Digital Commons Network^™

Exploring The Metabolic And Mitogenic Potential Of A Hyper-Stable Variant Of Fgf1, Emma Starr, Oshadi Edirisinghe, Thallapuranam Krishnaswamy Suresh Kumar

Inquiry: The University of Arkansas Undergraduate Research Journal

Fibroblast growth factors (FGFs) are a family of 22 human cytokines involved in critical cellular processes, such as proliferation, differentiation, metabolism, angiogenesis, tumor metastasis, and wound healing. Among these, fibroblast growth factor 1 (FGF1) possesses a powerful mitogenic potential as it can nonspecifically bind to all four FGF receptors. However, the therapeutic applications of FGF1 are hindered by its inherent thermal and proteolytic instability, especially at physiological temperatures. This is believed to be attributed to the heparin-binding pocket at the C-terminus, which contains numerous positively charged residues that repel each other. To combat this instability, FGF1 binds to a negatively …

To Have And To Not Hold: Long-Acting Insulin For Npo Patients With Diabetes, William Hicks, Cindy Iwuagwu, Suzan Khalil, Juan Pablo Meruvia Garron, Cynthia Schwartz, Carlos Botero Suarez, Ashwini Komarla, Mustafa Kinaan

North Florida Division GME Research Day 2024

No abstract provided.

Case Report: Special Considerations When Initiating Insulin In A Non-English-Speaking Patient With Diabetes: A Social Guide For New Insulin-Prescribing Residents, Jacob Uskavitch, Seth Barker

TriStar Division GME Research Day 2024

No abstract provided.

Risks And Benefits Of Continuing Metformin During Hospitalization, Joel Speir, Sean Shearan, Kevin Trappett, Elizabeth Uba, Kenneth Krell

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

The Relationship Between Mild Cognitive Dysfunction And Diabetes Self-Management In Community Dwelling Older Adults, Hossein Hafezi Nia

Wayne State University Dissertations

Background. Cognitive dysfunction is an important comorbidity of diabetes, which may reflect brain changes as a consequence of diabetes. Objective The purpose of this study was to examine the association between specific cognitive domains and diabetes self-management behaviors in individuals with diabetes and mild cognitive impairment (MCI). Furthermore, the association between social determinats of health and MCI was investigated. Design A cross-sectional descriptive correlational design was used to address the study aims using data extracted from the 2022 Health and Retirement Study (HRS) and 2016 Harmonized Cognitive Assessment Protocol (HCAP) datasets. Participants Of the total HRS and HCAP participants, 2035 …

Improving The Rates Of Diabetic Screening Exams In A Rural Outpatient Clinic, Sofia Rohde, Mohit Mathavan, Shalaka Venkatraman, David Nguyen, Gino Singer, Shivanie Ramdin, Jennifer Abernathy, Nicholas Dorsey

North Florida Division GME Research Day 2024

No abstract provided.

Audit Of Management Of Diabetic Ketoacidosis In Mansoura Specialized Medical Hospital, Walaa M Abd-El-Fatah, Omnia I State, Basma Z Elmorsy

Mansoura Medical Journal

Background: Egypt is listed among the world's top ten countries regarding the highest number of people with diabetes mellitus (DM). Diabetic ketoacidosis (DKA) is a medical emergency which is associated with significant mortality and morbidity in diabetic patients. It is also a common reason for hospitalization and thus is associated with significantly high costs. However, DKA is a potentially reversible condition provided that an emergency and immediate medical attention, appropriate diagnosis and therapy were provided.

Aim: auditing the adherence to protocol for the management of DKA in our Mansoura University Hospital (Specialized Medical Hospital) in Egypt from May 2021 to …

The Relationship Between Being Uninsured And Having Poor Health Outcomes And Experiences In Eastern Kentucky, Danielle Adams, Amber Todd

Scholarship in Medicine - All Papers

Objective: To examine health insurance and health outcome disparities in Eastern Kentucky since Kentucky’s implementation of the Affordable Care Act. Methods: Using data from County Health Rankings and Roadmap, rates of uninsurance will be compared before and a decade after implementation of the ACA in Kentucky (2013 and 2023). In addition, prevalence of certain health outcomes in Eastern Kentucky will be compared from 2013 and 2023 and correlation established between uninsured rates and particular health outcomes for 2023. Results: Since 2013, the percentage of those uninsured in Eastern Kentucky has seen a significant decline. While there is no correlation between …

The Delineation Of Platelet Pathology In Cardiometabolic Disease, Chi Peng

Theses and Dissertations--Pharmacology and Nutritional Sciences

Obesity is a multifactorial disease with many comorbidities leading to multiorgan dysfunction. Current studies point towards dysregulation of platelet signaling as a driver for increased risk of cardiovascular disease and stroke. The exact mechanisms remain elusive due to the complex interplay of factors involved, warranting the need to further understand how platelets are affected. Our preliminary data evaluating changes in platelet and coagulation parameters from bariatric patients showed that obesity did not affect platelet count or clotting time as demonstrated in INR values. However, female patients had increased bleeding events before surgery that were decreased after surgery. Due to limitations …

Whole-Food Plant-Based Diet Impact On Chronic Disease Reversal, Veena Patel

Capstone Showcase

This article delves into the prevalence and costs associated with various chronic diseases, elucidates how adopting a whole food plant-based (WFPB) diet can effectively combat these ailments, and offers resources and guidance for healthcare providers to engage in discussions about WFPB diets with their patients. A WFPB diet centers around unprocessed, natural foods like fruits, vegetables, whole grains, legumes, nuts, and seeds, while eschewing animal based products. This dietary regimen prioritizes nutrient-rich, plant-derived foods, favoring minimally processed options to enhance overall health and vitality. Its design is deliberate, offering a therapeutic approach to tackling chronic diseases and fostering recovery. By …

Evaluation Of Nutritional Guidance From Providers For Patients With Type 2 Diabetes In A Primary Care Setting, Whitney Rice

DNP Projects

Background: Adherence to diet is a challenging part of managing type 2 diabetes mellitus (T2DM). Guidelines recommend including a registered dietician and/or a diabetes educator. While this is the gold standard, there are barriers to implementation in primary care. The Starting the Conversation (STC) diet recall tool can aid primary care providers (PCPs) in providing brief nutrition counseling for patients with T2DM. Purpose: To evaluate the perceptions and practices of PCPs regarding dietary education and documentation for patients with T2DM after provider education and initiation of the STC tool. Methods: This was a quality improvement project using a quasi-experimental pretest …

Uncovering The Link Between Diabetes And Pulmonary Hypertension, Nishant Nundlall

Theses

Background

Diabetes is a common disorder in the general population with most studies focusing on its role on the left ventricle and coronary artery disease, however it effects on pulmonary hypertension (PH) have not been fully studied. There is a pressing need to more completely explore the cardiovascular impacts of diabetes. The impact of diabetes might vary according to the various forms of PH, their predominant contribution is likely to be in PH due to left heart disease (group II, the most common form of PH).

Thus far, most studies have offered a focussed perspective with data from specialised referral …

Implementation Of A Targeted “Micro-Learning” Inpatient Diabetes Education Program In A Rural Hospital Setting, Melissa Lynn Fannon-Wisner

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: Diabetes affects a large portion of Americans and West Virginians annually. Inpatient hospitalization provides an opportunity to provide evidence-based diabetes education to patients. A lack of access to diabetes education at rural hospitals across the United States exists, creating a need for patients who require education while hospitalized. An intervention needs to be explored to bridge the gap for patients that need education when the diabetes educator is not available.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project is to create and implement a video micro-learning diabetic education series that can be utilized for diabetes self-management …

Socioeconomic Status And Health Disparities Drive Differences In Accelerometer-Derived Physical Activity In Fatty Liver Disease And Significant Fibrosis, Lucia Tabacu, Sajag Swami, Mark Ledbetter, Mohamad S. Siddiqui, Ekaterina Smirnova

Mathematics & Statistics Faculty Publications

Background and aims

The cornerstone of clinical management of patients with nonalcoholic fatty liver disease (NAFLD) are lifestyle changes such as increasing physical activity (PA) aimed at improving cardiometabolic risk. To inform NAFLD prevention and treatment guidelines we aimed to: (i) quantify the role of PA on lowering the risk for NAFLD and fibrosis; (ii) characterize NAFLD and fibrosis association with PA in the context of socioeconomic environment.

Methods

A sample of 2648 participants from the NHANES 2003–2006 was selected to develop survey weighted multivariable logistic regression models for predicting NAFLD and significant fibrosis, diagnosed non-invasively via fatty liver index …

Plant But Not Animal Sourced Nitrate Intake Is Associated With Lower Dementia-Related Mortality In The Australian Diabetes, Obesity, And Lifestyle Study, Anjana Rajendra, Nicola P. Bondonno, Liezhou Zhong, Simone Radavelli-Bagatini, Kevin Murray, Stephanie R. Rainey-Smith, Samantha L. Gardener, Lauren C. Blekkenhorst, Dianna J. Magliano, Jonathan E. Shaw, Robin M. Daly, Kaarin J. Anstey, Joshua R. Lewis, Jonathan M. Hodgson, Catherine P. Bondonno

Research outputs 2022 to 2026

Introduction: Dietary nitrate is potentially beneficial for cardiovascular, cerebrovascular, and nervous systems due to its role as a nitric oxide (NO) precursor. Increased nitrate intake improves cardiovascular health and therefore could protect against dementia, given the cardiovascular-dementia link. Objective: To investigate the association between source-dependent nitrate intake and dementia-related mortality. As individuals with diabetes are at higher risk of dementia, a secondary aim was to investigate if the associations between nitrate and dementia varied by diabetes mellitus (DM) and pre-diabetes status. Methods: This study involved 9,149 participants aged ≥25 years from the well-characterised Australian Diabetes, Obesity, and Lifestyle (AusDiab) Study …

Maternal Western Diet Programs Cardiometabolic Dysfunction And Hypothalamic Inflammation Via Epigenetic Mechanisms Predominantly In The Male Offspring, Mona Elgazzaz, Clara Berdasco, Jone Garai, Melody Baddoo, Shiping Lu, Hisham Daoud, Jovanny Zabaleta, Franck Mauvais-Jarvis, Eric Lazartigues

School of Medicine Faculty Publications

Objective; Maternal exposure during pregnancy is a strong determinant of offspring health outcomes. Such exposure induces changes in the offspring epigenome resulting in gene expression and functional changes. In this study, we investigated the effect of maternal Western hypercaloric diet (HCD) programming during the perinatal period on neuronal plasticity and cardiometabolic health in adult offspring. Methods; C57BL/6J dams were fed HCD for 1 month prior to mating with regular diet (RD) sires and kept on the same diet throughout pregnancy and lactation. At weaning, offspring were maintained on either HCD or RD for 3 months resulting in 4 treatment groups …

Glp1 Receptor Agonists-Effects Beyond Obesity And Diabetes, Sydney S Wilbon, Mikhail G Kolonin

Faculty, Staff and Student Publications

Glucagon-like peptide-1 receptor agonists (GLP1RA) have been transformative for patients and clinicians in treating type-2 diabetes and obesity. Drugs of this class, the bioavailability of which is continuously improving, enable weight loss and control blood glucose with minimal unwanted side effects. Since adopting GLP1RA for treating metabolic diseases, animal and clinical studies have revealed their beneficial effects on several other pathologies, including cardiovascular diseases, neurodegeneration, kidney disease, and cancer. A notable commonality between these diseases is their association with older age. Clinical trials and preclinical data suggest that GLP1RA may improve outcomes in these aging-related diseases. Some of the benefits …

The Associations Of Cardiometabolic And Dietary Variables With Clinical Periodontitis In Adults With And Without Type 2 Diabetes: A Cross-Sectional Study, Arpita Basu, Leigh Ann Richardson, Alicia Carlos, Neamat Hassan Abubakr, Robin L. Weltmann, Jeffrey L. Ebersole

Kinesiology and Nutrition Sciences Faculty Research

Periodontitis is a commonly occurring inflammatory oral disease affecting a large proportion of global and US adults and is characterized by the destruction of the tooth-supporting apparatus. Its etiology is multifactorial, and type 2 diabetes and diet play critical roles in its remission and progression. However, few studies have addressed nutritional and serum vitamin D status in adults with periodontitis in the presence of diabetes. A cross-sectional study (n = 78), and a sub-set of age- and BMI-matched case–control studies (n = 50), were conducted to examine differences in dietary and cardiometabolic variables, and serum vitamin D in adults with …

Strategies To Reduce Chronic Disease: Adding Role To Community Health Workers, Ingrid J. Renwanz Dnp, Pmhfnp-Bc/Aprn, Msn, Rnc

Doctor of Nursing Practice (DNP) Projects

Background: Underserved, rural, immigrant, low-income Latinx communities need to strengthen healthcare access to improve their quality of life (Capitman et al., 2009; McCartney et al., 2019; Save the Children [STC] Organization, 2021). Non-communicable chronic disease of physical and behavioral origin is the leading cause of morbidity for adults and children in Latinx communities (Campbell et al., 2020). Estimates of greater than 30% of the Latinx populations within the United States have these health needs, with projections to reach 28% of the U.S. population by 2060 (Eghaneyan & Murphy, 2019; Ortega et al., 2018).

Local Problem: If poor access to preventive …

Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso

Master's Projects and Capstones

Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.

Context: The endocrinology clinic serves a patient population, …

Decreasing Surgical Complications In Diabetic Patients, Bandana Mahato

DNP Qualifying Manuscripts

Executive Summary

Objective: This manuscript aims to determine if controlling diabetes prior to undergoing low back surgery could decrease complications and disability.

Contexts: Despite the overwhelming information on the complications of uncontrolled diabetes, patients continue to have elevated HgA1C before having surgery. Furthermore, there is a plethora of data showing uncontrolled diabetic patients will have higher complications after surgery, yet patients continue to have elective surgery despite having unchecked diabetes. There are no clear guidelines for primary care providers or surgeons on when they should allow patients to have elective surgery. Therefore, it is vital that HgA1c needs to be …

Characterization Of Ocular Surface Pathology And Tear Film Dysfunction Due To Type 1 And Type 2 Diabetes Mellitus, Judy Weng

Pharmaceutical Sciences (PhD) Dissertations

Untreated diabetes mellitus leads to development of microvascular and macrovascular complications affecting heart, nerves, kidney, and eyes. While the etiological mechanisms of diabetes-associated retinopathy and cataract have been well characterized, the time kinetics and the severity of diabetes-mediated injury to the ocular surface and its various components like tear film, goblet cells and glycocalyx, has not yet been investigated. These pathological changes can potentially cause dry eye and corneal injury including epithelial erosion, impaired wound healing and keratopathy. As the mainstay treatment option for the management of dry eye disease due to diabetes mellitus, artificial tears are frequently used. Therefore, …

Investigation Of Heterocyclic Amines And N-Acetyltransferase 2 Genetic Polymorphism In The Dysregulation Of Hepatic Energy Homeostasis: A Gene-Environment Approach., Kennedy M Walls

Electronic Theses and Dissertations

Heterocyclic amines (HCAs) are mutagens generated when cooking meat for prolonged periods of time or until well-done. Recent epidemiological studies reported significant associations between dietary HCA exposure and insulin resistance and type II diabetes. However, no previous studies have examined if HCAs, independent of meat consumption, contributes to pathogenesis of insulin resistance or metabolic disease. It is well known that HCAs require hepatic bioactivation by cytochrome P450 1A2 (CYP1A2) and N-acetyltransferase 2 (NAT2). NAT2 expresses a well-defined genetic polymorphism in humans that, depending on the combination of NAT2 alleles, correlate to rapid, intermediate, or slow acetylator phenotypes that exhibit differential …

Sensory Spinal Interoceptive Pathways And Energy Balance Regulation, Heike Münzberg, Hans Rudolf Berthoud, Winfried L. Neuhuber

Division of Basic Science Faculty Publications

Interoception plays an important role in homeostatic regulation of energy intake and metabolism. Major interoceptive pathways include gut-to-brain and adipose tissue-to brain signaling via vagal sensory nerves and hormones, such as leptin. However, signaling via spinal sensory neurons is rapidly emerging as an additional important signaling pathway. Here we provide an in-depth review of the known anatomy and functions of spinal sensory pathways and discuss potential mechanisms relevant for energy balance homeostasis in health and disease. Because sensory innervation by dorsal root ganglia (DRG) neurons goes far beyond vagally innervated viscera and includes adipose tissue, skeletal muscle, and skin, it …

Ketogenic Propensity Is Differentially Related To Lipid-Induced Hepatic And Peripheral Insulin Resistance, J. T. Mey, B. Vandagmansar, W. S. Dantas, K. P. Belmont, C. L. Axelrod, J. P. Kirwan

Division of Basic Science Faculty Publications

Aim: Determine the ketogenic response (β-hydroxybutyrate, a surrogate of hepatic ketogenesis) to a controlled lipid overload in humans. Methods: In total, nineteen young, healthy adults (age: 28.4 ± 1.7 years; BMI: 22.7 ± 0.3 kg/m2) received either a 12 h overnight lipid infusion or saline in a randomized, crossover design. Plasma ketones and inflammatory markers were quantified by colorimetric and multiplex assays. Hepatic and peripheral insulin sensitivity was assessed by the hyperinsulinemic–euglycemic clamp. Skeletal muscle biopsies were obtained to quantify gene expression related to ketone body metabolism and inflammation. Results: By design, the lipid overload-induced hepatic (50%, p < 0.001) and peripheral insulin resistance (73%, p < 0.01) in healthy adults. Ketones increased with hyperlipidemia and were subsequently reduced with hyperinsulinemia during the clamp procedure (Saline: Basal = 0.22 mM, Insulin = 0.07 mM; Lipid: Basal = 0.78 mM, Insulin = 0.51 mM; 2-way ANOVA: Lipid p < 0.001, Insulin p < 0.001, Interaction p = 0.07). In the saline control condition, ketones did not correlate with hepatic or peripheral insulin sensitivity. Conversely, in the lipid condition, ketones were positively correlated with hepatic insulin sensitivity (r = 0.59, p < 0.01), but inversely related to peripheral insulin sensitivity (r = −0.64, p < 0.01). Hyperlipidemia increased plasma inflammatory markers, but did not impact skeletal muscle inflammatory gene expression. Gene expression related to ketone and fatty acid metabolism in skeletal muscle increased in response to hyperlipidemia. Conclusion: This work provides important insight into the role of ketones in human health and suggests that ketone body metabolism is altered at the onset of lipid-induced insulin resistance.

Exploratory Analysis Of Medication Adherence And Social Determinants Ofhealth Among Older Adults With Diabetes, M. L. Blakely, F. Sherbeny, T. J. Hastings, L. Boyd, Omolola A. Adeoye-Olatunde

Department of Pharmacy Practice Faculty Publications

Background

Diabetes is the fifth leading cause of death in the United States (US), affecting approximately 27%, or 15.9 million adults 65 years of age and older. Diabetes is the most expensive chronic condition in the US and accounts for the second largest avoidable healthcare cost. Adherence to long-term medication treatment plans is crucial among patients with diabetes because it decreases risk of developing comorbid conditions and improves quality of life. Greater exposure to adverse social determinants of health (SDOH) over an individual's lifespan can result in worse health outcomes. Hence, it is important to obtain a better understanding of …

Using Empowerment Theory To Improve Understanding Of Type 2 Diabetes Mellitus In Haitian American Women, Balkys Bivins, Brenda Owusu, Indra R Hershorin, Tony Umadhay, Janet Joseph, Arvinder Singh

Nursing & Health Sciences Research Journal

Introduction: The CDC (2020) revealed that the age-adjusted prevalence of diabetes mellitus in the United States among the Black, non-Hispanic population is 16.8%. A study conducted by Bivins et al. (2021) revealed a 39% prevalence of type 2 diabetes mellitus (T2DM) among Haitian Americans (HAs) living in several states. In the literature, HAs are often grouped with Black Americans, yet Haitian American women (HAW) have unique struggles with treatment and management of T2DM. No prior study used the empowerment theory to improve the management of T2DM in HAW. Purpose: To improve the understanding of T2DM in HAW using empowerment theory. …

Oral Glucose Tolerance Test In Pregnancy And Subsequent Maternal Hypertension, Maged M Costantine, Madeline Murguia Rice, Mark B Landon, Michael W Varner, Brian M Casey, Uma M Reddy, Ronald J Wapner, Dwight J Rouse, Alan T N Tita, John M Thorp, Edward K Chien, Alan M Peaceman, Sean C Blackwell

Faculty, Staff and Student Publications

Objective: The aim of the study is to evaluate whether values and the shape of the glucose curve during the oral glucose tolerance test (OGTT) in pregnancy identify women at risk of developing hypertension (HTN) later in life.

Study design: This category includes the secondary analysis of a follow-up from a mild gestational diabetes mellitus (GDM) study that included a treatment trial for mild GDM (n = 458) and an observational cohort of participants with abnormal 1-hour glucose loading test only (normal OGTT, n = 430). Participants were assessed at a median of 7 (IQR 6-8) years after their …

Prevalence Of Diabetes In Monterey County, Irenee Judith Flores-Morgado

Capstone Projects and Master's Theses

Aspire Health is a nonprofit organization that collaborates with community partners to improve the health and well-being for residents in Monterey County. In Monterey County, about 50% of the adult population is affected with type 2 diabetes and prediabetes. Aspire Health provides a free diabetes education module to students in Monterey County grade K-12, where they learn about diabetes and how to make healthier lifestyle choices. The project consisted of launching a texting feature that provided resources on diabetes. The purpose was to raise awareness and education about diabetes in Monterey County by providing local resources on diabetes with the …

Enhancing Diabetes Care With Peer Mentorship And Support Groups, Barry Mccann Bsn, Rn

Posters & Presentations

Poster presented at the Parkview Nursing Research Symposium, 2023.

Continued increase in prevalence of type 2 diabetes indicates need for more effective interventions to support lifestyle and behavior changes (ADA 2018).

• Evidence indicates attending diabetes self management education programs can improve diabetes outcomes, unfortunately they are often under referred and underutilized (Powers et al. 2015, Boakye et al. 2018).

• Limited class times, locations, and capacities can make attendance for all patients difficult and vulnerable populations are less likely to participate (Boakye et al. 2018).

• Diabetes education programs often lack culturally and individually relevant guidance, provide no long-term …