Multiple Daily Injection Insulin Regimen Is An Effective, And More Economical, Alternative To Continuous Insulin Infusion For Type 1 Diabetics, 2024 Wayne State University, School of Medicine
Multiple Daily Injection Insulin Regimen Is An Effective, And More Economical, Alternative To Continuous Insulin Infusion For Type 1 Diabetics, Julia Yee
Clinical Research in Practice: The Journal of Team Hippocrates
A clinical decision report using:
Heller S, White D, Lee E, et al. A cluster randomised trial, cost-effectiveness analysis and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial. Health Technol Assess. 2017 Apr;21(20):1-278. https://doi.org/10.3310/hta21200
for a patient with type 1 diabetes.
Primary Adrenal Insufficiency In Autoimmune Polyglandular Syndrome Type 1 - A Case Report And Literature Review, 2024 Reading Hospital - Tower Health
Primary Adrenal Insufficiency In Autoimmune Polyglandular Syndrome Type 1 - A Case Report And Literature Review, Hafiza A. Qadeer Md, Reshma Samkutty, Caitlyn Moss
Advances in Clinical Medical Research and Healthcare Delivery
Autoimmune Polyglandular Syndrome (APS) type 1 is a rare autosomal recessive disorder secondary to AIRE gene mutation, that is classically characterized by autoimmune hypoparathyroidism, chronic mucocutaneous candidiasis and Addison’s disease. A review of the literature shows that these disease manifestations may present in any order in different age groups. Patients with APS type 1 are also at risk for other endocrinopathies. We present the case of a female patient with a history of APS type 1 and type 1 diabetes who presented with new onset hypoglycemia and decreased insulin requirement and was diagnosed with new onset adrenal insufficiency due to …
Phaeochromocytoma-Induced Takotsubo Cardiomyopathy Presented With Cardiogenic Shock, 2024 Diabetes and Endocrinology Centre, Hong Kong Baptist Hospital, 222 Waterloo Road, Hong Kong
Phaeochromocytoma-Induced Takotsubo Cardiomyopathy Presented With Cardiogenic Shock, Wong Lai Sze Alice, Yu Cheuk-Man, Hong Kam Fai Jeffrey, Tsang Man Wo, Wat Yiu Kin Jason, Tong Mei Wa Gensy
Journal of the Hong Kong College of Cardiology
Background: Phaeochromocytoma, on its own, is a rare endocrine condition. Patient that presents with cardiogenic shock as a result of phaeochromocytoma-induced Takotsubo cardiomyopathy is even rarer, as phaeochromocytoma classically presents with hypertension. Clinical awareness and understanding of this disease entity is important for early identification and appropriate management of this endocrine emergency. Case presentation: A 39-year-old woman presented with one day history of repeated vomiting associated with epigastric pain. Her condition deteriorated rapidly with acute cardiac and renal failure with cardiogenic shock after intravenous fluid infusion, requiring high flow oxygen and high dose inotropic support in intensive care unit. Subsequent …
Perceived Neighborhood Disorder And Type 2 Diabetes Disparities In Hispanic, Black, And White Americans, Min Ying Yu, Alfredo J. Velasquez, Belinda Campos, Jennifer W. Robinette
Psychology Faculty Articles and Research
Introduction: Approximately 32 million Americans have type 2 diabetes, and that number continues to grow. Higher prevalence rates are observed among certain subgroups, including members of marginalized racial/ethnic groups as well as residents of disordered neighborhoods (i.e., those with more trash and vandalism). Institutionalized discriminatory practices have resulted in disproportionate representation of marginalized racial/ethnic groups in disordered neighborhoods compared to non-Hispanic Whites. These neighborhood disparities may partially contribute to health disparities, given that signs of neighborhood disorder often relate to a general withdrawal from the neighborhood, minimizing opportunities for both physical and social engagement. Yet, research suggests variability across …
Utility Of Bariatric Surgery In The Remission Of Type 2 Diabetes Mellitus, 2023 James Madison University
Utility Of Bariatric Surgery In The Remission Of Type 2 Diabetes Mellitus, Christine Ercoline, Alyssa Bower, Corinne Singh
Physician Assistant Capstones, 2020-current
Objective: Assess whether bariatric surgery is more effective than lifestyle modification and medication in the long-term reduction of hemoglobin A1c (HbA1c) and fasting plasma glucose among obese adults with type 2 diabetes mellitus. Design: Systematic literature review. Methods: A PubMed search was performed utilizing the terms bariatric surgery, type 2 diabetes and remission. In PubMed the following limits and terms were used: published in the last 10 years, humans, full text, clinical trial, randomized control trial, and English. Results: An analysis of three randomized control trials (RCTs) supports bariatric surgery as a modality to induce the remission of type 2 …
Enhancing Diabetic Patient Continuous Glucose Monitoring Access, 2023 The University of San Francisco
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, …
Evidence-Based Intervention For Decreasing Chronic Kidney Progression In Patients With Type Ii Diabetes Mellitus, 2023 University of St. Augustine for Health Sciences
Evidence-Based Intervention For Decreasing Chronic Kidney Progression In Patients With Type Ii Diabetes Mellitus, Lynn M. Johnson
Student Scholarly Projects
Practice Problem: The overall management of Type II Diabetes Mellitus (DM II) and the complications that accompany along with comorbidities are debilitating and financially exhausting. The American Diabetes Association dietary recommends a consistent low-carbohydrate diet to maintain optimal blood glucose levels to prevent complications and progression of other comorbidities. Uncontrolled diabetes mellitus leads to the development of chronic kidney disease (CKD) which can lead to the progression to End Stage Renal Disease.
PICOT: In patients in the outpatient setting aged 18 years and older(P), how does the ADA dietary guidelines for patients with type II DM(I) compared with patients self-reported …
Dietary Analysis For Hashimoto’S Thyroiditis: An Integrative Review, 2023 Kennesaw State University
Dietary Analysis For Hashimoto’S Thyroiditis: An Integrative Review, Evan Thompson, Alison Hultquist
Master of Science in Nursing Final Projects
Hashimoto’s Thyroiditis (HT) is the leading cause of primary hypothyroidism in the United States. In HT, there is an infiltration by lymphocytes which leads to the production of autoantibodies against the thyroid gland. Throughout this integrative review, the aim was to evaluate the effectiveness of micronutrient supplementation and dietary management as adjunct treatments in HT. The purpose was to assist primary care providers in the development of a more holistic plan of care. Literature published within the past seven years was gathered and reviewed from PubMed, CINAHL, and Cochrane Library. Findings indicate that many patients with HT may benefit …
Emergency Department Presentations Of Diabetic Ketoacidosis In A Large Cohort Of Children, 2023 Thomas Jefferson University
Emergency Department Presentations Of Diabetic Ketoacidosis In A Large Cohort Of Children, Lisa E. Nigrovic, Nathan Kuppermann, Simona Ghetti, Jeff E. Schunk, Michael J. Stoner, Arleta Rewers, Julie K. Mcmanemy, Kimberly S. Quayle, Jennifer L. Trainor, Leah Tzimenatos, Jonathan E. Bennett, Maria Y. Kwok, Sage R. Myers, Kathleen M. Brown, T. Charles Casper, Cody S. Olsen, Nicole S. Glaser
Department of Emergency Medicine Faculty Papers
Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of childhood diabetes. However, the influence of demographic factors on presentation are not well-defined.
We included children from 12 centers who were <18 years with DKA (glucose > 300 mg/dL, serum pH < 7.25, or serum bicarbonate <15 mEq/L) enrolled in the Pediatric Emergency Care Applied Research Network (PECARN) Fluid Therapies Under Investigation in DKA (FLUID) Trial. Data were also collected for children who presented to the centers during the enrollment period but were not enrolled due to disease or treatment-related reasons. We compared demographic, clinical, and biochemical findings among children with newly and previously diagnosed diabetes and children in different age groups.
Of the 1,679 DKA episodes in 1,553 children, 799 (47.5%) episodes occurred in children with newly diagnosed diabetes and 396 (23.6%) were severe (pH < 7.1). Newly diagnosed children <6 years of age were not more likely to have severe DKA in terms of pH, but had more severe hypocarbia and higher blood urea nitrogen levels, factors previously associated with the risk of cerebral injury. Lower socioeconomic status (SES) (based on family income and maternal education level) were associated with more severe DKA in new onset children, and recurrent DKA in the previously diagnosed children.
Greater efforts are needed to identify the children with diabetes early and to prevent recurrent DKA, particularly among children in low-SES groups. Young children with DKA may need more intensive monitoring due to higher …18>
Improving Effective Care In Obese Patients In A Primary Care Clinic, 2023 University of Louisiana at Monroe
Improving Effective Care In Obese Patients In A Primary Care Clinic, Amy Miller
Journal of Interprofessional Practice and Collaboration
Background: Obesity is a preventable epidemic and costs the United States $200 billion annually. The leading causes of death are linked to obesity.
Local Problem: In a chart review, 53% of patients at a northeast Louisiana primary care clinic were obese. However, none were offered comprehensive lifestyle intervention. The aim was to increase the percentage of patients with BMI < 30 kg/m2 to 60% over 8 weeks.
Methods: A rapid-cycle quality improvement initiative was implemented using four Plan-Do-Study-Act cycles over 8 weeks. Each cycle produced tests of change related to screening, patient and team engagement, and assessing effective care. Run charts and aggregate tables were used to analyze …
Cgm Use With Interprofessional Therapy Management Improves Hba1c Levels In T2dm Patients, 2023 University of Louisiana Monroe College of Pharmacy
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
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.
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 …
Diabetes-Associated Hyperglycemia Causes Rapid-Onset Ocular Surface Damage, 2023 Chapman University
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 …
Enhancing Diabetes Care In Lmics: Insights From A Multinational Consensus, 2023 Southeast Asian Medical Center, Philippines
Enhancing Diabetes Care In Lmics: Insights From A Multinational Consensus, Jose Carlos Miranda, S Abbas Raza, Babatope Kolawole, Jahanzeb Kamal Khan, Atiba Alvi, Fariha Sadiq Ali, Ejim Emmanuel Chukwudi, Nanik Ram, Amira Oluwatoyin
Section of Diabetes, Endocrinology and Metabolism
The International Cardio-Metabolic Forum held a plenary session to establish a multinational consensus on the challenges faced in diabetes management within lower-middle-income countries (LMICs) and their potential solutions. Stakeholders, including patients, family/caretakers, healthcare professionals, and healthcare policymakers & organizations, participated in discussions. The audience of 280 doctors from 15 different countries (Pakistan, Qatar, Sri Lanka, Kenya, Myanmar, Georgia, Nigeria, Philippines, Uzbekistan, Iraq, Tanzania, Cambodia, Kazakhstan, South Sudan and Libya) was divided into 4 groups led by Group Leaders to represent each stakeholder group. Questionnaires addressing key challenges and solutions specific to each group were used to facilitate consensus development. Participants …
Untargeted Metabolomics Analysis On Kidney Tissues From Mice Reveals Potential Hypoxia Biomarkers, 2023 Chapman University
Untargeted Metabolomics Analysis On Kidney Tissues From Mice Reveals Potential Hypoxia Biomarkers, Muhammad Imran Sajid, Francisco J. Nunez, Farideh Amirrad, Moom Rahman Roosan, Tom Vojtko, Scott Mcculloch, Amal Alachkar, Surya M. Nauli
Pharmacy Faculty Articles and Research
Chronic hypoxia may have a huge impact on the cardiovascular and renal systems. Advancements in microscopy, metabolomics, and bioinformatics provide opportunities to identify new biomarkers. In this study, we aimed at elucidating the metabolic alterations in kidney tissues induced by chronic hypoxia using untargeted metabolomic analyses. Reverse phase ultrahigh performance liquid chromatography-mass spectroscopy/mass spectroscopy (RP–UPLC–MS/MS) and hydrophilic interaction liquid chromatography (HILIC)–UPLC–MS/MS methods with positive and negative ion mode electrospray ionization were used for metabolic profiling. The metabolomic profiling revealed an increase in metabolites related to carnitine synthesis and purine metabolism. Additionally, there was a notable increase in bilirubin. Heme, N-acetyl-L-aspartic …
Social Supports For Adolescent And Young Adult Polycystic Ovary Syndrome Patients: A Scoping Review, 2023 Western University
Social Supports For Adolescent And Young Adult Polycystic Ovary Syndrome Patients: A Scoping Review, Caitlin E. Mungall
Western Libraries Undergraduate Research Awards (WLURAs)
Polycystic ovary syndrome (PCOS) is a chronic disorder with negative health consequences for millions of women. The paucity of research regarding interventions targeting the psychosocial symptoms of PCOS for adolescents and young adults (AYAs), susceptible to low self-esteem and depression, warranted this review. This paper provides an overview of research on the social supports currently available for AYAs and identifies areas where further research is required to elucidate their support needs. A scoping review methodology identified 15 studies that met inclusion criteria. Findings revealed that this is an emerging field of research and most included studies originated in North America. …
Penile Calciphylaxis In An End Stage Renal Disease Patient., 2023 The University of Texas Rio Grande Valley
Penile Calciphylaxis In An End Stage Renal Disease Patient., Juan Enrique Garcia Lopez, Alain Velazquez Blanco, Aileen Aguilar, Sareena Siyas, Daniel Ibarias Paz, Mays Abdulazeez, Jesus Garza-Tamez, Desmond Adamu
Background: Penile Calciphylaxis occurs in about 1–4% of hemodialysis patients worldwide. Associated mortality rates are very high, and hyperparathyroidism is the second most frequently associated disorder. Addressing the resulting metabolic imbalance, and surgical intervention guided by findings of radiological studies may improve quality of life. The pathogenesis is thought to be mediated by vascular smooth muscle cells which differentiate into osteoblast-like cells. Decrease in vascular calcification inhibitory proteins fetuin-A and matrix Gla is found in patients on dialysis causing systemic medial calcification of arterioles, leading to epidermal ischemia, tissue infarction, and ulceration.
Case presentation: 47-year-old male with history of coronary …
Tuberculosis In Elderly Hispanics: Bcg Vaccination At Birth Is Protective Whereas Diabetes Is Not A Risk Factor, 2023 Texas Biomedical Research Institute
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
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 …
Covid-19 And Chronic Diabetes: The Perfect Storm For Reactivation Tb?, 2023 Secretaria de Salud de Tamaulipas
Covid-19 And Chronic Diabetes: The Perfect Storm For Reactivation Tb?, Genesis P. Aguillón-Durán, Ericka Prieto-Martinez, Doris Ayala, Juan Garcia Jr, John M. Thomas, Juan I. Garcia, Jordi B. Torrelles, Eder Ledezma-Campos, Blanca I. Restrepo
Background: The Coronavirus disease 2019 (COVID-19) pandemic is predicted to have a net negative effect on tuberculosis (TB) control, with an estimated excess of 6.3 million tuberculosis cases and 1.4 million deaths by 2025. Programmatic issues like the lockdown of TB services affect all patients, while biosocial factors have a differential impact on an individual’s risk for TB or adverse TB outcomes.
Case presentation: We report three cases of incident TB after resolution of COVID-19 episodes.Coincidently, all cases shared a common risk factor: a chronic history poorly-controlled diabetes.
Conclusions: Our findings alert to the threat posed by …
Erk Required For Lipopolysaccharide-Induced Tlr4 Internalization In Macrophages, 2023 The University of Texas Rio Grande Valley
Erk Required For Lipopolysaccharide-Induced Tlr4 Internalization In Macrophages, Sara M. Reyna, Phoebe Fang-Mei Chang
Background: Insulin resistance is associated with low circulating levels of lipopolysaccharide (LPS). Binding of LPS to Toll like receptor 4 (TLR4) leads to the internalization and trafficking of TLR4 resulting in activation of downstream signaling pathways. TLR4 internalization in macrophages leads to the activation of pro-inflammatory signaling pathways and production of factors linked to the development of insulin resistance. The extracellular signal-regulated kinase 1 and 2 (ERK1 and 2) are activated downstream of TLR4 and are associated with insulin resistance. We hypothesized that ERK1 and ERK2 regulate TLR4 internalization in macrophages when exposed to LPS.
Methods: We examined whether inhibition …
Unusual Inflammatory Presentation For Locally Advanced Papillary Thyroid Carcinoma, 2023 The University of Texas Rio Grande Valley
Unusual Inflammatory Presentation For Locally Advanced Papillary Thyroid Carcinoma, Ana I. Vargas, Samuel K. Snyder
Background: Thyroid cancer usually presents as a thyroid nodule. If the history implies rapid growth of the nodule, new onset hoarseness or presence of ipsilateral cervical lymphadenopathy then it should raise concern for malignancy. Deep neck infection/inflammation has rarely been reported as initial presentation and these patients are potentially misdiagnosed.
Case Presentation: We present a 56-year-old male who comes to clinic for evaluation of left neck nodule. He started two weeks prior with sudden neck swelling associated with erythema and pain in his lower neck that caused choking sensation and swallowing discomfort, he was prescribed Bactrim and prednisone with improvement …