Endocrine System Diseases Commons^™

Implementing A Basal-Bolus Insulin Regimen Via A Manual Insulin Pump Device, Helen Stearns

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose:The purpose of this evidence-based practice project is to decrease glycated hemoglobin (HgbA1C) levelsby initiating use of a manual insulin pump in patients with Type II Diabetes Mellitus (T2DM) with poor glycemic control who are on multiple daily insulin injections (MDII).

Background: Uncontrolled hyperglycemia is associated with a myriad of complications and co-morbidities that are generally associated with vascular changes that include nephropathy, neuropathy, blindness, stroke, and heart disease (Winter et al., 2015). Coronary artery disease and cerebrovascular disease alone accounts for approximately 65% of the deaths in diabetic patients (Molinaro & Dauscher, 2017). Achieving and maintaining therapeutic glycemic ...

Change In Sex Of Rearing In Individuals With Disorders Of Sex Development, Michelle Knoll

Research Days

No abstract provided.

Effectiveness Of A Community Program For Older Adults With Type 2 Diabetes And Multimorbidity: A Pragmatic Randomized Controlled Trial, John J. Miklavcic, Kimberly D. Fraser, Jenny Ploeg, Maureen Markle-Reid, Kathryn Fisher, Amiram Gafni, Lauren E. Griffith, Sandra Hirst, Cheryl A. Sadowski, Lehana Thabane, Jean A. C. Triscott, Ross Upshur

Food Science Faculty Articles and Research

Background

Type II diabetes mellitus (T2DM) affects upwards of 25% of Canadian older adults and is associated with high comorbidity and burden. Studies show that lifestyle factors and self-management are associated with improved health outcomes, but many studies lack rigour or exclude older adults, particularly those with multimorbidity. More evidence is needed on the effectiveness of community-based self-management programs in older adults with T2DM and multimorbidity. The study purpose is to evaluate the effect of a community-based intervention versus usual care on physical functioning, mental health, depressive symptoms, anxiety, self-efficacy, self-management, and healthcare costs in older adults with T2DM and ...

An Investigation Of Treatments For The Prevention Of Metabolic Complications For Women Suffering From Polycystic Ovarian Syndrome: Diet, Exercise, Weight Reduction And Herbal Remedies, Brenda Martinez-Puente

Nursing | Senior Theses

The purpose of this research study is to compare the views of traditional versus alternative treatments available to women with Polycystic Ovarian Syndrome (PCOS) suffering from metabolic complications. Alternative treatments include diet, exercise, herbal remedies, or any combination of the three. Pharmacological interventions for the conditions associated with PCOS such as metformin, used to control glucose levels, and clomiphene, used to treat infertility. Through the literature review, articles show herbs and plant products to have similar mechanisms of actions as the pharmacological interventions, but with less side effects. For example, cinnamon was shown to increase insulin sensitivity and pomegranate juice ...

Transitioning To Value-Based Diabetes Care: A Call For Action Derived From Primary Care Providers In South Florida, Francois Sainfort, Julie A. Jacko, Johannes Vieweg

HCA Healthcare Journal of Medicine

Background: In Florida, 2.4 million people have diabetes and 5.8 million are pre-diabetic. Not only has the prevalence of diabetes doubled over the past 20 years from 5.2 in 1992 to 11.2 in 2014, but the Centers for Disease Control and Prevention expects 1 out of every 3 adults will have diabetes by the year 2050. In addition, in every year since 1996, Florida well exceeds the national levels in terms of prevalence of diabetes, and the gap is getting wider. A study was conducted to gather information from key physician stakeholders as to how to ...

Prrx1-Crealplfl/Flmice, A Model For Further Investigations Into The Pathophysiological Changes In Hypophosphatemia, Victoria Demambro, Jennifer Daruszka, Daniel Brooks, Mary Bouxsein, Cliff Rosen

Costas T. Lambrew Research Retreat 2020

Hypophosphatasia (HPP) is caused by loss of function mutations in the tissuenonspecific alkaline phosphatase (TNSALP) gene (Alpl) which results in rickets, osteomalicia and bone fragility with severe childhood forms resulting in lean body mass. TNSALP is a glycosylphosphatidylinositol (GPI)-anchored phosphatase localized at the plasma membrane which when cleaved can also be found in circulation. In vitro, inhibition of TNSALP leads to a significant decrease in lipid accumulation suggesting TNSALP, an enzyme known for its mineralizing properties, may be pro-adipogenic. TNSALP has been implicated in bone marrow mesenchymal stem cell (BMMSC) lineage determination between osteoblasts and adipocytes through direct interactions ...

Does Your Patient Know If They Have Prediabetes?, Sophia Adams, Christina Holt, Amy Haskins

Costas T. Lambrew Research Retreat 2020

BACKGROUND: Prediabetes is common; 1 in 3 people have prediabetes, but 9 out of 10 people with prediabetes do not know that they have it. Among those with prediabetes, 25% will progress to diabetes in 3-5 years. MaineHealth has now implemented Diabetes Prevention Program classes, based on a major multicenter clinical research study that showed structured lifestyle interventions can cut the risk of developing type 2 diabetes in half for pre-diabetic participants. This program is available to all patients, free of charge, but in order for patients to participate, they first need to know if they have prediabetes and be ...

Giving Credence To The Experience Of X-Linked Hypophosphatemia In Adulthood: An Interprofessional Mixed-Methods Study, Melissa Hughes, Carolyn Macica, Catherine Meriano, Maya Doyle

Journal of Patient-Centered Research and Reviews

Purpose: X-linked hypophosphatemia (XLH) is a rare X-linked dominant metabolic bone disease, often diagnosed in childhood but causing increasing physical debilitation and pain in adulthood. Physical comorbidities of XLH in adulthood include pervasive and early-onset degenerative arthritis, mineralizing enthesophytes and osteophytes, osteomalacia and pseudofracture, dental abscesses, and hearing loss.

Methods: This mixed-methods analysis included physical findings, diagnostic imaging, occupational and physical therapy assessments, and semi-structured interviews by social work to understand the functional outcomes and lived experience of XLH in adulthood, through connections between qualitative data obtained by social work and occupational therapy with the quantitative findings from other disciplines ...

Development Of Paper-Based Screen-Printed Carbon-Paste Electrode For Sensing Glucose For Diabetics, Yechan Hwang

19th Annual Celebration of Undergraduate Research and Creative Activity (2020)

In recent years there have been many interests in developing paper based electrodes.[1] The purpose of this project is to develop a working paper-based electrode that can detect glucose via an enzyme and redox mediator (Tris(5-amino-1, 10-phenanthroline) Iron(II)). In the process of developing a paper-based electrode, cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) were used as primary methods. The redox mediator was electropolymerized onto glassy carbon (GC) and carbon-paste electrodes (CPE) and their subsequent charge-transfer properties were characterized using CV and EIS. Cyclic voltammetry characterization studies of the electropolymerized films revealed excellent charge transfer properties with ...

A Collaborative Approach To Incentivizing Healthy Food Choices Among Uncontrolled Diabetic Patients At A Local Federally Qualified Health Center To Improve Health Outcomes, Briauna J. Taylor

Doctoral Projects

Background: The rate of uncontrolled diabetes among patients at a local Federally Qualified Health Center (FQHC) is higher than the nation standard, a phenomenon believed to be caused by the effects of social determinants of health (SDOH). SDOH, specifically food insecurity, play a significant role in health outcomes of diabetic patients. Increasing access to healthy foods, thereby reducing food insecurity, has the potential to improve glycemic control and reduce diet related chronic disease.

Objectives: The project aims to determine if partnership with a membership based incentivized grocery store has the potential to positively impact health outcomes among vulnerable patients with ...

Mechanisms Of Insulin Resistance Related To White, Beige, And Brown Adipocytes, Michael P. Czech

Open Access Articles

BACKGROUND: The diminished glucose lowering effect of insulin in obesity, called "insulin resistance," is associated with glucose intolerance, type 2 diabetes, and other serious maladies. Many publications on this topic have suggested numerous hypotheses on the molecular and cellular disruptions that contribute to the syndrome. However, significant uncertainty remains on the mechanisms of its initiation and long-term maintenance.

SCOPE OF REVIEW: To simplify insulin resistance analysis, this review focuses on the unifying concept that adipose tissue is a central regulator of systemic glucose homeostasis by controlling liver and skeletal muscle metabolism. Key aspects of adipose function related to insulin resistance ...

Cultural Influences On Dietary Self-Management Of Type 2 Diabetes In East Asian Americans: A Mixed-Methods Systematic Review, Tony Li-Geng, Jessica Kilham, Katherine M. Mcleod

Open Access Articles

Purpose: Many East Asian Americans (EAAs) (populations originating from China, Korea, Japan, and Taiwan) with type 2 diabetes mellitus (T2DM) experience unique challenges in managing their disease, including language barriers and traditional cultural beliefs, particularly among first-generation immigrants. The purpose of this mixed-methods systematic review was to examine cultural perspectives of EAAs that influence dietary self-management of T2DM and identify education interventions and their approaches to enhance EAAs' dietary self-management of diabetes.

Methods: A mixed-methods systematic review was conducted to examine EAAs' perspectives from qualitative studies and to identify education interventions and their approaches from quantitative studies. A literature search ...

Diabetes Mellitus Type 2 Is Associated With Increased Tumor Expression Of Programmed Death-Ligand 1 (Pd-L1) In Surgically Resected Non-Small Cell Lung Cancer - A Matched Case-Control Study, Christopher A. Febres-Aldana, Robert Poppiti, John M. Varlotto, Rick Voland, Michael Zaleski, Setareh Sharzehi, Negar Rassaei

Open Access Articles

OBJECTIVES: Programmed death-ligand 1 (PD-L1) expression is a biomarker for cancer immunotherapy. Diabetes mellitus type-2 is a comorbid disease associated with adverse outcomes in Non-Small Cell Lung Cancer (NSCLC). We aimed to investigate the differences in PD-L1 expression in diabetics.

METHODS: A matched case-control cohort of surgically-resected NSCLC was assembled from an early multicenter study (PMID: 19152440). PD-L1 immunohistochemistry (Clone 22C3) was graded by a tumor positive score (TPS) system (TPS0: no staining; TPS1: < 1%; TPS2: 1-49%; TPS3: > /=50%). Variables showing significance at univariate survival analysis were fit in a Cox regression survival model.

RESULTS: Diabetics (n=40) and nondiabetics (n=39) showed no ...

Proteomic And Transcriptional Profiles Of Human Stem Cell-Derived Beta Cells Following Enteroviral Challenge, Julius O. Nyalwidhe, Agata Jurczyk, Basanthi Satish, Sambra D. Redick, Natasha Qaisar, Melanie I. Trombly, Pranitha Vangala, Riccardo Racicot, Rita Bortell, David M. Harlan, Dale L. Greiner, Michael A. Brehm, Jerry L. Nadler, Jennifer P. Wang

Open Access Articles

Enteroviral infections are implicated in islet autoimmunity and type 1 diabetes (T1D) pathogenesis. Significant beta-cell stress and damage occur with viral infection, leading to cells that are dysfunctional and vulnerable to destruction. Human stem cell-derived beta (SC-beta) cells are insulin-producing cell clusters that closely resemble native beta cells. To better understand the events precipitated by enteroviral infection of beta cells, we investigated transcriptional and proteomic changes in SC-beta cells challenged with coxsackie B virus (CVB). We confirmed infection by demonstrating that viral protein colocalized with insulin-positive SC-beta cells by immunostaining. Transcriptome analysis showed a decrease in insulin gene expression following ...

Diabetic Cardiomyopathy: Understanding The Independent Relationship Between Diabetes And Heart Failure, W. Tyler Crawley, Rage Geringer Md, Jason Snarr Do, Elizabeth Hicks Md, Oliwier Dziadkowiec

Internal Medicine

No abstract provided.

Adrenocortical Carcinoma: A Stressful Diagnosis, Shabnam Khoie Do, Dmitriy Scherbak Do

Internal Medicine

Introduction: Adrenocortical carcinoma (ACC) is a rare and biologically aggressive malignancy. The incidence of ACC is between 0.7-2 cases per million, accounting for 0.05-2% of all malignant tumors. Cortisol-producing carcinomas are the most common, with clinical features consistent with hypercortisolism: refractory hypertension, glucose intolerance, and central obesity. We present a case of a 75-year-old male with a cortisol-secreting variant of adrenocortical carcinoma.

Case Description: A 75 year-old male with a prior medical history significant for refractory hypertension on multiple anti-hypertensives including hydrochlorothiazide, type two diabetes mellitus, and untreated obstructive sleep apnea, presented to the emergency department with a ...

The Effect Of Care Coordination On Hemoglobin A1c For Type 2 Diabetes Patients, Lee Ann Hinsky

Electronic Theses and Dissertations

The purpose of the study was to test the impact of care coordinator visits by primary care registered nurses on serum hemoglobin A1c (HbA1c) levels in patients with type 2 diabetes. In the study, the researcher compared 2 groups of type 2 diabetes patients—those who had care coordinator visits from registered nurses and those who did not—through retrospective data collection and analysis from the patients’ electronic medical record from July 2018 through December 2018. An independent samples t test was used to compare the means of the intervention and control groups’ change in HbA1c levels. The intervention and ...

Trajectories Of Health-Related Quality Of Life And Hba1c Values Of Children And Adolescents With Diabetes Mellitus Type 1 Over 6 Months: A Longitudinal Observational Study, Kathrin I. Fischer, Felix H. Fischer, Dana Barthel, Christiane Otto, Ute Thyen, Marcus Klein, Otto Walter, Ulrike Ravens-Sieberer, Matthias S. F. Rose, Sandra Nolte

Open Access Articles

Introduction: To achieve optimized blood glucose concentrations (assessed by HbA1c) and high health-related quality of life (HRQL), children and adolescents with diabetes mellitus type 1 (T1DM) must follow strict disease management strategies. This study aims to investigate HRQL of children and adolescents with T1DM and its association with HbA1c values over the course of 6 months.

Methods: Patients aged 7-17 years (n = 203) with T1DM provided HRQL data on a monthly basis. HRQL was measured using the Kids-CAT, a computer-adaptive test (CAT) comprising five generic HRQL domains. HbA1c concentrations were assessed at baseline, at 3 and 6 months. We explored ...

Hypertension And Diabetes Treatment Affordability And Government Expenditures Following Changes In Patient Cost Sharing In The "Farmacia Popular" Program In Brazil: An Interrupted Time Series Study, Isabel Cristina Martins Emmerick, Monica Rodrigues Campos, Rondineli Mendes. Da Silva, Luisa Arueira Chaves, Andrea Damaso Bertoldi, Dennis Ross-Degnan, Vera Lucia Luiza

Surgery Publications

BACKGROUND: Increasing medicines availability and affordability is a key goal of Brazilian health policies. "Farmacia Popular" (FP) Program is one of the government's key strategies to achieve this goal. Under FP, antihypertension (HTN) and antiglycemic (DM) medicines have been provided at subsidized prices in private retail settings since 2006, and free of charge since 2011. We aim to assess the impact of sequential changes in FP benefits on patient affordability and government expenditures for HTN and DM treatment under the FP, and examine their implications for public financing mechanisms and program sustainability.

METHODS: Longitudinal, retrospective study using interrupted time ...

Low Carbohydrate Ketogenic Diet Versus Aerobic Physical Activity In The Management And Treatment Of Type 2 Diabetes: A Review Paper, Nicole Weis

Capstone Showcase

Introduction: In recent decades, the number of people affected by type 2 diabetes mellitus has been a topic of interest. The wide reaching impact on both, individual and societal, healthcare costs and quality measures, begs for attention and interventions. Lifestyle modifications, such as: weight management or loss, increasing physical activity, and making healthier dietary choices, are the first line intervention. However, there are not studies that directly compare the role of a single dietary approach to a form of physical activity. Rather, different diets go head to head as well as aerobic versus resistance training. Therefore, in an attempt to ...