Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/29924


Recent Submissions

Now showing 1 - 8 of 8
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    Assessing elevated liver enzymes as a potential early screen for type II diabetes mellitus in children
    (2020) Bowman, William; Basha, Riyaz; Hamby, Tyler; Habiba, Nusrath; Das, Siddharth
    Purpose: As the rise of obesity tracks with the incidence of Type 2 Diabetes Mellitus (T2DM) and nonalcoholic fatty liver diseases (NAFLD), it suggests that metabolic changes in obesity give rise to a clinically significant association between insulin resistance and elevated liver enzymes. This is illustrated in recent adult studies showing a high prevalence of NAFLD in patients with T2DM. Considering the diagnosis of T2DM and NAFLD often occurs late into adulthood, assessing the validity of metabolic-based early screening protocols may identify high-risk individuals in the pediatric population. Our study assesses the prevalence of elevated liver enzymes in children and evaluates the association between elevated liver enzymes and noninvasive risk factors. Methods: Our study enrolled 151 nondiabetic children between the ages 10-14 at the pediatric outpatient clinic at UNTHSC. We recorded noninvasive risk factors and measured liver enzymes. The liver enzymes studied were alanine aminotransferase (ALT), alkaline phosphatase (ALP), and gamma-glutamyl transpeptidase (GGT). Results: Through chi-squared analysis, boys were shown to have a statistically significant relationship between increased BMI and elevated GGT as well a statistically significant relationship between presence of acanthosis nigricans and elevated GGT. It was also shown that young girls and African American children have a higher prevalence of ALP and GGT, respectively. Conclusions: There was significant association between elevated liver enzymes and specific noninvasive risk factors. Furthermore, this study noticed that gender and racial differences may play confounding roles suggesting there is variation within liver enzyme levels inherent in particular subpopulations.
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    A Literature Review: The Role of Fenugreek in Diabetes Management
    (2020) Cherian, Aaron; Ramanathan, Meenakshi; Hoque, Sanjida; Villavicencio, Madeleine
    Purpose: This review's objective is to identify evidence regarding fenugreek's role in reducing blood glucose in patients with type 2 diabetes mellitus (T2DM) or pre-diabetes. Methods: PubMed and SCOPUS were utilized to find trials which included "fenugreek AND diabetes", "fenugreek AND glucose" and "Trigonella AND diabetes". Trials excluded were those published before 2003 and fenugreek's impact in disease states unrelated to diabetes. Results: Based on five trials describing fenugreek's effects of increased glucose uptake, increased insulin sensitivity and lowering fasting plasma glucose, fenugreek was proven to be efficacious with regards to diabetes and pre-diabetes. One trial showed fenugreek to have no statistical changes in fasting blood glucose, yet it statistically changed GIR. In addition, one study showed no statistical change in fasting blood glucose or A1c% compared with glibenclamide while another showed no change in fasting blood glucose when compared to diet and exercise. Five of the studies evaluated the safety of fenugreek and demonstrated a high safety profile and tolerability. Conclusion: Fenugreek has proven to have a role in the management of patients with diabetes or pre-diabetes via its ability to reduce insulin resistance and lower blood sugar. In order to establish the defined role in therapy, additional clinical trials with larger amounts of study subjects should be conducted. Gaining a USP approval for a fenugreek product and utilizing it in future trials would increase the validity of the results, making it more applicable to specific guidelines.
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    Metformin Nanoparticles for Liver Delivery
    (2020) Dong, Xiaowei; Xu, Yong; Yang, Shaohua; Olowookere, Yetunde
    Metformin Nanoparticles for Liver Delivery Purpose: Metformin hydrochloride is a biguanide, an antidiabetic medicine, taken orally to lower blood sugar in diabetic patients, especially with Type 2 diabetes. Metformin is hydrophilic in nature and it has been observed that overtime, higher doses are usually required for effectiveness. This might result from low bioavailability due to its formulation. The purpose of this study was to develop a HPLC- method for Metformin Hydrochloride that will be used for further formulation development. Method: Metformin hydrochloride solution was analyzed quantitatively using Waters HPLC separation module 2695 equipped with auto injector and detector (PDA 2996) and UV detector (2487), Embedded with Empower software. Method was developed by utilizing a reverse phase chromatographic with Column Ultimate XB-SCX Dim 4.6 x250mm, an ambient temperature, 5µm particle size, Flow rate 1ml/min, Wavelength 232nm, Ammonium dihydrogen phosphate as the mobile phase and injection volume of 10µl. Forced degradation studies were conducted by employing stress conditions with various concentrations of HCl, NaOH, H2O2 for acid and base hydrolysis and oxidation. Results: The detection of the eluent was consistently observed at around 11 minutes for all concentrations. SD value was low, RSD was around 1% indicating accuracy and reproducibility with regression coefficient R ≥ 0.997 with six different concentrations from 1mg/ml-100mg/ml. Conclusion: The quantitative analysis result for the HPLC method was consistent with different concentrations, it did not appear there was any interference from the excipients. The method was simple, rapid reproducible and useful for further drug formulation development.
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    Assessing Body Image Perception among Children aged 10-14, and their Caregivers
    (2020) Fulda, Kimberly; Bowman, William; Habiba, Nusrath; Fernando, Shane; Desai, Shivani
    Purpose: The incidence of Type 2 Diabetes Mellitus in children continues to rise in the country. According to the ADA, in 2011-2012, the annual incidence of diagnosed diabetes in youth was estimated at 5,300 with T2DM. Not only can T2DM be managed with appropriate measures but also be prevented if the risk factors are identified.Methods: 10-14 year-old children and their caregivers participated in a 2-hour research study in which questions about body silhouettes were asked. Child subjects identified which body silhouettes (a gradient from 1: very thin to 9: obese) they currently looked like and the ones they wished to look like. Similarly, parents were asked to do the same for their child. Results: Male and female children wanted their desired silhouette number to be less than the number they picked for their current shape. The amount of male children who chose silhouette numbers 1-5 increased by 39% between their current and desired shape and for female children the increase was by 28%. For parents of male children, the increase was by 47% and for parents of female children, the increase was by 15%. Conclusion: This study suggests that the perception of desiring a thinner body were similar between male and female children and their parents. These body silhouettes may have potential as a screening tool for body image and healthy behaviors. Through this model, health care professionals can gauge their patient's perception on their body weight and help them facilitate conversation towards healthy behaviors.
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    Does alcohol use differ by diabetes status in middle aged males?
    (2020) Cummins, Emma; Sadruddin, Anmol; Maler, Ashley; Jih, Emily
    Purpose: Currently, there is a lack of research regarding the extent of alcohol use in patients diagnosed with diabetes. Therefore, the purpose of this study is to investigate whether alcohol use differs by diabetes status in middle aged males. Methods: This cross-sectional analysis used 2017 BRFSS data for males ages 45-64 from Wisconsin (n=897), Maine (n=1507), Michigan (n=1712), and Minnesota (n=2843). Ordered logistic regression was used to assess the relationship between diabetes status and alcohol use by state after controlling for health-related factors, health behaviors, socioeconomic status, and demographic factors. Results: A small number participants were diagnosed with diabetes (11-13%) and the majority reported alcohol use (70%). The results of adjusted statistics across states indicated that diabetes status was moderately and inversely related to alcohol use. Conclusions: Overall, our research showed that there may be high prevalence of up to 70% alcohol use across states, and alcohol use is moderately and inversely related to diabetes status in middle aged males. The results of this study may generalize to middle-aged men in primary care. Those who drink and do not have diabetes should be made aware of the signs and symptoms of diabetes as to avoid future health issues. Additionally, all patients with a diabetes diagnosis should be screened for alcohol use, as alcohol use can affect hemoglobin A1C levels and uncontrolled cases should be referred to endocrinology as needed.
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    A Study of Diabetes Mellitus in Chronic Lower Back Pain Patients
    (2020) Powell, Jake
    This study examined the association of diabetes mellitus and chronic lower back pain (CLBP) with chronic widespread pain (CWP). Differences in quality of life, disability, and opioid use between CLBP patients with and without diabetes mellitus were also measured. Methods: The study was a cross-sectional study to analyze the differences between groups using data acquired from patients within the PRECISION Pain Research Registry. Pain intensity was measured with an 11-point numerical rating scale. CWP was determined using an item from the NIH minimum data set. Quality of life was measured using 5 SPADE domains of the Patient-Reported Outcomes Measurement Information System (PROMIS-29). Disability was measured using the Roland Morris Disability Questionnaire (RMDQ). Current opioid use was assessed at the baseline encounter. Results: Of the 601 patients enrolled in the registry, 128 (21.3%) reported CLBP and comorbid diabetes. A total of 45 (35.2%) of these patients reported CWP. The mean SPADE score for CLBP patients with diabetes was 58.2 vs. 56.1 for those without diabetes (p< 0.001). Similarly, the mean RMDQ score for CLBP patients with diabetes was 16.0 vs. 13.7 for those without diabetes (p=0.003). A total of 61 (47.7%) CLBP patients with diabetes used opioids vs 159 (35.6%) CLBP patients without diabetes (OR, 1.65; 95% CI, 1.109-2.453; p=0.02). Conclusion: These results highlight the importance of diabetes as a comorbidity in patients with CLBP. Comorbid diabetes often confers CWP, and is significantly associated with poorer quality of life, greater disability, and more frequent opioid use.
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    Does fruit and vegetable intake differ by diabetes status in middle-aged females?
    (2020) Hartos, Jessica; Rosa, Paige; Fernandez, Courtney; Grafa, Amy; Julius, Jennifer
    Purpose:Healthy eating may impact development of diabetes, but research has not addressed whether healthy eating differs by those with and without diabetes in specific demographic groups. The purpose of this study was to determine whether fruit and vegetable intake differs by diabetes status in middle-aged females. Methods:This cross-sectional analysis used 2017 BRFSS data for females ages 45-64 years old in Arizona (n=2,609), Florida (n=3,768), Georgia (n=1,018), and Texas (n=2,092). Multiple logistic regression analysis by state assessed the relationship between daily fruit intake and diabetes status, and daily vegetable intake and diabetes status, while controlling for health status, health behaviors, demographic factors, and socioeconomic status. Results:The majority of middle-aged females reported daily fruit intake (60-67%) and most reported daily vegetable intake (81-86%). About one-fifth of participants reported ever being diagnosed with diabetes (15-19%). Adjusted analysis indicated that daily fruit and vegetable intake did not differ by diabetes status. Conclusions:Across states, daily fruit and vegetable intake did not differ by diabetes status in middle-aged females. However, active and highly active participants were more likely to report daily fruit and vegetable intake. Those reporting insufficiently active were more likely to report daily fruit intake, and those reporting current tobacco use were less likely to report daily fruit intake. In the primary care setting it is important for providers to screen and educate females ages 45-64 on the importance of diabetes management, daily fruit and vegetable intake, physical activity, and implications of tobacco use.
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    Does physical and mental health status differ by routine checkup in middle-aged males and females with diabetes?
    (2020) McGuffee, America E.; Johnson, Amber; Richardson, Regan; Williams, Hallie; Chillag, Kailyn
    Purpose: Middle-aged males and females with diabetes are more likely to have poor physical (PH) and mental health (MH); however, there is limited research determining the relationship between MH and PH and routine checkup in diabetic middle-aged adults, especially by gender. This study's purpose was to determine whether PH and MH status differ by routine check-up in middle-aged (age 45-64) diabetic adults in the general population. Methods: This cross-sectional analysis used data from the 2017 CDC BRFSS for diabetics aged 45-64 in Florida (N=1183), Kentucky (N=617), Maryland (N=731), New York (N=593), and Ohio (N=754). Multiple logistic regression by state and gender was used to determine the relationship between MH and PH status and routine check-up, controlling for health-related, socioeconomic, and demographic factors. Results: Across states, up to half reported good PH (32-50%), over half reported good MH (46-67%), and most reported having a routine check-up (87-93%). Adjusted analysis indicated that MH and PH were not significantly related to routine checkup, but were inversely related to having diabetes plus two other health conditions. Conclusions: Overall, routine checkup was not related to good PH and MH; however, health condition number was inversely related to good PH and MH. In a primary care setting, there may be low-moderate prevalence of good PH and MH and high prevalence of having a routine checkup and multiple health conditions. We recommend automatically screening this population for PH, MH, and other chronic conditions.