Medicine and Health Sciences Commons^™

Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin

Masters Theses/Capstone Projects

Poster presentation on the prevention of obesity related morbidity and mortality in adults.

Formalized Diabetes Self-Management Education In A Safety-Net Clinic, Emanpreet Kaur

Culminating Experience Projects

Diabetes is a complex and chronic illness requiring continuous medical care with multifactorial risk reduction strategies (American Diabetes Association [ADA], 2021). More than 37 million Americans are suffering from diabetes and 90% of them have Diabetes Mellitus Type 2 (DMT2) (Centers for Disease Control and Prevention, 2021). The purpose of this article is to review the background, an organizational assessment, a literature review, and the results of the quality improvement project that took place at a safety-net clinic in the Midwest. This project included 16 patients and data was analyzed through descriptive statistics. Results include improved hemoglobin (Hg) A1c, Body …

Comparing The Health Care Resource Utilization And Medication Adherence Of People With Epilepsy And People With Diabetes By Insurance Status, Nikole Hoffman, Gerald Shoultz, Sarah Nechuta

Culminating Experience Projects

Background: Epilepsy is one of the most common neurological diseases worldwide; diabetes is a chronic metabolic disease that affects how the body produces and uses insulin. Prescribed medications are vital for controlling these and other chronic diseases by minimizing severe health issues, which can be affected by insurance type and status. Consequences of non-adherence include uncontrolled blood glucose in people with diabetes and uncontrolled seizures in people with epilepsy. We aimed to compare the healthcare resource utilization and medication adherence of people with epilepsy and people with diabetes by insurance status. Methods: Data was from the 2021 National …

Technology-Mediated Diabetes Prevention Program (Dpp) Benchmark Project, Devon Senical

MSN Capstone Projects

This benchmark project intends to broaden access to the Diabetes Prevention Program (DPP) by offering technology-mediated content at the primary care level because the Primary Care Physician (PCP) predominantly diagnoses prediabetes due to the recommendation by The U.S. Preventive Services Task Force (USPSTF) that nonpregnant overweight or obese adults aged 35 to 70 be screened for prediabetes and type 2 diabetes (Davidson et al., 2021). Thus, the primary care setting is the first opportunity to impact the conversion from prediabetes to type 2 diabetes. Of the 84 million people in the United States (U.S.) with prediabetes, they are estimated to …

Importance And Impact Of Diabetes Education On People With Diabetes, Nicole R. Glasco

MSN Capstone Projects

This paper aims to explain the significance and importance of why it is essential to offer patients with diabetes standardized education regarding their diabetes.

The Impact Of County Level Characteristics On Type 2 Diabetes Related Ed Utilization, Jessica Wilson

MUSC Theses and Dissertations

Approximately 90-95% of the more than 37 million American adults who are living with diabetes have type 2 diabetes. Additionally, those living in rural areas face poor health outcomes related to chronic diseases such as diabetes. The impact of factors related to social determinants of health such as the role of rurality and social vulnerability were described by examining county diabetes related Emergency Department (ED) visit rates for adults aged 18-25 living in North Carolina. No difference in county level diabetes related ED visits were observed between rural counties vs. nonrural counties in the state. However, patterns did emerge in …

Improving Adherence To Annual Diabetes Guidelines In Rural Primary Care, Ashley Barney

Culminating Experience Projects

Background: The American Diabetes Association (ADA) (2022) identifies comorbidity risk assessments and treatment planning as key health maintenance components for diabetic patients. However, many providers do not adhere to the recommended national guidelines (Brenner et al., 2020).

Objectives: At a rural primary care clinic, the effectiveness of implementing a checklist was evaluated to improve provider adherence to the annual diabetes guidelines set by the ADA.

Methods: A quality improvement project was initiated and guided by the Lean Six Sigma framework. The checklist was implemented to assess if providers adhered to the recommended annual diabetes guidelines. The project …

The Experiences Of American Indian Participants And Site Coordinators In A Gestational Diabetes Risk Reduction Trial, Sarah Stotz, Kelly L. Gonzales, Kelly R. Moore, Heather Garrow, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Gestational diabetes mellitus is the most common complication of pregnancy and contributes to increased risk for type 2 diabetes in both the mother and offspring. We developed and evaluated a gestational diabetes risk reduction and preconception counseling program, Stopping GDM (SGDM), for American Indian females. The purpose of this study is to examine the experiences of American Indian mother-daughter dyad participants and the site coordinators who facilitated the SGDM randomized controlled trial to inform program revisions. We engaged mother-daughter dyads (n = 22 dyads) and site coordinators (n = 6) in focus group interviews. Four themes emerged: (1) …

The Effects Of Carbohydrate Counting On Hemoglobin A1c Levels In Adult Diabetics, Dillon Moore

Anna Vaughn School of Nursing Doctor of Nursing Practice (DNP) Projects

Diabetes is one of the most prevalent disease processes in the world. Approximately 537 million people have diabetes (International Diabetes Federation, 2021). Hemoglobin A1C levels are used to monitor overall blood glucose control in three-month increments. If the hemoglobin A1C can be lowered, the person should achieve better blood glucose control. Since carbohydrates are the main contributor to blood glucose, this project’s goal is to determine if carbohydrate counting via Cornerstones4Care Meal Planning and Carb Counting booklet (Cornerstones4Care, 2021) (Appendix A) will help diabetics achieve a lower hemoglobin A1C. Data were collected from a retrospective chart review during a five-year …

Cardiovascular Risk Of Metabolically Healthy Obesity In Two European Populations: Prevention Potential From A Metabolomic Study, Dongmei Wei, Vannina González Marrachelli, Jesus D. Melgarejo, Chia-Te Liao, Angie Hu, Stefan Janssens, Peter Verhamme, Lucas Van Aelst, Thomas Vanassche, Josep Redon

School of Medicine Publications and Presentations

Background

A new definition of metabolically healthy obesity (MHO) has recently been proposed to stratify the heterogeneous mortality risk of obesity. Metabolomic profiling provides clues to metabolic alterations beyond clinical definition. We aimed to evaluate the association between MHO and cardiovascular events and assess its metabolomic pattern.

Methods

This prospective study included Europeans from two population-based studies, the FLEMENGHO and the Hortega study. A total of 2339 participants with follow-up were analyzed, including 2218 with metabolomic profiling. Metabolic health was developed from the third National Health and Nutrition Examination Survey and the UK biobank cohorts and defined as systolic blood …

Improving Annual Diabetic Foot Examinations At A Rural Primary Care Clinic, Michaela Moore, Shannon Harris, Christy Mnzava

Poster Presentations

The goal of this quality improvement project was to increase the number of adult patients who receive an annual diabetic foot examination through the education and training of clinicians and support staff.

Food Insecurity In Youth And Young Adults With Diabetes: Prevalence And Association With Health Behaviors, Lauren Helene Martini

Theses and Dissertations

Given the life-long impact of diabetes(1-5), it is important to engage in behaviors that promote health and wellness to delay or prevent negative health outcomes(3, 6-10). Despite this, youth and young adults with diabetes generally do not adhere to nutritional(11-17) or physical activity(18, 19) recommendations. In households experiencing financial difficulties, especially those who are having difficulty providing sufficient food to all of its members, adhering to recommendations may be even more difficult.

The purpose of this dissertation is to better understand and contextualize food insecurity among youth and young adults (YYA) with youth-onset T1DM and T2DM. The first aim addresses …

A Nutritional Biomarker Score Of The Mediterranean Diet And Incident Type 2 Diabetes: Integrated Analysis Of Data From The Medley Randomised Controlled Trial And The Epic-Interact Case-Cohort Study, Jakub G. Sobiecki, Fumiaki Imamura, Courtney R. Davis, Stephen J. Sharp, Albert Koulman, Jonathan M. Hodgson, Marcela Guevara, Matthias B. Schulze, Ju Sheng Zheng, Claudia Agnoli, Catalina Bonet, Sandra M. Colorado-Yohar, Guy Fagherazzi, Paul W. Franks, Thomas E. Gundersen, Franziska Jannasch, Rudolf Kaaks, Verena Katzke, Esther Molina-Montes, Peter M. Nilsson, Domenico Palli, Salvatore Panico, Keren Papier, Olov Rolandsson, Carlotta Sacerdote, Anne Tjønneland, Tammy Y. N. Tong, Yvonne T. Van Der Schouw, John Danesh, Adam S. Butterworth, Elio Riboli, Karen J. Murphy, Nicholas J. Wareham, Nita G. Forouhi

Research outputs 2022 to 2026

Background: Self-reported adherence to the Mediterranean diet has been modestly inversely associated with incidence of type 2 diabetes (T2D) in cohort studies. There is uncertainty about the validity and magnitude of this association due to subjective reporting of diet. The association has not been evaluated using an objectively measured biomarker of the Mediterranean diet. Methods and findings: We derived a biomarker score based on 5 circulating carotenoids and 24 fatty acids that discriminated between the Mediterranean or habitual diet arms of a parallel design, 6-month partial-feeding randomised controlled trial (RCT) conducted between 2013 and 2014, the MedLey trial (128 participants …

Evaluating Education In Pregnant Women With Gestational Diabetes In Relation To Patient And Infant Outcomes, Lauren Young, Emily Abbott, Emilee Arsenault

Non-Thesis Student Work

Metabolic control and gestational diabetes can have significant impact on the health outcomes of new mothers and their newborns. This literature review focused on specifically on prenatal education and the impact to achieve adequate glycemic and metabolic control that affect health outcomes of women and their newborn. The goal of this literature review is to highlight the impact education has on gestational diabetes, and to promote positive health outcomes during pregnancy and postpartum. The CINAHL database was used to search the literature using keywords gestational diabetes, education, and patient outcomes. Exclusion criteria included women previously diagnosed with diabetes mellitus, and …

Relationship Between Treatment Comorbidities And Hiv Viral Suppression Among People Who Live With Aids In Johannesburg., Nwogo Immaculata Ekeji, Tolulope A. Osoba, Hebatullah Tawfik, Mehdi Agha

Journal of Social, Behavioral, and Health Sciences

HIV has globally infected over 37.9 million people, of which 28.2 million (73%) are on antiretroviral treatment, and 66% of those on treatment are virally suppressed. In South Africa, however, low rate of viral suppression (47%) among people living with HIV is a major health problem that has continued to fuel HIV prevalence. A cross-sectional quantitative research design was used to investigate the relationship between treatment comorbidities and viral suppression among HIV-infected adults aged 18–49 who were diabetic, had cancer, or tuberculosis in Johannesburg. HIV Care Continuum formed the theoretical framework for this research. An existing HIV-infected patient de-identifiable dataset …

Utilization Of Pressure Injury Prevention Team In Long-Term Care Settings, Riley Sullivan, Katie Seekins, Mia Stamey

Non-Thesis Student Work

In addressing the role that pressure injury prevention (PIP) teams can have in prevention and reduction of pressure ulcers for older adult patients in long-term care settings, this PICOT question is asked: In adults aged 65 and over in long-term care settings with a diagnosis of Type II Diabetes, does implementing weekly skin assessments performed by a pressure injury prevention (PIP) team to standard PIP strategies, compared to just standard PIP strategies, prevent or reduce pressure injury development over 6 months? Pressure injuries are a preventable complication that can lead to detrimental outcomes, including patients being “2.8 times more likely …

Identification And Management Of Atherosclerotic Cardiovascular Disease Risk In South Asian Populations In The U.S., Anandita Agarwala, Priyanka Satish, Mahmoud Al Rifai, Anurag Mehta, Miguel Cainzos-Achirica, Nilay S. Shah, Alka M. Kanaya, Garima V. Sharma, Dave L. Dixon, Salim S. Virani

Office of the Provost

South Asians (SAs, individuals with ancestry from Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka) are among the fastest growing ethnic subgroups in the United States. SAs typically experience a high prevalence of diabetes, abdominal obesity, and hypertension, among other cardiovascular disease risk factors, which are often under recognized and undermanaged. The excess coronary heart disease risk in this growing population must be critically assessed and managed with culturally appropriate preventive services. Accordingly, this scientific document prepared by a multidisciplinary group of clinicians and investigators in cardiology, internal medicine, pharmacy, and SA-centric researchers describes key characteristics of traditional and …

Information-Motivation-Behavioral Skill In Diabetes Self-Management Using Structural Equation Modeling Analysis, Dien Kurtanty, Adang Bachtiar, Cicilya Candi, Alya Pramesti, Almira Fanny Rahmasari

Kesmas

Diabetes is the “mother” of various diseases increasing the risk of morbidity and mortality. Diabetes self-management, an effort made by patients to control blood sugar levels, is an important part of the management strategy. Therefore, this study analyzed information, motivation, and behavioral skills associated with diabetes self-management. Data were collected in the Special Capital Region of Jakarta, with 277 diabetic patients selected using a questionnaire by a systematic random sampling method. The analyzed variables were information (with indicator variables of information on physical activity, nutritional intake, drug consumption, and blood sugar monitoring); sociodemographic (age, sex, occupation, education level, and duration …

Postprandial And Fasting Lipopolysaccharide Levels In Healthy Hispanic Residents Of Southeast Texas With Positive Family History Of Type 2 Diabetes, Amanda J. Wheeler, Yu Lun Tai, Smaran Marupudi, Ryan D. Russell

International Journal of Exercise Science: Conference Proceedings

PURPOSE: Healthy people with a family history (FH+) of type 2 diabetes (T2D) display impaired metabolic and microvascular function prior to glucose intolerance, and are at greater risk for developing T2D. While mechanisms to explain this disparity are lacking, it is possible that intestinal permeability plays a role, as it is also linked with insulin resistance, glucose intolerance, and chronic inflammation. Lipopolysaccharides (LPS) act as an outer membrane component of gram-negative bacteria in intestines and play a role in inflammation and chronic disease when in circulation, thus serving as a surrogate measure of intestinal permeability. However, the link between FH+ …

Serum Cotinine As A Predictor Of Lipid-Related Indices In Turkish Immigrants With Type 2 Diabetes: A Clinic-Based Cross-Sectional Study, Shiryn D. Sukhram, Gustavo G. Zarini, Lemia H. Shaban, Joan A. Vaccaro, Avinash R. Sukhram, Fatma G. Huffman

Publications and Research

Background: Turkish immigrants form the largest ethnic minority group in the

Netherlands and show a higher prevalence of (i) cardiovascular disease (CVD),

(ii) cigarette smoking, and (iii) type 2 diabetes (T2D) as compared to the native

Dutch. This study examines the association of CVD risk factors: serum cotinine, as

an indicator of cigarette smoke, and lipid-related indices among first-generation

(foreign-born) Turkish immigrants with T2D living in deprived neighbourhoods in the

Netherlands.

Methods: A total of 110 participants, physician-diagnosed with T2D, aged 30 years

and older, were recruited by convenience sampling from the Schilderswijk

neighbourhood of The Hague in a clinic-based …

Cardiogenic Shock Among Patients With Acute Myocardial Infarction In A Middle Eastern Country: A Single-Centre Experience, Ghada Shalaby, Azmat Khadija Niazi, Sheeren Khaled

Journal of the Saudi Heart Association

BACKGROUND: Cardiogenic Shock (CS) remains the most common cause of death in hospitalized acute ST-segment elevation myocardial infarction (STEMI) patients. Predictors of outcomes in those patients include clinical, laboratory, radiologic variables, and management strategies. The present study aimed to evaluate the incidence, characteristics, predictors of cardiogenic shock and mortality among acute ST-segment elevation myocardial infarction patients in our center METHODS: This was a retrospective, single-center study conducted at KAMC, Makkah during 2015-2020. All acute ST-segment elevation myocardial infarction patients during this era were divided into two groups CS group and non-CS group. RESULTS: In this study total 3074 acute ST-segment …

Evaluating The Association Between Depressive Symptoms And Glycemic Control Among Residents Of Rural Appalachia, Brittany L. Smalls, Adebola Adegboyega, Ellen Combs, Eli W. Travis, Felipe De La Barra, Lovoria B. Williams, Nancy Schoenberg

Journal of Appalachian Health

Introduction: Type 2 diabetes mellitus (T2DM) is associated with a range of co-morbid physical and psychological conditions, including depression. Yet there is a dearth of evidence regarding the prevalence of depression among those in Appalachia living with T2DM; this gap persists despite the higher regional prevalence of T2DM and challenging social determinants of health.

Purpose: This study aimed to provide greater detail about the relationships between T2DM and depressive symptoms in adults living in Appalachia Kentucky.

Methods: The present study was a cross-sectional analysis of baseline data derived from an ongoing study of Appalachia Kentucky adults living with T2DM. Outcome …

The Relationship Between Psychosocial Factors, Self-Care, And Blood Sugar In An Appalachian Population, Brittany L. Smalls, Md. Tofial Azam, Madeline Dunfee, Philip M. Westgate, Susan C. Westneat, Nancy Schoenberg

Journal of Appalachian Health

Introduction: Appalachian residents are more likely than other populations to have Type 2 Diabetes Mellitus (T2DM) and to experience more severe complications from the disease, including excess and premature mortality.

Methods: This study examines health alongside sociodemographic factors, psychosocial factors (including knowledge, empowerment, social support/function, religiosity, distress), and perceived problems in diabetes management that may influence self-care and HbA1c among vulnerable rural residents. A survey of a community–based sample of 356 adults with diagnosed diabetes or HbA1c > 6.5 was conducted in six counties in Appalachian Kentucky.

Results: Findings suggest that neither religiosity nor social support/function mediate/moderate the relationship between psychosocial …

Effects Of Diabetes On Speech And Language Across The Lifespan, Tayla Slay

2023 SLP Posters

According to the CDC, “diabetes is a chronic health condition that affects the way your body turns food into energy”. More than 37 million adults in the United States have diabetes which is the seventh leading cause of death in the United States. With diabetes affecting such a large portion of the population, what do speech-language pathologists need to know about how blood sugar affects speech and language in various types of individuals? This literature review explores the effects of language development later in the life of babies born to mothers with diabetes. The effects that diabetes has on adults’ …

Nutritional Medicine: Education For Advanced Practice Providers, Natalie Organ

DNP Research Projects

Abstract

OBJECTIVE: The project's primary goal was to educate the APP and develop positive attitudes and beliefs concerning plant-based nutrition regarding obesity, diabetes, cardiovascular disease, and cancer. The project addressed a crucial gap in healthcare education. APPs were not routinely given the chance to learn nutritional medicine, leading to decreased confidence in providing nutritional guidance in clinical practice.

METHODS: The DNP project participants were practicing advanced practice providers. The Knowledge, Attitude, Behavior (KAB) education theory and CREATION Life were used. This project used Qualtrics to send a pre-and post-intervention survey titled Student Survey for Nutritional Medicine. The intervention was a …

Examining Gestational Diabetes Mellitus Educational Resources: Patient And Provider Perspectives, Allison F. Peebles, Morgan E. Cooley, Rose A. Maxwell

Student Scholarship

Objective: To analyze the effectiveness of gestational diabetes mellitus (GDM) education as well as patient and provider confidence in education practices. Study

Design: Women with a diagnosis of GDM who delivered at Miami Valley Hospital were included in the study. Patients were asked to complete a questionnaire to evaluate their knowledge and confidence in managing their GDM. Providers were asked to complete a questionnaire to provide their perspective on patient education related to GDM.

Results: Patients correctly identified 66% of the correct ways that GDM affects maternal health, fetal health, and pregnancy complications. Patients felt empowered by their education and …

Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …

Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …

Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr

Walden Dissertations and Doctoral Studies

AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …

Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker

Walden Dissertations and Doctoral Studies

Diabetes imposes a major burden on society, especially in the state of Florida, in the form of increased medical costs, lost productivity, early mortality, and intangible costs in the form of diminished quality of life. Access to diabetic care affects health administration in Florida by impacting the overall cost of treating the condition. Limited access to care can lead to an increased risk of complications resulting in a higher cost of treatment. The purpose of this quantitative study was to determine whether access to care dependent variables (access to doctors and length of time since last routine checkup) were associated …