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Elton, Caroline Sarah. "Psychological aspects of pregnancy amongst women with insulin-dependent diabetes mellitus." Thesis, University College London (University of London), 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.265018.
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This study investigated emotional adjustment and regimen adherence of pregnant women \\ith insulin-dependent diabetes mellitus (lDDM). 40 pregnant women with IDDM (P/D group), 35 pregnant non-diabetic women (PIN-D group) and 25 non-pregnant women who had IDDM (NP/ D group) were interviewed in their homes. Both of the diabetic groups self-monitored their regimen adherence in the week following the interview. All PID and PIN-D interviews took place in the second trimester of pregnancy. Pregnancy was associated with significant shifts in blood glucose testing behaviour but only minor shifts in dietary behaviour. The two diabetic groups also differed in the factors that predicted blood glucose testing. Health beliefs and attitudes to the disease did not alter dramatically during pregnancy. The 2 pregnant groups did not differ in terms of physical symptoms of pregnancy or in rates of hospitalization. The PID group did not report higher levels of health anxieties and they were optimistic about the prognosis for the pregnancy. No group differences were found in psychological attachment to the foetus. Within both pregnant groups attachment to the foetus was found to be unrelated to feelings about the state of pregnancy. The three groups did not differ in current levels of depressed mood but the N-P/D group had experienced a significantly higher rate of previous emotional problems. The generally favourable psychological adjustment of the PIO women was attributed to changes in the medical management of diabetic pregnancy and the improved prognosis for both mother and baby. The suggestion is also made that that the PIO women may have differed in their tolerance of physical symptoms of pregnancy. The limitations of the current study and suggestions for future research are discussed.
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Scheibmeir, Monica Sue 1957. "THE QUALITY OF LIFE OF INDIVIDUALS WITH INSULIN DEPENDENT DIABETES MELLITUS." Thesis, The University of Arizona, 1986. http://hdl.handle.net/10150/276404.
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Belfer, Bonnee. "Factors associated with diet behaviour among individuals with type 2 diabetes mellitus attending an outpatient clinic." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=80224.
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Diet recommendations to achieve target metabolic control for prevention of micro and macrovascular complications have been outlined. Although previous studies in individuals with type 2 diabetes have identified certain factors associated with adherence to diet recommendations, adherence is multi-factorial in nature and includes demographic, biological and psychosocial variables. Our main objective was to identify factors associated With dietary behaviour among individuals with type 2 diabetes attending an out-patient clinic. Furthermore, we attempted to identify factors associated with frequency of seeing the dietitian and stages of change far lower fat intake. Principal hypothesis: those who are younger, female, lower in body mass index (BMI), higher in education level, exposed to a dietitian in the past year, higher in stage of change, having greater nutrition knowledge, greater perception of risk and benefits as well as fewer perceived barriers, would consume less total and saturated fat. (Abstract shortened by UMI.)
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Tong, Choi-ying, and 唐彩瑩. "An empowerment model for mothers with diabetes mellitus children in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1995. http://hub.hku.hk/bib/B31212682.
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Esparza, Annabelle Lucia Sandoval. "The relationship between self-esteem and glycemic control in 13-17 year old adolescent girls with type 1 diabetes mellitus." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2739.
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The purpose of this study was to explore the psychosocial phenomena of self-esteem in relation to gucose control in diabetic adolescent girls living in the Inland Empire. Three central themes emerged: body image, peer acceptance, and stress.
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David, Onyekachi P. "Ethnic and gender differences in the relationship between psychological, socio-cognitive and socio-demographic variables in people with diabetes mellitus in Nigeria." Thesis, University of Gloucestershire, 2017. http://eprints.glos.ac.uk/4678/.
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Background: Diabetes is a growing public health problem affecting people worldwide both in the developed and developing countries, and poses a major socio-economic, psychological and Behavioral challenge. Consequently, diabetes takes a staggering toll on the people in Nigeria and the economic burden is very high. It is a well known fact that numerous factors influence diabetes self-care: such as patient’s physical, psychological, social, cognitive and health care system factors. In this study, the researcher set out to elicit an understanding of the association between socio-demographic, socio-cognitive, and psychological health and to specifically provide explanations for how these three factors are related and differ across ethnicity, gender and type of diabetes. Conversely, studies investigating the psychological health in people with diabetes have observed disparities in terms of gender, ethnicity and the type of diabetes. More so, the impact of socio-cognitive health indicators on psychological status in the Nigerian context remains invisible and unknown. Additional investigations were carried out to assess the pattern of the psychological health of diabetic patients using socio-demographic and socio-cognitive factors, to identify if differences occur in the psychological and socio-cognitive factors by gender, ethnicity and type of diabetes. Finally, an exploration of the contextual and explanatory factors perceived to have underlain the gender ethnicity and type of diabetes differences observed in the psychological status and socio- cognitive health was carried out. Methods: A sequential explanatory mixed methods design comprising a quantitative phase followed by a qualitative phase was employed. In the quantitative phase general survey, data from the N= 486 participants were analysed to test for significant differences of ethnic groups, gender, type of diabetes and the relationship they all have on psychological status and socio-cognitive health. The qualitative phase on the other hand, was based on a follow up of the significant results by using semi-structured focus group interviews with 18 recruited respondents across gender, ethnic groups and type of diabetes. Findings: A 2x4x2 MANOVA hypotheses: 2 and 3 from the quantitative study showed a significant interaction between gender, ethnicity and type of diabetes; ethnicity and type of diabetes; gender and type of diabetes; gender and ethnicity. From the partial eta squared 2 , type of diabetes explains more of the variance remaining (after excluding the variance attributable to other variables) (21.4% vs 20.1%); than gender (21.1% vs 13.3%); which, in turn, explains more of the variance than ethnicity (5.6% vs 6.5%) on the combined DVs Psychological and Socio-cognitive health respectively. The qualitative results revealed extreme and overwhelmingchallenges diabetes imposed on the sufferers. It provided specific insight and on patients contextual experiences such as non-adherence; concerns about the present and the future’ health care systems and the way medical practitioners interact with patients which negatively impact on psychological status. These factors broadened the quantitative result in terms of the consistence in the patients’ descriptions of living with and self-managing their diabetes. Conclusions: The outcome of the t study has extended knowledge on the complex and dynamic nature of individuals’ responses to the challenges of diabetes in day-to-day self-care management and how best diabetic patients should be supported in order to promote adherence, positive treatment processes, provide assistance to the physical discomfort associated with diabetes, and support pro-diabetes coping behaviors (diet), through psychotherapy so as to enhance optimal psycho-behavioral health.
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Viviani, Juliana Caseiro. "Caracterização psicossocial de gestantes diabéticas em acompanhamento pré-natal em hospital terciário." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/59/59137/tde-07102013-105215/.
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A gestação é um período marcado por diversas transformações na vida da mulher e envolve aspectos sociais, biológicos, conjugais e psicológicos. No entanto, a maneira como cada gestante reage varia de acordo com as circunstâncias em que ocorreu a gravidez. Todos esses fatores são agravados na gestação de risco. O suporte social tem sido considerado como importante fator de proteção às adversidades desse período. Avaliar e considerar aspectos sociais e psicológicos se destaca como uma forma de contribuir para a melhoria da qualidade de vida da gestante. O objetivo deste estudo foi realizar uma caracterização psicossocial de 66 gestantes de alto risco, diabéticas em acompanhamento pré-natal, quanto aos aspectos sociodemográficos e psicológicos e buscar possíveis associações estatísticas entre tais aspectos. Quanto aos aspectos psicológicos, foram avaliados níveis de ansiedade, depressão, estresse e suporte social referido. Como resultados, pode-se constatar que 57,57% das pacientes avaliadas tinham idade entre 26 e 35 anos, 60,60% tinham de nove a onze anos de estudo e 92,42% tinham um companheiro. Dentre as pacientes, 4,55% tinham diabetes mellitus tipo 1, 33,33% tinham diabetes mellitus tipo 2 e 62,12% tinham diabetes mellitus gestacional. As pacientes avaliaram sua gravidez como planejada em 51,51% da amostra. Com relação a aspectos psicológicos, 36,36% das pacientes apresentaram sintomas significativos de ansiedade e depressão e a média da pontuação para o estresse foi de 24,24, em uma escala de até 56 pontos. Na amostra, 48,48% das pacientes referiram ter atividades de lazer em sua rotina e 93,94% apresentam uma boa percepção do apoio familiar. Foram encontradas associações entre número de gestações e depressão, sendo que dentre as pacientes que apresentaram sintomas depressivos, 50% delas estavam na segunda gestação. Não foram encontradas associações estatísticas entre idade, nível socioeconômico, escolaridade, planejamento da gravidez com sintomas de ansiedade e depressão. Pacientes que apresentaram maiores níveis de ansiedade e depressão apresentaram mais sintomas de estresse e menores níveis de suporte social. Ampliar o conhecimento sobre variáveis psicológicas no ciclo gravídico-puerperal possibilitará a estruturação de intervenções psicológicas específicas a este período tão particular.<br>Pregnancy is a period marked by several changes in women\'s lives and involves social, biological, psychological and marital aspects. However, the way each woman reacts varies according to the circumstances in which the pregnancy occurred. All these factors are worsen in high-risk pregnancies. Social support has been considered an important protective factor for the adversities of that period. Evaluating and considering social and psychological aspects stand out as a way to contribute to the improvement of the pregnant womans quality of life. The aim of this study was to make a psychosocial characterization of 66 high-risk diabetic pregnant women, in prenatal care, in terms of socio-demographic and psychological aspects, and search for possible statistical associations between these aspects. Concerning psychological aspects, levels of anxiety, depression, stress and related social support were evaluated. In the results, it can be seen that 57.57% of the patients evaluated were aged between 26 and 35 years, 60.60% had between nine to eleven years of study and 92.42% had a partner. Among the patients, 4.55% had diabetes mellitus type 1, 33.33% had diabetes mellitus type 2 and 62.12% had gestational diabetes mellitus. The patients rated their pregnancy as planned in 51.51% of the sample. Regarding psychological aspects, 36.36% of the patients had significant symptoms of anxiety and depression and the average score for stress was 24.24 out of a 56 points scale. In the sample, 48.48% of the patients reported having leisure activities routine and 93.94% have a good perception of family support. It was found associations between number of pregnancies and depression, whereas among patients with depressive symptoms, 50% were in their second pregnancy. There were no statistical associations between age, socioeconomic status, education and pregnancy planning with symptoms of anxiety and depression. Patients who had higher levels of anxiety and depression showed more symptoms of stress and lower levels of social support. Increasing the knowledge of psychological variables in pregnancy and childbirth will enable the structuring of specific psychological interventions to such a particular period.
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Gross, Carolina Campos. "Aspectos psicológicos e suas repercussões no controle metabólico e nas complicações crônicas em pacientes com diabetes melito tipo 1 e tipo 2." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2008. http://hdl.handle.net/10183/15372.
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Diabetes Melito (DM) é uma condição crônica que demanda uma série de cuidados médicos contínuos, cujos tratamentos requerem uma ação colaborativa entre o paciente, a família e a equipe de saúde. A importância dos aspectos psicológicos no cuidado do DM vem sendo discutida em muitos estudos. Desenvolver habilidades de enfrentamento, de auto-cuidado, e de atitude frente ao tratamento são características desejadas para pacientes que desejem viver bem com o DM. Evidências recentes sugerem que pacientes com diabetes tipo 1 e tipo 2 apresentam freqüentemente alterações do comportamento psicológico que podem afetar o seu tratamento. Problemas psicológicos e sociais podem prejudicar a habilidade individual de desempenhar as tarefas referentes ao tratamento, comprometendo o acompanhamento médico, o controle metabólico e conseqüentemente a qualidade de vida. A atenção aos aspectos psicossociais deve ser constante por parte da equipe de saúde. A avaliação da percepção do paciente a respeito do DM pode ser realizada através de questionários específicos. Em conclusão, existe uma necessidade urgente de encontrar novas técnicas para diminuir o impacto econômico e pessoal desta doença crônica e progressiva, através de estratégias eficazes de prevenção, detecção e tratamento. A partir de uma perspectiva onde o foco seja a pessoa, e não a doença, é importante investigar as barreiras emocionais e comportamentais ao efetivo tratamento da doença e sua relação com o controle glicêmico.<br>Diabetes Mellitus (DM) is a chronic condition that demands a continuous series of medical interventions, and whose treatment calls for a collaborative action between the patient, family and the health team. The importance of the psychological aspects in the care of DM has been discussed in many studies. Developing coping skills of self-care and attitude in face of the treatment is a required aim for patients who want to live well with DM. Recent evidence suggests that type 1 and type 2 diabetic patients frequently have psychological and behavioral changes that can directly affect treatment Psychological and social problems can impact the individual’s skill in fulfilling the tasks related to the treatment, affecting the medical follow-up, metabolic control, and consequently the quality of life. The attention to the psychosocial aspects must be continuously sought by the health team. The assessment of the patient’s perception of DM must be carried out through specific questionnaires. In conclusion, there is an urgent necessity of finding new techniques to reduce the economical and personal impact of this chronic and progressive disease, through efficient strategies of prevention, detection and treatment. From a perspective where the focus is the person, and not the disease, it is important to access the emotional and behavioral barriers to the effective treatment of the disease and their relation with glycaemic control.
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Gillespie, Christopher R. "Psychological variables in the self-regulation of diabetes mellitus." Thesis, University of Sheffield, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310882.
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Jackson, Clare. "Psychological adjustment of siblings to insulin dependent diabetes mellitus." Thesis, University of Oxford, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.275185.
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Moles, Kenneth William. "Aspects of the exocrine pancreas in diabetes mellitus." Thesis, Queen's University Belfast, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.356867.
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Blades, Mabel. "Aspects of the dietetic management of diabetes mellitus." Thesis, University of Surrey, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301111.
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Karlson, Björn. "Psychological and medical well-being and their relation in adults with insulin-dependent diabetes mellitus." Stockholm : Almqvist & Wiksell International, 1997. http://catalog.hathitrust.org/api/volumes/oclc/37330660.html.
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Henriksson, Freddie. "Economic aspects of chronic diseases : multiple sclerosis and diabetes mellitus /." Stockholm, 2001. http://diss.kib.ki.se/2001/91-628-5023-7/.
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Lucassen, Anneke M. "Molecular genetic aspects of susceptibility to Type 1 diabetes mellitus." Thesis, University of Oxford, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.259885.
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Trinick, Thomas Richard. "Pathophysiological aspects of diet in diabetes mellitus and normal man." Thesis, Queen's University Belfast, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.336194.
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Watson, Joanne Marie. "The effects of caffeine ingestion on the physiological and psychological responses to hypoglycaemia." Thesis, University of Southampton, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.390715.
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Liang, Ying, and 梁颖. "Association of diabetes mellitus and dioxins exposure : a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193792.
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Objective: To review in the literature on the association between diabetes and background exposure of dioxins among general population.
Method: Systematic review on studies the association of background dioxin exposure and diabetes among general population, published from January 1960 to July 2013 in PubMed, and from January 1979 to July 2013 in China National Knowledge Infrastructure (CNKI).
Result: A total of nine articles (including seven cross-sectional studies, one longitudinal study and one cohort study) out of 111 articles from PubMed and 5 articles from CNKI were included in the systematic review. Five out of nine studies found a positive association between background exposure to dioxins or dioxins-like compounds and the risk of diabetes whilst two studies reported an inverse association between dioxins and insulin concentrations or IGF-I serum levels. Two studies reported positive significant relation of dioxins and diabetes in women but not in men.
Discussion: Based on this systematic review, the association of background dioxins exposure and diabetes among general population remains unclear. Given the crosssection design of the studies, causal relation between dioxin exposure and diabetic risks cannot be drawn.<br>published_or_final_version<br>Public Health<br>Master<br>Master of Public Health
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McKenzie, Claire Sheila. "Online support for psychological wellbeing in adults with type 2 diabetes mellitus." Thesis, University of Bristol, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.683727.
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Introduction People with Type 2 diabetes mellitus are at an increased risk of developing depressive symptoms compared with those without the condition. Diabetes-related distress is commonly experienced and associated with the perceived burdens of self-management and fear of future complications. Psychological difficulties in Type 2 diabetes often go unrecognised by both patients and practitioners. This project used a mixed methods approach to explore the psychological needs of adults with Type 2 diabetes and involved them in the design and feasibility testing of a support web site to promote psychological wellbeing. Methods Phases 1 and 2 of the project consisted of ten patient interviews using an Interpretative Phenomenological Analysis (IPA) approach, three focus groups and a Design Workshop. Patient collaboration using Participatory Design methods was integral to the development of the intervention website. Phase 3 was a randomised controlled feasibility study assessing study procedures, process measures and the appropriateness of outcome measures. Results A complex relationship emerged between participants' objective physical body and how they subjectively experienced it. Mood regulation was often unconsciously prioritised over diabetes management or diabetes-management over mood regulation. Peer-to-peer communication and the anonymity of an Internet platform were felt to be important, particularly by men in the sample. Consent to participate was low in the feasibility study. Half of the intervention arm attempted registration for the website. Registration was found to be too long. All who registered used the website at least once. The main reason given for not registering was that psychological effects of diabetes were not being experienced. Follow-up data was provided by 76% of participants. Conclusion There were substantial barriers to use of an Internet-based intervention for psychological health in the sample. Amendments are required to aspects of the intervention and study design before it can translate to a larger trial.
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Watts, Gerald F. "Practical aspects of screening for and monitoring microalbuminuria in diabetes mellitus." Thesis, University of Southampton, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.316492.
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Martinez, Kelly Marie. "Psychological aspects of living with diabetes, in adolescence and childhood." Thesis, Queen's University Belfast, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.695664.
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Research thesis encompassing two papers: Psychological factors associated with diabetes self-management among adolescents with Type 1 diabetes: a systematic review The purpose of the review was to determine what psychological factors are associated with diabetes self-management. Twenty-one articles were determined to be eligible for this review. Numerous psychological factors were found to be associated with self management; however, correlations were typically small to moderate. Study validity was variable and there was little overlap between psychological factors examined. Variables are presented in a narrative synthesis. The strongest associations were found between social anxiety and diet (among boys); greater intrinsic motivation, conscientiousness and diet; and extraversion and exercise. Evidence exists for relationships between psychological factors and diabetes self-management but due to the individual nature of the studies, firm conclusions cannot be drawn. Future research needs to attempt replication and utilise validated measures to provide a stronger evidence base from which to develop theory for this population. The relationships between diabetes distress, illness perceptions and glycaemic control in adults with Type 2 diabetes This study aimed to investigate whether illness perceptions moderate the relationship between diabetes distress and glycaemic control. Participants with Type 2 DM attending diabetes outpatient clinics (n = 82) completed the Diabetes Distress Scale 17, Brief Illness Perceptions Questionnaire and the Patient Health Questionnaire 9 as well as providing demographic and clinical information. Most recent HbA 1 c and BMI were collected from medical records. Personal Control was the only significant contributor in the final regression model predicting HbA 1 c. The relationship between regimen-related distress and HbA 1 c was mediated by personal control. Moderating effects were non-significant. Personal control has an important role in explaining the link between diabetes distress and HbA 1 c. Psychological interventions seeking to improve HbA 1 c need to address individuals' perceptions of personal control.
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Ingberg, Claes-Mårten. "Type 1 diabetes mellitus: Aspects of long-term complications and body composition." Doctoral thesis, Uppsala University, Department of Medical Sciences, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3287.
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<p>Studies concerning social consequences, gastrointestinal and urinary tract symptoms were conducted in a population-based cohort comprising patients with long-standing type 1 diabetes and matched control persons. Three different questionnaires were sent by mail to diabetic patients and control persons. After a mean duration of 28.7±2.6 years, compared to the controls the diabetic patients showed an almost 10 times higher mortality, a lower employment rate and greater need for welfare benefits. These differences were mainly due to diabetic late complications. Education, housing conditions, life-style, civil state, alcohol and smoking habits were similar in the two groups. The prevalence of gastrointestinal symptoms was significantly higher in the diabetic patients than in the controls, and this was found to be attributable to the female diabetic patients. Female diabetic patients had been treated with antibiotics for urinary tract infections more often than controls, they experienced more social problems than controls in daily life because of urinary tract problems and used clamps to prevent wetting more often than did controls. </p><p>Body composition and bone mineral density were evaluated in parts of the cohort with long-standing type 1 diabetes and control persons in another population-based cohort comprising diabetic females aged 16-19 years with type 1 diabetes since childhood and matched controls. Besides a tendency to reduced abdominal fat mass in diabetic males, no difference was observed in fat mass, muscle mass or bone mineral density between the patients with long-standing type 1 diabetes and controls. Significant correlations were found between insulin dosage and whole body fat mass in diabetic females and between serum cholesterol levels and abdominal fat mass in diabetic males. The female adolescents had a higher body mass index than the controls, and their overweight was shown to consist almost entirely of an increased fat mass. The distribution of fat, expressed as abdominal-to-leg ratio, correlated significantly to HbA1c and daily dosage of insulin. Bone mineral density did not differ between the groups. IGF I was significantly lower both in patients with long-standing type 1 diabetes and in the adolescent diabetic females compared with their matched controls.</p>
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Wiggam, Malcolm Ivan. "Aspects of insulin resistance in essential hypertension and insulin-dependent diabetes mellitus." Thesis, Queen's University Belfast, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.387971.
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Whitelaw, Donald C. "Aspects of insulin secretion and action in non-insulin-dependent diabetes mellitus." Thesis, University of Edinburgh, 1999. http://hdl.handle.net/1842/22738.
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In a cross-sectional survey of coronary risk factors in subjects with recently diagnosed NIDDM I confirm the high prevalence of individual risk factors described by others, and show a broadly normal distribution pattern for the clustering of risk factors forming Reaven's Syndrome X, in contrast to that reported in other populations. I suggest that hyperinsulinaemia and hypertriglyceridaemia are the best markers of high coronary risk and note the association of obesity and other risk factors. In a study to examine the effects of the new oral hypoglycaemic drug A4166 in NIDDM I confirm its major effect as an insulin secretagogue but find limited effects on intermediary metabolism when assessed during and intravenous glucose tolerance test. Any enhancement of glucose clearance appears to be secondary to the increase in insulin secretion. If hypertriglyceridaemia exacerbates insulin resistance in NIDDM, then its treatment may reverse this process. In a randomised study comparing the fibrate drug gemfibrozil with placebo I show that reduction in serum triglyceride concentrations with gemfibrozil is associated with improved insulin sensitivity to non-esterified fatty acid (NEFA) and ketone metabolism but not to glucose metabolism, when assessed using a low-dose incremental insulin infusion technique. In established diabetes (NIDDM) the contribution of body fat to insulin resistance is less clear than among non-diabetic subjects. In a group of NIDDM subjects I show no consistent effects of body fat on insulin resistance using the low-dose incremental insulin infusion, and no relation between body fat indices and euglycaemic clamp measures of insulin sensitivity. From the insulin infusion data I show that fasting glucose concentration has the greatest impact on insulin resistance, suggesting that hyperglycaemia or perhaps glucose toxicity has an effect overwhelming that of other factors. Using the data from the body fat studies described, I compare measures of insulin resistance derived from insulin infusions, euglycamic clamps and homeostatic modelling (HOMA-R) in NIDDM, and discuss uses and limitations of these techniques. In a concluding chapter I attempt to summarise the findings from these studies and draw together a discussion of the results obtained in the context of the existing published literature.
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Forsander, Gun. "Clinical management of children with type I diabetes mellitus : a prospective, randomized psycho-educational intervention trial /." Stockholm, 2000. http://diss.kib.ki.se/2000/91-628-4551-9/.
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Singh, Harsimran. "Psychological aspects of diabetes management in South Asian and white men and women with diabetes." Thesis, Royal Holloway, University of London, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.499053.
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Mutize, Tinashe. "DNA methylation : a risk factor for type 2 diabetes mellitus." Thesis, Cape Peninsula University of Technology, 2016. http://hdl.handle.net/20.500.11838/2388.
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Thesis (MSc (Biomedical Technology))--Cape Peninsula University of Technology, 2016.<br>The early detection of individuals who are at risk of developing type 2 diabetes mellitus (T2DM) would decrease the morbidity and mortality associated with this disease. DNA methylation, the most widely studied epigenetic mechanism, offers unique opportunities in this regard. Aberrant DNA methylation is associated with disease pathogenesis and is observed during the asymptomatic stage of disease. DNA methylation has therefore attracted increasing attention as a potential biomarker for identifying individuals who have an increased risk of developing T2DM. The identification of high risk biomarkers for T2DM could facilitate risk stratification and lifestyle interventions, which could ultimately lead to better ways to prevent, manage and control the T2DM epidemic that is rampant worldwide. The aim of the study was to investigate global DNA methylation as a potential risk factor for T2DM by studying the association between the global DNA methylation levels and hyperglycaemic states. A cross-sectional, quantitative study design, involving 564 individuals of mixed ancestry descent, residing in Bellville South, South Africa was used. Participants were classified as normal, pre-diabetic (impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT)) or diabetic (screen detected diabetic and known diabetics) according to WHO criteria of 1998. DNA was extracted from whole blood using the salt extraction method. The percentage global DNA methylation was measured by an enzyme-linked immunosorbent assay (ELISA). The association between global DNA methylation and hyperglycaemia, as well as other biochemical markers of T2DM was tested in a robust linear regression analysis adjusted for age, gender and smoking.
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Riding, Julie K. "Psychological functioning, coping strategies and metabolic control in adolescents with insulin dependent diabetes mellitus." Thesis, Lancaster University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.413855.
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Drake, Bradley Stuart. "A cognitive conceptualization of depression in adults with diabetes mellitus." Thesis, Stellenbosch : Stellenbosch University, 2003. http://hdl.handle.net/10019.1/53231.
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Thesis (MA)--University of Stellenbosch, 2003.<br>ENGLISH ABSTRACT: Individuals diagnosed with diabetes mellitus are at an increased risk for
developing depression. According to the literature, depression in diabetes
mellitus has been associated with a poorer quality of life, poorer regimen
adherence, poorer adjustment to diabetes, poorer glycaemic control, and an
increased risk of developing diabetes related complications. While the role of
certain psychosocial determinants in the onset and maintenance of depression
has been investigated, mental health professionals and researchers have
neglected the task of conceptualizing the relationship between depression and
diabetes from a psychological perspective. This assignment presents a
psychological conceptualization of the relationship between diabetes and
depression, using Beck's (1967, 1979) cognitive model of depression as a
framework. This conceptualization may serve as a means of theoretically
understanding the relationship between these two conditions and as a framework
in directing future research on this relationship.<br>AFRIKAANSE OPSOMMING: Individue wat met diabetes mellitus gediagnoseer word, toon 'n verhoogde risiko
om depressie te ontwikkel. Volgens die literatuur word depressie in diabetes
mellitus geassosieer met 'n swakker lewensgehelte, swakker nakoming van
behandeling, swakker aanpassing by diabetes, swakker glisemie-kontrole, en 'n
verhoogde risiko om diabetes verwante komplikasies te ontwikkel. Hoewel die rol
van bepaalde psigososiale verandelikes in die ontstaan en instandhouding van
depressie reeds ondersoek is, is min nog gedoen oor 'n konseptualisering van
die assosiasie tussen diabetes en depressie. Hierdie werkstuk handeloor 'n
konseptualisering van die verband tussen diabetes en depressie, gebaseer op
Beck (1967, 1979) se kognitiewe model van depressie. Die konseptualisering
dien as 'n naamwerk om hierdie verband te verstaan en toekomstige narvorsing
hieroor te rig.
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Tsourdi, Elena, Andreas Barthel, Hannes Rietzsch, Andreas Reichel, and Stefan R. Bornstein. "Current Aspects in the Pathophysiology and Treatment of Chronic Wounds in Diabetes Mellitus." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-127033.
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Impaired wound healing is a frequent and very severe problem in patients with diabetes mellitus, yet little is known about the underlying pathomechanisms. In this paper we review the biology of wound healing with particular attention to the pathophysiology of chronic wounds in diabetic patients. The standard treatment of diabetic ulcers includes measures to optimize glycemic control as well as extensive debridement, infection elimination by antibiotic therapy based on wound pathogen cultures, the use of moisture dressings, and offloading high pressure from the wound bed. In this paper we discuss novel adjuvant therapies with particular reference to the use of autologous skin transplants for the treatment of diabetic foot ulcers which do not respond to standard care.
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Mead, Paul Arthur. "Aspects of cell membrane physiology in essential hypertension and type 1 diabetes mellitus." Thesis, University of Newcastle Upon Tyne, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391400.
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Arcanjo, Aysa Mara Roveri. "Relação dos sintomas e fases do estresse com características sociodemográficas e clínicas de pessoas com diabetes mellitus tipo 2." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-01022016-161614/.
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Estudo descritivo transversal, cujo objetivo foi analisar a relação das variáveis sociodemográficas, de tratamento, hábitos de vida, clínicas e laboratoriais com as variáveis sintomas e fases do estresse, em pessoas com diabetes mellitus tipo 2, em unidade ambulatorial de hospital de nível terciário de atenção à saúde. A amostra foi constituída por 222 pessoas e os dados foram coletados no período de junho de 2011 a agosto de 2012. O instrumento utilizado foi o Inventário de Sintomas de Stress de Lipp, composto por três quadros de sintomas de estresse, que fornecem porcentagens para classifica-los em quatro fases: alerta, resistência, quase exaustão e exaustão. Entre as características sociodemográficas, de tratamento, hábitos de vida, dados clínicos e laboratoriais, destacam-se que 53,15% das pessoas eram do sexo feminino, 43,85% do masculino, com média de idade de 60,68 anos (DP=8,40), tempo médio de escolaridade de 5,07 anos (DP=4,15), 71,17% viviam com o companheiro, 57,66% procediam da região de Ribeirão Preto (SP), 50,9% eram aposentados/pensionistas, 87,38% referiu fazer uso de insulina, 78,82% antidiabético oral, 68,91% seguir a dieta recomendada e 46,85% não praticava exercícios físicos regulares. O tempo médio de diagnóstico foi de 15,15 (DP=8,03) anos, índice de massa corporal 32,10 (DP=5,75) Kg/m2 , pressão arterial sistólica 180,10 (DP=14,03) mmHg e diastólica 143,7 (DP=23,63) mmHg, taxa de hemoglobina glicada 9,446 (DP=2) %, colesterol total 74,9 (DP=41,95) mg/dl, lipoproteína de alta densidade 35,67 (DP=8,58) mg/dl, lipoproteína de baixa densidade 101,55 (34,52) mg/dl e triglicerídeos 203,60 (DP=147,72) mg/dl. Quanto às variáveis do estresse, destaca-se que a maior média das porcentagens obtidas ocorreu para os sintomas de estresse do quadro 2 (20,16%-DP=20,165). Para fins de análises estatísticas, excluiu-se a fase de alerta e aglutinou-se as de exaustão e quase exaustão. A frequência dos sintomas de estresse referidos pelos participantes nos três quadros distintos permitiu verificar a presença do estresse em 63,51% da amostra, bem como a frequência de 53,60% na fase de resistência ao estresse, e predomínio de sintomas físicos (61,53%). As fases do estresse associaram-se com a idade, procedência, uso de insulina e lipoproteína de baixa densidade; os sintomas do estresse com o uso de antidiabéticos orais, tabagismo, consumo de bebida alcoólica e lipoproteína de baixa densidade. Quanto à porcentagem média obtida nos três quadros, observou-se que houve associação dos sintomas do primeiro quadro com a ocupação; do segundo quadro com o seguimento da dieta, glicemia plasmática de jejum, o colesterol total e lipoproteína de baixa densidade; correlação do terceiro quadro com o índice de massa corporal, de modo positivo e com a renda familiar, de modo negativo. A idade e a hemoglobina glicada correlacionaram-se com o segundo e terceiro quadros, porém de forma negativa e positiva, respectivamente. O presente estudo permitiu conhecer as possíveis relações do estresse com as variáveis sociodemográficas, tratamento da doença, hábitos de vida, clínicas e laboratoriais da pessoa com diabetes mellitus tipo 2 e reitera a importância desse conhecimento na prática clínica para intervenções que desenvolvam habilidades pessoais para o enfrentamento de situações estressantes percebidas pelas pessoas durante o curso da doença<br>Cross-sectional study aimed to examine the relations of sociodemographic variables, disease treatment, lifestyle, clinical and laboratory variables with the symptoms and phases of stress in people with type 2 diabetes mellitus, in an outpatient unit of a tertiary level hospital of health care. The sample consisted of 222 individuals and the data were collected between June 2011 and August 2012. The instrument used was the Lipp Stress Symptom Inventory, composed of three frames of stress symptoms, which provide percentages for grades them into four phases: alarm, resistance, near exhaustion and exhaustion. Among the sociodemographic characteristics, treatment, lifestyle, clinical and laboratory data, it highlights that 53.15% of those were female, 43.85% male, with a mean age of 60.68 years (SD = 8.40), mean years of education 5.07 years (SD = 4.15), 71.17% lived with a partner, 57.66% were from Ribeirao Preto region (SP) and 50.9% were retired / pensioners, 87.38% reported use insulin, 78.82% oral antidiabetic, 68.91% followed the recommended diet and 46.85% did not practice regular physical exercise. The average time of diagnosis was 15.15 (SD = 8.03) years, mean body mass index 32.10 (SD = 5.75) kg/m2, mean systolic blood pressure 180.10 (SD = 14 03) and diastolic 143.7 mmHg (SD = 23.63) mmHg, glycated hemoglobin rate 9.446 (SD = 2)%, total cholesterol 74.9 (SD = 41.95) mg/dl, high density lipoproteins 35.67 (SD = 8.58) mg/dL, low density lipoproteins 101.55 (34.52) mg/dL and triglycerides rate of 203.60 (SD = 147.72) mg/dl. As for the variables of stress, there is that most average of these percentages occurred to the frame stress symptoms 2 (20.16% - SD = 20.165). For the purpose of statistical analysis, we excluded the alert phase and connect them of exhaustion and near exhaustion. The frequency of symptoms of stress reported by participants in three different frames demonstrated the presence of stress in 63.51% of the sample, and the frequency of 53.60% in stress resistance phase, and predominance of physical symptoms (61,53%). The phases of stress were associated with age, origin, use of insulin and low-density lipoprotein; symptoms of stress with the use of oral antidiabetic drugs, smoking, consumption of alcohol and low-density lipoprotein. The average percentage obtained in the three frames, it was noted that there was an association of the symptoms of the first frame with the occupation; the second frame with the following the diet, fasting plasma glucose, total cholesterol and low-density lipoprotein; the third frame correlation with body mass index in a positive way and to family income, negatively. The age and glycated hemoglobin correlated with the second and third frames, but negatively and positively, respectively. This study helped identify the possible relations of stress with sociodemographic variables, disease treatment, lifestyle, clinical and laboratory of the person with type 2 diabetes mellitus and reiterates the importance of this knowledge in clinical practice to interventions that develop personal skills for coping stressful situations perceived by the people during the course of the disease
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Påhlsson, Hans-Ivar. "Methodological aspects of toe blood pressure measurements for evaluation of arterial insuffiency in patients with diabetes /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-181-4/.
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Roberts, Clare Louise. "Associations between satisfaction with diabetes care, diabetic control and psychological variables in adolescents with type I insulin dependent diabetes mellitus." Thesis, University of Edinburgh, 2000. http://hdl.handle.net/1842/26887.
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Insulin Dependent Diabetes Mellitus (IDDM) is a life-long condition, which is the third most common chronic illness in young people (Metcalfe & Baum, 1991). Management of the illness includes a daily regimen of blood testing, insulin injections and careful balancing of diet and exercise (Shillitoe, 1995). In adolescence, diabetes control often deteriorates (Brink, 1997; Jacobson, Hauser, Wolsdorf, Houlihan, Herskowitz, Wertlieb & Watt, 1987). This consequently can have a detrimental effect on future physical health (Diabetes Control and Complications Trial, 1994). A large amount of research has sought to identify the relevant variables that are indicative of good and poor adjustment to chronic illness (for example, Eiser, 1990a). Several models have been developed, including the Risk and Resilience Model (Wallander & Varni, 1998), which was used to guide this study. It is hypothesised that patient satisfaction with diabetes care will act as a resilience factor and therefore be associated with better psychological well-being. Eighty-three young people between the ages of 14 and 18 attending diabetes outpatient clinics in the Lothian area were assessed, using standardised measures of patient satisfaction, quality of life, psychological well-being and adaptation to diabetes. The relationships between these variables, diabetic control and the effects of age, gender and time since diagnosis were calculated. Results are discussed in relation to the planning and evaluation of medical and psychological services for adolescents with diabetes. Finally, methodological weaknesses are highlighted and implications for future research discussed.
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Hjorth, Maria. "Immunological profile and aspects of immunotherapy in type 1 diabetes." Doctoral thesis, Linköping : Department of Clinical and Experimental Medicine, Linköping University, 2010. http://www2.bibl.liu.se/liupubl/disp/disp2010/med1161s.pdf.
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Henriksson, Mikael. "Molecular aspects of proinsulin C-peptide interactions /." Stockholm : Department of medical biochemistry and biophysics, Karolinska institutet, 2006. http://diss.kib.ki.se/2006/91-7140-754-5/.
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Nordquist, Jenny. "Semicarbazide-sensitive amine oxidase and vascular complications in diabetes mellitus : Biochemical and molecular aspects." Doctoral thesis, Uppsala University, Pharmacology, 2002. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-2566.
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<p>Plasma activity of the enzyme semicarbazide-sensitive amine oxidase (SSAO; EC.1.4.3.6) has been reported to be high in disorders such as diabetes mellitus, chronic congestive heart failure and liver cirrhosis. Little is known of how the activity is regulated and, consequently, the cause for these findings is not well understood. Due to the early occurrence of increased enzyme activity in diabetes, in conjunction with the production of highly cytotoxic substances in SSAO-catalysed reactions, it has been speculated that there could be a causal relationship between high SSAO activity and vascular damage. Aminoacetone and methylamine are the best currently known endogenous substrates for human SSAO and the resulting aldehyde-products are methylglyoxal and formaldehyde, respectively. Both of these aldehydes have been shown to be implicated in the formation of advanced glycation end products (AGEs).</p><p>This thesis is based on studies exploring the regulation of SSAO activity and its possible involvement in the development of vascular damage. The results further strengthen the connection between high SSAO activity and the occurrence of vascular damage, since type 2 diabetic patients with retinopathy were found to have higher plasma activities of SSAO and lower urinary concentrations of methylamine than patients with uncomplicated diabetes. From studies on mice, it was also found that an SSAO inhibitor potently reduces the incorporation of methylamine-metabolite in the tissues. By quantifying SSAO-gene expression in alloxan-induced diabetes, increased transcription could be ruled out as a cause for the increased enzyme activity, thereby opening up for the possibility that the activity is regulated post-translationally. In fact, increased enzyme activity in adipose tissue was accompanied by decreased mRNA-levels, suggesting that the gene expression could be negatively controlled by the enzyme activity.</p>
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Taylor, Michelle D. "Assessment of coping in adults with type 1 diabetes." Thesis, University of Edinburgh, 2002. http://hdl.handle.net/1842/8975.
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The development of Type 1 diabetes has a profound impact on many aspects of everyday life, health and well-being. In this thesis the literature relevant to different aspects coping with Type 1 diabetes is reviewed. The research described in the thesis includes (i) a prospective assessment of how psychosocial factors affect diabetes-related outcomes in adults following the onset of Type 1 diabetes, (ii) qualitative analysis of interviews that were conducted to explore the patient's perspective of what it means to cope with diabetes, and (iii) the development, pilot testing, and subsequent partial validation of a diabetes-specific questionnaire. The Edinburgh Prospective Diabetes Study examines the relationships between psychosocial variables recorded at diagnosis and diabetes related outcomes recorded at four months (n = 69), 12 months (n = 65), 24 months (n = 56) and 36 months (n = 40) after diagnosis. The results showed that individuals who had a lower socio-economic status had consistently poorer glycaemic control at 24 months (p < 0.001) and at 36 months (p < 0.01) after diagnosis. Diabetes knowledge at four months after diagnosis was a significant predictor of glycaemic control at 12 months (r= 0.35, p < 0.01) and at 36 months after diagnosis (r = 0.35, p < 0.05). In adults, self-reported outcomes were significantly predicted by longstanding psychological (e.g. personality traits) and social factors (e.g. quality of life). There was some evidence to suggest that coping strategies have an intermediate position between psychosocial factors and diabetes-related outcomes. The results and their implications for future research are discussed in terms of existing theories of coping. To date there are few psychometrically sound instruments capable of assessing how well a person is coping with their diabetes. With this in mind, the present research was undertaken to develop a new diabetes self-report measure termed the Diabetes Impact, Adjustment and Lifestyle Scales (DIALS). The development, pilot testing and partial validation of the DIALS are described. Semi-structured interviews (n = 1 0) were conducted to explore the patients' descriptions of their adjustment to diabetes and the impact that diabetes has on aspects of their daily life. A grounded theory approach (Strauss, 1987) was adopted to analyse the data. Several domains were established, from which items were generated. Two studies, a small pilot study (n =57), and a large cross-sectional validation study (n = 246) were carried out to establish the underlying structure, internal consistency, partial validity, and stability of the DIALS. Principal components analysis of the DIALS identified five dimensions: Impact, Adherence, Information-seeking, Fear of complications and Diabetes-related distress. Overall, the results suggest that the DIALS is a valid, reliable and stable indicator of coping in adults with Type 1 diabetes. A hierarchal model of causal relationships between psychological constructs (i.e. personality traits and illness-related coping constructs) and the DIALS was formulated and tested formally using Structural Equation Modelling. There was considerable overlap in the constructs, with evidence for two latent variables relating to 'emotionoriented' and 'task-oriented coping'. In summary, coping variables may be important mediators in the link between antecedent variables such as longstanding character traits (e.g. personality) and self-reported outcomes of diabetes.
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Thiagarajan, Kristina Diann Munoz-Flores. "Stress, social support, problem solving coping, acceptance of diabetes & self-management as predictors of metabolic control & quality of life among adults with insulin-dependent diabetes mellitus /." Thesis, Connect to this title online; UW restricted, 1998. http://hdl.handle.net/1773/7280.
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Gnanasan, Shubashini. "Pharmaceutical care for patients with tuberculosis and diabetes mellitus in Malaysia : a complex intervention." Thesis, University of Nottingham, 2012. http://eprints.nottingham.ac.uk/28429/.
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The increasing comorbid burden of tuberculosis (TB) and diabetes mellitus (OM) worldwide requires the management of all stakeholders including pharmacists. This raises the question whether current single disease management system fulfils patients' health needs and whether pharmacists could effectively play a role in enhancing the joint management of these two commonly associated diseases. Pharmacists have begun to provide pharmaceutical care through pharmacist-led medication therapy adherence clinics and clinical pharmacy services for several diseases and conditions (e.g. OM, asthma) in some public hospitals in Malaysia but are yet to be involved in the management of TB. The management of TB has been largely delivered through directly observed treatment (OOT) as high level of adherence to treatment is vital. However, little is known on how TB patients with OM are being managed and how these patients cope with their medication. The aim of this study was to develop a pharmaceutical care service for patients with TB and OM. The first three phases (preclinical, phase 1 and phase 2) of the UK Medical Research Council framework for the development of complex interventions to improve health was applied to develop a pharmaceutical care service for patients with both TB and DM in a tertiary hospital in Malaysia. First, literature relating to TB and OM was reviewed (preclinical). Second, the pharmaceutical care needs of TB and DM patients were explored using semi-structured interviews with twenty patients, three physicians, three nurses, and a focus-group with four pharmacists (phase 1). Third, action research was conducted to assess the feasibility of providing a pharmaceutical care service for patients with TB and OM (phase 2). This study received ethical approval from the Medical Research and Ethics Committee (MREC), Ministry of Health, Malaysia. Patients and health care professionals reported several medication-related issues in the phase 1 study. Patients were most inclined to discuss their concerns about their medication. Patients also tended to display different attitudes towards medication-taking, depending on their beliefs, the severity of illnesses, perceived efficacy of the treatment, and the severity of medication-related problems. The findings also revealed that many of these concerns had not been discussed with their physicians. This was also caused by the patients' and physicians' tendencies to prioritise the management of TB, and unintentionally neglecting other comorbidities especially when patients were primarily managed at the chest clinic. Other difficulties identified in comorbid management included delayed initiation of both TB and OM treatment, chest physicians' lack of confidence in managing 'difficult' OM in TB patients and the burden of attending multiple clinics for patients. Health care professionals believed that pharmacist-led medication therapy adherence clinics (MTACs) encouraged the provision of patient-centred care, enhanced pharmacist-patient communication, created opportunities for inter-professional interactions and could be used as a model to provide pharmaceutical care services. Health care professionals urged pharmacists to play a role in the management of TB and OM by providing patient education and counselling. The phase 2 study revealed that the prevalence of OM in TB patients was 15%. Action research allowed the researcher, together with a hospital pharmacist, to identify pharmaceutical care needs in TB and OM patients, and fulfilled some of them. Pharmaceutical care issues identified included lack of medication adherence, poor management of OM, the need to manage adverse drug reactions, and the lack of frequent monitoring of certain monitoring parameters for TB, OM and other comorbidities at the chest clinic. Many patients had uncontrolled OM, however, many were more likely to be adherent to TB medication than medication of OM and/or other conditions. As a follow-up action, pharmacists advised these patients to place equal importance to TB and non-TB related management. Additionally, pharmacists also made treatment recommendations and referred patients to their chest physicians for further management of medication-related problems. Nevertheless, there were barriers that impinged the provision of pharmaceutical care service. The barriers include the lack of space with privacy to provide education and counselling to patients; the unavailability of medication records and other clinical information for comorbidities at the chest clinic; and the lack of time to develop inter-professional relationship. Despite the need to address the barriers, the provision of pharmaceutical care service to TB and OM patients was feasible as pharmacists were able to integrate TB and OM management by identifying, communicating, and resolving some medication-related problems. In summary, this study provided the groundwork by conducting phase 1 and phase 2 study prior to developing a full-fledged pharmaceutical care service for TB and DM patients. Future work can be done to improve the service through critical analysis of the challenges faced in the developmental phase with the effectiveness of the service care plan assessed through a randomised controlled trial (RCT).
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Lam, Chun-yin Julia, and 林駿瑛. "Psychosocial correlates of illness control and adjustment in patients with diabetes mellitus." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1997. http://hub.hku.hk/bib/B29873034.
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Bertolin, Daniela Comelis. "Estresse, modos de enfrentamento e aceitação da doença de pessoas com diabetes mellitus tipo 2 participantes de um programa educativo com o envolvimento do familiar: ensaio clínico randomizado." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-22012014-110133/.
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O presente estudo, trata-se de um ensaio clínico randomizado controlado, cujo objetivo principal foi avaliar o estresse, modos de enfrentamento e aceitação da doença de pessoas com diabetes mellitus tipo 2 após participarem de um programa educativo com o envolvimento do familiar. Foi desenvolvido em unidade ambulatorial de hospital de nível terciário de atenção à saúde. A amostra ficou constituída por 164 pessoas, de acordo com o cálculo amostral e critérios de inclusão/exclusão, e após randomização, os participantes foram alocados no grupo controle ou intervenção, para os quais foi desenvolvido um programa educativo com o uso dos Mapas de Conversação em Diabetes Mellitus, fundamentado na Teoria Social Cognitiva. As intervenções realizadas aos familiares seguiram protocolo com base nos temas abordados no programa educativo com os pacientes. A amostra do estudo caracterizou-se por predomínio do sexo feminino (56,7%), idade média de 60,4 anos (DP=8,4), baixo nível socioeconômico, longo tempo de tratamento, em uso de insulina (88,4%) e antidiabéticos orais (79,8%). As variáveis estudas, estresse percebido, sinais/sintomas de estresse, modos de enfrentamento e aceitação da doença não apresentaram diferenças significativas após as intervenções educativas aos familiares. Após as intervenções com envolvimento do familiar os modos de enfrentamento mais referidos pela amostra do estudo foram relacionados ao fator Minimização de ameaça ( X =3,6), seguido por Procura de informações ( X =3,4), e os menos referidos foram relacionados ao fator Auto-culpa ( X =2,0). O escore médio de aceitação da doença, que poderia variar de oito a 40, foi 26,3; e de estresse percebido, que poderia ser de zero à 56, foi 22,0. Entre os participantes, 51,5 % foram classificados sem estresse, 44,1% estavam na fase de resistência ao estresse, com predomínio dos sintomas psicológicos para 26,1% que apresentavam algum nível de estresse. A média da hemoglobina glicada A1c não apresentou relação significativa com os fatores da Escala Modos de Enfrentamento, no entanto houve relação inversa com aceitação da Doença no grupo controle; e direta com estresse percebido nos dois grupos, ou seja, quanto maior a aceitação da doença, menor foi a média de hemoglobina glicada A1c; e quanto maior a percepção de estresse, maiores os valores da hemoglobina glicada A1c. Verificou-se relação inversa entre aceitação da doença e os fatores Reestruturação cognitiva, Expressão emocional e Auto-culpa nos dois grupos e, para o fator Desejo de realizar fantasias para o grupo controle. Também foi observada relação inversa entre aceitação da doença e estresse percebido, o que sugere que quanto maior a percepção de estresse, menor foi a aceitação da doença. As intervenções educativas aos familiares, realizadas por meio de contato telefônico, parecem não ter influenciado os resultados das variáveis de interesse no presente estudo<br>This is a clinical trial, with main aim to evaluate the stress , coping and acceptance of the disease of people with diabetes mellitus type 2 after participating in an educational program with the involvement of family member. It was developed in the outpatient clinic of a tertiary hospital health care . The sample consisted of 164 people , according to the sample size calculation and inclusion / exclusion criteria. After randomization, the participants were allocated to the intervention or control group, and all participated of the educational program with the use of maps Conversation Diabetes Mellitus, based on Social Cognitive Theory, in order to establish a framework for interventions by telephone to family members in the intervention group. The sample was characterized by a predominance of females (56.7%), mean age 60.4 years (SD=8.4), low socioeconomic status, long-term treatment, using insulin (88,4%) and oral hypoglycemic agents (79.8%). Most people reported having religious beliefs (95.7%), diet (71.9%) and do not exercise (44.5%) . The variables studied, perceived stress, signs / symptoms of stress, coping and acceptance of the disease did not differ significantly after educational interventions to relatives . After interventions with involvement of the family member, the coping most reported by the study sample were related to the Threat minimization factor ( X = 3.6), followed by Information seeking ( X = 3.4), and the least were those related to Self- blame factor ( X = 2.0). The average score of acceptance of the disease, that could range from eight to 40, was 26.3, and perceived stress, that could be from zero to 56, was 22.0 . Among the participants, 51.5 % were classified without stress, 44.1% were in the resistance to stress, with a predominance of psychological symptoms to 26.1% who had some level of stress. The mean glycated hemoglobin A1c showed no significant association with the factors of the Ways of Coping Scale, however was observed an inverse relationship with acceptance of the disease in the control group, and directly with perceived stress in both groups, that meaning that higher the acceptance of the diseas, lower the average glycated hemoglobin A1c , and greater perceived stress, higher average of glycated hemoglobin A1c. There was an inverse relationship between acceptance of the disease and the factors Cognitive restructuring, emotional expression and Self-blame in the two groups, and for the factor Wish-fullfiling fantasy for the control group just. It was also observed an inverse relationship between acceptance of disease and perceived stress, suggesting that higher the perception of stress, lower the acceptance of the disease. Educational interventions for family members, conducted through telephone contact, seem no influence the results of the variables of interest in this study
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譚月明 and Y. M. Tam. "A case control study on infant outcomes in subjects with diabetes mellitus in pregnancy." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B42576441.
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Al-Lenjawi, Badriya. "Development, implementation and evaluation of a diabetes patient education toolkit (DPET) for self-management of type 2 diabetes mellitus in Doha, Qatar." Thesis, University of Greenwich, 2010. http://gala.gre.ac.uk/5714/.
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The randomised controlled education intervention study recruited 430 adults aged 25-65 years with established diagnosis of T2DM (M = 130, F = 309) via a multi-stage double-blind stratified sampling procedure from 22 hospitals and health centres in Doha, Qatar. The intervention group (n = 215) were assigned to a six-week, 2-hourly structured educational class based on the specifically designed DPET, plus their usual one-to-one routine clinical care; the control group (n = 215) used the DPET for home self-study, plus their usual one-to-one routine clinical care. Adherence to the programme in the intervention group (n = 109; M = 40, F = 69) was 50.7% compared to 84% among controls (n = 181; M = 50, F = 131); an overall non-adherence rate of 32.6%. Repeated measures ANOVA showed a highly significant change in each of diabetes knowledge, attitudes and practice among intervention compared to controls at 12 month follow-up (p<0.0001). The intervention had no significant overall impact on systolic blood pressure (p = 0.632) nor diastolic BP (p = 0.421) but improvements in BMI among the intervention group (p = 0.001). Repeated measures ANOVA also showed differences in overall change in HbA1c (p = 0.012), fasting blood glucose (p = 0.022), HDL-cholesterol (p<0.0001) and albumin-creatinine ratio (p<0.0001) in the intervention group but not total cholesterol (p=0.204), LDL-cholesterol (p = 0.203) and total triaclyglycerol (p = 0.200) from baseline values after 12 months follow-up. Post-sessional self-assessment tests of knowledge, attitudes, practices and goal-setting used as a proxy measurement of empowerment showed a significant improvement in the empowerment scores from baseline in the intervention group (p<0.0001).
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Turkish, Michelle L. "Dietary and physiological influences on circulating blood lipids in non-insulin-dependent diabetes mellitus patients." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/845947.
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Patients with non-insulin-dependent diabetes mellitus (NIDDM) usually exhibit a marked disturbance of lipid metabolism which is reflected in high levels of plasma total cholesterol, low-density lipoproteins (LDL), and triglycerides, along with low levels of high-density lipoproteins (HDL). Elevated triglycerides are the major contributor to diabetic hyperlipidemia. These plasma lipid concentrations and the fatty acid composition of these lipids are clearly influenced by the type of diet consumed along with the proportion of dietary fatty acids. Therefore, it was the purpose of this investigation to examine the relationships between glycemic control, serum lipid levels of total cholesterol, HDL, LDL and triglycerides to the amounts and types of fats in the typical diets of NIDDM patients as compared to non-diabetic individuals. The dietary fats were also compared with the distribution of fatty acids found in their total lipids and free (in vivo) fatty acids. The relationship between dietary fat intake and serum total lipid levels along with total and free fatty acid distributions was the primary focus.This investigation found that NIDDM subjects have significantly greater triglyceride levels (200 ± 18.4 mg/dL) than non-diabetic controls (93 ± 13.2 mg/dL). Total and LDL cholesterol levels of the NIDDM group were elevated from the control group while HDL levels were depressed, but these differences were of nonsignificant proportions. The NIDDM group typically consumed significantly lowered amounts of teal, saturated, and monounsaturated dietary fatty acids (46.7 ± 7.1 grams, 114.0 ± 2.9 grams, and 16.8 ± 2.5 grams, respectively) compared to the control group (80.0 ± 10.9 grams, 26.7 ± 4.5 grams, and 30.2 ± 4.5 grams, respectively). Even so, the percentage of kilocalories from total fat in the NIDDM vs. the control group diets was not statistically different which may explain the lack of significance between groups with regard to distribution of serum fatty acids. On an individual basis, the types of fat that predominated in the diet were also found in a large percentage in the serum lipid distributions. Positive correlations between saturated fat intake and the blood serum stearic free fatty acid along with polyunsaturated fat intake and linoleic free fatty acid supported this observation. Other investigators (6,62) have reported that dietary intake does indeed contribute to the percentage of fatty acids distributed in the plasma lipids. To determine if a particular dietary fatty acid contributes more significantly to hyperlipidemia, the diet needs to be controlled.On an individualized basis, it was also noted that the diabetics with the lowest amount and percentage of fat in their diets, also had the lowest serum lipid levels. Besides diet, other influential factors which may have contributed to the lipid levels of these NIDDM patients are genetic predisposition, environmental influences, and the stage and progression of each individual's disease. Thus, due to the underlying metabolic impairments which are exacerbated by genetic and/or environmental influences, it is of vital importance to recognize how essential diet manipulation is with regards to lipid control in the treatment of NIDDM patients.<br>Department of Biology
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Dickson, Sarah Louise. "A qualitative exploration of psychological flexibility and adjustment experiences in type 2 diabetes." Thesis, University of Exeter, 2016. http://hdl.handle.net/10871/24095.
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Objectives: To explore how adjustment to type 2 diabetes mellitus (T2DM) can be understood using psychological (in)flexibility, the theoretical model underlying acceptance and commitment therapy (ACT). The specific research questions are: (a) what are participant experiences of adjustment and coping in T2DM? and (b) how can participant experiences be understood in terms of the processes underlying the model of psychological (in)flexibility? Design: This interview study utilised a cross-case qualitative methodology. Methods: Semi-structured interviews were conducted with 11 purposively recruited individuals with a diagnosis of T2DM. Interview transcripts were subjected to an interpretative phenomenological analysis (IPA) methodology. Results: Three primary themes were identified from the IPA: (a) ‘Eating myself into diabetes’: Managing the self in relation to perceived diabetes stigma; (b) My other illness is the real problem: diabetes minimised in the context of co-morbid diagnoses; and (c) Knowledge reduces attachment to the patient-role self-story. Conclusion The interpretation of the qualitative data generated suggests that adjustment to a diagnosis of T2DM is a complex process incorporating intra-individual and systemic factors. Whilst psychological flexibility may be a useful model for understanding and supporting adjustment, interventions are required that also address wider systemic issues such as the integration of care, health-related stigma and relationships with health professionals.
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Pitz, M. Diane. "ASSESSMENT OF PSYCHOSOCIAL FACTORS RELATED TO SELF-CARE BEHAVIORS AND GLYCEMIC CONTROL IN TYPE II DIABETES." Thesis, The University of Arizona, 1987. http://hdl.handle.net/10150/276551.
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The relationships among psychosocial variables, adherence with self-care behaviors, and glycemic control in 90 men with non-insulin dependent diabetes mellitus (NIDDM) were investigated. Patients completed the Basic Personality Inventory, Social Support Questionnaire, and Magnitude Estimation Inventory. Adherence scores were based on self-reports of adherence with six criteria congruent with satisfactory metabolic control. Glycemic control was measured by Glycosylated Hemoglobin (GHb) analyses. Results revealed no differences between diabetics and non-diabetic comparisons on dimensions of personality. There were differences between the non-adherent and self-reported adherent diabetics on three personality dimensions, ratings of satisfaction with social support, and items on the MEI. GHb was not systematically related to dimensions of personality, adherence, or social support. Implications for treatment were discussed and recommendations for the use of multiple measures for assessing adherence were made.
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Shiu, Wing-ming Sammy, and 邵永明. "Role of lectin-like oxidized low density lipoprotein receptor-1 (LOX-1) in diabetes mellitus." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B50534075.
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Lectin-like oxidized low density lipoprotein receptor-1 (LOX-1) is a recently identified scavenger receptor expressed in endothelial cells and mediates the uptake of oxidized LDL (oxLDL). LOX-1 expression is increased in atherosclerotic lesions in animals and humans. Recent evidence has suggested that LOX-1 is involved in the development and progression of atherosclerosis. In addition to endothelial cells, it has also been reported that LOX-1 is also expressed by other cell types like macrophages. It is a multi-ligand class E scavenger receptor and cellular expression of LOX-1 can be induced by many of its ligands. The concentration of some of these ligands like oxLDL and advanced glycation end products (AGEs) are increased in the diabetic milieu. My hypothesis is that LOX-1 expression is increased in diabetes mellitus and LOX-1 activation may play a role in the development of micro- and/or macrovascular complications of diabetes. The objective of this thesis is to elucidate the role of LOX-1 in type 2 diabetes mellitus and its complications. The effect of modified LDL and AGEs on LOX-1 expression and the cellular response upon LOX-1 activation was investigated.
In vitro studies have shown that both AGEs and oxLDL can activate and increase cellular expression of LOX-1 and the soluble form of LOX-1 (sLOX-1) in cultured endothelial cells. In addition, LDL modified by glycoxidation, is also a ligand of LOX-1 and glycoxidized LDL is even more potent than oxLDL in inducing LOX-1 expression. In patients with type 2 diabetes, serum level of sLOX-1 was significantly higher than non-diabetic normal control, indicating that LOX-1 expression was increased in diabetes. Serum levels of AGEs and glycoxidized LDL were important determinants of serum sLOX-1 level, and lowering serum AGEs led to a beneficial reduction in serum sLOX-1 concentration. Hence, AGEs was clearly an important ligand of LOX-1 in diabetes mellitus, and experiments were performed to further elucidate the underlying signaling pathway involved in the up-regulation of LOX-1 by AGEs. This was mediated by ligation of AGEs to the receptor for advanced glycation end products (RAGE) and activation of phosphoinositide 3-kinase. Mammalian target of rapamycin was a found to be a key downstream intermediary in AGEs-inducible LOX-1 expression in endothelial cells. I further demonstrated that LOX-1 was also expressed in human renal mesangial cells, and expression was at a low level at basal state but inducible by its ligands. Up-regulation of LOX-1 expression in activated mesangial cells resulted in increased oxidative stress, as well as increased production of proinflammatory cytokines, chemokines and growth factors. These experimental findings would suggest that LOX-1 might potentially be involved in renal inflammation and diabetic nephropathy.
The above results collectively suggest that diabetes is associated with increased LOX-1 activation, and LOX-1 may play a role in the development of diabetic complications. Hence, LOX-1 might represent a suitable target for the future development of new strategies for treating and preventing diabetic vascular complications.<br>published_or_final_version<br>Medicine<br>Doctoral<br>Doctor of Philosophy
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Agardh, Emilie. "The influence of psychosocial stress, socioeconomic differences and coffee consumption in the etiology of type 2 diabetes /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-180-6/.
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Primomo, Janet. "Patterns of chronic illness management, psychosocial development, family and social environment and adaptation among diabetic women /." Thesis, Connect to this title online; UW restricted, 1989. http://hdl.handle.net/1773/7227.
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