Browsing by Subject "Nutritional and Metabolic Diseases"
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Item A Look at Diabetes Mellitus and the Effects of a Study Drug on Diabetic Nephropathy(2002-08-01) Schlueter, Cynthia K.; Debbie Lewis; Clifton Cage; Rustin ReevesDuring my internship, I assisted with a twenty-four week, phase 2, double blinded, placebo controlled trial for a drug being developed to slow, if not prevent, the development of ESRD from overt neuropathy in patients with both type 1 and type 2 diabetes. This drug is a naturally occurring component of vitamin B6 and is an AGE-inhibitor. The AGE-inhibitory effect of the study drug was discovered by isolating Amadori products in the pathway to AGE formation. Once the intermediates were isolated, the sponsor’s scientists searched for compounds that could specifically block the conversion of these Amadori products into AGEs. The study drug was found to be a strong inhibitor of this pathway. In comparison, the common AGE inhibitor, aminoguanidine was found to be ineffective in blocking the post-Amadori foundation AGEs. Therefore, it must block AGE formation at one of the less clinically relevant pathways, and should be less effective in treating nephropathy according to the sponsor’s scientists. This study included type 1 and type 2 patients with clinically diagnosed diabetic retinopathy and a urinary albumin excretion rate (UAE) of greater than 300 mg/24h. Other inclusion and exclusion criteria were applied for the safety of the subjects and greater viability of the data.Item Deltoid Opioid Receptor Phenotype Modulation of Hindlimb Vascular Conduction(2008-10-06) Barlow, Matthew A.; Raven, Peter B.; Gwirtz, Patricia A.; Dillon, Glenn H.Barlow, Matthew A. Deltoid Opioid Receptor Phenotype Modulation of Hindlimb Vascular Conduction. Doctor of Philosophy (Integrative Physiology), Oct 6th, 2008, 136 pp, 1 table 26 figures. Hypertension, diabetes mellitus and their presumed precursor the metabolic syndrome are part of a complex disease process associated with insulin resistance. Neurovascular complications in diabetics commonly involve the lower limbs resulting in a vicious cycle of autonomic neuropathy, painful occlusive claudication and resulting immobility that precipitates inactivity and progressive disability. The fixed neural and vascular diseases evolve slowly and the early events in this progressive decline in function are poorly understood. Sympathetic vasoconstriction is a major component of blood flow regulation in muscle. Active vasoconstriction in the lower limbs depends on continued transmission of efferent vasomotor signals through the lumbar sympathetic chain ganglia. Opioid receptors actively reduce normal ganglionic transmission presumably by lowering acetylcholine release. In the heart, the subtypes of delta-opioid receptors (DORs) facilitate (DOR-1, vagotonic) and inhibit (DOR-2, vagolytic) cholinergic transmission in the heart. The DOR-2 mediated inhibitory effects in heart are alterable and can change rapidly. Diabetes impairs vascular control. Ganglionic transmission is metabolically vulnerable during high fat feeding and insulin resistance. We hypothesized that the DOR-2 stimulation significantly facilitates vasodilation by reducing cholinergic transmission within the sympathetic chain ganglion. The ability to activate DOR-1 stimulation facilitates to cause further vasoconstriction in the anesthetized and surgically instrumented state of the dog did not show dose dependent activation. The DOR-1 activity in the insulin resistant dogs appears to be decreased as the DOR-1 blockade had no effect on the dose responses in the heart or the hindlimb. Enhanced sympathetic tone through BCO by increasing and reducing cholinergic transmission in the lumbar sympathetic ganglion shows an enhanced pro-constrictor phenotype under stresses of severe hypotension possibly through a DOR-1 mediated activation.Item Do Social Factors Influence the Severity of Diabetes among Hispanics in Fort Worth?: A Cross-Sectional Study(2004-05-01) Moayad, Neda Zandi; Hector Balcazar; Manuel Bayona; Sue LurieNeda Zandi Moayad, Do social factors influence the severity of Diabetes among Hispanics in Fort Worth? A cross-sectional study. Doctor of Public Health, May 2004, 91 pp., 5 tables, bibliography, 99 titles. The Latino population is the fastest growing ethnic group in Texas, representing more than 35% of the total population. There is evidence that diabetes among Latinos has increased considerably in recent years. The prevalence of type II diabetes in Latinos ages 45-74 is three times higher than in the non-Latino whites of the same age group. The goal of this research was to assess the importance of selected potential prognostic factors to severe type II diabetes in Latino patients. Among other findings, the results of this study show that family history of diabetes, place of birth and having spent childhood in Mexico, preferring Spanish as the spoken language, having been educated in Mexico, receiving food stamps, smoking, being overweight and obsess, acculturation and low family cohesiveness were associated with severe diabetes. These findings indicate that level of family cohesiveness and acculturation and other variables might be predictors of diabetes severity.Item Eating Disorders: Best Age for Education and Prevention(2004-05-01) Chasmawala, Jayshri R.; Susan Franks; Susan Eve; Muriel MarshallChasmawala, Jayshri R., Eating Disorders: Best Age for Prevention and Education. Master of Public Health (Dual Degree D.O./M.P.H.), May 2004, 22 pp., 11 tables, 6 illustrations, references, 16 titles. Objective: This study attempts to determine the best age to design a prevention program to prevent the development of eating disorders based on adolescents’ behavior and attitudes towards eating disorders. Methods: Forty students aged 11-17 answered a self-reported questionnaire regarding dieting and weight, identification of emotional states, and general awareness of eating disorders. Age group divided the sample: 13 years of age and younger; and 14 years of age and older. Multivariate analyses were performed to determine existence of any differences between the populations. Results: An overall difference in the age groups exists with statistic significance. The difference in mean values of interoceptive awareness is statistically significant between the age groups. Conclusion: Interoceptive Awareness, not awareness level of eating disorders, is more indicative of the best age for prevention. Younger age children may benefit more from prevention due to lack of emotional maturity which leads to higher risk of development of eating disorders.Item Effects of Cardiorespiratory Fitness on Serum Ferritin Concentration and Type 2 Diabetes: Evidence from the Aerobics Center Longitudinal Study (ACLS)(2008-05-01) Le, Tuan D.; Sejong Bae; Karan Singh; Steven BlairLe, Tuan D., Effects of Cardiorespiratory Fitness on Serum Ferritin Concentration and Type 2 Diabetes: Evidence from the Aerobics Center Longitudinal Student (ACLS). Doctor of Public Health (Clinical Research). May 2008, 114 pp., 12 tables, 8 figures, bibliography, 68 titles. Recent studies suggest that an elevated serum ferritin concentration is considered an independent factor associated with increased risk of type 2 diabetes and cardiorespiratory fitness (CRF) is inversely associated with diabetes. Using secondary data from Aerobics Center Longitudinal Study at the Cooper Institute, Dallas, Texas, the author explored the association between serum ferritin levels and diabetes, CRF and diabetes, and the effect of CRF on the association between serum ferritin levels and diabetes. A cross-sectional study and a longitudinal cohort study were used. In the cross-sectional study, an increased CRF level found to be associated with a decreased serum ferritin concentration and a lowered prevalence of type 2 diabetes. Participants with high ferritin levels and high triglyceride levels were 1.89 and 1.57 times more likely to have diabetes respectively. Overweight or obese individuals were 1.35 to 1.40 times more likely to have diabetes. Participants with a family history of diabetes were 3.69 times more likely to have diabetes. Participants in the highest CRF quintile levels were 40% and 15% less likely to have type 2 diabetes among persons with normal and high blood glucose, respectively. In the prospective cohort study, it was found that serum ferritin might predict the development of type 2 diabetes in males and high serum ferritin concentration levels. The incidence rate among males increased with serum ferritin quartile (ptrend [less than] 0.05). A reduction of serum ferritin concentration was associated with a reduction of diabetes risk in those participating in physical activity. It suggests physicians might use patients' serum ferritin concentrations as a marker for predicting risk for new-onset diabetes and patients should be encouraged to participate in physical activities.Item Meta-analysis: Effects of Opuntia Species(2000-05-01) Garcia, Anna R.; John Licciardone; Gilbert Ramirez; FongGarcia, Anna R., Meta-analysis: Effects of Opuntia species. Master of Public Health (Epidemiology), May, 2000, 73 pp., 10 tables, 10 figures, references, 62 titles. The Mexican American population is more susceptible to diabetes mellitus due to a number of risk factors. The earliest recorded treatments for diabetes mellitus involved the use of natural plants. Opuntia species are any member of the genus Opuntia of Cactus family and who are native to the Western Hemisphere. In order to determine the efficacy of Opuntia species as a hypoglycemic agent in non-insulin dependent diabetics, a meta-analysis was conducted to analyze the identified studies. In addition, insulin and the presence of a dose-response relationship upon ingestion of Opuntia were investigated. A statistically significant reduction in serum glucose was found after the ingestion of 500 grams of Opuntia species. Additional studies are needed to determine the mechanism of hypoglycemic action and to further investigate the properties of Opuntia species.Item Neuroprotective effects of peroxisome proliferator-activated receptor-gamma (PPAR-y) ligands against oxidative stress(2003-12-01) Aoun, Paul; Simpkins, James W.; Dillon, Glenn; Gracy, RobertAoun, Paul Neuroprotective effects of peroxisome proliferator-activated receptor-gamma (PPAR-y) ligands against oxidative stress. Doctor of Philosophy (Pharmacology and Neurosciences), December, 2003, 254 pp., 37 figures. Diabetes mellitus is a significant public health problem in the United States and the world resulting in substantial morbidity and mortality. Diabetes complications, i.e., neuropathy, are common and almost triple the annual cost of managing diabetes. In our studies, we investigated the role that insulin sensitizers currently used for the treatment of diabetes, the PPAR-y ligands, might play in protecting neurons against oxidative stresses. We showed that two PPAR-y ligands, 15 deoxy-PGJ2 and troglitazone, protected, in a dose-dependent manner, HT-22 mouse hippocampal and RGC-5 retinal ganglion cell lines against various oxidative insults. Further, we demonstrated that neuroprotection by 15deoxy-PGJ2 and troglitazone was independent of the PPAR-y receptor. Our findings brought to light an important role of PPAR-y ligands in preventing neuronal complications from diabetes. Moreover, the studies reported herein provide valuable insights into the development of novel therapeutic compounds that improve insulin sensitivity while preventing neurological, and possibly other complications of diabetes.Item Overweightness and Obesity as Risk Factors for Acanthosis Nigricans(2001-12-01) Wadley, Wendy Whittaker; Urrutia-Rojas, Ximena; Bae, Sejong; Bayona, ManuelWadley, Wendy Whittaker, Overweightness and Obesity as Risk Factors for Acanthosis Nigricans. Master of Public Health (Community Health), December, 2001, 42 pp., 6 tables, references, 54 titles. This study was a secondary analysis of data from a cross-sectional study of 1,066 fifth grade students, who were screened for risk factors for type 2 diabetes (T2DM) at Fort Worth Independent School District in Texas. Participants (ages 8 to 13) were 55.8% Hispanic, 23.6% African American, 16.1% Caucasian, and 4.5% other minorities. The study’s hypotheses were a) overweight or obese children (Body Mass Index [BMI] ≥85th percentile) were more likely to have acanthosis nigricans (AN) than non-overweight of non-obese children, b) obese children (BMI≥85th-94.9th percentile). Findings supported both hypotheses, overweight or obese children are 17 times (OR=17.24) more likely to have AN that non-overweight or non-obese children, and obese children were about four times (OR=3.88) more likely than overweight children to have AN.Item Pre-diabetes Screening Tools for Adults Living in the United States(2014-05-01) Evans, Eva L.; Sterling, David; Fischbach, Lori; Felini, Martha J.Almost 37% of persons living in the US aged [greater than] 18 years have pre-diabetes, Persons with pre-diabetes are at high risk of developing type-2 diabetes (advanced hyperglycemia) and also have a higher risk of cardiovascular disease than those with normal blood glucose levels. Furthermore, results from cross-sectional studies indicate that microvascular complications arising from hyperglycemia may begin at the pre-diabetic stage. There is evidence that progression of pre-diabetes may be halted or even reversed with lifestyle and pharmaceutical interventions. However, less than 10% of US adults with pre-diabetes are aware of their condition, which indicates that current pre-diabetes screening methods are inadequate. US physicians need a comprehensive pre-diabetes screening tool. To this end, non-invasive screening score sets were created to screen for IFG, IGT and elevated HbA1c. Because preliminary analyses indicated that the screening accuracy of the pre-diabetes screening score sets would be enhanced by not restricting the score sets to only the pre-diabetic ranges of hyperglycemia, the pre-diabetes screening tool was designed to screen for hyperglycemia in the pre-diabetic and diabetic ranges. These hyperglycemia screening score sets have been based on a scoring system of non-invasive factors associated with hyperglycemia that are already routinely measured or assessed during a visit to the doctor. These factors were age, gender, smoking status, diabetes family history, history of cardiovascular disease, history of hypertension, height, body mass index, physical activity level (by surrogate measure of fasting heart rate), level of alcohol consumption, history of early menarche (women only), and history of gestational diabetes (parous women only). To boost performance for the non-invasive fasting hyperglycemia score set and the non-invasive elevated HbA1c screening score set, both for use in parous women, the fasting screening score set and the HbA1c screening score set included the factor, ethnicity. The pre-diabetes tools were externally and internally validated and were also compared to other non-invasive methods that might be used to screen for hyperglycemia.Item Protein Phosphate in the Regulation of Protein Phosphorylation and Insulin Secretion(2003-05-01) Parameswara, Vinay K.; Robert Easom; Porunelloor Mathew; Ming-Chi WuParameswara, Vinay K., Protein Phosphatase 2A in the Regulation of Ca2+- Sensitive Protein Phosphorylation and Insulin Secretion. Doctor of Philosophy (Biomedical Sciences), May 2003; 191 pp., 28 illustrations; 5 tables; 250 references. Type 2 diabetes is characterized by insufficient insulin secretion in the midst of increased demand from concomitant insulin resistance of peripheral tissues. More specifically, the diabetic β-cell is characterized by impaired responsiveness to D-glucose, the primary physiological regulator of insulin secretion, necessitating that the mechanism of glucose-induced insulin secretion from the β-cell of the pancreas is critically dependent on an elevation of cytosolic calcium as a trigger signal but is also dependent on reversible protein phosphorylation. Accordingly, a number of protein kinases are activated by glucose, or by incretin hormones that enhance glucose-induced insulin secretion. This dissertation however stems from a general hypothesis that protein phosphorylation and insulin secretion may also be controlled via the regulation of protein phosphatases (PP). Initially, a panel of specific antibodies was used to profile the expression of known PP species in the β-cell. By immunoblotting cultured clonal β-cells, INS-1, were shown to express various protein phosphatases namely PP 1, 2A, 2B, 2C, 4 and 6, but with distinct subcellular localization suggesting that these phosphatases regulated distinct functions within the β-cells. Of particular interest, PP-2A holoenzyme was localized to purified fractions of insulin secretory granules suggesting an involvement in insulin regulation. Selective inhibition of PP-2A in the presence of endothall or low concentrations of okadaic acid, increased insulin secretion in the presence of glucose in INS-1 cells. In order to discern potential substrates of PP-2A and thus-mechanisms of action, microcystin immobilized to sepharose was employed to affinity purify phosphatase species from β-cell lysates and proteins complexed with them. Fractions containing PP-2A also contained synapsin I and a specific interaction of these proteins was confirmed by co-immunoprecipitation from INS-1 cell lysates. In contrast, PP-1 was not associated with synapsin I. That synapsin I is indeed a substrate for PP-2A in INS-1 cells was confirmed via the demonstration that synapsin I phosphorylation was increased by okadaic acid under conditions that increased insulin release. Okadaic acid also induced the autophosphrylation and activation of CaMKII, a Ca2+-dependent kinase that phosphorylates synapsin I; suggesting CaMKII may mediate PP-2A effects on insulin secretion. The elimination of syanpsin I, markedly modulates glucose homeostasis of mice and subtly modulates insulin release. In summary these studies document that the modulation of PP-2A in β-cells dramatically influences insulin secretion reinforcing a concept that the control of protein phosphatase may have a critical role in the regulation of insulin secretion. These data suggest that a role of PP-2A on insulin secretion is mediated in part through the regulation of CaMKII activity and synapsin I-phosphorylation.Item Regional Adipose Tissue Deposition, Its Rate of Lipolysis, and Subsequent Effect of Insulin Resistance-in Type II Diabetes Mellitus(1999-06-01) Schalscha, Alan G.; Raven, Peter B.; Downey, H. Fred; Caffrey, James L.Diabetes mellitus is a disease that plagues populations world wide. More than 5 percent of U.S. citizens are afflicted with one or another form of this disease (22). This paper begins by discussing the incidence of this illness as it affects Americans. An explanation of the four forms in which diabetes mellitus itself will be offered, and these will be classified according to etiology. Non-insulin dependent diabetes mellitus (NIDDM), also called type II diabetes mellitus, will be the last of these forms mentioned. Due to its prevalence, NIDDM will be the focus of this paper. The proposed pathophysiology of NIDDM will be discussed, though to researchers it still remains somewhat of a mystery. This paper will then briefly the genetic and environmental interaction responsible for the onset of non-insulin dependent diabetes mellitus. A brief discussion of the interrelationship between decreasing physical activity and a subsequent increase in obesity will follow (38). The location of adipose tissue seems to have adverse effects on certain aspects of NIDDM, including its sensitivity to insulin. This paper proposes that either subcutaneous or visceral adipose deposits specifically reduce insulin sensitivity more than other fat stores. The connection between adipose tissue and insulin sensitivity appears to be mediated by fatty acids released from specific depots and their destination immediately following release.Item Role of Adenosine in Acute Hibernation of Guinea-Pig Myocardium(1995-08-01) Gao, Zhi-Ping; H. Fred Downey; James L. Caffrey; Patricia A. GwirtzGao, Zhi-Ping, Role of Adenosine in Acute Hibernation of Guinea-Pig Myocardium Doctor of Philosophy (Biomedical Sciences), August, 1995; 111 pp; 3 tables; 15 figures, bibliography, 158 titles. Myocardial hibernation is a state of depressed contractile function and energy demand during chronic ischemia. When coronary flow is restored, depressed contractile function can partially or completely recover to the pre-ischemic level, and ischemic injury of the myocardium in not evident. This project tested the hypothesis that endogenous adenosine mediates hibernation in guinea-pig myocardium. Isolated working guinea-pig hearts, perfused with glucose fortified Krebs-Henseleit buffer, were subjected to global low-flow ischemia. Left ventricular performance and cytosolic energy level were assessed. Lactate and purine nucleotides were measured in venous effluent. Heart were perfused with [U-14C]glucose to investigate the role of adenosine on glucose metabolism in myocardium. Left ventricular function in untreated hearts decreased by 80% and remained stable during ischemia, and completely recovered upon reperfusion. Neither adenosine receptor blockade with 8-p-sulfophenyl theophylline (8-SPT; 20 μM) nor ecto 5’-nucleotidase inhibitor αβ-methylene adenosine 5’-diphosphonate (AOPCP; 50μM) affected left ventricular function either ischemia or during reperfusion. Cytosolic energy level fell by 67% at 10 min ischemia in untreated hearts, but subsequently recovered to the pre-ischemic level despite continued ischemia. Adenosine receptor blockade increased cytosolic energy level at 10 min ischemia relative to untreated hearts, but blunted the subsequent rebound of phosphorylation potential. Moreover, 8-SPT doubled ischemic lactate release. Adenosine receptor blockade also increased glucose uptake during pre-ischemia and hypoperfusion, but did not stimulate glucose oxidation. Crossover plots of glycolytic intermediates revealed that phosphofructokinase, a key rate-controlling step in glycolysis, was activated by adenosine receptor blockade in both pre-ischemic and hibernating myocardium. We conclude that 1) activation of adenosine receptors results in recovery of cytosolic energy level of moderately ischemic working myocardium, but this energetic recover is not solely responsible for post-ischemic contractile recovery; 2) endogenous adenosine attenuates anaerobic glycolysis during myocardial hibernation by blunting phosphofructokinase activity.Item Store operated calcium entry in glomerular mesangial cells and diabetic nephropathy(2016-08-01) Chaudhari, Sarika; Rong Ma; J. Thomas Cunningham; Robert T. MalletGlomerular mesangial cells (MCs) are the major source of extracellular matrix (ECM). One of the early pathological changes in diabetic nephropathy (DN) is accumulation of ECM in glomeruli. Multifunctional store-operated Ca2+ entry (SOCE) regulates MC function. However, whether and how SOCE in MCs contributes to pathophysiology of DN remains unknown. The aim of the study was to investigate association of SOCE in MCs with ECM protein expression and the underlying mechanism using both in vitro and in vivo systems. Study I was to determine the effect of diabetes on SOCE. In cultured human MCs, we found that prolonged high glucose (HG) treatment (7 days) significantly increased SOCE and membrane currents through store-operated channels (SOC). These responses were abolished by SOC inhibitors. Consistently, prolonged HG treatment also increased the abundance of SOC proteins STIM1 and Orai1. HG also increased STIM1, but not Orai1 mRNA expression. Furthermore, both STIM1 and Orai1 proteins were also increased in the glomeruli/renal cortices of diabetic rats. Study II determined the influence of SOCE in MCs on ECM protein expression. We found that activation of SOC by thapsigargin reduced the abundance of fibronectin and collagen IV while inhibitors of SOC had opposite effects. Knockdown of Orai1 in human MCs increased fibronectin abundance. The HG induced increase in fibronectin was attenuated by SOCE. Using a nanoparticle siRNA delivery system, specific knockdown of Orai1 in MCs in mice increased glomerular fibronectin and collagen IV protein content and mesangial expansion. Study III determined the mechanism for inhibition of ECM protein expression by SOCE. We found that activation of SOC attenuated TGFβ1 mediated phosphorylation and translocation of Smad3, a known fibrotic pathway in MCs. However, there was no change in the production or secretion of TGFβ1 by MCs. Orai1 knockdown in MCs in mice increased the activation of Smad3. Taken together, our results indicate that SOCE in MCs may be increased in the late stage of diabetes, which suppresses ECM protein expression by inhibiting TGFβ1-smad3 pathway.Item The Association between Health Literacy and Diabetes Outcomes and Self-Management Behaviors among Older Adults in the U.S(2015-08-01) Montoya, Maria F.; Dennis Thombs; Subhash Aryal; Emily Spence-AlmaguerBackground: In the United States an estimated 10.9 million people aged 65 and older are living with diabetes mellitus. Previous research has found that demographic and socioeconomic factors, health status, health behaviors, and interventions are potential determinants of diabetes outcomes. Recent studies have found that limited health literacy may be a potential new determinant of diabetes outcomes. Limited health literacy is common in underrepresented and marginalized groups such as people with low economic status, low educational attainment, new immigrants, the elderly, racial and ethnic minorities, and patients with chronic conditions. Older adults are at higher risk of developing chronic complications from improper diabetes self-management and self-care. Purpose: In this dissertation, we explore the association between health literacy and diabetes outcomes and self-management behaviors among older persons with an imputed health literacy score derived from demographic information. Methods: This study is a secondary analysis of existing cross-sectional data from the National Health & Nutrition Examination Surveys (2009-2010), in the United States. The final sample consisted of 779 participants who were ≥55 years and older and diagnosed with DM by self-report or through bio-marker laboratory testing. The predictor and outcome variables were DAHL proxy health literacy score, categorized as adequate (HL [greater than] 76), marginal (HL 63-75), and inadequate (HLp = 0.66). Proxy health literacy score contributed to the prediction of fasting blood glucose in Block 2, and made a unique contribution (β=−.392; Sig F. change: p = .028) to the full model. The fully adjusted hierarchical regression models for HbA1c showed that HL did not add any variability to the model. The fully adjusted FBG model was not statistically significant. After controlling for covariates, we found that in separate hierarchical logistic regression, health literacy level, was not associated with predicting the odds of the eight indicators of proper diabetes management. Furthermore, the R2 change attributed solely to the addition of health literacy level did not exceed 2.7% for any of the logistic regression models. Conclusion: The present study supports previous findings that found no association between HbA1c, diabetes self-management behaviors and health literacy. This study found that the characteristics of individuals who were not aware of their diabetes status was higher among subjects that were younger, more educated, higher socioeconomic status and not married. More studies are needed to examine factors associated with diabetes self-management behaviors that take into account individual health literacy, diabetes knowledge, and create targeted initiatives that decrease the risk factors associated with diabetes among the aging population.Item The Association of Health Literacy with the Management of Type 2 Diabetes(2017-12-01) Kumar, Samita; Stephen O. Mathew; Caroline A. Rickards; Johnny J. HeIntroduction: Type 2 Diabetes (T2D) is a chronic metabolic disease characterized by high blood glucose levels in the blood. It is associated with microvascular and macrovascular complications which can lead to potential threats such as to amputations and even death. The irony of the disease is that these complications are preventable with appropriate treatment and self-management. The Emergency Medicine Department (ED) at University of Southwestern Medical center conducted this study to assess health literacy Parkland Memorial Hospital patients with T2D. The objective for the research study was to assess the for association of health literacy with management of T2D. Methods: This was a prospective study with collection of personal health information (PHI) and 30 day-follow up for ED recidivism. Eligibility was assessed by pre-screening via EPIC (Electronic Medical Record System for Parkland). The tool for measuring health literacy was the Short Assessment of Health Literacy (SAHL) and data was collected. Results: The total number of subjects enrolled was 23 with ages 18 or above male and females both with Spanish or English speaking only with T2D. Mean age of the subjects was ~50 years with standard deviation of 10 years, males were over half than women. About 74% were white hispanic males. According to the data collected, 30% of the patients demonstrated inadequate health literacy based on SAHL score survey. Since the study could not reach adequate power due to low enrollment, no significant associations could be made from this small sample size. Total number of subjects required to have adequate power was 400. Conclusions: Due to low enrollment period at this time the recommendation would be to continue collecting data to have a larger sample size to afford the observation of statistically relevant associations. If any, statistically significant associations are found, then future studies will focus on improving diabetes outcomes through the development of educational tools at the individual patient’s appropriate literacy level. There are many reasons to improve diabetes care and explore all possible factors that contribute to poor outcomes. Millions of people are living with uncontrolled diabetes and the burden is not only on the patient but also on the community as a whole. Quality care should aim for improved benchmarks for patients with diabetes and their knowledge about the disease, such as 1) obtaining HbA1c levels below 8%, 2) blood pressure in the normal range, 3) having regular foot exams to keep a check on any developing signs of pressure sores and 4) most importantly having dilated eye exam on a regular basis.Item The Influence of Acculturation and Psychosocial Factors on Glycemic Control in Mexicans and Mexican Americans with Type II Diabetes(2007-04-01) Ross, Sarah; Luz Chiapa, Ana; Cardarelli, Roberto; Sanders, MarkRoss, Sarah., The Influence of Acculturation and Psychosocial Factors on Glycemic Control in Mexicans and Mexican Americans with Type II Diabetes. Master of Science (Biomedical Sciences), April, 2007, 51 pp., 5 tables, 1 figure, bibliography. Type 2 diabetes is prevalent among Mexican Americans. Tight glycemic control helps delay diabetic complications. This project aims to identify characteristics that contribute to poor glycemic control in this population. Mexican/Mexican American type 2 diabetics completed questionnaires measuring acculturation and psychosocial factors. This data was analyzed to assess the relationship of the factors and glycemic control as measured by HemoglobinA1C. Results demonstrated that subjects who felt that diabetes interfered with daily life and were dissatisfied with their physician’s answers to diabetes questions had poor glycemic control. Significant differences between acculturation groups’ responses to psychosocial measures were also found. Further studies may more accurately define the influence of acculturation on glycemic control in this population.Item The Public Health Impact of Type 2 Non-Insulin Dependent Diabetes Mellitus in Asian Indians, Chinese and Japanese(2001-08-01) Nadkarni, Neetee; Urrutia-Rojas, Ximena; Rene, Antonio; Lurie, SueNadkarni, Neetee A. The Public Health Impact of Type 2 Non-Insulin Diabetes Mellitus in Asian Indians, Chinese and Japanese. Master in Public Health (Community Health), August 2001, 22 pp, 4 tables, bibliography. The prevalence of type 2 non-insulin dependent diabetes mellitus (NIDDM) is increasing in Asians, especially among Asian, Indian, Chinese and Japanese populations. This increase will have a severe impact on the health and well being of these populations. In 1997, a health survey from the World Health Organization (WHO) found numbers of adults with NIDDM in Asian Indians, Chinese and Japanese populations to be first, second and fifth, respectively. According to the National Commisision on Diabetes, “it is not known how the course, the complications and mortality from diabetes among subgroups of the United States population compare with the same factors for persons with diabetes of the same ethnic origin in the homelands”. This review article focuses on the number and prevalence of NIDDM and risk factors contributing to the disease among these Asian sub-populations. This goal of this paper is to provide information to health and medical researchers, practitioners and community planners for use in public health interventions in the United States, India, China and Japan. The results of this paper direct attention to the migrant Asian Indian, Chinese and Japanese populations because the prevalence of NIDDM is increasingly rapid in these groups.Item The Tarrant County Diabetes Collaboration: A Case Study of a Community Diabetes Coalition(2001-08-01) Sammer, Christine; Lykens, Kristine; Lurie, Sue; Gonzalez, AdelaSammer, Christine, The Tarrant County Diabetes Collaboration: A Case of a Community Diabetes Coalition. Master of Public Health (Health Administration), August, 2001, 66 pp., 2 tables, 1 figure, bibliography, 20 titles. This study considers the characteristics of a diabetes coalition that are necessary for coalition maintenance beyond the formation and building stages. A case study was done of the Tarrant County Diabetes Collaboration (TCDC). Data were collected through recorded interviews and a review of documents. The concepts of collaboration identified were: composition, ownership, value, governance, operational map, fiscal structure, and domain. These concepts are presented in a conceptual model. Conclusions made were that the two main strengths of the TCDC were composition and member’s perception of value. Opportunities for growth included defining member roles, developing strong leadership, operating by an operational map and fiscal plan, and becoming recognized as a force for diabetes in the community.