Browsing by Subject "Diabetes"

Now showing 1 - 20 of 42
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    2-hydrazinoquinoline as a novel derivatization agent for LC-MS-based metabolomic investigation of ketoacidosis in streptozotocin-elicited diabetes
    (2013-07) Lu, Yuwei
    Short-chain carboxylic acids, aldehydes, and ketones are important intermediates and end products of many metabolic processes. Their levels in biofluids and tissues can reflect the status of specific metabolic reactions, the homeostasis of whole metabolic system, and the well-being of a biological entity. Traditionally, GC-MS has been widely used for analyzing carboxylic acids, aldehydes, and ketones in biological samples after chemical derivatization. However, due to poor compatibility of common GC columns with water, the derivatization process in GC-MS is often complicated and time consuming, especially for the metabolites in biofluids and tissues. Recently, new chemical derivatization techniques have been developed to enhance the sensitivity and performance of LC-MS for analyzing these metabolites. In this study, the use of 2-hydrazinoquinoline (HQ) as a novel derivatization agent for LC-MS analysis of carboxylic acids, aldehydes, and ketones in biological samples was explored, and the conditions for the derivatization reaction were optimized. The metabolites in urine, serum, and tissue extracts can be conveniently derivatized in a 60-min process. The formation of carboxylic acid derivatives is attributed to the esterification reaction between HQ and carboxyl group, while the production of aldehyde and ketone derivatives is through the formation of Schiff bases between HQ and carbonyl group. Compared to other known hydrazine derivatization agents, including 2-hydrazinopyridine, 2-picolylamine and dansyl hydrazine, HQ can react with a broader spectrum of intermediary metabolites in biological samples, and can achieve better chromatographic performance in reversed phase LC system and higher ionization efficiency in electrospray source. Using this HQ-based approach, the metabolic disorder induced by streptozotocin-elicited diabetes was examined by the LC-MS-based metabolomics. The results showed the time-dependent separation of mouse urine samples from STZ treatment in a multivariate model of urinary metabolites. Both known and novel small-molecule biomarkers associated with STZ-induced ketoacidosis were conveniently identified and subsequently elucidated, reflecting the dramatic changes in nutrient (glucose, amino acid, and lipid) and energy metabolism after STZ treatment. Overall, HQ derivatization of carboxylic acids, aldehydes, and ketones can be an effective platform for the LC-MS-based metabolomic investigation of endogenous metabolism.
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    An Alternative Approach to Type 2 Diabetes Care: The Inclusion of Community Health Worker Interventions in Patient Care
    (2017-05) Trump, Lisa
    A wealth of research has been conducted on the successful management of Type 2 diabetes. Yet for many patients and their families, this disease remains a considerable challenge and current care practices are insufficient. Previous research has highlighted how problematic this gap is with respect to patient- and community-health. Recently, scholarship and clinical practice have shifted attention to exploring alternative approaches to care. The use of community health workers (CHW) to bridge the gap between patients and the medical system has gained attention and support from preliminary research and practice. The present research aims to extend what is known about the association between CHW interventions and patients’ biopsychosocial health outcomes via a two-pronged approach. First, I conducted a systematic review of randomized controlled trials of CHW-delivered interventions to orient researchers and clinicians to the current state of this work and to present a call to action for where future research needs to go. This study identified the lack of consistency in the theoretical conceptualization, design, and delivery of CHW interventions. Specifically, there was great variation across studies’ intervention dosages, attrition rates, and methods of CHW training. The main foci across studies’ findings demonstrated a relationship between a CHW-delivered intervention and improvements in patients’ physical and emotional health, diabetes knowledge, and self-care behaviors. Second, I conducted a pilot study following a mixed-method design testing a one-year CHW-delivered intervention. A sequential, explanatory mixed-method approach was used to gain breadth and depth of understanding, and to corroborate findings. More specifically, quantitative data collection and analyses preceded the qualitative interviews and thematic analysis, which included a sample of the intervention group. Quantitative data were gathered at baseline, 6-months, and 12-months to assess patients’ physical health, emotional well-being, and perceived social support. Health outcomes data were compared with a matched control group. Phenomenological qualitative data were gathered via key informant interviews and analyzed using Crabtree and Miller’s (1999) thematic analysis method. Findings from statistical analyses based on standardized measures revealed a significant improvement in perceived social support from baseline to 6-months, and a significant improvement in dietary adherence from baseline to 12-months. Findings from phenomenological interviews showed a significant improvement in perceived social support from a special person and in dietary adherence. Thematic analysis revealed a major theme regarding CHW roles (i.e., coach, advocate, teacher, and confidant). A second major theme outlined ecological impacts (i.e., support that participants received from family members was primarily tangible in-nature, and diabetes management – for participants – represents only a part of a considerably larger and more complex picture of health and well-being). Implications of these two studies point to the need for comprehensive care that includes the CHW as a member of care teams. With the growing need to provide more comprehensive health care, future research is warranted to continue to tease out the primary mechanisms of change within CHW interventions. This information is important to further refine the hiring process of CHWs best equipped for the role, CHW training, and the foci of CHW attention in their work with patients. These efforts will also further-equip providers to support patients’ Type 2 diabetes management, advancing the Triple Aim of healthcare.
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    Bittersweet Migrations: Type II Diabetes and Healing in the Hmong Diaspora
    (2018-06) Thao, Mai
    As the seventh leading killer in the United States, type II diabetes disproportionally burdens minorities and those of lower socioeconomic standing, especially immigrant and refugee communities. However, why might a segment of a refugee population engage in return migration to places of exile for healing? Examining disease as socially and physically produced, this project investigates the multiple meanings behind return migrations to Laos and Thailand for Hmong-Americans with type II diabetes and who are 50 years and older. Based on 30 months of multi-sited ethnography, conducted in the clinic setting of St. Paul, Minnesota and the sites of Hmong-American travel destinations in Laos and Thailand, this dissertations argues that diabetes management focuses on the discipline of the somatic body through glucose monitoring, diet, and exercise. Yet, Hmong-American patients surface the need for social care-to attend to the social chronicity of being displaced refugees. Feelings of bodily difference and displacement in diabetes narratives produce a fluid Hmong-American subjectivity that actively remembers the past and places of familiarity. Nostalgia, melancholy, return migration, reception and discourse by Hmong-Lao and Hmong-Thai, and the embodiment of place and herbs, creatively engages in social care, centered around social continuity of kinship and origin. Through the social fields of the diabetic body, Hmong-Americans, Hmong-Lao, and Hmong-Thai, that a (de)territorialization of the Homeland, a place of exile, is transformed for a Hmong-American belonging. Yet, paradoxically, discourse about a cure from diabetes and a true Hmong-American return migration is often spoken as through death. The claim to death restructures the social order of chronic disease management (where death is often displaced) and Hmong-American racial position in the U.S. Death as an ultimate form of cure and return is a political claim to an eternal Hmong body politic.
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    Carvedilol offers significant advantages over Metoprolol for control of hypertension in patients with Type II Diabetes Mellitus.
    (2010-07-21) Stish, Brad
    When using beta-blocker for blood pressure in patients with Type II diabetes mellitus, the metabolic effects of Carvedilol are superior to those of Metoprolol. While both drugs appear to have equivalent ability to lower blood pressure, patients taking Carvedilol better HgbA1c levels, improved insulin sensitivity, and lower levels of microalbuminuria.
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    Controlling Blood Glucose – All about Blood Glucose for People with Diabetes
    (2010-09-15) Garber, Suzanne
    Intensive glucose-control strategy starting at the time of diagnosis as well as the addition of lipid lowering therapy and anti-hypertensive treatment significantly reduces the risk of heart attacks, stroke, and blindness/diabetic eye disease in diabetic patients.
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    Cryopreservation of Pancreatic Islets Experimental Data Repository 2022
    (2022-01-18) Bischof, John, C; Finger, Erik, B; efinger@umn.edu; Finger, Erik, B; University of Minnesota Organ and Tissue Preservation Group
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    "Death is due to lack of knowledge": community practices of a successful multi-partnered health disparities intervention for low-income African Americans in South Carolina
    (2013-05) Littleton, Dawn
    The purpose of this study was to describe the methods--including practices, policies, and roles--used by public and academic library staff in a Centers for Disease Control and Prevention (CDC) Racial and Ethnic Approach to Community Health (REACH) intervention that proved successful in reducing or eliminating several diabetes-related health disparities in a vulnerable population. An intrinsic case study methodology was used to identify effective services, resources, and practices for library staff. A semi-structured telephone interview was completed by 11 community partners from a successful multi-partnered, community-based, diabetes-related health disparities intervention that included librarians as community partners. Questions included (a) What were some traditional or innovative library roles, services, or resources used in this successful intervention? (b) How was helicopter research avoided? (c) How was trust with the vulnerable community members established and maintained? (d) How were community members with low literacy included? Data were audio-recorded and transcribed. Eight major themes consistent with transformative adult learning theories were identified from the coded transcripts, including (a) autonomy, (b) community-based and community-led, (c) incentives, (d) a new role for professionals, (e) participants realizing success, (f) church participation, (g) transformation, and (h) perspective of the librarians. The insights and guidelines suggested by this research may be helpful when deciding how or when to participate in community-based health disparities interventions for vulnerable populations.
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    Diabetes and Blood Pressure Control
    (2010-07-21) Lisberg, Aaron
    Lowering the systolic blood pressure of newly diagnosed type 2 diabetics can significantly decrease the incidence of diabetes related microvascular complications such as retinopathy, vitreous hemorrhage, and renal failure. A 10 mm Hg reduction in systolic blood pressure leads to a 13% (P < 0.0001) decrease in the incidence of microvascular complications.
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    Diabetes and Management: Why is it Important?
    (2011-08-03) Honstad, Angela
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    Diabetes and Your Future Health
    (2009-05-04) Vlaminck, Jay
    In patients with poorly controlled insulin dependent type 2 diabetes, addition of metformin to insulin regimen significantly lowers hemoglobin A1c levels and results in lower units of insulin needed per day than in patients receiving insulin alone. There is also a trend towards decreased weight gain in those receiving insulin + metformin, though this was not found to be statistically significant in this study.
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    Diabetes During Pregnancy
    (2012-09-24) Morcomb, Erin
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    Diabetes Mobile App Usability for Adult Patients with Diabetes
    (2018-05) Fu, Helen
    More than 1,100 diabetes apps are available, but are infrequently used. A systematic review identified unsatisfactory diabetes app usability and its clinical effect to lower hemoglobin A1c level (0.15% to 1.9%), with variations in interactive app features for real-time feedback through automatic data analysis, clinician text messages, reminder alerts, or an app-initiated phone call. This result identified the need for health behavior theory applications to guide diabetes app usability evaluation. This study applied the Self-Determination Theory on human motivation to select app testing functions and to understand adult patient perspectives to use apps. A total of 92 adults with diabetes type 1 or 2 participated in a randomized crossover trial to test the usability of two top-rated Android diabetes apps (mySugr and OnTrack). Multivariable linear regression models assessed the effects of patient characteristics (i.e., age, education, and diabetes) and psychological needs on user satisfaction and user performance. Psychological needs important for motivation and behavioral change were associated with diabetes app usability. Higher user satisfaction was observed for participants who reported competence, autonomy, or connectivity with a healthcare provider. To enhance motivation to use apps for self-management, clinicians should consider addressing the patient’s competence, autonomy, and connectivity. User performance was associated with patient characteristics of age, sex, education, and diabetes duration because they affect the patient’s ability to use apps efficiently, successfully, and accurately. App training and ongoing technical support should be tailored for older adults, men, patients with less education, and those with diabetes duration more than 10 years.
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    Diabetes: Taking Care of Yourself
    (2009-08-20) Maust, Thomas J.
    General information regarding type 2 diabetes care in a primary care setting including information regarding associated triopathy, eating habits, blood sugar information, what to expect at the doctor’s visit, and when to call the doctor.
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    The Diabetic Foot…A foot ulcer guide for diabetics and tips for healthy feet
    (2008-09-02) McCabe, James
    A major complication of diabetes is foot ulcer. This patient education tool uses specific clinical characteristics to determine a diabetic’s risk for getting a diabetic foot ulcer over the next 10 years. Tips on how to prevent foot ulcers and how to maintain healthy feet are included. Also referenced are multiple websites that overview diabetes, diabetic foot ulcers and prevention tips in both English and Spanish.
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    Diabetic Kidney Disease – What You Need To Know
    (2008-04-08) Olson, Shawn
    Diabetic kidney disease is a serious concern problem, requiring close attention. Within 20-25 years, as many as 25-40% of diabetic patients will begin showing signs of kidney disease. With diabetic kidney disease’s increased risk of disability and death, it is important for patients to understand the problem as well as how to decrease their risk. Interventions such as tight control of blood sugars, maintenance of a goal blood pressure as well as use of either an ACE Inhibitor or an Angiotensin Receptor blocker can help reduce patients’ risk from diabetic kidney disease.
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    Diagnosis and Management of Diabetes
    (2008-11-24) Solheid, Greg
    Aggressive use of glucose lowering agents to achieve HbA1c levels within normal (<6.0%) significantly increases risk of mortality in type 2 diabetics.
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    Drinking Coffee Decreases a Patients Risk for Developing Type II Diabetes.
    (2009-05-04) Feia, Kendall
    Many patients come to clinic asking about how drinking coffee can affect their health either for good or bad. A recent study published in the annals of internal medicine followed thousands of men and women over a number of years and showed that drinking coffee actually had a significant protective benefit in helping prevent type II diabetes, however more evaluation is necessary. The purpose of this pamphlet is to better describe the risk factors for type II diabetes, as well as lay out lifestyle modifications that can be made in order to reduce a patient’s risk of developing type II diabetes.
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    Early Pubertal Development and Cardiometabolic Risk: A Life Course Approach
    (2013-09) Dreyfus, Jill
    A number of reports have linked early pubertal development to adverse health conditions among women. Despite race disparities in pubertal timing and later cardiovascular disease (CVD)-related health in adulthood, few studies have investigated if associations of early maturation with cardiometabolic risk factors differ for African-American and white women. Furthermore, there are limited longitudinal data tracking the trajectory of change in cardiometabolic risk factors after puberty and into adolescence and adulthood. The three primary aims of this thesis were to 1) examine the relationship between earlier age at menarche and CVD risk factors at different points in the life course, 2) account for the role of adiposity in associations, and 3) explore possible race differences in associations. These aims were explored using data from three prospective cohort studies that included different age groups: the National Growth and Health Study (NGHS) for ages 9-19 years, the Coronary Artery Risk Development in Young Adults (CARDIA) study for ages 18-54 years, and the Atherosclerosis Risk in Communities (ARIC) study for ages 45-75 years. The results from the three manuscripts included in this thesis suggested that earlier age at menarche was associated with a more adverse cardiometabolic profile over the life course, but higher lifetime accumulated adiposity among early maturing women explained most associations. Earlier menarche was more strongly related to adulthood adiposity and metabolic syndrome among white compared with African-American women, but there were no other differences by race. Targeted efforts to prevent obesity starting before puberty, as well as among early maturing girls even if normal weight, might be helpful for primordial prevention of cardiovascular disease.