Medicine and Health Sciences Commons^™

Obesity And Diabetes: Evaluating The Impact Of Promotores As A Prevention And Intervention Strategy In The Latino Community, Jessica Castaneda

Master's Projects and Capstones

This paper aims to examine obesity and diabetes among the Latino population as a health problem. As the largest minority racial group in the U.S, Latino rates of obesity and diabetes are greatly higher than whites. The prevalence of obesity in Latinos is 45% compared to that of whites at 34.5% (CDC, 2015). The disproportionate rates at which Latinos are affected by obesity and diabetes have prompted numerous programs to combat this health problem. Promotores or Latino community health workers have been able to provide the important piece of culturally and linguistically appropriate education for the population. Evidence shows Promotores …

Proteomic Characterization Of Human Multipotent Stromal Cells Secreted Proteins With Therapeutic Potential For Β-Cell Regeneration, Miljan Kuljanin

Electronic Thesis and Dissertation Repository

Novel strategies to stimulate the expansion of β-cell mass in situ are warranted for diabetes therapy. Cell-replacement therapies for the treatment of diabetes have become a focal point in recent years. Endogenous regeneration of β-cell mass has been demonstrated using human multipotent stromal cells (hMSC). However, the secretory factors responsible for initiating endogenous regeneration remain unknown. Successful large-scale proteomic applications to address these questions have been limited in part by difficulties in correctly selecting the appropriate methodologies. Thus, the goal of this thesis was a combination of assessing different proteomic workflows to facilitate investigation into hMSC biology, applying these methods …

Role Of Race/Ethniciy, Pre-Pregnancy Bmi, And Socioeconomic Status On Risk For Large-For-Gestational (Lga) Infants Born To Women With Gestational Diabetes Mellitus (Gdm), Anna M. Kiefer

Masters Theses

Background Fetal macrosomia occurs in approximately 10% of all pregnancies taking place in the United States. Babies born LGA are placed at a greater risk for shoulder dystocia, perinatal trauma, cesarean section, jaundice, hypoglycemia, and neonatal intensive care admission. Even more, the long-term impacts are severe and include increased risk of becoming overweight or obese and developing type 2 diabetes later in life. Women with gestational diabetes mellitus (GDM) have higher rates of delivering macrosomic offspring due to insulin resistance taking place beyond what is normal during a pregnancy. Additionally, maternal obesity, socioeconomic status, and race/ethnicity have been associated with …

The Role Of Pre-Existing Type 2 Diabetes Mellitus In Colorectal Cancer Stage And Survival In Elderly Americans: A Seer-Medicare Population-Based Study 2002-~2011, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Diabetes is a common comorbid condition among colorectal cancer (CRC) patients, yet its effects in CRC outcomes, particularly stage at diagnosis, risk of death and variations by diabetes severity (complications vs no complications) and Hispanic ethnicity have not been adequately studied. The purpose of this study was to investigate the association between pre-existing T2DM and advanced stage at diagnosis in elderly patients with CRC; to examine whether diabetes is an independent predictor of poor survival from all-cause and CRC-specific mortality; to assess whether variations exist by diabetes severity and to analyze the outcomes for the Hispanic group.

The Surveillance Epidemiology …

Insights Into The Therapeutic Potential Of Salt Inducible Kinase 1: A Novel Mechanism Of Metabolic Control, Randi Fitzgibbon

Dissertations & Theses (Open Access)

Salt inducible kinase 1 (SIK1) has been considered a stress-inducible kinase since it was first cloned in 1999. Continued efforts since this time have been dedicated to characterizing the structure and function of SIK1. Such research has laid the ground work for our understanding of SIK1 action and regulation in tissue and stimuli dependent manners. The fundamental findings of this dissertation continue in this tradition and include investigations of SIK1 regulatory mechanisms in skeletal muscle cells, the cellular and physiological effects of SIK1 loss of function in vitro and in vivo, and intracellular metabolic and mitochondrial regulation by this …

Primary Care Provider’S Perspectives Of Integrating Public Health Into The Prevention And Management Of Type Ii Diabetes Mellitus In Rural Nebraska, Emma Frost-Briley

Capstone Experience

Through the 2011 Community Health Needs Assessment, the Four Corners Health Department has identified type II diabetes mellitus as one of the communities top concerns within their communities. The goals of this project were: to develop a survey to assess the state of current practices of primary care providers on type II diabetes mellitus in the health department district, to identify primary care providers views on prevention, treatment, and management of type II diabetes mellitus in the health department district, and to examine primary care providers and local health department’s views on how primary care and public health can be …

A Clinico-Pathological Study Of The Structural And Functional Changes In The Retina And Optic Nerve Following Diabetic Retinopathy Treatments, Richard Filek

Electronic Thesis and Dissertation Repository

Diabetic retinopathy (DR) is the result of microvascular changes in the retina due to hyperglycemia which alter the blood-retinal barrier (BRB). The increased permeability of BRB results in the accumulation of extracellular fluid, the development of diabetic macular edema (DME) and capillary occlusion. Capillary occlusion results in retinal ischemia which increases vascular endothelial growth factor (VEGF) levels, increases vascular permeability and results in neovascularization in proliferative diabetic retinopathy (PDR) patients. The treatments clinically used for DR are panretinal photocoagulation (PRP) for PDR and injectable vascular endothelial growth factor inhibitors (anti-VEGFs) for DME.

The safety of PRP and anti-VEGF therapy on …

Retinoic Acid Pathway Inhibition To Expand Human Hematopoietic Progenitor Cells With Islet Regenerative Capacity, Ruth Elgamal

Electronic Thesis and Dissertation Repository

Cellular therapy to induce islet regeneration is emerging as a novel treatment strategy for diabetes. Umbilical cord blood (UCB)-derived hematopoietic stem/progenitor cells (HSPC) isolated by high aldehyde dehydrogenase activity (ALDH^hi) reduce hyperglycemia after transplantation into streptozotocin (STZ)-treated NOD/SCID mice. However, UCB-derived ALDH^hi cells are rare and expansion without the loss of regenerative function is required. We hypothesized that BMS 493, an inverse retinoic acid receptor agonist, will prevent HSPC differentiation of HSPC during expansion, generating more ALDH^hi cells for therapy. ALDH^hi cells expanded for 6 days with BMS 493 showed a 2.70-fold-increase in ALDH^{hi …}

Resilience And Coping In The Adolescent And Young Adult With Type 1 Diabetes, Debra L. Messinger

Seton Hall University Dissertations and Theses (ETDs)

There is a need to understand the roles coping strategies play in enhancing resilience in adolescents and young adults with type 1 diabetes between the ages of 18-30. The purpose of this study was to examine the relationships between and among positive, protective coping strategies (courageous coping), negative coping strategies (defensive coping), and resilience. The Resilience in Illness Model (Haase, Kinter, Monahan, & Robb, 2014) was the theoretical model which guided this research.

A convenience sample was recruited via diabetes organizations’ Facebook and Forum pages, a College Diabetes Network chapter meeting, and Juvenile Diabetes Research Foundations’ (JDRF) sponsored events. Data …

Characterization And Function Of Islet Antigen Presenting Cells During Nod Diabetes, Stephen Thomas Ferris

Arts & Sciences Electronic Theses and Dissertations

Here we characterized the initial antigen presenting cells (APCs) within the islet of Langerhans to ascertain their identity and functional role as it pertains to autoimmune diabetes. The activation of the adaptive immune system is induced by the innate immune system, and more specifically APCs. Therefore, it is crucial to identify the APCs that are initiating T1D in order to elucidate the break in tolerance and intervene in order to inhibit progression. We have found that there is a resident macrophage that is present in all strains of mice. This islet macrophage has a distinct transcriptional profile that is unique …

Pursuing Equity In Diabetes Population, Aisha Rawlinson

Master's Projects and Capstones

Abstract

Background

Poor glycemic control (HbA1c >8) overtime leads to microvascular and macrovascular complications after the first and third years respectively, ultimately resulting in death after five years (Karter, 2016). Current Kaiser Permanente (KP) data stratified by race, ethnicity, age, and gender shows a significant disparity gap between Hispanics/Latino and Caucasian populations. The Pursuing IHI initiative is over a 2-year period completed at a microsystem that is focusing on health equity practices to reduce disparity gaps.

Project aim

KP Riverside, microsystem selected has a large population of Hispanic/Latino KP members, with focus on health equity. The project aim is to …

Dmt For T1d: Using Dance/Movement Therapy To Facilitate Coping, Self-Awareness, And Positive Body Image In Adolescents With Type I Diabetes, Nicole L. Williams-Mulet

Dance/Movement Therapy Theses

This paper explores type 1 diabetes (T1D) and the risk factors associated from its diagnosis. In particular, this paper addresses the onset of T1D in adolescence, which is a developmental period riddled with its own challenges. T1D is a chronic, autoimmune disease that affects the body’s ability to produce insulin. Unregulated, T1D affects the body in numerous ways and can ultimately lead to death. Research has suggested that children diagnosed with T1D should employ an integrated treatment team to account for the physical and emotional struggles that come from living with the disease. Dance/movement therapy (DMT) is a form of …

Sex After Gray Hair? Association Between Sexual Activity, Hugging, And Health Among Older Adults?, Chantelle Sharpe

USF Tampa Graduate Theses and Dissertations

Research on sexual behavior in late life is limited but is growing. Despite ageist stereotypes associating old age with asexuality, older adults continue to desire and engage in sexual behavior. Previous studies have examined the relationship between health and the ability to engage in sexual behavior, sexual satisfaction, desire, or interest in sex. Research has yet to examine the potential reverse of this relationship, where sexual behavior may serve as a protective factor against health outcomes.

This dissertation examined three research questions to test the relationship between sexual activity or hugging and self-reported health outcomes (e.g., arthritis and diabetes) and …

Transitional Healthcare Coordination In New York City Jails Among People With Chronic Health Conditions: Contributions To Reduced Reincarceration And Improved Health, Janet J. Wiersema

Dissertations and Theses

People in correctional settings often have poorer health than the general US population. For example, it is estimated that 27.9% of persons in jail have hypertension, 8.1% have diabetes, and 1.6% have HIV, compared to 25.6%, 6.5%, and 0.5%, respectively, in the general population. Jail and other correctional settings are also increasingly recognized as viable places to engage poor and underserved communities into the healthcare system by offering transitional care coordination services to connect people to healthcare and other services to meet priorities after incarceration. At the same time, recidivism is an issue—over 50% of persons in New York City …

Implementing An Emr Change For The Diabetic Foot Assessment, Nicole O'Neil, Karen Sue Hoyt

Doctor of Nursing Practice Final Manuscripts

The purpose of this project was to implement the American Diabetes Association (ADA) foot assessment guidelines utilizing an electronic medical record (EMR) template. Aims of this evidence based practice (EBP) project were to improve documentation of the comprehensive diabetic foot exam, increase identification of loss of protective sensation (LOPS), and increase podiatry and vascular surgery referrals. Diabetes Mellitus (DM) causes many health complications. The lifetime risk of foot ulceration in diabetic patients is 25%. The goal of Healthy People 2020 is to increase this number by 10% to a total of 21,617,200 individuals. The ADA recommends annual comprehensive foot exam …

The Turnover Of Succinated Proteins In The Adipocyte For The Treatment Of Diabetes, Dominique Jacobs

Senior Theses

In the United States 29.1 million people have diabetes, or 1 out of every 11 people. The rate of new cases of diagnosed diabetes has begun to fall, but the numbers are still very high. 86 million people are living with prediabetes, a serious health condition that increases a person’s risk of developing type 2 diabetes mellitus (T2DM) and other chronic diseases (1). Unfortunately, 90% of those 86 million people are unaware that they are at risk. The health and economic costs for both types of diabetes are enormous: more than 20% of health care spending is committed to people …

A1c Reduction And Weight Loss In A Veteran Population Using Glp-1-Ras, Shelby L. Beutel Darrow

Undergraduate Honors Thesis Collection

Background: Diabetes mellitus is a metabolic disorder defined by high blood glucose. Glucagon-like peptide-1 receptor agonists (GLP-1-RAs) are a newer class of medications that offer potential 2 to 3 kg weight loss and a 1% to 1.5% decrease in A1c. At the Indianapolis Veterans Affairs Medical Center (VAMC), GLP-1-RAs are non-formulary.

Objectives: Primary outcomes included mean change in weight, body mass index (BMI) and A1c in VAMC patients. Secondary outcomes included the comparison to published values, analysis of insulin needs, and analysis of GLP-1-RA discontinuation reasons.

Methods: Indianapolis VAMC patients ages 18-80 with type 2 diabetes who started a GLP-1-RA …

An Evaluation Of Gabab Receptors On Modulating Neuroinflammation In A Non-Transgenic Animal Model Of Alzheimer's Disease, Monica Bolton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by progressive memory loss and distinct neuropathological hallmarks, including amyloid beta plaques and neurofibrillary tau tangles (NFT). Although the etiology remains to be discovered, several risk factors exist that significantly contribute to developing AD. Diabetes is one of the major risk factors associated with AD and is characterized by disrupted insulin signaling that may contribute to or exacerbate AD pathologies. Furthermore, both disorders result in increased neuroinflammation. Considerable evidence has demonstrated that a chronic inflammatory response, in particular chronic microglia activation, promotes A production as well as the hyperphosphorylation of tau through …

An Assessment Of The Associate Degree Nursing Students’ Understanding Of Health Literacy Concepts When Providing Health Promotion For The Diabetic Patient, Donna L. Lebaron

Doctoral Projects

Health literacy (HL) concept deficiencies exist in undergraduate nursing curricula (Smith and Zsohar, 2011; Cornett, 2009; Jukkala, Deupree, Graham, 2009). As future nurses who will have a significant impact on client health literacy assessment, it is essential that health literacy-related content be integrated into undergraduate nursing educational curricula (Sand-Jecklin, Murray, Summers, Watson, 2010; McCleary-Jones, 2012). The prevalence of Type 2 diabetes (T2D) has significantly increased resulting in greater morbidity and mortality risks to the general public; therefore, programs for diabetes prevention, education, and health literacy assessments have become a national priority (Whittemore, Rosenberg, Gilmore, Withey, and Breault, 2013; Hemingway, Stephenson, …

The Effects Of An Acute Bout Of Exercise On Hunger Hormones In Individuals At Risk For Type 2 Diabetes, Sydney Spoon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Hunger hormone levels are typically dysregulated in obese and diabetic

populations, however; postprandial exercise has been shown to influence hunger hormone levels. Purpose: To determine if hunger hormones including acylated ghrelin and GLP-1 levels are altered in response to an acute bout (15 minutes) of walking in individuals at risk for type 2 diabetes mellitus (T2DM).

Methods: Ten subjects at risk for prediabetes (fasting blood glucose 100–125mg/dL) participated in this randomized crossover design trial. Subjects arrived at the laboratory following an overnight fast and underwent one of two conditions: 1) Test meal with no walking (CON) or 2) Test …

Steroid-Induced Hyperglycemia In Patients With Malignancies: Healthcare Team Adaptation To A Paradigm Shift, Miriam Ingrid Silva

Student Theses, Dissertations and Capstones

Background: Caring for patients with malignancies and presenting hyperglycemia has been an ongoing problem that needed to be addressed. The Endocrinologist Society and the Joint British Diabetes Societies for Inpatient Care suggested a change in the process by which patients in this population are managed. Purpose: The purpose of this project was to implement evidence-based practice guidelines for managing steroid-induced hyperglycemia focusing on the interdisciplinary team and adaptation of nurses who care for patients with malignancies. Theoretical Framework: The theoretical framework selected for this project was Roy’s Adaptation Model. Methods: This project used a mixed method approach, with a triangulation …

Correlation Between Self-Appraisal And Measured Risk For Prediabetes, Amanda Sowell

Nursing Theses and Capstone Projects

One-third of adults in the United States have prediabetes and 90% of those individuals are unaware they have the disease. Prediabetes is a disease where blood sugar levels are higher than normal, but not high enough to be diagnosed as prediabetes. The purpose of this thesis was to identify adults at risk for prediabetes in a rural community setting, and explore the relationship between adults’ perceived risk for prediabetes and actual measured risk for prediabetes as determined by the Centers for Disease Control (CDC) Prediabetes Screening Test. The organizing framework was based on Betty Neuman’s systems model. The participants of …

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 …

The Chance Of Complications From Type 2 Diabetes As Perceived By Some Black Seventh-Day Adventists Who Follow A Plant-Based Diet., Charles Misori

Walden Dissertations and Doctoral Studies

Type 2 diabetes has more than doubled in the past decade among Black Americans. Researchers have suggested that Black Seventh-day Adventists, who follow a plant-based diet, are concerned about preventing the complications from this disease. The purpose of this qualitative ethnographic study was to explore the chance and perceptions of complications from type 2 diabetes among 10 purposefully sampled Black Seventh-day Adventists. The health belief model (HBM) served as the conceptual framework. Two constructs, education and income, were chosen for this study. Education was chosen to increase understanding about the chronic nature of the disease, and income was chosen because …

Diabetes Self Care Behaviors And Social Support Among African Americans In San Francisco, Liseli Inonge Mulala

Walden Dissertations and Doctoral Studies

Both Type 1 and Type 2 diabetes are significant public health issues that affect people of all races; Type 2 diabetes disproportionately affects African Americans with higher diagnosis, morbidity, and mortality than it affects Caucasians, and Type 1 has been increasing in incidence. Diabetes self-care activities (DSCAs) and social support have been shown to help in managing both types, which can reduce morbidity and mortality. African Americans with diabetes in San Francisco have higher rates of complications, hospitalizations, and emergency room visits secondary to diabetes. This study assessed whether a relationship exists between emotional support, practical support, affirmational support, informational …

A Comparison Of Neuropathic Pain In Hiv Disease And Diabetes Mellitus, Mary Catherine George

Walden Dissertations and Doctoral Studies

Neuropathy is a nerve disorder found in HIV disease and diabetes mellitus that indicates damage in the peripheral nervous system. Burning, tingling, stabbing, shooting, and painful sensations in the hands and feet are common symptoms of this chronic disorder, and no treatments are available that repair the nerves. The approved pain treatments are few and only available for the diabetic neuropathy population. A mixed-methods study of archival data was performed to compare patients with painful neuropathy (PN) associated with 2 diseases: HIV (HIV-PN) and diabetes mellitus (DPN). This study examined the similarities and differences of the pain narratives and common …

Assessing For Awareness And Knowledge Regarding Diabetes In Pre-Diabetes Obese Patients, Remona Lysa Brown

Walden Dissertations and Doctoral Studies

Over the past few decades, there has been an increase in prevalence of diabetes in the United States. Prevention of diabetes and improving patients' knowledge and awareness of diabetes are crucial for healthcare providers. Using the Health Belief Model (HBM) as a theoretical foundation, the student used the National Diabetes Prevention Program (NDPP) from the Centers for Disease Control and Prevention (CDC), to improve awareness and knowledge of diabetes among obese individuals with prediabetes. The key research question of this project was to determine whether the patients' diabetes knowledge and awareness improved after the NDPP program. A convenience sample of …

Studying The Prevalence Of Depression Among Diabetic Patients In Primary Care, Lanita Rochelle Hood

Walden Dissertations and Doctoral Studies

Abstract

The prevalence of diabetes in the United States in 2015 was 30.3 million people; which is the equivalent of 9.4% of the population. It is a major contributor to morbidity and mortality. Depression is often underdiagnosed in these patients, which contributes to poor self-management and poor health outcomes. In a large primary-care practice on the East Coast, there is no guideline for depression screening in the diabetic population. Focusing on this specific primary care setting, the research question addressed the underdiagnoses of depression in diabetic patients. The project evaluated the prevalence of depression among patients diagnosed with diabetes by …

Testing Mice At Risk Of Pancreatic Cancer For Altered Protein Pathways Found In Diabetes, Henley Cheung

Honors Undergraduate Theses

Pancreatic cancer is nearly asymptomatic, which can result in extensive grow and even metastasis to other organs before detection. When diagnosed at a late stage, the survival rate is 3%. Early detection is therefore the key to treating pancreatic cancer. Diabetes was identified as a risk factor for the development of pancreatic cancer, but the mechanism remains unknown. In this project, the objective was to delineate a link between diabetes and pancreatic cancer by examining their shared protein signaling pathways. In a previous study, hyper-activation of AKT1 resulted in a pre-diabetic phenotype and also increased upregulation of downstream phosphorylated mTOR …

The Effect Of Yoga Practice On Glucose Control, Physiological Stress, And Well-Being In Type 2 Diabetes: Exploring A Mechanism Of Action, Maricarmen Vizcaino

Open Access Theses & Dissertations

Multiple studies have found yoga practice to be effective in improving glucose control and other health markers of adults with type 2 diabetes mellitus (T2DM). However, current findings cannot reach a consensus given multiple methodological inconsistencies. The primary purpose of this Dissertation work was to investigate the impact of yoga practice on the glucose control of participants with T2DM through two different approaches in two separate exploratory studies. The first study, a quasi-experimental design, examined the effect of eight weeks of yoga practice on glucose control taking into account previous limitations in the literature. The second study, a single-subject design, …