Beyond The Numbers: Supporting Young Adults With Diabetes In The Transition To Adulthood, Alexis Salkovick

Honors Projects

This project focuses on the transition to adulthood for young people with diabetes, a chronic medical condition. Both Type 1 and Type 2 diabetes are included. The main research focus is two-part: first examining this transition including barriers to health care, changes in lifestyle, and mental health, and then creating a new, innovative tool to support young adults with diabetes. An independent literature review was conducted to investigate diabetes management, barriers to health care, how transitioning to adulthood impacts diabetes care, and the importance of patient support systems. Then, a board game was developed with the dual purpose of educating …

The Effect Of A Low-Glycemic Index Diet On Polycystic Ovary Syndrome Symptoms Among University-Aged Women, Angelika A. Gonzalez, Annalise M. Sankar, Noelle D. Nguyen

Department of Nutrition Student Projects

Polycystic Ovary Syndrome is an endocrine disorder among women of reproductive age and is associated with insulin resistance, menstrual irregularities, hyperandrogenism, and metabolic dysfunction. Dietary modifications targeting glycemic response have emerged as a nonpharmacologic approach for PCOS management. However, long-term randomized controlled trials targeting young adult populations remain limited.

The purpose of this study is to evaluate long-term effects of adherence to a low-glycemic index diet on the frequency and severity of PCOS symptoms among female college students ages 18-22. This 12-month randomized controlled trial will recruit participants meeting the Rotterdam criteria from university health clinics. Participants will be randomly …

Are Berberine-Based Treatments Effective In Reducing Hemoglobin A1c (Hba1c%) In Adults With Type Ii Diabetes?, Queenie Douangpraseuth

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Are berberine-based treatments effective in reducing Hemoglobin A1c (HbA1c%) in adults with type 2 diabetes?”

STUDY DESIGN: A review of 3 randomized control trials (RCTs) published between 2015 to 2020 DATA SOURCES: Articles were found on PubMed and Google scholar. Selected articles were published in peer-reviewed journals in English and were chosen based on applicability to clinical questions posed in the objective and meeting inclusion criteria.

OUTCOMES MEASURED: All three RCTs measured the mean HbA1c% over time. A blood sample is taken and laboratory tests are …

Health Disparities In Cardiovascular Care: The Impact Of Diabetes Education And Post-Discharge Interventions For African American Adults At Risk For And After Myocardial Infarction, Trinity L. Billingsley

Nursing | Senior Theses

Background: Cardiovascular disease is the leading cause of death in the United States, affecting African American adults at higher rates compared to other racial and ethnic groups. Diabetes as a comorbidity is one of the risk factors of experiencing a myocardial infarction, remaining one of the leading causes of death among individuals with diabetes. Objective: To examine the effectiveness of structured diabetes education tailored to African American adults who are at risk for and after a myocardial infarction. Additionally assessing the complications of a myocardial infarction, the outcomes associated with structured education will be compared to the outcomes of …

Transition To Home Guideline For Patients With Diabetes, Kathleen R. Burgner

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Diabetes is a leading contributor to preventable hospital readmissions. These hospital readmissions often result from fragmented discharge planning, poor care coordination, and limited post-discharge support. At a 915-bed academic medical center in Southern California, the diabetes-related readmission rate was 13.3%, compared with 11.4% among patients without diabetes. This project aimed to develop an evidence-based Transition-to-Home (TTH) guideline for hospitalized patients with diabetes and evaluate the strength of its recommendations through multidisciplinary stakeholder review.

Methods: An evidence-based guideline development project was conducted over 8 weeks. A comprehensive literature search in CINAHL, MEDLINE, PubMed, and ScienceDirect identified current evidence on transitional …

Microneedle-Based Lc-Ms/Ms Profiling Of Dermal Interstitial Fluid Reveals Early Lipid Dysregulation Contributing To Painful Neuropathy In Prediabetic And Type 2 Diabetic Rats, Srinivasa Rao Gadam

Biomedical Sciences ETDs

Painful diabetic neuropathy (PDN), a complication of type 1 and type 2 diabetes, also occurs in obesity and prediabetes, with dyslipidemia as a modifiable risk factor. The distal-to-proximal neuropathy pattern and length-dependent intraepidermal nerve fiber loss suggest peripheral contributions. We hypothesized that elevated neurotoxic lipid intermediates—diacylglycerols (DAG), free fatty acids (FFA), and acylcarnitines (CARs)—in the dermal interstitial fluid (ISF) drive metabolism-associated hyperalgesia in prediabetic and diabetic rats. Using a microneedle array (MIA) with LC-MS/MS, we profiled ISF and serum lipids from high-fat diet (HFD) and HFD + streptozotocin (STZ) rat models alongside Hargreaves testing. ISF lipid changes appeared earlier (weeks …

Enhancing Diabetes Care In Adult Patients With Type 2 Diabetes In An Outpatient Setting, Osayanmo Ojo

All Doctor of Nursing Practice (DNP) Scholarly Projects

Type 2 diabetes mellitus (T2DM) is a prevalent chronic condition associated with significant morbidity, particularly among underserved populations. This Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to improve diabetes care among adult patients with poorly controlled T2DM (A1C > 9%) in an outpatient primary care clinic by increasing referrals to the Diabetes Self-Management Education (DSME) program. Guided by the Plan-Do-Study-Act (PDSA) cycle and the OhioHealth Change Management (OHCM) model, the project implemented structured interventions including standardized DSME referral workflows, electronic health record (EHR) prompts, provider education, and culturally tailored communication strategies.

The 12-week initiative targeted 68 eligible patients. …

Effect Of Standardized Phone Call Protocol On The Achievement Of Target Hba1c Levels, Felicia Choyce

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem:

Type 2 Diabetes Mellitus is a common chronic illness with far-reaching health and financial consequences. At the project’s primary care clinic, the average hemoglobin A1c among adults with Type 2 Diabetes Mellitus was 9.6%, exceeding the recommended clinical goal of less than 7% (American Diabetes Association, 2023). The absence of a standardized follow-up protocol and inconsistent use of health literacy-based communication contributed to persistent hyperglycemia and failure to reach target HbA1c levels. These factors indicated an urgent need for an evidence-based intervention.

Aim of the Project:
The aim of this project was to reduce HbA1c levels among adults with …

Engineering Cxcr2-Ligand-Based Fusion Proteins To Modulate Myeloid Cell Trafficking In Pancreatic Cancer, Benjamin N. Christopher

MUSC Theses and Dissertations

Pancreatic ductal adenocarcinoma (PDAC) has one of the lowest 5-year survival rates of all cancers, and limited treatment options exist. Immunotherapy is effective in some cancer types, but the immunosuppressive tumor microenvironment (TME) of PDAC is a barrier to effective immunotherapy. CXCR2+ myeloid-derived suppressor cells (MDSCs) are abundant in PDAC tumors in humans and in mouse models. MDSCs suppress effector cell function, making them attractive targets for restoring anti-tumor immunity. The studies outlined in this dissertation (1) link tumor-intrinsic oncogenic signaling to dysregulated myeloid activity in PDAC, (2) describe a rationally designed fusion protein and potent inhibitor of CXCR2+ myeloid …

Implementing The Fib-4 Tool For Liver Fibrosis Screening In Diabetic Patients In Primary Care, Robert I. Montillano

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly non-non-alcoholic fatty liver disease (NAFLD), affects over 1 in 3 adults with type 2 diabetes mellitus (T2DM) and is a leading cause of advanced liver fibrosis. Despite guideline support from the American Diabetes Association (ADA) and American Association for the Study of Liver Diseases (AASLD), screening practices remain inconsistent in primary care. The Fibrosis-4 (FIB-4) index is a validated, low-cost, noninvasive tool for fibrosis risk stratification, yet it remains underutilized despite its availability in many electronic health record (EHR) systems.

Purpose: This Doctor of Nursing Practice (DNP) evidence-based practice (EBP) project …

The Impact Of Motivational Interviewing On African-American Men With Type 2 Diabetes Mellitus, Jamekia Kitchens

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

African-American men with type 2 diabetes face an immense health disparity in the United States, with alarming mortality rates compared to their counterparts. This pilot study examined the impact of motivational interviewing on African-American Men with type 2 diabetes mellitus. The researcher conducted motivational interview sessions using the components of the Diabetes Management Self-Efficacy Scale to guide the meetings. Pre- and post-confidence levels and pre- and post-hemoglobin A1c levels were collected and analyzed. After the completion of three motivational interview sessions, participants displayed significantly higher self-efficacy scores with significantly decreased A1c levels. The results suggest that motivational interviewing has a …

Functional Characterization Of The C-Terminal Cholinesterase-Like (Chel) Domain Of The Thyroid Hormone Precursor Protein, Berenice Morales-Rodriguez

Pharmaceutical Sciences (MS) Theses

Vertebrate life is unsustainable without thyroid hormones. The only known precursor for thyroid hormone synthesis is thyroglobulin (Tg), composed of upstream regions I-II-III and a C-terminal cholinesterase-like (ChEL) domain, which bears 47% similarity to acetylcholinesterase (AChE). Mutations in Tg cause congenital hypothyroidism, the most common congenital endocrinopathy affecting 1 in 2,000-4,000 newborns, with a varying degree of phenotypic manifestations. Tg protein, regulated by TSH, is secreted to the lumen of thyroid follicles, where thyroxine (T₄) is formed primarily at the N-terminus, and triiodothyronine (T₃) is formed primarily in the ChEL domain. Previous in vitro studies indicated …

Navigating Insulin Access For Pediatric Type 1 Diabetes: Caregivers' Experiences And Challenges, Ella Anderson

Doctoral Dissertations

Between 2012 and 2018, the annual 14% increase in insulin prices made Type 1 Diabetes (T1D) the most expensive chronic health condition, significantly raising out-of-pocket costs for uninsured or underinsured individuals in the United States (Hayes & Farmer, 2020; Willner et al., 2020). This study utilized a qualitative content analysis methodology to explore the challenges and experiences of parents with children diagnosed with T1D with accessing insulin for their child. Five participants from various areas of the United States responded to open-ended questions both in person and via Zoom. The analysis revealed three main themes: pragmatics of managing diabetic care, …

Type 2 Diabetes Education And Knowledge In The Adult Hmong Community, Sheng Yang

Doctor of Nursing Practice Projects

Type 2 Diabetes is a chronic health condition that affects many individuals, but specifically has been found to significantly affect minority population groups. There has been very limited research regarding understanding the etiology of the disease in the Hmong community that migrated to the United States from Southeast Asia. The purpose of this project was to design and implement an evidence-based, culturally appropriate educational intervention in the Hmong language to increase knowledge of Type 2 Diabetes among the adult Hmong community in Burke County and Catawba County, NC areas. The intervention was delivered to a total of 30 participants who …

Enhancing Health Literacy Using Video Education And The Teach-Back Method For Hypertension And Diabetes Mellitus Type 2, Shelly-Ann M. Malcolm-Padilla

Doctor of Nursing Practice Projects

Diabetes type 2 and hypertension are chronic illnesses that have both physical and psychological impacts on an individual. Primary care providers play an important role in the management of chronic illness, specifically type 2 diabetes and hypertension. Changing behavior with a commitment to compliance with the treatment plan and living a healthy lifestyle can decrease disease complications for both diabetes and hypertension. With the use of educational videos and the teach-back method to confirm understanding of disease management, the goal of this quality improvement project was to contribute to positive health and lifestyle change for patients, their caregivers, clinical staff, …

Improving Glucose Levels In Adults With Type 2 Diabetes, Kaitlin Castillo

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Type 2 diabetes is a growing health crisis, posing significant challenges not only to individual well-being but also to healthcare systems' financial sustainability. The prevalence of type 2 diabetes continues to rise annually, contributing to increased medical costs, hospitalizations, and long-term complications. Houston, Texas, has a diabetes prevalence of 13.5%, exceeding the national average of 10%. A clinical gap exists in providers’ ability to prevent and manage type 2 diabetes. Prioritizing prevention, early intervention, and improved patient monitoring can reduce incidence rates, lower healthcare costs, and enhance overall population health. A Plan Do Study Act model was utilized for the …

Diabetes Device Knowledge And Confidence Among School Nurses: A Mixed Methods Study, Cassandra F. Moffitt

Nursing Theses and Dissertations

Problem: Type 1 diabetes is one of the most common chronic medical conditions in childhood. While manageable, these children may spend half of their day in the school setting and often need assistance from a school nurse to manage their care.

Theory: Bandura’s Social Cognitive Theory (1977) served as the theoretical framework for this study.

Research Questions: The research questions explored knowledge, confidence, and additional predictors of confidence related to diabetes devices.

Design/Methods: An explanatory sequential mixed methods design was used. The Diabetes Device Confidence Scale (DDCS) was used to measure device confidence, while Subscale 10 of the KAT-1 instrument …

Characteristics Contributing To The Risk Of Diabulimia In Adults Living In The United States, Danielle L. Van Hout

All Master's Theses

The purpose of this study was to determine the prevalence and factors that contribute to the risk of diabulimia by using the validated Diabetes Eating Problem Survey-Revised (DEPS-R) (Markowitz et al., 2009) screening tool in adults living in the U.S., as well as to examine differences in individuals at-risk and not-at-risk for diabulimia. This observational study involved a 30-question Qualtrics survey containing the DEPS-R distributed via various social media outlets and flyers on the CWU Ellensburg campus. Participants were required to be 18 years or older, diagnosed with T1DM for more than one year, and live in the U.S to …

Caspases Protect Against Hyperglycemia Induced Necroptosis-Like Cell Death In Brain Endothelial Cells, Aleena S. Mathew

Theses and Dissertations

Acute diabetes characterized by high spikes in blood glucose levels in association with severe hyperglycemia can lead to an increased risk of ischemic stroke in the brain. To better understand high blood glucose levels, hyperglycemia, in the brain we explored its effects on endothelial cells. Endothelial cells line the inner walls of blood vessels and are directly impacted in hyperglycemia. Brain endothelial cells are a major component of the blood brain barrier (BBB) which tightly regulates the brain’s microenvironment. The type of cell death such as apoptosis, caspase dependent, or necroptosis, caspase independent, can exacerbate diabetes associated complications. There is …

Critical Analysis Of Gestational Diabetes Risk Factors: A Systematic Review, Madison Keich, Madeleine Ray, Mia Ross

Williams Honors College, Honors Research Projects

Gestational Diabetes Mellitus (GDM) is a common complication of pregnancy that causes an increased blood sugar that can affect both the mother's and baby’s health. A variety of factors can increase the risk of developing the disease, including race, socioeconomic status, and prenatal education. Each of these factors contributes to the experience of one’s maternal care. Expecting mothers may not understand how significant GDM is, and its potential to result in negative outcomes. It is important to review these factors, acknowledge them, and help reduce health disparities caused by them. Nurses are vital to assessing and delivering patient education on …

Investigating The Impact Of Phthalate Exposures From Personal Care Products On Uterine Fibroid Incidence And Prevalence In Us-Born Black Women, Ella Brissett

CMC Senior Theses

Uterine fibroids are benign tumors composed of smooth muscle cells and connective tissue that develop within or on the walls of the uterus. Despite being non-cancerous, they can severely affect quality of life by causing heavy bleeding, chronic pain, and reproductive complications. Fibroids are typically found in women of reproductive age, but they disproportionately affect Black women, who experience higher incidence and severity. The underlying causes of this disparity is poorly understood; however, an emerging body of research is highlighting the role of phthalates, endocrine-disrupting chemicals found in many personal care products, in exacerbating fibroid development. Through a critical analysis …

Assessing The Impact Of An Individual Diabetic Education Program And Big Data App On Three Generations Of Patient Populations, Avery C. Carpenter, Rechendia C. Carpenter, Ester M. Felipe

Doctoral Projects

Diabetes is a chronic condition that affects numerous people worldwide. Diabetic education assists people with understanding the nature of diabetes, its side effects and how to successfully deal with the condition. The doctoral project incorporates finding out how glucose monitoring, prescription administration, dieting propensities, and the significance of customary activities. With proper education the impact on one’s health with this chronic condition can improve for the better.

The nature of this doctoral project is to assess the impact that a diabetic education program and big data app have on three generations. Members of the group partnered with Hutton Healthcare in …

Impact Of Diabetes Self-Management Education On Hemoglobin A1c Levels In The Rural Patient Population, Barbara Adomakomensah Sarpong

Electronic Theses and Dissertations

The global prevalence of type 2 diabetes is one of the greatest health threats in society, especially in the rural population. Rural healthcare data analysis has proved a need for type 2 diabetes control education. Despite the existence of helpful diabetes control interventions, rural diabetes patients still struggle to maintain healthy behaviors, with about 60% of the patients recording hemoglobin A1c levels above 9. Many suffer severe conditions (e.g., stroke, kidney failure, and heart attacks) because of poor management of the condition. The project examined the impact of diabetes self-management education on hemoglobin A1c levels in the rural patient population. …

Enriching The Pcos Lifestyle, Callie Coleman

Electronic Theses and Dissertations

Polycystic Ovary Syndrome (PCOS) is an endocrine disorder affecting approximately 4 – 20% of women worldwide. It is associated with insulin resistance, fertility problems, and an increased susceptibility to chronic conditions through multiple inflammatory pathways. Women with PCOS are also at increased risk for disordered eating. The Mediterranean diet is associated with decreased inflammation and risk of chronic conditions, and intuitive eating principles are associated with decreased disordered eating patterns. The purpose of this study was to determine if a six-week nutrition education workshop incorporating information and skills related to both the Mediterranean lifestyle and intuitive eating principles can improve …

“Shoes Enthused”: The Application Of An Evidence-Based Practice Podiatry Consultation And Footwear Education In Older Adults Living With Diabetes, Alissa Kathleena Gray, Razel Bacuetes Milo

Doctor of Nursing Practice Final Manuscripts

Background: Poorly fitted footwear contributes to falls in older adults living with diabetes, a population that experiences a baseline increased risk for falls in the presence of diabetic peripheral neuropathy. Despite this, baseline data reveals that 72% of older adults wear poorly fitted shoes with suboptimal shoe features¹.

Purpose of Project: Adhering to current evidence-based practice guidelines, the two goals of this project were to educate older adults with diabetes on the characteristics of properly fitted footwear and to increase access to properly fitted shoes via a podiatry consultation. Subsequently, the increased number of optimal footwear will decrease …

Identify And Overcome The Barriers Of Care From A Patient And Provider Perspective In Adult Patients With Type 2 Diabetes Mellitus In A Federal Qualified Health Clinic: A Quality Improvement Project, Jill Miscovich

Doctor of Nursing Practice (DNP) Manuscripts

Diabetes is a significant healthcare issue that not only effects the United States but also has a global impact, it is costly for the workforce and to manage. Diabetes management is more complex in rural areas due to increased SDOH and barriers to care. The purpose of this quality improvement (QI) project is to identify and overcome the barriers to care from the patients and nurse practitioners’ (NPs) perspectives in adult patients with type 2 diabetes mellitus (T2DM) in a rural federal qualified health clinic (FQHC). A mixed method approach was used including qualitative and quantitative data project manager created …

Identify And Overcome The Barriers To Care From A Patient And Provider Perspective In Adult Patients With T2dm In A Rural Federal Qualified Health Clinic (Fqhc): A Quality Improvement (Qi) Project, Jill Miscovich

Doctor of Nursing Practice (DNP) Manuscripts

Diabetes is a significant healthcare issue that not only effects the United States but also has a global impact, it is costly for the workforce and to manage. Diabetes management is more complex in rural areas due to increased SDOH and barriers to care. The purpose of this quality improvement (QI) project is to identify and overcome the barriers to care from the patients and nurse practitioners’ (NPs) perspectives in adult patients with type 2 diabetes mellitus (T2DM) in a rural federal qualified health clinic (FQHC). A mixed method approach was used including qualitative and quantitative data project manager created …

Pricks And Pills, Anna A. Charles

Theses and Dissertations

"Pricks and Pills" is a collection of audio pieces designed for an online platform where individuals with diabetes can listen to and find emotional support from others who share their experiences. This audio project provides an intimate look into the lives of people navigating the challenges of diabetes. Through heartfelt interviews with individuals and their families, the podcast highlights their journeys, showcasing both their struggles and triumphs.

The Role Of Microrna-152 In The Pathogenesis Of Diabetic Cardiomyopathy, Joy Olaoluwa Gbadegoye

Alternative Theses and Dissertations (AETDs)

Diabetes mellitus, one of the world’s fast-growing diseases, is characterized by high death rates from cardiac complications named diabetic cardiomyopathy (DCM). DCM is a heart disease that occurs in both type 1 and 2 diabetes mellitus patients. Many management options have been explored in the management of DCM, including ACE inhibitors, beta-blockers, etc.; however, limited success has been recorded from these. MicroRNAs, recently discovered gene regulators, have been reported to be associated with various physiology and pathological processes in the mammalian body. These include cell proliferation, cell death, senesis, carcinogenesis, diabetes, and heart failure, among others. Various miRs have been …

Education Of The Effects Of Obesity Medications And A Stepwise Approach To Mitigate Prevalence And Encourage Lifestyle Medicine For Primary Care Physicians, Kiely M. Curran

Department of Nutrition Student Projects

My Capstone project is an Educational Manual that emphasizes a healthcare team approach to the treatment and management of obesity. The Educational Manual consists of a standardized protocol in management of obesity in patients and a document with summarized references for primary care providers; and a simplified document for patient education. There is a growing interest in the usage of obesity medications. The purpose of my Capstone project is to provide a simplified manual for the primary care provider to reference to make knowledgeable and patient-centered decisions in the prescription of obesity medications and decisions in weight-management. My methodology included …