Diabetes

Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/21622

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    The Diabetes Epidemic
    (2019-03-05) Chandra, Michael; Singh, Jatinder; Khanna, Alisha; Brewer, Shannon; Taskov, Viktoria
    Background Diabetes is a disease of increasing prevalence in the United States. Thus, it is imperative to appreciate the current state of the disease, its impact on the population, and the resources available to potentially get ahead of the diabetes epidemic. This research project is a meta-analysis of diabetes data nationally, as well as within the state of Texas and Tarrant County itself. In 2015, 30.3 million Americans suffered from diabetes, which was approximately 9.4% of the population at the time. Every year there are approximately 1.5 million new diagnoses of diabetes. One of the most pressing issues that the United States has been facing in the last decade and a half is the increase in type 2 diabetes among children. Between 2002 and 2012, the rate of newly diagnosed cases in children between ages 0-19 increased by 4.8 percent each year. Diabetes remains the seventh leading cause of death (as of 2015) in the United States. This epidemic incurs a heavy financial burden, costing the country an estimated $327 billion annually. Our team uncovered the psychosocial impact the disease has on patients, which would also need to be addressed to tackle the diabetes epidemic from all aspects to be effective. Methods We sought additional resources that could help address the psychosocial impacts. Tarrant211.org and Tarrant Cares websites were used to identify community resources for people with diabetes in Tarrant County. Results We found a number of resources available in Tarrant County to handle this issue. These include national and local as well as governmental and non-profit organizations. These include Medicare, Medicaid, and the American Diabetes Association on the national level and programs such as the Texas Diabetes Council on a state level. Some of the programs specific to Tarrant county that we look into include the Diabetes Community Grant Health Program, and the Tarrant County Diabetes Collaboration. Conclusions A variety of community resources are available for those with diabetes, including those mentioned above. Resources that are targeted specifically at the adolescent population, however, remain scarce and some gaps remain.
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    Does Mental Health Differ by Diabetes Status in Older Adult Females?
    (2019-03-05) Flores, Amanda; Plec, Abigail; Vincent, Savannah; Hartos, Jessica; Forsberg, Julia
    Purpose. Research has assessed the relationship between specific mental health conditions and diabetes status, but not current mental health in specific demographic groups. The purpose of our study is to examine whether current mental health status differs by diabetes status in older adult females in the general population. Methods. This cross-sectional analysis used 2016 data from the Behavioral Risk Factor Surveillance System (BRFSS) for 65 to 75 year old females from Alabama (N=867), Kentucky (N=1356), Mississippi (N=668), and Texas (N=1714). We assessed the relationship between diabetes status and mental health using ordered logistic regression by state while controlling for weight status, the number of health conditions, access to health care, and demographic factors. Results. Across states, about one-fourth of participants reported low or moderate mental health in the last 30 days (22-31%), and a being diagnosed with diabetes (23-26%). The results of adjusted analysis indicated that mental health status and diabetes status were not significantly related in any state; however, mental health was inversely related to number of health conditions in all four states. Conclusion. Overall, current mental health status was not related to diabetes status in older adult females. However, mental health was consistently and inversely related to number of health conditions. Practitioners should not automatically screen for mental health issues in all 65-75 year old females based on diabetes status. However, practitioners should screen for mental health issues in patients with multiple health conditions, as well as screen for other health conditions in patients with mental health issues. Based on screening results, patients may need to be referred to psychiatry or other specialties after determining severity and management of their conditions.
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    Does Health Status Differ by Healthcare Access in Diabetic Females Ages 45-79?
    (2019-03-05) Berrier, Molly; Graff, Lindsey; Allen, Amy; Hartos, Jessica; Huang, Michelle
    Purpose: Healthcare access can impact health status in patients with diabetes, but research assessing healthcare access and health status in diabetic females is limited. The purpose of this study was to assess the relationship between health status (general, physical, and mental health) and healthcare access (coverage and cost) in diabetic females ages 45 to 79. Methods. This cross-sectional analysis used data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) for diabetic females ages 45 to 79 from Louisiana (N=594), Mississippi (N=541), Oklahoma (N=566), and Texas (N=1013). Multiple logistic regression and ordered logistic regression were conducted by state to determine the relationship between health status and healthcare access after controlling for health-related and demographic factors. Results. Across states, about half of diabetic females reported fair or poor general health (43-49%), low to moderate physical health (51-61%), and low to moderate mental health (39-45%). In addition, most reported having healthcare coverage (90-95%) and few reported that cost precluded doctor visits (16-22%). Adjusted analysis indicated that health status was related to healthcare cost, but not to coverage, across states. Those for whom cost precluded doctor visits were less likely to report higher levels of general, physical, and mental health. In addition, all health status variables were inversely related to having three or more health conditions. Also, general and physical health were inversely related to tobacco use across states. Conclusion. The results for diabetic females ages 45 to 79 indicated that health status was inversely related to healthcare cost and to having three or more comorbid health conditions, but not to healthcare coverage. Practitioners should screen all patients in the target population for multiple health conditions, determine severity and management, and educate patients on the importance of managing diabetes with comorbidities. Additionally, practitioners should be aware of how financial constraints can negatively impact patients’ health status, such as considering treatment costs when treating low income patients.
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    The Link Between Low Back Pain And Diabetes: Gene-Based Association Study In People With Comorbid Diabetes Mellitus And Low Back Pain
    (2019-03-05) Pathak, Gita; Phillips, Nicole R.; Licciardone, John C.; Schmitt, Monika
    Purpose Diabetes mellitus type 2 is a disease associated with chronic pain. Mechanisms of this association are not fully understood. Few studies have explored the genetics of this association, and an independent genetic link between diabetes and low back pain (LBP) has not been completely investigated. We hypothesize that variants in candidate genes are associated with comorbid diabetes and LBP phenotypes. Methods This cross-sectional study is a part of a larger study of subacute and chronic LBP within the PRECISION Pain Research Registry. Subjects were recruited from the Dallas–Fort Worth Metroplex and reported LBP for at least 2 months (subacute) or 6 months (chronic) for half or more of the days with the relevant time period. Primary outcomes were assessed using a Numerical Rating Scale (NRS) for pain intensity, the Roland-Morris Disability Questionnaire for back-specific functioning, and the Patient-Reported Outcomes Measurement Information System (PROMIS) for quality of life measures. Study participants self-reported diabetes. Biological samples were collected to determine participants’ genotypes using the Infinium Global Screening Array. Analyses were conducted using SPSS among 488 study participants, 109 of whom reported diabetes. Twenty-seven candidate genes concurrently implicated in both pain phenotypes and diabetic phenotypes were identified from the literature. These candidate genes were used to perform a gene-based association study (GBAS) to identify their potential association with diabetes and LBP. Genetic variants were mapped to candidate genes for association with each of the pain phenotypes after adjusting for age, sex, diabetes status, and ancestry components 1-10 using MAGMA. Results GBAS results point to variants in the PRKCA gene as being associated with both NRS of LBP intensity and diabetes. PRKCA is a family of protein kinases implicated in neuropathic pain and formation of advanced glycation end products. Conclusions Of the 27 genes tested, only variants in PRKCA are significantly associated with LBP and diabetes in the PRECISION cohort. These findings build on a framework which suggests that genetic predisposition in PRKCA may underlie diabetes and LBP.
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    Does Sleep Duration Differ by Diabetes Status in Middle-aged Adults?
    (2019-03-05) Alden, Brooke; Kaur, Harmeet; Wingo, Alexa; Hartos, Jessica; Graham, Eric
    Purpose: We wanted to assess whether sleep duration differed by diabetes status in middle-aged (40-65) males and females in the general U.S. population because there is currently insufficient research on this relationship. Methods: This cross-sectional analysis used 2016 data from the Behavior Risk Factor Surveillance System (BRFSS) for males and females aged 40-65 years old in Georgia (N=2352), Louisiana (N=2377), New Mexico (N=2832), and Oklahoma (N=2908). We performed multiple logistic regression analysis by state to assess the relationship between diabetes status and sleep duration while controlling for factors related to health, health behaviors, and demographics. Results: Across states, almost one-fourth of participants reported a non-moderate amount of sleep each night (less than 6 or more than 8 hours, 19-24%) and less than one-fifth reported a diagnosis of diabetes (16-18%). Adjusted results indicated that sleep duration was not significantly related to diabetes status across states. However, sleep duration was moderately and inversely related to number of health conditions in all four states, and moderately and positively related to mental health and physical activity in at least three of four states. Conclusion: Diabetes status was not significantly related to sleep duration in middle-aged males and females in the general population. However, up to one-third of middle-aged adults reported two or more health conditions, mental health issues, and physical inactivity, and these were inversely related to moderate sleep duration. Thus, primary care providers should screen for sleep duration, health conditions, mental health, and physical activity in this target population if symptoms of any are present and educate and treat as comorbid conditions.
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    Diabetes in Tarrant County: Populations Most at Risk, Barriers to Acquiring Care, and Resources Available for Disease Management
    (2019-03-05) Ahmed, Nadia; Mitchell, Michael; Panturu, Stefan; Patel, Vishal; Siraj, Sohail
    Abstract PurposeDiabetes mellitus is quickly becoming a public health crisis in the United States. As of 2015, 23.1 million adults in the U.S. are diagnosed with diabetes, with an estimated 1.5 million new cases diagnosed each year. The purpose of this research is to provide background information on diabetes in Tarrant county. We identified which populations are most at risk for being diagnosed with Diabetes Mellitus (DM) Type II, determined potential barriers to acquiring care, and searched for regional programs available for disease management. Materials and MethodsEpidemiological information regarding DM in Texas was acquired through searching the Texas Department of State Health Services for current census information, as well as the CDC for national data in order to compare regional statistics to the rest of the U.S. population. A web search for local resources was conducted and relevant information for five available organizations providing care for DM patients of Tarrant County is presented here. ResultsDiabetes is the 6th leading cause of death in Tarrant County. Diabetes prevalence is highest among Non-Hispanic African Americans (16%), followed by Hispanics (12%). Prevalence of diabetes in Tarrant county is also higher among adults who did not graduate from high school. In Tarrant county, 21.9% of the population is uninsured, compared to 12.2% nationally. Resources available in Tarrant county for disease management include; Tarrant County Diabetes Collaboration, HealthForMe Self Management Classes, United Way of Tarrant County, Texas Healthy Lifestyles Workshop, and JPS Diabetes Education program. ConclusionsIn Tarrant county diabetes prevalence is highest in African American and Hispanic populations. Barriers to acquiring care include lack of health insurance and lack of knowledge regarding proper nutrition. Various community resources are available to aide in management of diabetes.
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    Does General Health Differ by Routine Check-up in Diabetic, Middle-Aged Females?
    (2019-03-05) Moore, Haylee; Allen, Meredith; Gonzales, Tierney; McGuffee, America E.; Hartos, Jessica; Bowman, Micah
    Purpose: Given limited evidence that routine check-ups with a medical provider improves quality of life, the purpose of this study is to assess whether general health differs by routine check-up in diabetic, middle-aged females. Methods: This cross-sectional analysis used 2016 data from the Behavioral Risk Factor Surveillance System (BRFSS) for diabetic females ages 45-65 from Alabama (N=370), Georgia (N=256), Kentucky (N=485), Mississippi (N=275), and West Virginia (N=268). The relationship between general health and routine check-up was assessed separately by state using multiple logistic regression analysis while controlling for comorbid health conditions, weight status, physical activity, tobacco and alcohol use, age, ethnicity, educational level, income level, and employment status. Results: Across states, about half of diabetic females reported fair or poor general health (50-53%), while most reported having a routine check-up within the past year (90-93%). Adjusted analysis indicated that general health was not significantly related to routine check-up but was inversely related to having diabetes plus two or more health conditions and positively related to physical activity. Conclusion: The results of this study indicated that general health was not related to routine check-up in diabetic middle-aged females. However, there was a strong inverse relation between those patients with good or better general health and those with diabetes plus two or more health conditions and a moderate relation between physical activity and good or better general health. Therefore, in diabetic middle-aged females, practitioners should automatically screen for general health, other health conditions and physical activity in order to optimize treatment, manage diabetes and other health conditions, and properly educate their patients to optimize their general health.