Endocrinology, Diabetes, and Metabolism Commons^™

Severe Polyarticular Gout Flare Inducing Diabetic Ketoacidosis: A Case Report, John Rovig, Jose Lazarte Loayza, Sana Gurz, Jessica Chung, Winn Chatham

School of Medicine Faculty Research

Diabetic ketoacidosis (DKA) is a serious condition that is triggered by multiple stressors, including processes linked to inflammation. Gout is an inflammatory process that has not been directly linked to DKA, but it affects similar pathways, affecting glycemic control. This case illustrates the link between DKA and gout flares with emphasis on the nuanced management of gout in the setting of DKA.

Using Item Response Theory To Identify Key Symptoms Of Insomnia In A Sample Of University Students With Probable Eating Disorders, Kara A. Christensen Pacella, Brianne N. Richson, Nicole A. Short, Angeline R. Bottera, Leah A. Irish, Victoria L. Perko, Kelsie T. Forbush

Psychology Faculty Research

Purpose

Researchers have theorized that interactions between appetitive and circadian disruptions result in increased eating disorder (ED) symptoms and insomnia. However, it is unclear how specific insomnia symptoms present among people with EDs and if the latent structure of insomnia in this population is similar to that of people with insomnia disorder.

Methods

We conducted a secondary analysis of data collected on ED and insomnia symptoms using a subset of students with probable EDs at a large Midwestern American university. Item response theory (IRT) for polytomous items was performed to identify item difficulty, discrimination, and information parameters for the Insomnia …

The Associations Of Cardiometabolic And Dietary Variables With Clinical Periodontitis In Adults With And Without Type 2 Diabetes: A Cross-Sectional Study, Arpita Basu, Leigh Ann Richardson, Alicia Carlos, Neamat Hassan Abubakr, Robin L. Weltmann, Jeffrey L. Ebersole

Kinesiology and Nutrition Sciences Faculty Research

Periodontitis is a commonly occurring inflammatory oral disease affecting a large proportion of global and US adults and is characterized by the destruction of the tooth-supporting apparatus. Its etiology is multifactorial, and type 2 diabetes and diet play critical roles in its remission and progression. However, few studies have addressed nutritional and serum vitamin D status in adults with periodontitis in the presence of diabetes. A cross-sectional study (n = 78), and a sub-set of age- and BMI-matched case–control studies (n = 50), were conducted to examine differences in dietary and cardiometabolic variables, and serum vitamin D in adults with …

Diabetes Related Distress And Co-Occurrence With Depressive Symptoms In Urban Low-Income African American And Hispanic/Latinx Adults With Type 2 Diabetes, Laurie Ruggiero, Sarah Williams Leng, Mary De Groot, Ben S. Gerber, Rosalba Hernandez, Lauretta Quinn

Journal of Health Disparities Research and Practice

Introduction. Burden of diabetes in the U.S. is greater in racial-ethnic minority populations than non-Hispanic Whites. Depression and diabetes-related distress (DRD) are recognized as relatively common and important psychosocial areas to address in people living with diabetes. Limited research in the U.S. has focused on DRD in racial-ethnic minority populations. The purpose of this study is to describe patterns of DRD and co-occurrence with depressive symptoms in urban low-income African American and Hispanic/Latinx adults with type 2 Diabetes Mellitus (T2DM).

Method. We examined the baseline data collected for a randomized clinical trial (RCT) studying the impact of a culturally tailored …

Global, Regional, And National Burden Of Diabetes From 1990 To 2021, With Projections Of Prevalence To 2050: A Systematic Analysis For The Global Burden Of Disease Study 2021, Kavita Batra, Numerous Authors, See List Below

School of Medicine Faculty Research

Background:

Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050.

Methods:

Estimates of diabetes prevalence and burden were computed in …

The Impact Of High-Intensity Interval Training On Vascular Function In Adults: A Systematic Review And Meta-Analysis, Mousa Khalafi, Mohammad Hossein Sakhaei, Fatemeh Kazeminasab, Michael E. Symonds, Sara K. Rosenkranz

Kinesiology and Nutrition Sciences Faculty Research

Aim: We performed a systematic review and meta-analysis to investigate the effects of high-intensity interval training (HIIT) compared with moderateintensity continuous training (MICT) or with no exercise (CON) on vascular function in adults who were free of cardiometabolic diseases and those with cardiometabolic diseases.

Methods: A search across three electronic databases including Scopus, PubMed, and Web of Science was conducted through February 2022 to identify the randomized trials evaluating HIIT vs. MICT and/or CON on vascular function as measured using brachial artery flow-mediated dilation (FMD) in adults. Separate analyses were conducted for HIIT vs. MICT and/or CON to calculate weighted …

Diabetes-Related Outcomes Following Use Of Basal-Bolus Insulin Vs Premixed Insulin In A Va Population With Type 2 Diabetes: A Retrospective Chart Review., Ravisha Bai, Kavita Batra, Charmaine Yap, Kenneth Izuora

School of Medicine Faculty Presentations

No abstract provided.

1485-Pub: Assessing Correlates Of Microvascular Complications Among Patients With Diabetes Mellitus, Kenneth Izuora, Amalie Alver, Arpita Basu, Kavita Batra, Shelley J. Williams, Jeffrey L. Ebersole

Department of Internal Medicine Faculty Research

Background: Microvascular complications associated with diabetes (DM) are important predictors of morbidity and mortality. Understanding the factors associated with these complications is important in reducing their burden. Method: Using a cross-sectional study design, seventy-one ambulatory patients with Type 2 DM (female 60.6%, white 36.6%, mean age 64.1± 10.3 years, and mean duration of DM 15.8±9.1 years) were recruited using an investigator-administered questionnaire and chart review. Variables of demographics, smoking, HbA1c, DM duration, and complications were collected. CRP was measured and oral health status was assessed by a clinical exam. Data were analyzed using Chi-square/Fisher exact tests and binomial logistic regression …

Serum Urate And Cardiovascular Events In The Dcct/Edic Study, Alicia J. Jenkins, Barbara H. Braffett, Arpita Basu, Ionut Bebu, Samuel Dagogo-Jack, Trevor J. Orchard, Amisha Wallia, Maria F. Lopes-Virella, W. Timothy Garvey, John M. Lachin, Timothy J. Lyons

Kinesiology and Nutrition Sciences Faculty Research

In type 2 diabetes, hyperuricemia is associated with cardiovascular disease (CVD) and the metabolic syndrome (MetS), but associations in type 1 diabetes (T1D) have not been well-defined. This study examined the relationships between serum urate (SU) concentrations, clinical and biochemical factors, and subsequent cardiovascular events in a well-characterized cohort of adults with T1D. In 973 participants with T1D in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC), associations were defined between SU, measured once in blood collected 1997-2000, and (a) concurrent MetS and (b) incident 'any CVD' and major adverse cardiovascular events (MACE) through 2013. …

Examining The Impact Of Race And Rurality On Health Differences Among Overweight Youth Accessing Pediatric Endocrinology Care, Kelsee Halpin, Janelle R. Noel-Macdonnell, Yun Yan

Journal of Health Disparities Research and Practice

Methods: This study examines the impact of race and rurality on health differences, including prevalence of prediabetes and type 2 diabetes (T2D), among overweight children accessing pediatric endocrine specialty care. Cross-sectional analysis of overweight/obese youth 10 to 18 years of age receiving pediatric endocrinology consultation for weight gain, hyperglycemia, and/or T2D from 2013 to 2016 at a Midwest tertiary pediatric center.

Results: The 722 patients were 42% white, 25% black, 22% Hispanic; 88% lived in urban areas and 12% in rural areas. Rurality was determined using zip code approximation of Rural-Urban Commuting Area (RUCA) codes. After adjusting for confounders, black …

Racial/Ethnic Disparities In Diabetes Care And Outcomes: A Mixed Methods Study, Yhenneko J. Taylor, Marion E. Davis, Rohan Mahabaleshwarkar, Melanie D. Spencer

Journal of Health Disparities Research and Practice

Limited research has examined racial/ethnic differences in diabetes care and outcomes among primary care patients. This study examined racial/ethnic differences in diabetes care and outcomes among an ambulatory patient population and explored patient perceptions of the patient-provider relationship to inform strategies to improve care delivery. Using data from 62,149 adults with diabetes who received care within Atrium Health in 2013, regression models assessed associations between race/ethnicity and the following outcomes: glycated hemoglobin (HbA1c) tests, low density lipoprotein (LDL) and blood pressure (BP) screening, foot and eye exams, and HbA1c, LDL, and BP control. Eleven patients with diabetes and uncontrolled hypertension …

Testosterone And The Adult Male, Alex Straftis

Calvert Undergraduate Research Awards

Abstract

In the last 15 years, prescription testosterone sales have increased almost threefold. Testosterone is a powerful hormone, which has both physiological and behavioral effects on the adult male. These effects vary over a man’s life course and social ecology. In a natural setting, testosterone reaches a peak during early adulthood, declines gradually over midlife, and has exponential drops after the age of 70. Increasing testosterone, through testosterone replacement therapy (TRT), past early adulthood, is an evolutionary novel circumstance for an adult male. To gauge these effects, and the motivations that initiated them, this study conducted a preliminary text analysis …

Effects Of Anti-Inflammatory Foods On Hyperglycemia In Type-1 Diabetics, Primrose Martin, Michelle Chino

McNair Poster Presentations

Based on a case study administered by Dr. Charlotte Gerson, an IDDM patient referred to as R.H. reversed hyperglycemic symptoms within ten weeks while adhering to a diet of mainly vegetables and some low-glycemic index fruits. R.H. also ingested mineral supplements and underwent multiple coffee enemas each day (Gerson & Bishop, 2007, p. 56). This self-study hypothesizes that diet alone has a positive correlation coefficient with hyperglycemic blood glucose levels in type-1 diabetics (IDDM). Conducting this self-study contributes information to the limited research and database of alternative methods for managing IDDM hyperglycemia, and provides candid documentation of the effects that …

Prevention Of Type 2 Diabetes In Urban American Indian/Alaskan Native Communities: The Life In Balance Pilot Study, Daniel C. Benyshek, Michelle Chino, Carolee Dodge-Francis, Toricellas O. Begay, Hongbin Jin, Celeste Giordano

Environmental & Global Health Faculty Research

Objective: The Life in BALANCE (LIB) study is a pilot translational study modeling the Diabetes Prevention Program (DPP) intensive lifestyle coaching intervention among an underserved, high-risk population: American Indians/Alaska Natives (AI/ANs) living in a large urban setting (Las Vegas, Nevada). Research Design and Methods: A total of 22 overweight/obese AI/ANs (age, 39.6 ± 10.4 years; BMI, 34.1 ± 6.3 kg/m2) at increased risk for developing type 2 diabetes (HbA1c > 5.4 (36 mmol/mol) < 6.4 percent (46 mmol/mol) participated in the program between April and December, 2011. Study participants completed a 16 week intensive lifestyle coaching intervention. In addition to obtaining qualitative data regarding opportunities and challenges of applying the lifestyle intervention for AI/AN participants in an urban setting, clinical data, including BMI, waist circumference, blood pres- sure, fasting blood glucose, and blood lipids (HDL, LDL and Triglycerides), were collected. Results: Only 12 of the 22 participants remained in the LIB program at the final post-program follow-up. Participants demonstrated significant decreased waist circumference and elevated HDL cholesterol. Triglycerides manifested the highest percentage change without statistical significance. No significant change was ob- served in blood pressure or fasting blood glucose. Conclusions: LIB participants’ improvements in BMI, waist circumference, HDL cholesterol and triglycerides suggests type 2 diabetes prevention programs aimed at urban AI/ANs show significant potential for reducing the risk of developing type 2 diabetes among this underserved and high risk community. Qualitative data suggest the main challenge for type 2 diabetes prevention specific to this population is a need for improved community outreach strategies.

Lessons Learned From Training Of Promotores De Salud For Obesity And Diabetes Prevention, Erica T. Sosa, Lesli Biediger-Friedman, Zenong Yin

Journal of Health Disparities Research and Practice

Background: Promotores de Salud are impactful in reducing health disparities for Hispanic communities. The purpose of this paper is to present the training process and fidelity of study protocol implementation using a promotora model for community-based diabetes prevention.

Methods: Five Hispanic bilingual promotores were recruited from a Community Health Worker program and received intensive 30-hour promotora training on how to recruit participants, lead group sessions, and support participants making behavior changes. Evaluation of the training included a survey and focus group to assess promotores’ feedback, a post-training knowledge test to assess knowledge acquired during the training and an observational assessment …

Physically Interactive Games Increase Vo2 Above Resting Metabolic Rate, Shaelee Allen, Jacob E. Barkley, Janet Dufek, Paul Hafen, Michael Jarrett, Krystina Moschella, James Navalta, Robert Rietjens, Richard Tandy, Antonio Santo

Interdisciplinary Research Scholarship Day

The purpose of this study was to determine the energy cost, beyond resting metabolic rate (RMR), of playing select games on the Nintendo Wii for 30 contiguous minutes. Physically interactive games (i.e. Basic Run and Basic Step) increase energy expenditure above resting values compared to a sedentary game (Tanks!) and therefore may help individual’s become more active. Furthermore, Basic Run and Basic Step elicited MET values of 3.9 and 3.2, respectively, which is considered moderate-intensity exercise and could be used to meet daily recommendations for physical activity.

Ethnic And Gender Differences In Psychosocial Factors In Native Hawaiian, Other Pacific Islanders, And Asian American Adults With Type 2 Diabetes, Jillian Inouye, Dongmei Li, James Davis, Richard Arakaki

Journal of Health Disparities Research and Practice

This study examined the differences between 207 Asians and Native Hawaiian, other Pacific Islanders (NHOPI) with type 2 diabetes among various psychosocial measures. Responses to five multivariable regression models including the Diabetes Quality of Life Questionnaire (DQOL) and Short Form -36® Health Survey (SF-36) were analyzed. Differences were determined by linear contrasts in the multivariate linear regression models after adjusted for multiple demographic and socioeconomic variables. Compared to Asians, NHOPIs perceived a lower impact of diabetes on their quality of life; highlighting differences in perceptions of self-efficacy and self-care activities. Females did better on their diet while males perceived better …

Selective Screening Of Type 2 Diabetes For Washoe County’S Hispanic Population, Linda M. Dunn

Nevada Journal of Public Health

Hispanic Americans with unrecognized, asymptomatic diabetes are more likely to experience poor quality of life and diabetic complications such as heart, eye and kidney disease than non-Hispanic whites of similar age. Multiple factors, such as cultural beliefs, lack of knowledge and limited access to health care, contribute to the fact that one-third of total diabetes among Hispanic Americans is undiagnosed. For Washoe County, Nevada, the actual percentage of adult Hispanics with diabetes may be almost 12%. In 2003, the Defeat Diabetes Screening Project provided three screenings targeting the Hispanic population in Reno and Sparks. Seventy-one percent of 348 screened were …

The Convergence Of Science And Culture: Developing A Framework For Diabetes Education In Tribal Communities, Michelle Chino Dr, Carolee Dodge Francis, Lemyra Debruyn, Lynn Short, Dawn Satterfield

Journal of Health Disparities Research and Practice

In an unprecedented effort to address the epidemic of diabetes in tribal communities, the Diabetes Education in Tribal Schools project brought together a group of individuals from eight tribal colleges and three federal agencies to develop a diabetes prevention curriculum for American Indian and Alaska Native school children. The curriculum incorporates Western and Native science with culturally responsive teaching techniques. Both the project and its evaluation process have reached beyond conventional bounds to acknowledge fundamental issues of tribal culture, history and health and the integration of science, culture, and community. This article will discuss the challenges and rewards of the …

Equal Care, Unequal Outcomes: Experiences Of A Reach 2010 Community, Diane Neal, Barbara Carlson, Carolyn Jenkins, Gayenell Magwood

Journal of Health Disparities Research and Practice

Diabetes is growing in prevalence and costs. Guidelines for care have been available since 1983, yet diabetes care and outcomes remain less than ideal. CDC’s Racial and Ethnic Approaches to Community Health 2010 (REACH 2010) identified diabetes in African Americans as a priority for action. This article documents the activities, interventions, and current progress of the REACH 2010 diabetes coalition formed in Charleston and Georgetown counties, South Carolina, in reducing health care disparities and describes next steps for improving outcomes. The Chronic Care Model guided many of the implementation activities, and chart audits were used to document outcomes. Ambulatory care …

Stop Atherosclerosis In Native Diabetics Study (Sands): Baseline Characteristics Of The Randomized Cohort, Angela Silverman, Chun-Chih J. Huang, Marie Russell, Mihriye Mete, Mary J. Roman, Mario Stylianou, Elisa T. Lee, Fawn Yeh, Jerome Fleg, Charlton Wilson, Jeffrey A. Henderson, Matthew R. Weir, Robert E. Ratner, Barbara V. Howard

Journal of Health Disparities Research and Practice

Objectives: To present baseline characteristics of American Indians in the Stop Atherosclerosis in Native Diabetics Study (SANDS) and compare them with population-based data from American Indians and other ethnic groups. Design: 499 people with type 2 diabetes ≥ age 40, without known CVD, were recruited for a randomized 3-year trial to evaluate treatment targets for LDL-C (70 vs. 100 mg/dL) and systolic blood pressure (BP) (115 vs. 130 mmHg). Baseline evaluations included physical exam, collection of blood and urine samples, and carotid ultrasound and echocardiographic measures. Results: Mean age was 56 years; 66% were female. Average BMI was 33 kg/m2. …

Use Of Continuous Glucose Monitors In Type-1 Diabetes: An Analysis Of Wave Form Versus Glycemic Values In The Improvement Of Glucose Control And Fear Of Hypoglycemia, Tomas Charles Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Type-1 diabetes is a disease of subtle complexities. Patients struggle to understand glucose patterns and their responses to insulin or food intake while maintaining hectic lifestyles. Minor misjudgments in treatments can result in disastrous consequences with significant hypo- or hyperglycemic excursions.

Despite improvements in technologies available for diabetes management, including home monitoring of blood glucose, more predictable insulin therapies, and improved insulin delivery via insulin pump, the average HbA1c has remained relatively unchanged. Poor diabetes control is recognized as contributing to long-term diabetes comorbidities including neuropathy, nephropathy, retinopathy, and micro- and macrovascular disease.

Real-time continuous glucose monitors, such as the …

Care Patterns And Outcomes For Hospitalized Patients With Diabetes In Nevada, Jay J. Shen

Nevada Journal of Public Health

This study demonstrates substantial differences between Nevada and the national average in patterns of hospital based care in patients with type 2 diabetes. Diabetic patients in Nevada are more likely to be hospitalized through the emergency department, and more likely to be admitted for a condition related to diabetes. Moreover, in Nevada, Medicaid and uninsured patients with diabetes are more likely to experience adverse outcomes then their privately insured counterparts. These differences may be primarily reflective of variances in access to ambulatory care, care seeking behavior, and availability of health services and facilities. Policies promoting expansion of health care benefits …