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Tukay, Remeliza Navarrete. "Diabetes Mellitus Type 2: A Quality Improvement and Patient Safety Initiative." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3213.
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The purpose of the quality improvement (QI) project was to examine the relationship between amended nursing education concerning diabetes mellitus (DM) Type 2 self-care management incorporating Tune in, Explore, Assist, Communicate, and Honor (TEACH) and Motivational Interviewing (MI) strategies and techniques and the Glycosylated hemoglobin (HgbA1C) of veteran patients with uncontrolled diabetes. The target sample included the 2 licensed practical nurses and 2 registered nurses assigned to 2 primary care teams, and the 10 purposively sampled patients with uncontrolled DM Type 2 from each team. The nurses' competencies were measured through descriptive comparison before and after nursing education implementation using the instrument Patient Education: TEACH for Success Self-Assessment Questionnaire. The nurses' confidence and their perceived importance of the TEACH and MI skills application and skill assessment for promoting health behavior change were tested inferentially with a paired t test before and after nursing education implementation using the instrument Clinician Importance and Confidence Regarding Health Behavior Counseling Questionnaire. The primary care team developed their skills tailored to each patient's needs, considering the guiding principles and premises of the health belief model (HBM). Patients' self-care management knowledge, skills and confidence were improved. The project decreased the elevated HgbA1C of patients measured after the project initiative. The QI project leads to positive social change by decreasing the number of patients with uncontrolled diabetes among the veteran population. The patients and their providers can develop individualized plans of care for diabetes management by educating, redirecting, and evoking behavioral changes in the veteran patients by using a team approach.
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Bengtsson, Lisa, and Zhiar Mohamed. "Egenvård vid diabetes mellitus typ 2 - En litteraturöversikt." Thesis, Jönköping University, Hälsohögskolan, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-52910.
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MacArthur, Diane L. A. "Amyloid fibril formation in islets of transgenic mice expressing human islet amyloid polypeptide." Thesis, University of Oxford, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.325942.
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Löwendahl, Alma, Emelie Karlsson, and Therese Svensson. "Att leva med diabetes mellitus typ 2 : En kvalitativ litteraturöversikt." Thesis, Jönköping University, HHJ, Avd. för omvårdnad, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-52580.
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Titel: Att leva med diabetes mellitus typ 2. Bakgrund: Diabetes mellitus typ 2 (DMT2) är ett globalt problem och fler personer insjuknar årligen. Egenvård är en central del av behandlingen för dessa personer. Att förstå livsstilsförändringar, behandlingar och egenvården hos dessa personer bidrar till ökad kunskap inom hälso- och sjukvården. Syfte: Att beskriva personers erfarenheter av att leva med diabetes mellitus typ 2. Metod: Litteraturöversikt med artiklar av kvalitativ design baserad på 12 vetenskapliga artiklar från databaserna Cinahl och MedLine. Resultat: Resultatet presenteras i två huvudteman egenvård och information vid diabetes mellitus typ 2 och påverkan av diabetes mellitus typ 2 i livet med respektive underkategorier. Det fanns erfarenhet av bristande och otillräcklig information av hälso- och sjukvården. Erfarenheter fanns av att närstående gav bra information och under gruppbaserad utbildning reflekterades erfarenheter av att leva med DMT2. Resultatet visade att egenvården innefattade en del svårigheter som ändrade kostvanor, fysisk aktivitet, kulturella aspekter och förändrad livsstil. Slutsats: DMT2 är en global och livslång sjukdom där livsstilsförändringar bör genomföras. Erfarenheter av att det var svårt att genomföra livsstilsförändringar där kostvanor visade sig vara det svårast att anpassa sin DMT2 till. Vidare forskning kring erfarenheter hos personer med DMT2 bidrar till ökad kunskap för sjuksköterskan men även allmänheten. Vidare forskning av personer med DMT2 och hur kultur påverkar egenvården kan ge ökad kunskap till sjuksköterskan och allmänheten. Nyckelord: Diabetes mellitus typ 2, diabetes typ 2, livsstil, patienters erfarenheter, egenvård.Title: Living with diabetes mellitus type 2. Background: Type 2 diabetes mellitus (DMT2) is a global problem and more people are getting sick every year. Self-care is a central part of the treatment for these people. Understanding the lifestyle changes, treatments and self-care of these people contributes to increased knowledge in health care. Aim: Describing people's experiences of living with type 2 diabetes mellitus. Method: A qualitative literature review. Based on 12 scientific articles collected from Cinahl and MedLine. Results: The results are presented in two main themes of self-care and information in diabetes mellitus type 2 and the impact of diabetes mellitus type 2 in life with the respective subcategories. There was experience of inadequate and insufficient information from the health service. There was experience that close relatives provided good information and during group-based training, experiences of living with DMT2 were reflected. The results showed that self-care included some difficulties such as changing dietary habits, physical activity, cultural aspects and changing lifestyles. Conclusion: DMT2 is a global and lifelong disease where lifestyle changes should be implemented. Experiences that it was difficult to implement lifestyle changes where dietary habits proved to be the most difficult to adapt your DMT2 to. Further research on the experiences of people with DMT2 contributes to increased knowledge for the nurse but also the public. Further research of people with DMT2 and how culture affects self-care can provide increased knowledge to the nurse and the public. Keywords: Diabetes mellitus type 2, diabetes type 2, lifestyle, patient experience, self care.
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Al-Ghamdi, Yasser. "The Effects of Probiotics on High Sugar-Induced Type 2 Diabetes Mellitus Symptoms in Drosophila melanogaster." Thesis, Högskolan i Skövde, Institutionen för hälsa och lärande, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-17817.
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Background: Type 2 diabetes mellitus is a metabolic disorder characterized by the rise of fasting plasma glucose from its normal range (≥125mg/dl). It is marked by insufficient production of insulin from pancreatic β-cells as a result of failed compensation due to insulin resistance. Several treatments are available for the disorder, which mainly focus on improving the sensitivity of insulin in different body tissues. Recently, probiotics were suggested as candidate treatments for type 2 diabetes and for extending lifespan as well. This experiment aims to investigate such claims using Drosophila melanogaster as a disease model. Results: Other than the observed low average weights in treated larva samples, probiotics did not show any other significant results in affecting the length, glucose, glycogen, and trehalose levels (One-Way ANOVA and Kruskal-Wallis, p>0.05). Real-time PCR was only carried out once. Thus, no statistical tests were reliable enough to analyse the data obtained. The longevity study, on the other hand, did show significance (Log-rank (Mantel-Cox) test and Gehan-Breslow-Wilcoxon test, p<0.0001), as the probiotic Bifidobacterium lactis extended the lifespan of adult flies feeding on a high sugar diet significantly when compared to the control ones feeding on only high sugar diet without probiotics. Conclusion: Except for weight measurements, none of the other results was reliable enough to make a concrete conclusion on whether the treatments indeed worked in reversing type 2 diabetes symptoms or not. Real-time PCR results did show some effects of some of the treatments at different developmental stages. However, unless Real-time PCR is repeated at least once using the same protocol, no deduction can be made. Additionally, the data obtained hint that the dosage used (0.025 g) was too high for larvae and adult flies and might have caused malnutrition by blocking their midgut and decreasing food absorption. Hence, false significant or non-significant results were acquired instead. Further studies are required using a much lower probiotic dosage if Drosophila is used as a disease model. Although, other models such as mice or rats are recommended in this case, in order to reach a solid conclusion about the effectiveness of probiotics in treating type 2 diabetes mellitus. Baring these thoughts in mind and based on the results of this experiment, the null hypothesis indicating that there is no significant relationship between the use of probiotics and reversing type 2 diabetes mellitus symptoms is therefore accepted.
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Pye, Theresa. "Impact of Group Medical Visits for Adult Patients with Type 2 Diabetes Mellitus." UNF Digital Commons, 2011. http://digitalcommons.unf.edu/etd/378.
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Diabetes is a condition that is primarily self-managed and lifestyle modifications such as diet, exercise, and weight management are necessary to reduce morbidity and mortality. Motivation to implement lifestyle modifications through self management is an integral part of disease management and studies have shown group medical visits are more effective than individual appointments in this patient population. The purpose of this project was to develop, implement and evaluate an evidencebased group medical visit program for up to a maximum of 8 adult patients with type 2 diabetes in a family practice setting for six months. Seven participants with abnormal A1C results accepted the invitation to attend group medical visits. Here surrounded by peers with the same diagnosis, they were able to learn and discuss methods to self manage their type 2 diabetes. At the conclusion post survey results indicate positive change in some lifestyle behaviors and improvement with hemoglobin A1C. However there was no improvement in weight management. A cost analysis reveals group medical visits may generate a small profit when compared to individual visits. Group medical visits may offer an effective means to motivate patients to make lifestyle change to reduce risk.
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Ghadzi, Siti Maisharah Sheikh. "Pharmacometrics Modelling in Type 2 Diabetes Mellitus : Implications on Study Design and Diabetes Disease Progression." Doctoral thesis, Uppsala universitet, Institutionen för farmaceutisk biovetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-317040.
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Pharmacometric modelling is widely used in many aspects related to type 2 diabetes mellitus (T2DM), for instance in the anti-diabetes drug development, and in quantifying the disease progression of T2DM. The aim of this thesis were to improve the design of early phase anti-diabetes drug development studies with the focus on the power to identify mechanism of drug action (MoA), and to characterize and quantify the progression from prediabetes to overt diabetes, both the natural progression and the progression with diet and exercise interventions, using pharmacometrics modelling. The appropriateness of a study design depends on the MoAs of the anti-hyperglycaemic drug. Depending on if the focus is power to identify drug effect or accuracy and precision of drug effect, the best design will be different. Using insulin measurements on top of glucose has increase the power to identify a correct drug effect, distinguish a correct MoA from the incorrect, and to identify a secondary MoA in most cases. The accuracy and precision of drug parameter estimates, however, was not affected by insulin. A natural diabetes disease progression model was successfully added in a previously developed model to describe parameter changes of glucose and insulin regulation among impaired glucose tolerance (IGT) subjects, with the quantification of the lifestyle intervention. In this model, the assessment of multiple short-term provocations was combined to predict the long-term disease progression, and offers apart from the assessment of the onset of T2DM also the framework for how to perform similar analysis. Another previously published model was further developed to characterize the weight change in driving the changes in glucose homeostasis in subjects with IGT. This model includes the complex relationship between dropout from study and weight and glucose changes. This thesis has provided a first written guidance in designing a study for pharmacometrics analysis when characterizing drug effects, for early phase anti-diabetes drug development. The characterisation of the progression from prediabetes to overt diabetes using pharmacometrics modelling was successfully performed. Both the natural progression and the progression with diet and exercise interventions were quantified in this thesis.
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Ramsumeer, Soy. "A Plan for the Implementation and Evaluation of Diet Education in Type 2 Diabetes." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/1920.
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Type 2 Diabetes Mellitus (T2DM) is the seventh leading cause of death in the United States with a projected increase of 552 million people worldwide who will be affected with this illness by 2030. The need to address this issue is vital to prevent complications and reduce healthcare spending. The DNP project is aimed at planning and designing a nutritional education program tailored toward specific ethnic groups in order to increase knowledge in making healthy food choices. This project is intended to educate Registered Nurses (RNs) on nutrition so that they can offer dietary knowledge to T2DM patients. Additional patients can be reached by educating the RNs rather than patients being limited to consultations with a Certified Diabetes Educator or Registered Dietician. This project focused on whether healthy nutrition tailored toward the individual's own ethnic foods helps to stabilize glycemic values for patients with Type 2 diabetes. A toolkit was utilized to aid with the RNs' learning on healthy nutrition and its impact on the management of blood glucose. It addressed areas such as food groups and calories, grocery shopping, preparation methods, and portion control. The framework for design utilized the basic concepts associated with the systems theory with an intended goal to prevent further complications and improve patients' glycemic value through consuming nutritious foods. The logic model will be used to evaluate the impact of healthy nutrition on blood glucose through pre- and post-program tests of the RNs' nutritional knowledge on healthy eating. The continuation of this program will promote positive social change by helping patients to achieve a healthier lifestyle and reduce healthcare expenditures.
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Dannison, Phawlay, and Mustafa Rezaei. "Personers upplevelser av att leva med typ 2 diabetes." Thesis, Högskolan i Gävle, Avdelningen för vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-31317.
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Sammanfattning Bakgrund: Diabetes mellitus typ 2 (DMT2)är en av den vanligaste sjukdomarna och den ökar mer och mer på grund av ohälsosam livsstil. Faktorer som höjer risken för att utveckla DMT2 är livstillfaktorer som till exempel tobak, minskad fysisk aktivitet, stillasittande liv, matvanor och fetma. Sjukdomen behandlas med hälsosam kost, fysisk aktivitet och medicinering. Syftet: Syftet med studie var att beskriva personers upplevelser av att leva med DTM2. Metod: Litteraturstudie med en beskrivande design som bygger på 13 kvalitativa artiklar. Resultat: personerna upplever en psykologisk påverkan som visar sig som oro, rädsla, nedstämdhet och oro över framtiden. Personerna upplever också olika sociala begränsningar. Egenvården som främst består av medicinering, kost och fysisk aktivitet upplevs som mycket viktig. Kunskap och stöd av närstående och vårdpersonalen upplevs som viktig. Slutsats: Personer med DMT2 känner sig nedstämda och upplever oro. Genom att få stöd från närstående och vårdpersonal underlättas personernas självhantering av sjukdomen. Personerna upplever att umgänget med andra personer minskas på grund av sociala begränsningar. Olika copingstrategier samt egenvård spela stor roll för personer med diabetes typ 2. Mer kunskap inom området vore önskvärt för att ge ett adekvat bemötande. Nyckelord: diabetes mellitus typ 2, dagligt liv, upplevelser.
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Gustafsson, Julia, and Maria Vallberg. "Sjuksköterskors erfarenheter av egenvård hos diabetes typ-2 patienter." Thesis, Högskolan i Gävle, Avdelningen för vårdvetenskap, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-35697.
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Bakgrund: Diabetes mellitus typ-2 är en av de vanligaste folksjukdomar världen över, i Sverige uppskattas det till att ca 300 000 människor lider av sjukdomen. En stor del av behandlingen för människor med diabetes typ-2 är att ändra sina matvanor, fysisk aktivitet och att medicinera sig själva, detta kallas för egenvård. En stor del av sjuksköterskors arbete med diabetes typ-2 patienter är att motivera och ge stöd till patienterna så att de efterlever de livsstilsråd som ges i den mån det går. Hur patienterna upplever sin egenvård ser olika ut, några menade att eftersom sjukdomen är genetisk är det inget som kunde styras medan andra menade att egenvården och sjukdomen kunde vara svår att hantera och att stödet från sjukvården är viktigt. Syfte: Syftet med studien var att beskriva sjuksköterskans erfarenheter av egenvård hosdiabetes mellitus typ-2 patienter Metod: En litteraturstudie med beskrivande design som totalt innefattar 10 artiklar av kvalitativ ansats från databasen Pubmed. Huvudresultat: Resultatet visade att sjuksköterskorna ofta upplevde sina patienter som omotiverade i deras egenvård och att de hade svårt att efterfölja de livsstilsråd som gavs, detta var ett vanligt förekommande tema. Sjuksköterskorna använde sig av olika metoder till att förbättra egenvården och motivationen hos deras patienter. Det framkom även i resultatet att sjuksköterskorna upplevde stress och minskad arbetsglädje relaterat till att de inte kunde ge den bra diabetesvård de ville då de kände att de inte fick något gehör från patientens sida. Slutsats: Föreliggande litteraturstudie visade att sjuksköterskor kunde behöva stöd och verktyg till att ge rätt egenvårdsstöd till deras patienter. Detta kunde därmed leda till att sjuksköterskor kan känna sig mer nöjda med det arbete de åstadkommit och därmed även främja arbetsglädjen.Background: Diabetes mellitus type-2 is one of the most common public diseases worldwide, in Sweden it is estimated that about 300,000 people suffer from the disease. A large part of the treatment for people with type 2 diabetes is to change their eating habits, physical activity and to medicate themselves, this is called self-care. A large part of nurses' work with type 2 diabetes patients is to motivate and provide support to the patients so that they comply with the lifestyle advice given as far as possible. How patients experience their self-care looks different, some believe that because the disease is genetic it is not something that could be controlled while others thought that self-care and the disease could be difficult to manage and that support from health care is important. Aim: The aim of the study was to describe the nurse's experiences of self-care in diabetes mellitus type-2 patients Method: A literature study with descriptive design that includes a total of 10 articles of qualitative approach from the database Pubmed. Results: The results showed that nurses often perceived their patients as unjustified in their self-care and that they had difficulty following the lifestyle advice given, this was a common theme. Nurses used various methods to improve the self-care and motivation of their patients. It also emerged from the results that the nurses experienced stress and reduced job satisfaction, related to the fact that they could not provide the good diabetes care they wanted as they felt that they did not get any hearing from the patient. Conclusion: The present literature study shows that nurses may need support and tools to provide the right self-care support to their patients. This can thus lead to the nurses feeling more satisfied with the work they have accomplished and thus also promote job satisfaction.
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Miyamoto, Janine Hatsumi. "Prevalência de Síndrome Metabólica em Diabetes Mellitus tipo 2 e associação com Doença Coronariana." Faculdade de Medicina de São José do Rio Preto, 2012. http://bdtd.famerp.br/handle/tede/109.
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Previous issue date: 2012-01-25Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from insulin secretion defects, in its peripheral action, or both. Clinical manifestations of diabetes are broad and can range from asymptomatic glucose intolerance to acute complications as diabetic ketoacidosis or complications of slow evolution, such as neurological and vascular changes. Vascular changes affect virtually every body's blood vessels, large and small ones, constituting macro-and microangiopathy, respectively. The main clinical expressions of microangiopathy are diabetic nephropathy and retinopathy. The macroangiopathy is represented by early atherosclerosis, more severe and more frequent than that observed in non-diabetic population. The non-establishment or definition of a glycemic threshold in diabetic patients and the persistence of this relationship in non-diabetics suggest that glucose is a continuous variable risk, as well as other cardiovascular risk factors. The diabetic dyslipidemia is characterized by an increase in LDL small and dense particles, the reduction in HDL-cholesterol and high triglycerides levels. Diabetes or pre-diabetes, low HDL-cholesterol, high triglycerides and arterial hypertension are risk factors, when linked to central obesity, form the metabolic syndrome and 1.5-fold increase in overall mortality and 2.5 in cardiovascular mortality. Given the above, the purpose of the study was to assess the prevalence of metabolic syndrome according to the definition of the National Cholesterol Education Program Adult Treatment Panel III in patients with type 2 diabetes mellitus, its association and components with coronary disease. A total of 610 patients with type 2 diabetes mellitus were retrospectively analyzed, concerning age, gender, clinical and metabolic characteristics. The prevalence of metabolic syndrome was 78.4%. The comparative analysis between the groups with and without metabolic syndrome was significantly associated with coronary artery disease (p=0.032). By means of logistic regression, waist circumference (p=0.79) and fasting glucose (p=0.13) were not significant. The arterial hypertension (p=0.01) and dyslipidemia (p=0.005) showed significant association with coronary artery disease. Therefore, we can conclude that the metabolic syndrome is highly prevalent in patients with type 2 diabetes mellitus; it has shown an association with coronary heart disease and among its components, arterial hypertension and dyslipidemia indicate a significant association.
Diabetes Mellitus constitui um grupo de doenças metabólicas caracterizado por hiperglicemia resultante de defeitos na secreção de insulina, na sua ação periférica ou em ambas. As manifestações clínicas do diabetes são amplas e podem compreender desde intolerância assintomática à glicose até complicações agudas como a cetoacidose diabética ou complicações de evolução lenta, tais como alterações vasculares e neurológicas. As alterações vasculares atingem praticamente todos os vasos do organismo, pequenos e grandes, constituindo a micro e a macroangiopatia, respectivamente. As principais expressões clínicas da microangiopatia são a retinopatia e a nefropatia diabética. A macroangiopatia é representada pela aterosclerose mais precoce, mais grave e mais frequente que a observada na população não diabética. O não estabelecimento ou definição de um limiar glicêmico em diabéticos e a persistência desta relação em não-diabéticos sugerem que a glicemia é uma variável contínua de risco, da mesma forma que outros fatores de risco cardiovascular. A dislipidemia diabética caracteriza-se pelo aumento de partículas de LDL pequenas e densas, pela redução do HDL colesterol e valores elevados de triglicérides. Diabetes ou pré-diabetes, baixo valor de HDL colesterol, triglicérides elevado e hipertensão são fatores de risco que, ligados à obesidade central, formam a síndrome metabólica e aumentam em 1,5 vezes a mortalidade geral e em 2,5 vezes, a cardiovascular. Diante do exposto, o propósito do estudo foi avaliar a prevalência de síndrome metabólica de acordo com a definição do National Cholesterol Education Program Adult Treatment Panel III em pacientes com diabetes mellitus tipo 2 e a sua associação e a dos seus componentes com a doença coronariana. Um total de 610 pacientes com diabetes mellitus tipo 2 foram analisados, retrospectivamente, quanto à idade, sexo e características clínicas e metabólicas. A prevalência de síndrome metabólica foi de 78,4%. A Análise comparativa entre os grupos com e sem síndrome metabólica mostrou associação significativa com a doença coronariana (p=0,032). Por meio de regressão logística, a circunferência abdominal (p=0,79) e a glicemia de jejum (p=0,13) não foram significativas. A hipertensão arterial (p=0,01) e a dislipidemia (p=0,005) evidenciaram associação significativa com a doença coronariana. Portanto, podemos concluir que a síndrome metabólica tem alta prevalência em pacientes com diabetes mellitus tipo 2; mostrou associação com doença coronariana e entre os seus componentes, a hipertensão arterial e a dislipidemia denotaram associação significativa.
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Kwet, Avril. "Socker men inte söt: upplevelser av diabetes typ 2 : en kvalitativ litteraturstudie." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-89790.
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Background: Diabetes type 2 is a chronic system disease which has a huge impact on the patient’s life. The disease can lead to many sequalae and involves different types of sufferings for the patient. The treatment consists of both medical and lifestyle changes where self-care has great importance. Previous researches have made evident that life with diabetes type 2 means a great change in lifestyle that affects the patient psychologically, physically, spiritually and socially. In addition, there were many people who had difficulty making these changes. Patients experienced shame because diabetes type 2 is seen as a lifestyle disease. Aim: The aim of this study was to describe patient experiences of living with diabetes type 2. Method: A systematic qualitative literature study was conducted with an inductive approach. A manifest content analysis was conducted on 13 articles. Result: People with type 2 diabetes experienced negative emotions such as fear, depression, anxiety and loneliness. Living with a changed body hindered everyday life and triggered feelings of dissatisfaction and frustration. The participants experienced restrictions in travel, career and social outlooks. Furthermore, patients with type 2 diabetes blamed themselves of getting diabetes. They also felt judged and blamed by others for getting diabetes type 2 because it is seen as a lifestyle disease. The consequence of this was that many participants hid their illness from others. Conclusions: Many factors must work together, for life with type 2 diabetes to workout. It is the nurse’s responsibility support and provide the patient with the information needed to cope with the management of the disease, however, it is the patient’s responsibility to implement it. Furthermore, there is a lot of stigma against type 2 diabetes and more education is needed for patients, health care professionals and relatives/ the public in order to fight it.Bakgrund: Diabetes typ 2 är en kronisk systemsjukdom som har en stor påverkan på patientens liv. Sjukdomen kan leda till många följdsjukdomar och innebär olika typer av lidande för patienten. Behandlingen består av både medicin och livsstilsförändringar där egenvården har en stor betydelse. Tidigare forskning visar att livet med diabetes typ 2 innebär en stor förändring som berör personen psykiskt, fysiskt, andligt och socialt. Dessutom finns det många människor som hade svårigheter att göra dessa förändringar. Patienter upplever skamkänslor eftersom diabetes typ 2 ses som en livsstilssjukdom. Syfte: Syftet var att beskriva patienters upplevelser av att leva med diabetes typ 2. Metod: En systematisk kvalitativ litteraturstudie genomfördes med induktiv ansats. En manifest innehållsanalys gjordes på 13 artiklar. Resultat: Människor med diabetes typ 2 upplevde negativa känslor som bland annat rädsla, depression, oro och ensamhet. Att leva med en förändrad kropp hindrade det vardagliga livet och triggade igång känslor av missnöje och frustration. Deltagarna upplevde restriktioner i resor, karriär och sociala utsikter. Vidare, anklagade patienter med diabetes typ 2 sig själva för att ha fått diabetes. De kände sig även dömda och anklagade av andra för att ha fått diabetes genom att ha en dålig livsstil. Konsekvensen av detta blev att många deltagare dolde sin sjukdom för andra. Slutsats: Många faktorer måste samverka för att livet med diabetes typ 2 ska fungera. Det är sjuksköterskans ansvar att stötta och ge patienten informationen som krävs för att klara av hanteringen av sjukdomen dock är det patientens ansvar att genomföra det. Det finns mycket stigmatisering mot diabetes typ 2 patienter och det krävs mer utbildning för patienter, vårdpersonal och närstående/allmänheten för att kunna kämpa emot det.
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Österberg, John, and Namir Rahim. "En beskrivning av hur personer med diabetes typ 2 upplever att genomgå livsstilsförändringar till följd av sjukdomen." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-26478.
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Bakgrund: Diabetes är en av de sjukdomar som är mest växande globalt. I Sverige är det över 400 000 människor som lever med diabetes. Diabetessjukdomen finns i olika former och de vanligaste formerna är diabetes typ 1 och diabetes typ 2. Risken att bli drabbad av den sjukdomen ökar vid fetma, tobaks- och alkoholkonsumtion. Därför kan det bli nödvändigt att genomföra livsstilsförändring för att förbättra den mentala och fysiska hälsan hos personer som lever med diabetes typ 2. Syfte: Syftet med denna studie var att beskriva hur personer med diabetes typ 2 upplever att genomgå livsstilsförändringar till följd av sjukdomen. Syftet var också att beskriva datainsamlingsmetoderna i de inkluderade artiklarna i resultatet. Metod: En litteraturstudie med en deskriptiv design som baserades på 14 kvalitativa vetenskapliga artiklar. Huvudresultat: Resultatet för denna litteraturstudie baserades på möjligheter och svårigheter som påverkade upplevelsen av att genomgå livsstilsförändringar hos personer med diabetes typ 2. Utifrån möjligheter har fyra subteman identifierat: Kost och motion som motivationsfaktorer, erhållen kunskap, betydelsen av stöd från omgivningen och att ta personligt ansvar. I huvudteman svårigheter presenterades dessa subteman: Kost- och motions påverkan på det sociala och vardagliga livet, brist på kunskap samt krav och inre kamp. Slutsats: Flera personer fick blandade känslor utifrån upplevda möjligheter och svårigheter som de har stött på under livsstilsförändringen. Det blir viktigt att sjukvårdspersonal får en bättre helhetsförståelse kring patienters olika upplevelser av att genomgå en livsstilsförändring för att kunna optimera en personcentrerad vård, egenvårdsinsatser och tillgodose patienters egenvårdsbehov.
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Elangovan, Saravanan, Jacek Smurzynski, Emily Crewe, and Erin Dula. "Investigation of Auditory Processing Deficits in Patients With Type II Diabetes Mellitus (DM)." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/1569.
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The incidence of DM is 9.6% in the USA with its prevalence increasing globally (NIDDKD, 2005). A common, but under-recognized complication of DM is hearing difficulty (~ 93%). However, the nature of this often sub-clinical dysfunction is still poorly understood. The aim of this study is to better understand DM-related hearing loss.
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Larson, Kara L. "Regulation of Glucose Homeostasis by the PHLPP1 Phosphatase." UKnowledge, 2014. http://uknowledge.uky.edu/biochem_etds/17.
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Type 2 diabetes mellitus is a metabolic disease that affects one in ten people in the United States. It is caused by a combination of genetics and lifestyle factors. Disease progression begins with insulin resistance in peripheral tissues followed by pancreatic beta-cell failure. The mechanisms behind disease progression are not completely understood. PH domain leucine rich repeat protein phosphatase 1 (PHLPP1) is a known regulator of Akt and other members of the AGC kinase family. Akt has been established to play a role in numerous metabolic signaling pathways, including insulin action. It is hypothesized that as a regulator of Akt, PHLPP1 would have an important function in glucose homeostasis. Glucose tolerance tests performed on 8-week old Phlpp1-/- mice revealed no significant difference in glucose tolerance compared to wild type, however these mice did exhibit increased fasting blood glucose levels. Glucose tolerance tests were repeated at 20 weeks on the same mice and, interestingly, they displayed impaired glucose tolerance compared to wild type. Insulin tolerance tests showed that 8-week old mice have increased insulin sensitivity, however, the 20-week old mice were insulin-resistant compared to control animals. The 20-week old knockout mice also had significantly higher fasting blood glucose levels compared to 8-week old mice. To determine if the increased fasting blood glucose levels are due to increased hepatic glucose output, pyruvate tolerance tests were performed on both the 8 & 20 week old mice. Old mice displayed significantly increased hepatic glucose production compared to wild type. EchoMRI done on 24-week old mice showed significantly increased fat mass and decreased lean mass in the Phlpp1-/- mice compared to wild type littermates. Western blot analysis of liver samples from 32 week old Phlpp1-/- mice indicates loss of Akt signaling accompanied by a decrease in IRS2 protein levels, a common indicator of insulin resistance. These data suggest that Phlpp1-/- mice mimic the development of type 2 diabetes in humans, and provide a unique animal model to study the progression of type 2 diabetes and diabetes-associated complications.
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Hult, Amanda, Hanna Malmlöf, and Sonia Magnusson. "Erfarenheter av egenvård hos unga vuxna med diabetes mellitus typ 1 : En kvalitativ litteraturöversikt." Thesis, Jönköping University, HHJ, Avd. för omvårdnad, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-51647.
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Bakgrund: I Sverige är det cirka 50 000 personer som lever med diabetes mellitus typ 1. Det är en kronisk komplex sjukdom som kräver livslång behandling. Sampel med vården krävs under hela sjukdomsförloppet där en god vårdrelation blir betydande. Självkännedom och god självkänsla underlättar för egenvården eftersom det handlar om att kunna se de egna styrkorna för en god hanteringsförmåga av sjukdomen. Syfte: Syftet var att beskriva erfarenheter av egenvård hos unga vuxna med diabetes mellitus typ 1. Metod: En kvalitativ litteraturöversikt med induktiv ansats har gjorts. Resultatet baseras på 12 vetenskapliga artiklar. Resultat: Två huvudteman framkom i resultatet och ett av de var utmaningar med fyra underteman: rädsla och oro, begränsningar, övergång till vuxen livet och hur vardagen kan påverka egenvården. Andra huvudtemat var socialt stöd med tre underteman: stöd från familj och vänner, vårdpersonalens betydelse och okunskap från omgivningen påverkar egenvården. Slutsatser: Stöd från familj och vänner var av stor betydelse när det gällde hur de unga vuxna med diabetes mellitus typ 1 skötte egenvården. Vårdpersonal hade ett stort ansvar i att stötta och vägleda personer till egenvård. Utomståendes okunskap kunde leda till försämrad egenvård för personerna.Background: In Sweden there are about 50 000 people living with diabetes mellitus type 1. It is a chronic complex disease and demands a lifelong treatment. Teamwork with the healthcare is required throughout the course of the disease and a good relationship with the health care providers becomes significant. Self-awareness and good self-esteem facilitate self-care when it comes to being able to see one’s own strengths for a good management ability of the disease. Aim: The aim was to describe experiences of self-care among young adults with diabetes mellitus type 1. Method: A qualitative literature research that has an inductive design has been done. The results are based on twelve different scientific articles. Results: Two main themes have emerged in results and one of them was challenge with four sub themes: fear and anxiety, limitations, transitions to adult life and how daily life can affect self-care. The other main theme was social support with three sub themes: support from family and friends, the importance of healthcare professionals and lack of knowledge by others that affects self-care. Conclusion: Social support from family and friends was important when it comes to how young adults with diabetes mellitus type 1 managed self-care. Healthcare professionals have a big responsibility in supporting and guiding people to self-care. Lack of knowledge from others could lead to mismanagement of self-care.
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Evanson, Thea. "Preventiv behandling mot Diabetes Mellitus typ I : En jämförande litteraturstudie mellan Coxsackievirus-B-vaccin och behandling med GAD-alum." Thesis, Linnéuniversitetet, Institutionen för kemi och biomedicin (KOB), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-103118.
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Bakgrund: Diabetes Mellitus typ I är ett globalt hälsoproblem som skördar många liv varje år och påverkar livskvaliteten för de drabbade. Diabetes typ I är en autoimmun sjukdom som leder till destruktion av insulinproducerande betaceller i pankreas och således rubbad glukosreglering. Huvudsakliga patogena immunceller inkluderar autoantikroppar, exempelvis riktade mot glutaminsyra dekarboxylase 65, och autoreaktiva T-celler. Diagnos sker generellt baserat på förhöjda halter plasmaglukos och eventuellt stimulering av C-peptid för att utreda status för den endogena betacellsfunktionen. Diabeteskomplikationer är en vanlig dödsorsak hos diabetespatienter. År 2019 orsakades 4,2 miljoner dödsfall av diabetes eller diabeteskomplikationer. I dagsläget är administrering av exogent insulin enda behandlingsmöjligheten för typ I diabetespatienter. Det har dock länge forskats på alternativ i form av preventiv behandling men i dagsläget finns inga preventiva behandlingar på marknaden. Syfte: Litteraturstudiens syfte var att undersöka prospektiva möjligheter till diabetespreventiv behandling inom områdena glutaminsyra dekarboxylase 65 vaccin och coxsackievirus B vaccin med avseende på effekt samt jämföra dessa två prospektiva behandlingsmöjligheter. Metod: Arbetet har utförts genom granskning av artiklar från databasen PubMed. För litteraturgranskning av studier om GAD-behandling valdes tre kliniska studier utifrån sökning med ”type 1 diabetes”, ”diabetes mellitus”, ”type 1”, ”GAD” och ”vaccine” som sökord. För artiklar om CVB och CVB-vaccin användes ”type 1 diabetes”, ”vaccine” och ”coxsackievirus” som sökord. Resultat: Kliniska studier på GAD-behandling visar ingen signifikant skillnad mellan GAD-alum och placebo i helgruppsanalyser. Vid vissa stratifierade analyser för exempelvis kön, ålder, eller antal riskfaktorer detekteras signifikanta skillnader genom ökad mängd stimulerad C-peptid eller progression till klinisk diabetes. Den prospektiva kohortstudien över diabetesincidens påvisar att CVB är en riskfaktor för diabetes hos människa. Vidare visar de prekliniska studierna på signifikant minskad diabetesincidens i CVB-vaccinerade studiepopulationer jämfört med placebo. Slutsats: Varken behandling med GAD-alum eller CVB-vaccin är möjligt att använda som preventiv behandling i nuläget. Dock visar studierna på lovande framtidsmöjligheter för CVB-vaccin som primärprevention och GAD-alum som sekundär- eller tertiärprevention.Background: Diabetes Mellitus type I is a global health issue, causing numerous deaths each year and also influencing the quality of life of those affected. Type I diabetes is an autoimmune disease where the individuals own immune system causes destruction of insulin producing beta cells in the endocrine islets of pancreas. Main immunological features include, autoantibodies directed towards glutamic acid decarboxylase 65, and autoreactive T-cells. Diagnosis is generally based on elevated levels of plasma glucose and stimulated C-peptide, together disclosing the status of the beta cell function. The lack of endogen insulin causes disturbances in the glucose metabolism which leads to prevailing tissue damage in cells and organs of the diabetic individual’s body. Furthermore, insufficient control of plasma glucose is related to development of diabetes complications. Diabetic complications are known to be a major cause of death in diabetic patients. Diabetes and diabetic complications caused 4,2 million deaths in 2019. Insufficient adherence to treatment regimen during a long period of time is known to increase the risk for some common diabetes complications. Administration of exogenous insulin is the only current treatment available for type I diabetes, albeit recurrent attempts to find a cure or successful preventive treatment for diabetes mellitus type I. Recent promising research on diabetes preventive treatment includes the autoantigen glutamic acid decarboxylase-65 and vaccine against coxsackievirus B. Aim: The purpose of this literature study was to examine prospective possibilities for diabetes preventive treatments. Further, the purpose was to compare the promising preventive treatments of GAD65-vaccine and CVB-vaccine concerning effect and prospective treatment regimens. Methods: The thesis is a literature study based on articles found by searching the database PubMed. Clinical studies examining the effect of GAD-treatment was found by using key words such as ”type 1 diabetes”, ”diabetes mellitus”, ”type 1”, ”GAD” and ”vaccine”. Studies examining the effect of CVB and CVB-vaccines was primarily preclinical and prospective cohort studies, found by searching for the key words ”type 1 diabetes”, ”vaccine” and ”coxsackievirus”. Results: Clinical studies of GAD-treatment does not demonstrate a statistically significant difference between treatment with GAD-alum compared to placebo in full group analysis. Stratified groups occasionally prove significant differences in quantity of stimulated C-peptide or progression to clinical diabetes by age, gender or amount of risk factors for example. The prospective cohort study examining the incidence of diabetes, demonstrates that CVB is a risk factor for type I diabetes in humans. Furthermore, the preclinical studies detect a significant decrease in diabetes incidence in CVB-vaccinated mice compared with placebo. Conclusion: Neither treatment with GAD-alum nor CVB-vaccine is currently ready for use. However, the studies show a promising prospective possibility for CVB-vaccine as a primary prevention and GAD-alum as a secondary or tertiary prevention of type I diabetes.
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Bjarnegård, Niclas. "Aspects on wall properties of the brachial artery in man : with special reference to SLE and insulin-dependent diabetes mellitus." Doctoral thesis, Linköpings universitet, Institutionen för medicin och hälsa, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-11273.
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The mechanical properties of the arterial wall are of great importance for blood pressure regulation and cardiac load. With increasing age, large arteries are affected by increased wall stiffness. Furthermore, atherosclerotic manifestations may increase the stiffness even further, both processes acting as independent cardiovascular risk factors affecting the arterial system in a heterogeneous way. The aims of this thesis was to characterize the local mechanical properties of brachial artery (BA) with the aid of ultrasound technique and to evaluate the influence of 1) age, gender, sympathetic stimulation and examination site; 2) type 1 diabetes (DM) and its association to circulatory biomarkers; and 3) to evaluate the general properties of the arterial system with the aid of pulse wave velocity (PWV) as well as pulse wave analysis (PWA) in systemic lupus erythematosus (SLE) and correlate the findings to disease activity and circulatory biomarkers. In the most proximal arterial segment of the upper arm a pronounced age-related decrease in wall distensibility, increase in intima-media thickness (IMT), and a slight increase in diameter were seen. Sympathetic stimulation had no influence on wall mechanics. More distally in BA, no change in diameter, and only minor increase in IMT and decrease in distensibility were seen. No gender differences were found. These findings suggest that the principle transit zone between elastic and muscular artery behaviour is located in the proximal part of the upper arm. Women with uncomplicated insulin-dependent DM had similar diameter, IMT and distensibility in their distal BA as controls, whereas flow-mediated dilatation (FMD) was slightly, and nitrate mediated dilatation (NMD) markedly reduced. NMD was negatively correlated with higher HbA1c levels. Vascular smooth muscle cell function seems to be an early manifestation of vascular disease in women with DM, influenced by long-term hyperglycaemia. Women with SLE had increased aortic PWV compared to controls, a finding positively associated with increased levels of complement factor 3 (C3), but not with disease activity. The increased stiffness of central arteries may be one factor contributing to the increased cardiovascular risk seen in SLE.
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Gellar, Lauren A. "The Effect of Glycemic Index and Glycemic Load on Glucose Control, Lipid Profiles and Anthropometrics Among Low-Income Latinos With Type 2 Diabetes: A Dissertation." eScholarship@UMMS, 2011. https://escholarship.umassmed.edu/gsbs_diss/522.
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Background The incidence of type 2 diabetes has increased dramatically, particularly among Latinos. While several studies suggest the beneficial effect of lowering glycemic index and glycemic load in patients with type 2 diabetes, no data exists regarding this issue in the Latino population. The purpose of this study was to determine the effect of lowering glycemic index and glycemic load on diabetes control, lipid profiles and anthropometrics among Latinos with type 2 diabetes.
Methods Subjects participated in a 12 month randomized clinical trial. The intervention targeted diabetes knowledge, attitudes and behavioral capabilities related to diabetes self management with content including nutrition and physical activity. The nutrition protocol emphasized reduction in glycemic index, fat, salt and portion size and increase in fiber. The control group was given usual care. Measurements included Hba1c, fasting glucose, total cholesterol (TC), low density lipoproteins (LDL) and high density lipoproteins (HDL), HDL:LDL ratio, TC:HDL ratio, waist circumference and BMI and were collected at baseline, 4 and 12-months.
Results Two hundred fifty two Latino adults with type 2 diabetes participated in the study. Baseline mean HbA1C was 8.98% (SD=1.87), BMI was 34.76 kg/cm (SD=6.94), age was 56 (SD=11.18) years and 76% were female. Reduction in glycemic index was positively associated with a reduction in logHbA1c (p=0.006), HDL:LDL ratio (p=0.037) and waist circumference (p=0.003) overtime, but not with fasting glucose, TC, LDL and HDL, TC:HDL ratio, body weight or BMI. No significant associations were found between glycemic load and any measures.
Conclusion Results suggest that lowering glycemic index may have a positive effect on some markers of diabetes control, lipid profiles and anthropometrics among Latinos with type 2 diabetes, but not others. While statistically significant reductions in GI and GL were noted, the actual reduction was small. Thus, greater reduction in GI and GL may be needed for clinical significance and greater effect on metabolic outcomes. Future research should target populations with higher baseline GI and GL.
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Fernandes, Ana Barbosa de Matos Abreu. "Regulação integrada do metabolismo da glucose no estado pós-prandial : fisiologia e reversão de processos patológicos." Doctoral thesis, Faculdade de Ciências Médicas. Universidade Nova de Lisboa, 2011. http://hdl.handle.net/10362/7719.
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Resumo: Os mecanismos que regulam a homeostase da glucose no pós-prandial são
distintos dos mecanismos desencadeados em situações de jejum. Desta forma
o fígado parece desempenhar um papel fundamental na acção periférica da
insulina após a refeição através de um mecanismo que envolve os nervos
parassimpáticos hepáticos e o óxido nítrico (NO). Esta dissertação procura
evidenciar a importância de ambos na fi siologia de manutenção da glicémia
pós-prandial e na fi siopatologia da resistência à insulina.
Dos resultados obtidos observou-se que após a administração de uma refeição
mista o perfi l glicémico foi distinto em animais com ou sem ablação
dos nervos parassimpáticos hepáticos. A desnervação parassimpática hepática
aumentou as excursões de glucose imediatamente após a refeição. Estas
diferenças nas excursões de glucose dependentes do parassimpático ocorreram
devido a uma diminuição da clearance de glucose, sem que fosse afectada
a taxa de aparecimento de glucose no sangue, a produção endógena de glucose
e secreção de insulina ou péptido-C. Este aumento das excursões de glucose
revelou-se ser devida à diminuição da clearance de glucose pós-prandial
exclusivamente no músculo-esquelético, coração e o rim. Concluiu-se que o
fígado teria uma função endócrina nestes três órgãos. Surgiu assim a hipótese
dos S-nitrosotiois (RSNOs) poderem mimetizar essa resposta endócrina.
Testou-se o seu efeito in vivo na sensibilidade à insulina. Para níveis baixos
de sensibilidade à insulina, como jejum, desnervação no estado pós-prandial
e resistência à insulina os RSNOs potenciaram a sensibilidade à insulina para
valores semelhantes ao pós-prandial indicando-os como potenciais fármacos
no tratamento da resistência à insulina. O NO e seus derivados ganharam assim
uma evidência cada vez maior na acção periférica da insulina e portanto
fez-se uma caracterização dos seus níveis desde a fi siologia à fi siopatologia.
Os resultados obtidos nesta dissertação permitiram correlacionar a sintetase
de óxido nítrico (NOS), enzima responsável pela síntese de NO como um possível marcador da resistência à insulina. Os resultados obtidos contribuíram substancialmente para compreender os mecanismos fi siológicos e fi siopatológicos de manutenção da glicémia após
a refeição, colocando o fígado como órgão primordial na regulação periférica
(extra-hepática) da captação de glucose.-------- ABSTRACT: The mechanisms responsible for the postprandial response are different from the ones in the fasted state. Therefore the liver seems to play a fundamental role in postprandial insulin action through a mechanism that evolves
the hepatic parasympathetic nerves (HPN) and nitric oxide (NO). This work focused on the importance of both, HPN and NO, on postprandial glycemic control and on the pathophysiology of insulin resistance.
We observed that after administration of a mixed meal the glycemic profi les with or without the parasympathetic nerves were distinct, increasing glucose excursions after ablation of HPN.This increase in glucose excursions was due to a decrease on the rate of glucose disappearance in extra-hepatic tissues. Glucose appearance rate, endogenous glucose production and insulin
secretion were not related to this mechanism. The increase on glucose excursions
after the ablation of hepatic parasympathetic system was due to a decrease
on glucose clearance on extra-hepatic tissues, namely skeletal-muscle,
heart and kidney. We concluded that the liver has an endocrine function on
those tissues increasing their glucose uptake.This mechanism led to propose
the hypothesis that S-nitrosothiols (RSNOs) could mimic this mechanism.
Therefore RSNOs effects on insulin sensitivity were tested. For low insulin
sensitivity levels, i.e. fasted state, ablation of the HPN or insulin resistance
state induced by a high sucrose diet RSNOs increased insulin sensitivity to
levels normally observed in the postprandial state. These results indicated these drugs as potential pharmacological tools in the treatment of insulin resistance.
NO and their derivates emerged as fundamental parts of insulin action.
A characterization of nitric oxide and nitric oxide synthase (NOS), the enzyme responsible for NO synthesis was part of the work performed. We concluded that NO could be used as a biomarker for insulin resistance states.
This work contributed for understanding the mechanism underlying postprandial glycemic control indicating the liver as a key organ in the regulation of peripheral (extra-hepatic) insulin action.
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Maguire, Laura L. "Educating Grandparents of Grandchildren with Type I Diabetes Using Simulation: A Dissertation." eScholarship@UMMS, 2015. https://escholarship.umassmed.edu/gsn_diss/38.
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The purpose of this study was to explore the feasibility of using human patient simulation (HPS) to teach Type 1 diabetes (T1DM) management to grandparents of grandchildren with T1DM. Thirty grandparents (11 male, 19 female) of young grandchildren (aged 12 and under) with T1DM were recruited from an urban medical center. Experimental group (n = 14) grandparents received hands-on visual T1DM management education using an HPS intervention, and control group (n = 16) grandparents received similar education using a non-HPS intervention.
Post-intervention, researchers interviewed twelve grandparents (50% HPS, 50% non-HPS) who scored highest and lowest on the Hypoglycemia Fear Survey. Using a mixed-method design, researchers integrated study instrument data and post-intervention interview data to describe grandparent’s experience learning T1DM management. Post-intervention, grandparent scores for knowledge, confidence, and fear showed no significant difference by group assignment, however, all grandparent scores showed improvement from Time 1 to Time 2. Grandparents described how taking part in T1DM education heightened their awareness of T1DM risks. GP T1DM knowledge gains aided GPs to make sense of T1DM risks. Newfound T1DM knowledge enhanced GP T1DM management confidence. Improved T1DM knowledge and confidence helped to defuse T1DM management fear. Although study instruments did not measure significant difference between grandparents who received the HPS intervention and those who did not, the consistency of larger HPS-taught grandparent score improvement is suggestive of a benefit for HPS.
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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.
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Andrews, Robert. "Cortisol metabolism in type 2 diabetes mellitus." Thesis, University of Edinburgh, 2004. http://hdl.handle.net/1842/23073.
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In chapter 2, I describe my first study, which determined whether individuals with DMA or impaired glucose tolerance (IGT) exhibit abnormalities in cortisol activity. An integrated assessment of cortisol secretion, metabolism and action was carried out in 25 un-medicated lean male patients with hyperglycaemia (20 DM and 5 IGT) and 25 healthy controls carefully matched for body mass index, age and blood pressure. This study demonstrated that patients do exhibit abnormalities in cortisol activity. Chapter 3 describes a study that examined whether altered tissue concentration of the glucocorticoid receptor (GR), of 11β-HSD1 or of 11β-HSD2 could explain the difference in dermal blanching seen between patients with hyperglycaemia and normal healthy controls. Tissue concentrations of GR were found to be no different between patients with hyperglycaemia and normal healthy subjects. In chapter 4, I describe a study, which assessed whether inhibition of local tissue metabolism of cortisol, by carbenoxolone (an inhibitor of both 11β-HSD1 or 11β-HSD2) improved insulin sensitivity. 6 patients with DM and 6 matched controls, participated in a double-blind cross-over comparison of carbenoxolone (100 mg 8 hrly orally for 7 d) and placebo. At the end of each phase glucose kinetics were measured in the fasting state from 0700-0730 h, during a 3 h euglycaemic hyperinsulinaemic clamp and during a 2 h euglycaemic hyperinsulinaemic clamp with a 4-fold increase in glucagon levels. Carbenoxolone reduced total cholesterol in healthy subjects but had no effect on cholesterol in patients with DM. Carbenoxolone did not affect insulin sensitivity, but it did reduce glucose rate during hyperglucagonaemia in patients with DM. In conclusion I have demonstrated that abnormalities in cortisol activity are seen in patients with DM and that drugs specifically targeted at preventing cortisol regeneration in tissues may enhance insulin sensitivity and lead to novel developments in the treatment of DM.
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Li, Luosheng. "Molecular genetics of type 2 diabetes /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-194-2/.
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Zhou, Huali. "Reverse cholesterol transport in type 2 diabetes mellitus." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B39794003.
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Zhou, Huali, and 周華麗. "Reverse cholesterol transport in type 2 diabetes mellitus." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B39794003.
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Saugur, Anusooya. "Management of type 2 diabetes mellitus : a pharmacoepidemiological review." Thesis, Nelson Mandela Metropolitan University, 2011. http://hdl.handle.net/10948/1635.
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Type 2 diabetes mellitus (DM) is a progressive disease characterised by hyperglycaemia caused by defects in insulin secretion and insulin action. In early stages of type 2 DM, dietary and lifestyle changes are often sufficient to control blood glucose levels. However, over time, many patients experience β cell dysfunction and require insulin therapy, either alone or in combination with oral agents. There are guidelines available to structure the management of this disease state, including both the use of oral hypoglycaemic agents and or insulin. Besides health complications, there are economic burdens associated with the management of type 2 diabetes mellitus. The aim of this study was to determine the management of type 2 DM in a South African sample group of patients drawn from a large medical aid database. The objectives of the study were: to establish the prevalence of type 2 DM relative to age, examine the nature of chronic comorbid disease states, establish trends in the prescribing of insulin relative to other oral hypoglycaemic agents, investigate cost implications, and determine trends in the use of blood and urine monitoring materials by patients. The study was quantitative and retrospective and descriptive statistics were used in the analysis. DM was found to be most prevalent amongst patients between 50 and 59 years old. Results also demonstrated that 83% of DM patients also suffered from other chronic comorbid diseases, with cardiovascular diseases, especially hypertension and hypercholesterolaemia being the most prominent. This study also revealed that DM is predominantly managed with oral hypoglycaemic agents. Changes in drug prescribing, for chronic disease states such as DM may have medical, social and economic implications both for individual patients and for society and it is envisaged that the results of this study can be used to influence future management of DM. Keywords: Pharmacoepidemiology, management, type 2 diabetes mellitus
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Praet, Stephan Florent Eugenie. "Exercise therapy in Type 2 diabetes." Maarsen : Maastricht : Elsevier gezondheidszorg ; University Library, Universiteit Maastricht [host], 2007. http://arno.unimaas.nl/show.cgi?fid=9387.
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Dennis-Bradshaw, Rondalyn. "Diabetes Self-Management Education for Adults With Type 2 Diabetes Mellitus." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1812.
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Diabetes, a major public health challenge in St. Kitts, has been a focus of international public health community research. Although researchers have demonstrated that diabetes self-management education is a cost-effective strategy for the prevention of diabetes-related complications, they have yet to establish whether there is adequate education occurring in treatment settings with diabetic patients. The purpose of the study was to implement and evaluate the short-term effectiveness of a diabetes self-management education intervention on diabetes-related knowledge and accepted behavioral changes to decrease risk for complications. Based on a self-care approach, this education intervention was designed to improve diabetes-related knowledge and self-management behaviors. To test and evaluate the pre and post intervention effect, a convenience sample of 15 patients diagnosed with Type 2 diabetes attending a scheduled diabetic clinic completed the Diabetes Knowledge Test and a researcher-designed sociodemographic survey, which included self-report of blood glucose self-monitoring and foot care behaviors. The results of these analyses indicated that the participants’ knowledge level increased (p = < .001). However, Chisquare and Fisher’s exact tests determined no significant changes in the participants’ self management behaviors. The results may be attributed to the short time frame of the intervention. The implications for positive social change include opportunities to improve inter-professional collaboration in programs that will create positive effects on diabetic self care and reduce the incidence of negative health outcomes. Furthermore, the use of a self-care approach by health care professionals could be a key factor in strengthening diabetes knowledge, engagement, and self-management for Type 2 diabetic patients.
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Espelt, Hernández Albert 1981. "Socioeconomic inequalities in type 2 diabetes mellitus in Europe." Doctoral thesis, Universitat Pompeu Fabra, 2011. http://hdl.handle.net/10803/85055.
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Type 2 diabetes mellitus (T2DM) has become a major health problem worldwide. The St. Vincent declaration emphasized the urgent need to improve the epidemiological knowledge of this disease in Europe. Within Europe, research on the link between socioeconomic position (SEP) and type 2 diabetes is scarce.
The objective of this thesis was to conduct an extensive review of the current literature on socioeconomic inequalities in type 2 diabetes within European countries, while analyzing the relationship between, incidence, prevalence and mortality due to T2DM and SEP. In addition, we also analyzed trends on SEP inequalities in the prevalence of T2DM in Spain (1983-2006). Finally, we also assessed the appropriate use of health surveys with self-reported diagnosis in order to further analyze the relation between SEP and T2DM.
Different sources of information were used throughout the study. The systematic review was completed using the PUBMED database while the empirical studies used data of two European projects, the EUROTHINE, SHARE and the Spanish National Health Survey (study of trends in SEP inequalities in T2DM) along with the Catalonia health surveys (study of validation). The thesis consists of 5 papers that attempt to respond to the different objectives.
The studies included in this thesis suggest that socio-economic position (SEP) inequalities affect the incidence, prevalence and mortality by T2DM in Europe. These SEP inequalities are partly explained for body mass index, diet and physical activity. Moreover, these inequalities seemed to have remained constant or increased over time. Finally, health interview surveys with self-reported T2DM seems to be a good instrument to evaluate SEP inequalities in T2DM.La Diabetis Mellitus Tipus 2 (DM2) ha esdevingut un dels principals problemes de salut a nivell mundial. La declaració de ST VINCENT emfatitzava la necessitat i la urgència de millorar-ne el coneixement epidemiològic a nivell Europeu. Els estudis a nivell europeu sobre les desigualtats per Posició Socioeconòmica (PSE) en la DM2 eren força escassos. L’objectiu d’aquesta tesi era fer una revisió extensa dels estudis publicats sobre desigualtats per PSE en la DM2 a Europa, així com analitzar la relació entre la incidència, la prevalença i la mortalitat per DM2 i la PSE. Un altre objectiu també era analitzar la tendència de les desigualtats per PSE en la prevalença de DM2 a Espanya (1983-2006). Finalment, com a objectiu també hi figurava el valorar l’ús adequat de les enquestes de salut amb auto - declaració de DM2 per tal d’avaluar les desigualtats per PSE en la DM2. Per tal de dur a terme els objectius es van emprar diferents fonts d’informació. Per tal de dur a terme la revisió sistemàtica es va emprar la base de dades de PUBMED mentre que pels estudis empírics es van utilitzar les dades de dos projectes europeus com són el projecte EUROTHINE i el SHARE i les enquestes nacionals de salut d’Espanya (per la tendència de diabetis) i de Catalunya (per la validació). La tesi consta de 5 articles que intenten donar resposta als diferents objectius. Els estudis inclosos en aquesta tesi suggereixen que existeixen desigualtats per posició socioeconòmica (SEP) en la DM2, tant en la incidència, en la prevalença com en la mortalitat a Europa. Aquestes desigualtats per PSE s’expliquen en part per l’índex de massa corporal, la dieta o l’activitat física. A més a més, aquestes desigualtats sembla que s’han mantingut constants o han crescut al llarg del temps. Finalment, s’ha vist que les enquestes de salut amb la pregunta d’auto-declaració de la diabetis són un bon instrument per avaluar les desigualtats per PSE en la DM2.
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Isaacs, Renee Lalitha Cordelia. "Diet and type 2 diabetes mellitus in the Caribbean." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0004/MQ45413.pdf.
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Jeragh, Alhaddad Fatima Bakir. "Nonadherence among Kuwaiti nationals with type 2 diabetes mellitus." Thesis, University College London (University of London), 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.522824.
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Rees, S. M. "Bone density and neuropathy in type 2 diabetes mellitus." Thesis, Queen's University Belfast, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.419549.
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Johnson, Andrew. "Skeletal muscle insulin action in type 2 diabetes mellitus." Thesis, University of Newcastle Upon Tyne, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.321306.
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Minnaar, Danielle. "Audiovestibular function in adults with type 2 Diabetes Mellitus." Diss., University of Pretoria, 2017. http://hdl.handle.net/2263/65584.
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Diabetes is one of the most prominent health emergencies of the 21st century affecting millions worldwide. Approximately 415 million individuals had diabetes in 2015, more than 10% living in the Sub-Saharan Africa region. Diabetes is a chronic illness and is classified according to aetiology. Type 2 diabetes accounts for more than 90% of cases. The disease is initially asymptomatic resulting in 30% to 85% of cases remaining undiagnosed. Due to the delayed diagnosis, approximately 20% of the individuals will have developed secondary complications. Disorders of the auditory and vestibular systems are often associated with diabetes; however, the extent and nature of these vestibular manifestations are still unknown. A main aim of this research study was to investigate the audiovestibular function, risk of falling and health related quality of life (HRQL) in adults with type 2 diabetes, compared to findings of non-diabetic age and gender matched controls. This was achieved through testing, the audiovestibular function (pure tone audiometry, video head impulse testing, and cervical and ocular vestibular evoked myogenic potentials), fall risk utilising three assessments (TUG, BBS and DGI), and HRQL utilising a self-administered (EQ-5D-5L). A cross-sectional research design was employed. A purposive sampling method was employed to recruit the type 2 diabetics. The mean age was 49.1 years (± 6.2), 57.1% were female and had an average BMI of 31.6 ±7.6 (p=<0.001; t-test).The HbA1c for the type 2 diabetic participants was 9.3% (±2.2) and had disease durations of 15.36 years (±9.67). No significant difference between the two groups was observed in the pure tone audiometry results. Although there was a significant difference between the two groups at 500Hz in the left ear (p=0.007; t-test), indicating poorer hearing for the type 2 diabetics. Overall, there were no significant difference between the two groups was observed in video head impulse testing. There was, however, a significant difference between the two groups in the presence of saccades for the right lateral canal (p=0.002; McNemar test of symmetry).The type 2 diabetics had a 1.5 times higher risk of having absent cVEMP results. Furthermore, the type 2 diabetics had a 1.3 times higher risk of having absent oVEMP results. For the cVEMPs, 53.6% of the type 2 diabetics cVEMPs were absent (unilateral/bilateral), compared to 25% of the non-diabetic controls. For the oVEMPs, 74.1% of the type 2 diabetics oVEMPs were absent (unilateral/bilateral), compared to 53.6% of the non-diabetic controls. A significant difference between the two groups was obtained for the averaged TUG test (p=0.046; t-test), indicating a risk of falling amongst the type 2 diabetics. There were no significant differences between the two groups in the BBS and DGI scores. There was no significant difference between the two groups for the EQ-5D-5L questionnaire. There was, however, a significant difference between the two groups for the health dimension mobility (p=0.032; t-test). The type 2 diabetic participants had a higher occurrence of audiovestibular dysfunction, higher risk of falling and poorer HRQL than the non-diabetic adults, and should be examined and monitored through the progression of the disease. If there are any auditory or vestibular involvements, further assessments should be considered to minimize the functional limitations of quality of life.Dissertation (MCommunication Pathology)--University of Pretoria, 2017.
Speech-Language Pathology and Audiology
MA
Unrestricted
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Noll, Amanda N., and L. Lee Glenn. "Self-Efficacy and Management in Type 2 Diabetes Mellitus." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7493.
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Doyle, Todd A. "Inflammatory Pathways Linking Type 2 Diabetes Mellitus and Depression." Ohio University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1332460860.
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McDowell, Joan Rachel Somerville. "Management of Type 2 diabetes mellitus in primary care." Thesis, University of Glasgow, 2014. http://theses.gla.ac.uk/5139/.
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Background: The incidence and prevalence of diabetes mellitus (diabetes) is increasing globally. The majority of people have type 2 diabetes, initially managed by lifestyle changes and the gradual introduction of oral, followed by subcutaneous, medications. Due to the increasing numbers of people with type 2 diabetes, different models of care management have been utilised within the United Kingdom. One Health Board within Scotland received funding to undertake a service redesign whereby the responsibility of care for people with type 2 diabetes was transferred from secondary care to primary care, with referral to specialist services based on clinical need. Aim: The aim of this thesis is to present the body of published work on an evaluation research study on the change in service delivery for people with type 2 diabetes. The published works have arisen from two funded research studies resulting in one peer reviewed report and five peer-reviewed papers published in international journals.
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Quandt, Raegan Elizabeth. "Education Protocol for Type II Diabetes Mellitus." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/6095.
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Diabetes mellitus is one of the leading causes of death in the United States, contributing to rising health care costs and increased morbidity and mortality rates. Researchers demonstrated that aggressive heath measures involving ongoing diabetes self-management education are paramount in minimizing associated complications of diabetes. The management and prevention of diabetes is not standardized and providers within a health clinic in Illinois reported challenges in providing self-management education during scheduled patient appointments due to limited resources and time. The purpose of this DNP project was to develop a clinical practice guideline to be used by all providers within the health care clinic for the management of Type 2 diabetes. The goal of the developed guideline was to optimize the time providers spend with patients diagnosed with diabetes and improve the consistency and quality of education and care. The health promotion model provided a guide for the development of the practice guideline. The method and design of this DNP project involved extensive research, literature review, evidence grading, and development of an evidence-based practice guideline for Type 2 diabetes management. A selected team of 3 diabetes experts appraised the developed guideline using the AGREE II instrument, and guideline usability was evaluated by 3 nurse practitioners within the medical clinic using a 10-item questionnaire. Results of the appraisal confirmed the high quality, feasibility, and usability of the developed guideline for diabetes self-management education and support. Improving the delivery of care can bring about positive social change by improving health outcomes in individuals with Type 2 diabetes and reducing morbidity and mortality rates.
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Eltahla, Auda Abdelsalam Biotechnology & Biomolecular Sciences Faculty of Science UNSW. "Gestational diabetes mellitus: a model for the genetics of type 2 diabetes." Awarded by:University of New South Wales. Biotechnology & Biomolecular Sciences, 2009. http://handle.unsw.edu.au/1959.4/44607.
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The striking similarity between Gestational Diabetes Mellitus (GDM) and Type 2 Diabetes (T2D) in terms of the pathophysiologies and the risk factors has led to the hypothesis that GDM is an early manifestation of T2D, expressed under the stress of pregnancy, and therefore both diseases should share similar susceptibility genes. GDM patients may provide a more homogeneous sample for the genetic causes of the disease than T2D, and therefore make a useful group for the identification of the genes involved. Over 200 GDM affected sib-pairs from 178 families were investigated, with parents available in 40% of cases. Genomic regions from 4 different chromosomes, 6, 8, 14 and 18 were chosen from regions that showed clustering for positive linkage scores in previous linkage studies on T2D and one control region on 13, where no previous positive linkage was reported. A total of 19 microsatellite markers were analysed for linkage to GDM using sib-pair analysis. Subset analyses were performed by ranking sib-pairs on GDM-related variables, e.g. mean BMI of sibs, age at GDM episode, etc. GENEHUNTER was run multiple times, each time including the next highest ranked family in the analysis. This gave a continuous range of scores where increasing or decreasing NPL scores indicated heterogeneity associated with different environmental factors such as age and weight. To evaluate the significance of the subset analyses, the results were compared to 10,000 permutations generated by randomly ranking the sib-pairs. Using the entire dataset, the analysis showed no significant linkage to a disease locus. Positive evidence for linkage was found with the subset analysis on chromosomes 8 and 14, suggesting heterogeneity between sib-pairs in the dataset. Marker D8S1742 on 8p23 showed an NPL score of 3.01 (p=0.001) when age at GDM diagnosis was used as a covariate. Using waist-to-hip ratio (WHR), marker D14S275 on 14q12 showed an NPL score of 2.474 (p=0.006). When adjusted for multiple testing, the results were not statistically significant for linkage to a diabetes disease locus, but gave evidence that GDM and T2D share similar genetic determinants, and defined groups of siblings for follow-up analysis of both types of diabetes.
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Sudagani, Jaidev. "Genes and type 2 diabetes : polymorphisms of the EIF2AK3 gene and its relationship to type 2 diabetes mellitus." Thesis, Queen Mary, University of London, 2010. http://qmro.qmul.ac.uk/xmlui/handle/123456789/411.
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Aims/ Hypothesis: Wolcott- Rallison syndrome (WRS) is a rare autosomal recessively inherited Mendelian disorder. It is characterised by a short trunk compared to arm span, multiple epiphyseal dysplasia, multiple fractures, hepatosplenomegaly and renal insufficiency in addition to insulin dependent diabetes. The onset of diabetes in WRS families is mainly below the age of 6 months and is characterised by permanent severe non-autoimmune insulin deficiency. Mutations of the gene encoding eukaryotic translational initiation factor 2 - alpha kinase 3 (EIF2AK3) were found to account for diabetes in WRS. The aim of our study was to determine whether common polymorphisms in the EIF2AK3 gene (Candidate gene association study) could be associated with type 2 diabetes. Methods: Direct sequencing was performed on all 17 exons/coding regions and intron/exon boundaries of EIF2AK3 gene in 48 diabetes and control subjects. Single Nucleotide Polymorphisms (SNPs) tagging the common haplotypes (tag SNPs) were identified and 11 SNPs were genotyped initially in 2,835 subjects with type 2 diabetes, 3,538 control subjects in the British Irish, Bangladeshi and South Indian Populations and 522 families (n= 1,722) in the British Irish and South Indian Populations. Results: We identified 19 SNPs by direct sequencing. There was no association (all p>0.05) between the SNPs and type 2 diabetes in the case–control study and in the family study. In the one marker, rs7605713, that showed a nominal significance in Warren 2 European samples, further replication studies in the Dundee samples (3,334 diabetes cases and 3,456 controls) proved to be negative thereby avoiding a false positive result. The results also showed several of the SNPs had different minor allele frequencies between the British/Irish Caucasians as compared to the South Asians. Conclusions/interpretation: Common variations in the EIF2AK3 gene were not associated with type 2 diabetes in the British Irish and the South Asian population.
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Mathur, Aditi. "Genetic association between schizophrenia and type-2 diabetes." Thesis, University of the Highlands and Islands, 2011. https://pure.uhi.ac.uk/portal/en/studentthesis/genetic-association-between-schizophrenia-and-type2-diabetes(71a1d702-37b0-470d-87d9-956cbd52c821).html.
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Aims: This PhD project was designed under two studies, the genetic association study to investigate a genetic component or a genetic pathway that might be associated with both schizophrenia and type-2 diabetes (T2D). The gene functional study to explore whether clozapine could affect expression of the genes associated with obesity and T2D. Methods: In genetic association study, a total of 17 single nucleotide polymorphisms (SNPs) were genotyped in the PPARG, PLA2G4A, PTGS2 and AKT1 genes in 221 British nuclear families. In the gene functional study, U937 cells were treated with clozapine (1g/ml and 2g/ml) for 48 hours and 96 hours. Quantitative real-time PCR analysis was used to measure the mRNA expression levels of the genes of interest in clozapine-treated and untreated cells. Results: Eight SNPs tested across the PPARG gene did not show allelic association with schizophrenia. An association was detected at rs2745557 in the PTGS2 locus (2=4.19, p= 0.041) and rs10798059 in the PLA2G4A locus (2=4.28, p=0.039), but these associations did not survive after 10,000 permutations (global p=0.246). Allelic association for the AKT1 gene was detected at rs1130214 (2=6.28, p=0.012) and at rs11847866 (2=4.64, p=0.031) only although the global p-value of overall associations for the AKT1 was 0.059 after 10,000 permutations. Haplotype analysis showed a disease association for the rs1130214-rs2494746-rs11847866 haplotypes (2= 10.18, df= 4, p=0.037), of which the T-G-A haplotype was excessively transmitted (2=6.93, p=0.008) and this haplotypic association survived the Bonferroni correction (p=0.04). The expression of the MTCH2 gene showed a significant decrease in mRNA expression (combined p=0.001) and that of the PPARG gene showed a significant increase (combined p=0.005) in the cells treated with 1g/ml clozapine for 96 hours. Conclusions: The present results support the AKT1 gene association with schizophrenia as reported in previous studies; both the MTCH2 and PPARG genes may be involved in the development of clozapine-induced obesity and in an increased risk of T2D.
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Travers, Mary E. "Mechanisms of Type 2 diabetes susceptibility." Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:d99892d8-534a-4908-b5dc-ab1d8b1cab52.
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Type 2 diabetes (T2D) has a genetic component which is only partially understood. The majority of genetic variance in disease susceptibility is unaccounted for, whilst the precise transcripts and molecular mechanisms through which most risk variants exert their effect is unclear. A complete understanding of T2D susceptibility mechanisms could have benefits in risk prediction, and in drug discovery through the identification of novel therapeutic targets. Work presented in this thesis aims to define relevant transcripts and disease mechanisms at known susceptibility loci, and to identify disease association with classes of genetic variation other than common single nucleotide polymorphisms (SNPs). KCNQ1 contains intronic variants associated with T2D susceptibility and β-cell dysfunction, but only maternally-inherited alleles confer increased disease risk. It maps within an imprinted domain with an established role in congenital and islet-specific growth phenotypes. Using human adult islet and foetal pancreas samples, I refined the transcripts and developmental stage at which T2D susceptibility must be conferred by demonstrating developmentally plastic monoallelic and biallelic expression. I identified a potential risk mechanism through the effect of T2D risk alleles upon DNA methylation. The disease-associated regions identified through genome-wide association (GWA) studies often contain multiple transcripts. I performed mRNA expression profiling of genes within loci associated with raised proinsulin/insulin ratios in human islets and metabolically relevant tissues. Some genes (notably CT62) were not expressed and therefore excluded from consideration for a risk effect, whilst others (for example C2CD4A) were highlighted as good regional candidates due to specific expression in relevant tissues. GWA studies for T2D risk have focused predominantly upon common single nucleotide polymorphisms. As part of a consortium conducing GWA analysis for copy number variation (CNV) and T2D risk, I optimised and compared alternative methods of CNV genotyping, before using this information to validate two signals of disease association. I genotyped three rare single nucleotide variants emerging from an association study with T2D risk based on imputed data, providing an indication of imputation accuracy and more powerful disease association analysis. These data underscore the challenge of translating association signals to causal mechanisms, and of identifying alternative forms of genomic variation which contribute to T2D risk. My work highlights candidates for functional analysis around proinsulin-associated loci, and makes significant progress towards uncovering risk mechanisms at the KCNQ1 locus.
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Mbaya, John Kabamba. "Lay beliefs of type 2 diabetic patients at Prince Mshiyeni Memorial Hospital, Durban." Thesis, University of Limpopo (Medunsa Campus), 2010. http://hdl.handle.net/10386/547.
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Thesis (M Med(Family Medicine))--University of Limpopo (Medunsa Campus) 2010.Aim & Objectives Aim: To explore the lay beliefs of type 2 diabetic patients seen at Prince Mshiyeni Memorial Hospital. Objectives: To understand lay beliefs of effective life long management of type 2 diabetes patients and consequently to make recommendations of improving management of diabetes in conjunction with the findings of the study. Methodology Study Design: An exploratory study from a qualitative perspective using free attitude interviews as a data collection technique. Setting: Prince Mshiyeni Memorial Hospital a district hospital located in Umlazi in the outskirts of Durban, South Africa. Study Population: All type 2 diabetic patients above the age of 40 on treatment for 18 months or more. Ten respondents were purposively selected using maximum variation sampling strategy. Participants were asked individually to give an account of their beliefs and experience in the management of diabetes. All interviews were tape recorded, transcribed verbatim, and analyzed to identify emerging themes. Results The interpretative thematic analysis generated the following main themes: 1) Combination therapy 2) Modern versus Traditional 3) The bitter stuff 4) Traditional healers and alternative remedies viii 5) Stress: Physical, financial, emotional, psychosocial strain 6) Spiritual believes: Religious and Traditional 7) Eating right food and loose weight Conclusions This study has described most lay beliefs about the management of type 2 diabetes in this setting. The research has identified that type 2 diabetic patients seen at Prince Mshiyeni Memorial Hospital in Umlazi South of Durban held different diabetes management beliefs based on their respective initial symptom perception and beliefs, their illness origin and healing beliefs, their spiritual and traditional beliefs and values and to a significant extent, the beliefs of spouses or life partner in couples and of family members. These findings have challenged the functionality of the health care in its capacity to respond to the population expectations based on their ethnic, spiritual and cultural background.
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Hamilton, Dorothy Jean. "The Lived Experience of Homeless Individuals with Type 2 Diabetes Mellitus." Kent State University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=kent160623154767295.
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Yates, Thomas E. "Can we out-walk the type 2 diabetes mellitus epidemic?" Thesis, Loughborough University, 2008. https://dspace.lboro.ac.uk/2134/8077.
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Type 2 diabetes mellitus is a chronic and debilitating disease whose prevalence continues to rise inexorably. Type 2 diabetes is usually preceded by a condition called prediabetes, which is characterised by impaired glucose regulation. Those with prediabetes have a significantly increased risk of developing type 2 diabetes compared to those with normal glucose control and therefore represent a key population in the prevention of type 2 diabetes. Physical inactivity is thought to be one of the key factors driving the increasing prevalence of prediabetes and type 2 diabetes and consequently forms a pivotal focus of initiatives aimed at their prevention. The principal aims of this thesis were to: 1) conduct a systematic review investigating the effectiveness of lifestyle and physical activity interventions at promoting physical activity in individuals with prediabetes and the effect of physical activity change on the risk of developing diabetes; 2) investigate the effect of walking activity on markers of chronic low grade inflammation; and 3) design and evaluate with objectively measured endpoints a physical activity intervention for adults at risk of developing type 2 diabetes that is suitable for implementation in a health care or community setting if found to be effective. The main findings are listed in the order of the stated aims. 1) Due to the dearth of controlled exercise training studies in those with prediabetes and the absence of evidence that previous diabetes prevention programmes have been successful at initiating clinically significant increases in physical activity, the evidence for the efficacy of physical activity behaviour change at prevention or delaying the progression to type 2 diabetes in those with prediabetes is equivocal. 2) Walking at levels that are consistent with the current physical activity recommendations is associated with reduced chronic low-grade inflammation, independent of other forms of physical activity. 3) The PREPARE programme, developed after a review of health behaviour theory and the current health care climate, is a theorydriven, group-based structured education programme designed to promote increased walking activity in individuals with prediabetes in a health care setting. A randomized controlled trial was conducted to test two versions of the PREPARE programme, a standard version and a pedometer version, against control conditions (advice leaflet). The standard version encouraged participants to set time-based goals based on generic exercise recommendations, whereas the pedometer version enabled participants to set personalized steps-per-day goals and to objectively self-monitor their daily physical activity levels using a pedometer. One hundred and three individuals were recruited to the study and follow-up was conducted at 3,6 and 12 months. At 12 months both intervention conditions were successful at achieving significant increases in objectively measured ambulatory activity; compared to the control group, those who received the pedometer version of the PREPARE programme increased their ambulatory activity by 1952 steps per day (95% CI 953 to 2951) and those who received the standard version by 1480 steps per day (95% CI 436 to 2522). However, significant improvements in glucose tolerance were only seen in the pedometer group, where 2-h glucose levels decreased by -0.94 mmol/l (95% Cl -1.79 to - 0.10) compared to control conditions, despite no significant change in body weight or waist circumference. This thesis has identified important limitations in the current evidence linking physical activity to the prevention of type 2 diabetes in those with prediabetes and has addressed several of these limitations by developing a theory-driven structured education programme which was shown to be successful at promoting physical activity and improving glucose tolerance in those with prediabetes to levels that are equal to or greater than previous multifactor diabetes prevention programmes. This is likely to have important implications for future diabetes prevention trials and clinical practice in the United Kingdom.
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Hoffman, Kristin. "Cancer treatment and cellular stress induced type 2 diabetes mellitus." Thesis, Boston University, 2012. https://hdl.handle.net/2144/12422.
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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.
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Mutize, Tinashe. "DNA methylation : a risk factor for type 2 diabetes mellitus." Thesis, Cape Peninsula University of Technology, 2016. http://hdl.handle.net/20.500.11838/2388.
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Thesis (MSc (Biomedical Technology))--Cape Peninsula University of Technology, 2016.The early detection of individuals who are at risk of developing type 2 diabetes mellitus (T2DM) would decrease the morbidity and mortality associated with this disease. DNA methylation, the most widely studied epigenetic mechanism, offers unique opportunities in this regard. Aberrant DNA methylation is associated with disease pathogenesis and is observed during the asymptomatic stage of disease. DNA methylation has therefore attracted increasing attention as a potential biomarker for identifying individuals who have an increased risk of developing T2DM. The identification of high risk biomarkers for T2DM could facilitate risk stratification and lifestyle interventions, which could ultimately lead to better ways to prevent, manage and control the T2DM epidemic that is rampant worldwide. The aim of the study was to investigate global DNA methylation as a potential risk factor for T2DM by studying the association between the global DNA methylation levels and hyperglycaemic states. A cross-sectional, quantitative study design, involving 564 individuals of mixed ancestry descent, residing in Bellville South, South Africa was used. Participants were classified as normal, pre-diabetic (impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT)) or diabetic (screen detected diabetic and known diabetics) according to WHO criteria of 1998. DNA was extracted from whole blood using the salt extraction method. The percentage global DNA methylation was measured by an enzyme-linked immunosorbent assay (ELISA). The association between global DNA methylation and hyperglycaemia, as well as other biochemical markers of T2DM was tested in a robust linear regression analysis adjusted for age, gender and smoking.
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Perez, Nieves Magaly. "The Association between Rheumatoid Arthritis and Type 2 Diabetes Mellitus." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1228.
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A research report from the Centers for Disease Control and Prevention (CDC) indicated that more than 50% of people with diabetes mellitus (DM) in the United States (U.S.) also have arthritis. The diabetes population is disproportionately affected by arthritis, but there has been limited and inconsistent research to confirm the association between type 2 diabetes mellitus (T2DM) and rheumatoid arthritis (RA). The current study aimed to identify an association between T2DM and RA for noninstitutionalized U.S. adults between 1999 and 2012 using a nationally representative sample from the National Health and Nutrition Examination Survey (NHANES) database (n =31,488 ). A quantitative, cross-sectional investigation was conducted to determine if patients with T2DM had an increased prevalence of RA. The current study also sought to identify characteristics that could affect the association between both groups and the prevalence of cardiovascular disease (CVD) in this population. Prevalence and adjusted odds ratios (OR) using logistic regression were calculated. The results show evidence of a strong association between T2DM and concomitant RA. Prevalence of RA was significantly higher in participants with T2DM compare to those without T2DM. Important factors in this association were gender, ethnicity, education, disability, and work functioning. The prevalence of CVD and adjusted OR of association were doubled in participants with T2DM and RA when compared to participants who had just one of the conditions; the OR of association was quadrupled when compared to those without this comorbidity. This study may provide patients and health care providers with a better understanding of the need for management of both conditions in a interdisciplinary manner
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McCann, Adrian. "Physical activity in the management of type 2 diabetes mellitus." Thesis, Cardiff Metropolitan University, 2011. http://hdl.handle.net/10369/3471.
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The incidence of type 2 diabetes mellitus (T2DM) is rising throughout the world. Explicit evidence has demonstrated sedentary behaviour is a powerful but modifiable risk factor affecting glycaemic control and the incidence of diabetes complications. Despite this, current population estimates indicate the importance of physical activity is not effectively translated to the T2DM population. The aim of this thesis was therefore to investigate barriers and facilitators to physical activity behaviour among individuals with T2DM. An extensive literature review investigating evidence linking physical activity to the management of T2DM was performed, then followed on by three studies which 1) investigated the effects of a 12-week supported exercise programme among newly diagnosed patients, 2) explored factors that may be associated with sedentary or physical activity behaviour, and 3) compared and contrasted the perception and use of physical activity among patients who participated in an exercise programme and patients who received standard care. The findings of this thesis demonstrated that a supported exercise programme can help newly diagnosed T2DM patients achieve moderate-high intensity physical activity 3-5 days·week-1, improving glycaemic control through enhanced β-cell function associated with decreased insulin resistance and improved lipid profile. Exploratory investigation suggested self-efficacy to exercise, internal locus of control and physical activity advice may be important antecedents for physical activity behaviour. Furthermore, it also appeared to suggest that peer support and more comprehensive physical activity information and reinforcement, are key to satisfying psychological needs - autonomy, competence and relatedness - and internalising motivation for physical activity and exercise behaviour. Given the projected incidence of T2DM and prevalence of sedentary behaviour among this population, the findings from this thesis highlight the important role of physical activity and also the need for further research investigating supported exercise programmes and the development of more comprehensive physical activity guidelines for individuals with T2DM.