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Diabetes

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Articles 61 - 90 of 94

Full-Text Articles in Nutritional and Metabolic Diseases

Part I: Complete Dentures And Diabetes Correlation, Ibeth Erazo Jul 2019

Part I: Complete Dentures And Diabetes Correlation, Ibeth Erazo

Publications and Research

Diabetes is one of the most frequent pathologies that dentists encounter, due to its high prevalence worldwide. The aim of this study is to present the correlation between diabetes and complete denture wearers, intending to emphasize the importance of proper control and denture adaptation to oral environment for this type of patient. Within the sphere of the dental office, one of the main complications to consider in this type of patient is periodontal disease, which is their most frequent complication. Other important oral manifestations considered in the research are fungal infections, xerostomia, and burning mouth syndrome. It is common for …


Exploring The Utility Of Muac In Classifying Adult Metabolic Syndrome Using Nhanes 2015-16, Hayley Boucher Jan 2019

Exploring The Utility Of Muac In Classifying Adult Metabolic Syndrome Using Nhanes 2015-16, Hayley Boucher

Williams Honors College, Honors Research Projects

INTRODUCTION: Metabolic syndrome (MetS) is a constellation of cardiometabolic risk factors that, when presented in tandem, increases the risk of heart disease and insulin resistance. Finding a simple and validated screening method is critical to proactively intervene and attenuate the development of cardiometabolic diseases and improving healthcare outcomes. PURPOSE: This study defined and validated a risk criterion for MetS using MUAC as an alternative criterion for MetS classification risk. METHODS: The sample was derived from National Health & Nutrition Examination Survey 2015-2016 data of adults over 18 years (N = 9,971). MetS was defined using the NCEP ATP III 2005 …


Evaluation Of The New Onset Diabetic Education Program For Navajo Adults, Denise S. Bartley Dec 2018

Evaluation Of The New Onset Diabetic Education Program For Navajo Adults, Denise S. Bartley

Nursing ETDs

The prevalence of diabetes mellitus (DM) is higher in American Indians/Alaska Natives (AI/AN) than in any other racial or ethnic group in the United States (U.S. Department of Health and Human Services [USDHHS] Centers for Disease Control and Prevention [CDC], 2018). In response to this escalating health issue, the U.S. government funded a number of DM education and treatment programs focusing on AI/AN populations. The purpose of this study was to evaluate the New Onset Diabetes Education Program (NODEP) based at Northern Navajo Medical Center (NNMC) in Shiprock, N.M.

The Navajo philosophy of learning was used as a guiding framework. …


Effective Measures Of Weight Gain Five Years Post-Kidney Transplantation, Tara Calico Cherry Dec 2018

Effective Measures Of Weight Gain Five Years Post-Kidney Transplantation, Tara Calico Cherry

Theses and Dissertations (ETD)

BACKGROUND: Weight gain is commonly observed post-kidney transplantation and is associated with unfavorable health outcomes, such as graft loss, new onset diabetes, and cardiovascular disease. The purpose of this study was to determine the most effective measure for assessing body composition after kidney transplantation.

DESIGN: The study was a descriptive correlational follow-up study from a single kidney transplant site.

SUBJECTS: A total of 45 eligible patients from a 2007-2011 parent study were selected, ages of 37 to 78.

MEASUREMENTS: Body composition was obtained 5–8 years posttransplant via anthropometric measures (waist circumference, body mass index, and dual energy X-ray …


Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu Aug 2018

Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu

Journal of Health Disparities Research and Practice

Background: In the US, the percentage of adults with diagnosed diabetes are higher in members of racial and ethnic minority groups compared to non-Latino Whites. Understanding why such disparities exist has been less forthcoming.

Methods: Secondary data analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) 1999-2000 cross-sectional data.

Results: H.pylori seropositivity was highest in Mexican Americans (43.7%), lowest in non-Hispanic Whites (18.1%). Diabetes was highest in non-Hispanic Blacks (5.9%); lowest in non-Hispanic whites (4.3%). H.pylori seropositivity was associated with greater likelihood of having type 2 diabetes (1.927, 95% CI 1.142, 3.257) compared to H.pylori negative in …


Niemann-Pick C1, Its Connection To Obesity, And Its Impact On Human Evolution, Joseph Joshua Castillo Jul 2018

Niemann-Pick C1, Its Connection To Obesity, And Its Impact On Human Evolution, Joseph Joshua Castillo

Biomedical Sciences ETDs

Niemann-Pick type-C disease is a rare autosomal recessive neurodegenerative disease that classically presents in the first decade, leading to ataxia, vertical-gaze palsy, loss of communication skills, epileptic seizures, and eventually death. The stark reality about NPC disease underlines the important role the NPC1 protein plays in whole-body lipid homeostasis. It is no surprise, then, that the NPC1 gene has been associated with other diseases as well, such as obesity, diabetes, and Ebola virus infection. In this manuscript, a connection will be made that intertwines genetics, biochemical and molecular mechanisms, physiology, and evolutionary pressures, and will explain how a gene, discovered …


Pediatric Type Ii Diabetes Mellitus: Examining The Upward Trend, Allison Foering Apr 2018

Pediatric Type Ii Diabetes Mellitus: Examining The Upward Trend, Allison Foering

Senior Honors Theses

In recent years, there has been a significant increase in pediatric onset of type II diabetes. This paper will examine elements contributing to this trend. Type II diabetes will be discussed, including related pathophysiology, manifestations, diagnosis, and complications, with differentiation between adult and pediatric onset. Possible prevention and treatment methods appropriate for pediatric patients will also be discussed, along with possible outcomes in pediatric patients that could result from this disease. Overall, this paper will provide insight on the causes of this growing trend, and ways to improve the risks imposed on pediatric patients.


Seychelles: Diabetes, Camille Myers Jan 2018

Seychelles: Diabetes, Camille Myers

Global Public Health

One of the major health problems in Seychelles, a cluster of islands off the coast of Eastern Africa, is diabetes. There are many different types of diabetes, but the most common type to this region is Type 2 diabetes. At this time Seychelles, and many other countries in Africa, have about half of the adult population diagnosed with Type 2 diabetes. Along with the diagnosis of diabetes being a problem, people in Seychelles often go undiagnosed for a while because they are ignorant to the risks and the symptoms of the disease. Only about 50% of the population with pre-diabetic …


A Call To Action On Prediabetes, Joy A. Moverley, Alegria Cantillep, Kathryn Newberry, Jay H. Shubrook Jan 2018

A Call To Action On Prediabetes, Joy A. Moverley, Alegria Cantillep, Kathryn Newberry, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Diabetes and prediabetes have become an epidemic in the United States. The keys to battling this public health challenge are effective screening and evidence-based interventions. Studies show that intensive lifestyle interventions, medications, and weight loss surgery can reduce or delay new-onset type 2 diabetes. This article reviews the steps clinicians can take to help patients stay ahead of this disease.


Mechanisms And Potential Therapy On Disrupted Blood Pressure Circadian Rhythm In Diabetes, Tianfei Hou Jan 2018

Mechanisms And Potential Therapy On Disrupted Blood Pressure Circadian Rhythm In Diabetes, Tianfei Hou

Theses and Dissertations--Pharmacology and Nutritional Sciences

Arterial blood pressure (BP) undergoes a 24-hour oscillation that peaks in the active day and reaches a nadir at night during sleep in humans. Reduced nocturnal BP fall (also known as non-dipper) is the most common disruption of BP circadian rhythm and is associated with increased risk of untoward cardiovascular events and target organ injury. Up to 75% of diabetic patients are non-dippers. However, the mechanisms underlying diabetes associated non-dipping BP are largely unknown. To address this important question, we generated a novel diabetic db/db-mPer2Luc mouse model (db/db-mPer2Luc) that allows quantitatively measuring of mPER2 protein oscillation …


Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu Jan 2018

Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu

Department of Nutrition and Health Sciences: Faculty Publications

Background: In the US, the percentage of adults with diagnosed diabetes are higher in members of racial and ethnic minority groups compared to non-Latino Whites. Understanding why such disparities exist has been less forthcoming.

Methods: Secondary data analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) 1999-2000 cross-sectional data.

Results: H.pylori seropositivity was highest in Mexican Americans (43.7%), lowest in non- Hispanic Whites (18.1%). Diabetes was highest in non-Hispanic Blacks (5.9%); lowest in non-Hispanic whites (4.3%). H.pylori seropositivity was associated with greater likelihood of having type 2 diabetes (1.927, 95% CI 1.142, 3.257) compared to H.pylori negative …


Improved Service Efficiency Improves Racial Disparity In Diabetic Care, Abel Irena, Kushal Patel, David Thompson, Gregory Schleis, Abiy Gesese, Richard Battiola Nov 2017

Improved Service Efficiency Improves Racial Disparity In Diabetic Care, Abel Irena, Kushal Patel, David Thompson, Gregory Schleis, Abiy Gesese, Richard Battiola

Journal of Patient-Centered Research and Reviews

Background: Racial disparities in diabetes care have been documented. Disparities also have been shown to affect service quality and outcome of diabetic care. Analysis of our internal medicine residency clinic diabetic care management performance across REAL-G (race, ethnicity, age, preferred language and/or gender) showed race-based disparity on two outcome measures: 1) measurement of glycohemoglobin (A1C) at least twice a year; and 2) target blood pressure of < 140/90.

Purpose: Develop interventions to decrease racial disparities in diabetes care among patients managed by an internal medicine residency clinic, as part of the Alliance of Independent Academic Medical Center’s National Initiative V project.

Methods: …


Pursuing Equity In Diabetes Population, Aisha Rawlinson Aug 2017

Pursuing Equity In Diabetes Population, Aisha Rawlinson

Master's Projects and Capstones

Abstract

Background

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

Project aim

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


Cardiometabolic Risk Factors, Metabolic Syndrome And Pre-Diabetes In Adolescents In The Sierra Region Of Ecuador, Sharon L. Casapulla, Cheryl A. Howe, Gabriela Rosero Mora, Darlene Berryman, Mario J. Grijalva, Edgar W. Rojas, Jay H. Shubrook Jan 2017

Cardiometabolic Risk Factors, Metabolic Syndrome And Pre-Diabetes In Adolescents In The Sierra Region Of Ecuador, Sharon L. Casapulla, Cheryl A. Howe, Gabriela Rosero Mora, Darlene Berryman, Mario J. Grijalva, Edgar W. Rojas, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Background: Excess weight (overweight and obesity) is the major modifiable risk factor for type 2 diabetes mellitus (T2DM) and other non-communicable diseases. However, excess weight may not be as predictive of diabetes risk as once thought. While excess weight and other obesity-related non-communicable diseases are of growing concern in low-middle income countries in Latin America, there is limited research on risk factors associated with T2DM in adolescents. This study investigated prevalence of overweight, obesity, prediabetes, diabetes and metabolic syndrome in adolescents in Ecuador.

Methods: A cross-sectional study was conducted with 433 adolescents from two schools in a small …


Age- And Sex-Related Changes In Fasting Plasma Glucose And Lipoprotein In Cynomolgus Monkeys, Feng Yue, Guodong Zhang, Rongping Tang, Zhouquan Zhang, Liqiong Teng, Zhiming Zhang Jun 2016

Age- And Sex-Related Changes In Fasting Plasma Glucose And Lipoprotein In Cynomolgus Monkeys, Feng Yue, Guodong Zhang, Rongping Tang, Zhouquan Zhang, Liqiong Teng, Zhiming Zhang

Neuroscience Faculty Publications

Background: The age-related dysfunction of glucose and lipid metabolism has a long-standing relationship with cardiovascular and neurodegenerative disease. However, the effects of metabolic dysfunction on men and women are different. Reasons for these sex differences remains unclear. Cynomolgus monkeys have been used, in the past, for the study of human metabolic diseases due to their biologically proximity to humans. Nevertheless, few studies to date have focused on both age- and sex-related differences in glucose and lipid metabolism. The present study was designed to specifically address these questions by using a large cohort of cynomolgus monkeys (N = 1,399) including …


The Waist To Height Ratio Is A Better Anthropometric Index Of Abdominal Obesity And Its Association With The Prevalence Of Diabetes Among Asian Americans, Yu Xiao Jan 2016

The Waist To Height Ratio Is A Better Anthropometric Index Of Abdominal Obesity And Its Association With The Prevalence Of Diabetes Among Asian Americans, Yu Xiao

All Master's Theses

There is limited information about diabetes prevalence among Asian Americans. Diabetes risk factors include abdominal obesity (AO), which can be assessed by measuring waist circumference (WC) or waist-to-height-ratio (WHtR). The purpose of this study was to compare the prevalence of diabetes among Asians with non-Asians in the United States and compare WC and WHtR as predictors of diabetes. Data from the National Health and Nutrition Examination Survey (NHANES) 2011-14 was analyzed using SAS 9.2. There were 8,615 adult non-pregnant non-Asians and 1,224 Asians included in this study. Despite a lower prevalence of obesity among Asians compared to non-Asians (12% vs …


Review Of Diabetes Among Aboriginal And Torres Strait Islander People, Samantha Burrow, Kathy Ride Jan 2016

Review Of Diabetes Among Aboriginal And Torres Strait Islander People, Samantha Burrow, Kathy Ride

Research outputs 2014 to 2021

Diabetes is the world’s fastest growing chronic disease. Type 2 diabetes in particular, has reached epidemic proportions globally and in Australia, and poses a challenge for public health systems everywhere. The greatest burden tends to fall on socially disadvantaged groups and Indigenous peoples Aboriginal and Torres Strait Islander Australians experience disproportionately high levels of diabetes. They are three times more likely to have diabetes than non-Indigenous Australians and Aboriginal and Torres Strait Islander women are almost twice as likely to develop gestational diabetes as non-Indigenous women. There is also evidence that Aboriginal and Torres Strait Islander children are eight times …


Diabetes Update: Your Guide To The Latest Ada Standards, Eric Johnson, Florence Warren, Neil Skolnik, Jay H. Shubrook Jan 2016

Diabetes Update: Your Guide To The Latest Ada Standards, Eric Johnson, Florence Warren, Neil Skolnik, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

The authors highlight the latest changes in the ADA standards and review recommendations of particular relevance for family physicians.


Diabetes Status, Predisposing, Enabling, And Oral Health Illness Level Variables As Predictors Of Preventive And Emergency Dental Service Use, Sabha Alshatrat Oct 2015

Diabetes Status, Predisposing, Enabling, And Oral Health Illness Level Variables As Predictors Of Preventive And Emergency Dental Service Use, Sabha Alshatrat

Health Services Research Dissertations

The purpose of this study was to clarify the relationship between diabetes and dental service use. This study addressed the question of whether individuals with diabetes are more or less likely to utilize dental services, measured in terms of preventive and emergency services during the past year. A cross-sectional study was conducted to assess the contributions of diabetes status to dental service use, relative to the contributions of Andersen and Newman Framework of Health Services Utilization dimensions (predisposing, enabling, and illness variables) in predicting dental service utilization during the past year using a nationally representative sample from a 2001-2002 National …


Shining The Spotlight On Diabetes, Rodney Richmond Mar 2015

Shining The Spotlight On Diabetes, Rodney Richmond

Faculty Research ​and Publications

No abstract provided.


Insulin Pumps: Beyond Basal-Bolus, Richard Millstein, Nancy Mora Becerra, Jay H. Shubrook Jan 2015

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.


Regulation Of Ghrelin: A Possible Treatment Option For Obesity And Diabetes, Sarah Picciotto Jan 2015

Regulation Of Ghrelin: A Possible Treatment Option For Obesity And Diabetes, Sarah Picciotto

The Science Journal of the Lander College of Arts and Sciences

Obesity is a mounting problem in America today. One major concern about obesity is that it is a risk factor for type 2 diabetes, a disease that impairs insulin sensitivity and secretion. This interferes with blood glucose levels and can cause hyperglycemia, which is when there is too much circulating glucose in the blood. Ghrelin, an amino acid peptide responsible for appetite stimulation and energy balance, plays a direct role in insulin secretion and glucose metabolism. In many experiments, elevated ghrelin levels are associated with decreased insulin secretion from pancreatic islet cells. Although ghrelin concentration is decreased in obese individuals …


Regulation Of Pancreatic Β-Cell Function By The Renin-Angiotensin System In Type 2 Diabetes, Robin C. Shoemaker Jan 2015

Regulation Of Pancreatic Β-Cell Function By The Renin-Angiotensin System In Type 2 Diabetes, Robin C. Shoemaker

Theses and Dissertations--Pharmacology and Nutritional Sciences

Diet-induced obesity promotes type 2 diabetes (T2D). Drugs that inhibit the renin-angiotensin system (RAS) have been demonstrated in clinical trials to decrease the onset of T2D. Previously, we demonstrated that mice made obese from chronic consumption of a high-fat (HF) diet have marked elevations in systemic concentrations of angiotensin II (AngII). Pancreatic islets have been reported to possess components of the renin-angiotensin system (RAS), including angiotensin type 1a receptors (AT1aR), the primary receptor for AngII, and angiotensin converting-enzyme 2 (ACE2), which negatively regulates the RAS by catabolizing AngII to angiotensin-(1-7) (Ang-(1-7)). These two opposing proteins have been implicated in the …


Can A Vegetarian Diet Improve Quality Of Life In Type 2 Diabetics, Compared To Other Diabetic Diets?, Carly A. Kindbom Jan 2015

Can A Vegetarian Diet Improve Quality Of Life In Type 2 Diabetics, Compared To Other Diabetic Diets?, Carly A. Kindbom

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine if a vegetarian diet is more effective in improving quality of life in Type 2 Diabetics compared to other diabetic diets.

STUDY DESIGN: Review of two randomized control trials published in 2011 and 2013, and one prospective clinical intervention study published in 2010.

DATA SOURCES: Data sources were articles published in peer review journals found using PubMed and Cochrane Databases.

OUTCOMES MEASURED: Quality of life was measured by amount of weight loss from baseline and Obesity and Weight-Loss Quality of Life (OWLQOL) questionnaires.

RESULTS: Ferdowsian et al (2010) reported …


Prepregnancy Low-Carbohydrate Dietary Pattern And Risk Of Gestational Diabetes Mellitus: A Prospective Cohort Study, Wei Bao, Katherine Bowers, Deirdre K. Tobias, Sjurdur F. Olsen, Jorge Chavarro, Allan Vaag, Michele Kiely, Cuilin Zhang Apr 2014

Prepregnancy Low-Carbohydrate Dietary Pattern And Risk Of Gestational Diabetes Mellitus: A Prospective Cohort Study, Wei Bao, Katherine Bowers, Deirdre K. Tobias, Sjurdur F. Olsen, Jorge Chavarro, Allan Vaag, Michele Kiely, Cuilin Zhang

Publications and Research

Background: Low-carbohydrate diets (LCDs) have been vastly popular for weight loss. The association between a low-carbohydrate dietary pattern and risk of gestational diabetes mellitus (GDM) remains unknown.

Objective: We aimed to prospectively examine the association of 3 prepregnancy low-carbohydrate dietary patterns with risk of GDM.

Design: We included 21,411 singleton pregnancies in the Nurses’ Health Study II. Prepregnancy LCD scores were calculated from validated food-frequency questionnaires, including an overall LCD score on the basis of intakes of carbohydrate, total protein, and total fat; an animal LCD score on the basis of intakes of carbohydrate, animal protein, and animal …


The Interplay Of Diabetes, And Health Self Efficacy, Cognition And Compliance, Joseph Indelicato, Vanessa Gilchriest Jan 2014

The Interplay Of Diabetes, And Health Self Efficacy, Cognition And Compliance, Joseph Indelicato, Vanessa Gilchriest

The School of Health Sciences Publications and Research

The authors argue that screening tools for health self efficacy and cognitive impairment in patients with diabetes should be created to help implement interventions which would be most useful to those patients.


Effects Of Fatty Acids And Glycation On Drug Interactions With Human Serum Albumin, Jeanethe Anguizola, Sara B. G. Basiaga, David S. Hage Sep 2013

Effects Of Fatty Acids And Glycation On Drug Interactions With Human Serum Albumin, Jeanethe Anguizola, Sara B. G. Basiaga, David S. Hage

David Hage Publications

The presence of elevated glucose concentrations in diabetes is a metabolic change that leads to an increase in the amount of non-enzymatic glycation that occurs for serum proteins. One protein that is affected by this process is the main serum protein, human serum albumin (HSA), which is also an important carrier agent for many drugs and fatty acids in the circulatory system. Sulfonylurea drugs, used to treat type 2 diabetes, are known to have significant binding to HSA. This study employed ultrafiltration and high-performance affinity chromatography to examine the effects of HSA glycation on the interactions of several sulfonylurea drugs …


The Obesity Epidemic, Lenka Kollar, Evienne Epifano, Molly Mckneight, Jeff Miskovich, Heather Moore Jun 2013

The Obesity Epidemic, Lenka Kollar, Evienne Epifano, Molly Mckneight, Jeff Miskovich, Heather Moore

Student Papers in Public Policy

The incidence of chronic, noncommunicable diseases, such as heart disease, is increasing at an alarming rate on the global scale. The growing prevalence of overweight and obesity have led to an upsurge in cases of diabetes and other obesity-related diseases. About 18 million people die every year from heart disease, of which diabetes and obesity are major predisposing factors. Worldwide, more than 1.1 billion adults are overweight, 312 million of which are obese. The number of children that are overweight or obese is also growing (Hossain, Parvez et al.). Obesity, and the associated diseases, has become a worldwide epidemic and …


Factors That Influence Food Access In The United States: A Snapshot Of Food Access In Ohio And Kentucky, Maimouna Falls Jan 2012

Factors That Influence Food Access In The United States: A Snapshot Of Food Access In Ohio And Kentucky, Maimouna Falls

Master of Public Health Program Student Publications

Background: The United States is one the richest countries in the world with a Gross Domestic Product (GDP) per capita of $48,442, yet many communities lack access to affordable nutritious food. Access to food impacts health outcomes such as obesity and diabetes. The purpose of this study was to determine the association between food access and rates of obesity and diabetes in the states of Ohio and Kentucky.

Methods: County level food access data from 120 counties in Kentucky and 88 counties in Ohio were obtained from the USDA website. The dataset included demographic variables and poverty rates. Food access …


Age At Diagnosis Of Diabetes In Appalachia, Lawrence Barker, Robert Gerzoff, Richard Crespo, Molly Shrewsberry Sep 2011

Age At Diagnosis Of Diabetes In Appalachia, Lawrence Barker, Robert Gerzoff, Richard Crespo, Molly Shrewsberry

Family and Community Health

Background

Appalachia is a region of the United States noted for the poverty and poor health outcomes of its residents. Residents of the poorest Appalachian counties have a high prevalence of diabetes and risk factors (obesity, low income, low education, etc.) for type 2 diabetes. However, diabetes prevalence exceeds what these risk factors alone explain. Based on this, the history of poor health outcomes in Appalachia, and personally observed high rates of childhood obesity and lack of concern about prediabetes, we speculated that people in Appalachia with diagnosed diabetes might tend to be diagnosed younger than their non-Appalachian counterparts.

Methods …