Medical Specialties Commons^™

Chromosomal Localization Of The Islet Neogenesis Associated Protein (Ingap) Gene In Syrian Hamster By Tyramide Signal Amplification-Fluorescence In Situ Hybridization (Tsa-Fish), Sallie A. Smith

Biological Sciences Theses & Dissertations

Diabetes mellitus is a group of conditions characterized by hyperglycemia due to an inability to produce or properly utilize insulin. The majority of cases fall into two categories, Type I and Type 2. Type I results from the autoimmune destruction of pancreatic β-cells of the islets. The beta cells are the exclusive source of insulin and the patient becomes entirely dependent on exogenous insulin to survive. Patients with Type 2 are distinguished by insulin resistance, a condition that develops due to the inability of the body to effectively use the insulin being produced. The β-cells gradually lose their ability to …

The Relationship Of Attitude, Self-Efficacy, Physician, And Significant Other Influence To Type 2 Diabetes Outcomes, Heidi A. Larson

All-Inclusive List of Electronic Theses and Dissertations

The purpose of this study was to investigate the Theory of Planned Behavior (TPB) and its' relationship to Type 2 diabetes outcomes. One hundred and sixty-two adults ages 45 to 75 with Type 2 diabetes were recruited from two physicians' offices in the Midwest. Participants completed instruments that assessed (a) diabetes-specific attitude, (b) diabetes-specific self-efficacy, ( c) physician influence, ( d) significant other influence, and ( e) diabetes-specific quality of life. A measurement of metabolic control was also obtained. Multiple regressions were performed using (a) quality of life and (b) metabolic control as criterion variables. Attitude, self-efficacy, and physician influence …

The Effect Of Electrical Stimulation On Blood Flow In Chronic Wounds In Patients With And Without Diabetes, Daryl J. Lawson

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose. Only 3% of the U S population is afflicted by diabetes, yet one of the most common chronic wounds is the diabetic ulcer. Decrease in blood flow may be one reason why only 31% of neuropathic diabetic ulcers heal in 20-weeks. The purpose of this investigation was to compare healing rates and blood flow of chronic stage III and IV wounds in people with diabetes and those without diabetes over four weeks of treatment. Blood flow was measured before, during, and after stimulation using one of two different electrical stimulation waveforms in a 32°C room.

Subjects …

Multiple Metabolic Hits Converge On Cd36 As Novel Mediator Of Tubular Epithelial Apoptosis In Diabetic Nephropathy., Katalin Susztak, Emilio Ciccone, Peter Mccue, Kumar Sharma, Erwin P Böttinger

Department of Medicine Faculty Papers

BACKGROUND: Diabetic nephropathy (DNP) is a common complication of type 1 and type 2 diabetes mellitus and the most common cause of kidney failure. While DNP manifests with albuminuria and diabetic glomerulopathy, its progression correlates best with tubular epithelial degeneration (TED) and interstitial fibrosis. However, mechanisms leading to TED in DNP remain poorly understood.

METHODS AND FINDINGS: We found that expression of scavenger receptor CD36 coincided with proximal tubular epithelial cell (PTEC) apoptosis and TED specifically in human DNP. High glucose stimulated cell surface expression of CD36 in PTECs. CD36 expression was necessary and sufficient to mediate PTEC apoptosis induced …

Thyroid Hormone-Regulated Skeletal Muscle Glut4 Glucose Transporter Trafficking During Fasting In Diet-Induced Obesity And Insulin Resistance, Lucy Soo Yon Jun

Theses Digitization Project

This thesis project will investigate the effects of fasting on the serum levels of two key regulatory hormones, insulin and thyroid hormone (T3) and the effects of these hormones on the trafficking of Glut4 on soleus muscle.

Clinical Presentation Of Thyroid Cancer Patients In Pakistan--Akuh Experience, L M. Zuberi, A Yawar, N Islam, A Jabbar

Section of Diabetes, Endocrinology and Metabolism

Objective: To asses the clinical presentation of patients with thyroid cancer, their preferred diagnostic work-up and preferred surgical procedure.

Methods: A retrospective chart review of patients that underwent partial or total thyroidectomy for thyroid cancer at AKUH between 1989 and 2002. SPSS was used to analyze data. Pearson's chi square and likelihood ratios used to calculate tests of significance.

Results: A total of 97 patients were included in this review. Solitary thyroid nodule was the initial presentation in three. Majority (58.7%) presented with "neck swelling" or enlarging goiter. One out of every 3 patients showed evidence of lymph …

Clinical Features And Outcome Of Surgery In 30 Patients With Acromegaly, A Chandna, N Islam, A Jabbar, L Zuberi, N Haque

Section of Diabetes, Endocrinology and Metabolism

Objective: To assess the surgical outcome of hypophysectomy in acromegalic patients, differences in response to surgery in micro and macroadenoma and the development of associated hormonal deficiency after surgery.

Methods: Retrospective analysis of charts of acromegalic patients who were operated upon at Aga Khan University Hospital, Karachi, was done. Information regarding presentation, laboratory data, radiological assessment, details of surgery and postoperative outcome was recorded. Surgical outcome was classified depending on the degree of disease control after surgery as biochemical cure, remission and treatment failure.

Results: Out of 30 patients, eighteen (60%) were males and 12 (40%) females with …

Diabetes: The Interrelationship Between Vascular, Nervous Systems And Avandia, Salameh Bweir

Loma Linda University Electronic Theses, Dissertations & Projects

Diabetes Mellitus has been linked to vascular and neurological impairments. The purpose of this study was to assess the relationship between vascular endothelial dysfunction, autonomic and somatic nervous systems impairment in diabetic patients. These studies also evaluated the effects of rosiglitazone (Avandia) on the vascular, autonomic, and somatic nervous systems.

Fourteen diabetic subjects and fourteen control subjects (age matched) participated in three series of experiments. Using Whitney volume plesythmography to assess post occlusion blood flow in the subject’s forearm did assessment of vascular endothelial function. Evaluating skin blood flow, orthostatic tolerance, heart rate, and thermal responses under thermal and postural …

Characterization Of Insulin-Like Growth Factor Binding Protein-2 Secretion In Mouse Mesangial Cells, Marianne Ellen Albert

MUSC Theses and Dissertations

Dysregulation of the insulin-like growth factor (IGF) system plays a key role in the hyperproliferative state seen in diabetic complications. Enhanced IGF-I activity plays a causal role in diabetic glomerulosclerosis (DG) by stimulating mesangial cell proliferation, secretion and hypertrophy. Other alterations of the IGF system may include increased IGF-I receptor (IGF-IR) and increased IGF binding protein (IGFBP) expression. The IGFBP family consists of six soluble binding proteins, IGFBP 1-6, which have higher affinities for the IGFs than the IGF-IR, resulting in blocking IGF access to the IGF-IR. Since the IGFBPs primarily function to inhibit IGF action, we hypothesize that overexpression …

Effects Of 8 Weeks Of Flexibility And Resistance Training In Older Adults With Type 2 Diabetes, Matthew T. Herriot, Sheri R. Colberg, Henri K. Parson, Tanja Nunnold, Aaron I. Vinik

Human Movement Studies & Special Education Faculty Publications

(First paragraph) Flexibility is often downplayed as unimportant to fitness. However, flexibility training is imperative to maintain full range of motion (ROM) of joints, particularly in individuals with type 2 diabetes, who may experience limited joint mobility due to glycation of joint structures (1). Maladies such as “frozen shoulder” are common complaints in type 2 diabetes (2).

Cultural And Psychological Influences On Diabetic Adherence, Keikilani Mcmillin-Williams

Loma Linda University Electronic Theses, Dissertations & Projects

Diabetes mellitus is a serious disease that poses a particular healthcare challenge because progression is considered controllable (Cox, et al, 1985; Vinicor, et al, 1996) yet treatment adherence, and thus outcome, is very poor (Gonder-Frederick, Cox, & Ritterband, 2002; Goodall, 1991). Culture is a lethal risk factor for diabetic contraction and treatment maintenance. Latinos within the United States are two-to-three times more likely to develop complications and die than non-Latinos (Haffner et al, 1996; Rubin, Peyrot, & Saudek, 1991) and are less likely to adhere to treatment (Lipton, Losey, Giachello, Mendez, & Girotti, 1998). Efforts to eliminate health disparities have …

Cutaneous Blood Flow In Type 2 Diabetic Individuals After An Acute Bout Of Maximal Exercise, Sheri R. Colberg, Henri K. Parson, D. Robb Holton, Tanja Nunnold, Aaron I. Vinik

Human Movement Studies & Special Education Faculty Publications

OBJECTIVE - We previously demonstrated a positive association between chronic aerobic exercise and dorsal foot skin blood flow during local heating in type 2 diabetic individuals. Thus, we hypothesized that a prior acute bout of maximal exercise would also have positive effects on postexercise blood now.

RESEARCH DESIGN AND METHODS - Subjects consisted of 32 individuals with type 2 diabetes and 26 nondiabetic control subjects further subdivided based on their physical activity status diabetic exerciser (DE), diabetic sedentary (DS), control exerciser (CE), or control sedentary. Dorsal foot cutaneous blood flow was measured noninvasively by continuous laser-Doppler assessment at baseline and …

Use Of Heart Rate Reserve And Rating Of Perceived Exertion To Prescribe Exercise Intensity In Diabetic Autonomic Neueropathy, Sheri R. Colberg, David P. Swain, Aaron I. Vinik

Human Movement Studies & Special Education Faculty Publications

Objective- Individuals with diabetic autonomic neuropathy (DAN) exhibit an increased resting heart rate but depressed maximal heart rate. Thus, the purpose of this study was to examine the validity of using either percent of heart rate reserve (HRR) or a rating of perceived exertion (RPE) scale to prescribe exercise intensity in diabetic individuals both with and without DAN.

Research Design and Methods-The subjects consisted of 23 individuals with type 2 diabetes, ages 45-75 years, with (DAN; n=13) or without (No DAN; n=10) clinical signs of DAN, as assessed by heart rate variability using the expiration-to-inspiration ratio of the …

Role Of Neuropoietic Cytokines In Development And Progression Of Diabetic Polyneuropathy: From Glucose Metabolism To Neurodegeneration, Dusanka S. Skundric, Robert P. Lisak

Neurology Faculty Publications

Diabetic neuropathy develops as a result of hyperglycemia- induced local metabolic and microvascular changes in both type I and type II diabetes mellitus. Diabetic neuropathy shows slower impulse conduction, axonal degeneration, and impaired regeneration. Diabetic neuropathy affects peripheral, central, and visceral sensorimotor and motor nerves, causing improper locomotor and visceral organ dysfunctions. The pathogenesis of diabetic neuropathy is complex and involves multiple pathways. Lack of success in preventing neuropathy, even with successful treatment of hyperglycemia, suggests the presence of early mediators between hyperglycemia-induced metabolic and enzymatic changes and functional and structural properties of Schwann cells (SCs) and axons. It is …

The Effects Of A 10-Week Exercise Program On Physiological Variables And Quality Of Life In Type 2 Diabetes, David Robb Holton

Human Movement Studies & Special Education Theses & Dissertations

The purpose of this study was to determine the interaction between psychological and physiological parameters before and after a 10-week, aerobic training study of sedentary diabetic individuals and sedentary controls. Tests measuring physiological parameters (interstitial NO, blood flow, lactate threshold, VO₂ peak and glycosylated hemoglobin) and a quality of life survey were completed before and after training. Nine previously sedentary diabetic (DE, diabetic exerciser) and 10 control sedentary subjects (CE, control exerciser) engaged in 10 weeks of supervised aerobic exercise. A non-training diabetic group (DS, diabetic sedentary, n=12) and a non-training control group (CS, control sedentary, n=I0) were also …

Use Of An Anaerobic Chamber Environment For The Assay Of Endogenous Cellular Protein-Tyrosine Phosphatase Activities., Li Zhu, Barry Goldstein

Department of Medicine Faculty Papers

Protein-tyrosine phosphatases (PTPases) have a catalytic cysteine residue whose reduced state is integral to the reaction mechanism. Since exposure to air can artifactually oxidize this highly reactive thiol, PTPase assays have typically used potent reducing agents to reactivate the enzymes present; however, this approach does not allow for the measurement of the endogenous PTPase activity directly isolated from the in vivo cellular environment. Here we provide a method for using an anaerobic chamber to preserve the activity of the total PTPase complement in a tissue lysate or of an immunoprecipitated PTPase homolog to characterize their endogenous activation state. Comparison with …

Reduction In The Incidence Of Type 2 Diabetes With Lifestyle Intervention Or Metformin., William C. Knowler, Elizabeth Barrett-Connor, Sarah E. Fowler, Richard F. Hamman, John M. Lachin, Elizabeth A. Walker, David M. Nathan, P. G. Watson, J. T. Mendoza, K. A. Smith, J. Caro, B. Goldstein, C. Lark, L. Menefee, L. Murphy, C. Pepe, J. M. Spandorfer

Department of Medicine Faculty Papers

BACKGROUND: Type 2 diabetes affects approximately 8 percent of adults in the United States. Some risk factors--elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle--are potentially reversible. We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes.

METHODS: We randomly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin (850 mg twice daily), or a lifestyle-modification program with the goals of at least a 7 percent weight loss and at least …

An Investigation Of The Effects Of A 12-Week Exercise Programme For People With Diabetes, Olive Fanning

Theses

To determine and examine the effects of a 12-week exercise programme for people with diabetes on their blood glucose control, physiological components and psychological well-being.

The purpose of the study was to examine a wide variety of physiological components including assessment of aerobic capacity, body composition, lung, function, flexibility and blood glucose control (HbAlc levels). Psychological well-being was also assessed which includes sub scales for depression, anxiety, energy and positive well being. This had the purpose of identifying exact levels of these variables so as to compare these to the general public norms. It additionally had the benefit of being …

Oxidized Ldl Density Lipoprotein Antibodies And Oxidized Low Density Lipoprotein-Containing Immune Complexes: Characteristics And Pathogenic Significance In Diabetes, Daniel H. Atchley

MUSC Theses and Dissertations

Mounting evidence suggests that two major vascular complications of diabetes mellitus, atherosclerosis and nephropathy, are pathogenically analogous processes, with atherosclerosis occurring primarily in the microvasculature and nephropathy involving the microvasculature. Additionally, several lines of evidence point to oxidized low-density lipoprotein (oxLDL) as a major participant in both processes. OxLDL is found deposited in both types of vascular lesions, and appears to influence several events. It causes influx of macrophages, which ingest the oxLDL and are transformed into foam cells - a key component of atherosclerosis and glomerulosclerosis. OxLDL also appears to promote the proliferation of smooth muscle cells in atherosclerosis …

Prevalence And Risk Factors For Vaginal Candida Colonization In Women With Type 1 And Type 2 Diabetes, Ella M. De Leon, Scott J. Jacober, Jack D. Sobel, Betsy Foxman

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Diabetes mellitus increases the rate of vaginal colonization and infection with Candida species

Methods

We surveyed women with diabetes receiving care at either an urban or suburban diabetes clinic to examine the relationship between vaginal Candida colonization, diabetes type and duration, and HbA_1c level. 101 participants completed the self-administered questionnaire and self-collected a vaginal swab for Candida culture. Candida colonization was similar by age and race.

Results

Type 1 diabetics were three times as likely as type 2 diabetics to be colonized with any Candida species (OR = 3.4; 95% CI: 1.03, 11.41; p = 0.04); even …

An Examinaton Of The Enhanced Primary Care Model For The Organization Of Team Care In Managing Type 2 Diabetes Mellitus In The Elderly Population, Carolyn Morcom Rutledge

Health Services Research Dissertations

The healthcare system is faced with overwhelming demands as a result of the growing elderly population, especially those with chronic illnesses. One disease that significantly impacts the morbidity and mortality of the elderly population, especially the minority and poor population, is type 2 diabetes. This population often lacks access to resources and quality healthcare that may be due to inadequate knowledge by the patients and their healthcare providers regarding available services. Current models of healthcare have not been effective in meeting the healthcare demands of this population. The purpose of this study was to evaluate the effectiveness of the Enhanced …

Client-Centered Versus Traditional-Directive Educational Approach: A Randomized Study Of Exercises And Perceived Control Among Patients With Type 2 Diabetes, Melissa D. Olfert

Loma Linda University Electronic Theses, Dissertations & Projects

A patient’s adherence to self-management therapies in diabetes strongly influences health outcomes, health care utilization, and ultimately health care costs. Engaging in regular exercise therapy reduces risk factors associated with type 2 diabetes. The purpose of this randomized prospective study was to determine if a client-centered approach (CCA) toward diabetes education, verses a traditional-directive approach (TDA), would improve exercise participation, perceived control, intention to exercise, and glycemic control in patients with type 2 diabetes.

Fifty-nine type 2 patients were randomized into two groups: CCA and TDA. Diabetes education in the CCA group provided empowerment toward acquiring knowledge, skills, and responsibility …

Dietary Practices And Beliefs Of Patients With Chronic Liver Disease, S H. Badruddin, S M. Jafri, A Ahmed, S Abid

Section of Diabetes, Endocrinology and Metabolism

Objective: To study of the dietary practices and beliefs of patients suffering from chronic liver disease.

Setting: Two private tertcary care hospitals.

Method: Fifty patients presenting to the Gastroenterology Clinics at the Aga Khan University Hospital and Baqai Hospital, with compensated liver disease and no other co-morbid condition which required dietary modifications, were enrolled in the study. Patients were interviewed regarding their current dietary practices using an open-ended questionnaire.

Results: The mean age of the patients was 48 years and the majority were in relatively poor nutritional status. Four had BMI's < 18; 58% had Hb < 12 g/dl and 36% had albumin levels < 3 gm/dl. The percentage of patients avoiding various foods is as follows: meats 72%, fats and oils 64%, salt 42%, spices 34%, milk and milk products 28%, rice 20%.

Conclusion: The most commonly cited reason for avoiding a …

Evaluation Of The Role Of Fructosamine As An Indicator Of Diabetic Control, Katherine Hooley

Theses

Diabetes mellitus, a common metabolic disease, is characterised by excess circulating glucose concentrations. Such a hyperglycaemic status provides the stimulus for irreversible glycation (non-enzymatically post-translational) of structural and functional proteins. Protein glycation, although a cause of complication (neuropathy, micro/macrovascular disease), provides a time-averaged index of diabetes status and control. In particular, glycated plasma proteins analysis, i.e., the fructosamine assay, has received favourable response due to its speed, simplicity, low cost, and ease of automation. However, lack of standardisation and a universally-accepted calibrant has limited technical and subsequent clinical confidence in fructosamine analysis. In response, a comprehensive technical evaluation (including novel …

The Type 2 Iodothyronine Deiodinase Is Expressed Primarily In Glial Cells In The Neonatal Rat Brain, Ana Guadaño-Ferraz, Maria Jesus Obregón, Donald L. St. Germain, Juan Bernal

Dartmouth Scholarship

Thyroid hormone plays an essential role in mammalian brain maturation and function, in large part by regulating the expression of specific neuronal genes. In this tissue, the type 2 deiodinase (D2) appears to be essential for providing adequate levels of the active thyroid hormone 3,5,3′-triiodothyronine (T3) during the developmental period. We have studied the regional and cellular localization of D2 mRNA in the brain of 15-day-old neonatal rats. D2 is expressed in the cerebral cortex, olfactory bulb, hippocampus, caudate, thalamus, hypothalamus, and cerebellum and was absent from the white matter. At the cellular level, D2 is expressed predominantly, if not …

Effects Of Exercise And Psychosocial Stress On Blood Glucose In Non-Insulin Dependent Diabetics, Lisa Renae Clemensen

Dissertations

Non-insulin dependent diabetes often has serious consequences for individuals if blood glucose is not maintained within relatively normal ranges. Exercise and stress have been enumerated as important variables for the control of blood glucose in non-insulin dependent diabetics.

This study compared blood glucose and stress for eight exercise and eight matched control non-exercise adult noninsulin dependent participants. A prospective home monitoring design was used to monitor daily blood glucose, stress, and physical activity via multiple measures for six days.

Results indicated that control participants had significantly higher average blood glucose readings and higher blood glucose variability. Daily stress measures did …

Neuronal Toxicity Of Humoral Factors From Patients With Diabetic Neuropathy And Mechanism Of Neuronal Death On Cultured Adrenergic Neurons: Studies Of Autoimmune Pathogenesis In Diabetic Neuropathy, Dong Liu

Theses and Dissertations in Biomedical Sciences

Diabetic neuropathy is an extremely common medical problem because of the high frequency of diabetes and its complications. Diabetic neuropathy consists of not one, but many patterns of nerve injury, each potentially with its own discrete pathogenic mechanisms. Evidence is accumulating that indicates autoimmunity plays a role in diabetic peripheral neuropathy. However, the significance of immunopathogenesis of diabetic neuropathy is as yet unclear.

Using the N1E-115 mouse neuroblastoma cell line (NB) as a model of the adrenergic autonomic neuron, we found that sera of IDDM patients with neuropathy inhibit growth and differentiation of adrenergic neurons in culture (Pittenger et al, …

Thyroid Hormone Influence On Oxygen Consumption Rates, Body Mass, And Lipid Metabolism In Mice With Noninsulin Dependent Diabetes Mellitus, Catherine Renee Clark

Theses Digitization Project

No abstract provided.

A Thyroid Hormone-Regulated Gene In Xenopus Laevis Encodes A Type Iii Iodothyronine 5-Deiodinase., Donald L. St Germain, Robert Schwartzman, Walburga Croteau, Akira Kanamori, Zhou Wang, Donald D. Brown, Valerie Galton

Dartmouth Scholarship

The type III iodothyronine 5-deiodinase metabolizes thyroxine and 3,5,3'-triiodothyronine to inactive metabolites by catalyzing the removal of iodine from the inner ring. The enzyme is expressed in a tissue-specific pattern during particular stages of development in amphibia, birds, and mammals. Recently, a PCR-based subtractive hybridization technique has been used to isolate cDNAs prepared from Xenopus laevis tadpole tail mRNA that represent genes upregulated by thyroid hormone during metamorphosis. Sequence analysis of one of these cDNAs (XL-15) revealed regions of homology to the mRNA encoding the rat type I (outer ring) 5'-deiodinase, including a conserved UGA codon that encodes selenocysteine in …

The Role Of Sn-1,2-Diacylglycerol In Insulin-Stimulated Glucose Transport In Rat Skeletal Muscle, Kevin Paul Boggs

MUSC Theses and Dissertations

Insulin stimulates glucose transport into skeletal muscle upon binding to its cell surface receptor. The signals which stimulate transport are unknown. Studies of insulin's effects on muscle cell lines and adipocytes suggest that increases in sn-l,2-diacyglycerol (DAG) content may mediate insulin-stimulated glucose transport. To test this, the effect of insulin on muscle DAG content was measured. DAG increased in diaphragm and soleus muscles exposed to insulin in vitro and in diaphragm in vivo. However, the supraphysiologic insulin dose (60 nM) and incubation time required (10 min) are not consistent with a role for DAG as a mediator of insulin stimulated …