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- Title
- ASSOCIATIONS BETWEEN LOW-CARBOHYDRATE DIET SCORE AND PROGNOSTIC FACTORS AMONG ADULTS WITH DIABETES MELLITUS: AN ANALYSIS OF THE NHANES 2005-2016.
- Creator
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Charles, Elta N, Lee, Eunkyung, University of Central Florida
- Abstract / Description
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Background: Type 2 diabetes mellitus is one of the leading chronic diseases affecting Americans. There is a lack of literature discussing the link between diet and prognosis of those already diagnosed with DM. Objective: To provide insight into which diet is better for the outlook of diabetes mellitus by examining the associations between the low-carbohydrate diet (LCD) score and three diabetes-related health indicators: blood hemoglobin (HbA1c), triglycerides, and retinopathy. Methods: A...
Show moreBackground: Type 2 diabetes mellitus is one of the leading chronic diseases affecting Americans. There is a lack of literature discussing the link between diet and prognosis of those already diagnosed with DM. Objective: To provide insight into which diet is better for the outlook of diabetes mellitus by examining the associations between the low-carbohydrate diet (LCD) score and three diabetes-related health indicators: blood hemoglobin (HbA1c), triglycerides, and retinopathy. Methods: A total of 3,313 U.S. adults with DM were selected from the National Health and Nutrition Examination Survey 2005-2016. Presence of retinopathy was ascertained through self-reporting. Dietary intake was measured with 24- hour dietary recalls, and LCD scores were calculated from the proportion of energy of three macronutrients. Scores ranged from 0-30, with a higher score indicating lower carbohydrate intake. Results: There was no significant difference in HbA1c levels between the highest and the lowest quintile of LCD score (mean = 7.42% [95% CI: 7.23, 7.61] vs. 7.32% [95% CI: 7.13, 7.51]). There was no significant association between blood triglyceride levels and LCD score, comparing quintile 1 to quintile 5 (mean= 168.64 mg/dl; 95% CI = [150.14, 187.14] vs. mean= 162.44 mg/dl; 95% CI = [143.76, 181.11]). In multivariable logistic regression analysis, the odds ratio of having retinopathy comparing the highest to the lowest quintile was 1.01 (95% CI: 0.59, 1.72). Conclusion: Proportion of carbohydrate in diet was not associated with DM prognosis factors. Future studies should focus on carbohydrate quality as well as quantity.
Show less - Date Issued
- 2019
- Identifier
- CFH2000476, ucf:45834
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH2000476
- Title
- Diabetes Phenotypes in Transgenic Pancreatic Cancer Mouse Models.
- Creator
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Albury, Toya, Altomare, Deborah, Zhao, Jihe, Masternak, Michal, Khaled, Annette, University of Central Florida
- Abstract / Description
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Protein Kinase B/AKT, a serine/threonine kinase with three isoforms (AKT1-3), is downstream of phosphatidylinositol 3-kinase (PI3K), and signals through the phosphorylation and subsequent activation or inhibition of downstream substrates, such as mammalian target of rapamycin complex 1 (mTORC1) or glycogen synthase kinase 3 beta (GSK-3?), respectively. The AKT1 isoform is predominantly recognized for regulation of cell survival, growth, and proliferation, due to its constitutive activation in...
Show moreProtein Kinase B/AKT, a serine/threonine kinase with three isoforms (AKT1-3), is downstream of phosphatidylinositol 3-kinase (PI3K), and signals through the phosphorylation and subsequent activation or inhibition of downstream substrates, such as mammalian target of rapamycin complex 1 (mTORC1) or glycogen synthase kinase 3 beta (GSK-3?), respectively. The AKT1 isoform is predominantly recognized for regulation of cell survival, growth, and proliferation, due to its constitutive activation in pancreatic cancers (e.g., islet cell carcinoma and pancreatic adenocarcinoma). The progression of pancreatic ductal adenocarcinoma (PDAC), the most lethal common cancer, is initiated by activation mutations of the KRas oncogene. This leads to additional molecular changes, such as activation of the AKT1 oncogene, which drives PDAC progression and tumor formation. By mating transgenic mice with activation of KRas (Pdx- Cre;LSL-KRasG12D) and mice with activation of AKT1 (Pdx- Tta;TetO-MyrAKT1) we were able to produce mice with two activated oncogenes (AKT1Myr/KRasG12D) for comparative studies. Kaplan-Meier survival curves, histology, and genomic/proteomic analysis were used to characterize the incidence and frequency of histological (e.g. presence of mucin-4 in pancreatic intraepithelial neoplasms) and genetic (e.g. loss of tumor suppressors p16Ink4a and p19Arf) alterations known to commonly occur in human pancreatic cancer, as well as delineate the role of AKT1 in accelerating pancreatic tumor progression and metastasis. We determined that AKT1Myr/KRasG12D mice, unlike other PDAC mouse models, accurately mimic the human PDAC progression molecularly, structurally, and temporally. Interestingly, the AKT1Myr and AKT1Myr/KRasG12D models both exhibit a pre-tumor, diabetic phenotype. While, AKT1 hyperactivation in various cancers has been thoroughly studied, its role in glucose metabolism has been noted, but comparatively overlooked. As early as the 1900s a relationship between diabetes and pancreatic cancer has been proposed. With 80% of PDAC patients suffering from hyperglycemia or diabetes prior to diagnosis, one prevailing theory is that new onset diabetes is an early marker for pancreatic cancer. This is also supported by experimental and clinical studies, such as the resolution of diabetes with tumor removal and the induction of hyperglycemia with the implantation of cancer cell lines. To better understand the role of AKT1 and its hyperactivation in glucose metabolism, AKT1Myr mice were characterized via metabolic (e.g. glucose/insulin tolerance test) and histological (e.g. immunohistochemistry) studies. Beginning at weaning, 3 weeks of age, the glucose intolerant AKT1Myr mice exhibited non-fasted hyperglycemia, which progressed to fasted hyperglycemia by 5 months of age. The glucose intolerance was attributed to a fasted hyperglucagonemia, and hepatic insulin resistance detectable by reduced phosphorylation of the insulin receptor following insulin injection into the inferior vena cava. Additionally, AKT1Myr/KRasG12D mice currently being studied, appear to display a more severe diabetic phenotype, with fasted hyperglycemia noticeable at an earlier age, fasted hyperglucagonemia, polyuria, muscle wasting, and bloating. Treatment of both models with doxycycline diet, to turn-off the transgene, caused attenuation of the non-fasted and fasted hyperglycemia, thus affirming AKT1 hyperactivation as the trigger. These newly revealed roles of AKT1, along with future studies of these mouse models, will better delineate the molecular mechanisms responsible for the individual and joint roles of AKT1 and KRas in pancreatic cancer oncogenesis, the initiation of cancer associated diabetes, and the association of these two diseases.
Show less - Date Issued
- 2015
- Identifier
- CFE0006245, ucf:51081
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0006245
- Title
- COMPARATIVE DIFFERENCES BETWEEN TRADITIONAL CHINESE MEDICINE AND WESTERN MEDICINE IN TREATING TYPE II DIABETES MELLITUS.
- Creator
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Morales, Neley, Webster, Danielle, University of Central Florida
- Abstract / Description
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In the United States alone, there were 25.8 million people suffering from diabetes in 2010. The prevalence of diabetes is expected to markedly increase worldwide over the next 30 years, an estimated 2.8% in 2000 and 4.4% in 2030. For individuals diagnosed with type 2 diabetes mellitus (T2DM), treatment is essential to control adverse effects such as hypertension and diabetic neuropathy. The focus of this study is to examine various approaches to maintain and improve the lifestyle of...
Show moreIn the United States alone, there were 25.8 million people suffering from diabetes in 2010. The prevalence of diabetes is expected to markedly increase worldwide over the next 30 years, an estimated 2.8% in 2000 and 4.4% in 2030. For individuals diagnosed with type 2 diabetes mellitus (T2DM), treatment is essential to control adverse effects such as hypertension and diabetic neuropathy. The focus of this study is to examine various approaches to maintain and improve the lifestyle of individuals suffering from T2DM. A comparative approach has been used to evaluate the differences in the treatment of T2DM with the use of traditional Chinese medicine (TCM) and Western medicine. In Western society, pharmaceuticals are commonly used as a treatment method to manage hyperglycemia, along with life-style modifications. Furthermore, TCM views the human body and its functioning in a holistic way, stating that no single body part or symptom can be understood apart from its relation to a whole. Herbal medications and other treatments in TCM are targeted to treat underlying medical complaints that resulted in symptoms, instead of treating one specific manifestation. Data collection has been gathered through Qualitative over the phone interviews with patients suffering from T2DM, as well as TCM physicians. Interviews were conducted on patients that were diagnosed with T2DM (fasting plasma glucose levels of 126 or greater and HbAlc levels >8%), and had continued treatment longer than three months prior to interviews. Collection of chart notes containing glucose levels, levels of pain, lifestyle changes, and vital signs were also used. A total of 21 patients from a family practice were interviewed, answering 21 constructed questions based on treatment of choice (TCM or Western) and their personal input on treatment satisfaction. Patients varied in age, ethnicities, and gender, ranging from 39-70 years of age. Two traditional Chinese medicine physicians were also interviewed. Interviews with TCM physicians elaborated on course of treatment and steps taken to diagnose T2DM. Furthermore, prescription medications were also charted and documented to further analyze with secondary data. Upon completing the interviews, the data stated 21 patients (total population questioned) had not experienced alternative medicine and were exposed only to western medicine as treatment. A major concern for most patients were the pharmaceutical side effects, and 85.1% of patients stated they would be interested in an alternative treatment. Due to insufficient sources and knowledge on TCM treatment, 14.2% of patients stated they were satisfied with their western medicine treatment of choice and would not change treatment. The research's objective was to evaluate the differences in treatment of T2DM. Data collected supported the objective and showed the lack of sources to alternative treatments aside from western medicine. The researcher informed and educated interviewees about literature review on traditional Chinese medicine about alternative treatments available to treat T2DM.
Show less - Date Issued
- 2014
- Identifier
- CFH0004570, ucf:45170
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH0004570
- Title
- IDENTIFICATION OF THE EFFECTS OF DIABETES MELLITUS ON THE BRAIN.
- Creator
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Mikhail, Tryphina A, Samsam, Mohtashem, University of Central Florida
- Abstract / Description
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As more studies accumulate on the impact of diabetes mellitus on the central nervous system, they resound with the same conclusion - diabetes has a detrimental effect on cognition regardless of the presence of comorbidities. Less consistent however, are the specific mental processes wherein these declines are noticeable, and the structural changes that accompany these reductions in mental capacity. From global atrophy to changes in the volume of gray and white matter, to conflicting results...
Show moreAs more studies accumulate on the impact of diabetes mellitus on the central nervous system, they resound with the same conclusion - diabetes has a detrimental effect on cognition regardless of the presence of comorbidities. Less consistent however, are the specific mental processes wherein these declines are noticeable, and the structural changes that accompany these reductions in mental capacity. From global atrophy to changes in the volume of gray and white matter, to conflicting results regarding the effects of hypo- and hyperglycemic states on the development of the hippocampus, the studies display a variety of results. The goal of this research is to link the structural and compositional changes occurring in the diabetic brain with the clinical and behavioral findings highlighted in the literature, as well as to explore the potential mechanisms behind the pathologic brain state of diabetic encephalopathy. Using diabetic (OVE26) and non-diabetic wild type (FVB) mice as models, differences in the number of hippocampal neurons in the dentate gyrus, and cornu ammonis areas 1,2, and 3 were investigated through Nissl staining. Neurodegeneration was confirmed in those cells determined to be hyperchromatic in the diabetic model through staining with Fluoro-Jade C. Finally, the presence of progenitor cells in the hippocampus was compared in the diabetic and non-diabetic models using Musashi-1 antibodies, to determine whether neurogenesis in these areas is affected by diabetes. These experiments were performed to better understand the effect of DM on learning and memory, and could potentially explain the linkage between diabetes mellitus and the increased prevalence of Alzheimer�s disease, vascular dementia, and depression in this subset of the population.
Show less - Date Issued
- 2016
- Identifier
- CFH2000021, ucf:45601
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH2000021
- Title
- HEALTH-CARE SEEKING BEHAVIORS OF PUERTO RICANS WITH DIABETES MELLITUS WHO LIVE IN SOUTH FLORIDA: AN EXPLORATORY STUDY.
- Creator
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Gonzalez, Laura, Bushy, Angeline, University of Central Florida
- Abstract / Description
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ABSTRACT Latinos are the fastest growing minority population in the United States (U.S.) and have the worst access to health care of any ethnic group. The chronic disease of diabetes is twice as common in adult Latinos as in non-Latino whites, and the risk of death related to diabetes is twofold. Reasons for this disparity have yet to be clearly identified. This study had two purposes: 1) to explore cultural beliefs regarding health-care seeking behaviors in Puerto Ricans with diabetes who...
Show moreABSTRACT Latinos are the fastest growing minority population in the United States (U.S.) and have the worst access to health care of any ethnic group. The chronic disease of diabetes is twice as common in adult Latinos as in non-Latino whites, and the risk of death related to diabetes is twofold. Reasons for this disparity have yet to be clearly identified. This study had two purposes: 1) to explore cultural beliefs regarding health-care seeking behaviors in Puerto Ricans with diabetes who live in South Florida; and 2) to examine Puerto Ricans' perceptions about their health-care providers. The cultural phenomena of interest were familism, religiosity, spirituality, use of ethnomedicine, and perception of ethnic concordance of health-care provider. Numerous studies have examined these phenomena with other Latino groups, but none have specifically focused on Puerto Ricans. An overarching goal of the study was to contribute to the knowledge base on a particular health disparity--diabetes. Using a narrative inquiry approach, a purposive sample of self-identified Puerto Ricans with diabetes (N = 12) were recruited from six sites in a South Florida city. Data were obtained using a pencil-and-paper demographic instrument, the Short Acculturation Scale to determine language preference of Spanish or English, and a personal interview using a semi-structured, ten-item interview guide. Subjects gave written informed consent for participation, and all data were coded to ensure confidentiality. The personal interviews were tape recorded and transcribed verbatim. Interviews completed in Spanish were translated to English and transcribed. Using content analyses techniques, transcribed narratives were analyzed for content and thematic emergence. iii The findings revealed that familism was an important consideration in health-care seeking behaviors. Traditional gender role expectations, coupled with caregiver burdens, deterred some participants from seeking care even when care was needed. Religiosity and spirituality did not influence decision-making but did have a role in coping with the chronic disease. While participants were aware of culturally based ethnomedicine, they preferred Western medicine for the treatment of their diabetes. They also had a preference for a health-care provider who was ethnically concordant. Serendipitous findings that emerged in the analyses included the casual attitude of several participants about their diabetic status and reports of depressive-like symptoms among most of the women. Health-care providers need to take into consideration the cultural and linguistic preferences of Puerto Ricans to develop an appropriate and effective treatment plan. Discrepancies between the health-care providers and the clients' systems must be reconciled to improve adherence to evidence-based treatment.
Show less - Date Issued
- 2008
- Identifier
- CFE0002018, ucf:47631
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0002018
- Title
- SUPPORT SYSTEMS IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS AND THE RELATIONSHIP TO DIABETES-RELATED STRESS, CONFLICT, AND METABOLIC CONTROL.
- Creator
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Foarde, Samuel, LaManna, Jacqueline, University of Central Florida
- Abstract / Description
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The purpose of this integrated review of the literature was to explore the effects of social support on diabetes-related stress, conflict, and metabolic control in adolescents with type 1 diabetes mellitus (T1DM). Social support was examined in four subgroups: adolescents with T1DM, family caregivers, peers, and teachers. Relevant findings in the literature revealed a significant deficiency of research devoted to adolescent males with diabetes as well as fathers as primary and secondary...
Show moreThe purpose of this integrated review of the literature was to explore the effects of social support on diabetes-related stress, conflict, and metabolic control in adolescents with type 1 diabetes mellitus (T1DM). Social support was examined in four subgroups: adolescents with T1DM, family caregivers, peers, and teachers. Relevant findings in the literature revealed a significant deficiency of research devoted to adolescent males with diabetes as well as fathers as primary and secondary caregivers. Studies highlighted the importance of fostering autonomy and positive self-image in adolescents with T1DM and described effective interventions to improve diabetes-related stress, reduce disease-related conflict, and improve metabolic control. Findings suggested that nurses caring for adolescents with T1DM and their families should foster positive, open communication, while identifying barriers to problem solving, coping, stress, and optimal glycemic control. Interventions that educate caregivers and peers on how to better communicate and provide support are critical in fostering positive psychological and physiological outcomes in the adolescent with T1DM. The findings of this study may provide guidance in the way that nurses assess, identify, and counsel adolescents with TIDM regarding their disease management and access to support systems.
Show less - Date Issued
- 2013
- Identifier
- CFH0004324, ucf:45057
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH0004324
