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Improving An Outpatient Diabetes Program Telephone Follow-Up Process: Evaluating Its Impact On Glycosylated Hemoglobin Levels, Joan B. Niemczewski

Graduate Theses, Dissertations, and Capstones

Telephone follow-up for diabetes self-management is used to facilitate ongoing support for individuals striving to maintain a healthy lifestyle. With the use of telephone follow-up after Diabetes Self-Management Education (DSME), key concepts can be emphasized and goal reinforcement can occur. When successfully managed, improved glycemic control occurs, as evidenced by reductions in glycosylated hemoglobin (A1C) levels. A review of the literature surrounding this topic and description of a capstone scholarly project utilizing findings from the literature to create an evidence-based telephone follow-up pilot study are included. Findings from this study did not reveal statistically significant reductions in A1C levels with …

Non-Acute Care Clinical For Bsn Students Chronic Illness Care And Diabetes Self-Management Support, Kathleen J. Tilton

Doctor of Nursing Practice Projects

Baccalaureate nursing (BSN) programs work toward ensuring that curricula are current and relevant for the existing and evolving health care environment, health and illness trends, and care delivery systems. To this end this Systems Change Project (SCP) addresses an identified curricular gap between the traditional clinical experience of BSN students related to care of individuals with chronic illness and the predominant environment in which chronic illness care occurs. A non-acute care clinical experience was integrated into the junior year adult and chronicity clinical course of the Bethel University nursing program. The clinical experience was delivered through virtual simulation and focused …

Effect Of Functional Starch In Brown Rice And Grain Sorghum On Plasma Glucose And Insulin Responses In Humans, Nicole Marie Poquette

Graduate Theses and Dissertations

Diabetes and obesity are chronic illnesses increasing at dramatic rates in the U.S. and around the world. Research has looked to prevent or control diabetes and obesity through functional ingredients such as healthy-dietary carbohydrates to control blood glucose levels. Starch is a principle carbohydrate, which influences blood glucose levels, and measuring starch digestibility fractions can help predict the glucose response in the body. The objectives of this study were to investigate the functional starch content of parboiled brown rice flour and grain sorghum flour, and measure the effects on postprandial plasma glucose and insulin levels of 14 and 10 healthy …

Local Delivery Of Growth Stimulators For Diabetic Foot Ulcers: A Preliminary In Vitro Study, Jennifer Leigh Baldwin

Electronic Theses and Dissertations

Diabetic foot ulcers affect approximately 15% of the almost 20.8 million people with diabetes mellitus, costing approximately $10.9 billion annually. Diabetic foot ulcers are particularly difficult to treat due to neuropathy and healing deficiencies. The objective of this in vitro study was to measure the effects of adenosine and glutathione on fibroblast proliferation and collagen synthesis while improving the availability of these compounds at the wound site with the use of a chitosan sponge as a localized delivery vehicle. This study found adenosine (500µM) and glutathione (250µM) enhanced fibroblast proliferation by approximately 100% and 46% increase as compared to untreated …

Dia-Beat-It: An Online Game For Children And Teenagers With Type 1 Diabetes, Emily M. Stone

Honors Theses and Capstones

No abstract provided.

Vascular Stem Cells In Diabetic Complications, Emily C. Keats

Electronic Thesis and Dissertation Repository

Diabetes leads to a variety of secondary complications. At the heart of these complications lies endothelial cells (ECs) – cells that take up unregulated plasma glucose, experience various biochemical alterations, and provide the basis for whole organ vascular dysfunctions. With the purpose of generating new vascular networks for the treatment of these chronic complications, my initial work focused on vascular stem cells (VSCs). VSCs have the ability to differentiate into both endothelial (EPC) and mesenchymal (MPC) progenitor cells, both of which are necessary for the creation of stable and functional blood vessels. To establish whether these progenitor populations retain their …

Examination Of The Pediatric Diabetes Routines Questionnaire In Adolescents: Development Of An Adolescent Self-Report Version And Confirmatory Factor Analysis, Jessica Sima Pierce

Dissertations

Previous literature suggests a positive relationship between general child routines and diabetes treatment adherence. However, research examining routines specific to the diabetes regimen is lacking. Recently, the Pediatric Diabetes Routines Questionnaire (PDRQ) was developed as a parent-report measure of diabetes-specific routines for children and adolescents with type 1 diabetes. Though the PDRQ has provided a means to measure routines specific to the diabetes regimen, limitations exist in regard to its use with adolescents. Thus, the goals of this study were to develop and evaluate a parallel adolescent self-report version (PDRQ: Adolescent; PDRQ:A) of the PDRQ and to examine the psychometric …

The Role Of Snai2/Slug In Diabetes-Impaired Wound Healing, Krystle K. Quan

Biomedical Sciences ETDs

Impaired wound healing is a common complication of diabetes mellitus. Advanced glycation end products (AGEs) are a consequence of diabetes and are formed from non-enzymatic reactions between glucose and proteins. The accumulation of AGEs is believed to disrupt wound repair and alter protein function. The epidermal growth factor receptor (EGFR) and a downstream effector, Snai2/Slug, are key regulators of reepithelialization, a vital component of wound healing. Reepithelialization requires keratinocyte proliferation and migration. Therefore, we examined the impact of AGEs on these EGF-stimulated responses. In this dissertation, I present evidence for a critical role of Snai2 in diabetes-impaired wound reepithelialization, extending …

The Effect Of Whole Body Vibration On Skin Blood Flow And Nitric Oxide Production, Paula K. Johnson

Theses and Dissertations

Background: Vascular dysfunction due to hyperglycemia in individuals with diabetes is a factor contributing to distal symmetric polyneuropathy (DSP). Reactive oxygen species (ROS) reduce the bioavailability of nitric oxide (NO), a powerful vasodilator, resulting in reduced circulation and nerve ischemia. Increases in blood NO concentrations and circulation have been attributed to whole body vibration (WBV). The purpose of this study was to the determine the effects of low frequency, low amplitude WBV on whole blood NO concentration and skin blood flow (SBF) in individuals with symptoms of DSP. Research Design and Methods: Ten subjects with diabetes and impaired sensory perception …

Rates Of Obesity And Incidence Of Diabetes In Hispanics In The United States: An Examination Of The Epidemiological Paradox, Lucy Dean

Honors Theses

Using pooled data from the 2008-2011 National Health Interview Survey and employing multinomial and binomial logistic regression methods, this research examines disparities in rates of obesity and incidence of diabetes between individual Hispanic subgroups in comparison to non-Hispanic whites and blacks. Immigration status(including nativity, duration in the United States, and citizenship status) is hypothesized to play a central role in rates and obesity and incidence of diabetes. Unlike Cuban-Americans, Mexican-Americans, Puerto Ricans, and other Hispanics were more likely to be overweight as well as obese when compared to non-Hispanic whites. Mexican-Americans had the only significance in prevalence of type 2 …

Cardiovascular Disease Among Diabetic Women With Bilateral Oophorectomy., Duke Appiah

Electronic Theses and Dissertations

Cardiovascular Disease (CVD) is the leading cause of death in women and the risk is increased threefold in diabetics. In postmenopausal diabetics, the ovary responds to hyperinsulinemia by increasing secretion of testosterone precursors which increases the risk of CVD. Data from the National Health and Nutrition Examination Survey (1988-2010) and the Study of Osteoporotic Fractures were used to test the hypothesis that a history of bilateral oophorectomy -surgical removal of both ovaries-would decrease the risk of CVD among postmenopausal diabetic women due to reduced androgen levels. Logistic regression, discrete time logit model, B-Spline regression and Cox proportional hazards models were …

Patient Perspectives Of Nutrition In Healthcare: An Exploratory Study, Matthew Gary Petersen

Undergraduate Honors Capstone Projects

Healthcare is one of the most debated and controversial issues facing our nation and the world today. From availability to affordability, healthcare influences the lives of millions of people daily. For more than a decade the World Health Organization has called for an integrated approach to improve global health by improving patient adherence to prescribed treatments. Despite this, very little improvement has been made in adherence trends since the 1980's. Some current research has focused on improved adherence through an understanding of the patient's perspective of healthcare. By understanding how the patient sees healthcare, physicians are able to provide more …

Picture Superiority Effect In Prospective Memory: Examining The Influence Of Age And Attention Load, Nicole Fink

All Dissertations

The picture superiority effect (i.e. better memory for pictures than words) is well established in retrospective memory, but the examination of the picture superiority effect in prospective memory has been underrepresented in the literature. Understanding if pictures lead to better prospective memory than words has the theoretical benefit of increasing our understanding of what particular factors lead to spontaneous retrieval and the practical benefit of informing the design of memory aids. Additionally, I examine if there are differences in ongoing task and prospective memory task performance between age groups (old and young) and under different loads of attention (non-divided and …

Effects Of Short Term High Fat Diet On Obesity And Perivascular Adipose Structure And Function In Mice : Role Of Aldose Reductase, And Aldehyde Metabolizing Enzyme., Daniel Alan Murphy

College of Arts & Sciences Senior Honors Theses

This study was undertaken to determine the effects of high fat diet and aldose reductase deficiency on the structure and function of murine perivascular adipose tissue. Wild type (WT) (C57 bl/6) and aldose reductase knockout (AR-null) mice were aged to 8 or 18 weeks on a normal chow diet then some were switched to a high fat diet for 4 weeks while others remained on the control diet for the same amount of time. Following 4 weeks, mice were euthanized PVAT was analyzed. High fat feeding significantly increased body fat percentage in both age groups of mice and the area …

Relations Among Type 2 Diabetes, Arterial Stiffness And Cognitive Functioning, Gregory A. Dore

Electronic Theses and Dissertations

Although the associations among diabetes mellitus, cognitive functioning and arterial stiffness have been explored previously, the degree to which arterial stiffness is responsible for the association between diabetes and cognitive function has not been examined. The primary aim of the current investigations is to examine the extent to which arterial stiffness mediates the association between diabetes and cognitive function, as well as the extent to which this indirect effect is modified by age and APOE genotype. The sample included 590 participants (age 23-94, 62% women, 12% African- American) from the seventh wave of the Maine-Syracuse Longitudinal Study. Individuals with history …

Glucosensing, Hypoglycemia, And The Brain, Candace Reno

All Theses and Dissertations (ETDs)

Glucose homeostasis can be peripherally and centrally mediated. Within the periphery, GLUT4 in muscle and adipose tissue is required for normal glucose homeostasis and disruption of GLUT4 translocation in these tissues leads to glucose intolerance and insulin resistance, hallmarks of Type 2 diabetes. Within the brain, specialized glucose sensing neurons regulate whole body glucose homeostasis. Unlike GLUT4's role in the periphery, brain GLUT4 regulation of glucose tolerance is not well defined. Understanding how brain glucose sensing, mediated by GLUT4, regulates glucose tolerance and insulin sensitivity will aid in the development of treatment strategies to protect against the pathogenesis of diabetes. …

Linking Environmental Toxicant Exposure To Diabetes Susceptibility, Jannifer Beth Tyrrell

Wayne State University Dissertations

An important and unresolved question in the environmental health field is whether exposure to common environmental toxicants, such as dioxin and heavy metals like Pb, increase the risk of developing diabetes, especially in combination with other common metabolic stressors such as obesity.

Previous studies suggested that dioxin exposure increased peripheral insulin resistance but did not appear to cause fasting hyperglycemia or elevated hepatic glucose output. In concordance with those findings we observed that dioxin treatment caused a strong suppression of the expression of the key hepatic gluconeogenic genes PEPCK and G6Pase. However, this suppression was not solely mediated by the …

Polychlorinated Biphenyl Ligands Of The Aryl Hydrocarbon Receptor Promote Adipocyte-Mediated Diabetes, Nicki A. Baker

Theses and Dissertations--Nutritional Sciences

Numerous epidemiology studies suggest a correlation between exposures to polychlorinated biphenyls (PCBs) and the development and severity of type 2 diabetes (T2D); however, mechanisms remain largely unknown. Previous studies demonstrated that PCBs that are ligands of the aryl hydrocarbon receptor (AhR) promote the expression of proinflammatory cytokines, including tumor necrosis factor-α (TNF-α), that are linked to insulin resistance in adipocytes. To explore potential mechanisms linking PCB exposures to diabetes, we developed a mouse model of glucose and insulin intolerance induced by acute and chronic exposures to PCB-77. We hypothesized that PCB ligands of AhR result in adipocyte-specific elevations in TNF-α …

Bone Morphogenetic Protein-7 Attenuates Inflammation And Apoptosis And Improves Cardiac Function In Diabetes, Princess Urbina

Electronic Theses and Dissertations

Bone Morphogenetic Protein-7 (BMP-7) belongs to the transforming growth factor-β (TGFβ) family of cytokines has is known to have potent anti-inflammatory properties. It has been used in patients to treat osteoporosis clinically and has been reported to treat diabetic nephropathy in murine models. Moreover, studies show that inflammation is up-regulated in patients with pre-diabetes (PD). We, therefore, hypothesize that the administration of BMP-7 will attenuate inflammation in the heart of Streptozotocin (STZ)-induced PD mice. In this study, we divided C57Bl/6 mice into three groups: CONTROL, PD, and PD+BMP-7. CONTROL mice received intraperitoneal (i.p.) injections of Sodium Citrate Buffer while PD …

Early And Intermediate Hospital-To-Home Transition Outcomes Of Older Adults Diagnosed With Diabetes, Jacqueline Lamanna

Electronic Theses and Dissertations

Over 5 million older adults with diabetes are hospitalized each year. Though typically not the index condition that leads to hospitalization, diabetes control often decompensates during the course of an admission and necessitates changes in home self-management plans. The specific transitional care needs of older adults with diabetes have been largely unstudied. Transition theory provided the guiding framework for this research and proposes that each transition is a complex process created by the continuous interaction of personal, community, and societal-level conditions that facilitate or inhibit the health of a transition. Hospitalization has been described as a series of three successive, …

Development Of Novel Redox Sensors And Processes Towards Biological Applications, Jigna Patel

Electronic Theses and Dissertations

Research on the cure and early detection of diseases such as diabetes, Alzheimer's, and Parkinson's is becoming of great interest due to the increasing number of people affected by them every year. An accurate and quick detection of various damaging species is highly critical in treatments of such diseases not only for exploring possible cures but also for early detection. If these diseases are detected during the initial stages than the possibility of curing them is much higher. Motivated by this, many researchers today have developed numerous types of sensing devices that can detect various physiological and biological compounds. However, …

An Investigation Of Perinatal Polychlorinated Biphenyl Exposure On Body Composition And Glucose Homeostasis, Cetewayo S. Rashid

Theses and Dissertations--Nutritional Sciences

Recent advancements have uncovered environmental contributions to obesity and diabetes etiology. In fact, perinatal malnutrition resulting in low birth weight (LBW) has been shown to correlate with later life obesity and impaired glucose tolerance in aged offspring. LBW can result from a myriad of developmental perturbations including macronutrient restriction, hypoxia, maternal stress and toxin exposure.

Polychlorinated biphenyls (PCBs) are ubiquitous environmental pollutants that bioaccumulate in the food chain resulting in dietary exposure in humans. Maternal and cord blood PCB levels are inversely associated with birth weight, and recent studies indicate that perinatal exposures to PCBs contribute to gender-specific obesity development …

The Effect Of Diabetes Education On Self-Efficacy And Readmission Rates Of Diabetic Patients, Angela M. Rasheed

Nursing Theses and Capstone Projects

The purpose of this study was to determine the effect of a diabetes education program on self-efficacy and readmission rates of diabetic patients. All participants were recruited based on their current enrollment with one of the largest primary care physician's practices in the Southeastern United States. Qualifying criteria included the diagnosis of being either diabetic type I or II and commitment to attend a five-week diabetes educational workshop. Participants were given the Diabetes Self-Efficacy Survey at the initial start of the diabetes educational program and also at the end of the five-week workshop to evaluate the effectiveness of the diabetes …

Educational Materials And Brief Counseling Improve Diabetes Knowledge And Self-Efficacy, Tamara K. Wellman

DNP Projects

Purpose: The purpose of this study was to see if education and counseling of the Appalachian individual with diabetes and a family member/friend would improve knowledge of the disease and self-efficacy of the patient in regard to their diabetes care.

Setting: The setting was one of eight primary care offices of Our Lady of Bellefonte Hospital, Bon Secours, located in the Ashland, Kentucky.

Design: A pilot study of descriptive, comparative design was used.

Subjects: Data were collected from a convenience sample of patients with type 2 diabetes (n=15) that were established at the primary care office and their family members/friends …

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 …

30-Day Readmission And Emergency Department Visits : Experience Of Diabetes And Abdominal Surgery Patients, Andrea Jane Mathis

Legacy Theses & Dissertations (2009 - 2024)

Nearly one-fifth of Medicare beneficiaries are readmitted within 30 days of a hospital stay. Readmissions contribute to the rising health care costs and they serve as a proxy for overall inpatient quality of care. Policy makers and payers interested in the efficacy of strategies to improve care coordination have scrutinized readmission rates for some time, yet this analysis attends to several remaining gaps in the literature. First, the rising prevalence of diabetes may be an underappreciated driver for readmissions. Second, many abdominal surgery patients require post-operative care, yet the point of care delivery and level of care needed has not …

A Descriptive Study Of The Leadership Role Of Community Health Ambassadors On Diabetes-Related Health Behaviors, Barbara Pullen-Smith

Dissertations

Diabetes is a chronic disease that bears a disproportionate burden among African American populations. The lack of access to affordable, culturally appropriate health care is a key barrier to effective diabetes prevention or disease management for racial/ethnic minority populations. Living in public housing communities, with concentrated poverty, exacerbates the burden of diabetes and reduces access to screening and early detection services to prevent the onset of diabetes. The purpose of the study was to describe the leadership role of lay health advisors, known as Community Health Ambassadors (CHAs), on diabetes-related health behaviors of African Americans living in a public housing …

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 …

Parent Distress In Life With A Child With Type 1 Diabetes, Lauren Nicole Johnson

USF Tampa Graduate Theses and Dissertations

Objective:

The purpose of this study was to highlight parent distress in diabetes, identify factors associated with distress and to show how public health and clinical professionals can assist parents in coping with their child's diabetes and living positively as a family unit.

Methods:

Parents of youth with diabetes (N = 41 qualitative, N = 332 quantitative) were engaged in focus groups, interviews, and survey research to understand their needs and stressors in life with a child with diabetes. Themes were examined in the qualitative data, and correlations and a regression model were run and analyzed from the quantitative data …

Commensal Microbiota And Its Impact On Health And Autoimmune Diabetets, Kyle James Wolf

All ETDs from UAB

Environmental exposures such as diet, use of antibiotics, and lifestyle have significant impact on the health of an individual. One mechanism that acts as a major pathway in these environmental exposures is the role intestinal commensal microbiota play in both metabolic and immunological responses. Metabolic pathways are altered through changes in metabolites provided by commensal microbiota; alterations in microbial make-up can have drastic impacts on metabolic function. Similarly, the development and maturation of the immune system is dependent on the intestinal microbes to induce tolerance and act as both an immune modulator as well as a barrier against pathogens. We …