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1
Pereira, Arias Alberto Martin. "Regulation of postabsorptive glucose production in patients with type 2 diabetes mellitus." [Amsterdam : Amsterdam : Thela-Thesis] ; Universiteit van Amsterdam [Host], 2000. http://dare.uva.nl/document/56918.
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Wolffenbuttel, Bruce Herbert Ralph. "Type 2 diabetes mellitus pathology and treatment /." Maastricht : Maastricht : Datawyse ; University Library, Maastricht University [Host], 1991. http://arno.unimaas.nl/show.cgi?fid=5673.
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Andrews, Robert. "Cortisol metabolism in type 2 diabetes mellitus." Thesis, University of Edinburgh, 2004. http://hdl.handle.net/1842/23073.
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In chapter 2, I describe my first study, which determined whether individuals with DMA or impaired glucose tolerance (IGT) exhibit abnormalities in cortisol activity. An integrated assessment of cortisol secretion, metabolism and action was carried out in 25 un-medicated lean male patients with hyperglycaemia (20 DM and 5 IGT) and 25 healthy controls carefully matched for body mass index, age and blood pressure. This study demonstrated that patients do exhibit abnormalities in cortisol activity. Chapter 3 describes a study that examined whether altered tissue concentration of the glucocorticoid receptor (GR), of 11β-HSD1 or of 11β-HSD2 could explain the difference in dermal blanching seen between patients with hyperglycaemia and normal healthy controls. Tissue concentrations of GR were found to be no different between patients with hyperglycaemia and normal healthy subjects. In chapter 4, I describe a study, which assessed whether inhibition of local tissue metabolism of cortisol, by carbenoxolone (an inhibitor of both 11β-HSD1 or 11β-HSD2) improved insulin sensitivity. 6 patients with DM and 6 matched controls, participated in a double-blind cross-over comparison of carbenoxolone (100 mg 8 hrly orally for 7 d) and placebo. At the end of each phase glucose kinetics were measured in the fasting state from 0700-0730 h, during a 3 h euglycaemic hyperinsulinaemic clamp and during a 2 h euglycaemic hyperinsulinaemic clamp with a 4-fold increase in glucagon levels. Carbenoxolone reduced total cholesterol in healthy subjects but had no effect on cholesterol in patients with DM. Carbenoxolone did not affect insulin sensitivity, but it did reduce glucose rate during hyperglucagonaemia in patients with DM. In conclusion I have demonstrated that abnormalities in cortisol activity are seen in patients with DM and that drugs specifically targeted at preventing cortisol regeneration in tissues may enhance insulin sensitivity and lead to novel developments in the treatment of DM.
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Li, Luosheng. "Molecular genetics of type 2 diabetes /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-194-2/.
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Zhou, Huali. "Reverse cholesterol transport in type 2 diabetes mellitus." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B39794003.
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Zhou, Huali, and 周華麗. "Reverse cholesterol transport in type 2 diabetes mellitus." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B39794003.
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Saugur, Anusooya. "Management of type 2 diabetes mellitus : a pharmacoepidemiological review." Thesis, Nelson Mandela Metropolitan University, 2011. http://hdl.handle.net/10948/1635.
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Type 2 diabetes mellitus (DM) is a progressive disease characterised by hyperglycaemia caused by defects in insulin secretion and insulin action. In early stages of type 2 DM, dietary and lifestyle changes are often sufficient to control blood glucose levels. However, over time, many patients experience β cell dysfunction and require insulin therapy, either alone or in combination with oral agents. There are guidelines available to structure the management of this disease state, including both the use of oral hypoglycaemic agents and or insulin. Besides health complications, there are economic burdens associated with the management of type 2 diabetes mellitus. The aim of this study was to determine the management of type 2 DM in a South African sample group of patients drawn from a large medical aid database. The objectives of the study were: to establish the prevalence of type 2 DM relative to age, examine the nature of chronic comorbid disease states, establish trends in the prescribing of insulin relative to other oral hypoglycaemic agents, investigate cost implications, and determine trends in the use of blood and urine monitoring materials by patients. The study was quantitative and retrospective and descriptive statistics were used in the analysis. DM was found to be most prevalent amongst patients between 50 and 59 years old. Results also demonstrated that 83% of DM patients also suffered from other chronic comorbid diseases, with cardiovascular diseases, especially hypertension and hypercholesterolaemia being the most prominent. This study also revealed that DM is predominantly managed with oral hypoglycaemic agents. Changes in drug prescribing, for chronic disease states such as DM may have medical, social and economic implications both for individual patients and for society and it is envisaged that the results of this study can be used to influence future management of DM. Keywords: Pharmacoepidemiology, management, type 2 diabetes mellitus
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Praet, Stephan Florent Eugenie. "Exercise therapy in Type 2 diabetes." Maarsen : Maastricht : Elsevier gezondheidszorg ; University Library, Universiteit Maastricht [host], 2007. http://arno.unimaas.nl/show.cgi?fid=9387.
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Dennis-Bradshaw, Rondalyn. "Diabetes Self-Management Education for Adults With Type 2 Diabetes Mellitus." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1812.
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Diabetes, a major public health challenge in St. Kitts, has been a focus of international public health community research. Although researchers have demonstrated that diabetes self-management education is a cost-effective strategy for the prevention of diabetes-related complications, they have yet to establish whether there is adequate education occurring in treatment settings with diabetic patients. The purpose of the study was to implement and evaluate the short-term effectiveness of a diabetes self-management education intervention on diabetes-related knowledge and accepted behavioral changes to decrease risk for complications. Based on a self-care approach, this education intervention was designed to improve diabetes-related knowledge and self-management behaviors. To test and evaluate the pre and post intervention effect, a convenience sample of 15 patients diagnosed with Type 2 diabetes attending a scheduled diabetic clinic completed the Diabetes Knowledge Test and a researcher-designed sociodemographic survey, which included self-report of blood glucose self-monitoring and foot care behaviors. The results of these analyses indicated that the participants’ knowledge level increased (p = < .001). However, Chisquare and Fisher’s exact tests determined no significant changes in the participants’ self management behaviors. The results may be attributed to the short time frame of the intervention. The implications for positive social change include opportunities to improve inter-professional collaboration in programs that will create positive effects on diabetic self care and reduce the incidence of negative health outcomes. Furthermore, the use of a self-care approach by health care professionals could be a key factor in strengthening diabetes knowledge, engagement, and self-management for Type 2 diabetic patients.
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Espelt, Hernández Albert 1981. "Socioeconomic inequalities in type 2 diabetes mellitus in Europe." Doctoral thesis, Universitat Pompeu Fabra, 2011. http://hdl.handle.net/10803/85055.
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Type 2 diabetes mellitus (T2DM) has become a major health problem worldwide. The St. Vincent declaration emphasized the urgent need to improve the epidemiological knowledge of this disease in Europe. Within Europe, research on the link between socioeconomic position (SEP) and type 2 diabetes is scarce.
The objective of this thesis was to conduct an extensive review of the current literature on socioeconomic inequalities in type 2 diabetes within European countries, while analyzing the relationship between, incidence, prevalence and mortality due to T2DM and SEP. In addition, we also analyzed trends on SEP inequalities in the prevalence of T2DM in Spain (1983-2006). Finally, we also assessed the appropriate use of health surveys with self-reported diagnosis in order to further analyze the relation between SEP and T2DM.
Different sources of information were used throughout the study. The systematic review was completed using the PUBMED database while the empirical studies used data of two European projects, the EUROTHINE, SHARE and the Spanish National Health Survey (study of trends in SEP inequalities in T2DM) along with the Catalonia health surveys (study of validation). The thesis consists of 5 papers that attempt to respond to the different objectives.
The studies included in this thesis suggest that socio-economic position (SEP) inequalities affect the incidence, prevalence and mortality by T2DM in Europe. These SEP inequalities are partly explained for body mass index, diet and physical activity. Moreover, these inequalities seemed to have remained constant or increased over time. Finally, health interview surveys with self-reported T2DM seems to be a good instrument to evaluate SEP inequalities in T2DM.<br>La Diabetis Mellitus Tipus 2 (DM2) ha esdevingut un dels principals problemes de salut a nivell mundial. La declaració de ST VINCENT emfatitzava la necessitat i la urgència de millorar-ne el coneixement epidemiològic a nivell Europeu. Els estudis a nivell europeu sobre les desigualtats per Posició Socioeconòmica (PSE) en la DM2 eren força escassos.
L’objectiu d’aquesta tesi era fer una revisió extensa dels estudis publicats sobre desigualtats per PSE en la DM2 a Europa, així com analitzar la relació entre la incidència, la prevalença i la mortalitat per DM2 i la PSE. Un altre objectiu també era analitzar la tendència de les desigualtats per PSE en la prevalença de DM2 a Espanya (1983-2006). Finalment, com a objectiu també hi figurava el valorar l’ús adequat de les enquestes de salut amb auto - declaració de DM2 per tal d’avaluar les desigualtats per PSE en la DM2.
Per tal de dur a terme els objectius es van emprar diferents fonts d’informació. Per tal de dur a terme la revisió sistemàtica es va emprar la base de dades de PUBMED mentre que pels estudis empírics es van utilitzar les dades de dos projectes europeus com són el projecte EUROTHINE i el SHARE i les enquestes nacionals de salut d’Espanya (per la tendència de diabetis) i de Catalunya (per la validació). La tesi consta de 5 articles que intenten donar resposta als diferents objectius.
Els estudis inclosos en aquesta tesi suggereixen que existeixen desigualtats per posició socioeconòmica (SEP) en la DM2, tant en la incidència, en la prevalença com en la mortalitat a Europa. Aquestes desigualtats per PSE s’expliquen en part per l’índex de massa corporal, la dieta o l’activitat física. A més a més, aquestes desigualtats sembla que s’han mantingut constants o han crescut al llarg del temps. Finalment, s’ha vist que les enquestes de salut amb la pregunta d’auto-declaració de la diabetis són un bon instrument per avaluar les desigualtats per PSE en la DM2.
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Isaacs, Renee Lalitha Cordelia. "Diet and type 2 diabetes mellitus in the Caribbean." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0004/MQ45413.pdf.
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Jeragh, Alhaddad Fatima Bakir. "Nonadherence among Kuwaiti nationals with type 2 diabetes mellitus." Thesis, University College London (University of London), 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.522824.
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Rees, S. M. "Bone density and neuropathy in type 2 diabetes mellitus." Thesis, Queen's University Belfast, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.419549.
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Johnson, Andrew. "Skeletal muscle insulin action in type 2 diabetes mellitus." Thesis, University of Newcastle Upon Tyne, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.321306.
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Minnaar, Danielle. "Audiovestibular function in adults with type 2 Diabetes Mellitus." Diss., University of Pretoria, 2017. http://hdl.handle.net/2263/65584.
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Diabetes is one of the most prominent health emergencies of the 21st century affecting millions worldwide. Approximately 415 million individuals had diabetes in 2015, more than 10% living in the Sub-Saharan Africa region. Diabetes is a chronic illness and is classified according to aetiology. Type 2 diabetes accounts for more than 90% of cases. The disease is initially asymptomatic resulting in 30% to 85% of cases remaining undiagnosed. Due to the delayed diagnosis, approximately 20% of the individuals will have developed secondary complications. Disorders of the auditory and vestibular systems are often associated with diabetes; however, the extent and nature of these vestibular manifestations are still unknown. A main aim of this research study was to investigate the audiovestibular function, risk of falling and health related quality of life (HRQL) in adults with type 2 diabetes, compared to findings of non-diabetic age and gender matched controls. This was achieved through testing, the audiovestibular function (pure tone audiometry, video head impulse testing, and cervical and ocular vestibular evoked myogenic potentials), fall risk utilising three assessments (TUG, BBS and DGI), and HRQL utilising a self-administered (EQ-5D-5L). A cross-sectional research design was employed. A purposive sampling method was employed to recruit the type 2 diabetics. The mean age was 49.1 years (± 6.2), 57.1% were female and had an average BMI of 31.6 ±7.6 (p=<0.001; t-test).The HbA1c for the type 2 diabetic participants was 9.3% (±2.2) and had disease durations of 15.36 years (±9.67). No significant difference between the two groups was observed in the pure tone audiometry results. Although there was a significant difference between the two groups at 500Hz in the left ear (p=0.007; t-test), indicating poorer hearing for the type 2 diabetics. Overall, there were no significant difference between the two groups was observed in video head impulse testing. There was, however, a significant difference between the two groups in the presence of saccades for the right lateral canal (p=0.002; McNemar test of symmetry).The type 2 diabetics had a 1.5 times higher risk of having absent cVEMP results. Furthermore, the type 2 diabetics had a 1.3 times higher risk of having absent oVEMP results. For the cVEMPs, 53.6% of the type 2 diabetics cVEMPs were absent (unilateral/bilateral), compared to 25% of the non-diabetic controls. For the oVEMPs, 74.1% of the type 2 diabetics oVEMPs were absent (unilateral/bilateral), compared to 53.6% of the non-diabetic controls. A significant difference between the two groups was obtained for the averaged TUG test (p=0.046; t-test), indicating a risk of falling amongst the type 2 diabetics. There were no significant differences between the two groups in the BBS and DGI scores. There was no significant difference between the two groups for the EQ-5D-5L questionnaire. There was, however, a significant difference between the two groups for the health dimension mobility (p=0.032; t-test). The type 2 diabetic participants had a higher occurrence of audiovestibular dysfunction, higher risk of falling and poorer HRQL than the non-diabetic adults, and should be examined and monitored through the progression of the disease. If there are any auditory or vestibular involvements, further assessments should be considered to minimize the functional limitations of quality of life.<br>Dissertation (MCommunication Pathology)--University of Pretoria, 2017.<br>Speech-Language Pathology and Audiology<br>MA<br>Unrestricted
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Noll, Amanda N., and L. Lee Glenn. "Self-Efficacy and Management in Type 2 Diabetes Mellitus." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7493.
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Doyle, Todd A. "Inflammatory Pathways Linking Type 2 Diabetes Mellitus and Depression." Ohio University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1332460860.
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McDowell, Joan Rachel Somerville. "Management of Type 2 diabetes mellitus in primary care." Thesis, University of Glasgow, 2014. http://theses.gla.ac.uk/5139/.
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Background: The incidence and prevalence of diabetes mellitus (diabetes) is increasing globally. The majority of people have type 2 diabetes, initially managed by lifestyle changes and the gradual introduction of oral, followed by subcutaneous, medications. Due to the increasing numbers of people with type 2 diabetes, different models of care management have been utilised within the United Kingdom. One Health Board within Scotland received funding to undertake a service redesign whereby the responsibility of care for people with type 2 diabetes was transferred from secondary care to primary care, with referral to specialist services based on clinical need. Aim: The aim of this thesis is to present the body of published work on an evaluation research study on the change in service delivery for people with type 2 diabetes. The published works have arisen from two funded research studies resulting in one peer reviewed report and five peer-reviewed papers published in international journals.
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Quandt, Raegan Elizabeth. "Education Protocol for Type II Diabetes Mellitus." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/6095.
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Diabetes mellitus is one of the leading causes of death in the United States, contributing to rising health care costs and increased morbidity and mortality rates. Researchers demonstrated that aggressive heath measures involving ongoing diabetes self-management education are paramount in minimizing associated complications of diabetes. The management and prevention of diabetes is not standardized and providers within a health clinic in Illinois reported challenges in providing self-management education during scheduled patient appointments due to limited resources and time. The purpose of this DNP project was to develop a clinical practice guideline to be used by all providers within the health care clinic for the management of Type 2 diabetes. The goal of the developed guideline was to optimize the time providers spend with patients diagnosed with diabetes and improve the consistency and quality of education and care. The health promotion model provided a guide for the development of the practice guideline. The method and design of this DNP project involved extensive research, literature review, evidence grading, and development of an evidence-based practice guideline for Type 2 diabetes management. A selected team of 3 diabetes experts appraised the developed guideline using the AGREE II instrument, and guideline usability was evaluated by 3 nurse practitioners within the medical clinic using a 10-item questionnaire. Results of the appraisal confirmed the high quality, feasibility, and usability of the developed guideline for diabetes self-management education and support. Improving the delivery of care can bring about positive social change by improving health outcomes in individuals with Type 2 diabetes and reducing morbidity and mortality rates.
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Eltahla, Auda Abdelsalam Biotechnology & Biomolecular Sciences Faculty of Science UNSW. "Gestational diabetes mellitus: a model for the genetics of type 2 diabetes." Awarded by:University of New South Wales. Biotechnology & Biomolecular Sciences, 2009. http://handle.unsw.edu.au/1959.4/44607.
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The striking similarity between Gestational Diabetes Mellitus (GDM) and Type 2 Diabetes (T2D) in terms of the pathophysiologies and the risk factors has led to the hypothesis that GDM is an early manifestation of T2D, expressed under the stress of pregnancy, and therefore both diseases should share similar susceptibility genes. GDM patients may provide a more homogeneous sample for the genetic causes of the disease than T2D, and therefore make a useful group for the identification of the genes involved. Over 200 GDM affected sib-pairs from 178 families were investigated, with parents available in 40% of cases. Genomic regions from 4 different chromosomes, 6, 8, 14 and 18 were chosen from regions that showed clustering for positive linkage scores in previous linkage studies on T2D and one control region on 13, where no previous positive linkage was reported. A total of 19 microsatellite markers were analysed for linkage to GDM using sib-pair analysis. Subset analyses were performed by ranking sib-pairs on GDM-related variables, e.g. mean BMI of sibs, age at GDM episode, etc. GENEHUNTER was run multiple times, each time including the next highest ranked family in the analysis. This gave a continuous range of scores where increasing or decreasing NPL scores indicated heterogeneity associated with different environmental factors such as age and weight. To evaluate the significance of the subset analyses, the results were compared to 10,000 permutations generated by randomly ranking the sib-pairs. Using the entire dataset, the analysis showed no significant linkage to a disease locus. Positive evidence for linkage was found with the subset analysis on chromosomes 8 and 14, suggesting heterogeneity between sib-pairs in the dataset. Marker D8S1742 on 8p23 showed an NPL score of 3.01 (p=0.001) when age at GDM diagnosis was used as a covariate. Using waist-to-hip ratio (WHR), marker D14S275 on 14q12 showed an NPL score of 2.474 (p=0.006). When adjusted for multiple testing, the results were not statistically significant for linkage to a diabetes disease locus, but gave evidence that GDM and T2D share similar genetic determinants, and defined groups of siblings for follow-up analysis of both types of diabetes.
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Sudagani, Jaidev. "Genes and type 2 diabetes : polymorphisms of the EIF2AK3 gene and its relationship to type 2 diabetes mellitus." Thesis, Queen Mary, University of London, 2010. http://qmro.qmul.ac.uk/xmlui/handle/123456789/411.
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Aims/ Hypothesis: Wolcott- Rallison syndrome (WRS) is a rare autosomal recessively inherited Mendelian disorder. It is characterised by a short trunk compared to arm span, multiple epiphyseal dysplasia, multiple fractures, hepatosplenomegaly and renal insufficiency in addition to insulin dependent diabetes. The onset of diabetes in WRS families is mainly below the age of 6 months and is characterised by permanent severe non-autoimmune insulin deficiency. Mutations of the gene encoding eukaryotic translational initiation factor 2 - alpha kinase 3 (EIF2AK3) were found to account for diabetes in WRS. The aim of our study was to determine whether common polymorphisms in the EIF2AK3 gene (Candidate gene association study) could be associated with type 2 diabetes. Methods: Direct sequencing was performed on all 17 exons/coding regions and intron/exon boundaries of EIF2AK3 gene in 48 diabetes and control subjects. Single Nucleotide Polymorphisms (SNPs) tagging the common haplotypes (tag SNPs) were identified and 11 SNPs were genotyped initially in 2,835 subjects with type 2 diabetes, 3,538 control subjects in the British Irish, Bangladeshi and South Indian Populations and 522 families (n= 1,722) in the British Irish and South Indian Populations. Results: We identified 19 SNPs by direct sequencing. There was no association (all p>0.05) between the SNPs and type 2 diabetes in the case–control study and in the family study. In the one marker, rs7605713, that showed a nominal significance in Warren 2 European samples, further replication studies in the Dundee samples (3,334 diabetes cases and 3,456 controls) proved to be negative thereby avoiding a false positive result. The results also showed several of the SNPs had different minor allele frequencies between the British/Irish Caucasians as compared to the South Asians. Conclusions/interpretation: Common variations in the EIF2AK3 gene were not associated with type 2 diabetes in the British Irish and the South Asian population.
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Mathur, Aditi. "Genetic association between schizophrenia and type-2 diabetes." Thesis, University of the Highlands and Islands, 2011. https://pure.uhi.ac.uk/portal/en/studentthesis/genetic-association-between-schizophrenia-and-type2-diabetes(71a1d702-37b0-470d-87d9-956cbd52c821).html.
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Aims: This PhD project was designed under two studies, the genetic association study to investigate a genetic component or a genetic pathway that might be associated with both schizophrenia and type-2 diabetes (T2D). The gene functional study to explore whether clozapine could affect expression of the genes associated with obesity and T2D. Methods: In genetic association study, a total of 17 single nucleotide polymorphisms (SNPs) were genotyped in the PPARG, PLA2G4A, PTGS2 and AKT1 genes in 221 British nuclear families. In the gene functional study, U937 cells were treated with clozapine (1g/ml and 2g/ml) for 48 hours and 96 hours. Quantitative real-time PCR analysis was used to measure the mRNA expression levels of the genes of interest in clozapine-treated and untreated cells. Results: Eight SNPs tested across the PPARG gene did not show allelic association with schizophrenia. An association was detected at rs2745557 in the PTGS2 locus (2=4.19, p= 0.041) and rs10798059 in the PLA2G4A locus (2=4.28, p=0.039), but these associations did not survive after 10,000 permutations (global p=0.246). Allelic association for the AKT1 gene was detected at rs1130214 (2=6.28, p=0.012) and at rs11847866 (2=4.64, p=0.031) only although the global p-value of overall associations for the AKT1 was 0.059 after 10,000 permutations. Haplotype analysis showed a disease association for the rs1130214-rs2494746-rs11847866 haplotypes (2= 10.18, df= 4, p=0.037), of which the T-G-A haplotype was excessively transmitted (2=6.93, p=0.008) and this haplotypic association survived the Bonferroni correction (p=0.04). The expression of the MTCH2 gene showed a significant decrease in mRNA expression (combined p=0.001) and that of the PPARG gene showed a significant increase (combined p=0.005) in the cells treated with 1g/ml clozapine for 96 hours. Conclusions: The present results support the AKT1 gene association with schizophrenia as reported in previous studies; both the MTCH2 and PPARG genes may be involved in the development of clozapine-induced obesity and in an increased risk of T2D.
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Mbaya, John Kabamba. "Lay beliefs of type 2 diabetic patients at Prince Mshiyeni Memorial Hospital, Durban." Thesis, University of Limpopo (Medunsa Campus), 2010. http://hdl.handle.net/10386/547.
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Thesis (M Med(Family Medicine))--University of Limpopo (Medunsa Campus) 2010.<br>Aim & Objectives
Aim: To explore the lay beliefs of type 2 diabetic patients seen at Prince Mshiyeni Memorial Hospital.
Objectives: To understand lay beliefs of effective life long management of type 2 diabetes patients and consequently to make recommendations of improving management of diabetes in conjunction with the findings of the study.
Methodology
Study Design: An exploratory study from a qualitative perspective using free attitude interviews as a data collection technique.
Setting: Prince Mshiyeni Memorial Hospital a district hospital located in Umlazi in the outskirts of Durban, South Africa.
Study Population: All type 2 diabetic patients above the age of 40 on treatment for 18 months or more. Ten respondents were purposively selected using maximum variation sampling strategy. Participants were asked individually to give an account of their beliefs and experience in the management of diabetes. All interviews were tape recorded, transcribed verbatim, and analyzed to identify emerging themes.
Results
The interpretative thematic analysis generated the following main themes:
1) Combination therapy
2) Modern versus Traditional
3) The bitter stuff
4) Traditional healers and alternative remedies
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5) Stress: Physical, financial, emotional, psychosocial strain
6) Spiritual believes: Religious and Traditional
7) Eating right food and loose weight
Conclusions
This study has described most lay beliefs about the management of type 2 diabetes in this setting. The research has identified that type 2 diabetic patients seen at Prince Mshiyeni Memorial Hospital in Umlazi South of Durban held different diabetes management beliefs based on their respective initial symptom perception and beliefs, their illness origin and healing beliefs, their spiritual and traditional beliefs and values and to a significant extent, the beliefs of spouses or life partner in couples and of family members. These findings have challenged the functionality of the health care in its capacity to respond to the population expectations based on their ethnic, spiritual and cultural background.
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Hamilton, Dorothy Jean. "The Lived Experience of Homeless Individuals with Type 2 Diabetes Mellitus." Kent State University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=kent160623154767295.
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Yates, Thomas E. "Can we out-walk the type 2 diabetes mellitus epidemic?" Thesis, Loughborough University, 2008. https://dspace.lboro.ac.uk/2134/8077.
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Type 2 diabetes mellitus is a chronic and debilitating disease whose prevalence continues to rise inexorably. Type 2 diabetes is usually preceded by a condition called prediabetes, which is characterised by impaired glucose regulation. Those with prediabetes have a significantly increased risk of developing type 2 diabetes compared to those with normal glucose control and therefore represent a key population in the prevention of type 2 diabetes. Physical inactivity is thought to be one of the key factors driving the increasing prevalence of prediabetes and type 2 diabetes and consequently forms a pivotal focus of initiatives aimed at their prevention. The principal aims of this thesis were to: 1) conduct a systematic review investigating the effectiveness of lifestyle and physical activity interventions at promoting physical activity in individuals with prediabetes and the effect of physical activity change on the risk of developing diabetes; 2) investigate the effect of walking activity on markers of chronic low grade inflammation; and 3) design and evaluate with objectively measured endpoints a physical activity intervention for adults at risk of developing type 2 diabetes that is suitable for implementation in a health care or community setting if found to be effective. The main findings are listed in the order of the stated aims. 1) Due to the dearth of controlled exercise training studies in those with prediabetes and the absence of evidence that previous diabetes prevention programmes have been successful at initiating clinically significant increases in physical activity, the evidence for the efficacy of physical activity behaviour change at prevention or delaying the progression to type 2 diabetes in those with prediabetes is equivocal. 2) Walking at levels that are consistent with the current physical activity recommendations is associated with reduced chronic low-grade inflammation, independent of other forms of physical activity. 3) The PREPARE programme, developed after a review of health behaviour theory and the current health care climate, is a theorydriven, group-based structured education programme designed to promote increased walking activity in individuals with prediabetes in a health care setting. A randomized controlled trial was conducted to test two versions of the PREPARE programme, a standard version and a pedometer version, against control conditions (advice leaflet). The standard version encouraged participants to set time-based goals based on generic exercise recommendations, whereas the pedometer version enabled participants to set personalized steps-per-day goals and to objectively self-monitor their daily physical activity levels using a pedometer. One hundred and three individuals were recruited to the study and follow-up was conducted at 3,6 and 12 months. At 12 months both intervention conditions were successful at achieving significant increases in objectively measured ambulatory activity; compared to the control group, those who received the pedometer version of the PREPARE programme increased their ambulatory activity by 1952 steps per day (95% CI 953 to 2951) and those who received the standard version by 1480 steps per day (95% CI 436 to 2522). However, significant improvements in glucose tolerance were only seen in the pedometer group, where 2-h glucose levels decreased by -0.94 mmol/l (95% Cl -1.79 to - 0.10) compared to control conditions, despite no significant change in body weight or waist circumference. This thesis has identified important limitations in the current evidence linking physical activity to the prevention of type 2 diabetes in those with prediabetes and has addressed several of these limitations by developing a theory-driven structured education programme which was shown to be successful at promoting physical activity and improving glucose tolerance in those with prediabetes to levels that are equal to or greater than previous multifactor diabetes prevention programmes. This is likely to have important implications for future diabetes prevention trials and clinical practice in the United Kingdom.
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Hoffman, Kristin. "Cancer treatment and cellular stress induced type 2 diabetes mellitus." Thesis, Boston University, 2012. https://hdl.handle.net/2144/12422.
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Thesis (M.A.)--Boston University
PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.<br>Some cancer treatments induce stress responses that activate protective mechanisms and neuregulin expression. In turn, neuregulin activates ErbB receptors, which are responsible for phosphorylating Insulin Receptor Substrates interfering with insulin activity and causing insulin resistance. The effects of neuregulin have been known to enhance development and survival of various tissues by providing nutrients. The activation of ErbB receptors leads to the activation of P13K, which in turn activates serine kinases responsible for phosphorylating IRS-1 and IRS-2. The serine phosphorylated IRS-1 and IRS-2 negatively modulate insulin signaling through the immediate auto-degradation of the serine phosphorylation of IRS, and dissociation of the IR/IRS complex. Furthermore, serine phosphorylated IRS interferes with downstream effectors such as AKT, which are necessary for modulating the glucose transporter, GLUT4. The purpose of this study is to test the hypothesis that neuregulin induced stress pathways alter glucose transport through similar cascades as insulin signaling. A series of experiments were conducted applying variable doses and combinations of neuregulin and insulin to measure the downstream effect on the level of AKT. These applications demonstrated that insulin and neuregulin activate AKT independent from each other through different complimentary mechanisms.
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Mutize, Tinashe. "DNA methylation : a risk factor for type 2 diabetes mellitus." Thesis, Cape Peninsula University of Technology, 2016. http://hdl.handle.net/20.500.11838/2388.
Full textAbstract:
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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Perez, Nieves Magaly. "The Association between Rheumatoid Arthritis and Type 2 Diabetes Mellitus." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1228.
Full textAbstract:
A research report from the Centers for Disease Control and Prevention (CDC) indicated that more than 50% of people with diabetes mellitus (DM) in the United States (U.S.) also have arthritis. The diabetes population is disproportionately affected by arthritis, but there has been limited and inconsistent research to confirm the association between type 2 diabetes mellitus (T2DM) and rheumatoid arthritis (RA). The current study aimed to identify an association between T2DM and RA for noninstitutionalized U.S. adults between 1999 and 2012 using a nationally representative sample from the National Health and Nutrition Examination Survey (NHANES) database (n =31,488 ). A quantitative, cross-sectional investigation was conducted to determine if patients with T2DM had an increased prevalence of RA. The current study also sought to identify characteristics that could affect the association between both groups and the prevalence of cardiovascular disease (CVD) in this population. Prevalence and adjusted odds ratios (OR) using logistic regression were calculated. The results show evidence of a strong association between T2DM and concomitant RA. Prevalence of RA was significantly higher in participants with T2DM compare to those without T2DM. Important factors in this association were gender, ethnicity, education, disability, and work functioning. The prevalence of CVD and adjusted OR of association were doubled in participants with T2DM and RA when compared to participants who had just one of the conditions; the OR of association was quadrupled when compared to those without this comorbidity. This study may provide patients and health care providers with a better understanding of the need for management of both conditions in a interdisciplinary manner
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McCann, Adrian. "Physical activity in the management of type 2 diabetes mellitus." Thesis, Cardiff Metropolitan University, 2011. http://hdl.handle.net/10369/3471.
Full textAbstract:
The incidence of type 2 diabetes mellitus (T2DM) is rising throughout the world. Explicit evidence has demonstrated sedentary behaviour is a powerful but modifiable risk factor affecting glycaemic control and the incidence of diabetes complications. Despite this, current population estimates indicate the importance of physical activity is not effectively translated to the T2DM population. The aim of this thesis was therefore to investigate barriers and facilitators to physical activity behaviour among individuals with T2DM. An extensive literature review investigating evidence linking physical activity to the management of T2DM was performed, then followed on by three studies which 1) investigated the effects of a 12-week supported exercise programme among newly diagnosed patients, 2) explored factors that may be associated with sedentary or physical activity behaviour, and 3) compared and contrasted the perception and use of physical activity among patients who participated in an exercise programme and patients who received standard care. The findings of this thesis demonstrated that a supported exercise programme can help newly diagnosed T2DM patients achieve moderate-high intensity physical activity 3-5 days·week-1, improving glycaemic control through enhanced β-cell function associated with decreased insulin resistance and improved lipid profile. Exploratory investigation suggested self-efficacy to exercise, internal locus of control and physical activity advice may be important antecedents for physical activity behaviour. Furthermore, it also appeared to suggest that peer support and more comprehensive physical activity information and reinforcement, are key to satisfying psychological needs - autonomy, competence and relatedness - and internalising motivation for physical activity and exercise behaviour. Given the projected incidence of T2DM and prevalence of sedentary behaviour among this population, the findings from this thesis highlight the important role of physical activity and also the need for further research investigating supported exercise programmes and the development of more comprehensive physical activity guidelines for individuals with T2DM.
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Dekki, Wenna Nancy. "Serum proteins in type 1 diabetes /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-057-2/.
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Pepe, Banza Kalenga. "The Profile of patients diagnosed with type 2 diabetes mellitus at Vanga Hospital, Dr Congo." Thesis, University of Limpopo (Medunsa Campus), 2010. http://hdl.handle.net/10386/780.
Full textAbstract:
Thesis (Family Medicine)) -- University of Limpopo, 2010.<br>Background
In the Vanga Health Zone, diabetic patients have idea that diabetes is due to
witchcraft, which idea can interfere with the prevention and management of their
disease. The purpose of this study was to determine the profile of patients diagnosed
with type 2 diabetes mellitus at Vanga Hospital, Democratic Republic of Congo (DR
Congo).
Methods
A cross-sectional study was designed with use of a questionnaire to a systematic
sample of type 2 diabetic patients attending the diabetic clinic of Vanga hospital for at
least six months and resident at Vanga health zone.
Results
Only 2.1 % of the participants believe in a scientific cause for diabetes; 53.5 % of
them do not think that their disease is due to the fact that they crossed over a path
where some ritual was performed and, 89.2 % of the participants believe that God
deserted the person who suffered from diabetes and expect that prayer will rectify the
disease. The majority of participants (65.6 %) had poor glycaemic control. Correlation
analysis has shown that glycaemia level was not significantly associated with
sociodemographic characteristics or health belief factors.
Conclusion
The majority of patients at the Vanga diabetic clinic have a greater need for
management strategies to improve their glycaemic control.
Keywords: type 2 diabetes mellitus, health beliefs, knowledge, sub-Saharan Africa,
rural
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Morling, Joanne Rebecca. "The epidemiology of chronic liver disease in older people with type 2 diabetes mellitus : the Edinburgh Type 2 Diabetes Study." Thesis, University of Edinburgh, 2015. http://hdl.handle.net/1842/21101.
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Increasingly chronic liver disease is being acknowledged as a complication of type 2 diabetes, in particular non-alcoholic fatty liver and non-alcoholic fatty liver disease. Rates of non-alcoholic fatty liver are higher in people with type 2 diabetes than in the general population, with prevalence rates believed to be between 40-70%. Given the aging Scottish population and the obesity driven diabetes epidemic, the problem of chronic liver disease is likely to increase. Despite this there has been little investigation into the natural history of nonalcoholic fatty liver disease and the risks of clinically significant chronic liver disease in community based cohorts because diagnosis has been heavily reliant on liver biopsy. The use of liver biopsy is limited in both research and clinical practice due to its associated high mortality (1/1000) and morbidity and also due to practical limitations (sampling variability, semi-quantitative scoring systems). As a result the use of non-invasive markers of liver injury (non-specific liver injury, steatosis, steatohepatitis, liver fibrosis and surrogates of advanced portal hypertension) are rising, in the diagnosis of chronic liver disease, however, their utility in both community cohorts and patients with type 2 diabetes has not been widely studied. The aims of the studies presented in the thesis, using the Edinburgh Type 2 Diabetes Study, were: (i) to describe the distributions of a range of non-invasive markers of steatohepatitis and liver fibrosis in older people with type 2 diabetes, their relationship with metabolic and liver disease risk factors, and to compare the agreement of different non-invasive markers of hepatic fibrosis; (ii) to determine the frequency (prevalence and incidence) of and risk factors for clinically significant chronic liver disease in people with type 2 diabetes; and (iii) to determine the importance of chronic liver disease as a risk factor (or risk marker) for cardiovascular mortality or morbidity in type 2 diabetes. Prior to undertaking this work I undertook a detailed systematic review of the literature relating to the use of non-invasive markers of hepatic fibrosis to inform the choice of markers used in the study. Examination of a wide range of potential markers of steatohepatitis and liver fibrosis found varied relationships with diabetes history. Most commonly, elevated markers of steatohepatitis and liver fibrosis were associated with older age and higher body fat measures. However, most of these relationships between liver markers and body fat measures lost statistical significance when limiting the population to only those with hepatic steatosis and/or non-alcoholic fatty liver disease. There were marked differences in the associations between different liver fibrosis markers and potential diabetes and metabolic risk factors, suggesting that these markers are not actually measuring the same underlying “fibrosis” condition. There was poor correlation between the five markers of liver fibrosis studied. Using the top vigintile (5%) of each marker resulted in excellent agreement on the absence of advanced liver disease but poor agreement on the presence of advanced liver disease. The prevalence of clinically significant CLD (defined as cirrhosis, HCC or gastrooesophageal varices) was 2.2% - 0.9% diagnosed prior to enrolment with an additional 1.4% identified by study investigations. Over nearly 6 years of follow-up, only 1.4% of the cohort developed incident clinically significant CLD. Higher levels of systemic inflammation, steatohepatitis and hepatic fibrosis markers were associated with both unknown prevalent and incident clinically significant chronic liver disease. Less than half of participants developing incident significant disease were identified as high risk by the study investigations. Abnormal liver enzymes were statistically significantly associated with incident cases, however the presence of hepatic steatosis was not. There were 372/1033 (36.0%) patients with prevalent CVD and 319 (30.9%) with prevalent CAD at baseline. After mean follow-up of 4.4 years there were 44/663 incident CVD events, including 27 CAD events. There were 30/82 CVD related deaths. However, risk of dying from or developing CVD was no higher in subjects with steatosis than in those without. There was also no statistically significant relationship between CVD and steatohepatitis or liver fibrosis. The only statistically significant relationship between CVD and any liver markers was with GGT (prevalent CVD, OR 1.28, p=0.007; incident CAD, OR 2.35, p=0.042), suggesting that in our study population, CLD may have little effect on the development of, or mortality from, CVD. In conclusion, the potential for using non-invasive biomarkers to diagnose clinically significant chronic liver disease in type 2 diabetes remains limited, however chronic liver disease is a significant problem in older people with type 2 diabetes and is frequently undiagnosed.
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Tukay, Remeliza Navarrete. "Diabetes Mellitus Type 2: A Quality Improvement and Patient Safety Initiative." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3213.
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The purpose of the quality improvement (QI) project was to examine the relationship between amended nursing education concerning diabetes mellitus (DM) Type 2 self-care management incorporating Tune in, Explore, Assist, Communicate, and Honor (TEACH) and Motivational Interviewing (MI) strategies and techniques and the Glycosylated hemoglobin (HgbA1C) of veteran patients with uncontrolled diabetes. The target sample included the 2 licensed practical nurses and 2 registered nurses assigned to 2 primary care teams, and the 10 purposively sampled patients with uncontrolled DM Type 2 from each team. The nurses' competencies were measured through descriptive comparison before and after nursing education implementation using the instrument Patient Education: TEACH for Success Self-Assessment Questionnaire. The nurses' confidence and their perceived importance of the TEACH and MI skills application and skill assessment for promoting health behavior change were tested inferentially with a paired t test before and after nursing education implementation using the instrument Clinician Importance and Confidence Regarding Health Behavior Counseling Questionnaire. The primary care team developed their skills tailored to each patient's needs, considering the guiding principles and premises of the health belief model (HBM). Patients' self-care management knowledge, skills and confidence were improved. The project decreased the elevated HgbA1C of patients measured after the project initiative. The QI project leads to positive social change by decreasing the number of patients with uncontrolled diabetes among the veteran population. The patients and their providers can develop individualized plans of care for diabetes management by educating, redirecting, and evoking behavioral changes in the veteran patients by using a team approach.
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Baur, Dorothee M., Jens Klotsche, Ole-Petter R. Hamnvik, et al. "Type 2 diabetes mellitus and medications for type 2 diabetes mellitus are associated with risk for and mortality from cancer in a German primary care cohort." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-112687.
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There is growing evidence that patients with type 2 diabetes mellitus have increased cancer risk. We examined the association between diabetes, cancer, and cancer-related mortality and hypothesized that insulin sensitizers lower cancer-related mortality. Participants in the Diabetes Cardiovascular Risk and Evaluation: Targets and Essential Data for Commitment of Treatment study, a nationwide cross-sectional and prospective epidemiological study, were recruited from German primary care practices. In the cross-sectional study, subjects with type 2 diabetes mellitus had a higher prevalence of malignancies (66/1308, 5.1%) compared to nondiabetic subjects (185/6211, 3.0%) (odds ratio, 1.64; 95% confidence interval, 1.12-2.41) before and after adjustment for age, sex, hemoglobin A1c, smoking status, and body mass index. Patients on metformin had a lower prevalence of malignancies, comparable with that among nondiabetic patients, whereas those on any other oral combination treatment had a 2-fold higher risk for malignancies even after adjusting for possible confounders; inclusion of metformin in these regimens decreased the prevalence of malignancies. In the prospective analyses, diabetic patients in general and diabetic patients treated with insulin (either as monotherapy or in combination with other treatments) had a 2- and 4-fold, respectively, higher mortality rate than nondiabetic patients, even after adjustment for potential confounders (incidence of cancer deaths in patients with type 2 diabetes mellitus [2.6%] vs the incidence of cancer deaths in patients without type 2 diabetes mellitus [1.2%]). Our results suggest that diabetes and medications for diabetes, with the exception of the insulin sensitizer metformin, increase cancer risk and mortality.
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Baur, Dorothee M., Jens Klotsche, Ole-Petter R. Hamnvik, et al. "Type 2 diabetes mellitus and medications for type 2 diabetes mellitus are associated with risk for and mortality from cancer in a German primary care cohort." Technische Universität Dresden, 2011. https://tud.qucosa.de/id/qucosa%3A26862.
Full textAbstract:
There is growing evidence that patients with type 2 diabetes mellitus have increased cancer risk. We examined the association between diabetes, cancer, and cancer-related mortality and hypothesized that insulin sensitizers lower cancer-related mortality. Participants in the Diabetes Cardiovascular Risk and Evaluation: Targets and Essential Data for Commitment of Treatment study, a nationwide cross-sectional and prospective epidemiological study, were recruited from German primary care practices. In the cross-sectional study, subjects with type 2 diabetes mellitus had a higher prevalence of malignancies (66/1308, 5.1%) compared to nondiabetic subjects (185/6211, 3.0%) (odds ratio, 1.64; 95% confidence interval, 1.12-2.41) before and after adjustment for age, sex, hemoglobin A1c, smoking status, and body mass index. Patients on metformin had a lower prevalence of malignancies, comparable with that among nondiabetic patients, whereas those on any other oral combination treatment had a 2-fold higher risk for malignancies even after adjusting for possible confounders; inclusion of metformin in these regimens decreased the prevalence of malignancies. In the prospective analyses, diabetic patients in general and diabetic patients treated with insulin (either as monotherapy or in combination with other treatments) had a 2- and 4-fold, respectively, higher mortality rate than nondiabetic patients, even after adjustment for potential confounders (incidence of cancer deaths in patients with type 2 diabetes mellitus [2.6%] vs the incidence of cancer deaths in patients without type 2 diabetes mellitus [1.2%]). Our results suggest that diabetes and medications for diabetes, with the exception of the insulin sensitizer metformin, increase cancer risk and mortality.
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Davila, Nancy. "Physical Activity in Puerto Rican Adults with Type 2 Diabetes Mellitus." Diss., The University of Arizona, 2010. http://hdl.handle.net/10150/195609.
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Diabetes mellitus (DM) has been the third leading cause of death in Puerto Rico (PR) since 1989. According to the PR Diabetes Center for Data Management, the prevalence of complications associated with diabetes in PR include: ischemic heart disease, renal failure and cerebro-vascular events, among others. Although physical activity has been identified as an integral part of preventing diabetes disease and complications in people already diagnosed, only 32.6% of the population engages in 30 minutes of moderate physical activity daily.The purpose of this descriptive-correlational study was to explore physical activity self-efficacy beliefs and outcome expectancies (perceived physical activity benefits and barriers) as possible factors that affect physical activity level in Puerto Rican adults diagnosed with type 2 DM. The guiding theoretical foundation was Self-efficacy-Social Cognitive Theory (SCT). An exploratory data analysis was conducted to determine the effects of socio-demographic variables on the principal variables. The contribution of socio-demographic factors, body mass index and the medical diagnosis to the prediction of principal variables were also explored.A sample of 110 Puerto Rican men and women between 40-60 years of age, with a mean of 52.2 years were recruited from four settings. Data was collected through a Demographic Data Questionnaire, Exercise Self-efficacy Scale, Exercise Benefits/Barriers Scale and International Physical Activity Questionnaire. Qualitative data were gathered to identify additional benefits and barriers that were not included in the questionnaire.The median for the moderate to vigorous physical activity reported by the sample was 82.5 minutes per week. The relationship between self-efficacy beliefs and physical activity was significant but moderate (rs=.32, p = .001). No significant association was observed between perceived benefits and physical activity (rs =.09, p = .38). Also, no significant association was observed between perceived barriers and physical activity level (rs = -.17, p = .07). The correlation between self-efficacy beliefs and perceived benefits was significant and moderate (rs = .46, p < .001). The correlation between self-efficacy beliefs and perceived barriers was significant, moderate and negative (r= -.40, p <.001). Self-efficacy was the only significant predictor of physical activity.The low physical activity and the high rate of overweight and obesity are significant risk factors for the development of chronic complications and low quality of life that threaten Puerto Rican adults with type 2 DM. Physical activity is an essential component of a healthy life-style and important to achieve a better self-management of diabetes disease. Self-efficacy had relevance to the enhancement of physical activity in this population. The research findings support the importance of SCT in both nursing research and practice. SCT is important in future research because, as exemplified in this study, it provides an approach to explain physical activity behavior. SCT is important for practice; because addressing principal variables of the theory can promote the development of innovative interventional programs for Puerto Rican adults with type 2 DM.
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Gatlin, Patricia K. "Severity of Type 2 Diabetes Mellitus, Working Memory, and Self-care." Diss., The University of Arizona, 2012. http://hdl.handle.net/10150/222911.
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Orem's Self-Care Deficit Theory was used to inform hypotheses of associations between perceived severity of illness, working memory and self-care among adults (>45 years of age) with Type 2 Diabetes Mellitus (T2DM). Working memory capacity was examined as a foundational capability using Orem's theory. Measures include the modified Diabetes Care Profile section on Health Status Composite (HSC) providing information on severity of illness, the Working Memory Index (WMI) from the Wechsler Adult Intelligence Scale (WAIS-III), the Self-Care Inventory Revised (SCI-R) and hemoglobin A1c. Sixty-seven adults with a mean age of 62.9 years who were primarily Caucasian (92.5%) were involved. There were 30 men and 37 women. Mean body mass index was 35.11 reflecting the majority of participants were obese. Findings indicate that HSC is significantly associated with WMI (r = .54, p < .01) and associated with both indicators of self-care, the SCI-R and HgA1c (r = .23, p<.05, r = -.37, p < .01). Working memory was examined as a mediator between severity of illness and the indicators of self-care (SCI-R and HgA1c) with no evidence for mediation. Findings are discussed in relationship to Orem's Theory of Self-Care Deficit.
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Dymott, Jane Alison. "Cardiovascular disease and type 2 diabetes mellitus : investigation of underlying mechanisms." Thesis, University of Glasgow, 2011. http://theses.gla.ac.uk/2788/.
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Cardiovascular disease (CVD) remains the leading cause of death in the United Kingdom and is associated with a huge burden of morbidity. Within the group of cardiovascular diseases coronary artery disease (CAD) is the single largest cause of death. Death rates from CAD have been falling since the 1970s predominantly due to a reduction in the prevalence in major risk factors such as cigarette smoking. Type 2 diabetes mellitus (DM) is an important risk factor for CVD. Type 2 DM is increasing in prevalence and there is concern that this will contribute to an increase in the burden of CVD. Reducing cardiovascular risk in patients with type 2 DM has to date focussed on tight blood pressure and glycaemic control together with statin therapy to achieve tight low density lipoprotein cholesterol (LDL) targets. Recent studies such as ADVANCE and ACCORD have highlighted some of the limitations with this approach. Important vascular abnormalities underlying the development of CAD include endothelial dysfunction and increased arterial stiffness. Some of the mechanisms underlying these abnormalities are thought to include increased oxidative stress, inflammation, insulin resistance and dyslipidaemia. These processes in patients with type 2 DM are currently not fully understood. It is hoped that through increased understanding of these processes new strategies for reducing cardiovascular risk in patients with type 2 DM can be identified. This study aimed to investigate some of the processes thought to underlie CVD in patients with type 2 DM namely endothelial dysfunction, arterial stiffness, oxidative stress and dyslipidaemia. Finally this study aimed to assess the impact of two cardiovascular prevention strategies (statin therapy and increased physical activity) on these processes believed to underlie the development of CVD. One hundred and twenty six patients with CAD (36 patients with type 2 DM, 90 patients without diabetes) and 80 controls (64 healthy controls and 16 varicose vein controls) were recruited as part of the VASCAB study. In these patients in vivo and ex vivo endothelial function studies were performed. Indicators of arterial stiffness were measured using pulse wave velocity and pulse wave analysis techniques. Superoxide levels were assessed in vascular tissue, mononuclear cells and whole blood. LDL and high density lipoprotein cholesterol (HDL) subfractions were analysed in patients with CAD. To assess the impact of intensive statin therapy and tight LDL targets, endothelial function and vascular superoxide levels were compared in patients recruited as part of the VASCAB study (2007 cohort) to a group of patients recruited in 2003. Finally patients attending the cardiac rehabilitation programme following surgical revascularisation were recruited to assess the impact of increased physical activity on endothelial function and oxidative stress. Endothelial function was impaired in patients with CAD compared to controls. In patients with CAD, type 2 DM was associated with greater impairment of endothelial function compared to patients with CAD alone. Superoxide levels in the vasculature, mononuclear cells and whole blood were similar in patients with and without type 2 DM. Type 2 DM was associated with significantly lower HDL levels and a preponderance to small dense LDL compared to patients without diabetes. Arterial stiffness was increased in patients with CAD compared to controls. There was however no significant difference in arterial stiffness in patients with type 2 DM and CAD compared to patients with CAD alone. Intensive statin therapy was associated with lower LDL levels and improved endothelial function but no change in vascular superoxide levels. Following the cardiac rehabilitation programme endothelial function was improved and HDL levels increased. There were no changes in levels of oxidative stress. Endothelial dysfunction in patients with type 2 DM may partly account for the increased cardiovascular risk and worse cardiovascular outcomes seen in this group of patients. Increased oxidative stress did not explain the endothelial dysfunction associated with type 2 DM. The dyslipidaemia that was associated with type 2 DM (low HLD and small dense LDL levels) may partly explain the increased endothelial dysfunction observed. Targeting endothelial dysfunction may therefore be a strategy for reducing cardiovascular risk in patients with type 2 DM. Intensive statin therapy and increased physical activity were both associated with improvements in endothelial function. The lack of evidence for increased arterial stiffness in patients with type 2 DM may reflect deficiencies in the methods used for assessing arterial stiffness. However this study highlights the difficulties of assessing arterial stiffness clinically and raises questions regarding the impact of type 2 DM on commonly used measures of arterial stiffness. Future prospective studies assessing the impact of improving endothelial function in patients with type 2 DM on cardiovascular outcomes are required. .
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MuraliKrishnan, Singhan Thulasiraman. "Cutaneous neurovascular abnormalities and wound healing in type 2 diabetes mellitus." Thesis, University of East Anglia, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.445539.
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In this thesis, microvascular and neuronal function in the foot skin of subjects with Type 2 diabetes was investigated to determine whether abnormalities exist, if and so to determine the role of such abnormalities in the pathogenesis of ulceration and its healing. The principle findings of the thesis are: - In the absence of macrovascular disease, impaired nerve function, (large and small nerve fibre) is associated with foot ulceration in Type 2 diabetic subjects; however, there appears to be no additional predictive value in measuring small fibre function using sophisticated methods over large fibre function assessed by measuring vibration sensation. Neither Tcp02 nor the more complicated measurements of microvascular hyperaemic responses were able to discriminate between those with and without ulceration. This would suggest that such tests may not be of benefit in identifying those at greater risk of foot ulceration. The 'LDIflare' a novel, simple, non-invasive and objective method to assess small fibre function is described. This demonstrates that C-fibre dysfunction occurs relatively early in Type 2 diabetes before it is detected by the currently available methods. Thus, the LDlflare may be of value in screening for early diabetic neuropathy. The LDlflare correlates well with skin nerve fibre density and in addition demonstrates functional changes in subjects with painful neuropathy when structural nerve fibre changes are less well marked. This suggests the LDlflare may have an advantage over skin biopsies and quantitative sensory testing in diagnosing painful diabetic neuropathy. The rate of wound closure was identical between control subjects and diabetic patients despite a significant reduction in microvascular blood flow, epidermal and dermal VEGF-A and blood vessel VEGFR-2 expression, the LDlflare response and dermal nerve fibre density. These studies are important in directing further research into these devastating and expensive complications of diabetes.
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Billingham, M. S. "Lipoprotein subfraction composition in Type 2 (non-insulin dependent) diabetes mellitus." Thesis, Open University, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.233326.
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Stopford, Rosanna Elisabeth Alice. "The social determinants of glycaemic control in type 2 diabetes mellitus." Thesis, King's College London (University of London), 2018. https://kclpure.kcl.ac.uk/portal/en/theses/the-social-determinants-of-glycaemic-control-in-type-2-diabetes-mellitus(ecd40ca8-b921-4a1c-b2b3-cb7ab05134b9).html.
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The social determinants of health are important contributors to health inequalities and have prognostic significance for biomedical profiles, morbidity and mortality. Despite this, in type 2 diabetes, there is a focus on the traditional medical model of care with little emphasis on the social contexts within which individuals are embedded. The primary aim of this thesis was to identify the social determinants of glycaemic control over 2 years in individuals with newly diagnosed (< 6 months duration) type 2 diabetes. A prospective cohort was used. Individuals with newly diagnosed type 2 diabetes were recruited from primary care centres in 3 adjacent boroughs of South East London. The setting was multi-ethnic and socio-economically diverse. Socio-demographic, biomedical, psychological and social data were collected using standardised data collection schedules, clinical assessments and from medical records. The main outcome was HbA1c (mmol/mol) at 2 years. Mixed effects multi-level models were used to investigate associations between social variables and HbA1c when accounting for relevant confounding and clustering within general practices. From 96 general practices, 1447 participants were recruited between September 2008 and November 2011. Their mean age was 56 years (±11.06), 55% were male and 51%, 38% and 11% of the sample were white, black and south Asian/other ethnicities respectively. In multi-level models neither social support nor the neighbourhood environment were significantly associated with HbA1c at 2 years after correcting for multiple testing. Type 2 diabetes is a major and growing burden to the individual and to society. Current models of social mechanisms for ill health do not appear to apply to people at the time they are diagnosed with type 2 diabetes, but this does not mean they are not important. These findings may suggest that social processes in the natural history of type 2 diabetes are more complex than originally presumed. They highlight the need to revisit and potentially, re-define the conceptual underpinnings of social theories to be applicable to type 2 diabetes.
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Jackson, Alan Edward. "The genetics of type 2 diabetes mellitus from the Indian subcontinent." Thesis, Queen Mary, University of London, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.420503.
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Al-Khudairy, Lena. "Dietary factors and type 2 diabetes mellitus in urban Saudi adults." Thesis, University of Warwick, 2014. http://wrap.warwick.ac.uk/65510/.
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Background: Saudi Arabia is ranked sixth for the highest prevalence of T2DM worldwide. There is very little information on dietary factors associated with the prevalence of T2DM in Saudi Arabia. There is an urgent need for the identification of culturally specific T2DM risk factors to then develop culturally tailored public awareness programs and interventions, to reduce the prevalence of T2DM. Objectives: To conduct a systematic review of the association between dietary factors and T2DM in the Middle Eastern region. To determine the association between dietary factors, including anthropometric measures, selected food items and beverages, selected dietary biomarkers and T2DM in Saudi adults. To identify culturally specific barriers to healthy eating in Saudi adults, with and without T2DM. Methods: The systematic review was conducted by searching several electronic databases and contacting authors, libraries, and research centres in the Middle East. Included studies assessed potential dietary factors for T2DM in Middle Eastern adults. An existing cross-sectional survey (n = 2631), which is part of a larger Biomarkers Screening Survey conducted in the urban area of Riyadh, Saudi Arabia (2009), of Saudi adults aged ≥ 18 years, was used to examine the association between dietary factors and T2DM. Anthropometric measures (n = 2355) included body mass index (BMI), waist circumference (WC), waist to hip ratio and sagittal abdominal diameter. Selected food/beverage included 17 items collected from a food freque ncy questionnaire (FFQ) (n = 1867). The FFQ was validated in this study against two 24 hour dietary recalls (n = 98). Dietary biomarkers included vitamin D and selenium (n = 567). Barriers to healthy eating were assessed by face-to-face interviews (n =108) carried out using modified predeveloped Saudi questionnaires and an additional questionnaire developed and piloted for the purpose of this study. Results: The systematic review highlighted the large gap in evidence of associations between dietary factors and T2DM in the Middle Eastern region in general and Saudi Arabia specifically. For the cross-sectional analyses, the overall sample was 2631 adults (females: 1280, males: 1351) and the prevalence of T2DM was 29.3% (females: 25.4%, males: 32.9%). WC was associated with T2DM independently of BMI, specifically in males. The intake of dates showed an inverse association with T2DM in males. Vitamin D levels were significantly higher in females with diabetes in comparison to nondiabetics. Serum selenium was associated positively with lipid parameters in females and fasting insulin in males. However, selenium was not associated with diabetes. Lack of dietary knowledge and culturally specific barriers (lack of social support, lack of will power and reliance) were barriers to healthy eating in participants with and without T2DM. Conclusion: The findings of this thesis highlight culturally specific factors associated with T2DM in Saudi adults. Further dietary studies in relation to T2DM are required in Saudi Arabia. Cultural issues should be incorporated when designing health awareness campaigns to address Saudis specific needs.
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Tomás, Gonçalo David Cabral. "Male fertility and type 2 diabetes mellitus: effect of white tea." Master's thesis, Universidade da Beira Interior, 2013. http://hdl.handle.net/10400.6/1348.
Full textAbstract:
Diabetes mellitus (DM) is one of the major public health problems and its increase
incidence is closely related with a decrease in birth rates. Male infertility related with type 2
DM (T2DM) has been linked to reactive oxygen species (ROS) overproduction and increased
testicular oxidative stress (OS). Tea is one of the most widely consumed beverages and its
antihyperglycemic and antioxidant potential has been reported. Herein, we hypothesized that
White Tea (WTEA) consumption by T2DM rats could prevent testicular OS preserving sperm
quality. For that purpose, we used a neonatal STZ-induced diabetic rat model. At one month
of age, water was substituted by WTEA during two months and testicular antioxidant
potential and OS were evaluated, as well as sperm parameters in normal and T2DM rats
drinking water or WTEA.
WTEA consumption improved glucose tolerance and insulin sensitivity in T2DM rats.
WTEA consumption restored protein oxidation and lipid peroxidation to normal levels.
Testicular antioxidant potential was increased by WTEA consumption in T2DM, while
testicular OS was decreased. Nevertheless, glutathione content and redox state was not
altered. After WTEA consumption by T2DM rats, sperm concentration was improved while
sperm motility, viability and the abnormal spermatozoa reached normal values evidencing
that epididymal sperm quality was restored. Overall, our results show that WTEA consumption
causes an important improvement in sperm parameters and thus in male T2DM reproductive
function, due to a significant decrease in testes ROS production. WTEA consumption can be a
natural, economical and good strategy to counteract the deleterious effects of T2DM in male
reproductive function.<br>A diabetes mellitus é um dos principais problemas de saúde pública e seu aumento de incidência está intimamente relacionado com a diminuição das taxas de natalidade. A infertilidade masculina relacionada com a diabetes tipo 2 tem sido associada ao aumento de produção de espécies reactivas de oxigénio e ao aumento do stress oxidativo testicular. O chá é uma das bebidas mais consumidas no mundo e o seu potencial anti hiperglicémico e antioxidante tem sido descrito em diversos estudos. Com este trabalho pretende-se investigar se o consumo de chá branco por ratos diabéticos tipo 2 pode prevenir o stress oxidativo testicular e assim preservar a qualidade espermática. Para essa finalidade, utilizou-se um modelo de rato diabético tipo 2 induzido por streptozotocina. Em animais com um mês de idade, a água foi substituída por chá branco durante dois meses e após esse período o potencial antioxidante e o stress oxidativo nos testículos foi avaliado, bem como os parâmetros espermáticos em ratos normais e em ratos diabéticos tipo 2 que consumiram água ou chá branco.
O consumo de chá branco melhorou a tolerância à glucose e a sensibilidade à insulina em ratos diabéticos tipo 2. Restaurou ainda os níveis de oxidação proteica e de peroxidação lipídica para níveis presentes em ratos controlo. O potencial antioxidante testicular foi aumentado pelo consumo de chá branco em ratos diabéticos tipo 2, enquanto o stress oxidativo testicular foi diminuído. No entanto, o teor de glutationa e o seu estado redox não foram alterados. Após o consumo de chá branco por ratos diabéticos tipo 2, a concentração espermática foi aumentada, enquanto a motilidade, a viabilidade e o número de espermatozóides anormais atingiram valores normais, evidenciando que a qualidade dos espermatozóides epididimais foi restaurada. No geral, estes resultados mostram que o consumo de chá branco provoca uma melhoria acentuada nos parâmetros espermáticos e, portanto, na função reprodutora masculina em diabetes tipo 2, devido a uma diminuição significativa na produção de espécies reactivas de oxigénio nos testículos. O consumo de chá branco pode ser uma estratégia natural e económica para neutralizar os efeitos deletérios da diabetes tipo 2 na função reprodutiva masculina.
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Johnson, Petra, and Thanyawan Lindh. "Diabetes mellitus typ 2 patientens behov av stöd." Thesis, Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-14450.
Full textAbstract:
I Sverige är 365 000 personer drabbade av sjukdomen diabetes mellitus typ 2. Sjukdomen kan bero på ärftliga eller miljömässiga faktorer. Sjukdomen börjar med insulinresistens i muskler, lever och fettvävnad som kan leda till allvarliga komplikationer. Patienter har behov av stöd från sjukvårdspersonalen för att hantera de egenkontroller och livsstilsförändringar som är nödvändiga. Genom empowerment kan patienter ta kontroll över sjukdomen. Litteraturstudiens syfte var att undersöka hur patienter med diabetes mellitus typ 2 beskriver sitt behov av stöd. Litteraturstudien består av 10 vetenskapliga artiklar, sex kvalitativa, två kvantitativa och två artiklar som är både kvalitativa och kvantitativa. Resultatet redovisas i fem teman: patientens behov av information som stöd, patientens behov av kunskap som stöd, patientens behov av undervisning som stöd, patientens behov av socialt stöd, patientens behov av stöd från sjukvårdspersonal. Patienter önskar information om blodsockerkontroller, medicinering, kost och motion från sjukvårdspersonalen för att kunna genomföra egenvård. Utbildning i grupp uppskattades av patienter, särskilt tillsammans med patienter med samma sjukdom och erfarenheter som de själva. Stöd från patientens omgivning kan stärka patientens livskvalitet. Upplevs behovet av stöd från sjukvårdspersonalen som tillräckligt upplevs sjukdomen hanterbar av patienterna. Det är därför relevant att sjuksköterskeprogrammet lyfter fram behov av stöd för patienter med diabetes mellitus typ 2 redan i utbildningen. Blivande sjuksköterskor kan då överföra kunskapen till vårdverksamheten. För vidare forskning inom ämnet vore det intressant att fler studier i Sverige undersöker patienternas behov av stöd och hur de upplever att deras behov blir bemötta i dagens sjukvård.<br>There are 365 000 people in Sweden who suffer from diabetes mellitus type 2. The disease is caused by factors that are genetic or environmental. The disease occurs from insulin resistance in the cells of the muscle, liver or fat tissue. The disease can result in serious complications. The patient has a need for support from the healthcare professionals to be able to manage self-management and the life- style changes that are necessary. The patient can through empowerment take charge over the disease. The aim of this study was to define how patients who suffer from diabetes mellitus type 2 describe their need for support. The literature study consists of ten scientific articles, six qualitative, two quantitative and two articles that were both qualitative and quantitative. The result is presented as five themes: the patient’s need for information as support, the patient’s need for knowledge as support, the patient’s need for education as support, the patient’s need for social support, the patient’s need for support from healthcare professionals. The patients desired information from the healthcare professionals about self- monitoring of blood glucose, medications, diets and exercise to be able to perform self-management. Peer education was appreciated by patients, particularly with patients with the same disease and experience as their own. The support from the surroundings could strengthen patient’s quality of life. If the need for support from the healthcare professionals was experienced as adequate the disease seemed more manageable by the patients. Therefore it is relevant, already in the beginning of the nursing program, to emphasize the need for support with diabetes mellitus type 2. Registered nurses can then include the knowledge within the clinic. Further research within healthcare is recommended, especially studies within Sweden that investigate the patient’s need for support.
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Holm, Pernilla. "Genetic studies of susceptibility to diabetes mellitus with emphasis on type 1 diabetes /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-527-1/.
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Aweida, Hafez Hanna, and Narin Savo. "Diabetes mellitus typ 2 och parodontit hos äldre." Thesis, Högskolan Kristianstad, Sektionen för hälsa och samhälle, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-9377.
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Tam, Hoi-ling. "Soluble receptors for advanced glycation end products in type 2 diabetes mellitus." Click to view the E-thesis via HKUTO, 2010. http://sunzi.lib.hku.hk/hkuto/record/B43572182.
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Cooper, Helen C. "Capturing the impact of patient education for people with type 2 diabetes." Thesis, University of Liverpool, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.272589.
Full textAbstract:
The prevalence of Type 2 diabetes mellitus is increasing worldwide and with it, the demands on heath service resources. As the long-term outcomes of this disease are dependent upon reducing lifestyle risk factors, together with effective treatment and screening strategies, much of the responsibility for diabetes management ultimately resides with the patient. Therefore patient education is a key part of the care of this population. A trial of an empowerment based health education programme was underpinned by the theories associated with health protective behaviour and those associated with adult learning. These align patient education to an experiential learning process within which beliefs about self-efficacy and the effects of social-environmental influences are central to outcomes. This view was compatible with current health care policies which see patients taking a more active and informed role in their disease management. The trial utilised a randomised controlled wait-list design to allow for the ethical limitations of excluding patients from educational treatment, and permitted collection of data over a short- and long-term period. A qualitative approach to data collection, using symbolic interactionism, was also integrated into the clinical trial. The two types of data were treated as complementary so that the outcomes of the trial relied upon detailed exploration of how they complemented each other. Eighty-nine patients were recruited from three diabetes centres. All patients recruited were blindly randomised to a 'Look After Yourself education programme. Clinical, behavioural and psychological outcomes were measured at six and twelve months. The relationship between these, the content of the intervention and participants' perspectives was assessed through ten focus group interviews. The combined results showed that the educational intervention had modified participants' personal models of diabetes by increasing their knowledge and understanding, by clarifying their beliefs and by changing their attitudes toward the disease and its management. It facilitated the acquisition of skills and prompted movement into the behaviour change cycle for the majority of those taking part, regardless of socio-economic status. The impact of these changes upon clinical outcomes was most effective where participants perceived their risk factors to be greatest. These findings supported the production of a framework for guiding nursing intervention to enhance patient self-management of diabetes. To adhere to such a model of care, however, the trial highlighted the need to expand the biomedical orientation to patient education so that it allows for patients' self-perceived needs. This demands integration of the medical and behavioural sciences into the practice of diabetes care and recognition of the need to support patients in their lifelong task of maintaining their own health. It recognises that care for chronic illness is an inherently different social enterprise than is care for acute illness. The findings have therefore highlighted the training needs for health professionals so that they can develop the skills that can enhance this process. Whilst these conclusions acknowledge the importance of continuing education and support for patients, such clinical practice will rely upon tailoring nursing intervention to the outcomes of a diabetes-specific assessment instrument. In this way, educational referral can become an integral part of a patient's treatment profile. Only then might health professionals authenticate a culture that supports patient choice so that they can take greater control over their health.
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Santos, Ângela Ferro. "Conhecer a diabetes: promoção da literacia em diabetes nas pessoas idosas." Master's thesis, Universidade de Évora, 2018. http://hdl.handle.net/10174/23504.
Full textAbstract:
O envelhecimento, nomeadamente o aumento da longevidade, amplia o risco de doença. A incidência e prevalência da diabetes têm aumentado, sendo que a literacia em saúde melhora a capacidade de viver melhor com esta patologia. Este relatório apresenta o projeto desenvolvido na área da promoção da literacia em saúde, durante o Estágio de Mestrado em Enfermagem, tendo como objetivo promover o conhecimento das pessoas idosas do Concelho da Vila do Bispo sobre a DM tipo 2. Foi utilizada a metodologia de planeamento em saúde. Os resultados obtidos mostram que os idosos têm dúvidas acerca da diabetes relativamente à importância da vigilância, controle, sua evolução e cronicidade, tendo sido realizadas ações de educação para a saúde no sentido de contribuir para o aumento da sua literacia. Os resultados evidenciam a necessidade de se continuar a estudar estratégias de cuidados que envolvam o diabético de forma a obter ganhos em saúde; ABSTRACT: Knowing Diabetes: Promoting diabetes literacy in the elderly
The increase in life expectancy is a prevalent evidence, but efforts are necessary to promote health and prevent diseases, because it appears that elderly people are increasingly at high risk of developing pathologies has they age. Diabetes is a disease whose incidence and prevalence has increased in the last years, particularly seniors.
This internship report features the work developed in the area of nursing care needs in a specific population, having as general objective to promote the knowledge to the elderly people of the Concelho da Vila do Bispo, about type 2 DM. The methodology of health planning was used, and a descriptive study of quantitative nature and education for health was carried out.
After the identification of these results, it was performed several health educational actions that counted with the involvement of seniors in order to promote information on diabetes. The work developed evidence the necessity to continue to develop strategies that include the involvement of diabetic people, so that they can obtain gains in health.