkship Student Projects

Self-monitoring of blood glucose (SMBG) is a crucial tool in the management of Type 1 and Type 2 diabetics on insulin, and for Type 2 Diabetics who are titrating medications and/or undergoing lifestyle changes. Patients often fail to bring in their SMBG readings (or monitor at all) for a variety of reasons, hindering efforts to adjust their therapy. This project sought to address this gap through educating patients and providers about the EPICs ability to track SMBG readings submitted through MyChart.

Preventive Medicine Screening Measures, Isaac Adams

Family Medicine Clerkship Student Projects

In order to make progress towards long-term health on a community level, it is imperative to address health needs on a population basis and using a preventive strategy to prevent the development of more serious illness. With this in mind, this project aimed to create a poster providing easy to understand information to patients with regard to health screenings. Specifically, it addressed screenings for diabetes and pre diabetes, colon cancer, lung cancer, and breast cancer.

Increasing Healthcare Delivery To The Abenaki People Through Health Screenings, Warrick Sahene

Family Medicine Clerkship Student Projects

Utilizing health screenings can increase the number of Abenaki individuals identified with comorbidities related to diabetes and hypertension. Education and resources for health maintenance are also provided to this patient population through physician counseling.

Increasing Rates Of Urine Albumin Creatinine Ratio Ordering By Providers In Diabetics In Adult Primary Care: A Quality Improvement Initiative, James Ehrlich

DNP Scholarly Projects

Background: The rising incidence of diabetes within the United States and worldwide has led to increased diabetes related morbidity and mortality. As the leading cause of end stage renal disease (ESRD), more attention needs to be placed on increasing rates of diabetic nephropathy screening. The vast majority of diabetics are treated in primary care, positioning primary care as a center focus for diabetes related screening and treatment.

Local problem: Low rates of diabetic nephropathy screening were noted at an academic medical center affiliated primary care clinic. A quality improvement initiative was elicited to increase the number of urine microalbumin creatine …

Frequency And Type Of Diabetes Screening Tests In A Sample Of Women With Polycystic Ovarian Syndrome: A Descriptive Study, Jacklyn Vollmer

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: Polycystic ovarian syndrome (PCOS) is a hormonal disorder that affects 6-12% of United States women of reproductive age. Women with PCOS are at an increased risk of developing type 2 diabetes and fall into high-risk groups for screening guidelines put out by the American College of Obstetricians and Gynecologists (ACOG). Guidelines further suggest that an oral glucose tolerance test (OGTT) be used for diabetes screening in women with PCOS as opposed to an A1C or fasting plasma glucose test. The purpose of this study is to examine rates and type of diabetes screening used among a sample of women …

Summary Of Diabetes Among Aboriginal And Torres Strait Islander People, Australian Indigenous Healthinfonet, Kathy Ride

Research outputs 2022 to 2026

This publication, in plain language, is based on information presented in the Review of diabetes among Aboriginal and Torres Strait Islander people (2022). This short, visual report summarises the key findings and concepts from the review to provide a holistic picture of diabetes among Aboriginal and Torres Strait Islander people. It is a quick source of information covering:

• the social and cultural context of diabetes, and the behavioural and biomedical factors that contribute to diabetes among Aboriginal and Torres Strait Islander people
• the extent of diabetes among Aboriginal and Torres Strait Islander people, including incidence and prevalence data; hospitalisations; mortality …

Severe Metformin-Associated Lactic Acidosis In The Setting Of Diabetic Nephropathy, Steven Nevers, Jared Lewis, Omer Farooq

Gulf Coast Division GME Research Day 2022

No abstract provided.

Tracking Home Blood Glucose Through Mychart, Zachary T. Osborn

Family Medicine Clerkship Student Projects

Self-monitoring of blood glucose (SMBG) is a crucial tool in the management of Type 1 and Type 2 diabetics on insulin, and for Type 2 Diabetics who are titrating medications and/or undergoing lifestyle changes. Patients often fail to bring in their SMBG readings (or monitor at all) for a variety of reasons, hindering efforts to adjust their therapy. This project sought to address this gap through educating patients and providers about the EPICs ability to track SMBG readings submitted through MyChart.

Tracking Home Blood Glucose Through Mychart, Zachary T. Osborn

Family Medicine Clerkship Student Projects

Self-monitoring of blood glucose (SMBG) is a crucial tool in the management of Type 1 and Type 2 diabetics on insulin, and for Type 2 Diabetics who are titrating medications and/or undergoing lifestyle changes. Patients often fail to bring in their SMBG readings (or monitor at all) for a variety of reasons, hindering efforts to adjust their therapy. This project aimed to address this issue by educating patients and attendings about EPIC's ability to log blood glucose measurements through MyChart.

Addressing Diabetes Education In Chittenden County, Varun Gupta

Family Medicine Clerkship Student Projects

The percent of adults in Chittenden County with diabetes who have received diabetes education was short of national goals. To gather more information about the problem, a NP and 2 diabetic patients were interviewed. A educational handout was created to address some of the concerns brought up that reflect some of the unmet educational needs.