Medicine and Health Sciences Commons^™

Glycemic Variability Predicts Inflammation In Adolescents With Type 1 Diabetes, Robert P. Hoffman, Amanda S. Dye, Hong Huang, John A. Bauer

Pediatrics Faculty Publications

Background: Adolescents with type 1 diabetes (T1D) have increased risk of cardiovascular disease as well as elevations in biomarkers of systemic inflammation, plasma protein oxidation and vascular endothelial injury. It is unclear whether hyperglycemia itself, or variations in blood glucose are predictors of these abnormalities.

Methods: This study was designed to determine the relationship of inflammatory (C-reactive protein, CRP), oxidative (total anti-oxidative capacity, TAOC) and endothelial injury (soluble intracellular adhesion molecule 1, sICAM1) markers to glycemic control measures from 3 days of continuous glucose monitoring (CGM) and to hemoglobin A_1c (HbA_1c), and HbA_1c×duration area under …

A Case Of Pituitary Abscess Presenting Without A Source Of Infection Or Prior Pituitary Pathology, Derick Adams, Philip A. Kern

Internal Medicine Faculty Publications

Pituitary abscess is a relatively uncommon cause of pituitary hormone deficiencies and/or a suprasellar mass. Risk factors for pituitary abscess include prior surgery, irradiation and/or pathology of the suprasellar region as well as underlying infections. We present the case of a 22-year-old female presenting with a spontaneous pituitary abscess in the absence of risk factors described previously. Her initial presentation included headache, bitemporal hemianopia, polyuria, polydipsia and amenorrhoea. Magnetic resonance imaging (MRI) of her pituitary showed a suprasellar mass. As the patient did not have any risk factors for pituitary abscess or symptoms of infection, the diagnosis was not suspected …

Serum Amyloid A Impairs The Antiinflammatory Properties Of Hdl, Chang Yeop Han, Chongren Tang, Myriam E. Guevara, Hao Wei, Tomasz Wietecha, Baohai Shao, Savitha Subramanian, Mohamed Omer, Shari Wang, Kevin D. O'Brien, Santica M. Marcovina, Thomas N. Wight, Tomas Vaisar, Maria C. De Beer, Frederick C. De Beer, William R. Osborne, Keith B. Elkon, Alan Chait

Physiology Faculty Publications

HDL from healthy humans and lean mice inhibits palmitate-induced adipocyte inflammation; however, the effect of the inflammatory state on the functional properties of HDL on adipocytes is unknown. Here, we found that HDL from mice injected with AgNO₃ fails to inhibit palmitate-induced inflammation and reduces cholesterol efflux from 3T3-L1 adipocytes. Moreover, HDL isolated from obese mice with moderate inflammation and humans with systemic lupus erythematosus had similar effects. Since serum amyloid A (SAA) concentrations in HDL increase with inflammation, we investigated whether elevated SAA is a causal factor in HDL dysfunction. HDL from AgNO₃-injected mice lacking Saa1.1 …

Effect Of Vitamins C And E On Endothelial Function In Type 1 Diabetes Mellitus, Rachel-Marie Cazeau, Hong Huang, John A. Bauer, Robert P. Hoffman

Pediatrics Faculty Publications

Background/Objectives. Endothelial dysfunction due to hyperglycemia-induced oxidative damage is an important predictor of future cardiovascular risk in patients with type 1 diabetes mellitus (T1DM) and is present in adolescent T1DM. We hypothesized that combined treatment with the antioxidant vitamins C and E might improve endothelial function (EF) and other biochemical risk factors in adolescents with T1DM. Subjects/Methods. Open-label antioxidant supplementation was given for six weeks with endpoint measurements collected at baseline and study completion. Endpoints measured included EF and plasma measurements of biochemical endothelial risk. Results. Two males and 7 females were studied. Mean age was 12.9 ± 0.9 yrs; …

An Evaluation Of The Screening And Management Of Patients With Type 2 Diabetes, Laura A. Cahoe

DNP Projects

Purpose: This purpose of this project was to evaluate preventive screening practices and adherence to guidelines for patients with type 2 diabetes (T2DM) as recommended by the American Diabetes Association (ADA) and United States Preventive Services Task Force (USPSTF) in the primary care setting. The specific aims were to: 1) determine the percentage of patients who received recommended screenings from the ADA, 2) determine the percentage of patients who received recommended screenings from the USPSTF, and 3) determine if the proportion of patients to receive the recommended screenings met established benchmarks set by Healthy People 2020 (HP2020).

Methods: A retrospective …

Sglt2 Inhibitor Therapy Improves Blood Glucose But Does Not Prevent Diabetic Bone Disease In Diabetic Dba/2j Male Mice, Kathryn M. Thrailkill, R. Clay Bunn, Jeffry S. Nyman, Mallikarjuna R. Rettiganti, Gael E. Cockrell, Elizabeth C. Wahl, Sasidhar Uppuganti, Charles K. Lumpkin, John L. Fowlkes

Barnstable Brown Diabetes Center Faculty Publications

Persons with type 1 and type 2 diabetes have increased fracture risk, attributed to deficits in the microarchitecture and strength of diabetic bone, thought to be mediated, in part, by the consequences of chronic hyperglycemia. Therefore, to examine the effects of a glucose-lowering SGLT2 inhibitor on blood glucose (BG) and bone homeostasis in a model of diabetic bone disease, male DBA/2J mice with or without streptozotocin (STZ)-induced hyperglycemia were fed chow containing the SGLT2 inhibitor, canagliflozin (CANA), or chow without drug, for 10 weeks of therapy. Thereafter, serum bone biomarkers were measured, fracture resistance of cortical bone was assessed by …

Effect Of Enteral Feeding Timing In Septic Shock Patients, Shane D. Slone

DNP Projects

The goal of this research project was to identify the effect of the timing of enteral nutrition (EN) initiation timing on in-hospital mortality, ICU LOS and hospital LOS among patients with septic shock requiring norepinephrine. The study design was a cross-sectional analysis of retrospective electronic health record data. Patients who had received norepinephrine for septic shock were divided into early EN initiation (within 48 hours of ICU admission) and late EN initiation (Greater than or equal to 48 hours after ICU admission) groups. 680 subjects were included; 469 in the early group and 211 in the late group. Demographics, comorbidities, …

Evaluation Of A Diabetes Self-Management Program For Hispanics In Lexington Kentucky: A Pilot Study, Miguel A. Gamboa Oropeza

Theses and Dissertations--Nutrition and Food Systems

Hispanics are more affected by diabetes than non-Hispanic whites and they tend to experience more severe complications. Research shows that although self-management is poor among ethnic minorities, it is even more so among Hispanics. The “Taking Ownership of Your Diabetes” (TOYD) program has been shown to be successful in helping individuals manage their diabetes. However, no work has been conducted with Hispanic audiences in Kentucky. TOYD program allows individuals to modify lifestyle risks and solve problems related to diabetes management. The program was translated from English to Spanish. Hispanics males and females between ages 19 to 75 years …