Endocrinology, Diabetes, and Metabolism Commons^™

Impact Of Aerobic Exercise On Cardiometabolic Health In Patients With Diabesity: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Sameer Badri Al-Mhanna, Barry A. Franklin, John M. Jakicic, Emmanuel Stamatakis, Linda S. Pescatello, Deborah Riebe, Walter R. Thompson, James S. Skinner, Sheri R. Colberg, Jonathan K. Ehrman, George S. Metsios, Norsuhana Omar, Nouf H. Alkhamees, Bodor Bin Sheeha, Abdullah F. Alghannam, Alexios Batrakoulis

Human Movement Studies & Special Education Faculty Publications

Purpose

This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of aerobic exercise on cardiometabolic health-related indices in patients with type 2 diabetes and concurrent overweight/obesity (diabesity).

Methods

PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar databases were searched from inception to October 2024. The search strategy included the following keywords: diabetes, aerobic exercise, and endurance training. RCTs comparing aerobic exercise training ≥2 weeks in duration to standard treatment were considered eligible. Participants were adults with diabesity.

Results

A total of 1391 middle-aged/older adult patients (55 % females) were included …

Impact Of High-Intensity Interval Training On Cardiometabolic Health In Patients With Diabesity: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Sameer Badri Al-Mhanna, Barry A. Franklin, Mark A. Tarnopolsky, John A. Hawley, John M. Jakicic, Emmanuel Stamatakis, Jonathan P. Little, Linda S. Pescatello, Deborah Riebe, Walter R. Thompson, James S. Skinner, Sheri R. Colberg, Jonathan K. Ehrman, George S. Metsios, Helen T. Douda, Norsuhana Omar, Abdullah F. Alghannam, Alexios Batrakoulis

Human Movement Studies & Special Education Faculty Publications

Aims This systematic review and meta-analysis aimed to evaluate the effects of high-intensity interval training (HIIT) on cardiometabolic health-related outcomes in patients with type 2 diabetes and obesity (diabesity).

Methods PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar databases were searched from inception up to November 2024. The search strategy encompassed the following keywords: diabetes, obesity, and HIIT. Randomized controlled trials (RCTs) recruiting adult participants with diabesity and comparing HIIT per se for ≥ 2 weeks in duration with non-exercise standard treatment were included.

Results A total of 18 RCTs qualified involving 504 patients (52/48 women/men …

Protein Marker-Dependent Drug Discovery Targeting Breast Cancer Stem Cells, Ashley V. Huang, Yali Kong, Kan Wang, Milton L. Brown, David Mu

Department of Biomedical and Translational Sciences Faculty Publications

Breast cancer is one of the most common cancers globally. Unfortunately, many patients with breast cancer develop resistance to chemotherapy and tumor recurrence, which is primarily driven by breast cancer stem cells (BCSCs). BCSCs behave like stem cells and can self-renew and differentiate into mature tumor cells, enabling the cancer to regrow and metastasize. Key markers like CD44 and aldehyde dehydrogenase-1 (ALDH1), along with pathways like Wingless-related integration site (Wnt), Notch, and Hedgehog, are critical to regulating this stem-like behavior of BCSCs and, thus, are being investigated as targets for various new therapies. This review summarizes marker-dependent strategies for targeting …

Deletion Of Chop In Beta Cell Protects Mice From Cardiovascular Complications In Type 2 Diabetes: Evidence From A Pre-Clinical Mouse Model, Balaji Srinivas, Kiran Alluri, Nour-Eddine Rhaleb, Khalid Matrougui

Department of Biomedical and Translational Sciences Faculty Publications

Introduction

Cardiovascular complications are the leading cause of morbidity and mortality in patients with type 2 diabetes (T2D), which is recognized as a major independent risk factor for coronary artery disease, stroke, peripheral vascular disease, and heart failure. The interrelationship between metabolic dysfunction and cardiovascular disease is complex and multifactorial, involving hyperglycemia, insulin resistance, inflammation, and oxidative stress. Evidence indicates that endoplasmic reticulum (ER) stress and induction of the unfolded protein response (UPR) contribute to metabolic dysregulation and vascular dysfunction. However, the specific role of beta cell-derived UPR mediators, particularly C/EBP homologous protein (CHOP), in coordinating this interorgan axis between …

Improving The Diabetic Foot Screening Process And Foot Care Patient Education In A Primary Care Setting, Keelie Tillett

DNP Projects

Background: Foot ulcerations are a common diabetes-associated complication that can lead to significant morbidity, mortality, and financial burden for patients and health care systems. Health care providers (HCPs) play an important role in providing diabetic foot care. Despite national guidelines recommending HCPs perform an annual foot exam in all individuals with diabetes to recognize at-risk feet, research shows that many patients with type 2 diabetes (T2DM) do not receive routine diabetic foot exams (DFE) in the primary care setting.

Purpose: To evaluate the effect of provider education, a standardized DFE template, an electronic health record (EHR) alert, and online educational …

Risk Factors For Executive Functioning Development In Preschool Children With Type 1 Diabetes, Victoria L. Ledsham

Electronic Theses & Dissertations (2024 - present)

Links between Type 1 diabetes (T1D) and decreased cognitive functioning in children are well documented, but research on executive functioning (EF) in this population is more limited. Multiple T1D-related risk factors (e.g., hypoglycemia, hyperglycemia, glycemic variability, diabetic ketoacidosis) for EF have been established throughout the literature, but their individual effects have been difficult to determine given their interrelated nature. In result, cumulative risk has been proposed as a more robust predictor of EF differences in children with T1D. Moreover, despite the importance of early T1D onset as a risk factor for EF impairment, no studies have previously investigated EF in …

Major Adverse Cardiovascular Events Are Less Frequent In Psoriasis Patients Starting Glp-1ra Compared To Controls: An Observable Retrospective Cohort Study, Ana Ormaza Vera, Marla F. Osorlo, Madison Olexson, June Choi, Chunghwan Ro, Clinton Enos

Department Dermatology Faculty Publications

Background: Psoriasis is an independent risk factor for major adverse cardiovascular events (MACE). We have previously shown that psoriasis patients with dyslipidemia have an increased incidence of MACE despite treatment with a biologic and a statin. Glucagon-like peptide-1 receptor agonists (GLP-1RA) have shown to reduce MACE in patients with type 2 diabetes and obesity, comorbidities that commonly co-occur with psoriasis. However, the association between GLP-1RA and the incidence of MACE among patients with psoriasis remains unknown.

Methods: We conducted a retrospective cohort study from 2014-2024 using a large, multi-center, electronic health record network (TriNetX). Patients aged 18-90 who started GLP-1RA …

Risk And Prognosis Of Hepatocellular Carcinoma In Mexican Americans With Type 2 Diabetes Mellitus, Rikita I Hatia, Lu-Yu Hwang, Ruosha Li, Catherine Troisi, Prasun K Jalal, Christopher I Amos, Henry F Gomez, Yun Shin Chun, Asif Rashid, Ahmed O Kaseb, Paul A Scheet, Manal M Hassan

Faculty, Staff and Student Publications

INTRODUCTION: Hepatocellular carcinoma (HCC) disproportionately affects Hispanic persons with higher age-specific incidence and increased mortality rates compared to non-Hispanic Whites. These high rates of incidence and mortality may be explained by the variation in risk factors. Given the high prevalence of type 2 diabetes mellitus (DM) among the Hispanic population, we aimed to assess the risk and prognosis of HCC in Mexican Americans with type 2 DM with consideration of treatment for DM.

METHODS: A case-control study of 241 Mexican American HCC patients and 500 healthy controls in Texas was conducted. Multivariable logistic regression analysis was performed to determine the …

Exploring The Role Of 5-Hydroxymethyl-2-Furfural And Sumiki's Acid In Beta-Cell Metabolism, Daiwik Munjwani, Demitrius Hill, David Regan, David Lee, Mike Muehlbauer, Hans-Ewald Hohmeier, Mette Jensen, Neolle E. Younge, James Bain

Department of Medicine Faculty Publications

Type 1 diabetes (T1D), a leading cause of mortality in the United States, is associated with heart disease, nephropathy, neuropathy, retinopathy, and stroke. While management of T1D with medications and healthy lifestyle choices is critical, recent research highlights the contributory role of environmental diabetogens in the pathogenesis of T1D. Here, we propose that the furan compound, 5-hydroxymethyl-2-furfural (HMF), which forms when hexoses such as glucose or fructose lose three water molecules during thermal food processing, might be an unrecognized dietary diabetogen. HMF is a suspected mutagen and carcinogen. In a previous experiment in the rat 832/13 beta-cell line, when cultures …

Association Between The Intensity Of Exercise In The First Trimester And Early Second Trimester And The Risk Of Gestational Diabetes, Takaki Tanamoto, Misa Hayasaka, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

Although some studies show that exercise decreases the incidence of gestational diabetes mellitus (GDM), the optimal exercise intensity during pregnancy remains unclear. We examined GDM risk according to exercise intensity in pregnant individuals.

Methods

We analyzed data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers‐to‐Be (nuMoM2b), a prospective study enrolling nulliparous individuals in the first trimester. Participants with pregestational diabetes or delivery before 20 weeks were excluded. Exercise intensity during the first (6–13 weeks’ gestation) and early second (16–21 weeks’ gestation) trimesters was categorized by metabolic equivalent of task hours per week (MET‐hr/week) as none, low intensity (< 7.5), moderate intensity (7.5–14.9), or high intensity (≥ 15). The primary outcome was GDM; secondary outcomes included preeclampsia, gestational hypertension, preterm birth, small‐for‐gestational‐age birth, and stillbirth. Adjusted relative risks (aRRs) with 95% confidence intervals (CIs) were calculated using a generalized linear mixed‐effects model with a Poisson distribution and robust error variance, controlling for the random effects of individuals and potential confounders.

Results …

A Linear Presentation Of Cutaneous Rosai Dorfman Disease, Emily Sheetz, Ryan C. Saal, Molly K. Smith, Rachel Chikowski Byrd

Department of Medicine Faculty Publications

[Case description] A 53-year-old female with type II diabetes and hypertension presented to the dermatology clinic with a 3-month history of an asymptomatic linear eruption along the right knee that extended distally along the shin. Initial biopsy showed an atypical lymphohistiocytic infiltrate (Fig 1), which was found to be polyclonal. At her 3-month follow up visit, the eruption demonstrated significant clinical progression with numerous indurated papules and papulonodules, some of which were tender, along the right knee and pretibial surface (Fig 2). No improvement was noted with topical triamcinolone prescribed at her initial visit.

Cardiomyopathies Of Endocrine Origin: A State-Of-The-Art Review, Jenyfer M. Fuentes-Mendoza, Marcio J. Concepción-Zavaleta, Juan C. Morón-Siguas, Juan M. Muñoz-Moreno, Aranza I. Pérez-Reyes, Rodrigo Martinez-Galaviz, Raúl D. Aguilar-Castañeda, Oziel González-Godoy, Luis A. Concepción-Urteaga, José Paz-Ibarra

Department of Medicine Faculty Publications

Endocrine disorders are increasingly recognized as potentially reversible causes of secondary cardiomyopathies, yet they often remain underdiagnosed in clinical practice. These conditions-including thyroid dysfunction, acromegaly, pheochromocytoma, diabetes mellitus, adrenal disorders, among others-can significantly alter cardiac structure and function through hormonal excess, metabolic remodeling, and neurohumoral activation. Hyperthyroidism may lead to high-output heart failure (HF) and atrial fibrillation, while hypothyroidism is associated with diastolic dysfunction, pericardial effusion, and accelerated atherosclerosis. Acromegaly promotes biventricular hypertrophy and myocardial fibrosis via insulin-like growth factor 1 overproduction. Pheochromocytoma triggers catecholamine-induced cardiomyopathy, resembling Takotsubo syndrome and carrying a high risk of mortality if left untreated. Diabetes …

Associations Between Dietary Sodium And Potassium Intakes, Urinary Sodium And Potassium Excretion And Blood Pressure Among Adult Females In Oromia Region, Ethiopia, Fred Baffour Addo

Open Access Master's Theses

Introduction: Accurate assessment of sodium (Na) and potassium (K) intake is essential for population level monitoring of salt intake as part of global strategies to reduce salt consumption to control the increasing prevalence of high blood pressure (BP). Thus, a simple, cost-effective, and low-burden method is particularly valuable in resource-limited settings for population level monitoring of Na and K intake. This study aimed to compare the reliability of various methods of Na and K intake assessment, and their associations with blood pressure measurements.

Methods: This secondary analysis was based on a cross-sectional study of 100 non-pregnant women of …

Benchmarking And Improving Foundation Model Dietary Estimates From Meal Images, Yongcheng Mu, Jiangwen Sun, Jing He

Computer Science Faculty Publications

Accurate quantifying dietary contents, such as calories, proteins, carbohydrates, and fats, from an image of a meal plate is vital for managing diabetes. Recently, Large Multimodal Models (LMMs) have excelled in complex vision-language tasks due to their use of very large, highly diverse data. This study benchmarked the use of seven LMMs that include full and lightweight models of GPT, Gemini, and Llama for nutrition estimation based on Google's Nutrition5k dataset and our own phone-collected DonateAndLearn dataset. We analyzed the performance of LMMs and the RGB-D fusion model, in which the RGB-D model was specifically trained using Nutrition5k data. On …

Elevated Inflammation Supra-Additively Promotes The Progression From Prediabetes To Diabetes: A Prospective Cohort Study, Yulong Lan, Dan Wu, Huancong Zheng, Xiong Ding, Hui Zhou, Kuangyi Wu, Weiqiang Wu, Zegui Huang, Xianxuan Wang, Wei Wang, Shouling Wu, Youren Chen

Research outputs 2022 to 2026

Background Factors impacting on the conversion of prediabetes to diabetes or normoglycemia remain unclear. This study aimed to investigate the role of subclinical inflammation, assessed by high-sensitivity C-reactive protein (hsCRP), in the progression to diabetes from prediabetes, assessed by impaired fasting glucose (IFG). Methods Time-to-event survival analyses were conducted among 82 475 participants without diabetes from Kailuan Study (a real-life prospective cohort in China) to access the isolated and joint effect of hsCRP and IFG on diabetes risk, and quantify their relative contribution to incident diabetes. Results Over a median 11-year follow-up, 14 215 diabetes cases were recorded. IFG and …

Fecal Glucocorticoid Metabolite And T3 Profiles Of Orphaned Elephants Differ From Non-Orphaned Elephants In Zambia, Daniella E Chusyd, Janine L Brown, Steve Paris, Nicole Boisseau, Webster Mwaanga, Moses Kasongo, Lisa Olivier, Stephanie L Dickinson, Bailey Ortyl, Tessa Steiniche, Steven N Austad, David B Allison, Michael D Wasserman

Children’s Nutrition Research Center Staff Publications

Background: Elephants provide valuable insight into how early-life adverse events (ELAEs) associate with animal health and welfare because they can live to advanced ages, display extensive cognitive and memory capabilities, and rely heavily on social bonds. Although it is known that African savanna elephants that experienced ELAEs, such as being orphaned due to human activities, have altered behavioral outcomes, little is known regarding the physiological consequences associated with those stressors.

Methods: We compared fecal glucocorticoid (fGCM) and thyroid (fT3) metabolites as well as body condition scores (BCS) in rescued and rehabilitated orphaned (early-dry season: n = 20; late-dry season: n …

Mapping Epidermal And Dermal Cellular Senescence In Human Skin Aging, Grace T Yu, Clarisse Ganier, David B Allison, Tamara Tchkonia, Sundeep Khosla, James L Kirkland, Magnus D Lynch, Saranya P Wyles

Children’s Nutrition Research Center Staff Publications

Single-cell RNA sequencing and spatial transcriptomics enable unprecedented insight into cellular and molecular pathways implicated in human skin aging and regeneration. Senescent cells are individual cells that are irreversibly cell cycle arrested and can accumulate across the human lifespan due to cell-intrinsic and -extrinsic stressors. With an atlas of single-cell RNA-sequencing and spatial transcriptomics, epidermal and dermal senescence and its effects were investigated, with a focus on melanocytes and fibroblasts. Photoaging due to ultraviolet light exposure was associated with higher burdens of senescent cells, a sign of biological aging, compared to chronological aging. A skin-specific cellular senescence gene set, termed …

Quantitative Preventive Approaches To Diabetes: Mathematical Modeling And Analysis, Rushi P. Bhatt

Theses, Dissertations and Culminating Projects

The rising prevalence of diabetes presents a pressing global health concern, necessitating effective control strategies. This study aims to construct a mathematical model to analyze the influence of diverse factors on blood sugar levels, with a focus on identifying optimal methods for maintaining healthy glucose levels. Employing ordinary differential equations (ODE), the model investigates variables including leptin resistance, fat mass, glucose, insulin resistance, beta cell mass, daily physical activity, and dietary intake. Utilizing parameter estimates from existing literature, the model’s framework is established, and simulation results elucidate the intricate interplay between lifestyle choices and blood glucose dynamics. Furthermore, the model …

Semaglutide Vs Liraglutide For Weight Loss In Adults With Obesity, Orian Bar

The PA Department Journal of Medical Science

Introduction: Obesity is a growing chronic condition worldwide with limited effective and safe treatment options. Semaglutide and liraglutide are two GLP-1a medications with encouraging outcomes for the treatment of obesity. The purpose of this paper is to compare semaglutide to liraglutide for weight loss and obesity

Methods: Pubmed was searched for randomized controlled trials, systematic reviews, and meta- analyses from 2019 to 2024 to assess efficacy of semaglutide and liraglutide. Five articles were selected for clinical review.

Results: In 4 out of the 5 studies there was a greater reduction in weight in patients receiving semaglutide compared to liraglutide. Statistically …

Obesity, Metabolic Health, And Diabetic Complications In People With Type 1 Diabetes., Yuanjie Mao, Jen-Tzer Gau, Ning Jiang

Ambulatory and Primary Care Articles

AIM: The concept of metabolically healthy obesity (MHO) has not been studied in type 1 diabetes (T1D). By analysing datasets from the DCCT/EDIC study, we compared the development of diabetic complications by obesity and metabolic health over 30 years of follow up.

MATERIALS AND METHODS: Insulin resistance was calculated by estimated glucose disposal rate (eGDR). The participants (n = 1127) were then divided into four groups based on time-weighted mean body mass index and mean eGDR: metabolically healthy non-obesity (MHN, n = 874), metabolically unhealthy non-obesity (MUN, n = 66), MHO (n = 146) and metabolically unhealthy obesity (MUO, n …