Medicine and Health Sciences Commons^™

Oral Glucose Insulin Secretion Test For Identifying Patients With Insulin Resistance, David Kershner

Walden Dissertations and Doctoral Studies

Insulin resistance is an increasing public health issue with the current literature, suggesting reduced sensitivity of insulin leads to adult onset diabetes and associated downstream pathologies that reduce life expectancy. The main objectives of this study were to evaluate the ability of the Oral Glucose Insulin Secretion Test (OGIST) to identify insulin resistance and examine differences in the insulin sensitivity based on gender, age, and ethnicity. This study was supported by the insulin resistance theory which focuses on the reduced ability of insulin to bind to the cellular insulin receptor, reducing the sensitivity of insulin. The OGIST lab results of …

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. …

Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston

Walden Dissertations and Doctoral Studies

Diabetes is the 7th leading cause of death in the United States. Uncontrolled diabetes and lack of self-care knowledge leads to increased emergency department (ED) visits, utilizing limited health care resources. The practice-focused question asked whether a patient-focused diabetic self-care toolkit could decrease the number of diabetes-related ED visits. The purpose of this project was to reduce the number of diabetes-related ED visits and was supported by the social cognitive theory. The sources of evidence included the facility's ED Information System (EDIS) data and a patient survey developed by the project lead. There were 149 participants (135 males and 14 …

Health Insurance Status And Diabetes Management Practices Among Black Adults In The U.S., Luderve Rosier

Honors Undergraduate Theses

The purpose of this study was to investigate the relationship between health insurance status and diabetes management (in terms of medication adherence and physical activity levels) in Black adults based on socioeconomic factors. Data were harvested from the Sample Adult Questionnaires of the National Health Interview Survey (NHIS) between the years of 2010 and 2016. The survey questions that were collected included information about the participants' income, education level, insurance status, diabetes diagnosis, medication therapy and physical activity levels. This study employed the most recent version of the Statistical Package for Social Sciences (SPSS) software. The association between diabetes management …

The Impact Of Interprofessional Collaboration On Diabetes Outcomes In Primary Care Settings, Charette Coleman Deloach

Walden Dissertations and Doctoral Studies

Inadequate interprofessional collaboration (IPC) and communication among health care professionals are associated with medical errors and mortality. Guided by the theory of goal attainment and the chronic care model, a systematic review was conducted to explore the evidence related to whether interprofessional collaborative primary care can have a positive effect on health outcomes for patients living with diabetes (PLWD). The systematic review followed the Joanna Briggs Institute method for systematic reviews and results were complied with the PRISMA evidence-based minimum set for reporting. Data were analyzed to identify if IPC positively impacted the health outcomes of PLWD, as evidenced by …

Improving Glycemic Control In Adult With Type 2 Diabetes, Basirat Romoke Triplett

Walden Dissertations and Doctoral Studies

Ninety percent of people with diabetes have Type 2 diabetes mellitus (T2DM). T2DM is a complex disease that affects every organ in the body, which makes effective management of the disease imperative. The American Association of Clinical Endocrinologist (AACE) and American College of Endocrinology (ACE) strongly recommended early treatment initiation among the target population to delay disease progression and complications. The purpose of this evidence-based project was to examine the impact of using the T2DM management algorithm for effective management of adults with T2DM over a 3-month period. The shared experience decision-making model and the chronic care model were used …

Parasympathetic Nerve Derived Exosomes Inhibit Hyperglycemia Induced Apoptosis In Cardiomyoblast Cells, Reetish K. Singla

Honors Undergraduate Theses

Diabetic cardiomyopathy involves both forms of cardiac cell cell death such as apoptosis and necrosis. However, this remains unknown whether hyperglycemia induced apoptosis in the cell culture system is inhibited by parasympathetic nerve derived exosomes. We isolated parasympathetic and sympathetic nerves and derived exosomes. We developed hyperglycemia induced apoptosis in H9c2 cells. H9c2 cells were divided into 4 groups: 1) Control, 2) H9c2+ Glucose 100 mmol, 3) H9c2+ Glucose +parasympathetic-exo, 4) H9c2+ Glucose+sympathetic-exo. We determined cell proliferation and viability with MTT assay kit and apoptosis with TUNEL staining and cell death detection ELISA kit. Data was further confirmed with pro-apoptotic …

The Impact Of Comorbidities On Diabetes And Hypertension Co-Management And Healthcare Expenditures, Rashmi Goyat

Graduate Theses, Dissertations, and Problem Reports

Hypertension and type-2 diabetes mellitus (T2DM) are among the most prevalent chronic conditions that often co-exist. Their co-existence increases the risk for comorbidities due to their impact on other organs such as blood vessels (leading to vasoconstriction/hypertension); brain (resulting in increased caloric intake); pancreas (decreased in beta-cell mass and glucose sensing); bone (possibly decreasing bone mass and strength). Occurrence of comorbidities can complicate the already complex care of diabetes and hypertension. It increases the risk of poor patient outcomes such as preventable hospitalization, adverse drug events and mortality. However, different comorbidities can affect the co-management differently. We identified the types …

Impediments Of Self-Managed Type 2 Diabetes In Mgbidi Women, Nigeria, Augustina Oha

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a complex metabolic disorder characterized by hypoglycemia or hyperglycemia that affects fat, protein, and carbohydrate metabolism. Researchers have identified that for individuals with Type 2 diabetes, staying on interventions for diabetes self-management is sometimes difficult and challenging. It is an increasing public health concern, especially in certain minority populations and in many developing and developed nations. This is especially true for the population of women 40 years and older in Mgbidi, Nigeria. In the Enugu State of Nigeria, women bear most of the burden of Type 2 diabetes when compared to the males in the state. …

Self-Care Management Of African American Men With Type 2 Diabetes, Kevin Konstantinos

Walden Dissertations and Doctoral Studies

African American men are disproportionately affected by type 2 diabetes and have a 3 times higher rate of 3 serious complications of diabetes, including blindness, amputations, and end-stage renal disease, compared to other groups. The purpose of this project was to address the gap-in-practice disparity that exists in care of African American men with diabetes by providing one-on-one self-care management education in an outpatient clinic setting. The behavior change theories that supported the project intervention were Orem's self-care theory and Bandura's self-efficacy theory. Employing a quasi-experimental design, 33 participants between the ages of 40 and 65 were divided into an …

Inpatient Rehabilitation, Diabetes, And The Risk Of Clostridium Difficile Infection, Kerry A. Flint

Walden Dissertations and Doctoral Studies

Clostridium difficile is a frequent cause of healthcare-associated infections (HAI) and is associated with increased risk of morbidity and mortality. Studies suggest environmental and host characteristics increase patient's susceptibility to C. difficile infection (CDI). However, few studies have examined the risk of CDI among those with diabetes or patients in the acute rehabilitation (AR) setting. A case-control study, using secondary data (n = 473), evaluated the relationship between CDI and diabetes and identified modifiable environmental exposures. An ecosocial framework was used to examine the relationship between these two complex diseases among hospitalized patients in an AR setting. Results of the …

Association Between Body Mass Index And Depression On Hbaic Control Among Veterans, Opokua Osei-Yeboah

Walden Dissertations and Doctoral Studies

The study investigated the association between body mass index (BMI) and depression based upon glycated hemoglobin levels (HBA1C) among United States veterans. Based on Bandura's social cognitive theory, a cross-sectional analysis examined the association between BMI and depression on HBA1C regulation, and if the interaction between BMI and depression affects HBAIC regulation among veterans. Multiple regression analysis was used to test the multivariate associations between depression and BMI on the outcome variable of HBA1C. Linearity, normality, and homoscedasticity were assessed using normal probability plots and residual analysis. Durbin-Watson statistics were used to test for autocorrelations, and variance inflation factor was …

Physical And Psychological Health Outcomes Of Pregnancy-Related Intimate Partner Violence, Darrlyn Waynette Cornelius-Averhart

Walden Dissertations and Doctoral Studies

Intimate partner violence (IPV) is a public health issue that transcends cultures and nationalities. Women and men have been impacted by sexual violence through rape and other types of IPV. Each year, women experience IPV before and during pregnancies and are impacted by physical and psychological outcomes as a result. The purpose of the study was to examine the impact of IPV on the health outcomes of diabetes (Types 1, 2, and gestational), high blood pressure before pregnancy, and depression/anxiety among adult women before and during pregnancy. The social ecological model provided the framework for this quantitative cross-sectional study that …

Race, Gender, And Retention In A Diabetes Self-Management Program, Marcia Kaye Bygrave

Walden Dissertations and Doctoral Studies

Diabetes has quickly become an epidemic in the United States and affects all genders and races. Some ethnic groups are at greater risk for being diagnosed and face devastating health consequences due to poor diabetes self-management. Diabetes self-management education (DSME) is considered to be a positive step toward patient self-efficacy and diabetes management. The benefits of diabetes self-management education can only be realized if patients diagnosed with diabetes not only enroll, but complete the program. The purpose of this research study was to investigate the association between race and gender and dropout rates among participants enrolled in a DSME program. …

Diabetes Management Protocol In The Rehabilitation Setting, Hannah Mottel

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a growing healthcare problem in the United States. Diabetes affects 1.4 million Americans yearly, impacting the lives of individuals of all ages. One of the most challenging aspects about diabetes is that many individuals are not aware of the impact of the disease on multiple organs until the progression of the disease has reached latter stages. Prevention and early detection of diabetes is a key component of lifesaving interventions including proper nutrition counseling, exercise regimens, management, and patient compliance with a treatment plan. The purpose of this doctoral project was to create a standardized diabetes management protocol …

Effectiveness Of Continuous Subcutaneous Insulin Infusion Therapy Education In A Clinic Setting, Kimberly Rizzo

Walden Dissertations and Doctoral Studies

Diabetes affects an estimated 29.1 million Americans, with approximately another 1/3 of Americans not yet diagnosed. Complications associated with diabetes include heart disease, stroke, hypertension, blindness, kidney disease, neuropathy and death. All of these complications can be prevented with optimal control of blood glucose levels. Advances in technology provide people living with diabetes (PLWD) a multitude of treatment options such as continuous subcutaneous insulin infusion (CSII) therapy. Unfortunately, sustained improvement in glycated hemoglobin A1c (HgA1c) is not always achieved even with this advanced therapy. The purpose of this doctoral project was to educate nurses on CSII therapy and promote improved …

Creation Of A Diabetic Health Literacy Program For Staff Of A Rural Federally Qualified Healthcare Center, Cathy Jones

Walden Dissertations and Doctoral Studies

Adult residents in rural communities have a higher incidence of chronic diseases. This fact coupled with low health literacy and a lack of primary and specialty care services makes the management of diseases such as diabetes difficult. The purpose of this doctoral project was to develop a diabetic health literacy program for staff of a rural federally qualified health care center (FQHC) that is the largest primary care center within a 5-county area in a rural mid-Atlantic region of the United States. Most residents have difficulty understanding diabetic information as it is presented to them, which leads to an increase …

The Impact Of Diabetes And Obesity In The African American Population, Andrea Lynette Swails

Walden Dissertations and Doctoral Studies

Within the 21st century, Type II diabetes has emerged as a public health crisis. African Americans and Hispanic Americans have the highest rates of Type II diabetes and obesity compared to European Americans. The purpose of this DNP project was to teach medical assistants (MA) to provide self-management of diabetes and obesity for the African American population in the local clinical setting. An educational tool kit for health providers was developed to guide the educational project. The chronic care model was used to guide the development of the educational toolkit. A pretest posttest design was incorporated into the educational program. …

The Effect Of Exercise And Diet On Insulin Resistance, Kinsey M. Nelson

Honors Theses

This paper explores the effects of diet and exercise on an insulin-resistant individual, integrating the recommendations for exercise and diet as put forth by a variety of peer-reviewed articles. The purpose of this experiment was to determine if insulin resistance is a reversible condition, and if so, whether exercise alone, nutrition alone, or some combination of the two would be the most effective treatment. The results of this twenty-week trial suggest that insulin resistance may be reversible. Exercise alone was not found to be effective in decreasing insulin levels. Changing to a low-carbohydrate diet with no exercise saw a vast …

Are Children Of A Diabetic Mother In Comparison To Children Of A Nondiabetic Mother At An Increased Risk For Developing Obesity In The First 10 Years Of Life?, Chhorn Pho

Theses and Graduate Projects

Body weight, glucose, insulin, and leptin were studied in children of mothers with gestational diabetes, type 1 or type 2 diabetes. Breast milk of diabetic mothers was also analyzed to study its relationship to childhood obesity. In the first 2 years of life, infants of mothers with gestational diabetes have no significant difference in weight gain but by the age of 10, most of the children birthed by any diabetic mothers were either overweight or obese. Children of mothers diagnosed with diabetes mellitus type 2 have higher resistance to insulin than children of mothers with other diabetes types. Leptin was …

Exploring The Relationship Between Social Support, Pharmacy Access And Medication Adherence, Favel Leah Mondesir

All ETDs from UAB

Barriers of medication adherence exist among people with coronary heart disease (CHD) and CHD risk factors, including, poor social support, poor pharmacy access and other patient, social/economic, therapy, condition, and health-care system/health-care team-related factors. However, there are few data on influence of these factors on medication adherence among people with CHD risk factors other than diabetes. Therefore, this dissertation aimed to investigate associations of medication adherence with social support (n=17,113) and pharmacy access (n=8,250) quantitatively using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study (black and white adults with CHD or CHD risk factors ≥45 …

The Effects Of Body Size, Growth, And History Of Diabetes On Glioma Risk, Rebecca Barnhill Little

All ETDs from UAB

Many dietary exposures have weak or null associations with glioma risk. As nutrition can affect growth rate in adolescence, body size throughout the lifespan, and the propensity for Type 2 diabetes, the goal of this project was to examine the relationships between these surrogates of nutritional states and the risk of glioma. The aims of this project were to examine the associations between glioma risk and 1) self-reported body measures; 2) age when full height was attained; 3) and a history of diabetes. To investigate the first aim, 1,111 glioma cases and 1,096 community controls completed a structured interview to …

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 …

Implementing The National Diabetes Prevention Program In Mason County, Kentucky, Cassandra Yelton

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

The National Diabetes Prevention Program (DPP) is sponsored by the Centers for Disease Control and Prevention (CDC). The program’s goal is to reduce the incidence of diabetes through dietary modification and physical activity. On one hand, the DPP is currently offered by various organizations through the country. On the other hand, the DPP is mostly unavailable in rural areas, especially the Diabetes Belt. The Diabetes Belt is in the eastern Appalachian region of the United States. People who live in this area of the country are more likely to develop diabetes than those who do not. Mason County, Kentucky has …

Aps’Aalooke Led Diabetes Prevention Program, Lucy Hollingsworth Williamson

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

The primary objective of this proposed program is to decrease the burden of diabetes mellitus type II among the Crow Indian tribe members in Montana by preventing the progression of prediabetes to diabetes. Type II diabetes mellitus (DMII), is a debilitating disease that contributes to increased morbidity and mortality, in addition to billions of healthcare costs annually. In the United States, minority populations carry a higher burden of DMII, however American Indians have the highest prevalence of all. In fact, American Indians are 2.4 times more likely to be diagnosed with diabetes than white people.

In Montana, the Crow Indian …

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 …