Diabetes

Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/31254

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    PERCEIVED PERSONAL RISK VS. ACTUAL RISK FOR DEVELOPING DIABETES AMONG ADOLESCENTS
    (2013-04-12) Selvakumar, Prashanthi
    Purpose: Type 2 diabetes is a growing concern in adolescents in the United States. This study wanted determine if there was an association between perceived personal risk (PPR) and the actual risk for developing diabetes among high school adolescents aged 17 - 19 years in the Dallas/ Fort Worth area. Methods: A cross sectional design with a convenience sample of 351 participants was used in this study. The data was collected using a short survey distributed to high school blood donors. A series of four questions were used to measure PPR, with the average score of these questions taken as the independent variable. A1C levels were used as a proxy for actual diabetes risk, and were obtained from the blood results after donation. Logistic regression was used to assess for confounding and determine the main association. Results: The response rate was 86%. After cleaning the data, a total of 217 observations were used for the remainder of the analysis. The average participant was a Caucasian, 17 year old, female. Family history of diabetes was found to be a confounder, and after adjusting for it, the adjusted OR was 1.226 (95% CI: 0.527 - 2.852). About 57% had a high PPR, and the prevalence of high diabetes risk (A1C level >=5.7) was 12%. Among the high A1C participants, there was no statistical significance between the high and low PPR groups with respect to age, race, gender, physical activity and sugar intake. Conclusions: These results show that there is an association between PPR and actual diabetes risk in adolescents. However, a large proportion of those who though they were at high risk were incorrect, suggesting that there may be a gap in education about diabetes risk factors in this population
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    PROLONGED HIGH GLUCOSE TREATMENT INCREASED STIM1/ORAI1 PROTEIN EXPRESSION AND ENHANCED STORE-OPERATED CA2+ ENTRY IN HUMAN GLOMERULAR MESANGIAL CELLS
    (2013-04-12) Chaudhari, Sarika
    Purpose: Stromal interaction molecule1 (STIM1) and Orai1 regulate intracellular Ca2+ signaling via store operated Ca2+ entry (SOCE). Our previous study demonstrated that STIM1 is required for SOCE in human mesangial cells (HMC) of kidneys. However, its pathological relevance in HMCs is unknown. The aim of the present study was to determine the effect of high glucose (HG) on STIM1/Orai1 protein expression and SOCE in cultured HMCs. Methods: Western blot was used to detect the expression levels of STIM1/Orai1 proteins. Fura-2 fluorescence ratiometry was utilized to assess SOCE. Whole-cell patch clamp was employed to measure store-operated currents. Results: With 25 mM HG, STIM1/Orai1 protein expressions did not significantly increase until 7 days after treatment. With 7-day incubation, HG significantly elevated STIM1/Orai1 expressions in the range of 10-30 mM concentrations. Ca2+ imaging showed that the cyclopiazoic acid (30 µM)-stimulated Ca2+ entry was significantly enhanced in HMCs with 25 mM HG treatment for 7 days, but not 3 days. The HG-enhanced Ca2+ entry was nearly abolished by GSK-7975 (10 µM). Similarly, the whole cell currents induced by intracellular Ca2+ store depletion were significantly augmented in the HMCs with 7 day HG, but not in HMCs with 1 day HG treatment. Conclusions: Taken together, our results indicate that a prolonged HG treatment enhances SOCE in HMCs by upregulating STIM1/Orai1 protein expression.
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    HIP CIRCUMFERENCE AND WAIST CIRCUMFERENCE AS A MEASUREMENT OF RISK FOR TYPE II DIABETES IN MEXICAN AND MEXICAN AMERICAN CHILDREN
    (2013-04-12) Simon, Kaley
    Purpose: It is well documented that Hispanics have higher rates of Diabetes type 2 in comparison to other races. This paper will examine data on child study participant's waist circumference and hip circumference and the relation to being at higher risk of developing type 2 Diabetes and Depression. Most studies have found girls age 10 to 14 to have average waist measurements ranging from 62.8 cm to 70.6 cm and boys ages 10 to 14 to have measurements ranging from 63.3 cm to 70.6 cm. Our study population of children in the same age range has an average waist measurement of 83.34 cm, well above both of the averages. Methods: Data from 47 Mexican and Mexican-American children, ages 10 to 14 were collected. Of those that participated, 27 (57.4%) were female and 20 (42.6%) were male. Statistical analysis was conducted in SPSS and SAS software programs to obtain chi-square analysis, descriptive statistics and logistic regression. Child Depression Inventory (CDI) measurements were used to test the levels of depression of the child. Both children and parents completed CDI surveys and both were used for descriptive analysis in this study. Dependent variables examined are high risk and low risk of diabetes and CDI indicators. Independent variables examined were that of CDI indicators, and waist and hip circumference. Results: Of those children that participated, 36.2% are at high risk for developing Diabetes Mellitus based on participants meeting 3 to 5 of the criterion. Additionally, 10.6% have a glucose level in the pre-diabetic range. The CDI results on the child survey were 14.9% of children scored above high average, with 4.2% above the elevated range. The parent CDI results were similar with 17.0% of parents scoring their children above the high average range. Using logistic regression, waist circumference was found to be a significant indicator of High risk for diabetes with an odds ratio of .013. The 95% confidence intervals support this find with a lower limit of .685 and an upper limit of .957. Confounding will be examined to address why the odds ratio for waist circumference is inverse of the expected outcome. Conclusions: Waist circumference is a predictor of high risk status of developing Diabetes Type 2 among this population of participants. It should be noted that caution should be taken when interpreting the results so as to avoid bias. The participants in this study may have chosen to participate because they perceived themselves to be at greater risk than others.
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    DIETARY PATTERNS AMONG DIABETIC AND NON-DIABETIC MEXICAN AMERICAN WOMEN
    (2013-04-12) Alexander, Shane
    Purpose: Targeting ethnic disparities in diabetes mellitus (DM) prevalence has become a major focus of disease prevention. In the U.S., 13.3% of Mexican Americans have been diagnosed with DM - a rate 1.9 times higher than among non-Hispanic whites. Recent literature has focused on cultural perceptions and behaviors contributing to risk factors that lead to DM. The goal of this pilot study was to examine what type of information was given by health care providers, as well as obtain self-reported diabetic care activities among Mexican American women. Additionally, this study sought to compare the dietary patterns of diabetics and non-diabetics. Methods: Data was analyzed from 47 Mexican American women (diabetic n=24; non-diabetic n=23) recruited through the Health and Aging Brain Study among Latino Elders (HABLE), a translational research study that examines factors related to aging among Hispanics. Variables included age, food frequency questionnaire, HbA1c levels, blood glucose, BMI, and a summary of diabetes self-care activity measures. A one-way ANOVA was conducted to examine the difference in nutritional intake according to diabetic status. Results: The average age of onset of a DM diagnosis was 48 years old. Diabetics reported their health care providers advised them to: follow a healthy eating plan (94%), reduce number of calories (95%), follow a complex carbohydrate diet (74%), follow a diet high in fiber (74%), eat 5 servings of fruit and vegetables daily (63%), and lose weight (80%). Further examination showed that 50% had uncontrolled HbA1c (X=8.7) and blood glucose levels (X=170). Significant elevations in BMI [F(1,44)=5.4, p=0.02] and daily caloric intake [F(1,45)=4.2, p=0.04] were found in diabetic women compared to non-diabetic participants. No significant difference was found in daily intake of carbohydrates, protein, and total fat. Conclusions: The results suggest that diabetic women have a higher BMI and daily caloric intake than non-diabetic women despite reporting advice given from their health care providers regarding dietary patterns. This may be due to several reasons. First, it is possible that participants have changed their eating habits, though not enough to achieve glycemic control. Secondly, it is possible that more in depth dietary intervention or nutritional counseling is needed. Limitations include small sample size. More research into dietary patterns of diabetics is needed to design culturally appropriate interventions.
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    FACTORS RELATED TO DIABETES AND DIABETIC CONTROL AMONG RURAL MEXICAN AMERICAN ADULTS AND ELDERS
    (2013-04-12) Ho, Eric
    Purpose: Diabetes is a serious public health issue that affects nearly 26 million people in the United States, and Mexican Americans comprise approximately 13% of that pool. Mexican Americans exhibit higher rates of diabetes and are, more often, poorly controlled. The goal of this study is to explore factors influencing glycemic control among rural Mexican American adults and elders in the United States. Methods: Data is analyzed from 576 participants (341 non Hispanic and 235 Mexican American) of Project FRONTIER: an ongoing epidemiological study of factors impacting rural aging and health. Variables used in this study include: age, language of interview, reading and writing ability for primary language, a designated primary care physician, caregiver status, income, Geriatric Depression Scale assessment, Mini Mental State Examination, and duration of diabetes. Analyses of demographic characteristics between ethnic groups are conducted via t-tests or X2 analyses. The links between clinical findings, demographic data, and HbA1c levels are carried out via linear regression. Analyses are split by ethnicity and diabetes diagnosis. Results: Among non-Hispanic whites, annual household income (B=0.04, SE=0.007, t=4.97, p<0.001), GDS30 scores (B=0.03, SE=0.016, t=2.04, p=0.04) and MMSE scores (B=-0.076, SE=0.03, t=-2.52, p=0.012) are significantly related to HbAlc levels. None of the variables are significantly related to HbAlc levels among Mexican Americans. Among non-Hispanic whites with diabetes (n=43), age is the only variable significantly related to HbAlc levels (B=-0.08, SE=0.03, t=-2.59, p=0.01). For Mexican Americans with diabetes (n=60), duration of diabetes (B=0.13, SE=0.03, t=3.63, p=0.001) is the only variable significantly related to HbAlc levels accounting for 19% of the variance. Conclusions: The results of this study suggest that the factors related to HbA1c levels vary by ethnicity. Duration of diabetes is the only variable found to be significantly related to diabetic control in Mexican American adults and elders. The current findings suggest that adults, or elders, may need additional medical attention by physicians as they age.