Diabetes
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/21757
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Browsing Diabetes by Subject "diabetes"
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Item EFFECTIVNESS OF BALANCE TRAINING WITH VIRTUAL REALITY AND VIBROTACTILE DEVICE IN DIABETIC PATIENTS(2014-03) Behan, Francis; Jafari, Roozbeh; Patterson, Rita M.; Bugnariu, NicoletaPurpose (a): Patients with diabetic peripheral neuropathy experience different degrees of sensory loss in their feet and tend to rely heavily on visual inputs to maintain their balance. This is an efficient coping strategy for as long as they can attend to the placements of their feet, but becomes a high risk of falls when they have to visually attend to something else, like crossing a street or a conversation. The purpose of this research is to assess the effectiveness of a training program designed to improve balance through sensory reweighting based on the principles of stochastic resonance and using virtual reality (VR). Moreover, biomarkers for diabetic control and neuro-protection pre- and post- sensory retraining will be studied to identify possible correlations between balance control and specific lab values. In addition, membrane androgen receptor (mAR ) has been linked to poor cognitive performance in animal models and this link will be examined in terms of balance control in the human subjects. Methods (b): Subjects with peripheral neuropathy due to diabetes undergo 6 one hour long training sessions in which they practice increasingly more challenging task of balance and walking while their visual attention is engaged by the VR. During training subjects were fitted with vibratory devices placed above the level of sensory loss (around the ankles). The intended to enhance somatosensory perception in the feet vibration was constant and sub-threshold. At visit 1 and 8, Pre- and Post- training assessments of balance and gait function as well as blood values for mAR, follicle stimulating hormone, estradiol, estrogen, C reactive protein, glucose, and a lipid panel. Results (c): To date two subjects have been enrolled in the study and one diabetic subject has completed the entire 8 weeks training protocol. Comparison of pre- and post-training revealed an improved balance function expressed by increased anterior and lateral center of pressure movement (ability to reach forward and laterally without losing balance) and increased walking speed. At the end of the training subject was able to maintain a straight walking trajectory even in the presence of visual inputs entraining lateral movements. Conclusions (d): Preliminary results show that sensory retraining with VR and vibratory device is feasible in diabetic subjects and holds promise for improvement of balance due to an increased ability to integrate all sensory inputs available and a decreased reliance on visual inputs.Item THE ASSOCIATION BETWEEN ACCULTURATION AND RISK FOR TYPE 2 DIABETES IN MEXICAN-AMERICAN CHILDREN AND ADOLESCENTS(2014-03) Retana, Jos� D.; Proffitt Leyva, Randi; Fulda, Kimberly; Franks, SusanThe Association between Acculturation and Risk for Type 2 Diabetes in Mexican-American Children and Adolescents Purpose/Intro: Type 2 diabetes mellitus (DM2) is increasing in children and adolescents of all races/ethnicities in the United States, but especially in minorities such as Hispanics. In particular, Mexican-American children and adolescents are experiencing onset of DM2 at alarming rates. The purpose of this study was to examine the relationship between acculturation to a Mexican or Anglo orientation and risk for DM2. Methods: Participants completed demographic questions and the brief Acculturation Rating Scale for Mexican Americans II (Brief ARSMA-II). A linear acculturation score was derived from the Mexican Oriented Scale (MOS) and the Anglo Oriented Scale (AOS). Adolescents 10-14 years and a parent/legal guardian were included. At risk for DM2 was determined by having ≥3 of the following: relative with diabetes, BMI 95th percentile, blood pressure 95th percentile, elevated glucose, or positive for Acanthosis Nigricans. Simple and multiple logistic regressions were performed with risk of DM2 (high/low) as the outcome and acculturation score as the primary predictor. The adjusted model controlled for child’s age, gender, highest household education, child and maternal birth country (US/not US). Results: Participants (N=144) were 49% female and 51% male. The mean age was 11.96 years (SD=1.45). Forty-five children/adolescents (31.3%) had 3 of 5 risk factors for DM2. Approximately half (53.3%) of high risk children/adolescents were “strongly Anglo-oriented” and “Assimilated”. Higher acculturation was associated with an increased odds of being high risk for DM2 [OR=1.50; 95% CI (1.00-2.25)] Conclusions: For each degree of increased Anglo acculturation, risk for DM2 increased by 50%. Therefore, children of Mexican descent are more at risk for DM2 as they/their families become more acculturated to the Anglo cultural orientation. The degree of acculturation of a child/family should be taken into consideration when developing diabetes preventions and interventions.