Digital Commons Network^™

Putting The Dietary Guidelines For Americans Into Action Through The National Strategy On Hunger, Nutrition, And Health, Rachel Fischer, Katrina L. Piercy, Janet M. De Jesus, Paul Reed, Rachel L. Levine

Journal of Food Law & Policy

The United States is facing a crisis of widespread food insecurity and exceedingly high rates of diet-related diseases like diabetes, obesity, and hypertension. To address this challenge and set a course for improved nutrition and food access nationwide, the Biden-Harris Administration hosted the first White House Conference on Hunger, Nutrition, and Health in over 50 years on September 28, 2022. In the National Strategy, released in conjunction with the Conference, the Administration identified a set of actions that the federal government will take to help achieve its goal of ending hunger and increasing healthy eating and physical activity by 2030, …

The Impact Of Kentucky’S Medicaid Expansion On Adult Coverage And Diagnosis Of Type 2 Diabetes Mellitus And Diabetic Peripheral Neuropathy, The Use Of Antihyperglycemics And The Role Of Social Determinants Of Health 2011-2018., Brian Mcroberts

Electronic Theses and Dissertations

Objectives: This study analyzed the impact of Medicaid expansion in Kentucky on coverage of adults aged 19-64 and the diagnosis of type 2 diabetes mellitus (T2DM) and diabetic peripheral neuropathy (DPN) and the use of antidiabetic medications or insulin (antihyperglycemics) for T2DM, controlling for Social Determinants of Health (SDOH). Method: This study assembled ICD-based claims and prescription drug NDC claims from all adult residents of Kentucky enrolled in Medicaid from 2011 to 2018. Three-digit zip code (Zip-3) data was appended to each case from the American Community Survey to provide SDOH variables. Tests performed included ANOVA, decision trees, varimax rotated …

Associations Between Demographic, Social Determinant, And Health Factors And Self-Management Measures Among Insured Individuals With Type 2 Diabetes, Shari Bowers-Dueker

Capstone Experience: Master of Public Health

Background: Ensuring that individuals with type 2 diabetes properly manage their chronic condition is a nation-wide challenge, even among individuals who have health insurance coverage and access to the treatment they need. There exist several literature sources that suggest various factors that may influence an individual’s lack of self-management of type 2 diabetes. This study investigated some of these factors by determining whether various demographic, social determinant, and health factors were associated with three self-management measures among individuals with type 2 diabetes.

Methods: The self-management measures of interest included (i) whether the annual recommended two primary care visits were attended …

Telehealth In Patients With Type 2 Diabetes Mellitus, Saghi Nassrouie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Description: Type 2 diabetes mellitus (DM2) is an epidemic that has many factors involved in its management to maintain control. Patients with DM2 require routine evaluations and blood work to provide comprehensive care. COVID-19 caused major shifts in traditional care which sparked an increase in the utilization of technology like telehealth. Telehealth can be an effective tool used to manage diabetes and help attain better glucose control, but its effectiveness during the COVID-19 pandemic warrants further investigation.Purpose: The purpose of this project was to determine if telehealth visits were more effective in reducing Hemoglobin A1c (HbA1c) in adult patients with …

Distinct Hyperuricemia Trajectories Are Associated With Different Risks Of Incident Diabetes: A Prospective Cohort Study, Jia Liu, Huiying Pan, Yue Liu, Mengying Guan, Xia Li, Shuo Chen, Xingyao Tong, Yanxia Luo, Xiaonan Wang, Xinghua Yang, Xiuhua Guo, Jingbo Zhang, Lixin Tao

Research outputs 2022 to 2026

Background and aim: Conflicting results suggest a link between serum uric acid and diabetes and previous studies ignored the effect of continuous exposure of serum uric acid on diabetes risk. This study aims to characterize hyperuricemia trajectories in middle-aged adults and to examine its potential impact on diabetes risk, considering the role of obesity, dyslipidemia, and hypertension. Methods and results: The cohort included 9192 participants who were free of diabetes before 2013. The hyperuricemia trajectories during 2009–2013 were identified by latent class growth models. Incident diabetes during 2014–2018 was used as the outcome. Modified Poisson regression models were used to …

Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin

Masters Theses/Capstone Projects

Poster presentation on the prevention of obesity related morbidity and mortality in adults.

Effect Of The Golden Liquid From Honeybees And Refined Granulated Sugar On The Blood Glucose And Serum Iron Levels Of Albino Rats., Onyeka Ekwebene, Benjamin U. Ononye, C T. Udeagulu, C E. Akunne, K C. Onyewuchi, K C. Mbelede, C A. Chidi, F C. Akubukor, K P. Okafor, I Offorbuike, S E. Ayaegbunam, I E. Obiefule

Appalachian Student Research Forum

Honey is a naturally sweet substance produced by honeybees from water, pollen, and nectar. Due to its unique nutritional and therapeutic benefits, which are ascribed to the interaction of the various chemical groups it contains, natural honey is one of the most popular consumed products. Modern-day individuals consume a lot of refined granulated sugar, either directly through foods or indirectly from other sources. The consumption of large amounts of refined granulated sugar alters hematological and physiological changes in the body. According to several scientific studies, honey can be a healthier alternative to refined granulated sugar because it does not threaten …

Technology-Mediated Diabetes Prevention Program (Dpp) Benchmark Project, Devon Senical

MSN Capstone Projects

This benchmark project intends to broaden access to the Diabetes Prevention Program (DPP) by offering technology-mediated content at the primary care level because the Primary Care Physician (PCP) predominantly diagnoses prediabetes due to the recommendation by The U.S. Preventive Services Task Force (USPSTF) that nonpregnant overweight or obese adults aged 35 to 70 be screened for prediabetes and type 2 diabetes (Davidson et al., 2021). Thus, the primary care setting is the first opportunity to impact the conversion from prediabetes to type 2 diabetes. Of the 84 million people in the United States (U.S.) with prediabetes, they are estimated to …

Importance And Impact Of Diabetes Education On People With Diabetes, Nicole R. Glasco

MSN Capstone Projects

This paper aims to explain the significance and importance of why it is essential to offer patients with diabetes standardized education regarding their diabetes.

Challenges To Coordination Of Care In The Diabetic Homeless Population, Melissa K. Smith

Doctoral Dissertations & Projects

Abstract

Diabetes mellitus (DM) significantly impacts the lives of Americans and the healthcare industry. Clinicians and patients utilize significant time, effort, and resources to combat the challenges faced. Homeless patients have additional burdens not experienced by those of housed individuals. A Midwest homeless shelter recognized the ongoing unmet needs for primary care and behavioral health services for their clinic patients. It was postulated that implementing a streamlined referral process to primary care services, enabling patients to be seen same day or next day, would increase utilization of services by this population. To increase the probability of patients presenting for their …

The Experiences Of American Indian Participants And Site Coordinators In A Gestational Diabetes Risk Reduction Trial, Sarah Stotz, Kelly L. Gonzales, Kelly R. Moore, Heather Garrow, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Gestational diabetes mellitus is the most common complication of pregnancy and contributes to increased risk for type 2 diabetes in both the mother and offspring. We developed and evaluated a gestational diabetes risk reduction and preconception counseling program, Stopping GDM (SGDM), for American Indian females. The purpose of this study is to examine the experiences of American Indian mother-daughter dyad participants and the site coordinators who facilitated the SGDM randomized controlled trial to inform program revisions. We engaged mother-daughter dyads (n = 22 dyads) and site coordinators (n = 6) in focus group interviews. Four themes emerged: (1) …

Mapping The Metabolic Reprogramming Induced By Sodium-Glucose Cotransporter 2 Inhibition, Aviram Kogot-Levin, Yael Riahi, Ifat Abramovich, Ofri Mosenzon, Bella Agranovich, Liat Kadosh, Rachel Ben-Haroush Schyr, Doron Kleiman, Liad Hinden, Erol Cerasi, Danny Ben-Zvi, Ernesto Bernal-Mizrachi, Joseph Tam, Eyal Gottlieb, Gil Leibowitz

Faculty, Staff and Student Publications

Diabetes is associated with increased risk for kidney disease, heart failure, and mortality. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) prevent these adverse outcomes; however, the mechanisms involved are not clear. We generated a roadmap of the metabolic alterations that occur in different organs in diabetes and in response to SGLT2i. In vivo metabolic labeling with 13C-glucose in normoglycemic and diabetic mice treated with or without dapagliflozin, followed by metabolomics and metabolic flux analyses, showed that, in diabetes, glycolysis and glucose oxidation are impaired in the kidney, liver, and heart. Treatment with dapagliflozin failed to rescue glycolysis. SGLT2 inhibition increased glucose oxidation …

Cardiovascular Risk Of Metabolically Healthy Obesity In Two European Populations: Prevention Potential From A Metabolomic Study, Dongmei Wei, Vannina González Marrachelli, Jesus D. Melgarejo, Chia-Te Liao, Angie Hu, Stefan Janssens, Peter Verhamme, Lucas Van Aelst, Thomas Vanassche, Josep Redon

School of Medicine Publications

Background

A new definition of metabolically healthy obesity (MHO) has recently been proposed to stratify the heterogeneous mortality risk of obesity. Metabolomic profiling provides clues to metabolic alterations beyond clinical definition. We aimed to evaluate the association between MHO and cardiovascular events and assess its metabolomic pattern.

Methods

This prospective study included Europeans from two population-based studies, the FLEMENGHO and the Hortega study. A total of 2339 participants with follow-up were analyzed, including 2218 with metabolomic profiling. Metabolic health was developed from the third National Health and Nutrition Examination Survey and the UK biobank cohorts and defined as systolic blood …

Characterization Of The Principal And Secondary Islets During Pancreatic Development In Zebrafish With A Crispr-Mediated Glis3 Knockout, Caleb Harsin

Honors College Theses

The Krüppel-like transcription factor, Gli-similar 3 (Glis3) has been implicated in several human pathologies including neonatal diabetes, congenital hypothyroidism, and polycystic kidney disease. Numerous genome-wide association studies (GWAS) have additionally identified Glis3 as a risk locus for the development of both type 1 and type 2 diabetes mellitus. Our previous data suggest possible roles for Glis3 in endocrine pancreas specification in mice, but despite its clinical significance, much remains unknown about the role(s) Glis3 plays during development. To elucidate Glis3 gene function, a CRISPR-mediated knockout line of zebrafish was developed by deleting a segment of the Glis3 coding region …

Examining Associations Between Social Needs And Mental Health Among Youth And Young Adults With Diabetes, Andrea Danielle Brown

Theses and Dissertations

Household food insecurity (HFI) disproportionally affects people with diabetes living in the United States and is more likely to occur in households with children and in minority race/ethnicity households. Food insecure people with youth-onset diabetes likely have increased risk for poor mental health due to dealing with stress and cost related to diabetes management, especially if facing additional health-related social needs that intersect with HFI. If left untreated, poor mental health among youth and young adults (YYA) with diabetes can lead to diabetes-related complications, increased health care costs, and mortality. Yet few studies have examined associations between HFI and mental …

Long-Term Maternal Metabolic And Cardiovascular Phenotypes After A Pregnancy Complicated By Mild Gestational Diabetes Mellitus Or Obesity, Ashley N Battarbee, Lisa Mele, Mark B Landon, Michael W Varner, Brian M Casey, Uma M Reddy, Ronald J Wapner, Dwight J Rouse, John M Thorp, Edward K Chien, George Saade, Beth A Plunkett, Sean C Blackwell

Faculty, Staff and Student Publications

Objective:

To evaluate the association of mild gestational diabetes (GDM) and obesity with metabolic and cardiovascular markers 5-10 years after pregnancy.

Study Design:

This was a secondary analysis of 5-10 year follow-up study of a mild GDM treatment trial and concurrent observational cohort of participants ineligible for the trial with abnormal 1-hour glucose challenge test only. Participants with 2-hour glucose tolerance test at follow-up were included. The primary exposures were mild GDM and obesity. The outcomes were insulinogenic index (IGI), 1/HOMA-IR, and cardiovascular markers VEGF, VCAM-1, CD40L, GDF-15, and ST-2. Multivariable linear regression estimated the association of GDM and obesity …

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 …

A Nutritional Biomarker Score Of The Mediterranean Diet And Incident Type 2 Diabetes: Integrated Analysis Of Data From The Medley Randomised Controlled Trial And The Epic-Interact Case-Cohort Study, Jakub G. Sobiecki, Fumiaki Imamura, Courtney R. Davis, Stephen J. Sharp, Albert Koulman, Jonathan M. Hodgson, Marcela Guevara, Matthias B. Schulze, Ju Sheng Zheng, Claudia Agnoli, Catalina Bonet, Sandra M. Colorado-Yohar, Guy Fagherazzi, Paul W. Franks, Thomas E. Gundersen, Franziska Jannasch, Rudolf Kaaks, Verena Katzke, Esther Molina-Montes, Peter M. Nilsson, Domenico Palli, Salvatore Panico, Keren Papier, Olov Rolandsson, Carlotta Sacerdote, Anne Tjønneland, Tammy Y. N. Tong, Yvonne T. Van Der Schouw, John Danesh, Adam S. Butterworth, Elio Riboli, Karen J. Murphy, Nicholas J. Wareham, Nita G. Forouhi

Research outputs 2022 to 2026

Background: Self-reported adherence to the Mediterranean diet has been modestly inversely associated with incidence of type 2 diabetes (T2D) in cohort studies. There is uncertainty about the validity and magnitude of this association due to subjective reporting of diet. The association has not been evaluated using an objectively measured biomarker of the Mediterranean diet. Methods and findings: We derived a biomarker score based on 5 circulating carotenoids and 24 fatty acids that discriminated between the Mediterranean or habitual diet arms of a parallel design, 6-month partial-feeding randomised controlled trial (RCT) conducted between 2013 and 2014, the MedLey trial (128 participants …

The Role Of Preproglucagon Peptides In Regulating Β-Cell Morphology And Responses To Streptozotocin-Induced Diabetes, Deanna M. Arble, Chelsea R. Hutch, Hannah Hafner, Daria Stelmak, Kyle Leix, Joyce Sorrell, Joshua W. Pressler, Brigid Gregg, Darleen A. Sandoval

Biological Sciences Faculty Research and Publications

Insulin secretion from β-cells is tightly regulated by local signaling from preproglucagon (Gcg) products from neighboring α-cells. Physiological paracrine signaling within the microenvironment of the β-cell is altered after metabolic stress, such as high-fat diet or the β-cell toxin, streptozotocin (STZ). Here, we examined the role and source of Gcg peptides in β-cell function and in response to STZ-induced hyperglycemia. We used whole body Gcg null (Gcg^Null) mice and mice with Gcg expression either specifically within the pancreas (Gcg^ΔPanc) or the intestine (Gcg^ΔIntest). With lower doses of STZ exposure, insulin levels were …

Exposure To Pcb126 During The Nursing Period Reversibly Impacts Early-Life Glucose Tolerance, Brittany Breon Rice, Keegan W. Sammons, Sara Y. Ngo Tenlep, Madeline T. Weltzer, Leryn J. Reynolds, Cetewayo S. Rashid, Hollie I. Swanson, Kevin J. Pearson

Markey Cancer Center Faculty Publications

Polychlorinated biphenyls (PCBs) are persistent environmental organic pollutants known to have detrimental health effects. Using a mouse model, we previously demonstrated that PCB126 exposure before and during pregnancy and throughout the perinatal period adversely affected offspring glucose tolerance and/or body composition profiles. The purpose of this study was to investigate the glucose tolerance and body composition of offspring born to dams exposed to PCB126 during the nursing period only. Female ICR mice were bred, and half of the dams were exposed to either vehicle (safflower oil) or 1 μmole PCB126 per kg of body weight via oral gavage on postnatal …

Information-Motivation-Behavioral Skill In Diabetes Self-Management Using Structural Equation Modeling Analysis, Dien Kurtanty, Adang Bachtiar, Cicilya Candi, Alya Pramesti, Almira Fanny Rahmasari

Kesmas

Diabetes is the “mother” of various diseases increasing the risk of morbidity and mortality. Diabetes self-management, an effort made by patients to control blood sugar levels, is an important part of the management strategy. Therefore, this study analyzed information, motivation, and behavioral skills associated with diabetes self-management. Data were collected in the Special Capital Region of Jakarta, with 277 diabetic patients selected using a questionnaire by a systematic random sampling method. The analyzed variables were information (with indicator variables of information on physical activity, nutritional intake, drug consumption, and blood sugar monitoring); sociodemographic (age, sex, occupation, education level, and duration …

Postprandial And Fasting Lipopolysaccharide Levels In Healthy Hispanic Residents Of Southeast Texas With Positive Family History Of Type 2 Diabetes, Amanda J. Wheeler, Yu Lun Tai, Smaran Marupudi, Ryan D. Russell

International Journal of Exercise Science: Conference Proceedings

PURPOSE: Healthy people with a family history (FH+) of type 2 diabetes (T2D) display impaired metabolic and microvascular function prior to glucose intolerance, and are at greater risk for developing T2D. While mechanisms to explain this disparity are lacking, it is possible that intestinal permeability plays a role, as it is also linked with insulin resistance, glucose intolerance, and chronic inflammation. Lipopolysaccharides (LPS) act as an outer membrane component of gram-negative bacteria in intestines and play a role in inflammation and chronic disease when in circulation, thus serving as a surrogate measure of intestinal permeability. However, the link between FH+ …

Serum Cotinine As A Predictor Of Lipid-Related Indices In Turkish Immigrants With Type 2 Diabetes: A Clinic-Based Cross-Sectional Study, Shiryn D. Sukhram, Gustavo G. Zarini, Lemia H. Shaban, Joan A. Vaccaro, Avinash R. Sukhram, Fatma G. Huffman

Publications and Research

Background: Turkish immigrants form the largest ethnic minority group in the

Netherlands and show a higher prevalence of (i) cardiovascular disease (CVD),

(ii) cigarette smoking, and (iii) type 2 diabetes (T2D) as compared to the native

Dutch. This study examines the association of CVD risk factors: serum cotinine, as

an indicator of cigarette smoke, and lipid-related indices among first-generation

(foreign-born) Turkish immigrants with T2D living in deprived neighbourhoods in the

Netherlands.

Methods: A total of 110 participants, physician-diagnosed with T2D, aged 30 years

and older, were recruited by convenience sampling from the Schilderswijk

neighbourhood of The Hague in a clinic-based …

The Relationship Between Psychosocial Factors, Self-Care, And Blood Sugar In An Appalachian Population, Brittany L. Smalls, Md. Tofial Azam, Madeline Dunfee, Philip M. Westgate, Susan C. Westneat, Nancy Schoenberg

Journal of Appalachian Health

Introduction: Appalachian residents are more likely than other populations to have Type 2 Diabetes Mellitus (T2DM) and to experience more severe complications from the disease, including excess and premature mortality.

Methods: This study examines health alongside sociodemographic factors, psychosocial factors (including knowledge, empowerment, social support/function, religiosity, distress), and perceived problems in diabetes management that may influence self-care and HbA1c among vulnerable rural residents. A survey of a community–based sample of 356 adults with diagnosed diabetes or HbA1c > 6.5 was conducted in six counties in Appalachian Kentucky.

Results: Findings suggest that neither religiosity nor social support/function mediate/moderate the relationship between psychosocial …

Nutritional Medicine: Education For Advanced Practice Providers, Natalie Organ

DNP Research Projects

Abstract

OBJECTIVE: The project's primary goal was to educate the APP and develop positive attitudes and beliefs concerning plant-based nutrition regarding obesity, diabetes, cardiovascular disease, and cancer. The project addressed a crucial gap in healthcare education. APPs were not routinely given the chance to learn nutritional medicine, leading to decreased confidence in providing nutritional guidance in clinical practice.

METHODS: The DNP project participants were practicing advanced practice providers. The Knowledge, Attitude, Behavior (KAB) education theory and CREATION Life were used. This project used Qualtrics to send a pre-and post-intervention survey titled Student Survey for Nutritional Medicine. The intervention was a …

Relationship Between Childhood Trauma, ,Adverse Childhood Experiences, And Self-Management Of Type 1 And Type 2 Diabetes, Deserie J. Otoole

Walden Dissertations and Doctoral Studies

AbstractPoorly controlled diabetes is the result of lack of self-care, which contributes to complications, ill quality in life, the rise in health care costs, and early death. The purpose of this quantitative, nonexperimental study was to examine the extent to which diabetes type (Type 1 and Type 2), childhood trauma, and adverse childhood experiences predict diabetes self-management (glucose management, dietary control, physical activity, health care use, total self-management). Contemporary trauma theory suggests that early childhood trauma results in negative health-related consequences in adulthood. Standard multiple regression analyses showed that (a) higher levels of physical neglect and emotional abuse predicted poorer …

Providing Diabetes Education To Improve Staff Nurses' Knowledge, Marcia A. Patterson

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a chronic metabolic disease that affects over 34.2 million or 10.5% of the U.S. population and ranks as the seventh leading cause of death. Tennessee's diabetes prevalence rate is ranked 45th overall in the nation, with 14.9% of the population affected, and in the local area for this project, the rate is greater than 15%, creating a public health concern. Despite its prevalence, there is still a wide gap in knowledge among nurses on diabetes management. The practice-focused question for this project addressed whether a staff education program would improve nurses' knowledge regarding diabetes. The significant gap …

Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker

Walden Dissertations and Doctoral Studies

Diabetes imposes a major burden on society, especially in the state of Florida, in the form of increased medical costs, lost productivity, early mortality, and intangible costs in the form of diminished quality of life. Access to diabetic care affects health administration in Florida by impacting the overall cost of treating the condition. Limited access to care can lead to an increased risk of complications resulting in a higher cost of treatment. The purpose of this quantitative study was to determine whether access to care dependent variables (access to doctors and length of time since last routine checkup) were associated …

Exposure To Pcb126 During The Nursing Period Reversibly Impacts Early-Life Glucose Tolerance, Brittany B. Rice, Keegan W. Sammons, Sara Y. Ngo Tenlep, Madeline T. Weltzer, Leryn J. Reynolds, Cetewayo S. Rashid, Hollie I. Swanson, Kevin J. Pearson

Human Movement Studies & Special Education Faculty Publications

Polychlorinated biphenyls (PCBs) are persistent environmental organic pollutants known to have detrimental health effects. Using a mouse model, we previously demonstrated that PCB126 exposure before and during pregnancy and throughout the perinatal period adversely affected offspring glucose tolerance and/or body composition profiles. The purpose of this study was to investigate the glucose tolerance and body composition of offspring born to dams exposed to PCB126 during the nursing period only. Female ICR mice were bred, and half of the dams were exposed to either vehicle (safflower oil) or 1 µmole PCB126 per kg of body weight via oral gavage on postnatal …

Curbing Diabetes Prevalence And Reducing Risk Through Policy, Grayson Blount

Undergraduate Public Policy Capstone Projects

The purpose of this policy brief is to illuminate the dire circumstances surrounding the ongoing diabetes epidemic in Kentucky. Type II diabetes mellitus, a preventable and manageable chronic illness, affects nearly 465,000 Kentuckians currently. Beyond the daily struggle associated with diabetes, many acute complications can arise that are severly detrimental to quality of life, such as blindness or lower extremeity amputation. Additionally, the costs associated with diabetes are tremendous, to patients, to providers, and to the state. It is in the best interest of all stakeholders to do whatever we can in order to reduce prevalence and improve management of …