Medicine and Health Sciences Commons^™

Effectiveness Of Intervention Studies Based On Diet And/Or Physical Activity In Treatment, Prevention, And Management Of Diabetes Among South Asians: A Systematic Review, Ishaan Arora

Theses and Dissertations

The purpose of this study was to describe diet and/or physical activity-based interventions and their control in cardiometabolic risk factors of diabetes for the South Asian (SA) population. A systematic review was conducted in accordance with the PRISMA guidelines. Seventeen randomized control trials meeting the inclusion criteria were included for analysis. Interventions with type-2 diabetic SA showed significant improvements in HbA1c% (4/5 studies), fasting blood glucose (3/4 studies), and postprandial glucose (2/2 studies). Interventions with at-risk/prediabetic and non-diabetic SA showed a modest change in overall outcomes, with significant change reported for post-prandial insulin (3/4 studies), BMI and weight (2/4 studies), …

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 …

Medication Therapy Management Implementation In Conjunction With A Rural Health Clinic In Minnesota: A Cqi Impact On Diabetes Metrics, Abigail Sirek Pharmd

Theses and Dissertations

The purpose of this continuous quality improvement project was to implement a pharmacist-led Medication Therapy Management (MTM) clinic in rural, central Minnesota and assess the impact on patients’ healthcare over a six-month period. Patients were identified through the clinic’s diabetes registry, which included patients 18 through 75 years old with a diagnosis of diabetes not meeting all five D5 goals, as recommended by the Minnesota Community Measurements, independently referred by the provider, or be identified by their insurance company as a patient that would benefit from an MTM visit. The D5 focuses on blood pressure and blood sugar control, appropriate …

Dia.Ries, Katherine A. Doyle

Theses and Dissertations

dia.ries is a pilot episode of an episodic series that offers insight into the lives of a few of the 500 million people around the world with diabetes—otherwise normal, everyday people who happen to be living each day with an “invisible illness.” Produced through video diaries and other user-generated content, the series tells stories from first-person points of view along thematic lines, using a collaborative approach rooted in Third Cinema.

Health Disparities And Psychosocial And Behavioral Interventions For Type 2 Diabetes Within Latinx Communities: A Systematic Review, Elisa Hernandez-Guerrero Smith

Theses and Dissertations

As Hispanic adults are 70% more likely than non-Hispanic White adults to be diagnosed with diabetes (Centers for Disease Control and Prevention, 2022), there is an urgent need to provide culturally appropriate care to the people with diabetes of Latinx heritage. The purpose of this systematic review is to better understand the availability and effectiveness of psychosocial and behavioral interventions for T2DM within the Latinx population. Additional focus was given to the impact of health disparities and complexities within the Latinx population that have been diagnosed with, or are at risk of, T2DM. With a greater understanding of health disparities …

Household Food Security, Lifestyle Factors, And Glycemic Control Among Youth And Young Adults With Diabetes, Lauren A. Reid

Theses and Dissertations

The purpose of this study was to assess the associations between household food insecurity (HFI) and glycemic control, physical activity, and diet quality in youth and young adults (YYA) with type 1 diabetes (T1D) and type 2 diabetes (T2D). Among older adults, HFI has been shown to complicate diabetes management due to the essential role of diet in diabetes management and the financial stress associated with HFI. Although HFI is more prevalent among YYA with diabetes than the general population, there are only a handful of studies that have focused on this population and, studies that include YYA with T2D …

Kujdesi Infermieror Tek Pacientet Me Diabet Gestational, Gzonjetë Krosa

Theses and Dissertations

Diabeti në shtatzëni është një nga temat më të diskutuara kohët e fundit në fushën e obstetrikës për arsye të rritjes së incidencës së saj. Shfaqja e saj gjatë një shtatzënie ndërlikon përfundimin e shtatzanisë për nënën dhe foshnjen.

Duke qenë se diabeti është një sëmundje e pakurueshme e cila e shoqëron pacientin gjatë gjithë jetës së tij, menaxhimi i tij sa më i mirë jo vetëm që zgjat jetën e pacientit, por dhe frenon komplikacionet e diabetit që çojnë deri në koma dhe vdekje. Diabeti gestational, ndryshe i quajtur diabeti i shtatzanisë, është një prej tipeve të diabetit i …

Contribution Of Individual, Community, And Health System Factors To Health Outcomes In Inner-City African Americans With Type 2 Diabetes, Jennifer Annette Campbell

Theses and Dissertations

Diabetes is a complex disease that represents a major public health challenge due to its high prevalence, its association with increased morbidity, and early mortality. Inner-city African Americans with diabetes suffer a disproportionate burden of disease due to both economic and social disadvantage that reaches across individual, community, and health system levels of influence. Central to the principles of Public Health is the “pursuit of health equity for the elimination of health disparities, specifically in accordance to the empowerment of disenfranchised community members, aiming to ensure that the basic resources and conditions necessary for health are accessible to all”. To …

Doctor-Patient Communication: The Experiences Of Black Caribbean Women Patients With Diabetes, Rosanne Paul-Bruno

Theses and Dissertations

This applied dissertation was designed to examine the verbal and non-verbal communication experiences of Black Caribbean diabetic women patients with their doctors, in order to provide a better understanding of the essential aspects of doctor- patient communication and their experiences as they managed their condition. Black Caribbean women have been disproportionately impacted by medical conditions such as diabetes. It has been a documented fact that minorities experience disparities in the health care system at different levels and doctor-patient communication is no exception. Poor doctor-patient communication has been known to hinder patients’ health outcomes, and therefore warrants such studies to increase …

Effects Of Type I Diabetes On Labor Force Participation: A Propensity Score Match, Ore Aina-Badejo

Theses and Dissertations

Type I Diabetes (T1D) is a chronic autoimmune mediated form of insulin resistance that has lasting socioeconomic effects from childhood through old age that may impact labor force participation. Examining this relationship will enhance our understanding of life-long chronic illness beyond individual medical/financial impact by establishing broader socioeconomic implications. This study utilized data from the 2008-2015 data set of the Medical Expenditure Panel Survey (MEPS), to explore the effects of T1D on labor force participation. It was hypothesized that having T1D would decrease both employability and contribution to the labor force. Utilizing methods of propensity score matching and entropy balancing, …

What's In A Message? The Impact Of Patient-Clinician Email Message Content On Patient Health Outcomes And Healthcare Utilization, Dawn M. Heisey-Grove

Theses and Dissertations

Introduction

In the upcoming chapters, we present our study findings as three papers ready for submission to peer-reviewed journals. The first paper describes the associations between taxa and the characteristics of the patients and clinic staff who exchange those messages. The second paper explores the associations between those taxa and patients’ healthcare utilization. The third paper presents associations between taxa and patient health outcomes for diabetes and hypertension. We conclude with how the three papers are related and highlight the importance of this research.

Across the three papers, we reference a theory-based taxonomy we developed specifically for secure messaging. A …

The Impact Of Maternal Diabetes On Fetal And Infant Outcomes: A Secondary Analysis Of Peridata.Net® From 2013 To 2017, Christina Lynn Dzioba

Theses and Dissertations

ABSTRACT

THE IMPACT OF MATERNAL DIABETES ON FETAL AND INFANT OUTCOMES:

A SECONDARY ANALYSIS OF PERIDATA.NET® FROM 2013 TO 2017

Christina Dzioba, MS, ARNP, WHNP-BC, C-EFM

Background: Diabetes is a leading cause of morbidity and mortality for most of the developed world and is known to contribute to adverse maternal, fetal, and infant outcomes. The purpose of this study was to examine the relationship of maternal diabetes to fetal and infant outcomes for infants born in a small heterogeneous urban community with significant disparities in infant mortality using data in the PeriData.Net® database.

Methods: Women with diabetes were case matched …

A Qualitative Exploration Of Experiences And Motivations For Diabetes Self-Management In African American Men Between The Ages Of 40-85 With Type 2 Diabetes, Anthony Q. Walker

Theses and Dissertations

Diabetes is a devastating disease that can affect an individual’s health and quality of life, but if managed properly, individuals with diabetes can have a good quality of life. Diabetes strikes African American men at a high rate. This study used a qualitative design to explore African American men between the ages of 40-85 with type 2 diabetes (T2DM) and their definition of diabetes and motivation, their experience of living with diabetes, their self-management behaviors, their motivations for managing diabetes, and what they and healthcare providers believe motivates them to self-manage diabetes and to attend diabetes self-management education (DSME) programs. …

Relationship Between Patient-Health Coach Interactions And Changes In Markers Of Glucose Homeostasis, Jason P. Nagy

Theses and Dissertations

Diabetes and insulin resistance are on the rise in the United States. Early detection and deployment of therapies has allowed for the reversal of pancreatic beta cell damage. Unfortunately, not all providers can offer the support to facilitating the required life style modifications. The introduction of clinical health consultants (CHC) as supplemental care has improved patient health for a variety of chronic diseases. Missing in the literature are studies investigating the correlation between the number of CHC interactions and improvement in biomarkers.

The study utilized a non-experimental, retrospective study design to evaluate the relationship between the use between the use …

Association Of Insurance And Provider Type With Patients’ Perceived Cost And Ease Of Access To Healthcare Services Among Medicare Beneficiaries Diagnosed With Diabetes, Metria Harris

Theses and Dissertations

Medicare beneficiaries diagnosed with diabetes are likely to have health complications or episodes associated with diabetes, resulting in higher health care utilization and costs. Andersen’s Health Care Utilization Behavior Model (HCBM) includes predisposing, enabling, and need factors, but it excludes perception. Ajzen’s Theory of Planned Behavior (TPB) shows that perception influences health service use. This study was performed using a real-world model integrating Andersen’s HCBM and Ajzen’s TPB to determine whether there was an association between insurance type (Medicare Part D versus non-Part D) and perceived ease of access or cost among Medicare beneficiaries with diabetes. The second objective was …

Association Between Diabetes And Cancer In Indian And Us Populations Using Longitudinal Study Design, Shraddha S. Vyas

Theses and Dissertations

Background: There is growing evidence of association between diabetes and cancer. No studies have been conducted in India evaluating this association. With the current epidemiologic, nutritional and economic transition in India, it becomes extremely important to examine this association in an Indian population. Additionally, difference in association exists based on different cancer subtypes. Research has shown that diabetes is associated with an increased risk of colorectal cancer. However most of these studies suggest detection bias to be one of the probable reasons for this association. Additionally, the common risk factors shared by both these conditions are considered to one of …

Succination Impairs Protein Folding And Promotes Chop Stability In The Adipocyte During Diabetes, Allison Manuel

Theses and Dissertations

Type 2 diabetes mellitus has been diagnosed in ~21 million people in the United States and is closely correlated with obesity, prompting the need for a detailed understanding of adipocyte metabolism in the development of diabetes. The intake of excess nutrients surpasses the energy requirements of the cell and leads to increased mitochondrial stress in the adipocyte. We have shown that this is associated with increased levels of the mitochondrial metabolite fumarate. Fumarate can react with cysteine thiol groups to form the chemical modification S-(2-succino)cysteine (2SC), also termed protein succination. Succination is significantly increased in the adipose tissue of type …

Determining The Effect Of Knocking Out Microrna-21 On Subsarcolemmal And Interfibrillar Mitochondria, Madhur Batra

Theses and Dissertations

Type 2 diabetes mellitus is a growing problem across the world and has significant pathological changes associated with it, including diabetic cardiomyopathy, wherein cardiac function is reduced. MicroRNA-21 has been shown to play a role in both the heart and diabetes so it was thought that knocking out miR-21 could have a protective effect on oxidative phosphorylation function in diabetic mice. Subsarcolemmal and interfibrillar mitochondria were isolated from adult male WT, miR-21 KO, db/db, and double knockout mice (db/db and miR-21 KO cross) and evaluated for function. Knocking out miR-21 in diabetic mice showed a restorative effect in Complex I …

Embodiment Of Empathy: Experiencing Disease Through Design, Noha Fouad

Theses and Dissertations

Today, more than 400 million individuals around the world have diabetes. This number is expected to grow to more than 600 million by 2023. However, diabetes is more than just a statistic. It is an incurable, psychologically nuanced disease, with daily battles and far-reaching complications. The lives of those afflicted undergo permanent physical and psychological changes.

Reading the stories of diabetics, or hearing them share their experience may elicit an immediate yet often fleeting sense of realization. How, then, can this brief moment of awareness be prolonged? How can a non-diabetic feel diabetes? More importantly, why should they? This research …

Longitudinal Association Between Television Watching, Computer Use And Meal Frequency And Risk Markers In Diabetes Among Youth With Diabetes, Chao Li

Theses and Dissertations

BACKGROUND AND OBJECTIVES: Television watching and computer use are considered to be the main sedentary behaviors in children and youth. However, their longitudinal impact on HbA1c and serum lipids among youth with type 1 diabetes (T1D) and type 2 diabetes (T2D) are under-studied. Sedentary behavior is normally assessed by questionnaire in large epidemiological studies, however, its measurement by questionnaire has not been evaluated among youth with diabetes. Also, no recent studies have evaluated the optimal meal frequency for glycemic control in youth with T1D and T2D; for this reason nutritional guidelines on meal frequency for youth with diabetes are vague. …

Association Of Serum Immunoglobulin G (Igg) Antibodies Against Periodontal Bacteria In Type 2 Diabetes And Pre-Diabetes And Cardiovascular Risk Factors, Deepika Shrestha

Theses and Dissertations

Periodontal disease is an inflammatory disease caused by polybacterial infection and inflammation plays key role that associates periodontal disease with different systemic diseases including diabetes and cardiovascular diseases. The main objective of this study is to evaluate and explore the association of serum IgG antibodies in four distinct clusters that were formed empirically from species specific 19 periodontal antibody titers with T2DM and pre-diabetes adjusting for known confounders such as age, sex, race-ethnicity, income to poverty ratio, education, smoking and drinking alcohol, BMI, WC, physical activity, missing teeth, dentist visits and other nutritional factors.

From the first aim, we formed …

Development Of A Collaborative Goal Setting Measure For Patients With Diabetes, Heather Morris

Theses and Dissertations

Introduction: The potential benefits of collaborative goal setting in the clinical setting have been shown. However, we have a limited understanding about what needs to have transpired between a patient and his or her clinician for them to report that they engaged in collaborative goal setting. Therefore, our ability to monitor and foster collaborative goal setting remains limited. Methods: My three-manuscript dissertation used a mixed-methods approach utilizing both qualitative and quantitative research methods. The aims of my study were to: (1) develop a conceptual model of collaborative goal setting as perceived by patients; (2) generate a list of survey items …

Illness-Related Diabetes Social Support And Glycemic Control Among Middle Aged And Older Adults, Favel Leah Mondesir

Theses and Dissertations

Objective

The objective of this study is to investigate the association between illness-related diabetes social support (IRDSS) and glycemic control (GC) among a racially diverse sample of middle aged and older adults. In gender-stratified models we examine whether the relationship between IRDSS and GC is modified by race/ethnicity. Additionally, we explore the association between eight individual types of IRDSS and GC.

Methods

We used the Health and Retirement Study (HRS) 2002 and the 2003 Diabetes Survey. The final analytic sample consisted of 914 study respondents. Gender-stratified multivariable logistic regression models were used to calculate odd ratios (ORs) and 95% confidence …

Quantifying Polypharmacy In Diabetes Patients In The U.S., Jing Tao

Theses and Dissertations

ix Objectives: To quantify polypharmacy and assess the socio-economic predictors of medication use and expenditure in diabetics. Methods: This study analyzed adult diabetes patients using a nationally representative sample in Medical Expenditure Panel Survey in 2006. Top ten most highly utilized drug classes were identified. Descriptive statistics were used to portray the patients’ medication utilization and spending. Generalized linear models were conducted to assess the socio-economic variants in drug use and spending. Results: On average, a diabetes patient had 45 prescriptions in 2006, for total annual spending of $3,161. A diabetes patient used drugs from 3.43 classes within top ten …

Chronic Care Management To Improve Adherence: A Comparison Of Approaches In The Care Of Diabetes, Mary Ellen Gervais

Theses and Dissertations

Managing chronic conditions is seen as the public health challenge of the 21st century. The number of Americans with chronic conditions is expected to rise to 157 million by 2020. Diabetes prevalence and costs contribute to the growing problem. Diabetes was the seventh leading cause of death in 2006. Nationally, the cost of diabetes is expected to be $138 billion in 2020. Diabetes leads to multiple and significant complications. The desired outcomes of management of chronic conditions are improvement in clinical status, avoidance of complications, prevention of co-morbid conditions and avoidance of the costs associated with complications. In the 1990s, …

Association Between Obesity And Depression And Anxiety Disorders: Results From The 2008 National Health Interview Survey, Monica Gaidhane

Theses and Dissertations

Introduction: Obesity is one of the most important medical problems in the U.S. and is considered to be an epidemic with over 30% of the population being obese. Obesity is associated with increased risk of hypertension, diabetes, cardiovascular diseases, certain cancers and a shorter life expectancy. Recent studies have shown that higher BMI levels are also significantly associated with several lifetime mental disorders such as major depressive disorder, anxiety disorders as well as panic attacks and panic disorders. Purpose: The purpose of this study was to quantify the extent to which higher BMI increased the likelihood of Depression, Anxiety Disorder …

The Prevalence Of Comorbid Chronic Disease In Virginia's Adult Patient Population During The Years 2001 And 2004, Joseph D. Schwartz

Theses and Dissertations

Objective: Chronic disease comorbidities, on the rise in the U.S. and Virginia, represent a new challenge to the way medicine is practiced and prescribed. This descriptive study uses Virginia hospital discharge data to describe the prevalence and trends of chronic disease comorbidities present in the state's over-45 population during the years 2001 and 2004.Methods: Data collected by Virginia Health Information was utilized. Adults over the age of 45 years and who selected for race and location were included in this analysis, with an aggregate sample size of 813,336 (N=458,593 [2001]; N=364,743 [2004]). Pearson chi-square analyses determined significant sample population differences …

Obesity And Health Status Among Urban Vs. Suburban Elderly In Philadelphia And Surrounding Counties, Ockidde Dufayne Harris

Theses and Dissertations

Obesity is a dangerous health condition affecting approximately 30% of all Americans and can be attributed to 300,000 deaths a year. Obesity has been found to disproportionately affect Blacks, Latinos, and those with lower SES. Although obesity is a problem for all age groups, its prevalence is highest among those 60-74 years of age. Studies have shown that there is an association between obesity and chronic conditions such as cardiovascular disease, arthritis, cancers, and type-2 diabetes. According to the Centers for Disease Control, chronic health conditions affect 80% of all elderly persons, many times limiting function and decreasing quality of …