Endocrinology, Diabetes, and Metabolism Commons^™

Ricin B Chain-Insulin Fusion Protein Immunomodulation Of Type 1 Diabetes, James Edward Carter Iii

Loma Linda University Electronic Theses, Dissertations & Projects

Type 1 diabetes mellitus (T1D) is a debilitating chronic inflammatory disease of the insulin-producing pancreatic islet β-cells that results from a combination of genetic and environmental factors. Attempts to suppress Th1-mediated autoimmune diseases such as T1D by mucosal delivery of autoantigens for immunotolerization have yielded only partial success. Attainment of satisfactory levels of sustained immunological tolerance remains to be accomplished. To restore self-tolerance requires delivery of sufficient amounts of autoantigen to stimulate regulatory T helper cells that function to survey the gut and induce tolerance to consumed antigens such as food. Oral delivery of autoantigens has previously been shown to …

Patient/Physician Communication In Type 2 Diabetes-Related Health Behavior Change, Barbara Marie Thomas

Loma Linda University Electronic Theses, Dissertations & Projects

Adult type 2 diabetes is an increasing problem in the United States and affected over 16 million Americans in 2004. Most patients are treated in primary care settings and managed medically, but controlling insulin resistance through activity and diet is considered the greatest challenge for the next 30 years (Katen, et al., 2007). Understanding how physicians and patients communicate about health behaviors is necessary for developing the most effective strategies for facilitating health behavior change in this population. In the current study, adults with type 2 diabetes (n= 87) from the Loma Linda University Diabetes Treatment Center (LLUDTC), …

Quality Of Life And Depression: Outcome Markers For A Weight Management Program, Cecilia Dueñas

Loma Linda University Electronic Theses, Dissertations & Projects

Pediatric obesity has become a national epidemic and current trends suggest a continued increase. Obese children have been found to have higher incidences of depression and a lower quality of life (QOL) than children from other often more severe medical populations. As a result, weight management programs are on the increase with the majority measuring outcome success through weight loss and decreased body mass index (BMI). It is evident however, that health factors are not the only factors associated with obesity, and that psychosocial components are important as well. The Loma Linda University Growing Fit Program is unique in that …

Social Cognitive Predictors Of Diabetes Outcomes In Latinos And Whites, Diana Brown

Loma Linda University Electronic Theses, Dissertations & Projects

Investigating health care disparities in ethnic minority populations is an increasingly urgent issue as these disparities lead to higher morbidity and mortality in minorities (National Center of Health Statistics, 2000). There is clear evidence that Latino Americans, the fastest growing minority group in the United States, are more likely to be diagnosed with and experience more severe complications from type 2 diabetes than Anglo Americans. This study surveyed 38 White and 33 Latino diabetes patients from outpatient clinics in an academic medical center. Cultural values (individualism and collectivism), mental health (social support, mental health), and self-efficacy (diabetes and exercise) were …

Response Of Endothelial Cells To Stressors: The Impact Of Aging And Diabetes, Katie Mclellan

Loma Linda University Electronic Theses, Dissertations & Projects

Preliminary research indicates there is some impairment of the endothelial cells to respond to single stressors such as local heat, shear stress, and global heat in older people and people who have diabetes. The response of the skin blood flow to local heat is an indicator of the endothelial cells ability to cope with stress. In addition, factors such as thicker subcutaneous fat and skin moisture may impair the skin’s ability to dissipate heat. For older people and people with diabetes, this endothelial dysfunction may cause an even more diminished response to multiple stressors. However, no studies have examined the …

Is Electrical Stimulation A Predictive Tool For Autonomic Dysfunction In Males With Diabetes?, Susan Dorothy Rand

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to examine whether electrical stimulation can be used as a predictive tool to assess autonomic dysfunction in males with diabetes. The study was designed to better understand the extent of autonomic nervous system (ANS) dysfunction in the diabetic population.

Controls and patients with diabetes were recruited from the community at large and the Loma Linda University Diabetes Treatment Center and were managed by a physician. Twelve (12) people with diabetes and thirteen (13) control subjects participated. Mean age (years) for people with diabetes was 52.4 +/- 6.1 and 47.2 +/-11.1 for controls (p =0.05). …

Effects Of Diabetes Mellitus On The Healing Of The Dental Pulp, Stuart Evan Garber

Loma Linda University Electronic Theses, Dissertations & Projects

Diabetes Mellitus (DM) has been implicated as a factor affecting healing. The purpose of this study was to use the healing of experimentally exposed pulps subsequent to pulp capping as a model to determine the effect of DM on healing.

Twenty-two Sprague-Dawley rats were divided into two groups of eleven animals each. In one group, DM was induced by injection of 70 mg/KG of streptozotocin. In the other group, the animals were injected with sterile saline. Under anesthesia with Ketamine and Xylazine, the pulps of the maxillary first molars of all rats were exposed using a 1/16 round bur under …

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 …

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 …

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 …

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 …

The Effect Of Electrical Stimulation Of The Dorsal Raphe Nucleus On Local Cerebral Glucose Metabolism And Epileptogenesis In The Rat, Clifford C. Douglas

Loma Linda University Electronic Theses, Dissertations & Projects

Anatomic connections between the dorsal raphé and the hippocampus have been described in the literature; however, the understanding of the functional importance of these connections is not complete. In these studies the "functional" raphé-hippocampal pathway was elucidated first by the 2-deoxy-d-glucose (2-DG) method, and second by the effect of dorsal raphé electrical stimulation on kindled seizure in the rat. In the 2-DG study, differences in local rates of cerebral glucose metabolism were quantified. The pattern of 2-DG uptake differed significantly from controls (animals with electrodes placed and not receiving an electrical stimulus) and subjects stimulated in the pontine oral reticular …

Autonomic Nervous System And Cholesterol Transport, Yuan-Line Hung

Loma Linda University Electronic Theses, Dissertations & Projects

The effect of autonomic nervous system on cholesterol transport is of clinical interest because the relationship between lipoprotein metabolism and atherogenesis is expressed in coronary artery disease.

Generally speaking, beta blockers increase serum VLDL level but decrease both HDL and HDL₂ cholesterol levels without affecting the LDL in humans. We are unaware of reports concerning the effects of metoprolol on lipoprotein metabolism nor comparison of the effects of metoprolol and propranolol in the unhandled rat model. In part I we employed the unhandled rats to compared the effects of these 2 drugs administered with the drinking water in order …

Regeneration Of Meissner Corpuscles In Diabetic Mice Following Median Nerve Crush, Bonnie J. Forrester

Loma Linda University Electronic Theses, Dissertations & Projects

The hyperglycemic metabolic condition found in diabetes mellitus leads to the development of sensory neuropathies and causes delayed and incomplete neuronal regeneration. Diabetic sensory neuropathy has been shown to contribute to the impairment of light touch and low frequency vibratory perception. It is proposed that the regeneration of receptors that detect these sensations will be delayed and incomplete in diabetic animals with uncontrolled hyperglycemia. This study addresses the effects of diabetes on the regeneration of Meissner corpuscles, distal sensory endings that perceive light touch and low frequency vibration.

Corpuscles from 60 diabetic mice, and their age-matched, non-diabetic littermates, were examined …

Age-Related Changes In Meissner Corpuscles Of Diabetic Mice As Observed By Electron Microscopy, Vicky R. Ras

Loma Linda University Electronic Theses, Dissertations & Projects

Light touch and low-frequency vibration sense are often impaired in diabetic patients. Meissner corpuscles are distally located mechanoreceptors that respond to these stimuli. Peripheral sensory neuropathy in diabetes progresses from distal to proximal, therefore, Meissner corpuscles are ideally suited to study diabetic neuropathy in the C57BL/Ks (db/db) mouse.

Corpuscles from the forepaw digital pads of 9 diabetic and 9 nondiabetic littermates were studied by electron microscopy. These were divided into 3 age groups; 2.5 months, 10 months, and 17 months old.

Ultrastructural changes observed within various receptor components were myelin figures, multivesicular bodies, vacuoles, basal lamina duplication, abnormal and enlarged …

Decreased Triiodothyronine Binding To The Hepatic Nuclear Thyroid Hormone Receptor In The Diabetic Mouse, Thomas J. Dewind

Loma Linda University Electronic Theses, Dissertations & Projects

The diabetic C57BL/KsJ-db m mouse has abnormal thyroid hormone levels and indications of thyroid hormone resistance. To investigate the basis of these abnormalities, the hepatic nuclear thyroid hormone receptor was extracted with 0.4 M KCl, 1.1 mM MgCl₂, 20 mM Tris/HCl, pH 7.9 from hepatocyte nuclei of normal C57BL/KsJ, heterozygous C57BL/KsJ-db m (db/m), and diabetic C57BL/KsJ-db m (db/db) mice. Normal and heterozygous mice were grouped together as the controls. Triiodothyronine (T₃) binding studies at 4°C using nitrocellulose filtration to separate free T₃ from receptor bound T₃ demonstrated an …

Insulin And Glucagon Responses To Dietary Protein In Diabetic And Nondiabetic Men, Monica L. Blomstedt

Loma Linda University Electronic Theses, Dissertations & Projects

Five men with non-insulin-dependent diabetes mellitus and fourteen nondiabetic men, were given test meals with soy protein, casein or additional carbohydrate in place of protein. Blood levels of insulin, glucagon, glucose and lipids were measured at fasting, one-half hour and two hours postprandial. To all meals, the nondiabetic subjects responded with a quick rise of the insulin level which decreased at two hours. In contrast, the diabetics showed a significantly lower insulin response at one-half hour (p < 0.05), but a tendency to higher levels at two hours. The same pattern was observed in the insulin to glucagon ratio. No significant difference between the meals was found in regard to insulin or glucagon responses, suggests that a sustained, although delayed postprandial insulin response, may be a precursor to the higher cholesterol and increased risk for cardiovascular disease among diabetics.

Age-Related Changes Of Neurites In Meissner Corpuscles Of Diabetic, Vicky R. Ras

Loma Linda University Electronic Theses, Dissertations & Projects

This thesis is based on a qualitative and quantitative study of the neural component of Meissner corpuscles of diabetic and non-diabetic mice. Age-related changes were also documented in these mechanoreceptors. Corpuscles from forty-six diabetic mice and forty-six non-diabetic mice ranging from 2.5 to 17 months old were studied. Forepaw index digital pads were formalin-fixed and frozen-sectioned parallel to each digit and perpendicular to the skin. Serial sections were then silver-impregnated to allow light microscopic examination of the neurites in the corpuscles.

Neurites became more coarse, tortuous, branched, varicose, and thus more complex until middle age. Corpuscle size appeared greatest at …

The Effect Of Self-Help Support Groups On Self Esteem And Blood Glucose In Young Insulin-Dependent Diabetics, Linda L. Woertz

Loma Linda University Electronic Theses, Dissertations & Projects

Successful adaptation to diabetes is probably a function of many factors: the stress involved, the rewards, the motivation of the individual, and the self concept. The more optimal the self concept the more optimal the behavior may be. By helping the patient shape a positive self concept, a base can be built for blood glucose control (Bruhn, 1977, pp. 93-97). One method of improving self concept or self esteem may be through the development of self-help support groups for diabetics.

The purpose of this study was to evaluate the effect of self-help support group intervention on the levels of self …

A Comparison Of Self-Esteem And Health Locus Of Control In Adolescents With Insulin Dependent Diabetes Mellitus, Janice Mace

Loma Linda University Electronic Theses, Dissertations & Projects

This study was a descriptive survey establishing a baseline level of self-esteem and health locus of control in insulin dependent diabetes mellitus (IDDM) adolescents. The purpose of the research was to study and describe health behaviors of IDDM adolescents in regards to self-concept and health locus of control. These behaviors are believed to have life-long ramifications on the IDDM adolescent's health status.

The sample consisted of 91 IDDM adolescents, 34 male and 57 female, in a nonrandom convenience cluster attending a 10-day summer camp.

Null hypothesis one was: Insulin dependent diabetes mellitus would make no difference at the .05 level …

The Relationship Of Locus Of Control Of The Diabetic Patient And Compliance With Medical Regimen, Lois Daniel

Loma Linda University Electronic Theses, Dissertations & Projects

The literature indicates that many diabetic patients do not adhere to their prescribed medical regimen and that there is a need to discover factors that stimulate compliant behavior. It has been proposed that the patient's decision to accept or reject treatment has many determinants. This study explored the effect of one such determinant, the locus of control (the source of the stimulus for a person's behavior). It was hypothesized that a person with an internal locus (one who believes his actions influence his future) would be more likely to comply with a medical regimen than one with an external locus …

Oral Lichen Planus : A Clinical Study Of The Association With Diabetes Mellitus And Vascular Hypertension, Gordon M. Rick

Loma Linda University Electronic Theses, Dissertations & Projects

This investigation concerns the relationship of diabetes mellitus and vascular hypertension to oral lichen planus. Questionnaires were sent to 470 patients with oral lichen planus: 286 responded. Of these patients 103 were examined clinically, and 74 with current lesions were divided into ''keratotic'' and ''erosive'' categories. These patients underwent three-hour oral glucose tolerance tests; also, their asterial blood pressure was determined. In the survey group, diabetes was reported about three times more frequently by those with "erosive"; oral lichen planus than by those ''keratoic" lesions. The overall prevalence of diabetes was about two and one-half times greater than expected compared …

The Effect Of Elevated Glucose On Neutrophilic Phagocytosis In Genetically Diabetic Mice, Larry B. Thompson

Loma Linda University Electronic Theses, Dissertations & Projects

Infiltration to an injury site or area of bacterial contamination by polymorphonuclear leucocytes (or neutrophils) is an early and essential phase of the early inflammatory reaction. Their action on foreign matter is the most critical step taken by body defense mechanisms in the first 24 hours. Anything which interferes with that action, phagocytosis, greatly hampers early inflammation. This study was designed to see the effect of elevated glucose levels on neutrophil phagocytosis in a unique strain of genetically diabetic mice.

Twenty-two diabetic and twenty-four control female mice were used. Blood glucose determinations and total white counts were made on each …

A Study Of Patients With Recently Diagnosed Diabetes To Ascertain Extent Of Utilization Of Instruction, Ruth Yvonne Stafford

Loma Linda University Electronic Theses, Dissertations & Projects

This descriptive study was conducted to discover to what extent patients with diabetes utilized instruction received. If they did not, the reason why would be searched for. It was also hoped that area of instruction could be defined which needed greater emphasis while the patient was hospitalized at the time of diagnosis.

The interview with the aid of the interview guide was chosen as a data-gathering tool. The guide was complied and approve. Patients were selected from a review of medical records in the selected hospital, and their physicians contacted for permission to include their patient(s) in the study. The …

Effect Of Isocaloric Unsaturated Fats On Serum Cholesterol Of Patients Treated With Hypocholesterolemic Agents, Yvonne Marie Hatley

Loma Linda University Electronic Theses, Dissertations & Projects

The effect of a high unsaturated-low saturated fat diet on serum cholesterol levels were studied. Subjects were clinic patients receiving the following hypocholesterolmeic agents: triparanol (MER-29), diildothyroacetic acid (Diac), dextrothyroxine (d-T₄) and 3-methoxy-16, alpha-methyl-1,3,5, (10)-estratriene-16 beta, 17 beta-diol (Manvene or Anvene).

Fifteen hypercholesterolemic patients, eleven of whom were diabetic, were placed on diets with prescribed amounts of unsaturated fat. The caloric distribution was 40 per cent carbohydrate, 20 per cent protein, and 40 per cent fat. The level of unsaturated fat was 70 per cent of the total fat.

Seventy-one per cent of the patients on the hypocholesterolemic …

A Review Of Drug Addiction And A Study Of Its Relation To Carbohydrate Metabolism, Eppie Chung Hartsuiker

Loma Linda University Electronic Theses, Dissertations & Projects

The specter of addiction eventually involves everyone of the community. It is a three-fold problem of socio-economic, psychological, and physiological factors. The least understood is the physiological or biochemical aspect of addiction.

It has been postulated that an upset in carbohydrate metabolism may be a biochemical cause of addiction. Several avenues were employed to investigate this possible cause of addiction.

1. A diet survey was conducted and revealed a greater consumption of refined carbohydrates, confections and alcoholic beverages in addicts.

2. Five-hour oral glucose tolerance tests were performed on 7 addicts and 12 non-addicts. These tests revealed that there were decreased glucose …

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Pharmacological Studies Of Antidiabetic Chinese Herbs, Mun Fa Lee

Loma Linda University Electronic Theses, Dissertations & Projects

Rehmannia glutinosa, Atractylus ovata, and Polygonatum chinense have all been employed by the Chinese as oral antidiabetic agents and reported by Min (1928), Kin (1931), and Li et al. (1936) to possess hypoglycemic activity. This prompted the pharmacological studies of these herbs.

Materials and methods. Their pharmacognosy was condensed from all available Chinese and scientific literature. Preliminary chemical and physical analyses included determinations for moisture, ash, crude fat, carbohydrates, protein, phosphorus, pH, alkaloids, melting point, and spectroscopy. Employing the Somogyi-Nelson method, their glycemic activity was studied in rats, rabbits, and dogs. Stress reactions were minimized. The effect …