Endocrinology, Diabetes, and Metabolism Commons^™

Glycemic Control And Type 1 Diabetes Mellitus: Current Standard Treatment Vs. Closed-Loop Insulin Pumps, Kelsey Daley

Physician Assistant Scholarly Project Posters

As of 2015, 9.4% of the US population had a diagnosis of Diabetes Mellitus (DM). Although most of the data sets studied encompass type 1 (T1) and type 2 (T2) DM data in all ages of patients, the focus of this project will be primarily on T1DM.

There are effective methods currently available for the management of T1DM patients. These methods include: closed-loop insulin pumps that integrate a continuous glucose monitor (CGM) and insulin pump into one effective system that calculates the needed insulin doses through complicated algorithms, CGM with self-blood glucose monitoring calibrations (SBGM) and insulin administration, and SBGM …

Association Of Wrist Circumference And Waist-To-Height Ratio With Cardiometabolic Risk Factors Among Type Ii Diabetics In A Ghanaian Population, Christian Obirikorang, Yaa Obirikorang, Emmanuel Acheampong, Enoch Odame Anto, Emmanuel Toboh, Evans Adu Asamoah, Bright Amakwaa, Emmanuella Nsenbah Batu, Peter Brenya

Research outputs 2014 to 2021

The study determined the association of wrist circumference (WrC) and waist-to-height ratio (WHtR) with cardiometabolic risk factors among diabetics in a Ghanaian population. This cross-sectional study involved 384 diabetic patients at Begoro District Hospital, Ghana. Blood pressure, anthropometrics, and biochemical indices were measured. The overall prevalence of dyslipidaemia, metabolic syndrome (MetS), and hypertension was 42.4%, 76.3%, and 39.8%, respectively. The optimum cut-off range of WrC to identify individuals at increased cardiometabolic risk was 17.5 to –17.8 cm for men and 16.0 to 16.7 cm for women while that of WHtR was 0.52 to 0.61 for men and 0.53 to 0.59 …

Metabolic Syndrome Among Schizophrenic Patients: A Comparative Cross-Sectional Study In The Middle Belt Of Ghana, Angela Owusu-Ansah, Anto Berko Panyin, Christian Obirikorang, Christian Agyare, Emmanuel Acheampong, Simon Kwofie, Enoch Odame Anto, Emmanuella Nsenbah Batu

Research outputs 2014 to 2021

The study determined the prevalence ofMetS in patients with schizophrenia at the Psychiatric Unit of the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. This comparative cross-sectional study recruited 348 schizophrenic patients comprising 236 antipsychotic-treated and 112 newly diagnosed treatment-na¨ıve patients. The MetS prevalence was assessed based on World Health Organization (WHO), International Diabetes Federation (IDF), and the National Cholesterol Education Programme, Adult Treatment Panel III (NCEP ATP III) criteria. The overall prevalence of MetS was 14.1%, 20.4%, and 23.6% using NCEP ATP III, WHO, and IDF criteria, respectively, compared to 7.8%, 3.9%, and 2.2% reported in the generalGhanaian population.The prevalence …

50 Ways To Save Your Heart, David S. Schade, R. Philip Eaton

Faculty Book Display Case

If you want to place a winning bet, bet that heart disease will kill you. Yes, you. Why? Because heart disease kills more people in the U.S. than any other disease, including cancer. We want to reverse that bet and save your life. How? You need to read this book and follow its simple recommendations. Many people have already jumped on the bandwagon and defied the probability of dying from heart disease. This book gives you the easy tools to do just that. Prevention costs practically nothing and you don’t have to give up anything. You only have to eat …

Quality Improvement: Implementing A Foot Exam To Improve Care For Patients With Diabetes Mellitus, Emily Paprocki, Ryan Mcdonough, Tiffany Musick, Joseph Cernich

Posters

No abstract provided.

Iron Reduction Response And Demographic Differences Between Diabetics And Non-Diabetics With Cardiovascular Disease Entered To A Controlled Clinical Trial, Leo Zacharski, Galina Shamayeva, Bruce Chow

Dartmouth Scholarship

Iron-catalyzed oxygen free radical-induced oxidative stress mediates the pathogenesis of diabetes and cardiovascular disease (CVD). Diabetics (n=473) and non-diabetics (n=804) with CVD entered to a randomized trial of iron (ferritin) reduction by calibrated phlebotomy (www.clinicaltrials.gov, Identifier NCT00032357) had comparable iron measures at entry but diabetics had greater burden of CVD and comorbidities, lower hemoglobin and hematocrit levels, and higher glucose levels than non-diabetics. Entry iron measures were lower in diabetics on hypoglycemic therapy compared to diabetics untreated previously. Diabetics and non-diabetics had comparable iron measures during follow-up. Loess analysis of paired ferritin and hemoglobin, and paired ferritin and glucose levels …

Methylglyoxal Requires Ac1 And Trpa1 To Produce Pain And Spinal Neuron Activation, Ryan B. Griggs, Don E. Laird, Renee R. Donahue, Weisi Fu, Bradley K. Taylor

Physiology Faculty Publications

Methylglyoxal (MG) is a metabolite of glucose that may contribute to peripheral neuropathy and pain in diabetic patients. MG increases intracellular calcium in sensory neurons and produces behavioral nociception via the cation channel transient receptor potential ankyrin 1 (TRPA1). However, rigorous characterization of an animal model of methylglyoxal-evoked pain is needed, including testing whether methylglyoxal promotes negative pain affect. Furthermore, it remains unknown whether methylglyoxal is sufficient to activate neurons in the spinal cord dorsal horn, whether this requires TRPA1, and if the calcium-sensitive adenylyl cyclase 1 isoform (AC1) contributes to MG-evoked pain. We administered intraplantar methylglyoxal and then evaluated …

Type 1 Diabetes Alters Lipid Handling And Metabolism In Human Fibroblasts And Peripheral Blood Mononuclear Cells, Albert R. Jones Iv, Emily L. Coleman, Nicholas R. Husni, Jude T. Deeney, Forum Raval, Devin Steenkamp, Hans Dooms, Barbara S. Nikolajczyk, Barbara E. Corkey

Clinical and Translational Science Faculty Publications

Triggers of the autoimmune response that leads to type 1 diabetes (T1D) remain poorly understood. A possibility is that parallel changes in both T cells and target cells provoke autoimmune attack. We previously documented greater Ca²⁺ transients in fibroblasts from T1D subjects than non-T1D after exposure to fatty acids (FA) and tumor necrosis factor α (TNFα). These data indicate that metabolic and signal transduction defects present in T1D can be elicited ex vivo in isolated cells. Changes that precede T1D, including inflammation, may activate atypical responses in people that are genetically predisposed to T1D. To identify such cellular differences …

Improving Vaccination Rates In Adults With Type Ii Diabetes In A Family Practice Setting: An Evidence-Based Quality Improvement Project, Ronda Gottlieb

Doctor of Nursing Practice

The purpose of this evidenced-based quality improvement project is to implement processes to facilitate providers’ adherence to the American Diabetes Association (2017), American Association of Clinical Endocrinologist (2015), and American College of Endocrinology (2015) immunization guidelines for adults with type II diabetes. Presently, diabetes is the 7th leading cause of death in the United States contributing to serious complications throughout the body as a result of poor glucose control. Adults with diabetes are at increased susceptibility to infectious disease because of hyperglycemia, poor glucose control, and decreased immunity. A protocol was created using The Four Pillars Transformation Program ™ to …

Preserving And Restoring Bone With Continuous Insulin Infusion Therapy In A Mouse Model Of Type 1 Diabetes, Jeffry S. Nyman, Evangelia Kalaitzoglou, R. Clay Bunn, Sasidhar Uppuganti, Kathryn M. Thrailkill, John L. Fowlkes

Barnstable Brown Diabetes Center Faculty Publications

Those with type 1 diabetes (T1D) are more likely to suffer a fracture than age- and sex-matched individuals without diabetes, despite daily insulin therapy. In rodent studies examining the effect of bone- or glucose-targeting therapies on preventing the T1D-related decrease in bone strength, insulin co-therapy is often not included, despite the known importance of insulin signaling to bone mass accrual. Therefore, working toward a relevant pre-clinical model of diabetic bone disease, we assessed the effect of continuous subcutaneous insulin infusion (CSII) therapy at escalating doses on preserving bone and the effect of delayed CSII on rescuing the T1D-related bone deterioration …

The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey

Senior Theses

Type 1 Diabetics have various ways of managing their diabetes that have been studied for their effectiveness. Pregnancy in the Type 1 Diabetic has been understudied. It is known that Diabetics in general have poorer pregnancy outcomes because of poor glycemic control. This coupled with the fact that the body needs 3-4 times more insulin as pregnancy comes to an end makes managing blood glucose levels challenging for diabetics (Lowdermilk, 2016, p. 689). For the Type 1 Diabetic, there are two main ways to control diabetes: multiple daily injections using at least two type of insulin and continuous subcutaneous insulin …

Comparative Effectiveness And Safety Of Empagliflozin On Cardiovascular Mortality And Morbidity In Adults With Type 2 Diabetes, Wilbert S. Aronow, Tatyana Shamliyan

NYMC Faculty Publications

Background: Based on a single placebo-controlled randomized clinical trial, empagliflozin is licensed to reduce cardiovascular death in diabetes and comorbid cardiovascular disease. Methods: We examined the comparative effectiveness of empagliflozin on mortality and cardiovascular morbidity in type 2 diabetes. We conducted random-effects direct frequentist meta-analyses of aggregate data and appraised the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Our search in PubMed, EMBASE, the Cochrane Library, clinicaltrials.gov, and PharmaPendium up to May 2017 identified 11 meta-analyses, multiple publications, and unpublished data from 29 randomized controlled trials (RCTs). Results: Empagliflozin reduces all-cause mortality [relative …

Discrepancies In Publications Related To Hmb-Fa And Atp Supplementation, Jeremy A. Gentles, Stuart M. Phillips

Jeremy A. Gentles

A Low Carbohydrate, Ketogenic Diet For Treatment Of Type Ii Diabetes An Integrative Literature Review, Steven Lisowski

Grace Peterson Nursing Research Colloquium

A Low Carbohydrate, Ketogenic Diet for Treatment

of Type II Diabetes: An Integrative Literature Review

Steven Lisowski

Faculty Sponsor: Larry Maturin

Abstract

Background: Dietary modifications are commonly prescribed initial interventions in those recently diagnosed with type II diabetes. Presently, various researchers support that there is a growing body of evidence that advises to restrict carbohydrate intake to minimum levels to achieve optimal blood glucose levels and reduce complications related to poor diabetes management.

Objectives: To explore if the low carbohydrate, ketogenic diets (LCKD), in which carbohydrate intake of any kind is restricted, are very effective at reducing obesity and controlling …

Determinants Of Behavioral Intent To Adopt The Closed-Loop Artificial Pancreas Among Diabetes Healthcare Providers, Carolyn M. Serrano

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: Diabetes mellitus for both children and adults are broadly defined as a group of complex diseases characterized by high blood glucose, resulting from a defect in either the production of or action of insulin, or both (National Institutes of Health, 2014). There are 29.1 million people in the US that are estimated to have diagnosed or undiagnosed diabetes (Centers for Disease Control and Prevention (CDC), 2014). Type 1 diabetes accounts for approximately 5-10% of all diabetes cases however, it has serious short term and long-term implications (Daneman, 2006).

Technology for diabetes management is rapidly …

Sheehan’S Syndrome: It Is Time To Become More Proactive In Identifying This Disease, Yara E. Tovar, Waseem Ahmed, Madhulika Urella, Ayman H. Elkadry, Rodhan A. Khthir

Ayman Elkadry

Sheehan’s syndrome typically occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage and can present with varying degrees of pituitary insufficiency. It is more common in underdeveloped countries, and is frequently diagnosed years after delivery due to its nonspecific signs and symptoms. Failure to lactate is a common initial symptom, while many women also report amenorrhea or oligomenorrhea. This article presents a 26-year-old female with a history of hypertension, who presented to the hospital for diarrhea, vomiting, and dizziness. Her blood pressure was 80/40 mmHg, requiring aggressive fluid resuscitation, after which it remained borderline. Further testing …

Sheehan’S Syndrome: It Is Time To Become More Proactive In Identifying This Disease, Yara E. Tovar, Waseem Ahmed, Madhulika Urella, Ayman H. Elkadry, Rodhan A. Khthir

Ayman Elkadry

Figure 2: Sagittal MRI of the brain showing an empty sella

Improved Service Efficiency Improves Racial Disparity In Diabetic Care, Abel Irena, Kushal Patel, David Thompson, Gregory Schleis, Abiy Gesese, Richard Battiola

Journal of Patient-Centered Research and Reviews

Background: Racial disparities in diabetes care have been documented. Disparities also have been shown to affect service quality and outcome of diabetic care. Analysis of our internal medicine residency clinic diabetic care management performance across REAL-G (race, ethnicity, age, preferred language and/or gender) showed race-based disparity on two outcome measures: 1) measurement of glycohemoglobin (A1C) at least twice a year; and 2) target blood pressure of < 140/90.

Purpose: Develop interventions to decrease racial disparities in diabetes care among patients managed by an internal medicine residency clinic, as part of the Alliance of Independent Academic Medical Center’s National Initiative V project.

Methods: …

Sensitivity Of Current Methods For Diagnosing And Documenting Metabolic Syndrome Within A Large Community-Based Health Care System, Tiffany A. Mullen, Danielle M. Greer, Jennifer T. Fink, Renee E. Walker

Journal of Patient-Centered Research and Reviews

Background: Metabolic syndrome (MetS) is a constellation of metabolic conditions, including abdominal obesity, high blood pressure, high triglyceride level, low high-density-lipoprotein level and high fasting blood glucose level, that increase the risk of developing chronic health conditions. Various combinations of diagnostic criteria have been proposed, including those by the National Cholesterol Education Program Adult Treatment Panel III (ATP III), World Health Organization (WHO) and International Diabetes Foundation (IDF), among others. However, inconsistent use of diagnostic criteria and inadequate scientific evidence supporting use of specific criteria are current problems in health care.

Purpose: Quantify the prevalence of MetS diagnosis within the …

The Lifestyle Initiative: An Innovative Coaching-Based Quality Improvement Study To Improve The Health Of Aurora Health Care Caregivers And Family Members, Tiffany A. Mullen, Jessica J.F. Kram, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Background: Self-management support has been shown to improve clinical outcomes. Health coaching, one form of self-management support, empowers patients within the health care system by providing information and through collaboratively developed care plans.

Purpose: Assess the impact of The Lifestyle Initiative, a coaching-based health program utilized by Aurora Health Care caregivers or family members.

Methods: The Lifestyle Initiative is a coaching-based approach for Aurora caregivers or family members enrolled in Aurora’s health insurance network. Individuals were recruited from the care management database, and all participants had an Aurora primary care provider. Participation was limited to those ≥ 18 years of …