Ethnic Differences In Maternal Adipokines During Normal Pregnancy, Xinhua Chen, Theresa O Scholl

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Two adipokines (adiponectin and resistin) have opposite relations with insulin resistance and inflammation. Our major focus was to determine whether there were detectable ethnic differences in maternal adipokines during pregnancy. We also explored the correlation of the adipokines with maternal glucose homeostasis, blood pressure and anthropometric parameters. Pregnant women (n = 1634) were from a large prospective cohort study in Camden NJ (African-American 36.8%; Hispanic 47.6%; Caucasian 15.6%). Serum adiponectin and resistin were measured at entry (week 16.8) and the 3rd trimester (week 30.7) using the Luminex xMapTechnology. Significant differences were observed among ethnic groups, controlling for confounding variables. African …

The Feedforward And Feedback Controls On Gait In Adults With Diabetes, Chun-Kai Huang

Theses & Dissertations

There are nearly 26 million people with diabetes mellitus (DM) in the US, and half of chronic DMs develop somatosensory deficits due to diabetic polyneuropathy or diabetic peripheral neuropathy (DPN). The absence or impaired somatosensory feedback (e.g. touch sensation or joint proprioception) resulted from the damage of large nerve fiber, and motor deficits such as attenuated muscle strength and abnormal plantar pressure of lower extremity have been identified in DPN, and these sensorimotor impairments lead to an increased number of falls. To reduce the risk of falling, a well-coordinated and adapted limb movement driven by the feedforward (anticipatory) and feedback …

Enhanced Fitness And Renal Function In Type 2 Diabetes., Eric S. Nylen, S. M. Gandhi, Raya E. Kheirbek, Peter Kokkinos

Medicine Faculty Publications

Aims

To investigate the renal effects of fitness in people with diabetes with mild renal dysfunction.

Methods

The effect of a 12-week exercise programme on estimated GFR in 128 people with diabetes was evaluated.

Results

All cardiometabolic variables improved after 12 weeks of supervised exercise. Although there was a modest 3.9% increase in estimated GFR from baseline in the 128 people who completed the study, those with baseline chronic kidney disease stages 2 and 3 were found to have significant (6 and 12%, respectively; p < 0.01) improvements in post-exercise estimated GFR. Moreover, 42% of the people with chronic kidney disease stage 3 improved to chronic kidney disease stage 2 after the intervention.

Conclusion

Short-term exercise improves renal function in those with more moderate baseline chronic kidney disease. …

New-Onset Diabetes Mellitus With Exposure To Ledipasvir And Sofosbuvir., Resmi Premji, Nira Roopnarinesingh, Nazia Qazi, Eric S. Nylen

Medicine Faculty Publications

The combination therapy of ledipasvir/sofosbuvir was approved by the Food and Drug Administration in 2014 for the treatment of chronic hepatitis C. Although hyperglycemia is not well known to occur with its use, we present 2 cases of new-onset diabetes mellitus and a review of the literature suggesting an adverse event association. In the first patient with HIV, we postulate that ledipasvir/sofosbuvir increased the levels of tenofovir and thereby potentiated hyperglycemia. In the second case of a patient with prediabetes, ledipasvir/sofosbuvir appeared to increase insulin resistance. A literature review further supported an association of hyperglycemia and the use of ledipasvir/sofosbuvir. …

Diabetic Ketoacidosis, Mario Bianconi

Nursing Student Class Projects (Formerly MSN)

According to “Statistics About Diabetes” (2014), in 2012, 29.1 million Americans, or 9.3% of the population, had diabetes. Additionally, of the 29.1 million, 21 million of the population were diagnosed, and 8.1 million were undiagnosed. With such a high prevalence, it is imperative that the hospital nurse is aware not only how to treat diabetes, but also how to look for complications of diabetes. One of the severe complications of diabetes is Diabetic Ketoacidosis, or DKA. DKA occurs as a result of prolonged untreated diabetes. It is the result of the body not being able to produce, or use, insulin …

Maggot Therapy For Treating Diabetic Foot Ulcers, Amber Nikolaus

Nursing Student Class Projects (Formerly MSN)

Diabetes mellitus, Type 1 and Type 2, are associated with numerous debilitating consequences. One of the most common and serious complication is diabetic foot ulcers (DFU) (Baltzis, Elftheriadou, and Veves, 2014, p.817). DFUs are “caused by loss of glycemic control, peripheral neuropathy, peripheral vascular disease, and immunosuppression” and account for greater than 80,000 amputations per year in the United States (Aumiller & Dollahite, 2015, p.28). Approximately 15% of people with diabetes have diabetic foot ulcers (Aumiller & Dollahite, 2015, p.28) and studies demonstrate that 45% to 55% of patients presenting with neuropathic and ischemic diabetic foot ulcers will die within …

Insulin Resistance Due To Obesity, Chasity Crist

Nursing Student Class Projects (Formerly MSN)

Diabetes is defined as a common metabolic disorder where hyperglycemia or elevated glucose levels are prevalent (Shah & Vella, 2014). The most common form of diabetes is type two diabetes (T2DM) and effects around 9.3% of the population in the United States (Cornell, 2015, p. 631). The pathophysiology of this disease includes involvement from the pancreas, liver, skeletal muscle, adipose tissue, gastrointestinal tract, brain, and kidneys. Hyperglycemia is high blood sugar levels that effects multiple organs (Rymaszewski & Breakwell, 2013). Protocols are developed to allow nurses to identify and treat hyper/hypoglycemia. Patient education is a direct impact of the long …

Type Ii Diabetes And Its Treatment, Gregory Mountain

Nursing Student Class Projects (Formerly MSN)

Approximately 28.9 million Americans have been diagnosed with type II diabetes (Jia-Haur Hu, Lin, Miller, Nguyen, & Nguyen, 2014). It is a disease that can cause or potentiate numerous comorbidities that negatively affects multiple body systems if left untreated (Jia-Haur Hu, et al., 2014). In 2012, the total estimated cost for treatment of type II diabetes in America was an astronomical $245 billion (Jia-Haur Hu, et al., 2014). Type II diabetes is a result of many cellular processes that lead to insulin resistance resulting in increased blood glucose levels (Jia-Haur Hu, et al., 2014). Treatments for type II diabetes include …

Autoimmune Thyroiditis: A Look Into Hashimoto’S Disease, Jessica Hannan

Nursing Student Class Projects (Formerly MSN)

Thyroid disease is a general term utilized to describe a variety of conditions affecting the thyroid gland, including hypothyroidism, the deficient production of thyroid hormone; hyperthyroidism, the excess production of thyroid hormone; and goiter, the physiologic swelling of the thyroid gland (Cihakova, 2001; Warren, 2014). Primary hypothyroidism is the most prevalent thyroid disease in the United States, most frequently occurring as a result of chronic autoimmune thyroiditis, specifically Hashimoto’s Disease (Warren, 2014). Hashimoto’s disease (HD), also known as Hashimoto’s thyroiditis and human autoimmune thyroiditis, was named after Hakaru Hashimoto, a Japanese medical scientist who first described the condition in 1912 …

Diabetic Gastroparesis, Noreen Burris Welch

Nursing Student Class Projects (Formerly MSN)

According to the 2014 Centers for Disease Control (CDC) 9.3% of the United States Population have diabetes (National diabetes statistics report, “2014, p.1). One of the complications of diabetes is gastroparesis. Gastroparesis is “a delay in the emptying of ingested food in the absence of mechanical obstruction of the stomach or duodenum ‘’ (Koch & Calles-Escandon, 2015, p. 40). Mortality in the diabetic patient with gastroparesis is higher than the diabetic patient without gastroparesis (Koch & Calles-Escandon, 2015). Patients with either type 1 diabetes (T1DM) or type 2 diabetes (T2DM) may experience he clinical symptoms of early satiety, prolonged fullness, …

Hyperglycemic Hyperosmolar State: A Diabetic Emergency, Rachel Fisher

Nursing Student Class Projects (Formerly MSN)

Hyperglycemic hyperosmolar state (HHS) is an acute complication associated with diabetes mellitus. HHS has been known by several other names in the past. These labels include Hyperosmolar Nonketotic Coma, Hyperosmolar Hyperglycemic Nonketotic Coma, and Hyperglycemic Hyperosmolar Nonketotic Syndrome (Hackel, 2014). HHS is characterized by severe hyperglycemia, profound dehydration, and is often accompanied by altered mental status. Less than 1% of diabetes-related admissions are due to HHS, but mortality rates are estimated to be 10% to 20% (Lenahan & Holloway, 2015). HHS typically affects the older adult population, with the average age of HHS patients being 60 years (Collopy, Kivlehan, & …

Hashimoto’S Disease: The Underactive Thyroid Disease, Patty Anderson

Nursing Student Class Projects (Formerly MSN)

The thyroid gland is part of the endocrine system and has a widespread function that controls multiple organ systems and processes. The main function of the thyroid gland is to produce and secrete two different thyroid hormones: triiodothyronine (T3) and thyroxine (T4), both of which help to meet the metabolic demands of the entire body. When the thyroid gland fails to produce T3/T4 hormones (primary gland failure) or is not activated successfully by the pituitary gland (by the release of thyroid stimulating hormone (TSH)), or hypothalamus, this results in low levels of circulating thyroid hormone. As low levels of the …

Implications Of Underlying Pathophysiology Of Osteomyelitis In Diabetics For Nursing Care, Danielle Spencer

Nursing Student Class Projects (Formerly MSN)

Osteomyelitis is an infection of the bone caused by either bacteria, fungi, parasites, viruses or mycobacteria (McCance, et. al., 2014). The infection can enter bone either through an outside source or through the blood from a blood borne infection (McCance, et. al., 2014). The most common bacteria involved with osteomyelitis is Staphylococcus aureus (Hatzenbuehler & Pulling, 2011, p. 1027). Recently, at Dublin Methodist Hospital there has been an increase in the number of osteomyelitis cases in chronic uncontrolled diabetic patients requiring below the knee amputations. Two of the cases specifically were linked to chronic diabetic foot ulcers. Each of these …

Fatalism, Diabetes Management Outcomes, And The Role Of Religiosity, Vincent Berardi, John Bellettiere, Orit Nativ, Slezak Ladislav, Melbourne Hovell, Orna Baron-Epel

Psychology Faculty Articles and Research

This study aimed to determine whether fatalistic beliefs were associated with elevated levels of glycated hemoglobin (HbA1c) and to establish the role of religiosity in this relationship. A cross-sectional survey was conducted on a sample of 183 Jewish adults with diabetes visiting a large medical center in northern Israel. Self-administered questionnaires assessed level of religiosity, fatalistic beliefs, diabetes management behaviors, and demographic/personal characteristics; laboratory tests were used to measure HbA1c. Multivariate regression indicated that fatalism was significantly associated with HbA1c (β = 0.51, p = 0.01). The association was no longer statistically significant after including self-reported religiosity in the …

In-Patient Self-Management Diabetes Education, Amy Matthews

Master's Projects and Capstones

The diabetes program strives to provide diabetes self-management education to the in-patient with diabetes. The specific aim is to improve and standardize diabetes education for the inpatient with diabetes by June 2015. The microsystem is a medical surgical unit for patients 18 years and older who present with diabetes as either a primary diagnosis or secondary diagnosis. Fifty percent of the diabetes patients on this unit are ages 65-89 years old, twenty nine percent are ages 50-64. The unit has 32 beds and is filled to capacity ninety five percent of the time. The fishbone diagram revealed our microsystem lacked …

Using Technology To Improve Diabetes Self-Management Within A Federally Qualified Community Health Center, Lisa Diane Morgan

Doctoral Projects

The Patient Centered Medical Home (PCMH) concept places the patient and family at the center of healthcare. The patient becomes actively involved in their own care. One aspect of PCMH is managing care and increasing chronic disease self-management. Diabetes, a chronic disease, is a leading diagnosis among the patients served by the federally qualified community health center (FQCHC). The prevalence of diabetes in Mississippi in 2012 was 12.3%. The purpose of this DNP Capstone project was to implement a pilot study to increase diabetes self-management knowledge. The program utilized the current technology of text messaging to send biweekly supportive and …

The Effect Of Run Sprint Interval Training On Diabetic Metabolic Markers In Prediabetic Adults, Kathryn L. Hilovsky

Masters Theses, 2010-2019

Abstract

Purpose: The primary purpose of this study was to compare the effects of an 8-week run-sprint interval training (R-SIT) and continuous moderate-intensity training (MIT) on fasting blood glucose, HbA1c, insulin sensitivity, and β-cell function in sedentary, prediabetic adults. Secondary outcomes of the study included anthropometric, body composition variables, and aerobic capacity.

Methods: Sedentary, physician diagnosed prediabetic individuals were randomized into R-SIT (n=7, BMI 36.76 ± 9.79) or MIT (n=8, BMI 40.59 ± 12.49) interventions. Subjects participated in supervised exercise three times a week and attended a Diabetes Prevention Program course, once weekly. R-SIT participants performed 4-6 x 30-second …

Efficacy Of Behavioral Interventions In African-Americans With Type Ii Diabetes: A Comparative Effectiveness Analysis, Tangela Nicole Hales

Dissertations

Context: The efficiency and effectiveness of the healthcare system are prime foci for nursing research.

Objective:The purpose of this study was to review and critically appraise the current state of the evidence in the treatment of African American adults with type II diabetes. To address this objective, a systematic review was undertaken that investigated the comparative effectiveness of behavioral interventions in improving glycemic control.

Methods: Robust methodological approaches to comparative effectiveness research (CER) serve to improve the transparency, consistency, and scientific rigor of the research. The methods for this systematic review of literature followed those recommended in the Agency …

Diabetes Distress: Transforming A Practice, Goff M. Jeannie

Doctor of Nursing Practice Scholarly Projects

Diabetes mellitus affects millions of people in the United States, placing them at risk for other disease related complications. This makes the management of diabetes and the prevention of complications an important challenge. The psychological aspect of diabetes care may present a barrier to patients that inhibit them from achieving optimal self-care.

Diabetes distress (DD) is the psychological aspect of diabetes that is specific to the emotional distress caused from living a chronic disease. DD has been linked to poorer self-management behaviors which makes it a significant problem that should be taken into consideration for effective management of the diabetic …

A Six-Week Home Exercise Program Improves Endothelial Function And Cd34+ Circulating Progenitor Cells In Patients With Pre-Diabetes, Sabyasachi Sen, Sarah Witkowski, Ann Lagoy, Ashequl Islam

Medicine Faculty Publications

Background: Pre-diabetes is associated with endothelial dysfunction and affects endothelium-associated stem cells. Lifestyle modification has been shown to prevent the progression from pre-diabetes to overt type 2 diabetes; however, the effect of such interventions on CD34⁺ progenitor cells in pre-diabetes participants has not been tested. The purpose of this study was to determine whether a home-based 6-week exercise intervention improved vascular function, circulating number, function, and gene expression of circulating CD34⁺progenitor cells in patients with pre-diabetes.

Methods: Patients (40 - 70 years, BMI of 25 - 39.9, n = 11) were enrolled in a 16-week randomized crossover …

Should People Be More Educated On Type 1 Diabetes?, Adrianna Braggs

Nebraska College Preparatory Academy: Senior Capstone Projects

Many people know about so many diseases that are happening in the world today yet Type 1 Diabetes remains a mystery. Type I Diabetes (TD1) is an autoimmune disease in which a person’s pancreas stops producing insulin, a hormone that enables people to get enough energy from food. Research on this topic is important because many children and young adults are diagnosed with the disease yet the education is lacking.

Protein Composition And Movements Of Membrane Swellings Associated With Primary Cilia, Ashraf M. Mohieldin, Hanan S. Haymour, Shao T. Lo, Wissam A. Aboualaiwi, Kimberly F. Atkinson, Christopher J. Ward, Min Gao, Oliver Wessely, Surya M. Nauli

Pharmacy Faculty Articles and Research

Dysfunction of many ciliary proteins has been linked to a list of diseases, from cystic kidney to obesity and from hypertension to mental retardation. We previously proposed that primary cilia are unique communication organelles that function as microsensory compartments that house mechanosensory molecules. Here we report that primary cilia exhibit membrane swellings, which based on their unique ultrastructure and motility, could be mechanically regulated by fluid-shear stress. Together with the ultrastructure analysis of the bulb, which contains monosialodihexosylganglioside (GM3), our results show that ciliary membrane swelling has a distinctive set of functional proteins, including GM3 synthase (GM3S), bicaudal-c1 (Bicc1) and …

The Cell's Antenna And Bending With The Flow, Surya M. Nauli, Kimberly F. Atkinson, Sarmed H. Kathem

Pharmacy Faculty Articles and Research

Polycystic kidney disease (PKD) is the most common life-threatening genetic disease worldwide – affecting about 12.5 million people. Patients with the condition have multiple fluid-filled cysts in their kidneys that lead to a massive enlargement of the organ and gradual worsening of its function, as well as complete failure in many cases. The lack of available treatment means patients may eventually require regular dialysis or a kidney transplant.

Treating The Cognitive And Social Dysfunctions Related To Type 2 Diabetes, Joseph Indelicato

The School of Health Sciences Publications and Research

While much has been written about the effects of diabetes on cardiovascular functioning, less attention has been paid upon the role of diabetes on cognitive functioning. While researchers are still debating the pathophysiology of the cognitive dysfunction triggered by diabetes, including the possibility that Alzheimer’s being Type III diabetes, among other possibilities. Less research has targeted addressing these problems among those with diabetes. Social problems associated with having cognitive dysfunctions in diabetics, have received very little attention. Social activities are perhaps the most difficult and complicated behaviors humans engage in, Even the concept of measurable Social Intelligence comes relatively new …

Geographic Variation In Antidiabetic Agent Adherence And Glycemic Control Among Patients With Type 2 Diabetes, Eleanora Tan, Wenya Yang, Bo Pang, Mingliang Dai, F. Ellen Loh, Paul Hogan

Touro College of Pharmacy (New York) Publications and Research

BACKGROUND: Medication nonadherence is an imperative public health concern. Among patients with type 2 diabetes mellitus (T2DM), poor adherence to antidiabetic agents is strongly associated with suboptimal glycemic control. Poor adherence and hyperglycemia greatly increase diabetes-related morbidity and mortality. At a national level, diabetes drug adherence using average proportion of days covered (PDC) is estimated to range between 36% and 81%, with an estimated range for diabetes control between 38% and 47%. At a state level no such studies exist.

OBJECTIVE: To estimate the level of medication adherence to antidiabetic agents and of diabetes control, and their association among patients …

The Cost-Effectiveness Of Diabetes Prevention: Results From The Diabetes Prevention Program And The Diabetes Prevention Program Outcomes Study, William Herman

GW Biostatistics Center

Background

The Diabetes Prevention Program (DPP) was a randomized, controlled clinical trial. It demonstrated that among high-risk individuals with impaired glucose tolerance, diabetes incidence was reduced by 58 % with lifestyle intervention and 31 % with metformin compared to placebo. During the Diabetes Prevention Program Outcomes Study (DPPOS), all DPP participants were unmasked to their treatment assignments, the original lifestyle intervention group was offered additional lifestyle support, the metformin group continued metformin, and all three groups were offered a group-implemented lifestyle intervention. Over the 10 years of combined DPP/DPPOS follow-up, diabetes incidence was reduced by 34 % in the lifestyle …

What To Do After Basal Insulin: 3 Tx Strategies For Type 2 Diabetes, Lubaina Presswala, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

While many family physicians have become comfortable with using once-daily basal insulin such as glargine or detemir, what to do after basal insulin is much more complex. This review builds upon an earlier article in this journal, “Insulin for type 2 diabetes: How and when to get started,” by explaining 3 strategies to consider when basal insulin alone isn't enough.

Insulin Pumps: Beyond Basal-Bolus, Richard Millstein, Nancy Mora Becerra, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Insulin pumps are a major advance in diabetes management, making insulin dosing easier and more accurate and providing great flexibility, safety, and efficacy for people who need basal-bolus insulin therapy. They are the preferred treatment for people with type 1 diabetes and many with type 2 diabetes who require insulin. This article reviews the basics of how insulin pumps work, who benefits from a pump, and how to manage inpatients and outpatients on insulin pumps.

Effect Of Tai Chi Exercise Combined With Mental Imagery Theory In Improving Balance In A Diabetic And Elderly Population, Abdulrahman Alsubiheen, Jerrold S. Petrofsky, Noha S. Daher, Everett Lohman, Edward Balbas

College of Health & Human Services (TUN) Publications and Research

BACKGROUND: One of the effects of diabetes mellitus (DM), peripheral neuropathy, affects the sensation in the feet and can increase the chance of falling. The purpose of the study was to investigate the effect of 8 weeks of Tai Chi (TC) training combined with mental imagery (MI) on improving balance in people with diabetes and an age matched control group.
MATERIAL AND METHODS: Seventeen healthy subjects and 12 diabetic sedentary subjects ranging from 40–80 years of age were recruited. All subjects in both groups attended a Yang style of TC class using MI strategies, 2 sessions a week …

Dopaminergic Signaling Within The Primary Cilia In The Renovascular System, Kimberly F. Atkinson, Samred H. Kathem, Xingjian Jin, Brian S. Muntean, Wissam A. Aboualaiwi, Andromeda M. Nauli, Surya M. Nauli

Pharmacy Faculty Articles and Research

Activation of dopamine receptor type-5 (DR5) has been known to reduce systemic blood pressure, most likely by increasing renal vasodilation and enhancing natriuresis in the kidney. However, the mechanism of DR5 in natriuresis and vasodilation was not clearly known. We have previously shown that DR5 is localized to primary cilia of proximal renal epithelial and vascular endothelial cells. We here show that selective activation of DR5 specifically induces calcium influx only in the primary cilia, whereas non-selective activation of dopamine receptor induces calcium fluxes in both cilioplasm and cytoplasm. Cilia-independent signaling induced by thrombin only shows calcium signaling within cytoplasm. …