Dissertations / Theses on the topic 'Diabetes – Treatment'
To see the other types of publications on this topic, follow the link: Diabetes – Treatment.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Diabetes – Treatment.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Pickavance, Lucy Cecilia. "Thiazolidinedione treatment in models of insulin resistance." Thesis, University of Liverpool, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367553.
Full text
2
Ryysy, Leena. "Insulin treatment in type 2 diabetes." Helsinki : University of Helsinki, 2001. http://ethesis.helsinki.fi/julkaisut/laa/kliin/vk/ryysy/.
Full text
3
Vincent, Dawn A. "Acceptance of complementary and alternative medicine among pediatric patients with diabetes." Virtual Press, 2007. http://liblink.bsu.edu/uhtbin/catkey/1366504.
Full textAbstract:
The purpose of this research study was to determine the acceptability of complementary and alternative medicine use in a pediatric population with diabetes. Subjects included 76 patients who attend or have previously attended a diabetes clinic at Riley Hospital for Children in Indianapolis, Indiana.Once patient and parent approval had been granted, the researcher conducted a telephone interview to gather information. Using SPSS statistical software, frequencies and Chi-squared analysis were performed on the data collected. It was revealed that although subjects had a wide variety of concerns with the use of CAM and were unsure about whether it "could heal diabetes or other health problems," a majority were willing to try CAM. Results also indicated that willingness to try CAM was not affected by the age of the child, the type of diabetes present, use of insulin or special diet, or current use of a vitamin or supplement.Department of Family and Consumer Sciences
4
Dickason, Beverley Janine. "Optimisation of pharmacological management of diabetes mellitus in a primary health care setting." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/846.
Full textAbstract:
Levels of diabetic care in primary health care settings in South Africa have been found to be sub-optimal. Knowledge deficits and inadequate practices have been implicated in the poor quality of local diabetes care. Type 2 diabetes and hypertension are commonly associated chronic conditions hence to optimise diabetic care, tight control of blood pressure is essential. Although guidelines for the overall management of diabetes in a primary health care setting have been published (Working Group of the National Diabetes Advisory Board, 1997; Society for Endocrinology, Metabolism and Diabetes of South Africa, 2002a), adherence to these guidelines has not yet been optimised in the primary health care setting. The objectives of the study were: to design and implement an educational intervention aimed at nursing staff, based on the South African guidelines for type 2 diabetes and hypertension, at a public sector primary health care clinic; to determine the impact of the educational intervention on the level of knowledge and attitudes of the nursing staff, and on the level of diabetic and blood pressure control achieved in the patient population, and to determine the impact of the educational intervention on pharmacological management of patients. A questionnaire was used to quantitatively assess the nursing staffs’ knowledge of the management of type 2 diabetes and hypertension at a primary health care level. A qualitative evaluation of the nursing staff attitudes was obtained using focus group interviews. The educational intervention, in the form of lectures and based on national diabetes and hypertension guidelines (Working Group of the National Diabetes Advisory Board, 1997; Society for Endocrinology, Metabolism and Diabetes of South Africa, 2002a; Milne et al., 2003), was then implemented and directed at the nursing staff at a primary health care clinic. A post-intervention evaluation was performed after four months by repeating the questionnaire and focus group interviews. Comparisons between the pre- and post-intervention questionnaire and focus group interviews evaluated the impact of the educational intervention on the knowledge and attitudes of nursing staff towards the management of type 2 diabetes. Pre- and post-intervention patient data was collected from patient medical files and compared to determine if the management of diabetes and hypertension improved in the patient population after the implementation of the educational intervention. The patient population consisted of 103 patients. The educational intervention resulted in an extremely significant improvement in the level of knowledge of the nursing staff [93 correct responses (28.3 percent; n = 329 (pre-intervention)) vs 223 correct responses (67.8 percent; n = 329 (post-intervention)); p < 0.0001, Fisher’s Exact test]. The educational intervention resulted in improved attitudes of nursing staff towards the management of diabetes. Ideal random blood glucose concentrations improved significantly [16 percent; n = 100 (pre-intervention) vs 22 percent; n = 100 (post-intervention); p = 0.0003; Student t test]. The number of patients with a compromised HbA1c level (> 8 percent) decreased by 2 [51; 49.5 percent, n = 103 (pre-intervention) vs 49, 47.5 percent, n = 103 (post-intervention)] which was not a significant improvement. Ideal blood pressure control improved by one from 38 patients [36.9 percent; n = 103 (pre-intervention)] to 39 patients [37.9 percent; n = 103 (post-intervention)] which was not significant. Optimal change of pharmacological management following the referral of an uncontrolled diabetic patient was only noted for 18 patients (20.2 percent, n = 89) referred in the post-intervention phase. Clinical inertia was identified as a major limitation to the optimisation of diabetes care. Implementation of an educational intervention based on the South African diabetes and hypertension guidelines at a public sector primary health care clinic was successful in improving the knowledge levels and attitudes of nursing staff
5
Wolffenbuttel, Bruce Herbert Ralph. "Type 2 diabetes mellitus pathology and treatment /." Maastricht : Maastricht : Datawyse ; University Library, Maastricht University [Host], 1991. http://arno.unimaas.nl/show.cgi?fid=5673.
Full text
6
Tong, King-hung Daniel, and 唐琼雄. "Surgical treatment for type II diabetes mellitus." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193510.
Full textAbstract:
Introduction: Historically, type 2 diabetes (T2DM) has been regarded as a progressive and degenerative disease and only minority of patients can have disease remission with conventional treatment. It was noticed that gastrointestinal surgery could induce complete remission of T2DM in most of morbidly obese patients. Compared to the West, the development of bariatric and metabolic surgery is slow in Hong Kong. It is unknown whether the knowledge and attitudes of medical doctors and patients towards surgical treatment for T2DM have impacts on the development in this field. The novel procedure sleeve gastrectomy (SG) had been shown to be effective in inducing T2DM remission in obese human. Duodenal jejunal bypass (DJB) and ileal transposition (IT) were reported to be effective for ameliorating T2DM in non-obese diabetic animal model. The anti-diabetic potency of DJB and IT is unknown in comparing to SG particularly in non-obese subjects. Currently, SG is the main procedure for morbidly obese patients with or without T2DM in the authors’ institution.
Aims: The aims of the present thesis were to investigate the knowledge and attitudes of medical doctors and patients toward using surgery as a treatment for T2DM, to compare the anti-diabetic effect of SG, DJB and IT in non-obese T2DM animal model, and lastly, to review of outcomes of morbidly obese patients who underwent SG in authors’ institution.
Methods: Survey was conducted using questionnaire for interview of both doctors and patients to investigate their knowledge and attitudes toward surgical treatment of T2DM. The anti-diabetic effects of novel surgical procedures SG, DJB and IT were compared using non-obese T2DM animal model (Goto Kakizaki rats). The outcomes were evaluation by measuring fasting glucose and glycosylated haemoglobin (HbA1c) levels. Other parameters including alteration in gut hormones and lipid profile were also analyzed. The outcomes of morbidly obese patients who underwent laparoscopic SG in last 5 years in the authors’ institution were retrospectively reviewed.
Results: The knowledge of bariatric and metabolic surgery was inadequate both in medical doctors and patients. The attitude and pattern of referral from medical doctors depends on the amount of knowledge. Patients’ attitudes were positive and they accept surgery as a treatment option for T2DM as long as they were provided with adequate information. This implies that tremendous educational works are required both for medical doctors and patients for the development of bariatric and metabolic surgery in Hong Kong.
All 3 procedures (SG, DJB and IT) significantly improved glucose homeostasis and the effect was more potent and durable in DJB and IT than SG. The improved glucose homeostasis in IT was resulted from increased GLP-1 and PYY secretion (hindgut theory). In DJB, GIP, GLP-1 and PYY were raised and the anti-diabetic effect could be explained both by the foregut and hindgut theories. SG reduced the diet triglyceride absorption. DJB reduced cholesterol absorption whereas IT reduced cholesterol but increase triglyceride absorption.
The outcomes of SG for T2DM for morbidly obese patients were promising. More than 90% patients had T2DM ameliorated and 70% had complete remission. SG can effectively control the body weight of morbidly obese patients.
Conclusion: Education, both to doctors and patients, was crucial to overcome the potential obstacles for the development of this newly specialty. The anti-diabetic effects of DJB and IT were more potent than SG in non-obese diabetic animal model. The lipid absorption varied in different surgical procedures. Application of these procedures in non-obese T2DM patients warrants individual consideration and further investigation. SG in the authors’ institution was effective to induce T2DM remission in morbidly obese patients.published_or_final_version
Surgery
Doctoral
Doctor of Philosophy
7
Debbri, Hawa Abdulgader. "Plant extracts as treatment for diabetes mellitus." Thesis, University of Glasgow, 1996. http://theses.gla.ac.uk/2113/.
Full textAbstract:
The herbal extract of Artemisia has been regarded to be anti-hyperglycaemic since olden times and is commonly used by diabetics in Libya. The present work was designed to evaluate, test and determine which fraction or component of the herb had the hypoglycaemic effects in normal and streptozotocin-induced diabetic rats. The plant extract was administered to the animals in their drinking water and body weight, food and fluid intake and urine volume were all monitored daily. Food and fluid intake and body weight gain in normal rats were not altered by treatment with the plant extract but there was a rise in the urine glucose in the first six rats but rats 7, 8 and 9 were not affected by treatment with plant. Urine volume was increased in all rats suggesting Artemisia judaica is a mild diuretic. The streptozotocin-induced diabetic rat model, used in this study, was associated with the characteristic diabetic symptoms of hyperphagia, hyperglycaemia, polydipsia, weight loss and urinary glucose excretion. When a crude aqueous extract of Artemisia was given in their drinking water, it had little effect on these symptoms after 10 days of treatment. Urine glucose was reduced in the last two days and ketones in the urine were abolished by this treatment. Diabetes mellitus is known to affect many and varied parameters in rat liver. Insulin, biguanides and sulphonylureas are known antidiabetic diabetic treatments. Artemisia judaica extract was tested for its effect on hepatic steroid metabolism and glycogen phosphorylase a activity in comparison with the above drugs. Clearly Artemisia does act as an insulin-mimetic in these assays by reversing all the effects produced by the administration of streptozotocin. In particular the changes in the enzyme activities of cytochrome P-450 (2E1, 2B and 2C) on androst-4-ene-3, 17-dione metabolism are all reversed by the administration of Artemisia extract to diabetic rats.
8
Pearson, Ewan Robert. "The physiology and treatment of monogenic diabetes." Thesis, University of Exeter, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.414848.
Full text
9
Pearson, E. R. "The physiology & treatment of monogenic diabetes." Thesis, Exeter and Plymouth Peninsula Medical School, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.701066.
Full text
10
WHITE, NANCY EDNA. "AN EMPIRICAL TEST OF A THEORETICAL MODEL TO EXPLAIN ADHERENCE TO A DIABETIC THERAPEUTIC REGIMEN." Diss., The University of Arizona, 1985. http://hdl.handle.net/10150/188059.
Full textAbstract:
The purpose of this research was to investigate the impact of social support on adherence to a therapeutic regimen among obese Type II diabetic clinic patients. The aims of the study were to compare the effect of small reference group management with an educational advice program on the therapeutic outcomes of adherence and to test a theoretical model proposed to explain adherence to a diabetic regimen. The concepts of the model were derived from symbolic interactionist and role theory. Forty-one patients attending an outpatient diabetic clinic were randomly assigned to the two treatment programs and 32 patients completed the 6 month study. Subjects met for a total of 10 one-hour sessions which were held weekly the first month, biweekly the second month, and monthly the final 4 months. Demographic information, knowledge of diabetes, and measures of the model variables (social support, health locus of control, health perceptions, diabetic belief, regimen adherence), were collected at the start (t₁) and the termination of the study (t₁₀). Analysis of audiotapes recorded at t₂ and t₉ indicated that patient-initiated interactions were significantly longer in duration for the small reference group. The experimental group also demonstrated significantly lower blood glucose values at t₁₀, however, there was not a corresponding difference between groups in glycohemoglobin, urine glucose, or percent overweight. The total sample experienced a significant mean reduction in glycohemoglobin (-11.1%; p < .05) and an increase in social support and knowledge. Serial blood glucose and glycohemoglobin values indicated improvement in diabetic control was more marked when subjects met weekly or biweekly and stabilized or worsened when meetings were reduced. The staged recursive theoretical model was analyzed using multiple regression statistics. The empirical test of the model of t₁ indicated minimal support in terms of significant explained variance in 6 of the 8 dependent variables. In addition, some of the path coefficients indicated a possible interaction effect between resistance and locus of control. The t₁₀ model demonstrated cohesion among the first three stages of independent variables and greater explained variance, however, multicollinearity proved to be a significant problem when interpreting the path coefficients.
11
Orr, Neil John. "Patterns of care for diabetes: risk factors for vision-threatening retinopathy." Thesis, The University of Sydney, 2005. http://hdl.handle.net/2123/1421.
Full textAbstract:
OBJECTIVES: In Australia, diabetes causes significant morbidity and mortality. Whilst the need to prevent diabetes and its complications has been widely recognised, the capacity of health care systems - which organise diabetes care - to facilitate prevention has not been fully established. METHODS: A series of seven population-based case-control studies were used to examine the effectiveness of the Australian health care system and its capacity to manage diabetes. Six of the studies compared the patterns of care of patients who had developed advanced diabetes complications in 2000 (cases), to similar patients who remained free of the condition (controls) across Australia and for various risk groups. A secondary study investigated the role of treating GPs in the development of the outcome. RESULTS: A strong relationship between the patterns of care and the development of advanced diabetes complications was found and is described in Chapter 4. In Chapter 5, this same relationship was investigated for each Australian state and territory, and similar findings were made. The study in Chapter 6 investigated whether late diagnosis or the patterns of care was the stronger risk factor for advanced diabetes complications, finding that the greatest risk was associated with the latter. In Chapter 7 the influence of medical care during the pre-diagnosis period was explored, and a strong relationship between care obtained in this period and the development of advanced complications was found. In Chapter 8, which investigated the role of socio-economic status in the development of advanced complications, found that the risk of advanced diabetes complications was higher in low socio-economic groups. Chapter 9 investigated geographic isolation and the development of advanced diabetes complications and found that the risk of advanced complications was higher in geographically isolated populations. Finally, Chapter 10, which utilised a provider database, found that some GP characteristics were associated with the development of advanced diabetes complications in patients. CONCLUSION: A number of major risk factors for the development of advanced complications in Australia was found. These related to poorer diabetes management, later diagnosis, low socioeconomic status and geographic isolation. Strategies must be devised to promote effective diabetes management and the early diagnosis of diabetes across the Australian population.
12
Orr, Neil John. "Patterns of care for diabetes: risk factors for vision-threatening retinopathy." University of Sydney, 2005. http://hdl.handle.net/2123/1421.
Full textAbstract:
Master of Public HealthOBJECTIVES: In Australia, diabetes causes significant morbidity and mortality. Whilst the need to prevent diabetes and its complications has been widely recognised, the capacity of health care systems - which organise diabetes care - to facilitate prevention has not been fully established. METHODS: A series of seven population-based case-control studies were used to examine the effectiveness of the Australian health care system and its capacity to manage diabetes. Six of the studies compared the patterns of care of patients who had developed advanced diabetes complications in 2000 (cases), to similar patients who remained free of the condition (controls) across Australia and for various risk groups. A secondary study investigated the role of treating GPs in the development of the outcome. RESULTS: A strong relationship between the patterns of care and the development of advanced diabetes complications was found and is described in Chapter 4. In Chapter 5, this same relationship was investigated for each Australian state and territory, and similar findings were made. The study in Chapter 6 investigated whether late diagnosis or the patterns of care was the stronger risk factor for advanced diabetes complications, finding that the greatest risk was associated with the latter. In Chapter 7 the influence of medical care during the pre-diagnosis period was explored, and a strong relationship between care obtained in this period and the development of advanced complications was found. In Chapter 8, which investigated the role of socio-economic status in the development of advanced complications, found that the risk of advanced diabetes complications was higher in low socio-economic groups. Chapter 9 investigated geographic isolation and the development of advanced diabetes complications and found that the risk of advanced complications was higher in geographically isolated populations. Finally, Chapter 10, which utilised a provider database, found that some GP characteristics were associated with the development of advanced diabetes complications in patients. CONCLUSION: A number of major risk factors for the development of advanced complications in Australia was found. These related to poorer diabetes management, later diagnosis, low socioeconomic status and geographic isolation. Strategies must be devised to promote effective diabetes management and the early diagnosis of diabetes across the Australian population.
13
Yngen, Marianne. "Platelet function in diabetes mellitus : relationships to hyperglycaemia, antidiabetic treatment and microangiopathy /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-062-1/.
Full text
14
Day, Caroline. "Traditional medicines in the treatment of diabetes mellitus." Thesis, King's College London (University of London), 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.296837.
Full text
15
Ніколаєнко, Андрій Сергійович, Андрей Сергеевич Николаенко, and Andrii Serhiiovych Nikolaienko. "New treatment aproaches for ulceration caused by diabetes." Thesis, Sumy State University, 2017. http://essuir.sumdu.edu.ua/handle/123456789/65568.
Full textAbstract:
Trophic changes of lower extremities are among the most common complications in patients with vascular diseases and diabetes. In developed countries the ulceration is the most common cause of no traumatic amputations of lower extremities and it was determined as one of the biggest health problems worldwide.
16
Sharma, Divya. "Drug Delivery Systems for Treatment of Diabetes Mellitus." Diss., North Dakota State University, 2019. https://hdl.handle.net/10365/31745.
Full textAbstract:
Daily injections for basal insulin therapy are far from ideal resulting in hypo/hyperglycemic episodes associated with fatal complications in type-1 diabetes patients. The purpose of this study was to develop a thermosensitive copolymer-based in situ depot forming delivery system to provide controlled release of insulin for extended duration following a single subcutaneous injection, closely mimicking physiological basal insulin requirement. Size and nature of the incorporated therapeutic were observed to affect the release profile of insulin. Modification with zinc and chitosan preserved thermal, conformational, and chemical stability of insulin during the entire duration of storage (up to 9 months at 4 °C) and release (up to 3 months at 37 °C). In vivo, daily administration of long-acting insulin, glargine, resulted in fluctuating blood glucose levels between 91 – 443 mg/dL in type 1 diabetic rats. However, single administration of oleic acid-grafted-chitosan-zinc-insulin complexes incorporated in copolymer formulation demonstrated slow diffusion of insulin complexes maintaining peak-free basal insulin level of 21 mU/L for 91 days. Sustained release of basal insulin also correlated with efficient glycemic control (blood glucose <120 mg/dL), prevention of diabetic ketoacidosis and absence of cataract development, unlike other treatment groups. The suggested controlled basal insulin delivery system has the potential to significantly improve patient compliance by improving glycemic control and eliminating life-threatening diabetes complications.
Furthermore, oleic acid-grafted-chitosan (CO) nanomicelles were investigated as a non-viral vector to deliver plasmid DNA encoding short hairpin RNA (shRNA) against pro-inflammatory cytokines to adipose tissue macrophages and adipocytes for the treatment of insulin resistance. Nanomicelles modified using mannose (COM) and adipose homing peptide (AHP) (COA) showed significantly higher uptake and transfection efficiency in inflamed macrophages- adipocytes co culture owing to glucose transporter-1 and prohibitin receptor mediated internalization, respectively. Ligand modified nanomicelles loaded with shRNA against tumor necrosis factor alpha (COM-TNFα) and monocyte chemoattractant protein-1 (COA-MCP1) demonstrated significant attenuation of pro-inflammatory cytokines and improved insulin sensitivity and glucose tolerance in obese-diabetic mice for six weeks post treatment with single dose of optimized formulation. Overall, chitosan nanomicelles mediated targeted gene therapy can help attenuate inflammation, the chief underlying cause of insulin resistance, thereby helping reverse the progression of diabetes.National Institutes of Health (NIH) grant R15GM114701
ND EPSCoR seed award FAR0030636
17
Mijatovic, Jovana. "Diet for the Treatment of Gestational Diabetes Mellitus." Thesis, The University of Sydney, 2019. http://hdl.handle.net/2123/20651.
Full textAbstract:
Medical Nutrition Therapy is currently the cornerstone of gestational diabetes mellitus (GDM) management, but conflicting clinical evidence has led to a lack of expert consensus. Low carbohydrate (LC) diets are popular to help lower blood glucose levels but can increase the formation of ketones (beta-hydroxybutyrate, BHB) through increased fat catabolism. While LC diets have been endorsed by endocrine societies for GDM management, findings from a well-designed observational study indicated that high 3rd trimester serum BHB levels negatively impact child intelligence. Our literature search showed a knowledge gap related to the safety of LC diets in GDM. To address this knowledge gap, we conducted a 6-week pilot, 2-arm randomised controlled trial (MAMI 1 study) comparing the effects of a Modestly Lower Carbohydrate diet (MLC, 135 g/d carbohydrate) and Routine Care (RC, 180-200 g/d carbohydrate) on blood BHB levels and GDM outcomes. While there were no differences in BHB levels between study groups (mean ± SEM, MLC 0.1 ± 0.0 vs RC 0.1 ± 0.0 mmol/L; P = 0.308), glycaemia (6.1 ± 0.1 vs 6.0 ± 0.1 mmol/L, P = 0.317) or insulin dose (14.6 ± 1.8 vs 21.2 ± 3.9 units, P = 0.126), food analysis confirmed lower carbohydrate (165 ± 7 vs 190 ± 9 g/d, P = 0.042), energy (7040 ± 240 vs 8230 ± 320 kJ/d, P = 0.006), protein (85 vs 103 g/d, P = 0.006), and micronutrient intake (including iron and iodine) in the MLC group. The most surprising finding was a statistically smaller infant head circumference in the MLC group (33.9 ± 0.1 vs 34.9 ± 0.3 cm; P = 0.046), which remained significant after adjustment for gestational weight gain, gestational age at delivery and infant sex (P = 0.043). Head circumference ranged from the 10-25th percentile in the MLC group and between 25-50th percentile for the RC diet group. Head circumference is a proxy measure for brain volume and development, therefore this finding suggests the need for caution on LC dietary advice in GDM.
18
Davis, Ruth Elizabeth. "Advancing nursing jurisdiction in diabetes care." Thesis, University of South Wales, 2011. https://pure.southwales.ac.uk/en/studentthesis/advancing-nursing-jurisdiction-in-diabetes-care(9b06e8b5-a47f-44d6-9cab-371fb532a55b).html.
Full textAbstract:
Nursing has its own unique contribution to make to diabetes care, but that impact is rarely quantified, measured or conceptualised. The thesis makes this contribution in the form of three published research projects and proposes an adaptation to Abbott’s conceptual framework on the division of expert labour. The first research project demonstrates the value of the hospital based diabetes specialist nurse using a randomised controlled trial; the second delineates the competences of different levels of nurses in diabetes care using a nominal group technique and the third project provides a baseline of the state of nursing in relation to the initiation of insulin therapy using a survey approach. Each project is followed by a personal reflection and discussion of the implications in the light of Abbott’s framework. Abbott’s thesis is that the development of professions is determined by a series of jurisdictional disputes rather than by a grand plan of the professions themselves. While this assertion does not always hold true in diabetes care the studies do concur with Abbott in other ways, particularly that the profession can be taken forward by taking responsibility for appropriate educational preparation, extending the boundaries of knowledge and the nursing role where appropriate. The discussion cautions against setting up professional edifices that become self-serving and stifle development, either by rigid enforcement of competences or by fossilising the nursing contribution to diabetes care. In terms of the care of the person with diabetes, nursing remains most effective within the umbrella of a multi-disciplinary team while demonstrating its own contribution. Nursing should show professionalism by continually striving for excellence, developing new knowledge and pushing role boundaries when it is in the best interests of the patient. The original contribution to knowledge is shown in the research projects’ contribution to the evolution of diabetes nursing in the United Kingdom and the proposal that Abbott’s framework be modified to put more emphasis on the task of work to achieve optimum patient outcomes than on the jostling of professions; acknowledging the growth in multi-disciplinary team-working and rise in the power of organisations at the expense of the power of individual professions since his work was first published.
19
Wang, Ning, and 王宁. "Effectiveness of meal replacement on type 2 diabetes mellitus and intermediate hyperglycemia patients : a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206961.
Full textAbstract:
Background:
Lifestyle intervention is recommended as one important approach for Diabetes Mellitus management. Type 2 Diabetes Mellitus could be controlled and maintained by lifestyle intervention with no or less medications. It can delay the onset of diabetes related complications. Meal Replacement is one important lifestyle intervention. It modifies the composition and amount of nutrition intake, through daily meal, in order to control body weight and other metabolic indices. Effectiveness of meal replacement was examined by randomized controlled trials. Reviewing these studies systematically would demonstrate the clinical implication and other benefit of meal replacement, further more to guide the implementation in practice.
Method:
Search the online literature databases for related Randomized Controlled Trials. Analyze and compare different strategies of these interventions, as well as the outcomes. The effect of MR would be categorized into on body weight, on blood glucose, on serum lipid and on hypoglycemic medication and prognosis.
The economic benefit would also be one important objective.
Result:
MR intervention achieved body weight reduction, and considerable controlling effect on glucose and lipid. Majority of studies also reduced the hypoglycemic medication and improved prognosis.
Conclusion:
MR is one considerable intervention for T2DM and Intermediate Hyperglycemia patients. It could be integrated into structured lifestyle intervention for prevention and treatment. It also brings economic benefit so that reduce health care burden. Further research is needed for better effectiveness in practice.published_or_final_version
Public Health
Master
Master of Public Health
20
Kulik, Destini. "Reflexology and massage in the treatment of Type II diabetic neuropathy." Scholarly Commons, 2002. https://scholarlycommons.pacific.edu/uop_etds/571.
Full text
21
Wu, Xiao Hao. "A systematic review of Si-Miao-Yong-An decoction for the treatment of diabetic foot." HKBU Institutional Repository, 2015. https://repository.hkbu.edu.hk/etd_oa/142.
Full textAbstract:
Introduction: Diabetic foot (DF) is a common complication in patients with diabetes mellitus. Due to arterial abnormalities and diabetic neuropathy, as well as a tendency to delayed wound healing, infection or gangrene of the foot is relatively common. Early study indicated Si-Miao-Yong-An (SMYA) decoction is the most chosen Chinese herbal formulae in the treatment of DF. The aim of this study is to assess the quality of current evidence, and systematic review the effectiveness and safety of SMYA decoction for the treatment of DF. Method: (1) Search strategy: a special protocol was designed, and electronic databases and hand-search materials were used for screening eligible trials. (2) Inclusive criteria: randomized controlled trials (RCTs) to examine the efficacy and/or safety of SMYA decoction in DF treatments were valid. (3)Data analysis: the Jadad’s scale was used to assess the quality of eligible trials. Result: Total 23 RCTs met the inclusion criteria. Among those, 1341 patients are involved, 702 patients were treated by SYMA decoction. 22 trails using SMYA decoction combined WM claimed that they showed a statistically significant advantages over the treatments using WM alone in reducing DF symptoms. Only 1 RCT reported adverse events related to SMYA decoction, but less than WM treatment. Conclusion: All available evidence points to the fact that SMYA decoction may benefit to those diabetes patients with foot problem. However, due to the poor quality of included trials, more high-quality trials are required to substantiate or refute these early findings.
22
Kalergis, Maria. "The evaluation of three treatment strategies in subjects with type I diabetes mellitus undergoing intensive diabetes management : metabolic, psycho-social and educational implications." Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=24015.
Full textAbstract:
Three approaches, differing in flexibility of self-adjustments of insulin to food intake & exercise, have been identified in intensive management of Type I diabetes mellitus. They involve the exchange system (Protocols A/B) & carbohydrate counting (Protocol C) dietary strategies. The goal of this cross-over study was to determine differences among the approaches in terms of metabolic control (primarily glycated hemoglobin-GHb) and psycho-social adaptation (quality of life (QofL), self-efficacy (SE), stress & perceived complexity) in 15 adults with insulin-dependent diabetes.There were no significant differences in terms of metabolic control, self-efficacy and quality of life. Perceived complexity increased (p $<$ 0.0001) as subjects progressed from protocols A to C (least to most flexible). However, the subjects continued with Protocol B (n = 12) or Protocol C (n = 3) at the end of the study. Subjects who were very accurate in their self-monitoring of blood glucose (SMBG) reporting were also accurate in counting carbohydrate (p $<$ 0.001), more confident (SE) in their ability to adjust their insulin (p $<$ 0.05) and more satisfied (QofL) with their diabetes (p $<$ 0.01).
This study indicated that patients who are not ready to undertake carbohydrate counting need not be excluded from intensive management programs. Accuracy in SMBG reporting can be used to direct educational efforts.
23
Yan, Min, and 严敏. "Effects of self-management education on diabetic control among patients with type 2 diabetes : a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193810.
Full textAbstract:
Objective: To systematically review the effect of self-management education on diabetic control in type 2 diabetes
Research design and methods: PubMed was searched for English-language articles published between 2010 and 2013. All the studies were original articles selected manually and used randomized control trials generating results of self-management education in people with type 2 diabetes referring to diabetic control. Relevant data were divided and tabulated into factors of population characteristics, interventions and outcomes. Interventions were classified into three sections as collaborative information intervention, lifestyle intervention, and skills teaching intervention based on the patterns of education. Outcomes were categorized into glycemic control, cardiovascular disease (CVD) risk factors and nephropathy risk factors.
Results: A total of 24 studies were identified of initial 41 articles for this review. Effects of self-management education on glycemic control were demonstrated to be positive both in short-term (<10 months) and long-term (>10 months) follow-up, but more positive effects in short-term follow-up. The same effectiveness happens to CVD risk factors, including lipids, weight and blood pressure. On the other hand, with short-term follow-up, teaching skills intervention of self-management education is more effective than collaborative information intervention and lifestyle intervention on reducing glycemic control and CVD risk factors. Also with long-term follow-up, teaching skills intervention of self-management education had more effectiveness than collaborative information intervention and lifestyle intervention on reducing glycemic control. However, few studies including CVD risk factors in the long-term follow-up, so it is difficult to evaluate the effectiveness of on CVD risk factors with long-term follow-up.
Conclusions: Evidences supports the positive effectiveness of self-management education with collaborative information intervention, lifestyle intervention and skills teaching intervention among type 2 diabetes patients on diabetic control, in both short-term follow-up and long-term follow-up, but short-term follow-up is more effective than long-term follow-up. Further research is needed to develop self-management interventions to maintain long-term follow-up effects on glycemic control, CVD risk factors and other diabetes complications.published_or_final_version
Public Health
Master
Master of Public Health
24
Mykhailychenko, K., Світлана Григорівна Золотова, Светлана Григорьевна Золотова, and Svitlana Hryhorivna Zolotova. "Streptosotzin diabetes model." Thesis, Sumy State University, 2020. https://essuir.sumdu.edu.ua/handle/123456789/78064.
Full textAbstract:
Diabetes mellitus (DM) is a widespread disease leading to the development of serious complications, disability and premature death. A mandatory factor in the pathogenesis of type 1 diabetes is absolute insulin deficiency, leading to characteristic metabolic disorders. The fundamental treatment of Type 1 diabetes costs a lot of millions dollars every year for the past 100 years. Medicine spends a huge amount of money for daily insulin injections. Insulin therapy prevents death of patients from hyperglycemic coma, but doesn’t prevent the development of severe chronic complications. That is why, the search of more effective and preferably cardinal ways for antidiabetic treatment is extremely important. Great attention is paid to experiments on animals with experimental diabetes.
25
Boyden, Suzanne J. "Maintenance and monitoring system for diabetics : utilizing interface, product, and interactive design." Thesis, Georgia Institute of Technology, 2002. http://hdl.handle.net/1853/23356.
Full text
26
Ajudua, Emmanuel Enuagwuna. "Profile of diabetic complications amongst diabetics attending internal medicine outpatient department and family medicine outpatient department in Dora Nginza Hospital, PE hospital complex." Thesis, Stellenbosch : University of Stellenbosch, 2015. http://hdl.handle.net/10019.1/97196.
Full textAbstract:
Thesis (MFamMed)--Stellenbosch University, 2015.ENGLISH ABSTRACT: Introduction: Diabetes is the most prevalent endocrinology problem encountered in primary care practice. If recent trends showing a dramatic increase in prevalence (believed to be a consequence of a decline in physical activity and excessive caloric intake) continue, then the condition will soon affect nearly 20 million people in the U.S a reflection of the global trend. Effective management requires care that is thoughtful and meticulous, incorporating intensive patient education. Euglycemic control, with the level of glycosylated haemoglobin (HbA1c) kept below 7.0mmol/L, has emerged as a major treatment objective because of its association with a marked reduction in the risk for micro vascular complications. The primary physician is in the unique position to provide comprehensive care to the diabetic patient. Setting: The aim of this study is to evaluate the profile of complications arising due to diabetes mellitus among adult diabetics attending internal medicine outpatient department and family medicine/primary care outpatient department in the Dora Nginza hospital, PE hospital complex. Method: The study is a descriptive retrospective study in which names of patients were collated from clinic records of both clinics, files sought at the records department covering the period between Jan 2007 and Jan 2008 inclusive. Prevalence of statistical variables was generated using frequency tables, bar graphs, cross tabulations and chi square test. Results: Hyperglycemia was the major complication which predominantly was associated with high haemoglobin A1c (HbA1c) levels. However, some hyperglycaemic cases were also found to be associated with normal HbA1c. Complications were found to be more in type 2 diabetics. Patients with hypertension, obesity, smoking and alcohol use were observed to have a higher risk of developing diabetic complications. The findings on retinopathy in this study was inconclusive in view of the fact that patients sent for fundoscopy did not return with documented results from the sister hospital PE provincial hospital. Family Medicine outpatient department overall did better in patient care compared to the Internal Medicine outpatient department. Conclusion: The challenge for the primary care physician is to design a therapeutic program that is safe practical and acceptable to the patient. The ultimate goal of therapy is the prevention of micro vascular and macro vascular complications, consequence of diabetes that makes the condition a major risk factor for cardiovascular disease, stroke, visual impairment, renal failure, impotence, peripheral neuropathy, limb loss and ultimately death. These can be averted through appropriate education of both hospital staff, patients and their care givers. The recommendations made are based on the findings of the study.
AFRIKAANSE OPSOMMING: Nie beskikbaar.
27
Lucero, Marcelino. "A descriptive study of the use of the Diabetes Treatment Satisfaction Questionnaire (DTSQ) with different populations." The University of Arizona, 2006. http://hdl.handle.net/10150/624665.
Full textAbstract:
Class of 2006 AbstractObjectives: To examine the manner in which the DTSQ was used with a variety diabetic populations in different countries. The DTSQ is an 8 item questionnaire assessing satisfaction with diabetes treatment (6 items) and 2 items on glycemic control. Methods: Intensive search of published scientific literature was conducted to identify studies in which the DTSQ has been used in different countries. Data was extracted from each study on the following variables: country, ethnicitiy, DTSQ scores, Hg A1cgender, treatment, type of diabetes, and education level. Results: A total of twenty-four studies reporting the use of the DTSQ were identified. The majority studies (14/24) were treatment comparisons. The other studies were various other questions investigated. T he DTSQ was used for studies ranging in size from 15 to 1918 (mean 436.3 (SD=541.4) The DTSQ was used with patients who had thye 1, type 2, and gestational diabetes. Average HgA1c level was 7.6, and average DTSQ score was 29.9. Most studies did not describe the educational or ethnic background of their study participants. Most of the studies (18) were done in Europe with ten in the United Kingdom, two were in the USA, one in New Zealand, one in Nigeria, one in Canada, and one in Israel and Slovenia combined. Conclusions: The DTSQ appears useful with a variety of patient populations, although little information was presented on population characteristics.
28
McLaughlin, Darren Michael. "Antihypertensive treatment and insulin action in Type 2 diabetes." Thesis, Queen's University Belfast, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.437741.
Full text
29
Hoesli, Corinne. "Bioprocess development for the cell-based treatment of diabetes." Thesis, University of British Columbia, 2010. http://hdl.handle.net/2429/30255.
Full textAbstract:
The widespread cellular treatment of type 1 diabetes by islet transplantation is
limited by tissue shortage and graft rejection. This work describes two novel bioprocesses to
immobilize pancreatic cells in alginate using: (1) hollow fiber bioreactors or (2) alginate bead
generation by an adapted emulsion and internal gelation process. After optimization, live
cell recovery rates and growth rates were not significantly different between these more
scalable processes and conventional methods of alginate immobilization. After 10 days of
alginate-immobilized culture, the insulin content of neonatal porcine cells cultured in a
hollow fiber bioreactor increased by 4 fold, while the insulin expression of human isletdepleted
tissue cultured in emulsion beads increased by 67 ± 32 fold, matching previous
reports that used small-scale cultures. Solutions with >100 Pa·s viscosity could be used with
the emulsion process to generate beads with higher concentration and greater antibody
exclusion than has been so far permitted by nozzle-based encapsulators. The 5% alginate
beads generated by the emulsion process led to blood glucose normalization of allogeneic β-
cells transplanted into diabetic mice within 2 weeks, while mice transplanted with 1.5%
alginate beads generated by a conventional encapsulator remained hyperglycemic after 20
days. The improved result with the 5% alginate emulsion beads was associated with lower
graft-specific antibody plasma levels. These results suggest that the 5% alginate beads
provided improved immune isolation of the graft. If human pancreatic progenitors are to be
used for the large-scale generation of insulin+ cells in alginate, their expansion in serum-free
medium will be a prerequisite. Pancreatic duct-like cells are expected to have more potential
to generate insulin+ cells than the fibroblast-like cells that overgrow unsorted cultures of
islet-depleted human pancreatic tissue. The last part of this thesis describes the magneticactivated
depletion of CD90-expressing cells, which reduced the fraction of CD90+
fibroblast-like cells from 34 ± 20% to 1.3 ± 0.6%. This allowed the expansion of the duct-like
cell population in an optimized serum-free medium. These novel pancreatic cell culture
methods could be used to generate and/or offer immune protection to insulin+ cells for the
clinical-scale cellular treatment of diabetes.
30
Ilicak, Selin. "Children's adjustment to asthma or diabetes and treatment adherence." Thesis, Oxford Brookes University, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.515232.
Full textAbstract:
This thesis had two main aims. Firstly, to develop separate questionnaires for children with asthma and children with diabetes and their parents, which assess children's adjustment to the illness and treatment adherence. Secondly, to test the hypothesis of an association between children's adjustment and treatment adherence. The essence of asthma and diabetes treatment is self-care and consequently children with asthma or diabetes have to learn to cope with the long-term demands and responsibilities of complying with a strict and complex treatment regimen. It is currently recognized that a major problem in paediatrics is poor treatment adherence, which can result in serious health consequences. This led to a shift in paediatric medicine, from focusing only on the physical treatment of the illness to exploring the psychological impact of the illness and how it affects children's socio-emotional adjustment. However, there is a shortage of adjustment and treatment adherence measures; existing ones have major limitations. Thus, the new questionnaires aimed at assessing both children's adjustment and treatment adherence. Four interlinked studies utilising qualitative and quantitative methods were carried out. Study 1 and study 3 were parallel but separate studies and involved interviewing a group of 15 children with asthma and 15 children with diabetes, their parents and paediatric nurses about the children's experiences and feelings in a range of contexts. The interviews showed that there were commonalities in stressors across children but differences in adjustment and treatment adherence levels. On the basis of these interviews separate questionnaires for children with asthma (study 2) and children with diabetes (study 4) and their parents were developed and administered to a sample of 60 children and their parents. The new questionnaires proved to be reliable and valid and confirmed the hypothesis of a significant relation between children's adjustment and treatment adherence. The development of a new assessment tool involves several steps: This work represents the first steps in developing a new assessment tool. As with any new assessment instrument, further development will be required to examine its validity and reliability.
31
Gormley, M. J. J. "Aspects of insulin treatment of non-insulin-dependent diabetes." Thesis, Queen's University Belfast, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.373006.
Full text
32
Bednar, Kyle J. "Therapeutic Approaches to the Treatment of Type 1 Diabetes." University of Cincinnati / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1427962798.
Full text
33
Stewart, Catherine. "Insulin gene therapy for the treatment of diabetes mellitus." Thesis, Aston University, 1993. http://publications.aston.ac.uk/12599/.
Full textAbstract:
Currently available treatments for insulin-dependent diabetes mellitus are often inadequate in terms of both efficacy and patient compliance. Gene therapy offers the possibility of a novel and improved method by which exogenous insulin can be delivered to a patient. This was approached in the present study by constructing a novel insulin-secreting cell line. For the purposes of this work immortalized cell lines were used. Fibroblasts and pituitary cells were transfected with the human preproisinulin gene to create stable lines of proinsulin- and insulin-secreting cells. The effect of known -cell secretagogues on these cells were investigated, and found mostly to have no stimulatory effect, although IBMX, arginine and ZnSO_4 each increased the rate of secretion. Cyclosporin (CyA) is currently the immunosuppresant of choice for transplant recipients; the effect of this treatment on endogenous -cell function was assessed both in vivo and in vitro. Therapeutic doses of CyA were found to reduce plasma insulin concentrations and to impair glucose tolerance. The effect of immunoisolation on insulin release by HIT T15 cells was also investigated. The presence of an alginate membrane was found to severely impair insulin release. For the first implantation of the insulin-secreting cells, the animal model selected was the athymic nude mouse. This animal is immunoincompetent, and hence the use of an immunosuppressive regimen is circumvented. Graft function was assessed by measurement of plasma human C peptide concentrations, using a highly specific assay. Intraperitoneal implantation of genetically manipulated insulin-secreting pituitary cells into nude mice subsequently treated with a large dose of streptozotocin (STZ) resulted in a significantly delayed onset of hyperglycaemia when compared to control animals. Consumption of a ZnSO4 solution was shown to increase human C peptide release by the implant. Ensuing studies in nude mice examined the efficacy of different implantation sites, and included histochemical examination of the tumours. Aldehyde fuchsin staining and immunocytochemical processing demonstrated the presence of insulin containing cells within the excised tissue. Following initial investigations in nude mice, implantation studies were performed in CyA-immunosuppressed normal and STZ-diabetic mice. Graft function was found to be less efficacious, possibly due to the subcutaneous implantation site, or to the immunosuppresive regimen. Histochemical and transmission electron microscopic analysis of the tumour-like cell clusters found at autopsy revealed necrosis of cells at the core, but essentially normal cell morphology, with dense secretory granules in peripheral cells. The thesis provides evidence that gene therapy offers a feasibly new approach to insulin delivery.
34
Love, Alastair I. "Factors affecting nerve regeneration and function in experimental diabetes." Thesis, University of Aberdeen, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.241877.
Full textAbstract:
Rats with streptozotocin-induced diabetes exhibit both a reduction in nerve conduction velocity (NCV) and an impaired regenerative response after nerve injury. Nerve blood flow is also reduced in diabetic rats. Vasodilator treatment normalized the deficit in maximum regeneration distance after nerve injury. This strongly suggests a role for endoneurial hypoxia in the impaired regenerative response associated with diabetes. Inhibition of polyol pathway hyperactivity in diabetic rats corrects the deficit in nerve regeneration. Compensation for impaired essential fatty acid metabolism with evening primrose oil treatment had no significant effect on nerve regeneration, but corrected NCV. These findings implicate these two hyperglycemia-related metabolic disturbances in the development of diabetic nerve dysfunction. Levels of oxidative stress are increased in diabetic rats. It was demonstrated that various treatments which act to decrease levels of oxidative stress corrected both the deficit in nerve regeneration and the reduction in NCV found in diabetic rats. It is suggested that an increase in oxidative stress contributes towards nerve dysfunction in diabetes. Feeding non-diabetic rats a 40% galactose diet causes an increase in polyol pathway activity. These animals exhibited similar deficits in nerve regeneration and NCV to those seen in diabetic rats. Anti-oxidant treatment improved both nerve regeneration and NCV in galactose-fed animals. These studies give support to the suggestion that nerve dysfunction due to the diabetes-induced increase in polyol pathway activity involves an increase in levels of oxidative stress. Levels of certain growth factors are reduced in diabetic rats. Treatment of diabetic animals with ciliary neurotrophic factor normalized both nerve regeneration and NCV. Brain-derived neurotropic factor treatment improved nerve regeneration but had no significant effect on NCV.
35
Hunter, Steven J. "Insulin resistance : underlying mechanisms and influence of treatment." Thesis, Queen's University Belfast, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.337044.
Full text
36
Elmi, Shahrzad. "Sulfaphenazole treatment restores endothelium-dependent vasodilation in diabetic mice." Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/4090.
Full textAbstract:
Vascular dysfunction is linked with increased free radical generation and is a major
contributor to the high mortality rates observed in diabetes. Several probable sources of free
radical generation have been suggested in diabetes, including cytochrome P450 (CYP)
monooxygenase-dependent pathways. CYP-mediated superoxide production reduces nitric
oxide (NO) bioavailability. In this study, we focus on the contribution of CYP
monooxygenase enzyme-generated reactive oxygen species in vascular dysfunction in an
experimental model of type II diabetes mellitus. The purpose of this study is to test the
hypothesis that sulfaphenazole treatment can restore diabetic endothelial function in db/db
mice.
Diabetic male mice (db/db strain) and their age-matched controls received daily
intraperitoneal injections of either the CYP 2C inhibitor sulfaphenazole (5 mg/kg) or saline
(vehicle control) for 8 weeks. Fasting plasma glucose levels were measured before starting,
during, and after finishing the treatment. As well, plasma levels of 8-isoprostane (as a
marker of oxidative stress) and nitrite levels of aortic tissue (as a marker of NO
bioavailability) were determined.
Although sulfaphenazole did not change endothelium-dependent vasodilation in WT mice,
it restored endothelial-mediated relaxation in treated db/db mice. We concluded that CYP
2C inhibition by sulfaphenazole reduces oxidative stress (measured as plasma levels of 8-isoprostane), increases NO bioavailability (measured as NOj) and restores endothelial
function in db/db mice without affecting plasma glucose levels.
Based on our findings, we speculate that inhibition of free radical generating CYP
monooxygenase enzymes restores endothelium-dependent vasodilation induced by
acetylcholine. In addition, it reduces oxidative stress and increases NO bioavailability.
37
Williams, Gareth. "Investigation and management of brittle diabetic patients unresponsive to continuous subcutaneous insulin infusion." Thesis, University of Cambridge, 1986. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.685001.
Full text
38
Guldbrand, Hans. "Trials of Diets for Treatment of Diabetes : A comparison of diets for treatment of type 2 diabetes, aspects on long and short term effects." Doctoral thesis, Linköpings universitet, Institutionen för medicin och hälsa, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-116691.
Full textAbstract:
Background Type 2 diabetes is a common disease and the prevalence has increased in large parts of the world. In treatment of diabetes the type of diet is of great importance considering metabolic factors such as glucose level and blood lipids. Which diet that is most beneficial to avoid diabetic complications has been heavily debated in recent decades. This thesis is based on two clinical studies designed to compare the effects of different macronutrients. Methods A clinical trial was designed to compare a low-carbohydrate diet (LCD) to a low-fat diet (LFD) in treatment of patients with type 2 diabetes. Sixty-one patients at two health care centres were included and randomized to get advice to eat a LCD or a LFD. The LCD had an energy content where 50 energy percent (E%) where from fat, 20 E% from carbohydrates and 30 E% from protein. For the LFD the nutrient composition was similar to what is traditionally recommended for treatment of type 2 diabetes in Sweden. Metabolic factors, anthropometrics and questionnaires were analysed. To study postprandial effects a trial was designed to compare three different diets. Twentyone patients with type 2 diabetes were included to in randomized order test the three types of diets on separate test days. On each test day the patients were served breakfast and lunch and blood samples were taken at six times these days. Glucose, lipids and hormones were analysed. Results There were equal weight reduction in the two groups in the first trial during the two-year study period. At six month when compliance was good according to diet-records, the glucose level (HbA1c) was lowered and the HDL-cholesterol was increased in the LCD group. The inflammatory markers IL-6 and IL-1Ra were significantly lower in the LCD group than in the LFD group. At 12 months the physical function, bodily pain and general health scores improved within the LCD group only. In the second trial the postprandial glucose and insulin levels were lower on the LCD compared to the LFD. However, the LCD resulted in a tendency to higher postprandial triglyceride levels. The Mediterranean type of diet with all energy intake at lunch resulted in a more pronounced insulin response and a glucose level at lunch similar to that of the low-fat diet. The increase-ratio of insulin correlated to the elevation of the incretin glucose-dependent insulinotropic peptide (GIP). Conclusions In the two-year study we found benefits for the LCD group regarding glucose control and insulin doses. Furthermore, only the LCD was found to improve the subclinical inflammatory state and there were some aspects of improved well-being in this group. Aiming for 20% of energy intake from carbohydrates is safe with respect to cardiovascular risk factors compared with the traditional LFD and this approach could constitute a treatment alternative. In the postprandial state, the LCD induced lower insulin and glucose excursions than the LFD but at the same time a tendency of higher triglycerides. The long-term significance needs to be further examined. The accumulation of caloric intake from breakfast to lunch to a single large Mediterranean-style lunch-meal in type 2 diabetes might be advantageous from a metabolic perspective.
39
De, La Cruz Oller Joel. "Treatment Plans for Diabetes Management During Hurricane Maria in Puerto Rico." ScholarWorks, 2020. https://scholarworks.waldenu.edu/dissertations/7629.
Full textAbstract:
The purpose of this study was to evaluate the health outcomes of diabetic patients in Puerto Rico, before, during, and after Hurricane Maria, in 2017. The Department of Health in Puerto Rico provided the secondary data for the variables low-density lipoproteins (LDL) cholesterol, hemoglobin A1C (HbA1c), mortality, and consumer price index (CPI). The inclusion criteria were participants for whom electronic data were available before, during, and after Hurricane Maria; the sample size was 450. The theoretical framework for this investigation was the health outcomes and impact assessment. The data were analyzed by univariate and analysis of variance (ANOVA) to compare means and normality test analysis. Results of this study revealed that before Hurricane Maria, diabetics in Puerto Rico did not have control of their health. The American Diabetes Association (ADA) guideline for Hgb AIC is < 7.0; prior to Hurricane Maria Hgb AIC was 7.30 and after it was 7.21. The ADA LDL goal is
40
Tshivhase, Abegail Mukhethwa. "The prevalence of maturity onset diabetes of the young (Mody) in a population from the Western Cape." Thesis, Cape Peninsula University of Technology, 2019. http://hdl.handle.net/20.500.11838/2980.
Full textAbstract:
Thesis (MSc(Biomedical Technology))--Cape Peninsula University of Technology, 2019Background: Maturity Onset Diabetes of the Young (MODY) is a monogenic type of diabetes caused by a single gene mutation. Up to date 14 different MODY subtypes have been identified. Mutations in the glucokinase (MODY 3) and hepatic nuclear factor 1 alpha (HNF1A) (MODY 2) are the most frequent causes of MODY in all populations studied. Patients with MODY are misdiagnosed with type 1 or type 2 diabetes. Identifying patients with MODY is important as it affects treatment, for example, MODY 2 patients need no treatment, whereas those diagnosed with MODY 3 are very sensitive to low doses of sulphonylureas. To date, no data is available on the prevalence of MODY in populations from Africa. Thus, we aimed to investigate and report on the incidence of MODY, specifically mutations in the HNF1A gene in a population from the Western Cape. Methods: In this study, we screened for HNF1A MODY (MODY 3) mutations (rs115080759, rs140491072 rs137853245, and rs142318174) in 1639 (males = 406) individuals using real-time PCR. Positive MODY samples were confirmed by subsequent sequencing. All individuals underwent an oral glucose tolerance test. Results: The mean age of participants was 47.1±15.6 in males and 49.9±15.1 females. We identified 12 (0.73%) individuals with HNF1A gene polymorphisms; 12/1642 of rs115080759. Seven participants with a SNP in rs115080759 presented with normoglycemia, one with prediabetes, and four with diabetes. No polymorphism was detected in three SNPs; rs140491072, rs137853245 and rs142318174. Discussion and conclusion: To our knowledge, this is the first African study on MODY, and the incidence is similar to that reported in other studies. The results suggest that MODY is misdiagnosed with other types of diabetes in Africa; therefore, our findings support the introduction of diagnostic genetic testing for MODY in South Africa.
41
Hoffman, Kristin. "Cancer treatment and cellular stress induced type 2 diabetes mellitus." Thesis, Boston University, 2012. https://hdl.handle.net/2144/12422.
Full textAbstract:
Thesis (M.A.)--Boston University
PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.Some cancer treatments induce stress responses that activate protective mechanisms and neuregulin expression. In turn, neuregulin activates ErbB receptors, which are responsible for phosphorylating Insulin Receptor Substrates interfering with insulin activity and causing insulin resistance. The effects of neuregulin have been known to enhance development and survival of various tissues by providing nutrients. The activation of ErbB receptors leads to the activation of P13K, which in turn activates serine kinases responsible for phosphorylating IRS-1 and IRS-2. The serine phosphorylated IRS-1 and IRS-2 negatively modulate insulin signaling through the immediate auto-degradation of the serine phosphorylation of IRS, and dissociation of the IR/IRS complex. Furthermore, serine phosphorylated IRS interferes with downstream effectors such as AKT, which are necessary for modulating the glucose transporter, GLUT4. The purpose of this study is to test the hypothesis that neuregulin induced stress pathways alter glucose transport through similar cascades as insulin signaling. A series of experiments were conducted applying variable doses and combinations of neuregulin and insulin to measure the downstream effect on the level of AKT. These applications demonstrated that insulin and neuregulin activate AKT independent from each other through different complimentary mechanisms.
42
Dantas, Mariana Brito. "Betulinic acid effect in treatment of dyslipidemia and diabetes in mice." Universidade Federal do CearÃ, 2012. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=7379.
Full textAbstract:
CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel SuperiorDiabetes and dyslipidemia prevalence has been increasing globally configured as an epidemic resultant mainly from overweight, physical inactivity and genetic susceptibility. There are reports of many natural products that have hypoglycemic and hypolipidemic activity. Among them we mention the terpenes, which are the largest group of secondary products of plants metabolism. The terpene studied in this work was betulinic acid (BA), a pentacyclic triterpene lupano type that presents a variety of biological and pharmacological activities. The objective of this study was to evaluate BA hypoglycemic and hypolipidemic effects in experimental protocols of dyslipidemia and diabetes induced pharmacologically as well as studying their toxic potential in vivo. The BA-treated groups received doses of 5 (BA5), 10 (BA10) and 20 (BA20) mg/kg. The evaluation of the BA hypoglycemic action was carried out through diabetes induced by alloxan protocol and oral glucose tolerance test (OGTT). To check their activity on lipid metabolism, it was carried out dyslipidemia protocol induced by Triton WR 1339 intraperitoneal injection. In addition, it was performed the protocol modified diet-induced hypercholesterolemia. Toxicity was assessed by the study repeated doses for 28 days treating daily with BA doses via gavage. After the protocol of alloxan-induced diabetes, there was a blood glucose reduction in groups BA10 and BA20. Triglycerides and total cholesterol decreased significantly at all doses studied. BA10 treatment, also reduced the blood glucose peak caused by glucose overload (2g/Kg) in the OGTT. After 24 hours of dyslipidemia induced by triton, there was a significant triglycerides reduction in groups treated with BA at doses of 10 and 20mg/Kg. After 48h, triglycerides levels remained reduced in group treated with BA10. In hypercholesterolemia induced by diet modified protocol BA at doses of 10 and 20mg/kg, promoted a significant decrease in total cholesterol levels. There were no significant changes in the parameters evaluated after repeated dose oral toxicity protocol. Results demonstrate the therapeutic potential and safety of betulinic acid in the treatment of dyslipidemia and diabetes, although others pre-clinical and clinical studies are necessary for its use by population.
A prevalÃncia da diabetes e das dislipidemias vem crescendo mundialmente configurando-se como uma epidemia resultante,principalmente, do excesso de peso, da inatividade fÃsica e da suscetibilidade genÃtica. Existem relatos de muitos produtos de origem natural que possuem atividade hipoglicÃmica e hipolipidÃmica. Dentre eles, podemos citar os terpenos, que constituem o maior grupo de produtos do metabolismo secundÃrio de plantas. O terpeno estudado no presente trabalho à o Ãcido betulÃnico (AB), um triterpeno pentacÃclico do tipo lupano que apresenta uma variedade de atividades biolÃgicas e farmacolÃgicas. Assim, o objetivo deste estudo foi avaliar o efeito hipolipidÃmico e hipoglicÃmico do AB em protocolos experimentais de dislipidemias e diabetes induzidas farmacologicamente bem como estudar seu potencial tÃxico in vivo. O grupos tratados com AB receberam as doses de 5(AB5), 10(AB10) e 20(AB20)mg/Kg. A avaliaÃÃo da aÃÃo do hipoglicÃmica do AB foi atravÃs do protocolo de diabetes induzida por aloxano e o teste oral de tolerÃncia a glicose (TOTG). Para verificar sua atividade sobre o metabolismo lipÃdico, foi realizado o protocolo de induÃÃo da dislipidemia atravÃs da injeÃÃo intraperitoneal de triton WR 1339. AlÃm disso, foi realizado o protocolo de hipercolesterolemia induzida por dieta modificada. A toxicidade foi avaliada pela realizaÃÃo do estudo toxicolÃgico de doses repetidas durante 28 dias mediante administraÃÃo Ãnica diÃria por via oral de AB. Depois do protocolo de diabetes induzida por aloxano, observou-se uma reduÃÃo da glicemia nos animais dos grupos AB10 e AB20. Os triglicerÃdeos e o colesterol total reduziram significativamente em todas as doses estudas. O tratamento com AB10, reduziu ainda o pico glicÃmico causado pela sobrecarga de glicose (2g/Kg) no TOTG. ApÃs 24h da induÃÃo com triton, verificou-se a reduÃÃo significativa dos triglicerÃdeos nos grupos tratados com AB nas doses de 10 e 20mg/Kg. Depois de 48h, os animais do grupo AB10 manteve tal reduÃÃo. No protocolo de hipercolesterolemia induzida por dieta modificada o AB nas doses de 10 e 20mg/Kg, promoveu uma diminuiÃÃo significativa do colesterol total plasmÃtico. NÃo foram encontradas alteraÃÃes significativa nos parÃmetros avaliados apÃs protocolo de toxicidade oral em doses repetidas. Os resultados obtidos demonstram o potencial terapÃutico e a seguranÃa do Ãcido betulÃnico no tratamento das dislipidemias e diabetes, apesar de serem necessÃrios novos estudos prÃ-clÃnicos e clÃnicos para sua utilizaÃÃo no mercado.
43
Wu, Douglas Ching Gee. "Cellular therapeutic strategies for the treatment of Type 1 Diabetes Mellitus." Thesis, University of Oxford, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.670111.
Full text
44
Wentzel, Annalie. "Determinants of compliance behaviour among patients living with diabetes referred for diabetic retinopathy treatment in a government health care facility in Cape Town, South Africa." University of the Western Cape, 2020. http://hdl.handle.net/11394/8025.
Full textAbstract:
Magister Public Health - MPHUntreated and unmonitored diabetic retinopathy (DR) can lead to vision loss. This may have many negative implications on society. Currently, there is a dearth of evidence regarding the factors that influence compliance behaviour to treatment among patients diagnosed with DR in South Africa’s public healthcare system. The current study sought to fill this research gap and explore patient-, institution-, treatment-, and COVID-19- related factors associated with compliance behaviour among patients living with diabetes that have been referred for suspected vision-threatening DR in the Northern/Tygerberg sub-structure (NTSS) of Cape Town, South Africa. Methodology: A qualitative research approach was used. The study population included 19 years and older South Africans living with diabetes who were screened and referred for vision-threatening retinopathy within the last 18 months at public primary healthcare facilities in the NTSS.
45
Parker, Hameedah. "'Doing' diabetes: a focus on local experience, medical knowledge systems and herbal management of Type 2 Diabetes among individuals in Genadendal, Western Cape." University of the Western Cape, 2015. http://hdl.handle.net/11394/4659.
Full textAbstract:
Magister Artium - MAIn South Africa 3.5 million people (estimated 6% of the total population) are diagnosed and living with diabetes. The majority of the diagnosed group suffer from Type 2 diabetes respectively. Described as a metabolic disorder, diabetes is also understood as an illness and disease and is usually handled through the intervention of biomedical perspectives, especially in the manner in which it is treated and managed. However, few ethnographies have interrogated how individuals living with diabetes in South Africa in negotiate between various medical/healing knowledge systems- both ‘alternative’ and biomedical. The study explores the area of Genadendal as a case study, using an ethnographic approach and a material semiotic approach (Mol, 2002) in relation to medical sense-making and treatments. I investigate the partial connections as discussed by Strathern (2004), between medical/healing knowledge systems, i.e. biomedical and herbal management through plant medicines, which inform diabetic realities. Ultimately, this study considers the various notions and understandings of diabetes, local knowledge, experiences of individuals with diabetes and the interfaces of different ways of knowing with each other.
46
Fhärm, Eva. "Treatment of cardiovascular risk factors in type 2 diabetes time trends and clinical practice /." Umeå : Department of Public Health and Clinical Medicine, Umeå university, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-30686.
Full text
47
Elleri, Daniela. "Closed-loop insulin delivery in children and adolescents with type 1 diabetes." Thesis, University of Cambridge, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648562.
Full text
48
Cho, Li Wei, and 朱丽薇. "Systematic review of the effectiveness of telehealth diabetes management programme in improving diabetes care and its applicability to Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193772.
Full textAbstract:
Background
Telehealth is a communication technology that allows exchange of data between patients and health care providers. Disease management is a structured multifaceted intervention to patient care that promotes self-management skills and improves patient-doctor communication. This systematic review aims to determine the effectiveness of “telehealth diabetes management programmes” for patients with type-2 diabetes (T2DM) in improving outcomes such as glycaemic control, diabetes related mortality, hospital admissions and overall cost-effectiveness of programme. Its applicability to Hong Kong will be reviewed.
Methods
A literature search of electronic bibliographic databases was performed to identify relevant articles. Both randomised control trials and observational studies on patients with T2DM published up to March 2013 were included in the analysis.
Results
A total of 14 articles were eligible (n=9708 subjects). Eight were randomised controlled trials and six observational studies. Ten studies reported on mean change in HbA1c level, three on health care utilization and three on cost-effectiveness of telehealth management programme. No studies had diabetes related mortality as their outcome measure. Across these trials, telehealth diabetes management programme resulted in an improvement in glycaemic control, likely reduction in health service utilization and a probable cost-effective programme.
Discussions
The current Hong Kong’s health care system faces challenges from long wait-list for medical consultations and rising health care costs. The applicability of the results from this review to the setting in Hong Kong, and feasibility of implementation will be discussed.
Conclusion
Telehealth disease management programmes had clinically modest but significant improvement in HbA1c among adults with T2DM and likely to be cost-effective. The results of this review have potential important implications for policy makers in the allocation of health care resources.published_or_final_version
Public Health
Master
Master of Public Health
49
Dashora, Umesh Kumar. "Studies of insulin treatment in the management of type 2 diabetes." Thesis, University of Newcastle upon Tyne, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.430691.
Full text
50
Montgomery, Ian Andrew. "Modulation of gut hormone action as a treatment for obesity-diabetes." Thesis, University of Ulster, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.588750.
Full textAbstract:
The health and socio-economic burdens of the current diabesity epidemic present significant challenges worldwide. This thesis evaluates the therapeutic potential of two approaches to diabesity therapy namely; sustained GIP receptor antagonism and prolonged CCK receptor activation. Active immunisation against (Pro3)GIP in high-fat mice resulted in the generation of GIP specific neutralising antibodies, resulting in decreased circulating blood glucose, plasma insulin, LDL-cholesterol, tissue triglyceride content and improved glucose tolerance and insulin sensitivity. In an extension of this work, GIP signalling blockade by active immunisation against GIP or (Pro3)GIP resulted in similar significant improvements in metabolic status of high-fat fed mice, but was devoid of changes in energy expenditure, indirect calorimetry, behaviour and cognitive function. Furthermore, results were comparatively similar to the more established therapeutic regime of once-daily treatment with the stable and specific GIP receptor antagonist, (Pro3)GIP. Contrastingly, while acute administration of the small molecular weight GIP receptor antagonist, 4H2BH, effectively inhibited the acute in vitro and in vivo actions of GIP, chronic treatment was not associated with metabolic benefits in obese diabetic (ob/ob) mice. In a separate series of experiments, chronic treatment with the stable CCK receptor agonist, p(Glu,Gln)CCK-8, reduced food intake, decreased body weight and improved metabolic control without appreciable adverse effects in high-fat fed mice. Early treatment with p(Glu,Gln)CCK-8 also prevented the onset of obesity in high fat fed mice, and benefits persisted despite cessation of treatment. Finally, combined p(Glu,Gln)CCK-8 treatment with the stable GIP agonist, GIP [mPEG] , demonstrated some beneficial additive effects, however combination therapy with the leptin fragment, [D-Leu-4]-OB3, was associated with clear additive and synergistic benefits in high fat fed mice, including inhibition of food intake and curtailment of hyperglycaemia. This thesis demonstrates that modulation of gut hormones that regulate energy homeostasis may provide novel and effective means to treat obesity-diabetes.