Cardioprotective Roles Of Hydrogen Sulfide Donor Treatment In Diabetic Cardiomyopathy, Sumit Kar

Theses & Dissertations

Diabetes mellitus (DM) increases the risk of heart failure 2-4-fold. Intensive glycemic control does not abate this risk in DM patients, suggesting that DM-induced heart failure is beyond hyperglycemia. DM silently induces cardiac muscle disorder termed diabetic cardiomyopathy (DMCM), which progresses to heart failure. The objective of this dissertation is to understand the mechanistic underpinnings of DMCM to develop new solutions to diagnose and treat heart failure in DM.

The heart pumps blood due to the contraction and relaxation of terminally differentiated cardiomyocytes with limited regenerative capacity. The DM environment of hyperglycemia, hyperlipidemia, and inflammation causes cardiomyocyte death and leads …

Continuous Glucose Monitoring And Diabetes Management During Pregnancy, Nicole Beamish

Doctor of Nursing Practice (DNP) Projects

Continuous Glucose Monitoring and Diabetes Management During Pregnancy

Abstract

According to the Scope of Practice, Standards of Practice, and the Standards of Professional Performance for Diabetes Educators, registered nurses play an integral role in the promotion of diabetes self-management education and training in diabetes care (AADE, 2017). This paper upholds the standards set forth by the American Association of Diabetes Educators (2017) governing body, to stimulate the process of peer review, promote documentation of the outcomes of diabetes self-management education and training (DSME/T), encourage research to validate practice and improve quality DSME/T and diabetes care for pregnant women who use …

Eliminating Barriers To Chinese American Diabetic Patients: Implementation Of Diabetic Cantonese Group Visits, Sabrina Wong

Doctor of Nursing Practice (DNP) Projects

Problems: Asian Americans have higher incidence and prevalence of diabetes mellitus type 2 and less preventive care and higher complication rates than the rest of the American population.

Context: According to the National Healthcare Quality and Disparities Reports (2016), Asian Americans are more likely to be diagnosed with diabetes compared to non-Hispanic whites by over ten percent.

Interventions: A comprehensive group visit program was implemented in a clinic in Oakland, Chinatown catered towards Cantonese-speaking diabetic patients. The group visit included culturally and linguistically appropriate materials related to nutrition, exercise, and diabetes knowledge. Each cohort attended a ninety-minute group visit session …

Gut Microbiota And The Development Of Type 2 Diabetes, Janet Ryan

Nursing | Senior Theses

This paper explores the question: Can interventions focusing on healing the gut microbiome of a prediabetic patient prevent or delay the onset of type 2 diabetes? Diabetes is a major health problem that is becoming the biggest epidemic of the 21^st century. Efforts to derail the progression of disrupted blood glucose metabolism are often futile leaving patients frustrated with a lifelong burden of disease management. Recent studies suggest that collectively the gut microbiome acts as an endocrine organ and that injury to this “organ” can lead to dysfunctional glucose regulation. A comprehensive literature review revealed that further studies are …

Implementing A Three-Minute Foot Exam For Diabetic Patients In Primary Care, Emilee Laster

Dissertations

Problem- One in four U.S. Veterans have Diabetes Mellitus, and one in four U.S. Veterans with diabetes will develop a diabetic foot complication. There is currently no protocol for healthcare providers to perform foot screenings on diabetic patients at each visit. Utilizing a foot screening at each visit for high risk diabetic patients may help to recognize problems sooner, making treatment easier and less aggressive.

Methods- This quality improvement initiative was a retrospective and prospective record review before and after evidence based three-minute foot exams were implemented. A convenience sample of 50 patient medical records were reviewed to collect demographical, …

Type 2 Diabetes Mellitus In The Pediatric Population, Lorna Santiago

DNP Qualifying Manuscripts

The incidence and prevalence of diabetes in youth in the United States is increasing. In particular, type 2 diabetes mellitus (T2DM) is becoming more common in individuals younger than 20 years. Nurse practitioners and other primary care providers that see children should be knowledgeable about the condition and confident in participating in multidisciplinary management. Screening should begin at age 10 or at puberty, whichever comes first. Providers should screen all children who are overweight or obese or of Native American, African American, Latino, Asian American, or Pacific Islander race or ethnicity. Children of these ethnicities have a greater risk for …

Developing A Model To Assess The Contribution Of Cytokeratin 19-Expressing Cells During Multipotent Stromal Cell-Induced Islet Regeneration, Brianna Ananthan

Electronic Thesis and Dissertation Repository

Previously, pharmacological activation of Wnt-signaling in human bone marrow-derived multipotent stromal cells (hMSC) generated conditioned media (CM) that promoted β-cell regeneration in streptozotocin-treated mice. Ductal-derived endocrine progenitors, which have been shown to generate β-cells following pancreatic injury, represent a candidate for the ‘signal-receiving cell’. Ductal (CK19+) cells from mice pancreata obtained by purification of live Dolichos Biflorus Agglutinin lectin+ cells and cultured in minimal media supplemented with Untreated, Wnt-activated, or Wnt-inhibited CM demonstrated a significantly increased proportion of EdU+/CK19+ cells following 48-hours of supplementation but no endocrine phenotype acquisition. Lineage-tracing CK19-CreERT;Ai9(RCL-tdT) mice treated with tamoxifen (single dose) demonstrated specific labeling …

Health Insurance Plan Design And Chronic Disease Management, Daniel E. Feldman

Electronic Theses and Dissertations

Each year, Americans spend more money on health care than any other industrialized nation, despite comparable mortality rates for people with risk factors for heart disease. The reasons for this lack of health care value in the US are numerous and complex – including market distortions like supplier-inflated pricing and regulatory structures that enable consumers to utilize ubiquitous, high-cost medical technologies that yield uncertain benefits. Health insurance, once thought to be an insignificant contributor to rising health spending, has changed considerably in the past few decades in ways that make it more accessible and more generous in coverage. Health insurance …

Printed Educational Materials Directed At Ontario Primary Care Physicians Fail To Improve Adherence To Guideline Recommendations For The Management Of Diabetes Complications: A Pragmatic, Factorial, Cluster Randomized Trial, Alison Howie

Electronic Thesis and Dissertation Repository

Printed educational materials (PEMs) have long been used as a tool for knowledge translation despite the conflicting evidence surrounding their effectiveness. A pragmatic, 2x2 factorial, cluster-randomized controlled trial was designed to ascertain the effectiveness of two distinct formats of a PEM (insert and outsert) at improving adherence to guideline recommendations for the management of diabetes complications among Ontario family and general practitioners. Administrative databases were used to compare patient’s treatment regimens at baseline and one year following PEM mailout to determine whether prescription rates intensified in response to the PEMs. A total of 4,118 practices (4,957 physicians) and 185,454 patients …

Healthcare Provider Education: Adult Jamaicans With Type 2 Diabetes, Patricia Anderson

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: Worldwide prevalence of type 2 diabetes mellitus (T2DM) among the Jamaican population is 11.9% (WHO, 2016). Jamaican patients and their families have experienced first-hand the debilitating complications of this deadly disease.

Context: Jamaicans with diabetes who live in the US experience these same complications. Approximately 300,000 Jamaicans live in Florida (Peart, 2020). This change of practice project was conducted with healthcare providers employed in a family medicine clinic in Florida that treat Jamaicans with T2DM.

Intervention: This change of practice project used an online evidence-based educational training (i.e., Jamaican culture, diet, and health beliefs and how to use …

Needs Assessment: A Food Pharmacy During The Covid-19 Pandemic, Genesis Talavera

Master's Projects and Capstones

Introduction

The needs assessment report discusses the effects of COVID-19 (Coronavirus) pandemic on a low-income Hispanic/Latino population specifically for diabetic patients seeking food pharmacy services at a non-profit clinic in San Mateo County. Nutrition is an essential aspect of diabetes management, which can be challenging to obtain among low-income populations. The COVID-19 pandemic has caused additional challenges among the general population, making it more challenging for the diabetic low-income population. This project was undertaken to identify the effects COVID-19 has on the food pharmacy patients.

Methods

The needs assessment consisted of eleven in-depth interviews done in six week period. A …

Pathophysiology Of Diabetes Mellitus, Nancy Rozzo

Nursing Student Class Projects (Formerly MSN)

“Diabetes mellitus is the seventh leading cause of death in the United States. In the past twenty years, the number of people diagnosed with diabetes has doubled” (CDC, 2020). Diabetes affects many people and if not diagnosed early, or managed appropriately, can lead to other health complications involving the heart and kidneys, leading to blindness and even a possible stroke. The three main types of diabetes are: type 1, type 2, or gestational diabetes. Currently, there are 34.2 million adults in the United States that have diabetes, and 1 in 5 of them do not know they have it (CDC, …

Cardiovascular Disease, Samantha Kohler

Nursing Student Class Projects (Formerly MSN)

The purpose of the presentation is to expand on cardiovascular disease and the pathophysiology contributing to the disease process. The presentation allows for further education on modifiable risk factors, and the most common causes of cardiovascular disease. Cardiovascular disease is one of the main causes of death in the world (Najafipour, Afshari & Rostamzadeh, 2018). When diagnosing patients with cardiovascular disease they often have more than one modifiable risk factor. The modifiable risk factors are hypertension, diabetes, high cholesterol, obesity, smoking, and low physical activity (Najafipour et al., 2018). The purpose of the arteries of the heart is to provide …

Does Urbanization Or Industrialization Have More Impact On The Increasing Prevalence Of Diabetes In Developing Countries?, Simon Mazza

Theses and Graduate Projects

Regardless of how developed a nation is, diabetes mellitus II and other noncommunicable diseases are becoming an increasing problem throughout the globe. However, as more developing countries are introduced to the advancements of industrialized technologies, as well as the shift from rural living to an urban environment they are experiencing a more marked increase in diabetes than anywhere else in the world. In this article we break down the categories of industrialization and urbanization into several key underlying factors that contribute to their proliferation of diabetes in the developing world.

For industrialization we assess the influence of food processing, agriculture …

The Determinants Of Physical Activity, Self-Monitoring Of Blood Glucose, And Poor Glycemic Control Among Individuals Diagnosed With Type 2 Diabetes In Saudi Arabia: A Cross-Sectional Study Based On The Saudi Health Interview Survey (Shis), Mohammed Abdulrahman S. Alsuliman

Health Services Research Dissertations

The prevalence of diabetes and poor glycemic control in Saudi Arabia has increased that contributed to the growing number of deaths in Saudi Arabia. It is known that type 2 diabetes (T2DM) can be prevented but there is a lack information about the magnitude of the of diabetes at national level as well as the risk factors for physical activity (PA), self-monitoring of blood glucose (SMBG), and poor glycemic. Thus, through utilizing Health promotion model (HPM), the aims are to examine the personal factors, cognitive-perceptual, and behavioral determinants of three outcomes; physical activity, SMBG, and poor glycemic control. A secondary …

Factors That Impact Glycemic Control In Adolescents With Type 1 Diabetes, Kelsey Mcfarling

Theses and Graduate Projects

The incidence of Type 1 Diabetes (T1D) is increasing worldwide and is diagnosed disproportionately in adolescent populations. Additionally, studies show that adolescents with T1D experience worse glycemic control during this developmental period. Maintaining glycemic control in patients with T1D decreases the risk of developing future diabetic-related complications. Factors such as race, ethnicity, gender identity, sexual orientation, socioeconomic status, and medical comorbidities influence disparities in maintaining glycemic control in adolescents. The recognition of these factors on the management of T1D through an integrative team approach leads to increased glycemic control and decreased diabetic- related complications. This paper explores the effects of …

Redox Signaling In The Zebrafish Embryo And Implications For Endocrine Pancreas Morphogenesis, Archit Rastogi

Doctoral Dissertations

The glutathione (GSH) system evolved to combat oxygen toxicity in nearly all living organisms, and serves as the predominant cellular redox buffer in vertebrates. This dissertation explores the roles of GSH during embryogenesis using the zebrafish (Danio rerio). The first agnostic in vivo characterization of GSH utilization in the embryo revealed strict spatiotemporal GSH profiles in developing organ systems. Interruption of these GSH profiles by exogenous xenobiotics led to organ specific adverse developmental outcomes; pancreatic β-cells were found to be especially susceptible and developed atypical morphologies following redox active xenobiotic exposures. Pancreatic β-cells lacked expression of Nrf2a (Nuclear …

Evaluation Of A Type 2 Diabetes Mellitus Care Coordination Program, Carrie Smith

Dissertations

Abstract

Purpose: This Quality Improvement (QI) project evaluated the impact of an existing Diabetes Care Coordination (DCC) program at an urban clinic for clients with no health insurance in the Midwest. Diabetes related indicators of those enrolled in the DCC program and client reported barriers were documented over a 19 month period.

Sample: Clients included were 18 years and older, with no insurance, having the diagnosis of Type 2 diabetes mellitus, and were enrolled in the DCC program within the first six months of the program's initiation.

Methods: A retrospective chart review of 24 clients recording diabetes related outcome indicators …

Regulation Of Glucagon Secretion And Trafficking By Proteins In The Glucagon Interactome, Farzad Asadi Jomnani

Electronic Thesis and Dissertation Repository

Patients with diabetes exhibit hyperglucagonemia, or excess glucagon secretion. The glucagonocentric hypothesis of diabetes states that hyperglucagonemia, rather than hypoinsulinemia, may be the underlying mechanism of hyperglycemia of diabetes. Thus, uncovering mechanisms that regulate glucagon secretion from pancreatic α-cells is crucial for developing treatments for hyperglycemia. One clue to the regulation of glucagon secretion may lie in the proteins that interact with glucagon in α-cell’s secretory pathway, primarily within the secretory granule. The purpose of my work was to identify proteins that interact with glucagon within the secretory granule and characterize a candidate protein within this network that regulates the …

Assessment Of Prediabetes Testing Practices Among Primary Care Providers In Mississippi, Blake Mccaulley, Marlana Mcfarland, Erica Mosley, Yvette Munn, Lindsay Wynne

MSN Research Projects

Prediabetes is a condition in which a person has impaired glucose metabolism; however, his or her glucose levels do not meet criteria for the diagnosis of diabetes (ADA, 2019). Prediabetes is associated with an increased risk of developing diabetes and cardiovascular disease (ADA, 2019). Early diagnosis and treatment of prediabetes, including lifestyle interventions and medical management, are vital in preventing prediabetes from progressing to diabetes. The review of current literature indicates that prediabetes testing is not being properly utilized in primary care settings. The purpose of this study was to determine if primary care providers (PCPs) were performing prediabetes A1C …

Hyperosmolar Hyperglycemic State, Justin Momeyer

Nursing Student Class Projects (Formerly MSN)

Hyperosmolar hyperglycemic state (HHS) and diabetic ketoacidosis (DKA) are dangerous complications of diabetes. HHS is examined in this poster and compared to DKA. Even though both have some similarities, they have very different laboratory profiles, patient presentations, treatments, complications, and can require different levels of care. With diabetes becoming more common amongst patients in the hospital, it is imperative that healthcare providers are aware of both of these complications. Nurses who understand both of these complications are able to act pro-actively for their patients, ask questions regarding correct treatments and orders, include the right providers in the care team, and …

Therapeutic Interventions For Managing Diabetic Shoulder, Sanaa A. Alsubheen

Electronic Thesis and Dissertation Repository

Shoulder pain is a common complaint of diabetic patients that causes motion limitations and functional disability. Adhesive capsulitis (AC) is the most common disabling shoulder disorder. There is no optimal non-surgical treatment for managing AC in diabetic patients. Furthermore, the impact of diabetes on shoulder recovery and factors predicting shoulder function following shoulder arthroplasty is not well investigated.

Purpose and Methods

The main purpose of this thesis was to inform clinical practice about the best intervention for managing AC in diabetic patients, and to assess the impact of diabetes on functional outcomes after shoulder arthroplasty, with the following objectives: 1) …

Determining The Link Between Advanced Glycation Endproducts (Ages), Feeding, And Metabolism, Lauren Wimer

Natural Sciences and Mathematics | Biological Sciences Master's Theses

Reactive a-dicarbonyls (a-DC’s), such as methylglyoxal (MGO), are unavoidable metabolites generated during glycolysis that accumulate with age and have been linked with chronic age-related metabolic diseases such as Diabetes Mellitus. Diabetes Mellitus is generally characterized by peripheral neuropathy and sustained hyperglycemia. Chronic hyperglycemia leads to an increase in glycolysis and a downstream increase in reactive a-DC’s. The human body has a natural method of detoxifying these a-DC’s. Glycolytic cells have enzymes which can detoxify a-DC’s, but if overwhelmed, a-DC’s can accumulate and react non-enzymatically with proteins, lipids and DNA to yield a group of molecules called advanced glycation end-products (AGEs). …

Electrophysiology Of The Inner Retina In Health And Disease: Eaat5 In The Rod Bipolar Cell And Oscillatory Potentials In Diabetes, Gregory William Bligard

Arts & Sciences Electronic Theses and Dissertations

The inner retina is a highly tractable location for the study of neural networks in the central nervous system and improving our understanding of the inner retina is important for the treatment of a number of ophthalmic diseases. This dissertation aims to improve understanding of the inner retina in two parts: first, a basic neuroscientific project concerning normal neuronal processing in the inner retina at a cellular level, and second, a translational ophthalmologic project regarding the development in the inner retina of a common disease. In mammals, modulation of the amplitude of dim visual signals primarily occurs at axon terminals …

Baseline Health Assessment Of A Rural Delta Community, Sydney Mitchell

Honors Theses

The Lower Mississippi Delta is characterized by poverty, chronic health issues, health disparities, and food insecurity. The rural Delta communities are primarily African American, experiencing disproportionately higher rates of poverty, job loss, and chronic health problems. Historically, chronic health issues have persisted in these areas over time, including obesity, hypertension, and diabetes, which have only seemed to increase in this region. The food environment in this rural region tends to assist in the creation of the largely obesogenic population which, in turn, contributes to the increased prevalence of diabetes and hypertension and a lower quality of life. Many residents in …

Improving Diabetes Self-Management Developing A Patient Decision Aid To Improve Patient Education, Morgan Baker

Honors Theses

Type 2 diabetes is a complex disease that affects a large population of people. It is imperative that efforts are made to develop more effective and inclusive treatment strategies for patients with this condition. A promising approach being studied is the utilization of community pharmacists to individualize and implement diabetes self-management training and education. The objective of this study is to develop a preliminary version of a patient decision aid (PDA) designed to evaluate patient knowledge and behavior towards diabetes self-management for use in the community pharmacy setting. The study design used to achieve this objective was a cross-sectional survey …

Assessing The Health Literacy Levels Of Diabetic Patients Located In Rural Southeast Kansas, Meghan Murray

Doctor of Nursing Practice Scholarly Project

Data shows that limited health literacy is prevalent throughout the United States. This data has also found a correlative relationship between limited health literacy and poor health outcomes. An individual’s health literacy level affects many areas of their health, including their ability to effectively manage chronic diseases, such as diabetes mellitus. Awareness of an individual’s health literacy level allows for targeted interventions and a potential improvement for a patient’s health outcomes. The Newest Vital Sign (NVS) is a validated screening tool that allows for the identification of a patient’s likely health literacy level. The purpose of this Doctor of Nursing …

The Effects Of Elevated Pre-Operative Hemoglobin A1c On Post-Surgical Infection Risk, Emily Koska Rn

Nursing Capstones

No abstract provided.

Optimal Perioperative Blood Glucose Management And Its Effect On Patient Outcomes, Hilary Narum

Nursing Capstones

No abstract provided.

The Implementation Of Diabetic Foot Care Into Primary Care, Shelby D. Strong

Evidence-Based Practice Project Reports

Diabetes mellitus (DM) is one of the most common metabolic diseases worldwide. It can lead to complications in many parts of the body and can increase overall risk of dying prematurely (World Health Organization (WHO), 2016). Diabetic peripheral neuropathy (DPN) in the feet is one of the most frequent complications of DM (Wang et al., 2017). Other lower extremity complications which can occur as a result of diabetic foot complication (DFC) includes peripheral artery disease (PAD), infection, ulcer and amputation. One of the obstacles for preventing (DFC) is the lack of examinations of the feet in clinical practice (Feitosa et …