Endocrinology, Diabetes, and Metabolism Commons^™

Euglycemic Diabetic Ketoacidosis: Institutional Review And Protocol Development, Lim Kang, Jordan Amaro, Brittanii Prahl, Jack Huber

All Poster Presentations

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No abstract provided.

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The Interplay Between Osteosarcopenia And Intrinsic Capacity: Insights And Associations With All-Cause Mortality In The Toledo Study For Healthy Aging, Ivan Baltasar-Fernandez, Pedro L. Valenzuela, Irene Rodríguez-Gómez, Fabio Quiñonez-Bareiro, Luis M. Alegre, Konstantinos Prokopidis, Leocadio Rodriguez-Mañas, Ignacio Ara, Oscar Rosas-Carrasco, Lana J. Williams, Robinson Ramirez-Vélez, Julie A. Pasco, Guy Hajj-Boutros, Raman Agnihotram, Marc Sim, Wayne Lok Ok Choo, Mahdi Imani, Ana M. Ayala-Copete, Julia Chabot, Miguel G. Borda, Nailton J. Neto, Claire Godard-Sebillotte, Howard Bergman, Anna Andrianova, Hidenori Arai, Pierrette Gaudreau

Research outputs 2022 to 2026

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Background: Osteosarcopenia—the coexistence of osteopenia/osteoporosis and sarcopenia—is associated with numerous adverse health outcomes, but its association with intrinsic capacity (IC) remains unknown. We aimed to explore the associations of osteosarcopenia with IC and all-cause mortality in older adults. Methods: We conducted a cross-sectional analysis of IC and a prospective analysis of all-cause mortality in 1142 participants from the Toledo Study for Healthy Aging (75.1 ± 6.0 years, 53.1% women). Participants were classified as having no musculoskeletal disorders, osteopenia/osteoporosis, sarcopenia, or osteosarcopenia (DXA- and EWGSOP2-based criteria). IC was operationalized as a composite score integrating locomotion, cognition, psychological, vitality, and sensory domains. …

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Titanium Dioxide: An Inquiry Into The Mechanisms And Implications Of Exposure In Gut Dysbiosis And Metabolic Disorders, Meghan Gardiner

Senior Honors Theses

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Titanium dioxide (TiO₂) is one of the most prevalent food additives utilized in commercial products in the United States. While TiO₂ was originally hailed as a nontoxic and cost-effective additive, studies are beginning to reveal that TiO₂ is not as safe as it once seemed. TiO₂ may contribute to the development of insulin resistance and metabolic disorders through direct and indirect mechanisms. The compound induces gut dysbiosis, leading to alterations in bacterial metabolites and pro-inflammatory cytokines, which results in the selective resistance of glucocorticoid receptors. Additionally, TiO₂ itself can translocate from the gut to …

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Adrenal Crisis Induced-Seizures: A Case Report And Literature Review, Israel Umoh, Elizabeth Mikhail, Narjis Batool, Nosheen Hajra, Ibrahim Al-Sanouri

Journal of Community Hospital Internal Medicine Perspectives

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This case report underscores the critical interplay between adrenal crisis and seizure activity, emphasizing the importance of rapid recognition and management of this life-threatening condition. Adrenal crisis, characterized by severe hypotension and electrolyte disturbances, often manifests with nonspecific symptoms such as fatigue, nausea, and altered consciousness, which can obscure diagnosis, especially in pediatric and young adult populations. The report details a 21-year-old female with a complex endocrinologic background who developed seizures precipitated by an adrenal crisis triggered by gastroenteritis and compounded by medication noncompliance. Clinical findings included profound dehydration, electrolyte abnormalities, refractory hypotension, and low cortisol levels, which responded favorably …

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Two Glands, One Problem: Navigating Fertility Treatment In Concurrent Nonclassic Congenital Adrenal Hyperplasia And Polycystic Ovary Syndrome, Paul Meram, Mary Show, Elliott Gappy, Ajaz Banka

Conference Presentation Abstracts

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Background: Nonclassic congenital adrenal hyperplasia (NCCAH) caused by 21-hydroxylase deficiency is generally a milder variant of congenital adrenal hyperplasia characterized by partial enzyme activity and variable increases in adrenal androgen levels. Patients presenting with such a condition may present in adolescence or adulthood with symptoms such as acne, hirsutism, irregular menses, and infertility. These symptoms often overlap with those of Polycystic Ovary Syndrome (PCOS), creating challenges in differentiation and management. It is critical to differentiate between PCOS and NCCAH in females of reproductive age, as hyperandrogenism treatment depends on the underlying cause, such as adrenal, ovarian, or a combination of …

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Participant Recruitment, Baseline Characteristics And Burden Of Cardiometabolic Risk Markers Among Adults With Prediabetes In Kenya: Insights From The Fermented Foods And Prediabetes Study, Rosebella Iseme, Alex Muia, Jacob Shabani, Samuel Mucheru, Catherine Gathu, Eliphas Gitonga, Redempta Mutisya, Peter Kioko, Jalal Safipour, Cornelia Witthöft

Population Health, East Africa

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Aims

Cardiometabolic abnormalities such as obesity, hypertension, and dyslipidemia are rising globally and straining health systems. This study assessed the burden of cardiometabolic risk factors among prediabetic adults in Kenya.

Methods

We analyzed baseline data from the Fermented Foods and Prediabetes Randomized Controlled Trial, which recruited adults with prediabetes (HbA1c 39–46 mmol/mol; 5.7%–6.4%) from Aga Khan University Hospital outreach clinics in five Kenyan counties. Standardized questionnaires and clinical assessments were conducted, with HbA1c measured via turbidimetric inhibition immunoassay. Data were managed in REDCap and analyzed in Stata v13. Poisson regression identified factors associated with co-occurrence of cardiometabolic risk factors.

Results …

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Enhancing Gestational Diabetes Screening, Sataj Johnson, Daniel Ruegg

Books, Presentations, Posters, Etc.

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Background: Gestational diabetes mellitus (GDM) screening is recommended between 24–28 weeks of gestation to allow timely diagnosis and treatment and reduce adverse maternal and neonatal outcomes. The two-step glucose tolerance testing method is supported by ACOG, though completion can be delayed due to the need for multiple tests. In 2024 at Providence Milwaukie Family Medicine Clinic, incomplete GDM screening occurred in 23.1% of patients, and incomplete two-step screening occurred in 33.3%, with an average completion time of 12 days. Objective: To increase completion rates of two-step GDM screening and reduce time between abnormal 1-hour and diagnostic 3-hour glucose tolerance tests …

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Improving Recognition Of Chronic Kidney Disease In A Federally Qualified Health Center Through A Quality Improvement Initiative, Rachel Monroe, Evan Saulino, Kathleen Mckenna

Books, Presentations, Posters, Etc.

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Context/background: Chronic kidney disease (CKD) affects approximately 15% of adults in the United States, yet nearly 90% of affected individuals are unaware of their diagnosis. Early identification in primary care enables interventions such as blood pressure optimization, renin –angiotensin system blockade, and kidney -protective medications that can significantly delay disease progression and postpone dialysis. Screening and diagnosis gaps disproportionately affect high -risk populations, including Latinx patients and immigrant agricultural workers commonly served in federally qualified health centers (FQHCs). National CKD screening rates among patients with diabetes or hypertension remain low, leaving many high -risk individuals unscreened for kidney disease. Improving …

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Psychometric Properties Of Ecological Momentary Assessment Of Psychosocial Functioning In Adults With Complications Related To Type 1 Diabetes, Hayley Centola, Melissa Plegue, Dana Albright, Kara Mizokami-Stout, Lynn Ang, Jennifer Iyengar, Emily Hirschfield, Anna Kratz, Evan L. Reynolds, Brian C. Callaghan, Rodica Pop-Busui, Joyce M. Lee

Health Services and Informatics Research

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Objectives: Ecological Momentary Assessment (EMA) is a promising methodology for examining the contextual impact of psychosocial functioning on chronic disease management in individuals with type 1 diabetes (T1D). Little is known regarding psychometric properties of EMA of psychosocial functioning in adults with complications related to T1D. The aim of this study is to explore the feasibility, reliability, and validity of EMA psychosocial measures examining depression, anxiety, diabetes-related distress, and fear of hypoglycemia in a sample of adult individuals with complications related to T1D.

Methods: Fifty-one participants with T1D completed a 14-day EMA of symptoms of depression, anxiety, diabetes-related distress, and …

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Examining The Benefits Of A Standardized Protocol For Hyperglycemia Screening In Adult Oncology Patients: A Pilot Study, Alexa Dashko

Pacific Journal of Health

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Many individuals receiving cancer directed therapy are at risk of developing hyperglycemia and new, or worsening of, diabetes due to location of their cancer, treatment regimen, and/or prolonged use of steroids. Research shows that uncontrolled hyperglycemia can have detrimental effects on individuals’ response to cancer therapy, treatment associated toxicities, quality of life and overall mortality. Despite extensive research identifying the need for routine monitoring and management of hyperglycemia in oncology patients, medical societies have yet to establish formal screening guidelines for practitioners. The aim of this pilot study was to examine the outcomes of establishing a protocol for screening and …

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All-Cause And Cause-Specific Mortality In Patients With Bipolar Ii Disorder, Chih-Wei Hsu, Yang-Chieh Brian Chen, Edward Chia-Cheng Lai, Andrew A Nierenberg, Michael Berk, Sheng-Yu Lee, Liang-Jen Wang, Mu-Hong Chen, Yao-Hsu Yang, Chih-Sung Liang, Andre F Carvalho

Children’s Nutrition Research Center Staff Publications

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Importance: Whether bipolar II disorder (BD-II) is associated with increased long-term mortality remains uncertain because most studies have not distinguished BD-II from bipolar I disorder (BD-I).

Objective: To examine whether BD-II is associated with elevated all-cause and cause-specific mortality compared with population controls, unaffected siblings, and those with BD-I.

Design, setting, and participants: This population-based, retrospective cohort study used data from Taiwan's National Health Insurance Database from January 1, 2000, to December 31, 2022. Individuals 12 years or older with 2 or more psychiatrist-assigned BD-II diagnoses were individually matched to 4 controls without BD-II by sex and birthdate. Additional comparisons …

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Weaning Drives Microbiome-Mediated Epigenetic Regulation To Shape Immune Memory In Mice, Li Yang, Robert C Peery, Shirui Zhou, Xiaomin Chen, Leah M Farmer, Fabiola Gutierrez, Stephanie Fowler, Lanjing Zhang, Julia M Salamat, Karen Riggins, Jiejun Shi, Lanlan Shen

Children’s Nutrition Research Center Staff Publications

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During weaning, the transition to solid food diversifies the gut microbiome, triggering a programmed immune response critical for long-lasting mucosal immunity. Previous work showed that the gut microbiome mediates epigenetic development in intestinal stem cells (ISCs) during suckling, but what happens during weaning is unclear. Here, genome-wide profiling revealed that weaning-driven microbiome changes shape the DNA methylome and transcriptome of murine ISCs in an IFNγ-dependent manner. Specifically, we observe demethylation of enhancer elements essential for MHC class II genes, which results in a transcriptional memory that persists through differentiation into adulthood. IFNγ blockade, or low-dose penicillin to target Gram-positive bacteria, …

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A Flexible Wearable Glucose Sensor For Noninvasive Diabetes Screening: Functional Equivalence And Model Interpretability, Wenhan Xie, Wang, Hao Liu, Shuo Chen, Peng Wang, Yumei Han, Xianxiang Chen, Zhen Fang, Zhan Zhao, Guohong Zhang, Xiuhua Guo

Research outputs 2022 to 2026

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Real-world evidence for wearable noninvasive glucose monitoring (NIGM) remains limited. To evaluate the functional equivalence of a wearable NIGM device and explore its utility for T2DM and prediabetes screening. In this multicenter study, 12-h daytime glucose profiles obtained by a flexible reverse iontophoresis-based electrochemical sensor were compared with capillary glucose using functional equivalence. Subgroup analyses were conducted. Screening models of T2DM and prediabetes were developed using elastic net and Logistic regression. A total of 135 participants (mean age 35.3 years; 60.0% female) were included, and no serious device-related adverse events were reported. Compared to the capillary measurements, functional equivalence was …

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Sequential Presentation Of Diabetic Ketoacidosis, Acute Ischemic Stroke, And St-Elevation Myocardial Infarction: A Case Report, Ichlasul Mahdi Fardhani, Putu Aditya Darmawan Kuntadi, Hammam Arif Shabri, Muhammad Isra Rafidin Rayyan, Zarrah Yuniar Qolbi Harris, Tristi Lukita Wening, Azham Purwandhono

Chulalongkorn Medical Journal

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Cardio-cerebral infarction (CCI), the simultaneous occurrence of acute ischemic stroke (AIS) and acute myocardial infarction (AMI), is a rare and life-threatening emergency. Management becomes even more challenging when accompanied by metabolic complications like diabetic ketoacidosis (DKA). We report a case of a 45-year-old man with hypertension and a chronic smoking history, found unresponsive with right-sided hemiparesis. He was last seen well six hours before arrival. On examination, he was hypertensive, tachypneic, had a ketotic breath odor, GCS 12, and NIHSS 15. Laboratory results confirmed DKA, with a random blood glucose of 412 mg/dL and metabolic acidosis. Non-contrast brain CT revealed …

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2025 Novel Drug Approvals, Katherine Ghattas Pharmd, Amanda Rawa Pharmd

Transformative Medicine

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The year 2025 marked another strong chapter in pharmaceutical innovation, with multiple novel therapies gaining approval from the U.S. Food and Drug Administration (FDA). These approvals reflect continued progress in addressing unmet medical needs across a wide range of disease states. This article reviews the FDA’s 2025 novel drug approvals, spotlighting a few therapeutic advancements and emerging trends. A comprehensive table of all approved agents is provided, along with a focused discussion of four particularly impactful therapies: donidalorsen (Dawnzera), taletrectinib (Ibtrozi), delgocitinib (Anzupgo), gepotidacin (Blujepa), etripamil (Cardamyst). Each of these agents represents a step forward in its respective field and …

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3'Utr Mapping Reveals Alternative Polyadenylation In Right Ventricular Failure, Rahul Neupane, Kartiga Natarajan, Erik E Suarez, Henry J Pownall, Kai-Lieh Huang, Eric J Wagner, Ajay Kumar Verma, Rambabu Majji, Hari Krishna Yalamanchili, Ashrith Guha, Rajarajan A Thandavarayan

Children’s Nutrition Research Center Staff Publications

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No abstract provided.

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Educational Intervention To Improve Awareness Of The Female Athlete Triad Among Division I Athletes, Carly J. Haring, Jonathan Olson Md

Aesculapius Journal (Health Sciences & Medicine)

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Introduction: The Female Athlete Triad poses short- and long-term health risks for female athletes through the interrelated components of low energy availability, menstrual dysfunction, and impaired bone health. Despite its prevalence, awareness and education surrounding the Triad remain limited, contributing to delayed recognition and care. The objective of this project was to assess baseline knowledge and comfort discussing Female Athlete Triad–related topics among Division I female athletes and to evaluate the impact of a brief educational intervention on knowledge, attitudes, and help-seeking intentions.

Methods: A community-based educational initiative was conducted in November 2025 among Division I female athletes …

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Diagnosis And Characterization Of Thyroid Dysfunction In Patients Evaluated In Primary Care In A Rural Zone Of Honduras, Javier Shafick Asfura, Travis Wesley Harris, Amanda Reeck, María Fernanda Chévez

Journal of Community Hospital Internal Medicine Perspectives

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Background: Thyroid disorders are prevalent and frequently underdiagnosed in primary care, particularly in resource-limited rural areas. Their nonspecific symptoms complicate early recognition and treatment. This study aimed to determine the prevalence of thyroid dysfunction and describe the clinical reasoning, diagnostic strategies, and laboratory findings among adults evaluated with TSH testing in rural Honduras. Methods: A retrospective, descriptive, cross-sectional study was conducted at Hospital Loma de Luz in Balfate, Honduras. Adult patients aged ≥18 years who underwent diagnostic TSH testing between January 1, 2022, and January 31, 2023, were included. Patients with prior thyroid diagnoses or current pregnancy were …

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Misregulated Alternative Splicing In Endometriosis: A Role For Aberrant Mrna Variants In Endometriotic Cell Growth, Venkata Naga Goutham Davuluri, Michelle Dias, Roxanna Llinas, Kamath Neha, Pooja Popli, Shannon M Hawkins, Chandrakant Tayade, Elise T Courtois, Hari Krishna Yalamanchili, Ramakrishna Kommagani

Children’s Nutrition Research Center Staff Publications

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Endometriosis is a chronic gynecological disorder marked by the growth of endometrial-like tissue outside the uterus, often leading to pelvic pain, inflammation, and infertility. Despite its global prevalence, diagnosis remains delayed, and effective non-surgical treatments are lacking. While recent transcriptomic studies have identified mRNA transcript changes in ectopic lesions, the contribution of alternative pre-mRNA splicing, a key posttranscriptional regulatory layer, remains largely unknown. In this study, we performed a comprehensive analysis of alternative splicing (AS) events in endometriotic lesions using transcriptomic data. We uncovered distinct alterations in alternative splicing events are associated with endometriosis, highlighting a previously underappreciated layer of …

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3. Skin To Skin Holding To Reduce Neonatal Hypoglycemia, Merebea Danforth

Providence Nursing Research Conference 2023 – Present

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No abstract provided.

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