Tesi sul tema "Type 2 diabetes"
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1
Dow, Courtney. "Dietary Factors, Type 2 Diabetes and Diabetic Retinopathy". Thesis, Université Paris-Saclay (ComUE), 2018. http://www.theses.fr/2018SACLS380/document.
Testo completoAbstract (sommario):
Contexte : Le diabète de type 2 (DT2) constitue une pathologie majeure, au lourd fardeau, associ ée à de nombreuses complications, comme la rétinopathie diabétique (RD). Des facteurs modifiables, comme l’alimentation, ont déjà été identifiés pour le DT2 et la RD mais certains aspects de leurs rôles restent à préciser. Objectifs : Les objectifs de cette thèse étaient d’examiner le rôle de l’alimentation, en particulier la consommation d’acides gras (AGs), et des autres facteurs modifiables liés au mode de vie sur le risque de DT2 et de synthétiser, interpréter et analyser la relation entre l’alimentation et la RD. Résultats : Les résultats suggèrent que le rôle des AGs sur le risque de DT2 et de la RD pourrait être différent selon leur type, et même varier au sein d’un groupe comme les AG polyinsaturés (AGPI). Les résultats suggèrent aussi qu’une forte adhésion aux recommandations alimentaires n’est pas associée avec le développement d’un DT2, mais en revanche une forte adhérence aux autres recommandations de santé (concernant le tour de taille, l’activité physique et le statut tabagique) est fortement associée avec un moindre risque de DT2. On a montré qu’avoir un mode de vie sain aurait pu empêcher la survenue de plus de la moitié des cas de DT2. Conclusions : Cette thèse a permis de préciser l’importance et la complexité du rôle de l’alimentation dans le développement du DT2 et de la RD. Elle montre aussi l’impact des comportements sains dans la pathologie de DT2 et confirme que le DT2 est en grande partie, une maladie évitable. Les efforts devraient se focaliser sur la modification des comportements de santé à la fois dans la population générale et atteinte de DT2 et notamment encourager une alimentation modérée et variéeBackground : Type 2 diabetes (T2D) presents a significant health burden that is associated with many complications, such as diabetic retinopathy (DR), that further burden people with diabetes. Modifiable risk factors, such as the diet, have been identified for both T2D and DR; yet certain aspects of the role of the diet remain unclear. Objectives : The main objectives of this thesis were therefore to examine the role and impact of the diet, and in particular, the consumption of fatty acids (FAs), and other modifiable behaviours on the risk of T2D and to summarize, interpret and analyze the relationship between the diet and DR using data from both the E3N and AusDiab cohort studies. Results : The results suggest that the role of FAs on the risk of T2D and DR may differ between and within subgroups, and by individual polyunsaturated fatty acids (PUFAs). The findings also suggest that strongly adhering to national dietary guidelines is not associated with the development of T2D, but strongly adhering to other recommendations for healthy behaviours (for waist circumference, physical activity and smoking) is strongly inversely associated with T2D. Modifiable behaviour could have prevented more than half of the cases of T2D. Conclusions : This work underlines the importance and the complexity of the role of the diet in the development of T2D and DR. It also illustrates the impact of healthy behaviour in the etiology of T2D and confirms that T2D is largely preventable. Efforts should focus on the modification of multiple healthy behaviours in populations, and promote diets that are moderate and widely varied
2
Sundsten, Tea. "Protein Profiling and Type 2 Diabetes". Doctoral thesis, Uppsala University, Department of Medical Cell Biology, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8458.
Testo completoAbstract (sommario):
Type 2 diabetes mellitus (T2DM) is a heterogeneous disease affecting millions of people worldwide. Both genetic and environmental factors contribute to the pathogenesis. The disease is characterized by alterations in many genes and their products. Historically, genomic alterations have mainly been studied at the transcriptional level in diabetes research. However, transcriptional changes do not always lead to altered translation, which makes it important to measure changes at the protein level. Proteomic techniques offer the possibility of measuring multiple protein alterations simultaneously.
In this thesis, the proteomic technique surface enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF MS) has been applied and evaluated in the context of T2DM research. Protocols for pancreatic islet and serum/plasma protein profiling and identification have been developed. In addition, the technique was used to analyze the influence of genetic background versus diabetic environment by determining serum protein profiles of individuals with normal glucose tolerance (NGT) and T2DM with or without family history of diabetes. In total thirteen serum proteins displayed different levels in serum from persons with NGT versus patients with T2DM. Among these proteins, apolipoprotein CIII, albumin and one yet unidentified protein could be classified as being changed because of different genetic backgrounds. On the other hand, ten proteins for instance transthyretin, differed as a result of the diabetic environment.
When plasma protein patterns of NGT and T2DM individuals characterized by differences in early insulin responses (EIR) were compared, nine proteins were found to be varying between the two groups. Of these proteins five were identified, namely two forms of transthyretin, hemoglobin α-chain, hemoglobin β-chain and apolipoprotein H. However no individual protein alone could explain the differences in EIR. In conclusion, SELDI-TOF MS has been successfully used in the context of T2DM research to identify proteins associated with family history of diabetes and β-bell function.
3
Scott, Sarah R. "The management of type 2 diabetes". Thesis, University of Warwick, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.397095.
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4
Lindsay, J. R. "Glycated peptides in type 2 diabetes". Thesis, Queen's University Belfast, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269002.
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5
Steven, Sarah. "The reversibility of type 2 diabetes". Thesis, University of Newcastle upon Tyne, 2016. http://hdl.handle.net/10443/3177.
Testo completoAbstract (sommario):
The incidence of both obesity and type 2 diabetes continues to rise, creating a major worldwide public health challenge. Understanding the mechanisms determining the normalisation of blood glucose levels and the limitations to complete reversal of diabetes by bariatric surgery or a very low calorie diet (VLCD) has important implications for the treatment of type 2 diabetes, but also for improving our understanding of the pathophysiology. A unifying hypothesis to explain the major pathophysiological changes in type 2 diabetes, hepatic insulin resistance and pancreatic beta cell insufficiency, involves excess triglyceride accumulation in liver and pancreas. This is supported by in vitro demonstration of impaired insulin signalling (and thereby insulin resistance) and defective insulin secretion, induced by the toxic metabolites of fat. Triglyceride content in liver and pancreas can now be measured non-invasively and precisely using the three point Dixon magnetic resonance technique. This thesis presents data on a direct comparison of bariatric surgery and VLCD, suggesting that the mechanisms involved in the reversibility of type 2 diabetes using these two interventions are similar. Pancreatic triglyceride content appears to decrease with substantial weight loss in obese individuals with type 2 diabetes but not those with normal glucose tolerance. The clinical characteristics which limit reversal of diabetes are investigated, particularly the effect of longer diabetes duration. Both a retrospective study of bariatric surgery and a prospective study using VLCD suggest that long duration diabetes is reversible, however, normal blood glucose levels are less likely to be achieved than in short duration disease. Diabetes duration may be a surrogate marker for beta cell reserve. Finally, the longer term durability of the beneficial effects of an 8 week very low calorie diet is demonstrated. Over a subsequent 6 month weight maintenance period the decrease in hepatic and pancreatic triglyceride content, and the improvements in hepatic insulin sensitivity and first phase insulin secretion are maintained. The latter appears to be a key mechanism for determining a glucose response to VLCD.
6
Li, Luosheng. "Molecular genetics of type 2 diabetes /". Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-194-2/.
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7
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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8
Forbes, Shareen. "Catecholamine sensitivity preceding Type 2 diabetes". Thesis, Imperial College London, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.425685.
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9
Gloyn, Anna Louise. "Molecular genetics of type 2 diabetes". Thesis, University of Oxford, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.343364.
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10
Zhang, Yun. "Molecular genetics of type 2 diabetes". Thesis, University of Oxford, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.298425.
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11
Pascoe, Laura. "Genetic determinants of Type 2 diabetes". Thesis, University of Newcastle Upon Tyne, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.582170.
Testo completoAbstract (sommario):
Type 2 diabetes is a complex disease resulting from a combination of the inability of target cells to recognise and respond to insulin and a defect in the ability of the ~-cells to secrete insulin. Both genetic and environmental factors contribute to the risk, presentation and progression of the disease. Knowledge of the underlying architecture and mechanisms remain incomplete; however recent advancements in genotyping technology have allowed us to define potential type 2 diabetes genes through genome wide association (GWA) studies of very large populations, to compliment data from the more traditional candidate gene studies. The overall aim of this thesis was to assess common genetic variation within a healthy population of Europeans and to explore whether this alters their susceptibility to developing type 2 diabetes. The Relationship between Insulin Sensitivity and Cardiovascular disease (RISC) cohort of DNA was used to identify novel SNPs in the Perilipin/Pexlla gene region, and to validate potential type 2 diabetes susceptibility alleles identified via GWA scans. TaqMan and Sequenom platforms were used in house to genotype the Perilipin/ Pexlla gene region ht-SNPs in RISC, and deep sequencing was subsequently used to try to identify functional variants. The remaining GWA scan identified genes were genotyped by an external facility. Associations with measures of ~-cell function, insulin sensitivity and body composition were assessed. Expression studies on the Perilipin and Pexlla genes were performed on human islets and MIN6 cells. mRNA and protein levels of the expressed gene were then assessed and the impact of altered glucose and fatty acid levels on Perilipin or Pexlla expression was investigated. Two ht-SNPs were identified in the Perilipin/Pexlla gene region that were both associated with measures of ~-cell function. We confirmed Pexlla mRNA expression in both human islets and MIN6 cells, however Perilipin mRNA expression was not detectable. Exposure to low glucose and elevated palmitate levels both up-regulated Pexlla mRNA expression, but Perilipin remained undetectable. We showed that variation at the CDKALl, HHEX/IDE and MTNR1B loci increases type 2 diabetes susceptibility by decreased pancreatic ~-cell function. Finally we assessed the effects of combining susceptibility loci on the risk of ~-cell dysfunction. We demonstrated that individual type 2 diabetes-risk alleles combine in an additive manner to impact upon pancreatic ~-cell function in healthy individuals. In conclusion, we have identified two novel SNPs within the Perilipin/Pexlla gene locus associated with measures of paricreatic ~-cell function in the RISC cohort. We confirmed that Pexlla is expressed in pancreatic islets and ~-cells, and further work is required to define whether variation in this gene directly affects ~-cell function. We demonstrated for the first time that variation in the novel type diabetes susceptibility genes identified by GWA scans mediate their effects through altered pancreatic ~-cell function.
12
Hough, Alison Janette. "Mouse models of type 2 diabetes". Thesis, Oxford Brookes University, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.520928.
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13
Patel, Pushpa. "Molecular genetics of Type 2 diabetes". Thesis, Open University, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.314843.
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14
Wilmot, Emma Gwyn. "Type 2 diabetes in younger adults". Thesis, University of Leicester, 2013. http://hdl.handle.net/2381/27976.
Testo completoAbstract (sommario):
Background: The rising prevalence of obesity and sedentary behaviour has lead to a substantial increase in the number of younger adults (<45 years) developing Type 2 diabetes (T2DM). The amount of time spent sitting (sedentary) has been identified as a risk factor for T2DM which, if targeted, has the potential to prevent T2DM. Aims: 1) To extensively phenotype younger adults with T2DM; 2) To conduct a systematic review and meta-analysis to investigate the relationship between sedentary time, T2DM, cardiovascular disease, cardiovascular and all-cause mortality; 3) To develop the Sedentary Time ANd Diabetes (STAND) structured education programme, designed to reduce sedentary time in younger adults at risk of T2DM and use data from the baseline cohort to describe the prevalence of undiagnosed T2DM in this study population; 4) To assess the effectiveness of the STAND intervention to reduce sedentary behaviour. Key findings: 1) T2DM in younger adults is a associated with an adverse metabolic profile: hyperlipidaemia, vitamin D deficiency, pro-inflammatory state, low physical activity and fitness. Cardiac magnetic resonance imaging demonstrated reduced diastolic strain which was present in the T2DM but not obese or lean control groups. 2) Excess sedentary time was positively associated with diabetes, cardiovascular events, cardiovascular mortality and all-cause mortality. 3) Previously undiagnosed T2DM was present in 4.7% of 193 participants recruited for the STAND randomised controlled trial. 4) The STAND intervention did not significantly reduce sedentary time in the intervention group compared to the control group (p=0.43). Conclusion: This thesis assesses the impact of T2DM on the individual (Chapter Two, Three), quantifies the risk associated with excess sedentary time (Chapter Four) and examines the effectiveness of the STAND programme to reduce sedentary time in younger adults with risk factor for T2DM (Chapters Five to Eight). Recommendations are provided for future research and clinical practice to promote the prevention of T2DM in younger adults.
15
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.
Testo completoAbstract (sommario):
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.
16
Weedon, M. N. "Molecular genetics of type 2 diabetes". Thesis, Exeter and Plymouth Peninsula Medical School, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.701317.
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Ryysy, Leena. "Insulin treatment in type 2 diabetes". Helsinki : University of Helsinki, 2001. http://ethesis.helsinki.fi/julkaisut/laa/kliin/vk/ryysy/.
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18
Simonen, Piia. "Cholesterol metabolism in type 2 diabetes". Helsinki : University of Helsinki, 2002. http://ethesis.helsinki.fi/julkaisut/laa/kliin/vk/simonen/.
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19
Ikpeama, Blessing Nneoma. "Telehealth and Type 2 Diabetes Management". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6907.
Testo completoAbstract (sommario):
The use of telehealth in healthcare has grown in recent years; however, little is known about the effectiveness of this delivery method in the management of Type 2 diabetes mellitus (T2DM). Guided by the chronic care model and telehealth in chronic disease model, the purpose of this systematic literature review was to explore evidence related to lowering hemoglobin A1c levels and managing T2DM using telehealth in the outpatient setting. The practice-focused questions explored telehealth interventions used in T2DM management and their effectiveness. The Joanna Briggs Institute (JBI) method for conducting systematic literature reviews was the process, and data were compiled using the PRISMA evidence-based minimum set for reporting. Eighteen studies met the inclusion criteria for this project. Data were extracted, analyzed, and synthesized using JBI tools for data extraction and critical appraisal. Article appraisals revealed numerous telehealth interventions for management of T2DM including telephone, Internet-based, clinical video, remote monitoring, and smart phones/applications. Overall, telehealth interventions showed statistically significant improvement in the hemoglobin A1c levels of participants compared to traditional outpatient care. Success of the interventions is associated with components of evidenced-based diabetes management such as education, self-management, support, and feedback loop. The implications of this project for positive social change include the integration of telehealth interventions in the outpatient setting to manage T2DM with enhanced access to care, reduction in health disparities, and improved health outcomes for society.
20
Stavrou, Eftyhia P. "Functional losses in type 2 diabetes mellitus". Thesis, Queensland University of Technology, 2001. https://eprints.qut.edu.au/36771/1/36771_Digitised%20Thesis.pdf.
Testo completoAbstract (sommario):
Aims:
Psychophysical tests such as Letter contrast sensitivity (CS) and flicker perimetry have been used to detect early functional losses in ocular disease such as age-related maculopathy (ARM) and in vascular disorders such as migraine. This study set out to determine the ability of these tests to detect early functional losses in type 2 diabetics with minimal or early diabetic retinopathy (DR).
Methods:
Subjects consisted of 20 patients with type 2 diabetes (duration, following diagnosis, ranging from 6 months to 18 years) and 24 age-matched normal controls.
Letter CS, using the Pelli-Robson cha.ii, visual acuity (VA) using the standard high contrast Bailey-Lovie chart and monocular visual fields (VF) were measured. Static and flicker VF were measured using the Medmont M600 perimeter (MFA) and SIT A-standard fields using the Humphrey Field Analyser (HFA) were tested.
Results:
Letter CS was able to discriminate those diabetic subjects with none or early DR and those with and without ME from the control group, whereas VA was not able to detect any significant differences in visual function in these diabetic sub-groups compared to the control group.
In terms of visual fields, both the pattern defect (PD) index and hill-ofvision profiles were analysed. In those with early onset of diabetes and in those with none/minimal DR, only the PD index obtained with the flicker technique was significantly worse than the control group. The hill-of-vision profiles showed that the PD loss in those with minimal DR when flicker perimetry was used, was due to a central depression close to fixation, whereas the MFA static and HFA profiles consisted of a general depression across the field. This indicated that the flicker technique is a more sensitive test than the static technique in determining central visual field defects in those with minor observable retinal changes.
The inability of the HFA to detect changes to the macula region was thought to be due to the large grid spacing of the stimuli, as when the severity of retinopathy increased to a moderate level, the MFA static technique produced central losses which were not evident with the HFA.
Conclusion:
For diabetic patients who had either, a duration of diabetes of less than five years, or displayed only minimal or no DR or no ME, VF defects were only elicited with the use of the MFA flicker technique. Further functional losses in those with no or early, clinically detectable changes, were revealed by measuring Pelli-Robson Letter CS.
21
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.
Testo completoAbstract (sommario):
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.
22
Carey, Peter Edward. "Post prandial metabolism in type 2 diabetes". Thesis, University of Newcastle upon Tyne, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.430693.
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West, Sophie Diana. "Obstructive sleep apnoea and type 2 diabetes". Thesis, University of Leicester, 2007. http://hdl.handle.net/2381/29539.
Testo completoAbstract (sommario):
Aims: To establish the prevalence of OSA in individuals with type 2 diabetes, and whether treatment with CPAP improves glycaemic control and insulin resistance. Methods and Results: A questionnaire was sent to 1682 men with type 2 diabetes from hospital and primary care databases. Fifty-six percent replied; 57% scored as 'high' and 39% as 'low' risk for OSA; 4% had known OSA. Overnight oximetry in 240 respondents from the 'high' and 'low' risk groups showed 31% and 13% respectively had significant OSA, verified by sleep studies. Exploration and oximetry data to the questionnaire respondent population suggests 23% have OSA. Comparison with a general population showed OSA prevalence to be significantly higher in the diabetes population (p<0.001). Multiple linear regression revealed diabetes was a significant independent OSA predictor after correction for BMI, explaining 8% of OSA variance (p<0.001). There was no correlation of OSA with HbA1c. A double blind randomized controlled trial of CPAP in men with type 2 diabetes and newly diagnosed OSA was performed. Forty-two men attended for baseline investigations and then received either therapeutic or placebo CPAP for 3 months; baseline tests were then repeated. In the therapeutic group, significantly improved subjective and objective sleepiness were noted, however no significant improvement in HbA1c, euglycaemic clamp, adiponectin or HOMA-%S were found. Conclusions: OSA is highly prevalent in men with type 2 diabetes; most individuals are undiagnosed. Diabetes may be a significant independent contributor to OSA risk. CPAP treatment of OSA does not improve insulin resistance or HbA1c in men with type 2 diabetes.
24
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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Lim, Ee Lin. "Unravelling the pathogenesis of type 2 diabetes". Thesis, University of Newcastle Upon Tyne, 2012. http://hdl.handle.net/10443/1507.
Testo completoAbstract (sommario):
Type 2 diabetes has become a worldwide epidemic. It is characterised by insulin resistance in major metabolic tissues, and failure of β-pancreatic cells to compensate for this abnormality. Insulin resistance is recognised as an early event in the pathogenesis of type 2 diabetes. Although the precise factors that lead to insulin resistance have not been elucidated fully, there is strong association between insulin resistance and lipid accumulation, in particular lipotoxic fatty acid metabolites in insulin-target tissues. Most recently, evidence has been presented to link abnormal fatty acid accumulation in muscle with reduced mitochondrial activity. However it was unclear if these aberrations are causally related to the development of insulin resistance and type 2 diabetes. The two major pathophysiological abnormalities that underlie type 2 diabetes have long been viewed to require two separate pathogenic processes. The resolution of type 2 diabetes after bariatric surgery has allowed the elucidation of the sequence of events that lead to the restoration of normal metabolism, paving the way for a new understanding of type 2 diabetes as a metabolic state precipitated by a single cause of chronic excess intra-organ lipid accumulation. Magnetic resonance technique provides a non-invasive way to evaluate metabolism in both normal and pathological states. Specifically, 31P magnetic resonance spectroscopy allows the observation of real-time ATP synthesis as a direct measurement of mitochondrial activity. 13C magnetic resonance spectroscopy can be applied to assess muscle glycogen concentration. Both 1H magnetic resonance spectroscopy and magnetic resonance imaging can be used to evaluate intra-organ lipid concentration. Collectively, these innovative techniques offer safe and powerful approaches to study the role of skeletal muscle oxidative capacity and intra-organ fatty acid accumulation and metabolism in the pathogenesis of type 2 diabetes. This thesis presents data which lead to a simplified understanding of the aetiology and pathogenesis of type 2 diabetes.
26
Elston, Lucinda Mary. "Exercise, the microcirculation and type 2 diabetes". Thesis, University of Exeter, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.409025.
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Фадєєва, Ганна Анатоліївна, Анна Анатольевна Фадеева, Hanna Anatoliivna Fadieieva e A. Albert. "Cancer risk due to type 2 diabetes". Thesis, Sumy state university, 2017. http://essuir.sumdu.edu.ua/handle/123456789/54963.
Testo completoAbstract (sommario):
Epidemiologic studies show that type 2 diabetes increases the risk of certain cancers. Different antidiabetic drugs used for the treatment of type 2 diabetes can modify cancer risk. Study objectives: to evaluate risk factors common to both diabetes and cancer.
28
Shotckaia, Anastasiia. "Deprived neighbourhoods, borders and type 2 diabetes". Thesis, Malmö universitet, Fakulteten för kultur och samhälle (KS), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-22945.
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Eason, Robert C. "Treating type 2 diabetes through insulin resistance". Thesis, Aston University, 2002. http://publications.aston.ac.uk/10953/.
Testo completoAbstract (sommario):
Type 2 diabetes is an insidious disorder, with micro and/or macrovascular and nervous damage occurring in many patients before diagnosis. This damage is caused by hyperglycaemia and the diverse effects of insulin resistance. Obesity, in particular central obesity, is a strong pre-disposing factor for type 2 diabetes. Skeletal muscle is the main site of insulin-stimulated glucose disposal and appears to be the first organ that becomes insulin resistant in the diabetic state, with later involvement of adipose tissue and the liver. This study has investigated the use of novel agents to ameliorate insulin-resistance in skeletal muscle as a means of identifying intervention sites against insulin resistance and of improving glucose uptake and metabolism by skeletal muscle. Glucose uptake was measured in vitro by cultured L6 myocytes and isolated muscles from normal and obese diabetic ob/ob mice, using either the tritiated non-metabolised glucose analogue 2-deoxy-D-glucose or by glucose disposal. Agents studied included lipoic acid, isoferulic acid, bradykinin, lipid mobilising factor (provisionally synonymous with Zinca2 glycoprotein) and the trace elements lithium, selenium and chromium. The putative role of TNFa in insulin resistance was also investigated. Lipoic acid improved insulin-stimulated glucose uptake in normal and insulin resistance murine muscles, as well as cultured myocytes. Isoferulic acid, bradykinin and LMF also produced a transient increase in glucose uptake in cultured myocytes. Physiological concentrations of TNFa were found to cause insulin resistance in cultured, but no in excised murine muscles. The effect of the M2 metabolite of the satiety-inducing agent sibutramine on lipolysis in excised murine and human adipocytes was also investigated. M2 increased lipolysis from normal lean and obese ob/ob mouse adipocytes. Arguably the most important observation was that M2 also increased the lipolytic rate in adipocytes from catecholamine resistant obese subjects. The studies reported in this thesis indicate that a diversity of agents can improve glucose uptake and ameliorate insulin resistance. It is likely that these agents are acting via different pathways. This thesis has also shown that M2 can induce lipolysis in both rodent and human adipocytes. M2 hence has potential to directly reduce adiposity, in addition to well documented effects via the central nervous system.
30
Andrews, Robert. "Cortisol metabolism in type 2 diabetes mellitus". Thesis, University of Edinburgh, 2004. http://hdl.handle.net/1842/23073.
Testo completoAbstract (sommario):
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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De, Groot Julia A. "An Analysis of Type 2 Diabetes Interventions". Thesis, Griffith University, 2022. http://hdl.handle.net/10072/415269.
Testo completoAbstract (sommario):
Background Type 2 diabetes is a type of chronic and progressive metabolic disorder characterized by persistent hyperglycaemia. It is associated with numerous complications, a high burden of disease, and large economic costs. This thesis intends to explore the existing knowledge about current and emerging interventions for type 2 diabetes, aiming to identify and fill in some of the current gaps in the literature. Currently, telemedicine has become increasingly popular as a convenient and cost-saving method of intervention. However, in-depth analysis of telemedicine for various health outcomes and sub-groups about intervention characteristics are not well explored. Furthermore, the selfmanagement paradigm intends to develop the patient’s own ability to respond to the disease physically, cognitively, and emotionally. This thesis features an analysis of the importance of self-care, self-efficacy, and diabetes knowledge in type 2 diabetes, and how a self-management intervention affects these parameters in comparison to a control. Methodology Paper 1 of this thesis consisted of a published systematic review and meta-analysis, which explored the effect of telemedicine interventions for type 2 diabetes by comprehensively searching the literature. Glycaemic control and other biomedical outcomes were compared between the intervention and control using mean difference. Furthermore, subgroup analysis investigated the effect of patient demographics, changes to self-care behaviours, and characteristics of the intervention on change to glycaemic control. Paper 2 was a randomised controlled trial, which is prepared for publication. This examined the effect of a self-management intervention on outcomes of self-care behaviours, self-efficacy, and diabetes knowledge. The intervention group received 10 fortnightly group sessions aimed at self-management of the disease, whilst the control received a single 2-hour education session. Binomial logistic regression was used to compare the intervention and control groups, at baseline, 26 weeks, and 52 weeks. Results The systematic review and meta-analysis included 43 studies, which found that glycosylated haemoglobin (HbA1c), diastolic blood pressure (DBP), post-prandial glucose (PPG), fasting plasma glucose (FPG), weight, body mass index (BMI), mental and physical quality of life (QoL) were improved in the telemedicine interventions more than the control. Systolic blood pressure (SBP) and cholesterol were not significant between the groups. Subgroup analysis revealed that patient demographics of obesity and Hispanic racial background had significantly higher benefits to glycaemic control post-telemedicine intervention. The intervention characteristics that were most effective for improving glycaemic control were: clinical treatment models, telemonitoring, videoconferencing, interactive telephone systems, a delivery of less than weekly, led by allied health, lasted for a duration of 6 months, focussed on biomedical parameters, had an engagement level of >70%, with a drop-out rate of 10-19.9%. As for self-care behaviours, higher post-intervention self-blood-glucose monitoring and self-efficacy were associated with improved glycaemic control. The randomised control trial found that the intervention was alike the control for most outcomes. However, the intervention was superior for improving self-monitoring of the foot, and possibly for daily sock changes at the 52 weeks. Grouping by time analysis found that the intervention was more effective at improving foot care behaviours over time, which may lead to reduction in diabetic foot-related complications. Interestingly, the control was slightly superior to the intervention for improving overall diabetes knowledge. Although analysis of individual questions showed that control was better for improving knowledge about the normal range of fasting glucose, BMI and blood pressure, and the self-management intervention was better for developing ability to take appropriate actions, which is reflective of developing self-management. For selfefficacy, the intervention is possibly better than control for improving ability to do daily activities normally affected by depression. Conclusion Telemedicine is an effective measure for improving glycaemic control and other healthrelated outcomes in type 2 diabetes patients. The current research suggests that it is likely superior to controls, and subgroup analysis completed in paper 1 helps to inform decision-making for change of practice in widely accepted type 2 diabetes management. Self-management interventions are at least as effective as traditional interventions and show promise for being superior for improving factors such as self-care, and selfefficacy.Thesis (Masters)
Master of Medical Research (MMedRes)
School of Medicine & Dentistry
Griffith Health
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Dille, Renee. "Serum Uric Acid and Type 2 Diabetes". Thesis, The University of Arizona, 2013. http://hdl.handle.net/10150/281174.
Testo completoAbstract (sommario):
A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.Objectives: In recent years, serum uric acid has emerged as a possible risk factor for type 2 diabetes mellitus (T2DM). It remains unclear if this is independent of other well-known risk factors related to the metabolic syndrome. This retrospective epidemiologic study attempts to clarify the relationship between uric acid and T2DM, as well as to assess uric acid as a predictor for future diabetes development. Methods: Data was collected by the NIDDK biennial study from Pima Indians in Arizona over several decades. A cross sectional analysis using multivariate logistic regression and a survival analysis using a Cox proportional hazards model were created. Sex and body mass index (BMI) were hypothesized to create significant interactions with other variables. Interactions were confirmed by log likelihood tests, so the data was analyzed stratifying by sex. An interaction term between body mass index and uric acid was also included in analyses performed in women, as it was found to be significant in women only. Results: The cross sectional analysis showed that men with diabetes are significantly more likely to be older (OR=1.033, p<0.0001), have a higher BMI (OR=1.117, p<0.0001), mean arterial pressure (MAP) (OR=1.020, p=0.0024), cholesterol (OR=1.003, p=0.003), and lower uric acid (OR=0.625, p<0.0001) than men without diabetes. Uric acid levels did not correlate with diabetes status in women, but an interaction between uric acid and BMI was significant (p=0.0094). A goodness of fit test of the models comparing predicted to observed outcomes were significant with an R-squared value of almost 0.90 in both sexes. The survival analysis in women demonstrated that BMI (p=<0.0002) and uric acid (p=0.0209) both confer risk for diabetes development, and a significant interaction between BMI and uric acid exists with a negative parameter estimate. A nested analysis of the effect of uric acid assessed in BMI quartiles demonstrated an increased risk in normal to moderately overweight individuals, and a hazard ratio under 1 in more obese individuals. Results in men demonstrated no significance of uric acid (p=0.6571). Conclusion: The relationship between serum uric acid and diabetes varies significantly by sex, and BMI appears to have a confounding relationship with uric acid, especially in women. Uric acid is lower in men with current diabetes, confirming previous studies, which may be due to renal hyperfiltration or induction of uric acid as an antioxidant response to diabetes. In women, elevated uric acid confers higher risk of future development of T2DM. Why this was not shown in men is unclear. Utilizing uric acid in clinical practice as a screening tool is limited by interactions between uric acid and other metabolic risk factors, specifically BMI, as well as variations influenced by diet and renal function.
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Saker, Philip John. "The molecular genetics of Type 2 diabetes". Thesis, Open University, 1995. http://oro.open.ac.uk/57565/.
Testo completoAbstract (sommario):
Type 2 diabetes has a substantial genetic component. The aim of this dissertation was to investigate the molecular basis of Type 2 diabetes with particular emphasis on the role of the glucokinase gene. Other work studied specific mutations in the tRNALeu(UUR) gene of mitochondrial DNA and in the glucagon receptor gene. The Introductory chapter presents an overview of Type 2 diabetes, and the influence of the environment and the contribution of genetics to its development. It then introduces the molecular biological approach to the study of this disease and the function of the J3-cell and the important role of glucokinase in glucose homeostasis. Chapter 2 gives details of ascertainment criteria for the subjects studied and outlines the methodology used to study the molecular genetics of Type 2 diabetes. The techniques described include DNA extraction, the polymerase chain reaction (PCR), microsatellite markers, restriction fragment length polymorph isms (RFLPs), mutation screening, separation of PCR products and direct sequencing of them. Chapter 3 investigates the role of the glucokinase gene in five pedigrees with maturity onset diabetes of the young (MOOY). Using the microsatellite polymorph isms GCK1 and GCK2, diabetes was found not to be linked to the glucokinase gene in these multi-generation pedigrees. Chapter 4 assesses the contribution of the glucokinase gene to Type 2 diabetes in the UK Caucasian population by investigating the two microsatellite polymorph isms in well-characterised Type 2 diabetic subjects and normoglycaemic control subjects. There was no linkage disequilibrium between the two polymorphisms, and no association with diabetes was found. This suggests that a single mutation in or near the glucokinase gene is not a common cause of Type 2 diabetes in this population. Chapter 5 describes the development of a robust method to screen for mutations using the technique of single-stranded conformational polymorphism (SSCP) analysis. Chapter 6 utilises this method, and found that mutations in the glucokinase gene can contribute to the pathogenesis of gestational diabetes. Four pedigrees from the Oxford district had been found to possess the same missense mutation in the glucokinase gene at position 299. Chapter 7 establishes that the high prevalence of this glucokinase mutation in this district is probably due to a founder-effect, by haplotyping affected members of the four pedigrees for GCK1 and GCK2. Chapters 8 and 9 use restriction fragment length polymorphism (RFLP) analysis to detect specific mutations known to create, or remove a cutting site for a restriction endonuclease. Chapter 8 investigates the contribution of the mitochondrial transfer RNA (tRNALeu(UUR) mutation at position 3243bp to Type 2 diabetes. Chapter 9 studies a mutation in the glucagon receptor and its possible susceptibility to Type 2 diabetes. Chapter 10 concludes the dissertation and outlines future areas for investigation.
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Fort, Fachecia L. "Type 2 Diabetes Management for Geriatric Veterans". ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5462.
Testo completoAbstract (sommario):
Managing diabetes in the geriatric long-term care population can be challenging, yet important because diabetes is a chronic, progressive disease. The purpose of this project was to identify clinical practice guidelines for managing Type 2 diabetes in geriatric veterans and to develop a class to educate providers on diabetes management in the geriatric long-term care population at a community living and rehabilitation center. The practice focused question asked if providing education to providers about the clinical practice guidelines for managing Type 2 diabetes in geriatric long-term care veterans would improve knowledge as measured by a pre- and posttest. The project was based on the stage theory of organizational change and focused on the goal of improving diabetes management in the long-term care geriatric population by using clinical practice guidelines. The American Medical Directors Association's and Diabetes Association's updated clinical practice guidelines and systematic review literature on diabetes provided the evidence to support the educational project. A pretest, posttest, and summative evaluation were used to evaluate the project. A paired t test was used to compare the pretest and posttest scores for all participants. Posttest results showed a significant improvement in provider knowledge compared to pretest scores (t = -4.416, df = 12, p < .01). Participant evaluation of the program showed that the goals and objectives were met, content was understandable, and presentation was professional. The findings of the project may be beneficial at the organizational level to promote positive social change by improved management of diabetes in the geriatric long-term care population, thus potentially decreasing unwanted side effects and improving geriatric veteran health.
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Dann, Fiona. "Type 2 diabetes and depression : an exploration into the most effective depression screen to be used in a type 2 diabetes population /". [St. Lucia, Qld.], 2004. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18463.pdf.
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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.
Testo completoAbstract (sommario):
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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Santos, Anabela Gonçalves dos. "Mapeando pés: prevenir lesões nos pés de utentes com diabetes tipo 2". Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2019. http://hdl.handle.net/10400.26/28809.
Testo completoAbstract (sommario):
Mestrado em Enfermagem, Área de especialização: Enfermagem Comunitária e de Saúde PúblicaIntrodução: O défice na gestão da Diabetes Mellitus propicia o aparecimento de complicações tardias. O Pé Diabético é uma das mais frequentes e graves. Objetivo: Capacitar para a promoção do autocuidado das pessoas com Diabetes tipo 2, relativamente ao risco de úlcera de pé diabético. Método: Com base na Metodologia do Planeamento em Saúde, foi desenvolvido um projeto de intervenção comunitária, dirigido a pessoas com diabetes tipo 2. Foi aplicado um questionário aos utentes com diabetes e realizadas sessões de educação para a saúde Resultados: Verificou-se défice de autocuidados e de conhecimentos sobre a boa prática de cuidados a ter com os pés. Após intervenção com as sessões de educação para a saúde, constatamos que foi possível contribuir para a capacitação e promoção do autocuidado .Conclusão: A educação para saúde é uma das estratégias mais eficaz para a capacitação da pessoa com diabetes.
Introduction: The deficit in the management of Diabetes Mellitus leads to the appearance of late complications. The Diabetic Foot is one of the most frequent and severe. Objective: To train for the promotion of self-care of people with Type 2 diabetes, regarding the risk of diabetic foot ulcer. Method: Based on the Health Planning methodology, we developed a community intervention project, aimed at people with type 2 diabetes. Was applied a questionnaire to users with diabetes and conducted education sessions for personal health. Results: was found deficit self-care and knowledge about good practice of foot care. After intervention with education sessions for health, we found that it was possible to contribute to the awareness and promotion of self-care. Conclusion: Education for health is one of the most effective strategies for the awareness of people with diabetes.
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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.
Testo completoAbstract (sommario):
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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Asimakopoulou, Koula Georgia. "Cognitive function in type 2 diabetes : relationship to diabetes self management". Thesis, University of Surrey, 2001. http://epubs.surrey.ac.uk/835/.
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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.
Testo completoAbstract (sommario):
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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Morling, Joanne Rebecca. "The epidemiology of chronic liver disease in older people with type 2 diabetes mellitus : the Edinburgh Type 2 Diabetes Study". Thesis, University of Edinburgh, 2015. http://hdl.handle.net/1842/21101.
Testo completoAbstract (sommario):
Increasingly chronic liver disease is being acknowledged as a complication of type 2 diabetes, in particular non-alcoholic fatty liver and non-alcoholic fatty liver disease. Rates of non-alcoholic fatty liver are higher in people with type 2 diabetes than in the general population, with prevalence rates believed to be between 40-70%. Given the aging Scottish population and the obesity driven diabetes epidemic, the problem of chronic liver disease is likely to increase. Despite this there has been little investigation into the natural history of nonalcoholic fatty liver disease and the risks of clinically significant chronic liver disease in community based cohorts because diagnosis has been heavily reliant on liver biopsy. The use of liver biopsy is limited in both research and clinical practice due to its associated high mortality (1/1000) and morbidity and also due to practical limitations (sampling variability, semi-quantitative scoring systems). As a result the use of non-invasive markers of liver injury (non-specific liver injury, steatosis, steatohepatitis, liver fibrosis and surrogates of advanced portal hypertension) are rising, in the diagnosis of chronic liver disease, however, their utility in both community cohorts and patients with type 2 diabetes has not been widely studied. The aims of the studies presented in the thesis, using the Edinburgh Type 2 Diabetes Study, were: (i) to describe the distributions of a range of non-invasive markers of steatohepatitis and liver fibrosis in older people with type 2 diabetes, their relationship with metabolic and liver disease risk factors, and to compare the agreement of different non-invasive markers of hepatic fibrosis; (ii) to determine the frequency (prevalence and incidence) of and risk factors for clinically significant chronic liver disease in people with type 2 diabetes; and (iii) to determine the importance of chronic liver disease as a risk factor (or risk marker) for cardiovascular mortality or morbidity in type 2 diabetes. Prior to undertaking this work I undertook a detailed systematic review of the literature relating to the use of non-invasive markers of hepatic fibrosis to inform the choice of markers used in the study. Examination of a wide range of potential markers of steatohepatitis and liver fibrosis found varied relationships with diabetes history. Most commonly, elevated markers of steatohepatitis and liver fibrosis were associated with older age and higher body fat measures. However, most of these relationships between liver markers and body fat measures lost statistical significance when limiting the population to only those with hepatic steatosis and/or non-alcoholic fatty liver disease. There were marked differences in the associations between different liver fibrosis markers and potential diabetes and metabolic risk factors, suggesting that these markers are not actually measuring the same underlying “fibrosis” condition. There was poor correlation between the five markers of liver fibrosis studied. Using the top vigintile (5%) of each marker resulted in excellent agreement on the absence of advanced liver disease but poor agreement on the presence of advanced liver disease. The prevalence of clinically significant CLD (defined as cirrhosis, HCC or gastrooesophageal varices) was 2.2% - 0.9% diagnosed prior to enrolment with an additional 1.4% identified by study investigations. Over nearly 6 years of follow-up, only 1.4% of the cohort developed incident clinically significant CLD. Higher levels of systemic inflammation, steatohepatitis and hepatic fibrosis markers were associated with both unknown prevalent and incident clinically significant chronic liver disease. Less than half of participants developing incident significant disease were identified as high risk by the study investigations. Abnormal liver enzymes were statistically significantly associated with incident cases, however the presence of hepatic steatosis was not. There were 372/1033 (36.0%) patients with prevalent CVD and 319 (30.9%) with prevalent CAD at baseline. After mean follow-up of 4.4 years there were 44/663 incident CVD events, including 27 CAD events. There were 30/82 CVD related deaths. However, risk of dying from or developing CVD was no higher in subjects with steatosis than in those without. There was also no statistically significant relationship between CVD and steatohepatitis or liver fibrosis. The only statistically significant relationship between CVD and any liver markers was with GGT (prevalent CVD, OR 1.28, p=0.007; incident CAD, OR 2.35, p=0.042), suggesting that in our study population, CLD may have little effect on the development of, or mortality from, CVD. In conclusion, the potential for using non-invasive biomarkers to diagnose clinically significant chronic liver disease in type 2 diabetes remains limited, however chronic liver disease is a significant problem in older people with type 2 diabetes and is frequently undiagnosed.
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White, Kathryn Elizabeth. "Glomerular structure and function in type 1 and type 2 diabetes". Thesis, University of Newcastle Upon Tyne, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.394642.
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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.
Testo completoAbstract (sommario):
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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Macrodimitris, Sophia D. "Coping, control, and adjustment in type 2 diabetes". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ39211.pdf.
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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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Cook, Joanne. "Genetic and environmental contributions to type 2 diabetes". Thesis, University of Oxford, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.306218.
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Balasubramanian, Ravikumar. "Postprandial metabolism in health and type 2 diabetes". Thesis, University of Newcastle Upon Tyne, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.500958.
Testo completoAbstract (sommario):
hisulin resistance is a characteristic halhnark of type 2 diabetes and contributes to impaked glucose disposal and utilization in insulin-sensitive tissues (liver, skeletal muscle and fat) and inadequate suppression of postprandial hyperglycaemia. Elevated hepatic and intramuscular triglyceride (TG) content in type 2 diabetes has been postulated to underpin the insulin resistance seen in each of these issues. The reasons for this increased tissue TG content is poorly understood. Reduction in liver TG content with weight loss normalizes basal rates of EGP. Likewise peroxisome proliferator activated receptor-7 agonists (PPAR-y) and peroxisome proliferator activated receptor-a agonists (PPAR-a) also decrease liver TG content, but their effects on EGP is unclear. A mutation in PPP1R3A, the gene encoding muscle-specific glycogen-regulating subunit, a key regulator of muscle glycogen metabolism has recently been reported. The physiological implication of this genetic variant on human muscle glycogen metabolism is unknown.
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Mathur, Aditi. "Genetic associaton between schizophrenia & type-2 diabetes". Thesis, University of Aberdeen, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.542850.
Testo completoAbstract (sommario):
Methods: In a genetic association study, 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 (1μg/ml and 2μg/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 (χ2=4.19, p= 0.041) and rs10798059 in the PLA2G4A locus (χ2=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 (χ2=6.28, p=0.012) and at rs11847866 (χ2=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 (χ2= 10.18, df= 4, p=0.037), of which the T-G-A haplotype was excessively transmitted (χ2=6.93, p=0.008) and his 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 1μg/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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Zhou, Huali, e 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.
Testo completo
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Hull, Rebecca L. "Pro-islet amyloid polypeptide and type 2 diabetes". Thesis, University of Nottingham, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.285837.
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