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Racial/Ethnic Disparities In Diabetes Care And Outcomes: A Mixed Methods Study, Yhenneko J. Taylor, Marion E. Davis, Rohan Mahabaleshwarkar, Melanie D. Spencer 2018 Atrium Health

Racial/Ethnic Disparities In Diabetes Care And Outcomes: A Mixed Methods Study, Yhenneko J. Taylor, Marion E. Davis, Rohan Mahabaleshwarkar, Melanie D. Spencer

Journal of Health Disparities Research and Practice

Limited research has examined racial/ethnic differences in diabetes care and outcomes among primary care patients. This study examined racial/ethnic differences in diabetes care and outcomes among an ambulatory patient population and explored patient perceptions of the patient-provider relationship to inform strategies to improve care delivery. Using data from 62,149 adults with diabetes who received care within Atrium Health in 2013, regression models assessed associations between race/ethnicity and the following outcomes: glycated hemoglobin (HbA1c) tests, low density lipoprotein (LDL) and blood pressure (BP) screening, foot and eye exams, and HbA1c, LDL, and BP control. Eleven patients with ...


Central Precocious Puberty In Boston Boys: A 10-Year Single Center Experience, Lisa Swartz Topor, Kimberly Bowerman, Jason T. Machan, Courtney L. Gilbert, Tairmae Kangarloo, Natalie D. Shaw 2018 Brown University

Central Precocious Puberty In Boston Boys: A 10-Year Single Center Experience, Lisa Swartz Topor, Kimberly Bowerman, Jason T. Machan, Courtney L. Gilbert, Tairmae Kangarloo, Natalie D. Shaw

Open Access Articles

OBJECTIVE: Recent studies in the US and abroad suggest that boys are undergoing puberty at a younger age. It is unknown if this secular trend extends to boys with central precocious puberty (CPP), who sit at the extreme end of the pubertal spectrum, and if neuroimaging should remain a standard diagnostic tool.

STUDY DESIGN: Retrospective chart review of all boys with CPP seen by Endocrinology at a US pediatric hospital from 2001-2010.

RESULTS: Fifty boys had pubertal onset at an average age of 7.31 years (95CI 6.83-7.89), though many did not present until nearly one year thereafter ...


Data From: Tobacco Smoke Exposure Is An Independent Predictor Of Vitamin D Deficiency In Us Children, Benjamin U. Nwosu, Philip Kum-Nji 2018 University of Massachusetts Medical School

Data From: Tobacco Smoke Exposure Is An Independent Predictor Of Vitamin D Deficiency In Us Children, Benjamin U. Nwosu, Philip Kum-Nji

Pediatric Research Data

Manuscript abstract:

Importance: The role of tobacco-smoke exposure on serum vitamin D concentration in US pediatric population is not known. We hypothesized that tobacco smoke exposure would increase the prevalence of vitamin D deficiency in US children.

Methods: Representative national data were accessed from the National Health and Nutrition Examination Survey (NHANES) 2009-2010 databank on 2,263 subjects of ages 3 to 17 years. Subjects were categorized into two groups based on their age: children, if <10 years; and youth if 10 to 17 years. Descriptive and multiple logistic regression analyses were conducted to determine the effect of serum cotinine-verified tobacco smoke exposure on vitamin D status after controlling for key sociodemographic confounders. Vitamin D deficiency was defined as 25(OH)D <20 ng/mL, insufficiency as 25(OH)D of 20-29.9 ng/mL, and sufficiency as 25(OH)D of ≥30 ng/mL. Tobacco smoke exposure status was defined by serum cotinine concentration as follows: unexposed and non-smoking (<0.05 ng/mL) and exposed (passive and active smokers combined) (≥0.05ng/mL). Specifically, passive and active smoking were defined as cotinine of 0.05-10 ng/mL, and ≥10ng/mL respectively.

Results: The prevalence of second-hand smoke exposure was 42.0% (95%CI, 36.7%-47.5%); while the prevalence of active smoking among teenagers ...


Pituitary Tuberculoma, Amir Humza Sohail, Umar Farooq Bhatti, Najmul Islam 2018 Aga Khan University

Pituitary Tuberculoma, Amir Humza Sohail, Umar Farooq Bhatti, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Tuberculosis rarely involves the hypothalamo-pituitary region and constitutes only 1% of the lesions involving the sellar and/or suprasellar region. Coleman and Meredith first reported pituitary tuberculosis in 1940, and only a handful of cases have been reported ever since. It may manifest as a chiasmal syndrome due to compression of the optic chiasm or as hypopituitarism due to pituitary destruction. It has a characteristic radiological appearance and can mimic a pituitary adenoma. Diagnostic procedures, such as trans-sphenoidal biopsy, are crucial for accurate diagnosis. We report a case of a 32-year male, who presented with complaints of headache and decreased ...


Evaluation Of A Digital Diabetes Prevention Program Adapted For The Medicaid Population: Study Design And Methods For A Non-Randomized, Controlled Trial., Sue E Kim, Cynthia M Castro Sweet, Eliza Gibson, Erica N Madero, Barbara Rubino, Janina Morrison, Debra Rosen, Wendy Imberg, Michael R Cousineau 2018 Providence Medical Group, Monroe Clinic, 19200 North Kelsey Street, Monroe, WA

Evaluation Of A Digital Diabetes Prevention Program Adapted For The Medicaid Population: Study Design And Methods For A Non-Randomized, Controlled Trial., Sue E Kim, Cynthia M Castro Sweet, Eliza Gibson, Erica N Madero, Barbara Rubino, Janina Morrison, Debra Rosen, Wendy Imberg, Michael R Cousineau

All Publications

Previous studies have shown that lifestyle modification can successfully prevent or delay development of type 2 diabetes. This trial aimed to test if an underserved, low-income population would engage in a digital diabetes prevention program and successfully achieve lifestyle changes to reduce their risk of type 2 diabetes. Participants were recruited from three health care facilities serving low-income populations. The inclusion criteria were: a recent blood test indicating prediabetes, body mass index (BMI) > 24 kg/m


Children With Type 1 Diabetes Who Experienced A Honeymoon Phase Had Significantly Lower Ldl Cholesterol 5 Years After Diagnosis, Benjamin U. Nwosu, Bo Zhang, Sanaa S. Ayyoub, Stephanie Choi, Tony R. Villalobos-Ortiz, Laura C. Alonso, Bruce A. Barton 2018 University of Massachusetts Medical School

Children With Type 1 Diabetes Who Experienced A Honeymoon Phase Had Significantly Lower Ldl Cholesterol 5 Years After Diagnosis, Benjamin U. Nwosu, Bo Zhang, Sanaa S. Ayyoub, Stephanie Choi, Tony R. Villalobos-Ortiz, Laura C. Alonso, Bruce A. Barton

Pediatric Publications and Presentations

IMPORTANCE: Landmark studies showed that partial clinical remission in new-onset type 1 diabetes is associated with reduced prevalence of long-term complications, but early clinical indicators of this favorable outcome are poorly characterized.

AIM: To determine if there were any differences in lipid parameters, especially LDL-cholesterol, between remitters and non-remitters 4 to 5 years after the diagnosis of type 1 diabetes after controlling for hemoglobin A1c, body mass index, and pubertal status.

SUBJECTS AND METHODS: A longitudinal retrospective cohort study of 123 subjects of mean age 11.9 +/- 2.9 years, [male 11.7 +/- 2.9 years, (n = 55); female 12 ...


The Effect Of Diabetes Self-Management Education On Hba1c And Quality Of Life In African-Americans: A Systematic Review And Meta-Analysis., Amy T. Cunningham, Denine R. Crittendon, Neva White, Geoffrey D. Mills, Victor Diaz, Marianna LaNoue 2018 Thomas Jefferson University

The Effect Of Diabetes Self-Management Education On Hba1c And Quality Of Life In African-Americans: A Systematic Review And Meta-Analysis., Amy T. Cunningham, Denine R. Crittendon, Neva White, Geoffrey D. Mills, Victor Diaz, Marianna Lanoue

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Type 2 diabetes presents a major morbidity and mortality burden in the United States. Diabetes self-management education (DSME) is an intervention associated with improved hemoglobin A1c(HbA1c) and quality of life(QOL), and is recommended for all individuals with type 2 diabetes. African-Americans have disproportionate type 2 diabetes morbidity and mortality, yet no prior meta-analyses have examined DSME outcomes exclusively in this population. This systematic review and meta-analysis examined the impact of DSME on HbA1c and QOL in African-Americans compared to usual care.

METHODS: Randomized controlled trials, cluster-randomized trials, and quasi-experimental interventions were included. 352 citations were retrieved; 279 ...


The Synergistic Effects Of Saxagliptin And Metformin On Cd34+ Endothelial Progenitor Cells In Early Type 2 Diabetes Patients: A Randomized Clinical Trial., Fiona J Dore, Cleyton C Domingues, Neeki Ahmadi, Nabanita Kundu, Yana Kropotova, Sara Houston, Carol Rouphael, Aytan Mammadova, Linda Witkin, Anamil Khiyami, Richard L Amdur, Sabyasachi Sen 2018 George Washington University

The Synergistic Effects Of Saxagliptin And Metformin On Cd34+ Endothelial Progenitor Cells In Early Type 2 Diabetes Patients: A Randomized Clinical Trial., Fiona J Dore, Cleyton C Domingues, Neeki Ahmadi, Nabanita Kundu, Yana Kropotova, Sara Houston, Carol Rouphael, Aytan Mammadova, Linda Witkin, Anamil Khiyami, Richard L Amdur, Sabyasachi Sen

Surgery Faculty Publications

AIMS: Type 2 diabetes is associated with endothelial dysfunction leading to cardiovascular disease. CD34+ endothelial Progenitor Cells (EPCs) are responsible for endothelial repair and neo-angiogenesis and can be used as a cardiovascular disease risk biomarker. This study investigated whether the addition of saxagliptin, a DPP-IV inhibitor, to metformin, may reduce cardiovascular disease risk in addition to improving glycemic control in Type 2 diabetes patients.

METHODS: In 12 week, double-blind, randomized placebo-controlled trial, 42 subjects already taking metformin 1-2 grams/day were randomized to placebo or saxagliptin 5 mg. Subjects aged 40-70 years with diabetes for < 10 years, with no known cardiovascular disease, BMI 25-39.9, HbA1C 6-9% were included. We evaluated EPCs number, function, surface markers and gene expression, in addition to arterial stiffness, blood biochemistries, resting energy expenditure, and body composition parameters. A mixed model regression to examine saxagliptin vs placebo, accounting for within-subject autocorrelation, was done with SAS (p < 0.05).

RESULTS: Although there was no ...


Sofosbuvir Causing Diabetes Mellitus: Is There A Link?, Sumerah Jabeen, Owais Rashid, Saira Furqan 2018 Aga Khan University

Sofosbuvir Causing Diabetes Mellitus: Is There A Link?, Sumerah Jabeen, Owais Rashid, Saira Furqan

Section of Diabetes, Endocrinology and Metabolism

No abstract provided.


Sofosbuvir Causing Diabetes Mellitus: Is There A Link?, Sumerah Jabeen, Owais Rashid, Saira Furqan 2018 Aga Khan University

Sofosbuvir Causing Diabetes Mellitus: Is There A Link?, Sumerah Jabeen, Owais Rashid, Saira Furqan

Section of Diabetes, Endocrinology and Metabolism

No abstract provided.


Ahsg Rs4918 Polymorphism Poses A Weak Predisposition To Insulin Resistance During Pregnancy, Aisha Tariq, Aleezay Asghar, Faiza Alam, Syeda Sadia Fatima 2018 Aga Khan University

Ahsg Rs4918 Polymorphism Poses A Weak Predisposition To Insulin Resistance During Pregnancy, Aisha Tariq, Aleezay Asghar, Faiza Alam, Syeda Sadia Fatima

Medical College Documents

Objective: To identify the association between Fetuin-A levels and genetic polymorphism with gestational diabetes mellitus among pregnant women visiting a tertiary care centre.

Methods: This cross-sectional case-control study was conducted at Aga Khan University Hospital, Karachi, from December 2015 to September 2016, and comprised pregnant women in their second trimester. Those with gestational diabetes mellitus were considered the cases while the rest acted as controls. The enzyme-linked immunosorbent assay was used to quantify Fetuin-A levels while genotyping for alpha-2-Heremans-Schmidglycoprotein rs4918 was performed using restriction fragment length polymorphism technique. Blood samples were collected and serum and deoxyribonucleic acid were extracted and ...


Oxidative Stress And Cardiovascular Risk In Type 1 Diabetes Mellitus: Insights From The Dcct/Edic Study, W. Wilson Tang, P. McGee, John M. Lachin, D. Li, B. Hoogwerf, S. Hazen, +several additional authors 2018 George Washington University

Oxidative Stress And Cardiovascular Risk In Type 1 Diabetes Mellitus: Insights From The Dcct/Edic Study, W. Wilson Tang, P. Mcgee, John M. Lachin, D. Li, B. Hoogwerf, S. Hazen, +Several Additional Authors

Epidemiology and Biostatistics Faculty Publications

Background--Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus. Methods and Results--A random subcohort of 349 participants was selected from the DCCT/EDIC (Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from DCCT baseline, year 1, and closeout of DCCT, and 1 to 2 years post-DCCT (EDIC years ...


Prevalence Of Prediabetes, Diabetes, And Its Associated Risk Factors Among Males In Saudi Arabia: A Population-Based Survey, Khaled K. Aldossari, Abdulrahman Aldiab, Jamaan M. Al-Zahrani, Sameer H. Al-Ghamdi, Mohammed Abdelrazik, Mohammed Ali Batais, Sundas Javad, Shanila Nooruddin, Hira Abdul Razzak, Ashraf El-Metwally 2018 Prince Sattam Bin Abdulaziz University

Prevalence Of Prediabetes, Diabetes, And Its Associated Risk Factors Among Males In Saudi Arabia: A Population-Based Survey, Khaled K. Aldossari, Abdulrahman Aldiab, Jamaan M. Al-Zahrani, Sameer H. Al-Ghamdi, Mohammed Abdelrazik, Mohammed Ali Batais, Sundas Javad, Shanila Nooruddin, Hira Abdul Razzak, Ashraf El-Metwally

Department of Paediatrics and Child Health

Objectives: The study aims at determining the prevalence of prediabetes and diabetes and at ascertaining some concomitant risk factorsamong males in Saudi Arabia.
Methods: A population-based cross-sectional study including 381 Saudi adult males from different institutions was recruited. Odds ratios for diabetes risk and risk factors were calculated using log-binomial and multinomial logistic regression, using STATA version 12.
Results: The participants included 381 diabetic males with a median age of 45 years, average body mass index of 25 ± 40 kg/m2, whereas waist circumferences ranged from 66 to 180 cm in the male study population. In addition, 27.82 ...


Cystic Fibrosis-Related Diabetes Is Caused By Islet Loss And Inflammation, Nathaniel J. Hart, Jenny Aurielle B. Babon, Megan E. DeNicola, Sally C. Kent, Alvin C. Powers 2018 Vanderbilt University Medical Center

Cystic Fibrosis-Related Diabetes Is Caused By Islet Loss And Inflammation, Nathaniel J. Hart, Jenny Aurielle B. Babon, Megan E. Denicola, Sally C. Kent, Alvin C. Powers

Open Access Articles

Cystic fibrosis-related (CF-related) diabetes (CFRD) is an increasingly common and devastating comorbidity of CF, affecting approximately 35% of adults with CF. However, the underlying causes of CFRD are unclear. Here, we examined cystic fibrosis transmembrane conductance regulator (CFTR) islet expression and whether the CFTR participates in islet endocrine cell function using murine models of beta cell CFTR deletion and normal and CF human pancreas and islets. Specific deletion of CFTR from murine beta cells did not affect beta cell function. In human islets, CFTR mRNA was minimally expressed, and CFTR protein and electrical activity were not detected. Isolated CF/CFRD ...


Do Global Diets Affect The Rate Of Type 2 Diabetes?, Demetria Meyer 2018 Western Michigan University

Do Global Diets Affect The Rate Of Type 2 Diabetes?, Demetria Meyer

Honors Theses

The purpose of this study is to determine whether different global diets correlate with the increase in type 2 diabetes rates. Type 2 diabetes is the main diabetes type being looked at due to it being the one that can be maintained primarily by glycemic control, which is controlled by a good diet. Five different countries from different regions will be examined: Brazil, China, Micronesia, Nigeria, and the United States. The diets of these countries will be broken down into smaller pieces, like calories consumed each day and the percentage of macronutrients that make up the calories. Eleven food groups ...


Markers Of Cardiometabolic Risk And Thyroid Dysfunction In U.S. Adolescents: Nhanes Iii, Jonathan Austin 2018 Illinois State University

Markers Of Cardiometabolic Risk And Thyroid Dysfunction In U.S. Adolescents: Nhanes Iii, Jonathan Austin

Theses and Dissertations

The global prevalence of metabolic syndrome (MetS) and its associated components (high fasting glucose, waist circumference, blood pressure, triglycerides, and low HDL) have increased over the past few decades. In addition, abnormal thyroid hormone levels have been found to manifest in a cascade of metabolic dysfunction, which may be linked to MetS in youth. PURPOSE: The purpose of the study is to investigate the association between MetS, its components, and markers of thyroid function in a nationally-representative sample of adolescents. METHODS: The National Health and Nutrition Examination Survey III (1988-1994) collected data on the components of metabolic syndrome and thyroid ...


Disparities In Diabetes Rates And Quality Of Care Within Immigrants In The Usa, Anyun Chatterjee, Martin Blanco, George Gray 2018 George Washington University

Disparities In Diabetes Rates And Quality Of Care Within Immigrants In The Usa, Anyun Chatterjee, Martin Blanco, George Gray

GW Research Days 2016 - Present

Immigrants to the USA present an interesting opportunity to test the classical public health question of the impact of place on a health outcome. Diabetes is a prevalent disease in the USA which is slated to rise in rate in the future. Currently, 9.4% of the country is diabetic, and another 28% of the country is prediabetic. We posed the question - is this impact felt disproportionately by immigrants as they live in the US for a decade or more? Our preliminary literature search indicated that this has not been studied extensively, although the impact of American fast food on ...


Effects Of An Online Diabetes Self-Management Educational Class On Perceived Self-Efficacy In Patients With Type 2 Diabetes Mellitus, Samantha L. Sugarman, DNP, BA, BSN, MSN, FNP-C 2018 George Washington University

Effects Of An Online Diabetes Self-Management Educational Class On Perceived Self-Efficacy In Patients With Type 2 Diabetes Mellitus, Samantha L. Sugarman, Dnp, Ba, Bsn, Msn, Fnp-C

Doctor of Nursing Practice Projects

Background: Diabetes is a complex, chronic disease that, without adequate glycemic control, may result in avoidable complications. Without proper diabetes self-management education, achieving good glycemic control is difficult. Furthermore, lacking self-efficacy to perform such tasks may prevent even the most educated patients from achieving good glycemic control. Studies have shown that live diabetes education has improved self-efficacy in patients with diabetes, but few look at the effects of a lecture-style educational format in an online approach.

Objectives: The purpose of this study is to determine if an online, lecture-style diabetes self-management educational class will improve self-efficacy among patients with type ...


Pediatric Type Ii Diabetes Mellitus: Examining The Upward Trend, Allison Foering 2018 Liberty University

Pediatric Type Ii Diabetes Mellitus: Examining The Upward Trend, Allison Foering

Senior Honors Theses

In recent years, there has been a significant increase in pediatric onset of type II diabetes. This paper will examine elements contributing to this trend. Type II diabetes will be discussed, including related pathophysiology, manifestations, diagnosis, and complications, with differentiation between adult and pediatric onset. Possible prevention and treatment methods appropriate for pediatric patients will also be discussed, along with possible outcomes in pediatric patients that could result from this disease. Overall, this paper will provide insight on the causes of this growing trend, and ways to improve the risks imposed on pediatric patients.


Unmodifiable Variables Related To Thyroid Cancer Incidence, Cornelia Nitipir, Lucian Alecu, Iulian Slavu, Raluca Tulin, Radu C. Jecan, Cristina Orlov, Silviu Pituru, Dana L. Stanculeanu, Razvan Hainarosie, Anca P. Stoian, Adrian Tulin 2018 Carol Davila University of Medicine and Pharmacy, Elias University Emergency Hospital, Department of Medical Oncology

Unmodifiable Variables Related To Thyroid Cancer Incidence, Cornelia Nitipir, Lucian Alecu, Iulian Slavu, Raluca Tulin, Radu C. Jecan, Cristina Orlov, Silviu Pituru, Dana L. Stanculeanu, Razvan Hainarosie, Anca P. Stoian, Adrian Tulin

Journal of Mind and Medical Sciences

The incidence of thyroid cancer is significantly different between male and female patients. Thyroid cancer is also the only form of cancer where age can be considered a staging variable. Identifying biological prognostic factors such as age or sex is important as it helps select an optimal personalized therapy. The present analysis is an observational, prospective study that enrolled all patients with thyroid disease who were operated upon at a single center. The study aimed to determine the most frequent age at presentation, the predominance of one sex over the other, the incidence of malignant thyroid disease, and the relative ...


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