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Food Insecurity In Youth And Young Adults With Diabetes: Prevalence And Association With Health Behaviors, Lauren Helene Martini

Theses and Dissertations

Given the life-long impact of diabetes(1-5), it is important to engage in behaviors that promote health and wellness to delay or prevent negative health outcomes(3, 6-10). Despite this, youth and young adults with diabetes generally do not adhere to nutritional(11-17) or physical activity(18, 19) recommendations. In households experiencing financial difficulties, especially those who are having difficulty providing sufficient food to all of its members, adhering to recommendations may be even more difficult.

The purpose of this dissertation is to better understand and contextualize food insecurity among youth and young adults (YYA) with youth-onset T1DM and T2DM. The first aim addresses …

Pre-Existing Diabetes Mellitus, Hypertension And Kidneydisease As Risk Factors Of Pre-Eclampsia: A Disease Of Theories And Its Association With Genetic Polymorphism, Abdullah Salah Alanazi, Francis Victor, Kanwal Rehman, Yusra Habib Khan, Ismaeel Yunusa Ph.D., Abdulaziz Alzarea, Muhammad Sajid Hamid Akash, Tauqeer Hussain Mallhi

Faculty Publications

Pre-existing diabetes, hypertension and kidney disorders are prominent risk factors of pre-eclampsia (PE). It is a multifactorial pregnancy disorder associated with high blood pressure, proteinuria, and multiorgan failure, which develops after the 20th week of pregnancy. It is one of the most feared pregnancy disorders, as it consumes thousands of fetomaternal lives per annum. According to clinical and pathological studies, the placenta appears to be a key player in the pathogenesis of PE; however, the exact origin of this disorder is still under debate. Defective placentation and angiogenesis are the hallmarks of PE progression. This angiogenic imbalance, together with maternal …

Higher Adherence To A Mediterranean Diet Is Associated With Improved Insulin Sensitivity And Selected Markers Of Inflammation In Individuals Who Are Overweight And Obese Without Diabetes, Surbhi Sood, Jack Feehan, Catherine Itsiopoulos, Kirsty Wilson, Magdalena Plebanski, David Scott, James Hébert Scd, Nitin Shivappa Mbbs, Mph, Ph.D., Aya Mousa, Elena S. George, Barbora De Courten

Faculty Publications

Insulin resistance (IR) and chronic low-grade inflammation are risk factors for chronic diseases including type 2 diabetes (T2D) and cardiovascular disease. This study aimed to investigate two dietary indices: Mediterranean Diet Score (MDS) and Dietary Inflammatory Index (DII®), and their associations with direct measures of glucose metabolism and adiposity, and biochemical measures including lipids, cytokines and adipokines in overweight/obese adults. This cross-sectional study included 65 participants (males = 63%; age 31.3 ± 8.5 years). Dietary intake via 3-day food diaries was used to measure adherence to MDS (0–45 points); higher scores indicating adherence. Energy-adjusted DII (E-DII) scores were calculated with …

Quantile Differences In The Age-Related Decline In Cardiorespiratory Fitness Between Sexes In Adults Without Type 2 Diabetes Mellitus In The United States, Andrew Ortaglia, Melissa Stansbury, Michael David Wirth, Xuemei Sui, Matteo Bottai

Faculty Publications

Objective: To comprehensively assess the extent to which the decline in cardiorespiratory fitness (CRF) with age differs between sexes. Participants and Methods: This study used data from the Aerobics Center Longitudinal Study, conducted between September 1974 and August 2006, consisting primarily of White adults from middle-to-upper socioeconomic strata restricted to adults without type 2 diabetes mellitus (33,742 men and 9,415 women). Quantile regression models were used to estimate the differences in age-associated changes in CRF between the sexes, estimated using a maximal treadmill test. Results: For adults aged up to 45 years, significant differences in slopes relating to age and …

The Impact Of Cannabis And Alcohol Use On The Management Of Type 1 Diabetes Mellitus, Joshua Eric Sellner

Theses and Dissertations

This dissertation sought to contribute to the evidence-base of diabetes management and acute complications associated with alcohol and cannabis use among individuals with Type 1 Diabetes (T1DM). Three interconnected studies were initiated to complete this goal. First, existing literature surrounding the potential consequences of cannabis consumption among individuals with T1DM were summarized within a systematic review. Study results were combined to provide a single measure of association through a meta-analysis. Second, identified associations were further investigated through a cross-sectional study using the SEARCH for Diabetes in Youth data on alcohol and cannabis use on diabetes management and acute complications including …

Longitudinal Relation Of Dietary Quality And Hemoglobin A1c In Youth And Young Adults With Diabetes, Hope Bercaw

Theses and Dissertations

Background Hemoglobin A1c (HbA1c) is a clinical measure of glycemic control among people with diabetes and is associated with health outcomes such as cardiovascular disease. It is possible to decrease HbA1c by improving diet, but it is largely unknown which dietary components are most important in targeting glycemic control.

Objective This study aims to examine whether changes in diet quality across diabetes duration, assessed with the 2015-Healthy Eating Index (HEI), are associated with HbA1c in youth and young adults (YYA) with type 1 (T1D) and type 2 diabetes (T2D). Additionally, we aim to assess whether these relationships differ when dietary …

Trends In Insulin Prescribing For Patients With Diabetes During The Covid-19 Pandemic In The Us, Ismaeel Yunusa Ph.D., Bryan L. Love Pharm D., Chao Cai, Tessa Hastings, Claiborne E. Reeder, Elizabeh W. Blake, Cynthia Phillips

Faculty Publications

Introduction

For the approximately 7 million US individuals with diabetes who rely on insulin,¹ the number of insulin prescriptions rose steadily in the decade before the COVID-19 pandemic.² Reduced access to medical care and disruptions in supply related to the pandemic may have decreased access to insulin,³ with possible adverse consequences for diabetes control.⁴ Conversely, emergency Medicaid expansions that increased capacity for telemedicine services during the pandemic may have been associated with improved access to treatment.⁵ Therefore, this study aimed to assess whether changes to insulin prescription claims occurred during the COVID-19 pandemic.

Methods

In …

Household Food Security, Lifestyle Factors, And Glycemic Control Among Youth And Young Adults With Diabetes, Lauren A. Reid

Theses and Dissertations

The purpose of this study was to assess the associations between household food insecurity (HFI) and glycemic control, physical activity, and diet quality in youth and young adults (YYA) with type 1 diabetes (T1D) and type 2 diabetes (T2D). Among older adults, HFI has been shown to complicate diabetes management due to the essential role of diet in diabetes management and the financial stress associated with HFI. Although HFI is more prevalent among YYA with diabetes than the general population, there are only a handful of studies that have focused on this population and, studies that include YYA with T2D …

The Association Of Exercise Training Modalities With Circulating Branched Chain Amino Acid And Ketone Body Levels In Patients With Type 2 Diabetes, Ryan Andrew Flynn

Theses and Dissertations

Background: Elevated levels of circulating branched-chain amino acids (BCAA) and ketone bodies are recognized as biomarkers for cardiovascular disease (CVD) and other pathological conditions in type-2 diabetes mellitus (T2DM). Aerobic exercise interventions have been shown to decrease the levels of these markers, suggesting improved metabolic status and reduced risk of CVD. However, the efficacy of resistance training and concurrent programs in reducing BCAA and ketone body levels has not been well researched.

Methods: The current study was performed as a secondary analysis of the HART-D trial, a 9-month randomized, controlled exercise-training trial of 262 participants with T2DM. Participants were randomized …

Differential Relationships Between Waist Circumference And Cardiorespiratory Fitness Among People With And Without Type 2 Diabetes, Andrew Ortaglia, Samantha M. Mcdonald, Christina Supino, Michael D. Wirth, Xuem Sui, Matteo Bottai

Faculty Publications

Adults with type 2 diabetes mellitus tend to exhibit an increased level of central adiposity, augmenting their risk of further non-communicable diseases (NCDs). Importantly, consistent evidence demonstrates a significant, negative association between cardiorespiratory fitness (CRF) and waist circumference (WC). However, no previous studies have investigated differences in these CRF-related reductions in WC between adults with and without diabetes.

This study used data from the Aerobic Center for Longitudinal Studies, conducted between 1970 and 2006 among predominately Non-Hispanic White, middle-to-upper class adults in Texas. Quantile regression models were used to estimate CRF-related differences in WC between persons with and without diabetes. …

Body Mass Index Z-Score Modifies The Association Between Added Sugar Intake And Arterial Stiffness In Youth With Type 1 Diabetes: The Search Nutrition Ancillary Study, Natalie S. The, Sarah C. Couch, Elaine M. Urbina, Jamie L. Crandell, Angela D. Liese, Dana Dabelea, Grace J. Kim, Janet A. Tooze, Jean M. Lawrence, Elizabeth J. Mayer-Davis

Faculty Publications

The relationship between added sugar and arterial stiffness in youth with type 1 diabetes (T1D) has not been well-described. We used data from the SEARCH for Diabetes in Youth Study (SEARCH), an ongoing observational cohort study, to determine the association between added sugar and arterial stiffness in individuals diagnosed with T1D(n = 1539; mean diabetes duration of 7.9 ± 1.9 years). Added sugar intake was assessed by a food frequency questionnaire, and arterial stiffness measures included pulse wave velocity (PWV) and augmentation index. Separate multivariate linear regression models were used to evaluate the association between added sugar and arterial stiffness. …

A Qualitative Exploration Of Experiences And Motivations For Diabetes Self-Management In African American Men Between The Ages Of 40-85 With Type 2 Diabetes, Anthony Q. Walker

Theses and Dissertations

Diabetes is a devastating disease that can affect an individual’s health and quality of life, but if managed properly, individuals with diabetes can have a good quality of life. Diabetes strikes African American men at a high rate. This study used a qualitative design to explore African American men between the ages of 40-85 with type 2 diabetes (T2DM) and their definition of diabetes and motivation, their experience of living with diabetes, their self-management behaviors, their motivations for managing diabetes, and what they and healthcare providers believe motivates them to self-manage diabetes and to attend diabetes self-management education (DSME) programs. …

Association Of Insurance And Provider Type With Patients’ Perceived Cost And Ease Of Access To Healthcare Services Among Medicare Beneficiaries Diagnosed With Diabetes, Metria Harris

Theses and Dissertations

Medicare beneficiaries diagnosed with diabetes are likely to have health complications or episodes associated with diabetes, resulting in higher health care utilization and costs. Andersen’s Health Care Utilization Behavior Model (HCBM) includes predisposing, enabling, and need factors, but it excludes perception. Ajzen’s Theory of Planned Behavior (TPB) shows that perception influences health service use. This study was performed using a real-world model integrating Andersen’s HCBM and Ajzen’s TPB to determine whether there was an association between insurance type (Medicare Part D versus non-Part D) and perceived ease of access or cost among Medicare beneficiaries with diabetes. The second objective was …

Characterizing Health Behavior Information: Developing A Surveillance Text Mining Framework Using Twitter For Diet, Diabetes, Exercise, And Obesity, George Shaw Jr.

Theses and Dissertations

Previous studies have documented the relationship that exists among diabetes, diet, exercise, and obesity. Obesity increases people’s risk of developing heart disease and type 2 diabetes. Exercise and proper dieting are modifiable lifestyle behaviors that can help with reducing people’s overall weight and risk to various chronic conditions like diabetes. A national survey conducted by the Centers for Diseases Control and Prevention (CDC) is the annual Behavioral Risk Factor Surveillance Survey (BRFSS). Twitter provides researchers with a new opportunity and alternative data source to collect information regarding health behaviors using real-time data. Previous studies have demonstrated Twitter’s ability to monitor …

The Turnover Of Succinated Proteins In The Adipocyte For The Treatment Of Diabetes, Dominique Jacobs

Senior Theses

In the United States 29.1 million people have diabetes, or 1 out of every 11 people. The rate of new cases of diagnosed diabetes has begun to fall, but the numbers are still very high. 86 million people are living with prediabetes, a serious health condition that increases a person’s risk of developing type 2 diabetes mellitus (T2DM) and other chronic diseases (1). Unfortunately, 90% of those 86 million people are unaware that they are at risk. The health and economic costs for both types of diabetes are enormous: more than 20% of health care spending is committed to people …

Association Between Diabetes And Cancer In Indian And Us Populations Using Longitudinal Study Design, Shraddha S. Vyas

Theses and Dissertations

Background: There is growing evidence of association between diabetes and cancer. No studies have been conducted in India evaluating this association. With the current epidemiologic, nutritional and economic transition in India, it becomes extremely important to examine this association in an Indian population. Additionally, difference in association exists based on different cancer subtypes. Research has shown that diabetes is associated with an increased risk of colorectal cancer. However most of these studies suggest detection bias to be one of the probable reasons for this association. Additionally, the common risk factors shared by both these conditions are considered to one of …

Succination Impairs Protein Folding And Promotes Chop Stability In The Adipocyte During Diabetes, Allison Manuel

Theses and Dissertations

Type 2 diabetes mellitus has been diagnosed in ~21 million people in the United States and is closely correlated with obesity, prompting the need for a detailed understanding of adipocyte metabolism in the development of diabetes. The intake of excess nutrients surpasses the energy requirements of the cell and leads to increased mitochondrial stress in the adipocyte. We have shown that this is associated with increased levels of the mitochondrial metabolite fumarate. Fumarate can react with cysteine thiol groups to form the chemical modification S-(2-succino)cysteine (2SC), also termed protein succination. Succination is significantly increased in the adipose tissue of type …

Longitudinal Association Between Television Watching, Computer Use And Meal Frequency And Risk Markers In Diabetes Among Youth With Diabetes, Chao Li

Theses and Dissertations

BACKGROUND AND OBJECTIVES: Television watching and computer use are considered to be the main sedentary behaviors in children and youth. However, their longitudinal impact on HbA1c and serum lipids among youth with type 1 diabetes (T1D) and type 2 diabetes (T2D) are under-studied. Sedentary behavior is normally assessed by questionnaire in large epidemiological studies, however, its measurement by questionnaire has not been evaluated among youth with diabetes. Also, no recent studies have evaluated the optimal meal frequency for glycemic control in youth with T1D and T2D; for this reason nutritional guidelines on meal frequency for youth with diabetes are vague. …

Association Of Serum Immunoglobulin G (Igg) Antibodies Against Periodontal Bacteria In Type 2 Diabetes And Pre-Diabetes And Cardiovascular Risk Factors, Deepika Shrestha

Theses and Dissertations

Periodontal disease is an inflammatory disease caused by polybacterial infection and inflammation plays key role that associates periodontal disease with different systemic diseases including diabetes and cardiovascular diseases. The main objective of this study is to evaluate and explore the association of serum IgG antibodies in four distinct clusters that were formed empirically from species specific 19 periodontal antibody titers with T2DM and pre-diabetes adjusting for known confounders such as age, sex, race-ethnicity, income to poverty ratio, education, smoking and drinking alcohol, BMI, WC, physical activity, missing teeth, dentist visits and other nutritional factors.

From the first aim, we formed …

Illness-Related Diabetes Social Support And Glycemic Control Among Middle Aged And Older Adults, Favel Leah Mondesir

Theses and Dissertations

Objective

The objective of this study is to investigate the association between illness-related diabetes social support (IRDSS) and glycemic control (GC) among a racially diverse sample of middle aged and older adults. In gender-stratified models we examine whether the relationship between IRDSS and GC is modified by race/ethnicity. Additionally, we explore the association between eight individual types of IRDSS and GC.

Methods

We used the Health and Retirement Study (HRS) 2002 and the 2003 Diabetes Survey. The final analytic sample consisted of 914 study respondents. Gender-stratified multivariable logistic regression models were used to calculate odd ratios (ORs) and 95% confidence …

Longitudinal Effects Of Depression And Sexual Dysfunction On Glycemic Control In Veterans With Diabetes, Adrian Laseter

Theses and Dissertations

Diabetes rates are on the rise, particularly among members of racial and ethnic minority groups. Individuals with diabetes are more vulnerable to developing depressive symptoms when compared to those without diabetes. While there appear to be no racial and ethnic differences in depression prevalence estimates among individuals with diabetes, members of racial and ethnic minority groups are less likely to achieve glycemic control over time, and may be at greater risk for diabetes related health issues. One such health issue is sexual dysfunction, with individuals with diabetes being more vulnerable to sexual dysfunction than those without diabetes. Sexual dysfunction may …

Identifying Postpartum Intervention Approaches To Preventing Type 2 Diabetes In Women With A History Of Gestational Diabetes, Jacinda M. Nicklas, Chloe A. Zera, Ellen W. Seely, Zainab S. Abdul-Rahim, Noelle D. Rudloff, Sue E. Levkoff

Faculty and Staff Publications

Background: Women who develop gestational diabetes mellitus (GDM) have an increased risk for the development of type 2 diabetes. Despite this "window of opportunity," few intervention studies have targeted postpartum women with a history of GDM. We sought perspectives of women with a history of GDM to identify a) barriers and facilitators to healthy lifestyle changes postpartum, and b) specific intervention approaches that would facilitate participation in a postpartum lifestyle intervention program.

Methods: We used mixed methods to gather data from women with a prior history of GDM, including focus groups and informant interviews. Analysis of focus groups relied on …

Associations Between Mental Health And Diabetes: Findings From The South Carolina Medicaid Managed Care Program In 2006-2008, Ana Lopez-De Fede, James W. Hardin, Kathy L. Mayfield-Smith, Qiduan Liu

Publications

Objectives: To assess differences in services associated with mental health status and prescriptions among Medicaid patients diagnosed with diabetes mellitus. Design: Secondary data analyses of South Carolina (SC) Medicaid enrollees. Participants: SC Medicaid enrollees with a diagnosis of diabetes mellitus (N5555) continuously enrolled in either managed care (MC) or fee for service (FFS) programs between 2006 and 2008. Main Outcome Measures: Health Plan Employer Data and Information Set (HEDIS)- based diabetes management service outcomes including: 1) whether the recipient received a nephrology exam; 2) the number of eye exams received; 3) the number of low-density lipoprotein cholesterol services received; and …

Succination Of Thiol Groups In Adipose Tissue Proteins In Diabetes: Succination Inhibits Polymerization And Secretion Of Adiponectin, Norma Frizzell, Mathur Rajesh, Matthew J. Jepson, Ryoji Nagai, James A. Carson, Suzanne R. Thorpe, John W. Baynes

Faculty Publications

S-(2-Succinyl)cysteine (2SC) is formed by reaction of the Krebs cycle intermediate fumarate with cysteine residues in protein, a process termed succination of protein. Both fumarate and succination of proteins are increased in adipocytes cultured in high glucose medium (Nagai, R., Brock, J. W., Blatnik, M., Baatz, J. E., Bethard, J., Walla, M. D., Thorpe, S. R., Baynes, J. W., and Frizzell, N. (2007) J. Biol. Chem. 282, 34219-34228). We show here that succination of protein is also increased in epididymal, mesenteric, and subcutaneous adipose tissue of diabetic (db/db) mice and that adiponectin is a major target for succination in both …

Cardiac And Renal Function Are Progressively Impaired With Aging In Zucker Diabetic Fatty Type Ii Diabetic Rats, John W. Baynes, David B. Murray

Faculty Publications

This study investigated the temporal relationship between cardiomyopathy and renal pathology in the type II diabetic Zucker diabetic fatty (ZDF) rat. We hypothesized that changes in renal function will precede the development of cardiac dysfunction in the ZDF rat. Animals (10 weeks old) were divided into four experimental groups: Lean Control (fa/?) LC(n = 7), untreated ZDF rats (n = 7) sacrificed at 16 weeks of age, and LC (n = 7) untreated ZDF rats (n = 9) sacrificed at 36 weeks of age. LV structural/functional parameters were assessed via Millar conductance catheter. Renal function was evaluated via markers of …

The Metal Chelators, Trientine And Citrate, Inhibit The Development Of Cardiac Pathology In The Zucker Diabetic Rat, John W. Baynes, David B. Murray

Faculty Publications

Purpose. The objective of this study was to determine the efficacy of dietary supplementation with the metal chelators, trientine or citric acid, in preventing the development of cardiomyopathy in the Zucker diabetic rat.

Hypothesis. We hypothesized that dietary chelators would attenuate metal-catalyzed oxidative stress and damage in tissues and protect against pathological changes in ventricular structure and function in type II diabetes.

Methods. Animals (10 weeks old) included lean control (LC, fa/+), untreated Zucker diabetic fatty (ZDF, fa/fa), and ZDF rats treated with either trientine (triethylenetetramine) or citrate at 20 mg/d in drinking water, starting …

Pyridoxamine Traps Intermediates In Lipid Peroxidation Reactions In Vivo: Evidence On The Role Of Lipids In Chemical Modification Of Protein And Development Of Diabetic Complications, Thomas O. Metz, Nathan L. Alderson, Mark E. Chachich, Suzanne R. Thorpe, John W. Baynes

Faculty Publications

Maillard or browning reactions between reducing sugars and protein lead to formation of advanced glycation end products (AGEs) and are thought to contribute to the pathogenesis of diabetic complications. AGE inhibitors such as aminoguanidine and pyridoxamine (PM) inhibit both the formation of AGEs and development of complications in animal models of diabetes. PM also inhibits the chemical modification of protein by advanced lipoxidation end products (ALEs) during lipid peroxidation reactions in vitro. We show here that several PM adducts, formed in incubations of PM with linoleate and arachidonate in vitro, are also excreted in the urine of PM-treated animals. The …

Age-Dependent Increase In Ortho-Tyrosine And Methionine Sulfoxide In Human Skin Collagen Is Not Accelerated In Diabetes: Evidence Against A Generalized Increase In Oxidative Stress In Diabetes, Mary C. Wells-Knecht, Timothy J. Lyons, David R. Mccance, Suzanne R. Thorpe, John W. Baynes

Faculty Publications

The glycoxidation products Nepsilon-(carboxymethyl)lysine and pentosidine increase in skin collagen with age and at an accelerated rate in diabetes. Their age-adjusted concentrations in skin collagen are correlated with the severity of diabetic complications. To determine the relative roles of increased glycation and/or oxidation in the accelerated formation of glycoxidation products in diabetes, we measured levels of amino acid oxidation products, distinct from glycoxidative modifications of amino acids, as independent indicators of oxidative stress and damage to collagen in aging and diabetes. We show that ortho-tyrosine and methionine sulfoxide are formed in concert with Nepsilon-(carboxymethyl)lysine and pentosidine during glycoxidation of collagen …

Enhanced Nonenzymatic Glucosylation Of Human Serum Albumin In Diabetes Mellitus, C. Earl Guthrow, Mary Ann Morris, James F. Day, Suzanne R. Thorpe, John W. Baynes

Faculty Publications

Use of an ion exchange chromatographic method and a colorimetric method with thiobarbituric acid showed that levels of nonenzymatically glucosylated serum albumin were increased in patients with poorly controlled diabetes mellitus compared to controls. The two methods correlated well (r = 0.99) and clearly discriminated between normal and poorly controlled diabetic populations. The levels of glycosylated hemoglobin were also measured in both populations. Several patients apparently in good control based on glycosylated hemoglobin measurements were found to have increased levels of glycosylated albumin. Because albumin has a shorter circulating half-life than does the human erythrocyte, the plasma concentration of glucosylated …