Medicine and Health Sciences Commons^™

Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso

Master's Projects and Capstones

Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.

Context: The endocrinology clinic serves a patient population, …

Decreasing Surgical Complications In Diabetic Patients, Bandana Mahato

DNP Qualifying Manuscripts

Executive Summary

Objective: This manuscript aims to determine if controlling diabetes prior to undergoing low back surgery could decrease complications and disability.

Contexts: Despite the overwhelming information on the complications of uncontrolled diabetes, patients continue to have elevated HgA1C before having surgery. Furthermore, there is a plethora of data showing uncontrolled diabetic patients will have higher complications after surgery, yet patients continue to have elective surgery despite having unchecked diabetes. There are no clear guidelines for primary care providers or surgeons on when they should allow patients to have elective surgery. Therefore, it is vital that HgA1c needs to be …

Exploring The Relationship Between Diabetes, Diabetes Risk, Depressive Symptoms, Chronic Stress, And Inflammatory Markers In Mexican-American Men, Aleli Fernandez

Open Access Theses & Dissertations

Background: Individuals with depression and stress are 60% more likely to develop type 2 diabetes compared to those without (Mezuk et al., 2008). Moreover, biological pro-inflammatory markers associated with psychosocial stress are risk factors for diabetes. Examining the relationship between psychological disorders, inflammation, and diabetes risk among MAH is important as they have high rates of diabetes.

Purpose: To examine the relationship between 1) depressive symptoms, chronic stress, and inflammatory markers, 2) inflammation and diabetes risk factors and 3) depression, stress, inflammation, diabetes risk, and metabolic syndrome (MetS).

Methods: A cross-sectional study of 100 adult men from El Paso, Texas …

Using Empowerment Theory To Improve Understanding Of Type 2 Diabetes Mellitus In Haitian American Women, Balkys Bivins, Brenda Owusu, Indra R Hershorin, Tony Umadhay, Janet Joseph, Arvinder Singh

Nursing & Health Sciences Research Journal

Introduction: The CDC (2020) revealed that the age-adjusted prevalence of diabetes mellitus in the United States among the Black, non-Hispanic population is 16.8%. A study conducted by Bivins et al. (2021) revealed a 39% prevalence of type 2 diabetes mellitus (T2DM) among Haitian Americans (HAs) living in several states. In the literature, HAs are often grouped with Black Americans, yet Haitian American women (HAW) have unique struggles with treatment and management of T2DM. No prior study used the empowerment theory to improve the management of T2DM in HAW. Purpose: To improve the understanding of T2DM in HAW using empowerment theory. …

Investigation Of Heterocyclic Amines And N-Acetyltransferase 2 Genetic Polymorphism In The Dysregulation Of Hepatic Energy Homeostasis: A Gene-Environment Approach., Kennedy M Walls

Electronic Theses and Dissertations

Heterocyclic amines (HCAs) are mutagens generated when cooking meat for prolonged periods of time or until well-done. Recent epidemiological studies reported significant associations between dietary HCA exposure and insulin resistance and type II diabetes. However, no previous studies have examined if HCAs, independent of meat consumption, contributes to pathogenesis of insulin resistance or metabolic disease. It is well known that HCAs require hepatic bioactivation by cytochrome P450 1A2 (CYP1A2) and N-acetyltransferase 2 (NAT2). NAT2 expresses a well-defined genetic polymorphism in humans that, depending on the combination of NAT2 alleles, correlate to rapid, intermediate, or slow acetylator phenotypes that exhibit differential …

Geospatial Distribution Of Pharmacist Diabetes Management Within A Patient Centered Medical Home Model In Omaha, Nebraska, Anthony Donovan

Capstone Experience

Patients with uncontrolled diabetes, defined as a hemoglobin A1c value greater than 9%, are at an increased risk of diabetes progression. Primary care is often the first point of contact where patients with uncontrolled diabetes are identified and treated. Pharmacists are utilized in diabetes medication management of patients with uncontrolled diabetes as one component of primary care multidisciplinary models of care. This descriptive project describes the geospatial distribution of patients with uncontrolled diabetes from a single institution in the Omaha, Nebraska area who were exposed to pharmacists within a Patient Centered Medical Home (PCMH) model of care compared to those …

Data-Driven Decision Support Tool Co-Development With A Primary Health Care Practice Based Learning Network, Jacqueline K. Kueper, Jennifer Rayner, Sara Bhatti, Kelly Angevaare, Sandra Fitzpatrick, Paulino Lucamba, Eric Sutherland, Daniel J. Lizotte

Epidemiology and Biostatistics Publications

Background: The Alliance for Healthier Communities is a learning health system that supports Community Health Centres (CHCs) across Ontario, Canada to provide team-based primary health care to people who otherwise experience barriers to care. This case study describes the ongoing process and lessons learned from the first Alliance for Healthier Communities’ Practice Based Learning Network (PBLN) data-driven decision support tool co-development project.

Methods: We employ an iterative approach to problem identification and methods development for the decision support tool, moving between discussion sessions and case studies with CHC electronic health record (EHR) data. We summarize our work to date in …

Enhancing Diabetes Care With Peer Mentorship And Support Groups, Barry Mccann Bsn, Rn

Posters & Presentations

Poster presented at the Parkview Nursing Research Symposium, 2023.

Continued increase in prevalence of type 2 diabetes indicates need for more effective interventions to support lifestyle and behavior changes (ADA 2018).

• Evidence indicates attending diabetes self management education programs can improve diabetes outcomes, unfortunately they are often under referred and underutilized (Powers et al. 2015, Boakye et al. 2018).

• Limited class times, locations, and capacities can make attendance for all patients difficult and vulnerable populations are less likely to participate (Boakye et al. 2018).

• Diabetes education programs often lack culturally and individually relevant guidance, provide no long-term …

Global Variation In Diabetes Diagnosis And Prevalence Based On Fasting Glucose And Hemoglobin A1c, Ncd Risk Factor Collaboration (Ncd-Risc), Bin Zhou, Kate E. Sheffer, James E. Bennett, Edward W. Gregg, Goodarz Danaei, Rosie K. Singleton, Jonathan E. Shaw, Gladys Maestre, Jesus D. Melgarejo

School of Medicine Publications and Presentations

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed …

Cgm Use With Interprofessional Therapy Management Improves Hba1c Levels In T2dm Patients, Stephen R. Hill, Courtney Robertson, Teri B. O'Neal, Sonia Garner

Journal of Interprofessional Practice and Collaboration

Background

Type 2 Diabetes Mellitus (T2DM) is a chronic disease state with increased complications over time from uncontrolled glucose. Significant data has shown benefits of continuous glucose monitoring (CGM) in reducing glycated hemoglobin (HbA1c) levels of Type 1 Diabetes Mellitus (T1DM) patients, but a lack of robust evidence is seen in T2DM. This study assessed the impact of short-term CGM placement on HbA1c levels in T2DM.

Objectives

The primary outcome was the change in baseline HbA1c levels in patients with T2DM up to six months after CGM placement. Secondary outcomes assessed intensification of diabetes medications made by an interprofessional team …

Reduced Risk Of Dementia In Patients With Type 2 Diabetes Mellitus Using Chinese Herbal Medicine: A Nested Case-Control Study, Hou-Hsun Liao, Hanoch Livneh, Hua-Lung Huang, Jui-Yu Hung, Ming-Chi Lu, How-Ran Guo, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Dementia is a prevalent condition in type 2 diabetes mellitus (T2DM) patients. While Chinese herbal medicine (CHM) is often employed as complementary therapy for glycemic control, its effect in controlling likelihood of dementia has not yet been fully elucidated. AIM To compare the risk of dementia between T2DM patients with and without CHM treatment. METHODS We undertook a nested case-control study and obtained data on patients 20-70 years of age who received medical care for T2DM between 2001 and 2010 from the National Health Insurance Research database in Taiwan. Cases, defined as those with dementia that occurred at least one …

Diabetes-Associated Hyperglycemia Causes Rapid-Onset Ocular Surface Damage, Judy Weng, Christopher Ross, Jacob Baker, Saleh Alfuraih, Kiumars Shamloo, Ajay Sharma

Pharmacy Faculty Articles and Research

Purpose: The metabolic alterations due to chronic hyperglycemia are well-known to cause diabetes-associated complications. Short-term hyperglycemia has also been shown to cause many acute changes, including hemodynamic alterations and osmotic, oxidative, and inflammatory stress. The present study was designed to investigate whether diabetes-associated hyperglycemia can cause rapid-onset detrimental effects on the tear film, goblet cells, and glycocalyx and can lead to activation of an inflammatory cascade or cellular stress response in the cornea.

Methods: Mouse models of type 1 and type 2 diabetes were used. Tear film volume, goblet cell number, and corneal glycocalyx area were measured on …

Putting The Dietary Guidelines For Americans Into Action Through The National Strategy On Hunger, Nutrition, And Health, Rachel Fischer, Katrina L. Piercy, Janet M. De Jesus, Paul Reed, Rachel L. Levine

Journal of Food Law & Policy

The United States is facing a crisis of widespread food insecurity and exceedingly high rates of diet-related diseases like diabetes, obesity, and hypertension. To address this challenge and set a course for improved nutrition and food access nationwide, the Biden-Harris Administration hosted the first White House Conference on Hunger, Nutrition, and Health in over 50 years on September 28, 2022. In the National Strategy, released in conjunction with the Conference, the Administration identified a set of actions that the federal government will take to help achieve its goal of ending hunger and increasing healthy eating and physical activity by 2030, …

Special Issue: Hunger, Nutrition, And Health, Susan Rice

Journal of Food Law & Policy

Everyday millions of Americans face barriers to accessing food, housing, and other supports–––making the impossible decision of whether to put food on the table or cover other essential needs. Food insecurity and diet-related diseases, such as heart disease and diabetes, affect people of all ages and in all communities. It was for this reason that the Biden-Harris Administration hosted the White House Conference on Hunger, Nutrition, and Health in September 2022. As the President said at the Conference, “No child should go to bed hungry. No parent should die of a disease that can be prevented.” It will require all …

Tuberculosis Presentation And Outcomes In Older Hispanic Adults From Tamaulipas, Mexico, Belinda Medrano, Miryoung Lee, Gretchen L. Gemeinhardt, Javier E. Rodríguez-Herrera, Moncerrato García-Viveros, Blanca I. Restrepo

School of Medicine Publications and Presentations

Older people are at high risk of developing and dying from pulmonary infections like tuberculosis (TB), but there are few studies among them, particularly in Hispanics. To address these gaps, we sought to identify host factors associated with TB and adverse treatment outcomes in older Hispanics by conducting a cross-sectional study of TB surveillance data from Tamaulipas, Mexico (2006–2013; n = 8381). Multivariable logistic regressions were assessed for older adults (OA ≥65 years) when compared to young (YA, 18–39 years) and middle-aged adults (40–64 years). We found that the OA had features associated with a less complicated TB (e.g., lower …

Exploring Transfer Learning In Chest Radiographic Images Within The Interplay Between Covid-19 And Diabetes, Muhammad Shoaib, Nasir Sayed, Babar Shah, Tariq Hussain, Ahmad Ali Alzubi, Sufian Ahmad Alzubi, Farman Ali

All Works

The intricate relationship between COVID-19 and diabetes has garnered increasing attention within the medical community. Emerging evidence suggests that individuals with diabetes may experience heightened vulnerability to COVID-19 and, in some cases, develop diabetes as a post-complication following the viral infection. Additionally, it has been observed that patients taking cough medicine containing steroids may face an elevated risk of developing diabetes, further underscoring the complex interplay between these health factors. Based on previous research, we implemented deep-learning models to diagnose the infection via chest x-ray images in coronavirus patients. Three Thousand (3000) x-rays of the chest are collected through freely …

A Case Of Chorea-Hemiballism In The Presence Of Labile Glucose Levels, Bhargavi Akkineni, Karina Torres

Research Colloquium

Introduction: Uncontrolled blood glucose is notorious for inflicting multi-organ pathologies. One such pathology, chorea-hemiballism, has been reported in individuals who exhibited either hyperglycemia or hypoglycemia, and although rare, it is debilitating and calls for active management.

Case Description: A 50-year-old female, with a past medical history of anemia, chronic kidney disease, type 2 diabetes mellitus, and hypertension, presented to the emergency room with acute onset chorea-hemiballism. Patient reported experiencing abnormal movements for two weeks prior to her ER visit, but otherwise denied prior episodes of movement disorders. On physical examination, patient displayed generalized jerky choreiform movements of upper and …

Quality Improvement Project To Assist In Implementation Of Prediabetes Screen Protocol, Kyai Forney

Doctoral Projects

Prediabetes is a reversible condition that causes blood glucose levels to be higher than normal, but not high enough to be diagnosed as type 2 diabetes. When one has prediabetes, the cells in the body do not respond normally to insulin, and insulin acts like a key to letting blood sugar into cells to use energy. The pancreas produces insulin to try to get the cells to respond, but eventually, the pancreas has a challenging time keeping up, and the blood sugar level rises causing prediabetes (Lehrman, 2021). A person can have prediabetes for years with no obvious symptoms, so …

Diabetes Risk During Pregnancy Among Second-Generation Immigrants: A National Cohort Study In Sweden, Per Wändell, Xinjun Li, Nouha Saleh Stattin, Axel C Carlsson, Jan Sundquist, Casey Crump, Kristina Sundquist

Journal Articles

BACKGROUND AND AIMS: Gestational diabetes is more common in many first-generation immigrant women in Europe and other Western countries. Less is known about second-generation immigrant women; such knowledge is needed to understand generational influences on diabetes risk. We aimed to study second-generation immigrant women regarding the presence of all types of diabetes during pregnancy.

METHODS AND RESULTS: A cohort study was conducted using the Swedish National Birth Register, the National Patient Register, and the Total Population Register. We used Cox regression analysis to compute hazard ratios (HRs) and 99% confidence intervals (99% CI) for any diabetes during pregnancy and specific …

Tuberculosis In Elderly Hispanics: Bcg Vaccination At Birth Is Protective Whereas Diabetes Is Not A Risk Factor, Julia M. Scordo, Genesis P. Aguillón-Durán, Doris Ayala, Ana P. Quirino-Cerrillo, Eminé Rodriguez-Reyna, Francisco Mora-Guzmán, Jose A. Caso, Eder Ledezma-Campos, Larry Schlesinger, Jordi B. Torrelles, Joanne Turner, Blanca I. Restrepo

Research Symposium

Background. Aging increases the risk of tuberculosis (TB) and its adverse outcomes, but most studies are based on secondary analyses, and few are in Hispanics. Diabetes is a risk factor for TB in adults, but its contribution in the elderly is unknown. We aimed to identify the role of diabetes and other risk factors for TB in elderly Hispanics.

Methods. Cross-sectional study among newly-diagnosed TB patients, recent contacts (ReC), or community controls (CoC) totaling 646 participants, including 183 elderly (>60 years; 43 TB, 80 ReC, 60 CoC) and 463 adults (18 to 50 years; 80 TB, 301 …

Enhancing Appropriate Statin Therapy In Type 2 Diabetic Patients Aged Between 40-75 Years At Graduate Medical Education (Gme) Internal Medicine Clinic, Adriana Betancourth Alvarenga, Ans Albustamy, Ayesha Khan, Steffi Sathiyaraj, Nghia Nguyen, Martha Solis, Rodolfo Garza-Morales, Oscar Lopez, Yilen Karen Ng-Wong, Hector Arredondo, Andres R. Suarez Parraga

Research Symposium

Background: The prevalence of type 2 diabetes mellitus (T2DM) is significantly higher in Rio Grande Valley than the rest of the United States. T2DM patients have an elevated risk of Atherosclerotic cardiovascular disease (ASCVD), and clinical trials have demonstrated the beneficial effects of statin therapy on ASCVD. A quality-improvement project was implemented in the GME Internal Medicine (IM) Clinic at Doctors Hospital at Renaissance to improve statin therapy appropriateness.

Methods: T2DM patients aged 40-75 were selected from the GME IM Clinic visits from July 2021 to October 2021 for baseline data and from January 2022 to April 2022 after implementing …

Effectiveness Of Intervention Studies Based On Diet And/Or Physical Activity In Treatment, Prevention, And Management Of Diabetes Among South Asians: A Systematic Review, Ishaan Arora

Theses and Dissertations

The purpose of this study was to describe diet and/or physical activity-based interventions and their control in cardiometabolic risk factors of diabetes for the South Asian (SA) population. A systematic review was conducted in accordance with the PRISMA guidelines. Seventeen randomized control trials meeting the inclusion criteria were included for analysis. Interventions with type-2 diabetic SA showed significant improvements in HbA1c% (4/5 studies), fasting blood glucose (3/4 studies), and postprandial glucose (2/2 studies). Interventions with at-risk/prediabetic and non-diabetic SA showed a modest change in overall outcomes, with significant change reported for post-prandial insulin (3/4 studies), BMI and weight (2/4 studies), …

Spatial Epidemiology Of Prediabetes And Diabetes In Florida, Md Marufuzzaman Khan

Doctoral Dissertations

The burden of diabetes and diabetes-related Emergency Department (ED) visits has increased in Florida. However, Diabetes Self-management Education (DSME) Program participation remained considerably low. Little is known about disparities of DSME participation, diabetes complications, and ED use by diabetes patients in Florida and yet this information is important for guiding health programs aimed at reducing diabetes burden. Therefore, the objectives of this study were to investigate: (a) disparities of diabetes prevalence and DSME participation; (b) disparities of diabetes-related ED visit risks; and (c) prevalence and predictors of stroke among persons with prediabetes and diabetes.

Behavioral Risk Factor Surveillance System and …

In Vitro And In Vivo Diabetic Models For Assessment Of Tissue Engineered Vascular Grafts, Juan Carlos Carrillo Garcia

All Dissertations

Diabetes has become one of the leading causes of lower-limb loss worldwide. Every 30 seconds, a person loses a limb due to diabetic-related vascular complications. About one-third of patients needing lower-limb bypass surgery have debilitated autologous vessels unsuitable for use, and no other good long-term options are available. These detrimental effects on the vasculature are caused mainly by the hyperglycemic and hyperlipidemic conditions derived from diabetes. Under these conditions, an increase in advanced glycation end products (AGEs) and reactive oxygen species leads to irreversible crosslinks of extracellular matrix proteins, accelerating vascular pathology through vascular stiffening, endothelial dysfunction, inflammation, atherosclerosis, fibrosis, …

Respecting Tribal Voices In The Development Of A Gestational Diabetes Risk Reduction Preconception Counseling Program For American Indian/Alaska Native Adolescent Females: A Qualitative Study, Kelly R. Moore, Sarah Stotz, Martha Ann Terry, Ellen Seely, Kelly Gonzales, Gale Marshall, Jay Nadeau, Aletha Akers, Yesenia Garcia-Reyes, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background American Indians and Alaska Natives (AI/AN) are disproportionately affected by adolescent obesity, adolescent pregnancy and gestational diabetes mellitus (GDM). GDM is associated with increased risk for perinatal death, obesity, and subsequent type 2 diabetes (T2D) for the offspring. Moreover, mothers with GDM are also at increased risk for T2D post-partum. Yet few lifestyle interventions exist to reduce GDM risk prior to pregnancy. We describe the process of adapting an existing validated preconception counseling intervention for AI/AN adolescent girls at-risk for GDM and their mothers. Perspectives and recommendations were gathered from a diverse array of stakeholders to assure the new …

The Prevalence Of Diabetes In Juveniles, Tatyana Johnson

Graduate Student Dissertations, Theses, Capstones, and Portfolios

Diabetes mellitus, simply known as diabetes, is a metabolic disorder that impacts how the body makes use of glucose or blood sugar. Glucose is the primary supply of energy for the body’s cells, which is controlled by insulin, a pancreatic hormone. Diabetes results in high blood glucose levels (hyperglycemia), which are caused by either insufficient insulin production by the pancreas or ineffective insulin utilization by the body (Dean & McEntyre, 2004). Although there are several types of diabetes, the two main types are type 1 and type 2. Type 1, also known as juvenile diabetes, is an inflammatory condition in …

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 …

The Impact Of Culture On Health Perceptions And Help-Seeking Behaviors Among Older Latinos With Co-Occurring Diabetes And Depression: A Literature Review, Alejandra M. Aguirre

McNair Research Journal SJSU

Diabetes is one of the most common health disparities in the United States today and disproportionately affects older Latino populations. Increased recognition of the bidirectional relationship between diabetes and mental health has led to more awareness and treatments for diabetes and depression. Despite high prevalence rates, diabetes and depression are commonly undiagnosed and untreated in older Latinos. Existing literature reports that factors including genetic and behavioral factors, low socioeconomic status (SES), limited healthcare access, and language barriers may prevent this population from seeking professional treatment. Prior research also suggests that culturally based stigma toward these conditions can negatively impact health …

Editorial: Physiology And Pathology Of Neuroglia, Daniel Reyes-Haro, Alejandro Lopez-Juarez, Adrián Rodríguez-Contreras

Health & Biomedical Sciences Faculty Publications and Presentations

Neuroglia is the largest population of cells in the brain and participates in formation, maintenance, and modulation of synaptic circuits. This heterogenous group includes macroglia (astroglia and oligodendroglia) and microglia. Neurons and neuroglia form assemblies that potentiate the cognitive capability of the brain. In this topic, nine articles highlight structural and functional roles of neuroglia in brain physiology, which is fundamental to better understand the biology of neurodevelopmental and neurodegenerative diseases.

Our understanding of brain connectivity evolves rapidly and the cytoarchitecture of underexplored brain regions such as the cerebellum need to be revisited (De Zeeuw et al., 2021). …

Editorial: Physiology And Pathology Of Neuroglia, Daniel Reyes-Haro, Alejandro Lopez-Juarez, Adrián Rodríguez-Contreras

Health & Biomedical Sciences Faculty Publications and Presentations

Neuroglia is the largest population of cells in the brain and participates in formation, maintenance, and modulation of synaptic circuits. This heterogenous group includes macroglia (astroglia and oligodendroglia) and microglia. Neurons and neuroglia form assemblies that potentiate the cognitive capability of the brain. In this topic, nine articles highlight structural and functional roles of neuroglia in brain physiology, which is fundamental to better understand the biology of neurodevelopmental and neurodegenerative diseases.

Our understanding of brain connectivity evolves rapidly and the cytoarchitecture of underexplored brain regions such as the cerebellum need to be revisited (De Zeeuw et al., 2021). …