Medicine and Health Sciences Commons^™

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

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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 …

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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

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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 …

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The Impact Of Statin Use On Outcomes Of Diabetic Adult Patients Hospitalized For Community Acquired Pneumonia., Joel Lanceta

Electronic Theses and Dissertations

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BACKGROUND: Statins, a class of drugs that treat hyperlipidemia, may have an immunosuppressive effect for patients with community acquired pneumonia (CAP). Retrospective and in vitro studies have suggested an immunomodulatory, antioxidative and anticoagulant effects from statin use in patients with Type 2 Diabetes Mellitus (T2DM) hospitalized for CAP. Prospective studies that have tested any effect of statin therapy on patients with T2DM and CAP have not been found literature. To date, prospective studies showing of the effects statin therapy may have on T2DM patients hospitalized for CAP are not available. METHODS: This dissertation is a secondary analysis using deidentified data …

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Integration Of Consumer-Based Activity Monitors Into Clinical Practice For Children With Type 1 Diabetes: A Feasibility Study, Jason R. Jaggers, Timothy Mckay, Kristi M. King, Bradly J. Thrasher, Kupper A. Wintergerst

Faculty Scholarship

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Current technology commonly utilized in diabetes care includes continuous glucose monitors (CGMs) and insulin pumps. One often overlooked critical component to the human glucose response is daily physical activity habits. Consumer-based activity monitors may be a valid way for clinics to collect physical activity data, but whether or not children with type 1 diabetes (T1D) would wear them or use the associated mobile application is unknown. Therefore, the purpose of this study was to test the feasibility of implementing a consumer-based accelerometer directly into ongoing care for adolescents managing T1D. Methods: Adolescents with T1D were invited to participate in this …

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Expediting Dental Treatment For Patients With Diabetes Mellitus In A University-Based Dental Clinic., Michelle Baxter

Doctor of Nursing Practice Papers

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Oral health and diabetes are connected in a reciprocal relationship linked through the pathological mechanisms of bacteremia, inflammation, and the immune response. Dental patients experience a delay in receiving treatment at a university-based dental clinic secondary to obtaining required medical consultation from the patients’ private providers for complex medical conditions. This project was implemented to minimize barriers in access to care, reduce the risk for oral health and systemic diabetes complications, and optimize the health outcomes for diabetic patients seeking comprehensive dental treatment. The intervention group included 32 patients with diabetes who participated in hemoglobin A1c (HbA1c) testing during their …

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Association Between Physical Activity And Sport Participation On Hemoglobin A1c Among Children And Adolescents With Type 1 Diabetes, Kristi King, Jason R. Jaggers, Lindsay J. Della, Timothy Mckay, Sara Watson, Amy E. Kozerski, Kimberly Hartson, Kupper A. Wintergerst

Faculty Scholarship

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Purpose: To determine associations between physical activity (PA) and sport participation on HbA1c levels in children with type 1 diabetes (T1D). Method: Pediatric patients with T1D were invited to complete a PA and sport participation survey. Data were linked to their medical records for demographic characteristics, diabetes treatment and monitoring plans, and HbA1c levels. Results: Participants consisted of 71 females and 81 males, were 13 +- 3 years old with an average HbA1c level of 8.75 +- 1.81. Children accumulating 60 min of activity 3 days or more a week had significantly lower HbA1c compared to those who accumulated less …

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Impact Of Metformin On Feeding, Behavior, And Metabolism In Drosophila Melanogaster., Erica E. Hassoun, Heba Kourhabi, Jason Bui Ho, Dae-Sung Hwangbo

Undergraduate Research Events

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Metformin is a first-line drug used in the treatment of type II diabetes mellitus and is the 4th-most prescribed drug in the United States. It functions in lowering blood glucose levels and increasing insulin sensitivity. Despite its wide scale use, the degree to which it affects aspects of behavior and metabolism unrelated to diabetes is not fully understood.

Recent studies have attempted to fill this gap, particularly in the context of metformin’s impact on lifespan. We decided to extend this research by focusing on measurable behaviors as well as traits related to metabolism and physiology. Using the fruit fly Drosophila …

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Understanding Diabetes-Related Distress Characteristics And Psychosocial Support Preferences Of Urban African American Adults Living With Type 2 Diabetes: A Mixed-Methods Study, Sula Marie Hood, Amy Irby-Shasanmi, Mary De Groot, Elissabeth Martin, Andrew S. Lajoie

Faculty Scholarship

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Purpose

The purpose of this study is to understand diabetes-related distress (DRD) characteristics and identify psychosocial support preferences of urban African American adults living with type 2 diabetes (T2DM).

Methods

A 2-phase, mixed-methods sequential explanatory study design was used to gather data. In phase 1, a purposive sample of participants (N = 155) was recruited and asked to complete a written survey. The Diabetes Distress Scale (DDS17) was used to assess DRD, including subscales—emotional burden (EB), regimen distress (RD), interpersonal distress (ID), and physician distress (PD). In phase 2, a subset of phase 1 participants (N = 23) volunteered to …

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Type 2 Diabetes Mellitus (T2dm) Onset And "Remission"., Srikanth Tangelloju

Electronic Theses and Dissertations

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Background: Type 2 diabetes mellitus (T2DM) is a progressive disease condition. As the disease progresses the function of beta (β) cells (cells which regulate insulin) decline, thereby increasing the circulating blood glucose levels. If left unmanaged the disease progresses from onset to development of T2DM related complications and eventually death. When managed, in certain individuals, T2DM onset can be prevented and/or slowed down and in certain T2DM individuals, remission is observed. There are some known modifiable risk factors such as diet and physical activities that are associated with the speed and direction of progression, but much is still unknown. In …

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The Role Of O-Glcnacase During Heart Failure., Sujith Dassanayaka

Electronic Theses and Dissertations

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Global augmentation of protein O-GlcNAcylation occurs in response to a myriad of stressors and confers a survival advantage at the cellular level. This protective phenomenon has been demonstrated to mediate cardioprotection through various in vitro and in vivo studies during ischemia-reperfusion, myocardial infarction, and oxidative stress; however, relatively little is known of the regulation of protein O-GlcNAcylation. Protein O-GlcNAcylation is regulated by two antagonistic enzymes, namely, O-GlcNAc transferase (OGT) and O-GlcNAcase (OGA). Ablation of cardiomyocyte OGT, the enzyme that catalyzes the addition of O-GlcNAc to proteins, exacerbates cardiac dysfunction during infarct-induced heart failure (HF). However, little is known of the …

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The Effect Of The Patient Protection And Affordable Care Act On The Medicare Part D Coverage Gap As Reflected In Diabetes Medication Adherence., Jennifer A. Forristal

Electronic Theses and Dissertations

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This dissertation involves an evaluation of the effect of the Patient Protection and Affordable Care Act (ACA) on diabetic medication adherence for mail order utilizers over 6 years as the Medicare Part D coverage gap begins to close. The study had 3 objectives: 1) to evaluate diabetes medication adherence of health plan members before they reach the coverage gap and then while they are in the coverage gap, 2) to compare diabetes medication adherence between two similar groups with differing benefit structures, one group with a gap in coverage as opposed to a group with no benefit changes within the …

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Circulating Angiogenic Stem Cells In Diabetes., Nagma Zafar

Electronic Theses and Dissertations

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Circulating angiogenic stem cells (CACs) are rare cells found in peripheral blood that have been shown to contribute to endothelial repair and new blood vessel formation. These cells could be biomarkers and/or therapeutic targets for the assessment and prevention of cardiovascular disease (CVD), which is the leading cause of mortality globally and in the United States. Diabetes is an independent risk factor for CVD, and there are inconsistent reports on the role of CACs in diabetic vasculopathy. To study this further we tested the hypothesis that diabetes depletes circulating levels of CACs, due to hyperglycemia or insulin resistance and that …

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Effects Of Short Term High Fat Diet On Obesity And Perivascular Adipose Structure And Function In Mice : Role Of Aldose Reductase, And Aldehyde Metabolizing Enzyme., Daniel Alan Murphy

College of Arts & Sciences Senior Honors Theses

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This study was undertaken to determine the effects of high fat diet and aldose reductase deficiency on the structure and function of murine perivascular adipose tissue. Wild type (WT) (C57 bl/6) and aldose reductase knockout (AR-null) mice were aged to 8 or 18 weeks on a normal chow diet then some were switched to a high fat diet for 4 weeks while others remained on the control diet for the same amount of time. Following 4 weeks, mice were euthanized PVAT was analyzed. High fat feeding significantly increased body fat percentage in both age groups of mice and the area …

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Cardiovascular Disease Among Diabetic Women With Bilateral Oophorectomy., Duke Appiah

Electronic Theses and Dissertations

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Cardiovascular Disease (CVD) is the leading cause of death in women and the risk is increased threefold in diabetics. In postmenopausal diabetics, the ovary responds to hyperinsulinemia by increasing secretion of testosterone precursors which increases the risk of CVD. Data from the National Health and Nutrition Examination Survey (1988-2010) and the Study of Osteoporotic Fractures were used to test the hypothesis that a history of bilateral oophorectomy -surgical removal of both ovaries-would decrease the risk of CVD among postmenopausal diabetic women due to reduced androgen levels. Logistic regression, discrete time logit model, B-Spline regression and Cox proportional hazards models were …

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