Endocrinology, Diabetes, and Metabolism Commons^™

Glucagon-Like Peptide-1s Compared To Sulfonylureas In The Treatment Of Adults Diagnosed With Type Ii Diabetes Mellitus In Primary Care, Tracy Kirchner

Physician Assistant Scholarly Project Posters

Type II diabetes mellitus (T2DM) is a prevalent disease in our country. Bullard et al. (2018) report approximately 21 million adults have T2DM in the United States. “The total estimated cost of diagnosed diabetes in 2017 is $327 billion, including $237 billion in direct medical costs and $90 billion in reduced productivity” (Yang et al., 2018). Treatment of T2DM is individualized to each patient based on their co-morbidities, fiscal responsibility, and route of administration options. Sulfonylureas and Glucagon-like Peptide-1s (GLP-1) are two classes of antidiabetic drugs that are available for use as second line treatment options after metformin. This review …

Utility Of Point-Of-Care Beta-Hydroxybutyrate Testing For Predicting Diabetic Ketoacidosis In The Pediatric Emergency Department, Michelle Knoll, Kelsee Halpin, Ryan Mcdonough

Posters

The objective of our investigation was to describe the diagnostic characteristics of point-of-care capillary beta-hydroxybutyrate (BOHB) testing to predict diabetic ketoacidosis among pediatric patients presenting with hyperglycemia in the pediatric emergency department.

Serum Amyloid A And Janus Kinase 2 In A Mouse Model Of Diabetic Kidney Disease., Brad P Dieter, Rick L Meek, Robert J Anderberg, Sheryl K Cooney, Jen L Bergin, Hongyu Zhang, Viji Nair, Matthias Kretzler, Frank C Brosius, Katherine Tuttle

Articles, Abstracts, and Reports

BACKGROUND: Serum amyloid A (SAA), a potent inflammatory mediator, and Janus kinase 2 (JAK2), an intracellular signaling kinase, are increased by diabetes. The aims were to elucidate: 1) a JAK2-mediated pathway for increased SAA in the kidneys of diabetic mice; 2) a JAK2-SAA pathway for inflammation in podocytes.

METHODS: Akita diabetic mice (129S6) with podocyte JAK2 overexpression and angiotensin II infusion (4 weeks) were given a JAK1,2 inhibitor (LY03103801, 3 mg/kg/day orally for the last two weeks). Kidneys were immunostained for SAA isoform 3 (SAA3). SAA3 knockout and control mouse podocytes were exposed to advanced glycation end products (AGE) or …

Examining Biobehavioral Variables And Predictors Associated With Type 2 Diabetes Self- Management, Karin A. Emery

Theses and Dissertations

Type 2 diabetes mellitus self-management is a challenging process that brings forward a variety of emotional responses. The purpose of this work was to explore relationships between diabetes distress, self-efficacy and resilience and outcomes of glycosylated hemoglobin, quality of life and health status. A cross sectional descriptive design was used for this pilot study of 78 individuals enrolled from an Endocrine clinic in the Midwest United States and a Primary Care clinic in the southeast United States.

Data were analyzed using descriptive statistics to characterize the sample and model variables. Spearman’s correlation was completed to identify relationships among variables. A …

The Feasibility Of A Behavioral Group Intervention After Weight-Loss Surgery: A Randomized Pilot Trial, Michelle R. Lent, Laura K Campbell, Mackenzie C Kelly, Jessica L Lawson, Jessica M Murakami, Sasha Gorrell, G Craig Wood, Marianne M Yohn, Stephanie Ranck, Anthony T Petrick, Krystal Cunningham, Megan E Lamotte, Christopher D Still

PCOM Scholarly Works

BACKGROUND: Formal psychosocial support programs after weight-loss surgery are limited in scope and availability.

OBJECTIVE: This randomized pilot study evaluated the feasibility of a postoperative behavioral intervention program.

MATERIALS AND METHODS: Postoperative weight-loss surgery patients (N = 50) were recruited from February 2017-July 2017 and randomized to a four-month behavioral program or usual care wait-list. Outcomes evaluated in addition to feasibility included health-related quality of life (Short Form -36), psychosocial functioning and adherence. Secondary outcomes included within-group changes for each outcome.

RESULTS: Out of eight possible sessions, intervention participants attended a mean of 4.2 sessions. Intervention group participants experienced greater …

Associations Of Hemoglobin A1c With Cognition Reduced For Long Diabetes Duration, Jeremy M. Silverman, James Schmeidler, Pearl G. Lee, Neil B. Alexander, Michal Schnaider Beeri, Elizabeth Guerrero-Berroa, Rebecca K. West, Mary Sano, Martina Nabozny, Carolina Rodriguez Alvarez

Publications and Research

Introduction: Associations of some risk factors with poor cognition, identified prior to age 75, are reduced or reversed in very old age. The Protected Survivor Model predicts this interaction due to enhanced survival of those with extended risk factor duration. In a younger sample, this study examines the association of cognition with the mean hemoglobin A1c risk factor over the time at risk, according to its duration.

Methods: The interaction of mean hemoglobin A1c (average = 9.8%), evaluated over duration (average = 116.8 months), was examined for overall cognition and three cognitive domains in a sample of 150 “young-old” veterans …

Early Aggressive Insulin Therapy In Type 2 Diabetes, Bryan Johnson

Physician Assistant Scholarly Project Posters

Metformin has been proven beneficial for the first-line treatment of type 2 diabetic mellitus (T2DM) due to its efficacy and low adverse effect profile. Current US guidelines do not address the use of early intensive insulin use in T2DM. Treatment plans are slowly adjusted over the months until the A1C goal is met. Insulin is initiated several years after the time of T2DM diagnosis and utilized as second-line therapy. Dual therapy of insulin and metformin have shown regression of T2DM in certain patient populations. However, the linear relationship between diabetes and cardiovascular disease does not show greater improvement with dual …

Delaying Diabetes In The Native American Population, Seth Tramm

Physician Assistant Scholarly Project Posters

Diabetes is a debilitating disease process caused by the body’s inability to control blood glucose levels. With over 30 million diabetics in the United States and another 85 million prediabetics, the effects of this disease are wide-spread and far-reaching. Native American/Alaska Native populations have a nearly two-fold increase in prevalence of diabetes when compared to non-native populations. Risk factors for diabetes in all populations include modifiable risks such as obesity, diet, and physical inactivity as well as non-modifiable factors such as age, family history, and ethnicity. Studies have shown that early identification of symptoms, coupled with proper and intentional treatment …

Detection Of Human Plasma Glucose Using A Self-Powered Glucose Biosensor, Gymama Slaughter, Tanmay Kulkarni

Bioelectrics Publications

This work presents the characterization of a self-powered glucose biosensor using individual sequential assays of human plasma glucose obtained from diabetic patients. The self-powered glucose biosensor is exploited to optimize the assay parameters for sensing plasma glucose levels. In particular, the biofuel cell component of the system at pH 7.4, 37 °C generates a power density directly proportional to plasma glucose and exhibited a maximum power density of 0.462 mW·cm⁻² at a cell voltage of 0.213 V in 5 mM plasma glucose. Plasma glucose is further sensed by monitoring the charge/discharge frequency (Hz) of the integrated capacitor functioning as …

Associations Between Income, Acculturation, Country Of Origin, And Type Ii Diabetes Among African Immigrants To Ontario, Canada, Girma Aman Goshe

Walden Dissertations and Doctoral Studies

Diabetes has become a longstanding public health challenge around the world. Over the last 3 decades, the number of people with Type II diabetes (T2DM) has grown to an epidemic level in Canada. Prior research indicated African immigrants residing in Ontario, Canada experienced a 2-4 times higher prevalence of T2DM than Canadian-born individuals. The social determinants of health theoretical framework guided this study assessing the relationship of the risk factors with T2DM. A quantitative, cross-sectional design was employed using the 2007-2014 Canadian Community Health Survey data. The random sample included 1,526 African immigrants residing in Ontario, Canada. Descriptive, bivariate, and …

A Time-Friendly, Feasible Measure Of Nutrition Knowledge In Type 1 Diabetes: The Electronic Nutrition And Carbohydrate Counting Quiz (Encq)., Arwen M. Marker, Amy E. Noser, Nicole Knecht, Mark A. Clements, Susana R. Patton

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Greater knowledge about nutrition and carbohydrate counting are associated with improved glycemic control and quality of life in youth with type 1 diabetes (T1D). However, limited assessments of nutrition and carbohydrate knowledge have been developed, and existing measures can be time-consuming, overly broad, or not conducive to routine clinical use. To fill this gap, we developed and examined the feasibility of administering the electronic Nutrition and Carbohydrate Counting Quiz (eNCQ).

METHOD: Ninety-two caregivers and 70 youth with T1D (mean age 12.5 years; mean time since diagnosis 5 years; English speaking) completed the 19-item eNCQ via tablet during a routine …

Insulin Pump Adherence Behaviors Do Not Correlate With Glycemic Variability Among Youth With Type 1 Diabetes (T1d)., Emily Paprocki, Vincent S. Staggs, Susan Patton, Mark A. Clements

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Does Whole Body Vibration Therapy Improve Balance In Patients With Type 2 Diabetes Mellitus?, Samantha L. Aksu

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not whole body vibration (WBV) therapy improves balance in patients with type 2 diabetes mellitus (DM).

STUDY DESIGN: A review of three peer-reviewed studies published between 2013 and 2015.

DATA SOURCES: Two randomized controlled trials and one case series. Using PubMed and Google Scholar, studies were selected if they assessed the effects of whole body vibration therapy on improving balance in diabetic patients, and whether the outcomes were patient oriented.

UTCOMES MEASURED: The outcome measured in this study was balance, which was assessed using the Timed Up …

Is Low-Level Laser Therapy (Lllt) Effective In Reducing Pain And Ulcer Size In Diabetic Patients With Foot Ulcers?, Corey J. Elmer

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Low-level laser therapy (LLLT) is an effective therapy in reducing pain and ulcer size in diabetic patients with foot ulcers.

STUDY DESIGN: Systematic review of three randomized controlled trials (RCTs) from peer reviewed journals, published in 2015, 2016 and 2017.

DATA SOURCES: The studies compare the effectiveness of LLLT versus conventional wound treatment in reducing pain and ulcer size in diabetic patients with foot ulcers. All studies were found using PubMed and CINAHL Plus.

OUTCOMES MEASURED: Pain as perceived by the patient, measured by visual analog …

Is Metoclopramide Effective In Treating Symptoms In Diabetic Gastroparesis?, Prachi Patel

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not is metoclopramide effective in treating symptoms in diabetic gastroparesis?

Study Design: Systematic review of 1 controlled randomized double blinded study, 1 controlled randomized open label study, and 1 controlled open label case analysis published in peer reviewed journals between 2012-2014, all in English language.

Data Sources: 1 randomized double blinded study, 1 randomized open label study, and 1 case analysis comparing symptom reduction of gastroparesis after the intervention of nasal and oral metoclopramide compared to placebo controls. These sources were found using PubMed and OVID.

Outcomes …

Blended Learning Mediated Fostering Of Students’ Engagement In An Undergraduate Medical Education Module, Lena Jafri, Hafsa Majid, Salman Siddiqi, Najmul Islam, Faraz Khurshid

Department of Pathology and Laboratory Medicine

Introduction: The study investigated students’ perception of introducing blended learning strategies to engage and motivate them towards lecture halls and Problem Based Learning (PBL) sessions for improving the quality of the overall students’ learning experience.
Methods: A prospective study was conducted at the Aga Khan University Medical College involving a total of one hundred four (104) year II medical students for the Endocrine and Reproduction module in the academic year 2018. This module ran for six weeks. Modifications in teaching methods were made for this module introduced after approval from Endocrine & Reproduction module, year II and curriculum committees. Written …

Diagnosing And Treating Diabetes In Rural Jamaica, Emily C. Sims

Scholarship in Medicine - All Papers

Objective: This research study was conducted to determine the correlation between finger stick glucose and finger stick hemoglobin A1c values in order to draw conclusions about the redundancy of the two tests in a rural Jamaican traveling clinic setting. Methods: This study was conducted using de-identified data from an electronic health record used in clinics in St. Mary’s Parish, Jamaica. A correlational analysis was completed using the glucose and A1c variables to determine both the direction and strength of the correlation. Results: A positive correlation of 0.654549 was found in analysis. This correlation did not meet the set threshold for …

Clinical And Genetic Associations Of Renal Function And Diabetic Kidney Disease In The United Arab Emirates: A Cross-Sectional Study, Wael M. Osman, Herbert F. Jelinek, Guan K. Tay, Ahsan H. Khandoker, Kinda Khalaf, Wael Almahmeed, Mohamed H. Hassan, Habiba S. Alsafar

Research outputs 2014 to 2021

OBJECTIVES: Within the Emirati population, risk factors and genetic predisposition to diabetic kidney disease (DKD) have not yet been investigated. The aim of this research was to determine potential clinical, laboratory and reported genetic loci as risk factors for DKD.

RESEARCH DESIGN AND METHODS: Four hundred and ninety unrelated Emirati nationals with type 2 diabetes mellitus (T2DM) were recruited with and without DKD, and clinical and laboratory data were obtained. Following adjustments for possible confounders, a logistic regression model was developed to test the associations of 63 single nucleotide polymorphisms (SNPs) in 43 genetic loci with DKD (145 patients with …

Prefronto-Cerebellar Neuromodulation Affects Appetite In Obesity, Elena M. Marron, Raquel Viejo-Sobera, Guillem Cuatrecasas, Diego Redolar-Ripoll, Pilar García Lorda, Abhishek Datta, Marom Bikson, Greta Magerowksi, Miguel Alonso-Alonso

Publications and Research

Human neuroimaging studies have consistently reported changes in cerebellar function and integrity in association with obesity. To date, however, the nature of this link has not been studied directly. Emerging evidence suggests a role for the cerebellum in higher cognitive functions through reciprocal connections with the prefrontal cortex. The purpose of this exploratory study was to examine appetite changes associated with noninvasive prefronto-cerebellar neuromodulation in obesity. 12 subjects with class I obesity (mean BMI 32.9 kg/m2) underwent a randomized, single-blinded, sham-controlled, crossover study, during which they received transcranial direct current stimulation (tDCS; active/sham) aimed at simultaneously enhancing the activity of …

Accuracy Of Wrist-Worn Activity Monitors During Common Daily Physical Activities And Types Of Structured Exercise: Evaluation Study., Ravi Kondama Reddy, Rubin Pooni, Dessi P. Zaharieva, Brian Senf, Joseph El Youssef, Eyal Dassau, Francis J. Doyle Iii, Mark A. Clements, Michael R. Rickels, Susana R. Patton, Jessica R. Castle, Michael C. Riddell, Peter G. Jacobs

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Wrist-worn activity monitors are often used to monitor heart rate (HR) and energy expenditure (EE) in a variety of settings including more recently in medical applications. The use of real-time physiological signals to inform medical systems including drug delivery systems and decision support systems will depend on the accuracy of the signals being measured, including accuracy of HR and EE. Prior studies assessed accuracy of wearables only during steady-state aerobic exercise.

OBJECTIVE: The objective of this study was to validate the accuracy of both HR and EE for 2 common wrist-worn devices during a variety of dynamic activities that …