Medicine and Health Sciences Commons^™

Ethnic And Gender Differences In Psychosocial Factors In Native Hawaiian, Other Pacific Islanders, And Asian American Adults With Type 2 Diabetes, Jillian Inouye, Dongmei Li, James Davis, Richard Arakaki

Journal of Health Disparities Research and Practice

This study examined the differences between 207 Asians and Native Hawaiian, other Pacific Islanders (NHOPI) with type 2 diabetes among various psychosocial measures. Responses to five multivariable regression models including the Diabetes Quality of Life Questionnaire (DQOL) and Short Form -36® Health Survey (SF-36) were analyzed. Differences were determined by linear contrasts in the multivariate linear regression models after adjusted for multiple demographic and socioeconomic variables. Compared to Asians, NHOPIs perceived a lower impact of diabetes on their quality of life; highlighting differences in perceptions of self-efficacy and self-care activities. Females did better on their diet while males perceived better …

Effects Of Exercise On Ampk Signaling And Downstream Components To Pi3k In Rat With Type 2 Diabetes, Shicheng Cao, Bowen Li, Xuejie Yi, Bo Chang, Beibei Zhu, Zhenzhen Lian, Zhaoran Zhang, Gang Zhao, Huili Liu, He Zhang

Barnstable Brown Diabetes Center Faculty Publications

Exercise can increase skeletal muscle sensitivity to insulin, improve insulin resistance and regulate glucose homeostasis in rat models of type 2 diabetes. However, the potential mechanism remains poorly understood. In this study, we established a male Sprague-Dawley rat model of type 2 diabetes, with insulin resistance and β cell dysfunction, which was induced by a high-fat diet and low-dose streptozotocin to replicate the pathogenesis and metabolic characteristics of type 2 diabetes in humans. We also investigated the possible mechanism by which chronic and acute exercise improves metabolism, and the phosphorylation and expression of components of AMP-activated protein kinase (AMPK) and …

Loss-Of-Function Variants In Endothelial Lipase Are A Cause Of Elevated Hdl Cholesterol In Humans, Andrew Edmondson, Robert Brown, Sekar Kathiresan, L. Cupples, Serkalem Demissie, Alisa Manning, Majken Jensen, Eric Rimm, Jian Wang, Amrith Rodrigues, Vaneeta Bamba, Sumeet Khetarpal, Megan Wolfe, Stephanie Derohannessian, Mingyao Li, Muredach Reilly, Jens Aberle, David Evans, Robert Hegele, Daniel Rader

Dr Robert Brown

Elevated plasma concentrations of HDL cholesterol (HDL-C) are associated with protection from atherosclerotic cardiovascular disease. Animal models indicate that decreased expression of endothelial lipase (LIPG) is inversely associated with HDL-C levels, and genome-wide association studies have identified LIPG variants as being associated with HDL-C levels in humans. We hypothesized that loss-of-function mutations in LIPG may result in elevated HDL-C and therefore performed deep resequencing of LIPG exons in cases with elevated HDL-C levels and controls with decreased HDL-C levels. We identified a significant excess of nonsynonymous LIPG variants unique to cases with elevated HDL-C. In vitro lipase activity assays demonstrated …

Evaluating The Impact Of Two Different Methods Of Diabetes Self-Management Education On Knowledge, Attitude, And Behaviours Of Patients With Type 2 Diabetes Mellitus, Laura B. Briden

Electronic Thesis and Dissertation Repository

This study compared the effectiveness of diabetes self-management education (DSME) methods by examining changes in knowledge, attitude, and behaviour (KAB) after receiving education. Participants from a convenience sample were randomized into two groups, one receiving education through conversation maps and the other through traditional group education. Participants’ knowledge and attitude changes were measured by using a repeated measures pre-test/post-test design and changes in Hb A1c were observed. Focus groups were conducted after education was received to obtain perceptions and self-reported behaviour changes. Significant knowledge and attitude score changes were observed in the conversation map group after education. When comparing the …

Transfusion Of Cxcr4-Primed Endothelial Progenitor Cells Reduces Cerebral Ischemic Damage And Promotes Repair In Db/Db Diabetic Mice, Ji Chen, Jianying Chen, Shuzhen Chen, Cheng Zhang, Liangqing Zhang, Xiang Xiao, Avik Das, Yuhui Zhao, Bin Yuan, Mariana Morris, Bin Zhao, Yanfang Chen

Pharmacology and Toxicology Faculty Publications

This study investigated the role of stromal cell-derived factor-1α (SDF-1α)/CXC chemokine receptor 4 (CXCR4) axis in brain and endothelial progenitor cells (EPCs), and explored the efficacy of CXCR4 primed EPCs in treating ischemic stroke in diabetes. The db/db diabetic and db/+ mice were used in this study. Levels of plasma SDF-1α and circulating CD34+CXCR4+ cells were measured. Brain SDF-1α and CXCR4 expression were quantified at basal and after middle cerebral artery occlusion (MCAO). In in vitro study, EPCs were transfected with adenovirus carrying null (Ad-null) or CXCR4 (Ad-CXCR4) followed with high glucose (HG) treatment for 4 days. For pathway block …

Selective Screening Of Type 2 Diabetes For Washoe County’S Hispanic Population, Linda M. Dunn

Nevada Journal of Public Health

Hispanic Americans with unrecognized, asymptomatic diabetes are more likely to experience poor quality of life and diabetic complications such as heart, eye and kidney disease than non-Hispanic whites of similar age. Multiple factors, such as cultural beliefs, lack of knowledge and limited access to health care, contribute to the fact that one-third of total diabetes among Hispanic Americans is undiagnosed. For Washoe County, Nevada, the actual percentage of adult Hispanics with diabetes may be almost 12%. In 2003, the Defeat Diabetes Screening Project provided three screenings targeting the Hispanic population in Reno and Sparks. Seventy-one percent of 348 screened were …

Health Maintenance Regarding Carbohydrate Counting And Calorie Restricted Diets In Diabetes Mellitus Type 2 Patients, Chelsea Stoltzfus, Katie Siegle, Lauren Trainer

Pharmacy and Nursing Student Research and Evidence-Based Medicine Poster Session

Diabetes Mellitus is a rapidly growing epidemic in today’s society. In 2000, 2.8% (171 million) of the world had this diagnosis. In 2030, it is expected to increase to 4.4% (366 million). There is an increased need for research and implementation in the nursing field to manage diabetic symptoms. Diabetes mellitus type 2 is a cellular change causing insulin to be resistant to the cells which leads to a build up of glucose. Multiple medical complications can result from the diagnosis of diabetes mellitus type 2. The purpose of this study is to determine which diabetic diet is more effective …

A Pilot Study Of Diabetes Management In The Managed Care Setting, Rachel Wagman

The Medicine Forum

Diabetes mellitus represents a disease entity that primary care providers commonly encounter in the outpatient setting. Patient visits encompass a broad range of concerns, from optimizing management of hyperglycemia to the sequelae of chronic disease. The third National Health and Nutrition Exam Survey, (NHANES III) 1988-1994 has reported the prevalence of diabetes mellitus type 2 in the U.S. adult population at 12.3%. The cost of diabetes in 1998, estimated at $77 billion, is a formidable challenge to the health care community and third-party payers. Historically, Health Maintenance Organizations (HMOs) have encouraged more preventative tests, procedures, and exams to curtail the …

Melena With Fever, Monica Patel, Jennifer Wilhelm

The Medicine Forum

The patient is a 62 year old Indian male with a past medical history significant for myasthenia gravis, hypertension, and diabetes mellitus, who presented to an outside hospital with fever, fecal incontinence, and melena. Work up at that hospital was remarkable for elevated liver function tests, heme-positive brown stool and a CT of the abdomen showing a thick ascending colon suggesting possible mass. The patient had an episode of desaturation and fever to 105 degrees Fahrenheit prior to transfer to Thomas Jefferson University Hospital for further evaluation. Upon arrival, the patient was in respiratory distress with oxygen saturation of 70% …

A Case Of Hypercalcemia, Daniel Lin

The Medicine Forum

A 79-year-old man with a past medical history of diet-controlled type 2 diabetes mellitus, hypertension, and chronic lower extremity venous stasis ulcers requiring two skin grafts was admitted to the hospital due to dehydration. He was in his usual state of health intermittently being wheelchair bound due to leg ulcers until four days earlier, when he accidentally spilled hot tea on his left arm while in the kitchen. In his attempt to maneuver the wheelchair away from the spill, the wheelchair turned over, pinning him on the floor and against the cabinets. He remained in that position for four days …

Dissecting The Workforce And Workplace For Clinical Endocrinology, And The Work Of Endocrinologists Early In Their Careers, Claude Desjardins, Mark A. Bach, Anne R. Cappola, Ellen W. Seely, Ronald G. Ehrenberg

Ronald G. Ehrenberg

[Excerpt] No national mechanism is in place for an informed, penetrating, and systematic assessment of the physician workforce such as that achieved by the National Science Foundation (NSF) for the periodic evaluation of the nation’s scientists and engineers. Likewise, knowledge of the workforce for clinical research is enigmatic and fragmentary despite the serial recommendations of “blue-ribbon” panels to establish a protocol for the recurrent assessment of clinical investigators early in their careers. Failure to adopt a national system for producing timely, high-quality data on the professional activities of physicians limits the application of improvement tools for advancing clinical investigation and …

Awareness Of Type Ii Diabetes In The Developing World: Case Study In Binh Du’O’Ng, Vietnam, Anna Hong Le

Independent Study Project (ISP) Collection

Vietnam’s rapid economic development after 1986 forever changed the lifestyle of the Vietnamese. Economic development has highly impacted behavior, “changing from a traditional lifestyle to an industrial lifestyle [increasing] noncommunicable diseases (NCDs) : diabetes, overweight, high blood pressure, and high cholesterol disorders” (Danh, Personal Interview). With the increase of NCDs within the country, it is important to focus on awareness education that motivates the population especially those living in the urban sector to practice healthy behaviors. This study project focuses on the evaluating the reach and effectiveness of current diabetes awareness educational materials. One week was spent in Ha Noi, …

Diabetes Related Knowledge Among Residents And Nurses: A Multicenter Study In Karachi, Pakistan., Asma Ahmed, Abdul Jabbar, Lubna Zuberi, Muhammad Islam, Khusro Shamim

Department of Medicine

Background: Assessment of knowledge among resident trainees and nurses is very important since majority of patients admitted in hospital have underlying diabetes which could lead to adverse clinical outcomes if not managed efficiently. Therefore, the purpose of this study was to evaluate and compare the knowledge related to the management of diabetes among registered nurses (RN) and trainee residents of internal medicine (IMR), family medicine (FMR) and surgery (SR) at tertiary care hospitals of Karachi, Pakistan.

Methods: A validated questionnaire consisting of 21 open ended questions related to diabetes awareness was acquired through a study done at Thomas Jefferson University …

Carrs Surveillance Study: Design And Methods To Assess Burdens From Multiple Perspectives, Manisha Nair, Mohammed K. Ali, Vamadevan S. Ajay, Roopa Shivashankar, Viswanathan Mohan, Rajendra Pradeepa, Hassan M. Khan, Muhammad M. Kadir, Zafar Fatmi, K Srinath Reddy, Nikhil Tandon, Km Venkat Narayan, Dorairaj Prabhakaran

Community Health Sciences

Background

Cardio-metabolic diseases (CMDs) are a growing public health problem, but data on incidence, trends, and costs in developing countries is scarce. Comprehensive and standardised surveillance for non-communicable diseases was recommended at the United Nations High-level meeting in 2011.

Aims: To develop a model surveillance system for CMDs and risk factors that could be adopted for continued assessment of burdens from multiple perspectives in South-Asian countries.

Methods

Design: Hybrid model with two cross-sectional serial surveys three years apart to monitor trend, with a three-year prospective follow-up of the first cohort.

Sites: Three urban settings (Chennai and New Delhi in India; …

Serum 25-Hydroxyvitamin D Levels Do Not Correlate With Asthma Severity In A Case-Controlled Study Of Children And Adolescents, Jennifer Menon, Louise Maranda, Benjamin U. Nwosu

Benjamin U. Nwosu

Background: There is no consensus on the association between vitamin D and asthma.

Objective: To determine the relationship between 25-hydroxyvitamin D [25(OH)D] levels and asthma symptom severity in children and adolescents.

Methods: A retrospective, case-control study of 263 subjects of ages 2–19 years with asthma who were compared to 284 non-asthmatic controls of similar ages. Subjects were excluded if they had diseases of calcium or vitamin D metabolism or were receiving calcium or vitamin D supplementation. Serum 25(OH)D was measured in all subjects. Asthma symptom severity, usually stratified into 6 steps, was stratified into five steps [1–5] based on the …

Elucidating The Function Of Transplanted Islets Of Langerhans And Predicting Their Ability To Reverse Diabetes, Andrew R. Pepper

Electronic Thesis and Dissertation Repository

Type 1 diabetics require daily injections of exogenous insulin to control hyperglycemia. Unfortunately, patients are still plagued by vascular and hypoglycemic complications. Beta cell replacement therapy by either whole organ pancreas or islet transplantation has been shown to restore carbohydrate control to these patients. A major barrier to successful islet transplantation is the lack of a reliable pre-transplant assay of post-transplant function thus providing an objective measure of whether a particular islet isolation should be transplanted. Such an assay would also prove to be a valuable tool in the experimental evaluation of innovative islet isolation strategies and technologies. The initial …

The Convergence Of Science And Culture: Developing A Framework For Diabetes Education In Tribal Communities, Michelle Chino Dr, Carolee Dodge Francis, Lemyra Debruyn, Lynn Short, Dawn Satterfield

Journal of Health Disparities Research and Practice

In an unprecedented effort to address the epidemic of diabetes in tribal communities, the Diabetes Education in Tribal Schools project brought together a group of individuals from eight tribal colleges and three federal agencies to develop a diabetes prevention curriculum for American Indian and Alaska Native school children. The curriculum incorporates Western and Native science with culturally responsive teaching techniques. Both the project and its evaluation process have reached beyond conventional bounds to acknowledge fundamental issues of tribal culture, history and health and the integration of science, culture, and community. This article will discuss the challenges and rewards of the …

Equal Care, Unequal Outcomes: Experiences Of A Reach 2010 Community, Diane Neal, Barbara Carlson, Carolyn Jenkins, Gayenell Magwood

Journal of Health Disparities Research and Practice

Diabetes is growing in prevalence and costs. Guidelines for care have been available since 1983, yet diabetes care and outcomes remain less than ideal. CDC’s Racial and Ethnic Approaches to Community Health 2010 (REACH 2010) identified diabetes in African Americans as a priority for action. This article documents the activities, interventions, and current progress of the REACH 2010 diabetes coalition formed in Charleston and Georgetown counties, South Carolina, in reducing health care disparities and describes next steps for improving outcomes. The Chronic Care Model guided many of the implementation activities, and chart audits were used to document outcomes. Ambulatory care …

Is Vitamin D Deficiency A Feature Of Pediatric Celiac Disease?, Jeffrey Villanueva, Louise Maranda, Benjamin U. Nwosu

Benjamin U. Nwosu

Background: Celiac disease (CD) is an autoimmune enteropathy characterized by villus atrophy and malabsorption of essential nutrients. Vitamin D deficiency has been described in autoimmune diseases, but its status in prepubertal children with CD has not been adequately studied.

Objective: To determine the vitamin D status of prepubertal children with CD.

Study design: A retrospective study of prepubertal children aged 3–12 years with CD (n=24) who were compared to prepubertal, non-CD children of the same age (n=50). Children were included in the study if they had a diagnosis of CD by intestinal biopsy, and were not on a gluten-free diet …

Metabolic Syndrome In Type 2 Diabetes: Comparison Of Who, Modified Atpiii & Idf Criteria, Asma Ahmed, Talha Ehsan Khan, Tahira Yasmeen, Safia Awan, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

OBJECTIVES: To determine the frequency of metabolic syndrome in type 2 diabetes according to three commonly used operational definitions {World Health Organization (WHO), National Cholesterol Education Program Adult Treatment Panel (NCEP ATP III) and International Diabetes Federation( IDF)}. To evaluate the agreement between these classifications in the Pakistani cohort.

METHODS: Data was collected retrospectively of 210 patients with type 2 diabetes visiting outpatient clinics of one of the large tertiary care hospitals at Karachi, Pakistan between June 2008 to November 2008.

RESULTS: The prevalence of metabolic syndrome was found to be 81.4% (WHO), 86.7 % (IDF) and 91.9 % (NCEP …

Methodological Challenges And Clinical Applications Of Hair Cortisol Analysis, Evan W. Russell

Electronic Thesis and Dissertation Repository

This thesis examines methodological and clinical aspects of hair cortisol analysis. The methodological study examines the role of sweat as a contributor to hair cortisol concentrations. Hair cortisol analysis is an effective measure of chronic stress. Cortisol is assumed to enter the hair via blood, sebum, and sweat, however the extent to which sweat contributes to hair cortisol content was unknown. This study concluded that human sweat contains cortisol that likely contributes to hair cortisol content. Subjects with prolonged sweating at the time of hair collection may have increased hair cortisol concentrations that cannot be decreased with conventional laboratory washing …

Stop Atherosclerosis In Native Diabetics Study (Sands): Baseline Characteristics Of The Randomized Cohort, Angela Silverman, Chun-Chih J. Huang, Marie Russell, Mihriye Mete, Mary J. Roman, Mario Stylianou, Elisa T. Lee, Fawn Yeh, Jerome Fleg, Charlton Wilson, Jeffrey A. Henderson, Matthew R. Weir, Robert E. Ratner, Barbara V. Howard

Journal of Health Disparities Research and Practice

Objectives: To present baseline characteristics of American Indians in the Stop Atherosclerosis in Native Diabetics Study (SANDS) and compare them with population-based data from American Indians and other ethnic groups. Design: 499 people with type 2 diabetes ≥ age 40, without known CVD, were recruited for a randomized 3-year trial to evaluate treatment targets for LDL-C (70 vs. 100 mg/dL) and systolic blood pressure (BP) (115 vs. 130 mmHg). Baseline evaluations included physical exam, collection of blood and urine samples, and carotid ultrasound and echocardiographic measures. Results: Mean age was 56 years; 66% were female. Average BMI was 33 kg/m2. …

Interactions Of Nitric Oxide And Superoxide Pathways In Hyperglycemic Endothelial Cells, Steven Clay Rogers

Graduate Theses and Dissertations

Cardiovascular complications arising from diabetic hyperglycemia represents one of the leading causes of death and greatest public health challenges of modern societies. Despite state-of-the-art glucose control, diabetic patients remain at a markedly increased risk of cardiovascular disease. The loss of endothelial function (the development of diabetic endothelial dysfunction) has been implicated in the development of numerous diabetic cardiovascular diseases. The endothelial cell produces many vasoactive substances, hormones and cytoprotective biological factors. Endothelial cells are also involved in and affected by the initiation of inflammatory responses through the release and interaction of cytokines and other immune system molecules. Therefore, regulation of …

Regulation Of Protein Degradation In The Heart By Amp-Activated Protein Kinase, Kedryn K. Baskin

Dissertations & Theses (Open Access)

The degradation of proteins by the ubiquitin proteasome system is essential for cellular homeostasis in the heart. An important regulator of metabolic homeostasis is AMP-activated protein kinase (AMPK). During nutrient deprivation, AMPK is activated and intracellular proteolysis is enhanced through the ubiquitin proteasome system (UPS). Whether AMPK plays a role in protein degradation through the UPS in the heart is not known. Here I present data in support of the hypothesis that AMPK transcriptionally regulates key players in the UPS, which, under extreme conditions can be detrimental to the heart. The ubiquitin ligases MAFbx /Atrogin-1 and MuRF1, key regulators of …

Use Of Continuous Glucose Monitors In Type-1 Diabetes: An Analysis Of Wave Form Versus Glycemic Values In The Improvement Of Glucose Control And Fear Of Hypoglycemia, Tomas Charles Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Type-1 diabetes is a disease of subtle complexities. Patients struggle to understand glucose patterns and their responses to insulin or food intake while maintaining hectic lifestyles. Minor misjudgments in treatments can result in disastrous consequences with significant hypo- or hyperglycemic excursions.

Despite improvements in technologies available for diabetes management, including home monitoring of blood glucose, more predictable insulin therapies, and improved insulin delivery via insulin pump, the average HbA1c has remained relatively unchanged. Poor diabetes control is recognized as contributing to long-term diabetes comorbidities including neuropathy, nephropathy, retinopathy, and micro- and macrovascular disease.

Real-time continuous glucose monitors, such as the …

Diabetes: A Reference For The Primary Eyecare Clinician, Brandon Reed, David Glabe

David K Glabe

With the prevalence of diabetes in the United States increasing and expected to climb higher in coming years, eyecare practitioners should have a thorough understanding of the treatment and management of diabetic patients. Eyecare providers form part of a team of practitioners, that includes primary care medical doctors, endocrinologists, and podiatrists, who should be involved in the regular management of diabetic patients.

A detailed understanding of the clinical manifestations, treatment, and pathogenesis of diabetes is of importance to the primary eyecare practitioner. This document is designed to provide a fundamental and accessible resource for the clinician, with an emphasis on …

Does Hepatic Dysfunction Worsen Glucose Homeostasis By Impairing Vitamin D Metabolism?, Benjamin U. Nwosu

Benjamin U. Nwosu

The Management of diabetes mellitus (DM) remains an enigma even though the symptoms of the disease had been described more than 3000 years ago. This is because the central therapeutic goal of DM therapy, euglycemia, is influenced by complex physiologic and pathologic processes, some of which are clearly understood, while others are less clear. Suboptimal glycemic control is a recognized risk factor for acute and chronic complications of diabetes including microvascular and macrovascular diseases. The central question for this editorial is whether mild hepatic dysfunction could impair vitamin D metabolism and secondarily lead to sub-optimal glycemic control.

Bean And Rice Meals Reduce Postprandial Glycemic Response In Adults With Type 2 Diabetes: A Cross-Over Study, Sharon V. Thompson, Donna M. Winham, Andrea M. Hutchins

Donna Winham

Background: Around the world, beans and rice are commonly consumed together as a meal. With type 2 diabetes increasing, the effect of this traditional diet pattern on glycemic response has not been studied fully. Methods: We evaluated the glycemic response of bean and rice traditional meals compared to rice alone in adults with type 2 diabetes. Seventeen men and women with type 2 diabetes controlled by metformin (n = 14) or diet/exercise (n=3) aged 35–70 years participated in the randomized 4 × 4 crossover trial. The white long grain rice control, pinto beans/rice, black beans/rice, red kidney beans/rice test meals, …

Alternative Therapy And Treatment Of Type 2 Diabetes, Carmine R. Grieco

Human Movement Sciences & Special Education Theses & Dissertations

The rise in prevalence and incidence of type 2 diabetes mellitus (T2D) in the developing world continues unabated. Current treatment strategies, however, fall short of achieving optimal glycemic control. The aim of project I was to investigate the effect of an acute bout of a yogic breathing exercise on heart rate variability (HRV) in individuals with T2D. Project II was designed to assess the effectiveness of the neurohormone melatonin in lowering short- and long-term glucose levels, lipids and oxidative stress in T2D. Project III investigated the differential effects of two different styles of aerobic exercise on postprandial glycemia, mood and …

Evaluation And Management Of Pediatric Thyroid Nodules, Melanie Goldfarb, John I. Lew

Melanie Goldfarb, M.D., M.Sc., FACS, FACE

No abstract provided.