Diabetic Gastroparesis, Noreen Burris Welch

Nursing Student Class Projects (Formerly MSN)

According to the 2014 Centers for Disease Control (CDC) 9.3% of the United States Population have diabetes (National diabetes statistics report, “2014, p.1). One of the complications of diabetes is gastroparesis. Gastroparesis is “a delay in the emptying of ingested food in the absence of mechanical obstruction of the stomach or duodenum ‘’ (Koch & Calles-Escandon, 2015, p. 40). Mortality in the diabetic patient with gastroparesis is higher than the diabetic patient without gastroparesis (Koch & Calles-Escandon, 2015). Patients with either type 1 diabetes (T1DM) or type 2 diabetes (T2DM) may experience he clinical symptoms of early satiety, prolonged fullness, …

Hyperglycemic Hyperosmolar State: A Diabetic Emergency, Rachel Fisher

Nursing Student Class Projects (Formerly MSN)

Hyperglycemic hyperosmolar state (HHS) is an acute complication associated with diabetes mellitus. HHS has been known by several other names in the past. These labels include Hyperosmolar Nonketotic Coma, Hyperosmolar Hyperglycemic Nonketotic Coma, and Hyperglycemic Hyperosmolar Nonketotic Syndrome (Hackel, 2014). HHS is characterized by severe hyperglycemia, profound dehydration, and is often accompanied by altered mental status. Less than 1% of diabetes-related admissions are due to HHS, but mortality rates are estimated to be 10% to 20% (Lenahan & Holloway, 2015). HHS typically affects the older adult population, with the average age of HHS patients being 60 years (Collopy, Kivlehan, & …

Hashimoto’S Disease: The Underactive Thyroid Disease, Patty Anderson

Nursing Student Class Projects (Formerly MSN)

The thyroid gland is part of the endocrine system and has a widespread function that controls multiple organ systems and processes. The main function of the thyroid gland is to produce and secrete two different thyroid hormones: triiodothyronine (T3) and thyroxine (T4), both of which help to meet the metabolic demands of the entire body. When the thyroid gland fails to produce T3/T4 hormones (primary gland failure) or is not activated successfully by the pituitary gland (by the release of thyroid stimulating hormone (TSH)), or hypothalamus, this results in low levels of circulating thyroid hormone. As low levels of the …

In-Patient Self-Management Diabetes Education, Amy Matthews

Master's Projects and Capstones

The diabetes program strives to provide diabetes self-management education to the in-patient with diabetes. The specific aim is to improve and standardize diabetes education for the inpatient with diabetes by June 2015. The microsystem is a medical surgical unit for patients 18 years and older who present with diabetes as either a primary diagnosis or secondary diagnosis. Fifty percent of the diabetes patients on this unit are ages 65-89 years old, twenty nine percent are ages 50-64. The unit has 32 beds and is filled to capacity ninety five percent of the time. The fishbone diagram revealed our microsystem lacked …

Using Technology To Improve Diabetes Self-Management Within A Federally Qualified Community Health Center, Lisa Diane Morgan

Doctoral Projects

The Patient Centered Medical Home (PCMH) concept places the patient and family at the center of healthcare. The patient becomes actively involved in their own care. One aspect of PCMH is managing care and increasing chronic disease self-management. Diabetes, a chronic disease, is a leading diagnosis among the patients served by the federally qualified community health center (FQCHC). The prevalence of diabetes in Mississippi in 2012 was 12.3%. The purpose of this DNP Capstone project was to implement a pilot study to increase diabetes self-management knowledge. The program utilized the current technology of text messaging to send biweekly supportive and …

The Effect Of Run Sprint Interval Training On Diabetic Metabolic Markers In Prediabetic Adults, Kathryn L. Hilovsky

Masters Theses, 2010-2019

Abstract

Purpose: The primary purpose of this study was to compare the effects of an 8-week run-sprint interval training (R-SIT) and continuous moderate-intensity training (MIT) on fasting blood glucose, HbA1c, insulin sensitivity, and β-cell function in sedentary, prediabetic adults. Secondary outcomes of the study included anthropometric, body composition variables, and aerobic capacity.

Methods: Sedentary, physician diagnosed prediabetic individuals were randomized into R-SIT (n=7, BMI 36.76 ± 9.79) or MIT (n=8, BMI 40.59 ± 12.49) interventions. Subjects participated in supervised exercise three times a week and attended a Diabetes Prevention Program course, once weekly. R-SIT participants performed 4-6 x 30-second …

Efficacy Of Behavioral Interventions In African-Americans With Type Ii Diabetes: A Comparative Effectiveness Analysis, Tangela Nicole Hales

Dissertations

Context: The efficiency and effectiveness of the healthcare system are prime foci for nursing research.

Objective:The purpose of this study was to review and critically appraise the current state of the evidence in the treatment of African American adults with type II diabetes. To address this objective, a systematic review was undertaken that investigated the comparative effectiveness of behavioral interventions in improving glycemic control.

Methods: Robust methodological approaches to comparative effectiveness research (CER) serve to improve the transparency, consistency, and scientific rigor of the research. The methods for this systematic review of literature followed those recommended in the Agency …

The Effect Of Aerobic Exercise Training On Hepatic Glycogen Metabolism In Type 1 Diabetic Rats, Michael Murray

Electronic Thesis and Dissertation Repository

The purpose of this investigation was to determine if ten weeks of aerobic exercise training could increase hepatic glycogen storage in rats with Type 1 Diabetes Mellitus (T1DM) and whether elevated hepatic glycogen content is associated with alterations in glycogenic proteins and insulin signaling. Rats were divided into control-sedentary, control-exercised, T1DM-sedentary and T1DM-exercised groups. Animals from each group underwent a euglycemic-hyperinsulinemic clamp at the conclusion of the study. Exercise training consisted of treadmill running at 27m/min, 6% incline for 1hr, five days/week for ten weeks. T1DM rats had lower liver glycogen concentrations than control rats and glycogen was not increased …

Diabetes Distress: Transforming A Practice, Goff M. Jeannie

Doctor of Nursing Practice Scholarly Projects

Diabetes mellitus affects millions of people in the United States, placing them at risk for other disease related complications. This makes the management of diabetes and the prevention of complications an important challenge. The psychological aspect of diabetes care may present a barrier to patients that inhibit them from achieving optimal self-care.

Diabetes distress (DD) is the psychological aspect of diabetes that is specific to the emotional distress caused from living a chronic disease. DD has been linked to poorer self-management behaviors which makes it a significant problem that should be taken into consideration for effective management of the diabetic …

Hypothyroidism And The Development Of Hypertension, Kaleb Short

All Graduate Theses, Dissertations, and Other Capstone Projects

Low thyroid hormone (TH) in adulthood is associated with increased risk of cardiovascular disease, including risk of hypertension. The Spontaneously Hypertensive Rat (SHR), exhibits alterations in thyroid function when compared to normotensive controls. Interestingly, inhibiting thyroid gland function before 4 weeks of age prevented hypertension in the SHR, indicating that TH is involved in the etiology of SHR hypertension. However, these studies utilized tail-cuff photoplethysmography (PPG), which is known to have stress-induced artifacts, and did not compare effects in the normotensive parent strain Wistar Kyoto (WKY) rat. Therefore, it is uncertain whether TH is responsible for an elevation in baseline …

An Examination Of Factors That Influence Health Behaviors Among Low Income African American Women With Type 2 Diabetes In Memphis, Tn: A Qualitative Inquiry Using Mixed Methods, Adole Muruako

Theses and Dissertations (ETD)

Obesity and type 2 diabetes are increasing health concerns in the United States, particularly among women and minorities. Generally, research has highlighted the health disparities that exist among African American women, especially as these disparities relate to obesity and type 2 diabetes. In Memphis, TN, the ZIP codes of 38106 and 38109 have the highest rates of diabetes hospitalizations in the city. Further, African American women in Memphis, TN have been identified as being most vulnerable to experiencing a potentially avoidable hospitalization due to chronic disease. The purpose of study was to identify factors that may impact African American overweight/obese …

Hemoglobin A1c And The Diagnosis Of Diabetes And Prediabetes In Children And Adolescents, Jennifer Mcguire Hitt

Theses and Dissertations (ETD)

Although the American Diabetes Association (ADA) adopted the use of the glycated hemoglobin (A1C) test as a method of diabetes and prediabetes diagnosis, the ADA has not developed firm guidelines concerning the use of the A1C test in children and adolescents, as research has not validated thresholds in this group. Diabetes and prediabetes are diseases influenced by multiple factors, including race and ethnicity, age, vitamin D deficiency, and body mass index (BMI). The purpose of this study was to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the A1C test compared to the gold …

Effect Of Nedd4 Haploinsufficiency On Insulin Sensitivity, Adiposity And Neuronal Behaviors, Jingjing Li

Theses and Dissertations (ETD)

The neural precursor cell expressed developmentally down-regulated gene 4 (NEDD4) is a HECT-type E3 ubiquitin ligase that has received broad attention in recent years. Many of its reported substrates are active players in metabolism, implying a potential role of NEDD4 itself in metabolic regulation. Since homozygous Nedd4 deletion leads to embryonic or perinatal lethality, we investigated the function of NEDD4 in metabolic regulation in vivo, using Nedd4- haploinsufficient mice in a high fat diet-induced obesity (HFDIO) model.

Our studies show that Nedd4-haploinsufficient mice fed a normal diet (ND) exhibited decreased body weight in both genders and proportionally reduced tissue mass …

Increased Body Weight In Adulthood Following A Peripubertal Stressor And Proposed Mechanism For Effects Of Increased Adiposity On Estrogen-Dependent Behaviors, Christina F. Gagliardi

Masters Theses

Exposure to certain stressors during a sensitive period around puberty can lead to enduring effects on an animal’s response to estradiol. In estradiol-influenced behaviors, such as sexual receptivity, hippocampal-dependent learning and memory, depression-like behavior, and anxiety-like behaviors, exposure to a peripubertal stressor such as shipping stress or an injection of lipopolysaccharide (LPS) can eliminate or even reverse the normal response to estradiol. In addition to regulating these behaviors, estradiol play a role in the regulation of body weight. While some of the previous studies touched on short-term effects on body weight, no systemic long-term study of the effects of a …

Management Of A Dka Patient With Severe Metabolic And Ketoacidosis With Chronic Renal Insufficiency, Brian Albany

Nursing Student Class Projects (Formerly MSN)

Diabetic ketoacidosis (DKA) serves as one the leading causes of mortality in diabetic patients [14]. The mortality has decreased over the past several decades due to the rapid recognition of the disease state and the improvement of management of DKA [14]. Despite a decline in mortality rates over the past twenty years from 7.96% to 0.67%, errors in management of the disease state are associated with significant morbidity and mortality [2]. Utilization of DKA protocols in the acute care setting have allowed congruency in care and delivery of effective lifesaving treatment. Despite advances in standardized DKA protocols, there still remains …

Acute Pancreatitis, Laura Payne

Nursing Student Class Projects (Formerly MSN)

Acute pancreatitis is a common diagnosis seen in intensive care units worldwide. The incidence of pancreatitis has increased over the last decade. It ranks third amongst the gastrointestinal diseases resulting in hospital admissions. The destructive complications of pancreatitis make it a life-threatening disease. If pancreatitis progresses to the severe form the mortality rate significantly increase from one percent to upwards of thirty percent. Pancreatitis is associated with high rates of morbidity, mortality, and prolonged hospital admissions(Goozen, Besselink, Santroort, & Bollen, 2013). An increased understanding of the pathophysiology of pancreatitis has changed the approach to treatment from early surgical treatment to …

Incretin Hormones And Their Effects In Type 2 Diabetes, Molly Getz

Nursing Student Class Projects (Formerly MSN)

Type 2 diabetes mellitus (T2DM) is a progressive disease characterized as having pancreatic β-cell dysfunction, insulin resistance and hyperglycemia (Stephens, 2010, p. 491). T2DM affected 29.1 million Americans or 9.3% of the population in 2012 and was the seventh leading cause of death in the United States in 2010 ("ADA Statistics," 2014), with many of these patients finding it difficult to achieve or maintain adequate glycemic control despite making lifestyle changes and pharmacologic interventions (Freeman, 2007). Disease management of T2DM requires a comprehensive plan including medication therapy, education and active involvement of the patient, with the goal of therapy to …

Literary Research On Alport Syndrome, Shailendra Jain

Nursing Student Class Projects (Formerly MSN)

Alport syndrome is rare genetic disorder of the glomerulus in the kidneys that can be X-linked, Autosomal recessive, or Autosomal dominant in nature. Clinical manifestation includes hearing loss, hematuria, proteinuria, and hypertension (Cheungpasitporn, Kaewpoowat, Suksaranjit, Kittanamongkolchai, Srivali, Ungprasert, & Rangan, 2012). It is most common disease in males. A 24-hour urine specimen is usually obtained to check for proteinuria and elevated creatinine, which indicate acute renal failure (Cosgrove, 2012). A renal biopsy and ultrasounds is used to confirm the diagnosis of Alport Syndrome. Patients that are diagnosed with such disease require dialysis and referral to an ophthalmology and audiology. The …

Necessity For Excellent Glycemic Control Before, During And After Cabg Surgery, Sheri Clouse

Nursing Student Class Projects (Formerly MSN)

A 72 year old male patient was admitted to the hospital presenting with sharp substernal pain and pressure to the left upper chest rated a “10” out of 10. Patient complained of chest pain even at rest which was relieved by a nitroglycerin infusion. Patient had established coronary artery disease as evidenced by five prior stent placements, with the last stent placement being in 2010. The patient also presented to the Emergency Room with a blood glucose level over 600 mg/dL and because of his complaints of chest pain, was transferred to a neighboring hospital facility to have a cardiac …

New Beginnings: A Discussion Guide Adaptation For Living With Diabetes Among An Urban American Indian Community, Eudora Lynette Claw

UNLV Theses, Dissertations, Professional Papers, and Capstones

Diabetes is a chronic disease where the body has the inability to control the sugar levels in the blood to convert into to usable energy needed to fuel the body's cells. Some common diabetic complications include heart disease, stroke, amputations, and possibly blindness. It can be successfully managed with routine care of monitoring of sugar levels, eating a healthy diet, and daily exercise. The occurrence of type 2 diabetes is rising rapidly worldwide, but is a burden for AI/ANs (American Indian/Alaska Natives) at a substantially disproportionate rate. The purpose of this pilot study was to participate in a one-day curriculum …

Comparative Differences Between Traditional Chinese Medicine And Western Medicine In Treating Type Two Diabetes Mellitus, Neley Morales

HIM 1990-2015

In the United States alone, there were 25.8 million people suffering from diabetes in 2010. The prevalence of diabetes is expected to markedly increase worldwide over the next 30 years, an estimated 2.8% in 2000 and 4.4% in 2030. For individuals diagnosed with type 2 diabetes mellitus (T2DM), treatment is essential to control adverse effects such as hypertension and diabetic neuropathy. The focus of this study is to examine various approaches to maintain and improve the lifestyle of individuals suffering from T2DM. A comparative approach has been used to evaluate the differences in the treatment of T2DM with the use …

Diabetes And Obesity Induce Transcriptomic And Metabolomic Changes Enhancing Pancreatic Cancer Aggressiveness, Guermarie Velázquez Torres

Dissertations & Theses (Open Access)

Pancreatic cancer is one of the most aggressive types of cancer, with poor prognosis that lacks effective diagnostic markers and therapies. It is expected that in 2014 the incidence and the mortality of pancreatic cancer in the United States will be 46,420 and 39,590 respectively. Diabetes and obesity are modifiable risk factors associated with accelerated pancreatic carcinogenesis and tumor progression, but the biological mechanisms are not completely understood. The purpose of this study is to demonstrate direct evidence for the mechanisms mediating these epidemiologic phenomena. Our hypothesis is that obesity and diabetes mellitus type 2 (DM2) accelerate pancreatic cancer and …

Inhibition Mechanisms Of Type 2 Diabetes, Jalise Maree Cotton

Thinking Matters Symposium Archive

Type 2 Diabetes (T2D) is the most common form of diabetes mellitus which affects approximately 8.3% of the popula@on (diabetes.org 2013). T2D is most oDen brought on by reduced sensi@vity to insulin receptors. This is thought to be caused by a muta@on in the gene Insulin Receptor Substrate-­‐ 1 (IRS-­‐1). It is the suppression of IRS-­‐1 that leads to inac@va@on of signaling molecules insulin signaling pathways causing insulin resistance (Victor D. H. et al). This literature review will focus on the major mechanisms of inhibi@on of the insulin signaling pathways.

The Role Of Il-22 Produced By Th17 Cells In Type 1 Diabetes, Stacey M. Bellemore

Electronic Thesis and Dissertation Repository

Interleukin-22 (IL-22) is produced by T helper 17 (Th17) cells. Th17 cells have been shown to be pathogenic in autoimmune diseases, however their role in type 1 diabetes (T1D) remains controversial. We have shown that Th17-differentiation of naïve T cells can be driven by IL-23 + IL-6 to produce large amounts of IL-22 and induce T1D. Conversely, polarizing T cells using TGF-β + IL-6 led to nonpathogenic Th17 cells that produced lower IL-22 levels. We have shown that neutralizing IFN-γ during polarization leads to a drastic increase in IL-22. We have also found IL-22-producing cells in the pancreas of diabetic …

Risk Factors For Diabetes Mellitus: A Comparative Analysis Of Subpopulation Differences In A Large Canadian Sample, Michael James Taylor

Electronic Thesis and Dissertation Repository

Objectives: Certain Canadian subpopulations observe numerous modifiable and non-modifiable risk factors for diabetes. This study compares immigrants and Aboriginals (First Nations, Inuit, and Métis) with Canada-born individuals at higher risks for diabetes, and deciphers the determinant differences between them.

Methods: Pooled Canadian Community Health Survey data (2001-2010) were used. Time trends for diabetes within each subsample were calculated using individual survey year prevalence rates; diabetes diagnoses were self-reported (N=33,565). Various risk factors were also examined using logistic regression.

Results: Diabetes prevalence rates significantly increased from 2001 to 2010 for each subpopulation, as well as the total sample: Canada-Born individuals (3.9% …

Associations Between Alcohol Consumption And Fasting Blood Glucose In Young Adults, Julie Ann Lucca

Master's Theses

Current research shows moderate alcohol consumption is associated with decreased risk of diabetes and excessive consumption or binge drinking can cause insulin resistance and diabetes. In 2010, diabetes was the seventh leading cause of death in the United Statesand was responsible for significant health complications: blindness, kidney failure, and limb amputations, and is a large national economic burden. Fasting blood glucose (FBG) is a tool used to help diagnose diabetes. Abnormally high FBG, ≥100 mg/dl, is indicative of diabetes and pre-diabetes. Few studies have observed diabetic prevalence among young adults or college students. Studying young adults can help provide added …

The Relationship Between Vitamin D Status Of Adult Women And Diet, Sun Exposure, Skin Reflectance, Body Composition, And Insulin Sensitivity, Marisa M. Mcadler

Master's Theses

As the prevalence of vitamin D deficiency continues to grow, mounting evidence supporting its link with chronic disease strengthens suggesting vitamin D’s candidacy in the prevention and treatment of multiple disease states and their complications. Dietary guidelines, however, do not take sun exposure into account. The present study sought to explore the impact of sun exposure on vitamin D status (serum 25(OH)D), and identify other significant determinants of serum levels which may have the greatest effects on overall health. Participants (n = 34) were pre-menopausal women aged 18 to 50 years (mean age 39 ± 6 years), who had their …

Practitioners' Use Of Clinical Practice Guidelines: An Evidence-Based Approach, Sondra Michelle Phipps Santana

UNF Graduate Theses and Dissertations

Pre-diabetes is a serious health problem in the United States. Distinguished by plasma glucose levels that are above the normal threshold, patients with pre-diabetes are 10 times more likely to develop type 2 diabetes. Patients with pre-diabetes suffer the same complications as patients with diabetes including diabetic retinopathy, nephropathy, and microalbuminuria.

There is considerable evidence to support the idea that early identification and aggressive treatment of pre-diabetes has the potential to delay disease progression. The American Diabetes Association’s clinical practice guideline recommends management of with lifestyle modification and metformin for patients who are at risk for developing type 2 diabetes. …

Does Ranibizumab Improve Best Corrected Visual Acuity In Adults With Diabetic Macular Edema Compared To Those Without Ranibizumab?, James E. Huang

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine (EBM) review is to determine whether or not ranibizumab improves best corrected visual acuity (BCVA) in adults with diabetic macular edema compared to patients who do not receive ranibizumab.

STUDY DESIGN: The selective review examined best corrected visual acuity values reported from published, primary literature sources that examined the efficacy of ranibizumab in diabetic macular edema.

DATA SOURCES: Two double blind randomized controlled trials and one case control study were selected and reviewed.

OUTCOMES MEASURED: Best corrected visual acuity (BCVA) as measured from Early Treatment Diabetic Retinopathy Study visual …

Is The Use Of Honey An Effective Dressing Option For The Treatment Of Diabetic Foot Ulcers?, Michelle A. Wimmer

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not honey could be used as an effective topical treatment for diabetic foot ulcers in diabetic patients.

STUDY DESIGN: Review of three primary journal articles published in English between the years of 2008 and 2010.

DATA SOURCES: Two Randomized Controlled Trials comparing honey as a treatment for diabetic foot ulcers to either previous failed treatments or Povidone Iodine Solution, and a pilot prospective study, exploring the effectiveness of PEDYPHAR a royal jelly ointment. All articles were found using Pubmed, OVID and Cochrane Database.

OUTCOMES MEASURED …