Medicine and Health Sciences Commons^™

Exploring The Relationship Between Diabetes, Diabetes Risk, Depressive Symptoms, Chronic Stress, And Inflammatory Markers In Mexican-American Men, Aleli Fernandez

Open Access Theses & Dissertations

Background: Individuals with depression and stress are 60% more likely to develop type 2 diabetes compared to those without (Mezuk et al., 2008). Moreover, biological pro-inflammatory markers associated with psychosocial stress are risk factors for diabetes. Examining the relationship between psychological disorders, inflammation, and diabetes risk among MAH is important as they have high rates of diabetes.

Purpose: To examine the relationship between 1) depressive symptoms, chronic stress, and inflammatory markers, 2) inflammation and diabetes risk factors and 3) depression, stress, inflammation, diabetes risk, and metabolic syndrome (MetS).

Methods: A cross-sectional study of 100 adult men from El Paso, Texas …

Geospatial Distribution Of Pharmacist Diabetes Management Within A Patient Centered Medical Home Model In Omaha, Nebraska, Anthony Donovan

Capstone Experience

Patients with uncontrolled diabetes, defined as a hemoglobin A1c value greater than 9%, are at an increased risk of diabetes progression. Primary care is often the first point of contact where patients with uncontrolled diabetes are identified and treated. Pharmacists are utilized in diabetes medication management of patients with uncontrolled diabetes as one component of primary care multidisciplinary models of care. This descriptive project describes the geospatial distribution of patients with uncontrolled diabetes from a single institution in the Omaha, Nebraska area who were exposed to pharmacists within a Patient Centered Medical Home (PCMH) model of care compared to those …

Quality Improvement Project To Assist In Implementation Of Prediabetes Screen Protocol, Kyai Forney

Doctoral Projects

Prediabetes is a reversible condition that causes blood glucose levels to be higher than normal, but not high enough to be diagnosed as type 2 diabetes. When one has prediabetes, the cells in the body do not respond normally to insulin, and insulin acts like a key to letting blood sugar into cells to use energy. The pancreas produces insulin to try to get the cells to respond, but eventually, the pancreas has a challenging time keeping up, and the blood sugar level rises causing prediabetes (Lehrman, 2021). A person can have prediabetes for years with no obvious symptoms, so …

Spatial Epidemiology Of Prediabetes And Diabetes In Florida, Md Marufuzzaman Khan

Doctoral Dissertations

The burden of diabetes and diabetes-related Emergency Department (ED) visits has increased in Florida. However, Diabetes Self-management Education (DSME) Program participation remained considerably low. Little is known about disparities of DSME participation, diabetes complications, and ED use by diabetes patients in Florida and yet this information is important for guiding health programs aimed at reducing diabetes burden. Therefore, the objectives of this study were to investigate: (a) disparities of diabetes prevalence and DSME participation; (b) disparities of diabetes-related ED visit risks; and (c) prevalence and predictors of stroke among persons with prediabetes and diabetes.

Behavioral Risk Factor Surveillance System and …

Shifting Gears: - The Expected Post-Transplant Survival (Epts) Usefulness In The Era Of Continuous Distribution- Examination Of The United Network Of Organ Sharing (Unos) Database 2000-2020, Vaughn Whittaker, Vaughn Easton Whittaker

NYMC Student Theses and Dissertations

The allocation of organs is a constantly evolving area of transplantation. The latest iteration of this process is a move toward continuous distribution of organs. This process considers dynamic factors instead of static constraints that box patients into certain categories. The expected post-transplant survival of patients is one of these dynamic factors that will be included in the assessment of patients' place in a continuous distribution allocation process. However, the predictive value of this construct is questionable, given that it uses only four factors (age, diabetes diagnosis, years on dialysis, and previous transplant) to represent complex patients who are on …

Transforming Monterey Counties Food Environment, Geovanni Miron Solis

Capstone Projects and Master's Theses

The Blue Zones project was brought to Monterey County due to the high prevalence of type 2 diabetes. Nearly fifty percent of Monterey county are pre-diabetic or diabetic. The Blue Zones Project of Monterey County is a well being improvement initiative that works with local schools, worksites, restaurants and organizations to educate and promote healthier habits. The food sector of the project consists of individuals who work with restaurants and grocery stores here in Monterey County. The project serves Marina, Seaside, Monterey, Salinas, Pacific Grove, Gonzalez, King City, Soledad, Castroville, and Chular. A major issue the project wants to address …

Associations Between Demographic, Social Determinant, And Health Factors And Self-Management Measures Among Insured Individuals With Type 2 Diabetes, Shari Bowers-Dueker

Capstone Experience

Background: Ensuring that individuals with type 2 diabetes properly manage their chronic condition is a nation-wide challenge, even among individuals who have health insurance coverage and access to the treatment they need. There exist several literature sources that suggest various factors that may influence an individual’s lack of self-management of type 2 diabetes. This study investigated some of these factors by determining whether various demographic, social determinant, and health factors were associated with three self-management measures among individuals with type 2 diabetes.

Methods: The self-management measures of interest included (i) whether the annual recommended two primary care visits were attended …

Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin

Masters Theses/Capstone Projects

Poster presentation on the prevention of obesity related morbidity and mortality in adults.

Comparing The Health Care Resource Utilization And Medication Adherence Of People With Epilepsy And People With Diabetes By Insurance Status, Nikole Hoffman, Gerald Shoultz, Sarah Nechuta

Culminating Experience Projects

Background: Epilepsy is one of the most common neurological diseases worldwide; diabetes is a chronic metabolic disease that affects how the body produces and uses insulin. Prescribed medications are vital for controlling these and other chronic diseases by minimizing severe health issues, which can be affected by insurance type and status. Consequences of non-adherence include uncontrolled blood glucose in people with diabetes and uncontrolled seizures in people with epilepsy. We aimed to compare the healthcare resource utilization and medication adherence of people with epilepsy and people with diabetes by insurance status. Methods: Data was from the 2021 National …

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 …

Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …

Relationship Between Childhood Trauma, ,Adverse Childhood Experiences, And Self-Management Of Type 1 And Type 2 Diabetes, Deserie J. Otoole

Walden Dissertations and Doctoral Studies

AbstractPoorly controlled diabetes is the result of lack of self-care, which contributes to complications, ill quality in life, the rise in health care costs, and early death. The purpose of this quantitative, nonexperimental study was to examine the extent to which diabetes type (Type 1 and Type 2), childhood trauma, and adverse childhood experiences predict diabetes self-management (glucose management, dietary control, physical activity, health care use, total self-management). Contemporary trauma theory suggests that early childhood trauma results in negative health-related consequences in adulthood. Standard multiple regression analyses showed that (a) higher levels of physical neglect and emotional abuse predicted poorer …

Providing Diabetes Education To Improve Staff Nurses' Knowledge, Marcia A. Patterson

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a chronic metabolic disease that affects over 34.2 million or 10.5% of the U.S. population and ranks as the seventh leading cause of death. Tennessee's diabetes prevalence rate is ranked 45th overall in the nation, with 14.9% of the population affected, and in the local area for this project, the rate is greater than 15%, creating a public health concern. Despite its prevalence, there is still a wide gap in knowledge among nurses on diabetes management. The practice-focused question for this project addressed whether a staff education program would improve nurses' knowledge regarding diabetes. The significant gap …

Risk Factors Associated With The Development Of Type Ii Diabetes-Related Complications, Jessica Danielle Lucas Williams

Walden Dissertations and Doctoral Studies

By 2040, it is estimated that 642 million people ages 20 to 79 will have Type II diabetes, thereby making it a heavily studied topic among scholars. As more people are diagnosed with Type II diabetes each year, the literature is slowly shifting to long-term complications. However, the many risk and protective factors that exist have created gaps in the literature. The purpose of this study was to determine the relationship between participation in diabetes self-management classes, mental health, physical health, BMI, smoking status, exercise, and possible diabetes complications (diabetes-related retinopathy and diabetes-related kidney disease). The gap in the literature …

Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …

Process Evaluation Of A Community Asset Mapping Protocol For Diabetes Prevention And Management, Andrea Peterson

Capstone Experience

Prediabetes and type 2 diabetes mellitus (DM) are highly prevalent conditions with new diagnoses occurring each year (Centers for Disease Control and Prevention, 2022a). Type 2 DM negatively impacts many aspects of life, to include social, financial, cultural, and everyday living. Asset mapping is a useful tool to build upon existing resources to help community members identify and expand services based on understanding the interconnected systems that influence type 2 DM prevention, screening, education, and care management. An Asset Mapping Protocol was created and piloted through a rural community coalition in Nebraska. The protocol includes an activity for community stakeholders …

Diabetes Self-Management Education And Support: Understanding Knowledge And The Impact, Christina Dietz

All Dissertations

Diabetes has reached epidemic proportions in the United States. To address this, many organizations employ diabetes self-management education and support (DSMES) programs to aid in managing the impact of increasing prevalence. The purpose of this dissertation is to examine the impact of two Upstate South Carolina DSMES programs on several process and outcome measures for adults with diabetes, while also identifying current primary care provider DSMES knowledge and perceptions in an Upstate South Carolina health system.

This dissertation found inconclusive results on the impact of DSMES on PCP utilization, retinal exam screening, nephropathy attention, HDL, LDL, TC, and TG. DSME …

Assessing Nutritional Health Knowledge In Sharing Clinic Patients With Diabetes, Minden Huntrods

Capstone Experience

Effective diabetes prevention and management relies on nutritional behaviors, thus a basic level of health knowledge is important for patients with diabetes and their caregivers in their quest to acquire acute glycemic control and minimize negative health outcomes (Ley et al., 2014). The purpose of this study was to assess the nutrition-related health knowledge of patients living with diabetes who are seen at the UNMC Sharing Clinic by use of a verbal questionnaire. This nutritional health knowledge assessment was a quantitative, prospective, survey-based study utilizing descriptive statistics. Approximately 86% of patients were proficient in food group and nutritious foods knowledge …

Evaluation Of A Hands-On Cooking Class And Its Effects On Self-Efficacy In Relation To Healthy Eating In Type 2 Diabetics, Codi A. Jenshak-Gorzinski

DNP Scholarly Projects

The prevalence of Type 2 diabetes is alarming and poses a great threat to U.S. national health. Chronic diabetes can lead to serious conditions such as heart attack and stroke, and can result in premature mortality (World Health Organization, 2018). Diabetes can be prevented or treated by eating a healthy diet. Cooking classes are a potential way to improve American’s knowledge of nutritional principles and help them become confident that they have the capacity to eat a healthy diet. The purpose of this DNP project was to determine if participation in cooking classes enhanced self-efficacy as it pertains to healthy …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

Racial And Ethnic Disparities In Diabetes-Related Healthcare Service Use In The United States, 2016–2020, Gaole Song

CGU Theses & Dissertations

Diabetes is a serious public health issue in the United States. As one of the leading causes of death, the prevalence of diabetes has increased steadily and leads to an enormous medical and societal burden each year. Compared to non-Hispanic White adults, racial/ethnic minority adults have a higher risk to develop diabetes and its complications. Proper healthcare service use is important for reducing the prevalence of diabetes and the risk of complications. However, minority populations receive a lower quality healthcare service and have greater barriers to diabetes self-management. To get a better understanding of racial disparities in diabetes-related healthcare service …

Diabetes Self-Management Education In The Urban Low Socioeconomic Status Senior Population, Heather Santa Barbara

Walden Dissertations and Doctoral Studies

This exploratory quantitative study used a survey design to address a gap in the literature concerning primary care team perceptions about diabetes care for urban low socioeconomic status seniors with diabetes. Diabetes is a chronic health problem that is often managed in primary care offices, and primary care teams are often the first source of education and support for patients. Standards of management for seniors with diabetes has changed to eliminate tight control of glucose levels, and primary care team members may have differing perceptions about diabetes care depending upon their role in the primary care team and years of …

Effective Management Of Diabetes Mellitus Type Ii In A Military Treatment Facility, Jozy Merizier Smarth

Walden Dissertations and Doctoral Studies

In the United States, 34 million people have diabetes and 79 million have prediabetes. Currently, one in nine Americans are diagnosed with diabetes and it is projected that one in five will have diabetes by 2025 and one in three by 2050. The practice-focused question answered by this project addressed the question if implementing a staff education program improved staff’s knowledge about self-management education and intent for providers and staff to promote a formal diabetes self-management education (DSME) program in an overseas military treatment facility. The site has 47% of empaneled beneficiaries with diabetes mellitus Type II with an elevated …

Weight Management Clinical Practice Guidelines For The Obese, Pre-Diabetic, And Diabetic Population, Dawn Williams

Walden Dissertations and Doctoral Studies

AbstractDiabetes is among chronic or lifestyle-related illnesses posing health care challenges at epidemic proportions, pressuring health care systems infrastructure for positive outcome-driven practices and sustainable costs, as continued research suggests that obese people are up to 80 times more likely to develop type 2 diabetes. In June 2021, a weight-loss and wellness center serving this high-risk population established recommended guidelines for Hemoglobin A1C (HbA1C) screening and education. During the initial 3 months of implementation, data findings captured 37% in a total of 220 with elevated HbA1C levels. The gap in practice is that the Wellness Center did not have a …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

Adverse Childhood Events And Protective Health Behaviors Among Adults With Diabetes Or Diabetes With Comorbid Heart Disease, Ciara Michelle Rukse

Walden Dissertations and Doctoral Studies

Diabetes is a prevalent and costly chronic condition that can lead to other comorbid conditions such as heart disease. Disease management is essential but can be stressful and complicated, especially for individuals who have developed maladaptive behaviors in response to exposure to adverse childhood events (ACEs), which are chronic stressors that impact physiological and psychological development. There is limited research on the potential relationship between childhood adversity and engagement in protective health behaviors among U.S. populations with diabetes or diabetes with comorbid heart disease. The ACEs pyramid was the theoretical framework of this quantitative cross-sectional study concerning morbidity and early …

Nursing Staff Education On The Use Of The American Diabetes Association Guidelines, Terrie Hattie Allen

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus is a complex chronic condition that requires continuous care and management. Approximately 34 million Americans are diagnosed with diabetes and around 90%–95% suffer from Type 2 diabetes. The problem identified in this project was the need to follow the American Diabetes Association guidelines in place at the study site clinic but are not adhered to by the staff. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, the purpose of this project was to plan, implement, and evaluate a nursing staff education program on the use of the American Diabetes Association Guidelines for diabetes. …

Physicians’ Perceptions Of The Utility Of Clinical Guidelines In The Management Of People With Type 2 Diabetes In Saudi Arabia, Abdulaziz Eskandarani

CGU Theses & Dissertations

Aim: The aim of this research was to assess physicians’ perception of the utility of clinical guidelines in the management of people with Type 2 diabetes in Saudi Arabia and how their perception is affected by different physicians’ characteristics and whether high perception would result in adherence to guidelines. Methods: This study employed a cross-sectional study design and used a self-administered online survey through Qualtrics software. The survey was distributed through the Saudi Society for Diabetes (SSD) whose membership includes more than five-thousand active physicians from all regions of Saudi Arabia. There were 493 respondents to the survey. Results: Around …

Frequency And Type Of Diabetes Screening Tests In A Sample Of Women With Polycystic Ovarian Syndrome: A Descriptive Study, Jacklyn Vollmer

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: Polycystic ovarian syndrome (PCOS) is a hormonal disorder that affects 6-12% of United States women of reproductive age. Women with PCOS are at an increased risk of developing type 2 diabetes and fall into high-risk groups for screening guidelines put out by the American College of Obstetricians and Gynecologists (ACOG). Guidelines further suggest that an oral glucose tolerance test (OGTT) be used for diabetes screening in women with PCOS as opposed to an A1C or fasting plasma glucose test. The purpose of this study is to examine rates and type of diabetes screening used among a sample of women …

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

Electronic Theses and Dissertations

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 …