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Diabetes

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Role Of Serum Biomarkers In Early Detection Of Diabetic Cardiomyopathy In The West Virginian Population, Adam Shaver, Alexandra Nichols, Ellen A. Thompson, Amrita Mallick, Nandini Manne, Shanmuga Sundaram, Joseph I. Shapiro Md, Komal Sodhi Feb 2016

Role Of Serum Biomarkers In Early Detection Of Diabetic Cardiomyopathy In The West Virginian Population, Adam Shaver, Alexandra Nichols, Ellen A. Thompson, Amrita Mallick, Nandini Manne, Shanmuga Sundaram, Joseph I. Shapiro Md, Komal Sodhi

Biochemistry and Microbiology

Objectives: Diabetic cardiomyopathy (DCM) is an established complication of diabetes mellitus. In West Virginia, the especially high incidence of diabetes and heart failure validate the necessity of developing new strategies for earlier detection of DCM. Since most DCM patients remain asymptomatic until the later stages of the disease when the fibrotic complications become irreversible, we aimed to explore biomarkers that can identify early-stage DCM.

Methods: The patients were grouped into 4 categories based on clinical diabetic and cardiac parameters: Control, Diabetes (DM), Diastolic dysfunction (DD), and Diabetes with diastolic dysfunction (DM+DD), the last group being the preclinical DCM group.

Results: …


The Role Of Cdk5r1 In Β-¬Cell Survival From Apoptosis, Amanda Hobson, Jeffrey Tessem Feb 2016

The Role Of Cdk5r1 In Β-¬Cell Survival From Apoptosis, Amanda Hobson, Jeffrey Tessem

Journal of Undergraduate Research

Type 1 and Type 2 diabetes are classified as a decrease in functional ß-cell mass, which results in impaired blood glucose regulation. Functional ß-cell mass is defined as the glucose stimulated insulin secretion rate multiplied by the total cellular mass which is determined by the proliferation and cell death rates. Though ß-cell mass proliferation rates generally decrease by adolescence, obesity and pregnancy have been shown to be times of significant ß-cell proliferation (1). This implies that the inherent molecular pathways necessary for ß-cell proliferation are present, but highly regulated. Discovering the molecular pathway of ß-cell proliferation could lead to diabetes …


Chronic Treatment With A Carbon Monoxide Releasing Molecule Reverses Dietary Induced Obesity In Mice, Peter Hosick, Abdulhadi A. Alamodi, Michael W. Hankins, David E. Stec Feb 2016

Chronic Treatment With A Carbon Monoxide Releasing Molecule Reverses Dietary Induced Obesity In Mice, Peter Hosick, Abdulhadi A. Alamodi, Michael W. Hankins, David E. Stec

Department of Exercise Science and Physical Education Scholarship and Creative Works

ABSTRACT: Chronic, low level treatment with a carbon monoxide releasing molecule (CO-RM), CORM-A1, has been shown to prevent the development of obesity in response to a high fat diet. The objective of this study was to test the hypothesis that chronic, low level treatment with this CO-RM can reverse established obesity via a mechanism independent of food intake. Dietary induced obese mice were treated with CORM-A1, the inactive compound iCORM-A1, or saline every 48 hours for 30 weeks while maintained on a high fat (60%) diet. Chronic treatment with CORM-A1 resulted in a 33% decrease from initial body weight over …


An Adenovirus-Derived Protein: A Novel Candidate For Anti-Diabetic Drug Development, Vijay Hegde, Ha Na Na, Olga Dubuisson, Susan J. Burke, J. Jason Collier, David Burk, Tamra Mendoza, Nikhil V. Dhurandhar Feb 2016

An Adenovirus-Derived Protein: A Novel Candidate For Anti-Diabetic Drug Development, Vijay Hegde, Ha Na Na, Olga Dubuisson, Susan J. Burke, J. Jason Collier, David Burk, Tamra Mendoza, Nikhil V. Dhurandhar

Faculty Publications

© 2015 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). Aims Exposure to human adenovirus Ad36 is causatively and correlatively linked with better glycemic control in animals and humans, respectively. Although the anti-hyperglycemic property of Ad36 may offer some therapeutic potential, it is impractical to use an infectious agent for therapeutic benefit. Cell-based studies identified that Ad36 enhances cellular glucose disposal via its E4orf1 protein. Ability to improve glycemic control in vivo is a critical prerequisite for further investigating the therapeutic potential of E4orf1. Therefore, the aim of this study was to determine the ability of E4orf1 …


Depression In Mexican Americans With Diagnosed And Undiagnosed Diabetes, Rene L. Olvera, Susan P. Fisher-Hoch, Douglas E. Williamson, Kristina Vatcheva, Joseph B. Mccormick Feb 2016

Depression In Mexican Americans With Diagnosed And Undiagnosed Diabetes, Rene L. Olvera, Susan P. Fisher-Hoch, Douglas E. Williamson, Kristina Vatcheva, Joseph B. Mccormick

School of Mathematical & Statistical Sciences Faculty Publications

Background: Depression and diabetes commonly co-occur; however, the strength of the physiological effects of diabetes as mediating factors towards depression is uncertain.

Method: We analyzed extensive clinical, epidemiological and laboratory data from n = 2081 Mexican Americans aged 35-64 years, recruited from the community as part of the Cameron County Hispanic Cohort (CCHC) divided into three groups: Diagnosed (self-reported) diabetes (DD, n = 335), Undiagnosed diabetes (UD, n = 227) and No diabetes (ND, n = 1519). UD participants denied being diagnosed with diabetes, but on testing met the 2010 American Diabetes Association and World Health Organization definitions of diabetes. …


Diabetes Educational Program, Djenane Bartholomew Jan 2016

Diabetes Educational Program, Djenane Bartholomew

DNP and Student Works

Diabetes is the seventh leading cause of death in the United States, despite medical advancements (Centers for Disease Control [CDC], 2011). Diabetes management and education is the key to curtail the rapid spread of this disease. As American baby boomers age, the diagnoses of diabetes increase and cause the disease to reach epidemic proportions (King, Matheson, Chirina, & Shankar, 2013). A New York City nursing home conducted a needs assessment in 2013, which revealed an increase in the readmission of residents with diabetes or diabetes-related complications. These sobering facts led to the project question: Does a diabetes educational program in …


Improving Quality Of Life In Older Adults With Depression And Diabetes Through Medication Compliance Education, Valreen Hinds-Beharrie Jan 2016

Improving Quality Of Life In Older Adults With Depression And Diabetes Through Medication Compliance Education, Valreen Hinds-Beharrie

Walden Dissertations and Doctoral Studies

Improving Quality-of-Life in Older Adults with Depression and Diabetes through Medication Compliance Education

by

Valreen Hinds-Beharrie

MSN, Adelphi University, 1997

BSN, Adelphi University, 1986

Project Submitted in Partial Fulfillment

of the Requirement for the Degree of

Doctor of Nursing Practice

Walden University

March 2016

Diabetes and depression are prevalent diseases that cause morbidity and mortality. Diabetes is a heterogeneous metabolic disease in which hypoglycemia is a central feature. Depression is associated with increased counter-regulatory, hormone release, and alteration in glucose transport function. Depression occurs in some individuals with diabetes and is associated with poor metabolic control, inadequate control of diet, …


Chronic Disease Self-Management Program, Raquel Marie Biati Jan 2016

Chronic Disease Self-Management Program, Raquel Marie Biati

Walden Dissertations and Doctoral Studies

The World Health Organization noted that 2 global health problems have reached epidemic proportions: obesity and type 2 diabetes. These conditions affect nearly 170 million people worldwide. The clinical practice problem addressed by this project was the prevalence of adults ages 50 and older in an ambulatory care setting who suffer from obesity and diabetes and may benefit from a tailored weight management and nutrition education intervention. The purpose of this project was to design a program that would decrease body mass index and hemoglobin A1c in older patients through adaption of the Chronic Disease Self-Management Program. The evidence supporting …


Type 2 Diabetes In Offspring Of Diabetic African American Women, Toby Valentino Yak Jan 2016

Type 2 Diabetes In Offspring Of Diabetic African American Women, Toby Valentino Yak

Walden Dissertations and Doctoral Studies

The prevalence of Type 2 diabetes is greater among African American women and their offspring than it is among Caucasian women and their offspring. In Iowa, there has been a gap in public health knowledge regarding risk factors associated with Type 2 diabetes in African American women and their offspring. The behavioral change wheel model was used to guide this study. This research study was a quantitative, retrospective cohort using primary data to investigate the association between a sample of diabetic African American and the occurrence of diabetes in their offspring. The sample included 105 diabetic African American women between …


Measuring Return-On-Investment (Roi) Of A Worksite Wellness Program Using An Accountable Care Organization Software Program: What Is The Roi At 12 Months?, Andrew J. Hartung Jan 2016

Measuring Return-On-Investment (Roi) Of A Worksite Wellness Program Using An Accountable Care Organization Software Program: What Is The Roi At 12 Months?, Andrew J. Hartung

MUSC Theses and Dissertations

Over the past several decades, significant research has been completed in an effort to understand the impact Type 2 diabetes has on the expense associated with disease treatment and maintenance, health care industry resources, and prevention of the disease. At the same time many corporations have taken on the challenge of providing workplace wellness programs to reduce health care expense associated with chronic illness or unhealthy behaviors and improve the overall health of employees. Coupling these efforts with the accountable care organization model established via the Patient Protection and Affordable Care Act, this research determined that obtaining a positive return …


Estimated Maximal Oxygen Consumption Of Transfemoral Amputees Utilizing The Ebbeling Treadmill Test, Samantha Stauffer Jan 2016

Estimated Maximal Oxygen Consumption Of Transfemoral Amputees Utilizing The Ebbeling Treadmill Test, Samantha Stauffer

Senior Honors Theses and Projects

OBJECTIVE: It is reasonable to utilize kinematic data in the evaluation of amputee functional capacity. However, physiological response to activity is another aspect that should be taken into account when evaluating patient functional K-Ievel. The purpose of this study is to document the physiological responses of lower-limb amputees to clinical exercise testing and compare the results of using a simple submaximal protocol designed for non-amputees to an established method of measuring functional capacity in amputees.

METHODS: Three healthy unilateral transfemoral subjects had all previously been classified as functional K3-K4 ambulators using the Amputee Mobility Predictor. They were tested using the …


Diabetes Update: Your Guide To The Latest Ada Standards, Eric Johnson, Florence Warren, Neil Skolnik, Jay H. Shubrook Jan 2016

Diabetes Update: Your Guide To The Latest Ada Standards, Eric Johnson, Florence Warren, Neil Skolnik, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

The authors highlight the latest changes in the ADA standards and review recommendations of particular relevance for family physicians.


The Association Between Antidepressant Medications And A1c Among Individuals With And Without Diabetes, Jamie Kammer Jan 2016

The Association Between Antidepressant Medications And A1c Among Individuals With And Without Diabetes, Jamie Kammer

Legacy Theses & Dissertations (2009 - 2024)

While depression is known to increase the risk of diabetes and worsen glycemic control, the effect of antidepressants on these outcomes is unclear. Within the past few years, a cross-sectional study performed in a large, nationally-representative sample of individuals without diagnosed diabetes concluded that there are no differences between antidepressant users and non-users with regard to a number of diabetes-related outcomes including A1C, a measure of average glucose levels over the past few months commonly used to detect and monitor diabetes. The current set of studies was conducted to determine whether replicating this research in a higher-risk population or using …


The Role And Impact Of School Nurses And Intentions To Delegate Diabetes-Related Tasks Amidst Budget Cuts And Legislative Changes, Michelle J. Lineberry Jan 2016

The Role And Impact Of School Nurses And Intentions To Delegate Diabetes-Related Tasks Amidst Budget Cuts And Legislative Changes, Michelle J. Lineberry

Theses and Dissertations--Kinesiology and Health Promotion

As the percentage of school children with chronic conditions such as diabetes continues to rise, funding for school nurses to keep those students healthy and safe is decreasing. This dissertation includes three studies: (1) a systematic review of the literature on the role and impact of American elementary school nurses, (2) a focus group study that further examined the role of Kentucky school nurses and described their reaction to a new regulation that necessitates delegation of diabetes-related nursing tasks to unlicensed assistive personnel (UAP), and (3) a quantitative study that examined Kentucky school nurses’ past behaviors and future intentions regarding …


Nucleobindin-2: A Novel Regulator Of Immune-Metabolic Interactions, Anthony Ravussin Jan 2016

Nucleobindin-2: A Novel Regulator Of Immune-Metabolic Interactions, Anthony Ravussin

LSU Doctoral Dissertations

Over the past half century, obesity has become a widespread concern to human health. Obesity is defined as having a body mass index above 30 and is accompanied by altered metabolic physiology. Obesity is one of the leading causes of mortality in the United States and in the world. The prevalence of obesity has increased over the past few decades. High body fat in adipose, excess calorie intake, low aerobic fitness are all associated with the comorbidities of obesity. Recently, an emphasis has been given to increased leukocytes in adipose tissue and the resulting low-grade systemic inflammation on the development …


Diet And Nutrition Reverse Type 3 Diabetes And Accelerated Aging Linked To Global Chronic Diseases, Ian James Martins Jan 2016

Diet And Nutrition Reverse Type 3 Diabetes And Accelerated Aging Linked To Global Chronic Diseases, Ian James Martins

Research outputs 2014 to 2021

The acceleration in the rate of chronic diseases that involve insulin resistance has become of global concern. The rate of the most prevalent chronic disease such as cardiovascular disease is linked to the metabolic syndrome, non alcoholic fatty liver disease (NAFLD) and other chronic diseases that include obesity, diabetes and neurodegenerative diseases. The gene-environment interaction in Western countries indicates that with urbanization access to food and its content may lead to induction of epigenetic alterations and identify the gene Sirtuin 1 (Sirt 1) to be responsible for the increased risk for insulin resistance and NAFLD relevant to Type 1, Type …


Type 3 Diabetes With Links To Nafld And Other Chronic Diseases In The Western World, Ian J. Martins Jan 2016

Type 3 Diabetes With Links To Nafld And Other Chronic Diseases In The Western World, Ian J. Martins

Research outputs 2014 to 2021

In the year 2015 it is now estimated that 30% of the Western World will now progress to non alcoholic fatty liver disease (NAFLD) and by the year 2050 if NAFLD remains untreated in the Western world the prevalence of the disease may rise to 40% of the global population. Type 3 diabetes and circadian rhythm disturbances may be involved in the induction of NAFLD that may promote insulin resistance and various chronic diseases such as cardiovascular disease, pancreatic disease, kidney disease and neurodegenerative disease. Multiple risk factors that induce Type 3 diabetes and NAFLD include stress, magnesium deficiency, bacterial …


Food Intake And Caffeine Determine Amyloid Beta Metabolism With Relevance To Mitophagy In Brain Aging And Chronic Disease, Ian J. Martins Jan 2016

Food Intake And Caffeine Determine Amyloid Beta Metabolism With Relevance To Mitophagy In Brain Aging And Chronic Disease, Ian J. Martins

Research outputs 2014 to 2021

In the global world diabetes and mitochondrial disease is expected to cost the developing world in the next 30 years US $400 million. In diabetes an absent peripheral sink amyloid beta clearance pathway is now relevant to amyloid beta induced mitochondrial apoptosis. The quality of food consumed has raised major concerns with increased levels of plasma bacterial lipopolysaccharides (LPS) that induces amyloid beta aggregation and mitochondrial apoptosis with programmed cell death linked to non alcoholic fatty liver disease (NAFLD) and many organ diseases. The amount, nature and time of day of fat consumption in diabetes has become important with relevance …


Geriatric Medicine And Heat Shock Gene Therapy In Global Populations, Ian J. Martins Jan 2016

Geriatric Medicine And Heat Shock Gene Therapy In Global Populations, Ian J. Martins

Research outputs 2014 to 2021

No abstract provided.


Review Of Diabetes Among Aboriginal And Torres Strait Islander People, Samantha Burrow, Kathy Ride Jan 2016

Review Of Diabetes Among Aboriginal And Torres Strait Islander People, Samantha Burrow, Kathy Ride

Research outputs 2014 to 2021

Diabetes is the world’s fastest growing chronic disease. Type 2 diabetes in particular, has reached epidemic proportions globally and in Australia, and poses a challenge for public health systems everywhere. The greatest burden tends to fall on socially disadvantaged groups and Indigenous peoples Aboriginal and Torres Strait Islander Australians experience disproportionately high levels of diabetes. They are three times more likely to have diabetes than non-Indigenous Australians and Aboriginal and Torres Strait Islander women are almost twice as likely to develop gestational diabetes as non-Indigenous women. There is also evidence that Aboriginal and Torres Strait Islander children are eight times …


The Waist To Height Ratio Is A Better Anthropometric Index Of Abdominal Obesity And Its Association With The Prevalence Of Diabetes Among Asian Americans, Yu Xiao Jan 2016

The Waist To Height Ratio Is A Better Anthropometric Index Of Abdominal Obesity And Its Association With The Prevalence Of Diabetes Among Asian Americans, Yu Xiao

All Master's Theses

There is limited information about diabetes prevalence among Asian Americans. Diabetes risk factors include abdominal obesity (AO), which can be assessed by measuring waist circumference (WC) or waist-to-height-ratio (WHtR). The purpose of this study was to compare the prevalence of diabetes among Asians with non-Asians in the United States and compare WC and WHtR as predictors of diabetes. Data from the National Health and Nutrition Examination Survey (NHANES) 2011-14 was analyzed using SAS 9.2. There were 8,615 adult non-pregnant non-Asians and 1,224 Asians included in this study. Despite a lower prevalence of obesity among Asians compared to non-Asians (12% vs …


Diabetes Mellitus Type 2: A Quality Improvement And Patient Safety Initiative, Remeliza Navarrete Tukay Jan 2016

Diabetes Mellitus Type 2: A Quality Improvement And Patient Safety Initiative, Remeliza Navarrete Tukay

Walden Dissertations and Doctoral Studies

The purpose of the quality improvement (QI) project was to examine the relationship between amended nursing education concerning diabetes mellitus (DM) Type 2 self-care management incorporating Tune in, Explore, Assist, Communicate, and Honor (TEACH) and Motivational Interviewing (MI) strategies and techniques and the Glycosylated hemoglobin (HgbA1C) of veteran patients with uncontrolled diabetes. The target sample included the 2 licensed practical nurses and 2 registered nurses assigned to 2 primary care teams, and the 10 purposively sampled patients with uncontrolled DM Type 2 from each team. The nurses' competencies were measured through descriptive comparison before and after nursing education implementation using …


Implementation And Evaluation Of Dietary Modification With Gestational Diabetes, Celia T. Ojeaga Jan 2016

Implementation And Evaluation Of Dietary Modification With Gestational Diabetes, Celia T. Ojeaga

Walden Dissertations and Doctoral Studies

Gestational diabetes mellitus (GDM) negatively affects the health of both mothers and babies, and is the most common pregnancy complication in the United States. Many dietary modification programs for pregnant women diagnosed with GDM rely on a one-size-fits-all approach to menu planning. The purpose of this project was to develop a diet modification program for GDM management using a patient-centered approach. The project objective was to develop the policies, procedures, and supporting documents needed to implement a successful GDM management program for pregnant women receiving antenatal care at an obstetrical clinic. The developed program incorporated strategies for clinic nursing staff …


Risk Of Alzheimer's Disease Among Older Hispanic/Latinos With Diabetes, Kathy Bianco Jan 2016

Risk Of Alzheimer's Disease Among Older Hispanic/Latinos With Diabetes, Kathy Bianco

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is the 6th leading cause of death in older Americans. Currently there is no cure for AD, and even though the specific cause is unknown, diabetes mellitus type 2 (DM2) is regarded as a risk factor. Hispanics have a higher incidence of DM2 and possibly AD. I chose a life course theoretical model for this quantitative cross-sectional study to illuminate the variables most pertinent to a pathway from good health to poor health. The variables chosen were hypertension (HTN), obesity, smoking, stroke, dyslipidemia, and lower educational attainment. The research questions were used to examine biologic, metabolic, sociologic, …


Applying The Health Justice Framework To Diabetes As A Community-Managed Social Phenomenon, Lindsay Wiley Jan 2016

Applying The Health Justice Framework To Diabetes As A Community-Managed Social Phenomenon, Lindsay Wiley

Scholarly Articles in Law Reviews & Journals

INTRODUCTION: In East Harlem, it is possible to take any simple nexus of people -the line at an A.T.M., a portion of a postal route, the members of a church choir -and trace an invisible web of diabetes that stretches through the group and out into the neighborhood, touching nearly every life with its menace.Ten years ago, the New York Times published "Bad Blood," a series of articles examining the impact of diabetes on the residents of New York City. In the years that followed, New York pioneered a series of groundbreaking legal interventions, including implementing measures to track diabetes …


Diabetes Management Regimens And Cardiovascular Disease Risk In African American Men, Joseph Garilus Jan 2016

Diabetes Management Regimens And Cardiovascular Disease Risk In African American Men, Joseph Garilus

Walden Dissertations and Doctoral Studies

One of the most common health complications related to diabetes is the development of cardiovascular disease (CVD). Studies addressing the association between adherence to diabetes management regimens and the risk of CVD among minority populations are limited. This cross-sectional study was conducted to examine the association between diabetes management regimens and risk of CVD among African American men. The health belief model was used to frame the study. Data were collected from the Behavioral Risk Factor Surveillance System database for the states of Missouri and Ohio. Multiple logistic regression analysis was used to assess the association between adherence to diabetes …


Experiences Managing Type 1 Diabetes Mellitus Among Parents Of African-American Youth, Sonya T. Strider Jan 2016

Experiences Managing Type 1 Diabetes Mellitus Among Parents Of African-American Youth, Sonya T. Strider

Walden Dissertations and Doctoral Studies

Type 1 diabetes mellitus (T1DM) is one of the most frequently diagnosed endocrine and metabolic conditions that occur during childhood. This research study utilized a phenomenological study design to examine how the lived experiences of 20 African American (AA) parents of children with T1DM recruited using social media affects their management and control of the disease among AA youth age 5-17 years old. The interview questions were outlined in categories that tested key constructs of the health belief model (HBM) to determine the perceived barriers, seriousness, and susceptibility to maintaining good glycemic control for their children. Data from each interview …


Communicating Periodontal Disease Risk To American Indian Patients With Diabetes, Jennifer Jordan Jan 2016

Communicating Periodontal Disease Risk To American Indian Patients With Diabetes, Jennifer Jordan

Walden Dissertations and Doctoral Studies

Type 2 diabetes is epidemic in the American Indian population. One problem health care providers face when working with the American Indian population is communicating about secondary complications, such as periodontal disease. From a public health standpoint, periodontal disease prevention is important not only to prevent unnecessary oral pain and tooth loss, but also to prevent other more serious systemic problems from occurring such as cardiovascular disease, strokes, and bacterial pneumonia. The purpose of this qualitative study was to examine the communication efforts of health care providers and understand if and how they discuss periodontal disease with their American Indian …


Culturally-Based Diabetes Self-Management Education And Diabetes Knowledge In The Hispanic Population, Leslie Weldon Grunden Jan 2016

Culturally-Based Diabetes Self-Management Education And Diabetes Knowledge In The Hispanic Population, Leslie Weldon Grunden

Walden Dissertations and Doctoral Studies

The Hispanic population has an elevated prevalence of diabetes, resulting in large part from a lack of self-management skills required to obtain glycemic control. The purpose of this project was to determine whether diabetes self-management knowledge was improved through the use of a culturally-based diabetes self-management program for Hispanic adults with diabetes using elements of the Hispanic culture. The research question asked whether a researcher-developed diabetes self-management education program that incorporated elements of the Hispanic culture improved diabetes knowledge in the Hispanic population when compared to a non-culturally based diabetes self-management program. The project was conducted using a quasi-experimental control …


Cardiovascular Risk Factors In Ambulatory Blood Pressure Monitoring Phenotypes, Samantha G. Bromfield Jan 2016

Cardiovascular Risk Factors In Ambulatory Blood Pressure Monitoring Phenotypes, Samantha G. Bromfield

All ETDs from UAB

Hypertension and diabetes are common and are known risk factors for cardiovascular disease (CVD). Several blood pressure (BP) phenotypes, identified by ambulatory BP monitoring (ABPM), have been reported to be associated with an increased risk for CVD. However, there are few data on ABPM phenotypes among individuals with diabetes. Identifying modifiable factors that improve cardiovascular health may reduce CVD events and the prevalence of ABPM phenotypes, such as masked hypertension. Given the ability of ABPM to identify unconventional BP phenotypes that provide prognostic information beyond clinic BP, it is important to understand the optimal number of 24-hour ABPM readings necessary …