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Qu, Zilin, and 曲姿霖. "The association between different types of dairy consumption and type 2 diabetes mellitus : a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206957.
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Background: Type 2 diabetes mellitus is one of the most prevalent chronic diseases worldwide, currently affecting about 3 million global populations. The incidence of Type 2 diabetes has been increasing particularly in recently developed Asian settings including Hong Kong. Dairy product, as a part of dietary guidelines, has been hypothesized to help reduce risks of Type 2 diabetes. However different types of dairy product might have different effects on Type 2 diabetes given their varying content in fat, sugar and vitamins.
Objective: To review literature on the examination of the association between consumption of different types of dairy products (total dairy, high-fat dairy, low-fat dairy and fermented dairy) and the risk of type 2 diabetes
Methods Relevant studies were searched and identified through database of PubMed and Google Scholar using combination of keywords. Studies examining the association between consumption of total dairy and subtypes of dairy products and the risk of type 2 diabetes were included.
Results: Of the 163 papers identified, 10 studies were finally included in this systematic review. All studies were prospective cohort study from Western countries. Findings for different kinds of dairy products varied. For high-fat dairy products consumption, nine out of the ten studies found there was no association with type 2 diabetes risks. For low-fat dairy products, six out of ten studies found an inverse association after adjusted for confounders like age, sex and total energy intake; among these six studies, three still reported an inverse association after further adjusted for confounders like education level, smoking status and alcohol intake, physical activities and family history of type 2 diabetes. For fermented dairy products (mainly yoghurt), among seven studies which examined this, three studies found an inverse association between yogurt consumption and Type 2 diabetes risk before and after adjusted for multivariate confounders (age ,sex, total energy drink, education level, social class, physical activities, smoking status, alcohol intake and family history of type 2 diabetes, etc) . One of the three studies also found that, other than yogurt, there was an inverse association between low-fat fermented dairy and total fermented dairy consumption and type 2 diabetes risks after adjusted for age and sex. However, after further adjustment, the association became null for total fermented dairy products while it remained for low-fat fermented dairy products. All of the 10 studies that examined subtypes of dairy product also reported total dairy product consumption. For total dairy product, six out of ten studies found an inverse association.
Conclusion: Overall, total dairy consumption might be associated with lower risks of type 2 diabetes, but the associations may be varied by subtypes of dairy products. Across different types of dairy products, low-fat dairy consumption was associated with lower risk of type 2 diabetes while high-fat dairy consumption was clearly not associated with type 2 diabetes risk. Results for subtypes of fermented dairy consumption remain unclear. Further prospective cohort study in other non-Western populations may provide are required.<br>published_or_final_version<br>Public Health<br>Master<br>Master of Public Health
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Nordwall, Maria. "Long term complications in juvenile diabetes mellitus." Doctoral thesis, Linköping : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-6377.
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Jamali, Reza. "Peripheral Hypoglycaemic Neuropathy in Type 1 Diabetic Rats : Morphologic and Metabolic Studies." Doctoral thesis, Linköping : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7978.
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Elrayah-Eliadarous, Hind. "Economic burden of diabetes on patients and their families in Sudan /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-450-1/.
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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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Walker, Kelly N. "Family functioning and diabetic ketoacidosis in pediatric patients with type i diabetes." [Gainesville, Fla.] : University of Florida, 2004. http://purl.fcla.edu/fcla/etd/UFE0004901.
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Thesis (M.S.)--University of Florida, 2004.<br>Typescript. Title from title page of source document. Document formatted into pages; contains 42 pages. Includes Vita. Includes bibliographical references.
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Barazandegan, Melissa. "Assessment of type II diabetes mellitus." Thesis, University of British Columbia, 2016. http://hdl.handle.net/2429/59826.
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Several methods have been proposed to evaluate a person's insulin sensitivity (ISI). However, all are neither easy nor inexpensive to implement. Therefore, the purpose of this research is to develop a new ISI that can be easily and accurately obtained by patients themselves without costly, time consuming and inconvenient testing methods. In this thesis, the proposed testing method has been simulated on the computerized model of the type II diabetic-patients to estimate the ISI. The proposed new ISI correlates well with the ISI called M-value obtained from the gold standard but elaborate euglycemic hyperinsulinemic clamp (r = 0.927, p = 0.0045).
In this research, using a stochastic nonlinear state-space model, the insulin-glucose dynamics in type II diabetes mellitus is modeled. If only a few blood glucose and insulin measurements per day are available in a non-clinical setting, estimating the parameters of such a model is difficult. Therefore, when the glucose and insulin concentrations are only available at irregular intervals, developing a predictive model of the blood glucose of a person with type II diabetes mellitus is important. To overcome these difficulties, under various levels of randomly missing clinical data, we resort to online Sequential Monte Carlo estimation of states and parameters of the state-space model for type II diabetic patients. This method is efficient in monitoring and estimating the dynamics of the peripheral glucose, insulin and incretins concentration when 10%, 25% and 50% of the simulated clinical data were randomly removed. Variabilities such as insulin sensitivity, carbohydrates intake, exercise, and more make controlling blood glucose level a complex problem. In patients with advanced TIIDM, the control of blood glucose level may fail even under insulin pump therapy. Therefore, building a reliable model-based fault detection (FD) system to detect failures in controlling blood glucose level is critical. In this thesis, we propose utilizing a validated robust model-based FD technique for detecting faults in the insulin infusion system and detecting patients organ dysfunction. Our results show that the proposed technique is capable of detecting disconnection in insulin infusion systems and detecting peripheral and hepatic insulin resistance.<br>Applied Science, Faculty of<br>Graduate
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Stavrou, Eftyhia P. "Functional losses in type 2 diabetes mellitus." Thesis, Queensland University of Technology, 2001. https://eprints.qut.edu.au/36771/1/36771_Digitised%20Thesis.pdf.
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Aims:
Psychophysical tests such as Letter contrast sensitivity (CS) and flicker perimetry have been used to detect early functional losses in ocular disease such as age-related maculopathy (ARM) and in vascular disorders such as migraine. This study set out to determine the ability of these tests to detect early functional losses in type 2 diabetics with minimal or early diabetic retinopathy (DR).
Methods:
Subjects consisted of 20 patients with type 2 diabetes (duration, following diagnosis, ranging from 6 months to 18 years) and 24 age-matched normal controls.
Letter CS, using the Pelli-Robson cha.ii, visual acuity (VA) using the standard high contrast Bailey-Lovie chart and monocular visual fields (VF) were measured. Static and flicker VF were measured using the Medmont M600 perimeter (MFA) and SIT A-standard fields using the Humphrey Field Analyser (HFA) were tested.
Results:
Letter CS was able to discriminate those diabetic subjects with none or early DR and those with and without ME from the control group, whereas VA was not able to detect any significant differences in visual function in these diabetic sub-groups compared to the control group.
In terms of visual fields, both the pattern defect (PD) index and hill-ofvision profiles were analysed. In those with early onset of diabetes and in those with none/minimal DR, only the PD index obtained with the flicker technique was significantly worse than the control group. The hill-of-vision profiles showed that the PD loss in those with minimal DR when flicker perimetry was used, was due to a central depression close to fixation, whereas the MFA static and HFA profiles consisted of a general depression across the field. This indicated that the flicker technique is a more sensitive test than the static technique in determining central visual field defects in those with minor observable retinal changes.
The inability of the HFA to detect changes to the macula region was thought to be due to the large grid spacing of the stimuli, as when the severity of retinopathy increased to a moderate level, the MFA static technique produced central losses which were not evident with the HFA.
Conclusion:
For diabetic patients who had either, a duration of diabetes of less than five years, or displayed only minimal or no DR or no ME, VF defects were only elicited with the use of the MFA flicker technique. Further functional losses in those with no or early, clinically detectable changes, were revealed by measuring Pelli-Robson Letter CS.
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Penishkevych, Ya I., O. P. Kuchuk, O. O. Kuzio, and S. V. Tymofiychuk. "Risk factors for progression of diabetic retinopathy in patients with type 2 diabetes mellitus." Thesis, БДМУ, 2017. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/16914.
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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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Tong, King-hung Daniel, and 唐琼雄. "Surgical treatment for type II diabetes mellitus." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193510.
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Introduction: Historically, type 2 diabetes (T2DM) has been regarded as a progressive and degenerative disease and only minority of patients can have disease remission with conventional treatment. It was noticed that gastrointestinal surgery could induce complete remission of T2DM in most of morbidly obese patients. Compared to the West, the development of bariatric and metabolic surgery is slow in Hong Kong. It is unknown whether the knowledge and attitudes of medical doctors and patients towards surgical treatment for T2DM have impacts on the development in this field. The novel procedure sleeve gastrectomy (SG) had been shown to be effective in inducing T2DM remission in obese human. Duodenal jejunal bypass (DJB) and ileal transposition (IT) were reported to be effective for ameliorating T2DM in non-obese diabetic animal model. The anti-diabetic potency of DJB and IT is unknown in comparing to SG particularly in non-obese subjects. Currently, SG is the main procedure for morbidly obese patients with or without T2DM in the authors’ institution.
Aims: The aims of the present thesis were to investigate the knowledge and attitudes of medical doctors and patients toward using surgery as a treatment for T2DM, to compare the anti-diabetic effect of SG, DJB and IT in non-obese T2DM animal model, and lastly, to review of outcomes of morbidly obese patients who underwent SG in authors’ institution.
Methods: Survey was conducted using questionnaire for interview of both doctors and patients to investigate their knowledge and attitudes toward surgical treatment of T2DM. The anti-diabetic effects of novel surgical procedures SG, DJB and IT were compared using non-obese T2DM animal model (Goto Kakizaki rats). The outcomes were evaluation by measuring fasting glucose and glycosylated haemoglobin (HbA1c) levels. Other parameters including alteration in gut hormones and lipid profile were also analyzed. The outcomes of morbidly obese patients who underwent laparoscopic SG in last 5 years in the authors’ institution were retrospectively reviewed.
Results: The knowledge of bariatric and metabolic surgery was inadequate both in medical doctors and patients. The attitude and pattern of referral from medical doctors depends on the amount of knowledge. Patients’ attitudes were positive and they accept surgery as a treatment option for T2DM as long as they were provided with adequate information. This implies that tremendous educational works are required both for medical doctors and patients for the development of bariatric and metabolic surgery in Hong Kong.
All 3 procedures (SG, DJB and IT) significantly improved glucose homeostasis and the effect was more potent and durable in DJB and IT than SG. The improved glucose homeostasis in IT was resulted from increased GLP-1 and PYY secretion (hindgut theory). In DJB, GIP, GLP-1 and PYY were raised and the anti-diabetic effect could be explained both by the foregut and hindgut theories. SG reduced the diet triglyceride absorption. DJB reduced cholesterol absorption whereas IT reduced cholesterol but increase triglyceride absorption.
The outcomes of SG for T2DM for morbidly obese patients were promising. More than 90% patients had T2DM ameliorated and 70% had complete remission. SG can effectively control the body weight of morbidly obese patients.
Conclusion: Education, both to doctors and patients, was crucial to overcome the potential obstacles for the development of this newly specialty. The anti-diabetic effects of DJB and IT were more potent than SG in non-obese diabetic animal model. The lipid absorption varied in different surgical procedures. Application of these procedures in non-obese T2DM patients warrants individual consideration and further investigation. SG in the authors’ institution was effective to induce T2DM remission in morbidly obese patients.<br>published_or_final_version<br>Surgery<br>Doctoral<br>Doctor of Philosophy
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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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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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Urrutia, Aliano Débora, and Eddy R. Segura. "Depressive symptoms and type 2 diabetes mellitus in outpatients of an Armed Forces hospital in Lima, Peru, 2012: a cross-sectional study." Universidad Peruana de Ciencias Aplicadas (UPC), 2016. http://hdl.handle.net/10757/609239.
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El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.<br>Revisión por pares<br>INTRODUCCIÓN:
Los pacientes con diabetes mellitus tipo 2 son más propensos a una baja calidad de vida, discapacidad e incluso muerte. También, tienen una mayor predisposición a la depresión en comparación con los pacientes no diabéticos; así como una evolución favorable producto de la evaluación e intervención de su salud mental.
OBJETIVOS:
El objetivo de este estudio fue explorar la presencia de síntomas depresivos en una población ambulatoria con diagnóstico de diabetes mellitus tipo 2 y filiación militar. También examinar los factores asociados a la presencia de síntomas depresivos.
MÉTODOS:
Realizamos un estudio transversal en 108 personas con diabetes mellitus tipo 2, durante enero de 2012 en una muestra ambulatoria de un hospital de las fuerzas armadas. Los síntomas depresivos se evaluaron con el test autoaplicado de Zung. Usamos la prueba de Chi-cuadrado para examinar las asociaciones entre síntomas depresivos y los factores asociados de interés. Usamos modelos lineales generalizados crudos y ajustados para estimar las Razones de Prevalencia (RP) de la asociación entre las características clínicas y sociodemográficas con la presencia de síntomas depresivos.
RESULTADOS:
La prevalencia de sintomatología depresiva fue de 56,5% (intervalo de confianza 95%: 46,6-66,0%). El análisis bivariado mostró como significativa la asociación entre la presencia de síntomas depresivos con las variables: sexo, edad y complicaciones clínicas de la diabetes. En los análisis ajustados, la retinopatía diabética [RP: 1,3; intervalo de confianza 95%: 1,1-1,7], y la neuropatía diabética [RP: 1,4; intervalo de confianza 95%: 1,1-1,7] se asociaron a una mayor presencia de síntomas depresivos luego de considerar el sexo de los participantes.
CONCLUSIONES:
Observamos una elevada presencia de síntomas depresivos en la población de estudio, especialmente en los pacientes geriátricos o del sexo femenino. También en aquellos con complicaciones tardías de la diabetes mellitus tipo 2, y que probablemente representen la repercusión de la enfermedad en la calidad de vida del paciente. Un abordaje multidisciplinario, con enfoque físico y mental, debe ser considerado ya que podría beneficiar a la evolución de los pacientes con esta concomitancia en Perú.
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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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Ma, Jun. "Identification of the susceptibility genes in type 1 diabetes and diabetic nephropathy /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-398-6/.
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GREGOR, SARAH MARGARET. "INVESTIGATION OF HEARING LOSS IN NEONATES OF MOTHERS WITH DIABETES MELLITUS (TYPE I, TYPE II, AND GESTATIONAL DIABETES MELLITUS)." University of Cincinnati / OhioLINK, 2002. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1022180186.
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Gregor, Sarah. "Investigation of hearing loss in neonates of mothers with diabetes mellitus (type I, type II, and gestational diabetes mellitus." Cincinnati, Ohio : University of Cincinnati, 2002. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=ucin1022180186.
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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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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.
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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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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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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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Martinell, Mats. "Diabetes Mellitus at the Time for Diagnosis : Studies on Prognostic Factors." Doctoral thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-328382.
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The aim for this thesis was to identify prognostic factors for chronic diabetes complications that exist at the time of diabetes diagnosis. Low level of education (<12 years) and low income (<60% of median) was found to increase the risk to have high (>70 mmol/mol) HbA1c at the time of diagnosis with 34 % and 35 %, respectively. Prevalence of diabetic retinopathy (DR) was 12% in a cohort of patients newly diagnosed with diabetes. Diabetic macular edema was present in 11% of patients with type 2 diabetes (T2D) and 13% of those with Latent Autoimmune Diabetes in Adults (LADA). Low beta cell function and low level of education increased the risk for DR with 110% and 43%, respectively. For every unit of increase in body mass index, the risk for DR was reduced by 3%. The cellular immunology of LADA patients was a mixture of that observed in both type 1 (T1D) and T2D patients. Compared to patients with T1D, LADA patients had more B-regulatory lymphocytes and antigen presenting cells capable of producing interleukine-35. This indicates a higher anti-inflammatory capacity in LADA patients compared to type T1D patients. By imputing age, body mass index, HbA1c at diagnosis, beta cell function and insulin resistance in a cluster analysis, five distinct diabetes clusters were identified. The four clusters representing T2D patients differed in incidence of DR, nephropathy and non-alcoholic fatty liver disease. This was replicated with similar results in three geographically separate populations. By studying socioeconomic background and factors present at the time of diagnosis we can better predict prognosis for chronic diabetes complications. These findings may facilitate better-targeted diabetes screening programs and more individually tailored treatment regimes.
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Simpson, Sandra Marcia. "Walking the line managing type 2 diabetes : a grounded theory study of part-Europeans from Fiji : a thesis submitted in partial fulfilment of the requirement for the degree of Master in Health Science, Department of Nursing Studies, Auckland University of Technology, November 2004." Full thesis. Abstract, 2004.
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Edmundsson, David. "Chronic exertional compartment syndrome of the lower leg a novel diagnosis in diabetes mellitus: a clinical and morphological study of diabetic and non-diabetic patients /." Doctoral thesis, Umeå : Department of Surgical and Perioperative Sciences, Othopaedics, Department of Integrative Medical Biology, Anatomy, Umeå university, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-33694.
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Hoogma, Roeland Petrus Leonardus Maria. "Subcutaneous insulin infusion in type 1 diabetes mellitus." [S.l. : Amsterdam : s.n.] ; Universiteit van Amsterdam [Host], 2006. http://dare.uva.nl/document/29301.
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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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Wong, Xing-Wei. "Model-Based Therapeutics for Type 1 Diabetes Mellitus." Thesis, University of Canterbury. Mechanical Engineering, 2008. http://hdl.handle.net/10092/1573.
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The incidence of Type 1 diabetes is growing yearly. Worryingly, the aetiology of the disease is inconclusive. What is known is that the total number of affected individuals, as well as the severity and number of associated complications are growing for this chronic disease. With increasing complications due to severity, length of exposure, and poor control, the disease is beginning to consume an increasingly major portion of healthcare costs to the extent that it poses major economic risks in several nations. Research has shown that intensive insulin therapy aimed at certain minimum glycosylated haemoglobin threshold levels reduces the incidence of complications by up to 76% compared to conventional insulin therapy. Moreover, the effects of such intensive therapy regimes over a 6.5y duration persists for at least 10y after, a so called metabolic memory. Thus, early intervention can slow the momentum of complications far more easily than later intervention. Early, safe, intensive therapy protocols offer potential solutions to the growing social and economic effects of diabetes. Since the 1970s, the artificial endocrine pancreas has been heralded as just this type of solution. However, no commercial product currently exists, and ongoing limitations in sensors and pumps have resulted in, at best, modest clinical advantages over conventional methods of insulin administration or multiple daily injection. With high upfront costs, high costs of consumables, significant complexity, and the extensive infrastructure and support required, these systems and devices are only used by 2-15% of individuals with Type 1 diabetes. Clearly, there is an urgent need to address the large majority of the Type 1 diabetes population using conventional glucose measurement and insulin administration. For these individuals, current conventional or intensive therapies are failing to deliver recommended levels of glycaemic control. This research develops an understanding of clinical glycaemic control using conventional insulin administration and glucose measurement techniques in Type 1 diabetes based on a clinically validated in silico virtual patient simulation. Based on this understanding, a control protocol for Type 1 diabetes that is relatively simple and clinically practical is developed. The protocol design incorporates physiological modelling and engineering techniques to adapt to individual patient clinical requirements. By doing so, it produces accurate, patient-specific recommendations for insulin interventions. Initially, a simple, physiological compartmental model for the pharmacokinetics of subcutaneously injected insulin is developed. While the absorption process itself is subject to significant potential variability, such models enable a real-time estimation of plasma insulin concentration. This information would otherwise be lacking in the clinical environment of outpatient Type 1 diabetes treatment due to the inconvenience, cost, and laboratory turnaround for plasma insulin measurements. Hence, this validated model offers significant opportunity to optimise therapy selection. An in silico virtual patient simulation tool is also developed. A virtual patient cohort is developed on patient data from a representative cohort of the broad diabetes population. The simulation tool is used to develop a robust, adaptive protocol for prandial insulin dosing against a conventional intensive insulin therapy, as well as a controls group representative of the general diabetes population. The effect on glycaemic control of suboptimal and optimal, prandial and basal insulin therapies is also investigated, with results matching clinical expectations. To gauge the robustness of the developed adaptive protocol, a Monte Carlo analysis is performed, incorporating realistic and physiological errors and variability. Due to the relatively infrequent glucose measurement in outpatient Type 1 diabetes, a method for identifying the diurnal cycle in effective insulin sensitivity and modelling it in retrospective patient data is also presented. The method consists of identifying deterministic and stochastic components in the patient effective insulin sensitivity profile. Circadian rhythmicity and sleep-wake phases have profound effects on effective insulin sensitivity. Identification and prediction of this rhythm is of utmost clinical relevance, with the potential for safer and more effective glycaemic control, with less frequent measurement. It is thus a means of further enhancing any robust protocol and making it more clinically practical to implement. Finally, this research presents an entire framework for the realistic, and rapid development and testing of clinical glycaemic control protocols for outpatient Type 1 diabetes. The models and methods developed within this framework allow rapid and physiological identification of time-variant, patient-specific, effective insulin sensitivity profiles. These profiles form the responses of the virtual patient and can be used to develop and robustly test clinical glycaemic control protocols in a broad range of patients. These effective insulin sensitivity profiles are also rich in dynamics, specifically those circadian in nature which can be identified, and used to provide more accurate glycaemic prediction with the potential for safer and more effective control.
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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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Carvalho, Tiago Filipe Cruz. "Type 1 diabetes mellitus effects on mitochondrial function." Master's thesis, Universidade de Aveiro, 2011. http://hdl.handle.net/10773/7520.
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Mestrado em Bioquímica-Métodos Biomuleculares<br>Despite type 1 diabetes mellitus being more rare, it has an
autoimmune origin and appears early in life, greatly affecting its
quality. With the aim of better understand the molecular
mechanisms underlying the observed phenotypic alterations in
the skeletal muscle from diabetic patients, it was planned an
experimental protocol using 20 Wistar rats 8 weeks old,
randomly divided in two groups (n=10). The animals from one
group were injected with 60mg/Kg of streptozotocin (STZ), while
the others were injected with vehicle buffer. Four months after
STZ injection, rats were confirmed as diabetic, considering
hyperglycemia and body weight loss. After animals sacrifice,
gastrocnemius muscles were excised and used for mitochondria
subpopulations (subsarcolemmal (SS) and intermyofibrillar
(IMF)) isolation. mtDNA-to-muscle mass ratio suggest an
increased biogenesis of SS mitochondria in the STZ animals,
paralleled by a decreased protein content per mitochondrion, in
opposite to the observed in IMF mitochondria. The BN-PAGE
profile revealed a slight difference of the oxidative
phosphorylation complexes organization between mitochondrial
subpopulations, apparently not affected by STZ administration.
Mitochondrial proteolysis analysis, evaluated through
zymography, revealed two proteases with molecular weights
around 15 and 25 KDa, with the smaller one presenting STZinduced
significant decreased activity in IMF mitochondria. A
similar behavior was observed for paraplegin, a subunit of m-
AAA proteolytic system, and mitofilin, a protein involved in
cristae organization. Interestingly, these protein levels were
higher in SS mitochondria from diabetic animals.
With this work it was verified that subsarcolemmal mitochondria
are not so affected by STZ administration as IMF mitochondria.
The decreased activity of the protein quality control system
seems to be associated with the morphological and biochemical
alterations observed in the mitochondria interspersed in fibrils.<br>Apesar de a diabetes tipo 1 ser uma das formas mais raras
de diabetes mellitus, tem uma origem auto-imune e aparece
precocemente na vida de um indivíduo afectando
grandemente a qualidade da mesma. No sentido de melhor
compreender os mecanismos moleculares subjacentes às
alterações fenotípicas observadas no músculo esquelético
dos pacientes diabéticos, delineou-se um protocolo
experimental com 20 ratos Wistar com 8 semanas de idade,
aleatoriamente divididos em dois grupos (n=10). Os animais
de um dos grupos foram injectados com 60mg/Kg de
streptozotocina (STZ), e os outros com veículo. Após 4
meses, os ratos injectados com STZ foram confirmados
como diabéticos, tendo em consideração a hiperglicemia e a
perda de massa corporal. Após o sacrifício dos animais
foram retirados os músculos gastrocnemius, a partir dos
quais foram isoladas as duas subpopulações mitocondriais
(subsarcolemal (SS) e intermiofibrilar (IMF)). A análise da
razão mtADN-massa muscular sugere que a administração
de STZ induziu o aumento da biogénese mitocondrial SS
associado a um decréscimo do teor proteico mitocondrial, ao
contrário do observado nas mitocôndrias IMF. O perfil de BNPAGE
revelou uma ligeira diferença entre a organização dos
complexos da fosforilação oxidativa entre ambas as
subpopulações mitocondriais, aparentemente não afectada
pela administração de STZ. A análise da proteólise
mitocondrial, efectuada por zimografia, evidenciou duas
proteases com 15 e 25 KDa, tendo-se observado uma
diminuição acentuada da actividade da protease com menor
peso molecular nas mitocôndrias IMF dos animais
diabéticos. Uma tendência semelhante foi observada para a
expressão da subunidade paraplegina do sistema proteolítico
m-AAA e para a mitofilina, uma proteína envolvida na
organização da membrana interna mitocondrial.
Curiosamente, nas mitocôndrias SS dos animais diabéticos
verificaram-se níveis mais elevados destas proteínas.
Com este estudo verificou-se que no gastrocnemius, as
mitocôndrias IMF são mais afectadas pela diabetes mellitus
tipo 1 do que as SS. A diminuição da actividade do sistema
de controlo da qualidade proteica parece estar associada às
alterações morfológicas e bioquímicas observadas nas
mitocôndrias localizadas entre as fibrilas.
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Roberts, Clare Louise. "Associations between satisfaction with diabetes care, diabetic control and psychological variables in adolescents with type I insulin dependent diabetes mellitus." Thesis, University of Edinburgh, 2000. http://hdl.handle.net/1842/26887.
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Insulin Dependent Diabetes Mellitus (IDDM) is a life-long condition, which is the third most common chronic illness in young people (Metcalfe & Baum, 1991). Management of the illness includes a daily regimen of blood testing, insulin injections and careful balancing of diet and exercise (Shillitoe, 1995). In adolescence, diabetes control often deteriorates (Brink, 1997; Jacobson, Hauser, Wolsdorf, Houlihan, Herskowitz, Wertlieb & Watt, 1987). This consequently can have a detrimental effect on future physical health (Diabetes Control and Complications Trial, 1994). A large amount of research has sought to identify the relevant variables that are indicative of good and poor adjustment to chronic illness (for example, Eiser, 1990a). Several models have been developed, including the Risk and Resilience Model (Wallander & Varni, 1998), which was used to guide this study. It is hypothesised that patient satisfaction with diabetes care will act as a resilience factor and therefore be associated with better psychological well-being. Eighty-three young people between the ages of 14 and 18 attending diabetes outpatient clinics in the Lothian area were assessed, using standardised measures of patient satisfaction, quality of life, psychological well-being and adaptation to diabetes. The relationships between these variables, diabetic control and the effects of age, gender and time since diagnosis were calculated. Results are discussed in relation to the planning and evaluation of medical and psychological services for adolescents with diabetes. Finally, methodological weaknesses are highlighted and implications for future research discussed.
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Gambelunghe, Giovanni. "Immunogenetic studies in autoimmune endocrine diseases /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-691-x/.
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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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Ferreira, Filipa Cristina Costa. "A Diabetes - Principais Parâmetros para o Controlo da Diabetes." Master's thesis, Faculdade de Ciências Médicas. UNL, 2013. http://hdl.handle.net/10362/10001.
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RESUMO: A Diabetes Mellitus é uma doença metabólica crónica, com deficiência a nível do metabolismo dos hidratos de carbono, lípidos e proteínas, resultante de deficiências na secreção ou ação da insulina, ou de ambas, que quando não tratada antecipadamente e de modo conveniente, pode ter consequências muito graves. Dado a incidência a nível mundial da Diabetes Mellitus, torna-se de elevada importância avaliar toda a sua envolvência e estudar bem quais os critérios a ter em consideração. Este trabalho propõe-se estudar para além dos parâmetros bioquímicos relacionados com a doença - Glicose e Hemoglobina Glicada A1c (HbA1c), analisar os resultados dos últimos cinco anos (2008-2012) dos ensaios interlaboratoriais do PNAEQ, do Departamento de Epidemiologia, do Instituto Nacional de Saúde Dr. Ricardo Jorge. Foram também analisadas as metodologias utilizadas e as variações interlaboratoriais, de forma a entender qual ou quais são os parâmetros mais adequados para o seu diagnóstico e controlo.
Este estudo utilizou a população de laboratórios portugueses, públicos e privados, de Portugal Continental e Ilhas, um laboratório de Angola e outro de Macau que se inscreveram no PNAEQ nestes cinco anos, sendo a amostra composta pelo n.º de participações. No programa de Química Clinica foram distribuídas 38 amostras e no programa de HbA1c foram distribuídas 22 amostras.
Para a glicose, o nível de desempenho nos ensaios é na globalidade das amostras de Excelente, no entanto verifica-se que sempre que a concentração da amostra é de nível patológico, que a maioria dos ensaios o desempenho foi inferior – Bom. O método de eleição e com CV% mais baixos foi o método da hexoquinase. Para a HbA1c, o nível de desempenho nos ensaios é na globalidade das amostras de Excelente. O método de eleição e com CV% mais baixos foi o método de HPLC. O CV% para a glicose ronda desde 2010 a 2012, os 3% e para a HbA1c foi de aproximadamente 4,0% em 2012.
A HbA1c tem mostrado ser uma ferramenta muito útil, importante e robusta na monitorização da Diabetes, sendo hoje em dia quase sempre requisitada em análises de rotina a diabéticos de modo a prevenir complicações que possam vir a acorrer. No futuro poderá ser um importante, senão o parâmetro de futuro, para o diagnóstico da Diabetes, no entanto, mesmo já tendo sido muito trabalhada a sua padronização, ainda existem questões por responder como quais são na realidade todos os seus interferentes, qual a verdadeira relação da HbA1c com a glicose média estimada, em todas as populações e com estudos epidemiológicos. Também a própria educação do diabético e clínico deve ser aprimorada, pelo que neste momento as PTGO e os doseamentos de glicose em jejum devem ser utilizados e encontrando-se a Norma da DGS N.º 033/2011 de acordo com as necessidades e com o estado da arte deste parâmetro. A implementação da glicose média estimada será uma mais-valia na monitorização dos diabéticos pelo que deverá ser uma das prioridades a ter em conta no futuro desta padronização, uniformizando a decisão clinica baseada nela e minimizando a dificuldade de interpretação de resultados de laboratório para laboratório. --------------ABSTRACT: Diabetes Mellitus is a chronic metabolic disease, with a deficit in the metabolism of carbohydrates, lipids and proteins, resulting from deficiencies in insulin secretion or action, or both, which if, when not early treated in a proper way, may result in very serious consequences. Given the worldwide incidence of diabetes mellitus, it is highly important to evaluate all its background and study specifically all the criteria to take into consideration. The aim of this thesis is to study and evaluate beyond the biochemical parameters related to the disease - Glucose and Glycated Haemoglobin A1c (HbA1c), analyze the results of the last five years (2008-2012) of the PNAEQ interlaboratorial tests, in the Department of Epidemiology of National Institute of Health Dr. Ricardo Jorge. It is also intended to analyze the methodologies used and the interlaboratorial variations, in order to understand the most suitable parameters for the diagnosis and control.
This study was based in a population of Portuguese laboratories, public and private, of Portugal mainland and islands, a laboratory of Angola and other from Macau, who enrolled in PNAEQ in these five years, and the sample was composed by the n. º of holdings. In the Clinical Chemistry Program there were distributed 38 samples and in the program HbA1c were distributed 22 samples.
For glucose, the level of performance in the total nº of the samples was Excellent; however, it was found that when the concentration level of the sample was pathological, in most of the tests the performance was Good. The most preferred method with the lowest CV% is the hexokinase method. For the HbA1c, as a whole, the samples’ tests were Excellent, at the level of performance. The method of election with the lower CV% was the HPLC. The CV% for glucose was around 3%, from 2010 to 2012 and the HbA1c was approximately 4.0% in 2012.
The HbA1c method has demonstrated to be a very useful tool, important and robust for monitoring diabetes, being nowadays, almost always required in routine analysis to prevent future complications. In the future it may be an important parameter, if not the most important, for the diagnosis of diabetes. However, despite it has already been standardized, there are still some questions that need to be answered, such as, which are in fact all their interferences, which is the true connection of HbA1c, when compared with the estimated average glucose, in all populations and epidemiological studies. Moreover, the education of the patient and the doctor concerning diabetes should be improved. Nowadays, the Oral Glucose Tolerance Test (OGTT) and fasting glucose determinations should be used and, the needs and the state of the art of this parameter, should be in accordance with the Standard DGS N. º 033/2011.
The Implementation of the estimated average glucose will be an added value in monitoring diabetics and, therefore, should be a priority to consider in its future standardization and clinical decision based on it, will be uniform and the difficulty of interpreting results from laboratory to laboratory will be minimal.
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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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Clark, DessyeDee M. "Computer-aided hypoglycemia detection in adolescents with insulin-dependent diabetes mellitus /." Thesis, Connect to this title online; UW restricted, 2001. http://hdl.handle.net/1773/7368.
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Silva, Kely Nayara dos Reis. "A autoeficácia da insulinoterapia em portadores de Diabetes Mellitus." Universidade Federal do Maranhão, 2016. http://tedebc.ufma.br:8080/jspui/handle/tede/1603.
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Previous issue date: 2016-07-25<br>Diabetes Mellitus (DM) is a heterogeneous group of metabolic disorders that have in common hyperglycemia. Diabetics under treatment with insulin therapy must embrace responsibility of the control and management of their condition on a daily basis; in this context the congnitive theory of self efficacy (SE) proposed by Bandura can be considered a decisive factor in achieving behavioral goals of diabtes, resulting in improvements to self-care and glycemic control. The research here presented aimed to analyse the self efficacy to the treatment of patients with diabetes mellitus type 1 and 2 in insulin therapy and its correlaton with sociodemographic and clinical variables. To that end, we conducted and analytical study of cross-sectional, with quantitative approach and sample consisting on 134 patients with DM type 1 and 2 in insulin therapy at University Hospital's Endocrinology Clinic - Unit President Dutra (HUUPD) of São Luís-MA. For data collection, we used two instruments: identification data with open and closed questions related to sociodemographic and clinical variables and the Insulin Management Diabetes Self Efficacy (IMDSES), Brazilian version. The search resulted 3.07 global media, on the scale of self efficacy, the areas that stood out with the highest and lowest average respectively were the general management domain (3.38) and the diet field (2.90). We have found the following significant correlations: marital status (widowed had more SE in the diet), education (the higher the education, the better the SE in the management, control and correction of glycemia), treatment with diet and insulin (higher SE in the diet), absence of dyslipidemia (increased SE to the overall management of diabtes) and age (higher SE for older in the diet). It was concluded that there are factors relates to socioeconomic and clinical features that interfare in self efficacy of patients with Diabetes mellitus type 1 e 2 in insulin therapy, against the desease.<br>O Diabetes Mellitus (DM) é um grupo heterogêneo de distúrbios metabólicos que apresentam em comum a hiperglicemia, resultado de defeitos na ação da insulina, na secreção de insulina ou em ambas. Os diabéticos que fazem tratamento com insulinoterapia devem assumir a responsabilidade do controle e gestão de sua condição no dia a dia. Nesse contexto, a teoria cognitiva da autoeficácia (AE) proposta por Bandura pode ser considerada um fator decisivo para atingir as metas comportamentais do diabetes, resultando em melhorias para o autocuidado e controle glicêmico. A pesquisa que se apresenta, teve como objetivo analisar a autoeficácia do tratamento dos portadores de diabetes mellitus tipo 1 e 2 em insulinoterapia e a sua correlação com as variáveis sociodemográficas e clínicas. Para tanto, foi realizado um estudo analítico de corte transversal, com abordagem quantitativa e amostra de 134 portadores de DM tipo 1 e 2 em insulinoterapia, atendidos no Ambulatório de Endocrinologia do Hospital Universitário - Unidade Presidente Dutra (HUUPD) de São Luís-MA. Para a coleta de dados, utilizaram-se dois instrumentos: dados de identificação com questões abertas e fechadas referente às variáveis sociodemográficas e clínicas e o Insulin Management Diabetes Self Efficacy (IMDSES), versão brasileira. A pesquisa resultou média global de 3,07 na escala de autoeficácia, os domínios que se destacaram com maior e menor média respectivamente foram o domínio administração geral (3,38) e o domínio dieta (2,90). Encontraram-se as seguintes correlações significativas: estado civil (viúvos tinham maior AE na dieta), escolaridade (quanto maior a escolaridade, melhor a AE na administração, controle e correção da glicemia), tratamento com dieta e insulina (maior AE na dieta), ausência de dislipidemia (maior AE para o manejo geral do diabetes) e idade (maior AE para os mais velhos na dieta). Concluiu-se que existem fatores relacionados às características socioeconômicas e clínicas que interferem na autoeficácia do portador de Diabetes mellitus tipo 1 e 2 em Insulinoterapia, frente à doença.
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Kirov, Eliena. "The management of Type 2 diabetes mellitus in Western Australians of Southern European origin." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2008. https://ro.ecu.edu.au/theses/206.
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Type 2 diabetes mellitus is a growing health problem both nationally and internationally. In Australia and Western Australia, prevalence rates have been increasing steadily over the past 20 years which has prompted the Commonwealth Government to implement strategies and recommendations encouraging increased attention relating to the various lifestyle aspects of type 2 diabetes. The strategies include aims to lessen the burden of type 2 diabetes on the health system and mortality and morbidity at the social level, and enhance the management, life expectancy, and quality of life for the individual. Drawing on this increased attention to lifestyle factors, this study focuses on lifestyle and ethnicity. This study identifies and describes the diabetes management strategies of Southern European-born Slav and Italian cultural groups, as well as an Australian-born Anglo-Celtic cultural group. Southern Europeans are a group at high risk for type 2 diabetes development, and form the second largest immigrant group in Australia after those born in the United Kingdom, and are one of the oldest migrant groups, having reached a peak in migration during the post-World War II immigration boom.
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Hall-Johnson, Richard Earl. "Effects of Acute and Chronic Glycemic Control on Memory Performance in Persons with Type II Diabetes Mellitus." Thesis, University of North Texas, 1995. https://digital.library.unt.edu/ark:/67531/metadc279158/.
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Memory performance was measured in 48 persons between the ages of 40 - 65 with Type II diabetes. Correlations between performance on the California Verbal Learning Test, tests of Working Memory, Priming Memory, and Prospective Memory and several predictor variables were examined. These variables included the Slosson Intelligence Test Scores, demographic variables, presence of diabetic complications, finger-stick and HbA1c measures. Subjects performed worse than the normative sample on the California Verbal Learning Test. Higher chronic and acute blood glucose tended to be associated with worse performance on the CVLT, Priming, and Working Memory. However, after the effects of intelligence, education, and sex were statistically controlled, glycemic status predicted performance on just a few memory measures. These were short-delay recall compared with recall on List A trial 5, and List B on the CVLT, and recall accuracy on digit forward of the Working Memory Test. Glucose status was unrelated to performance on a prospective memory test. Several other demographic and diabetic complication factors predicted performance beyond the contribution of intelligence. These results contrast with previous studies which found strong effects of glycemic control, but did not statistically control for the contribution of intelligence. Differential effects of diabetic status on different aspects of memory were discussed.
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Elfvin, Åkesson Karin. "Genetic analysis of type 1 diabetes /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-321-4/.
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Carbonell, Puig Marc. "Retinopatia diabètica i gruix coroïdal com a factors associats a la malaltia ateroscleròtica subclínica en pacients amb diabetis mellitus tipus 1 sense antecedents previs de malaltia cardiovascular." Doctoral thesis, Universitat Autònoma de Barcelona, 2020. http://hdl.handle.net/10803/669545.
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La retinopatía diabética (RD) es la principal complicación microvascular de los pacientes con diabetes mellitus (DM). Además, los pacientes con DM y RD presentan un riesgo aumentado de enfermedad cardiovascular (CV). La enfermedad CV por aterosclerosis es la principal causa de morbimortalidad en pacientes con DM. Por otro lado, existen evidencias que muestran que la neurodegeneración de la retina puede preceder los cambios vasculares visibles en la RD. Finalmente, la relación del grosor coroideo (GC) con el estadío de RD no está bien definida. El objetivo del estudio fue evaluar la relación de la presencia y carga de la enfermedad aterosclerótica carotídea subclínica en pacientes con DM de tipo 1 (DM1) con la presencia y gravedad de la RD, así como evaluar los cambios estructurales de la retina y la coroides en pacientes con DM1 y comparar los resultados con sujetos normoglucémicos. Se realizó un estudio transversal con 340 pacientes con DM1 sin enfermedad CV previa ni enfermedad renal crónica (MRC) establecida y 304 sujetos normoglucémicos, con el objetivo de evaluar la asociación de la enfermedad aterosclerótica carotídea subclínica con la presencia y la gravedad de la RD. Para el objetivo de evaluar los cambios estructurales de la retina y la coroides, se incluyeron 242 pacientes con DM1 y 69 sujetos normoglucémicos. Los resultados que se presentan en esta Tesis muestran que en los pacientes con DM1, el porcentaje de pacientes con placas carotídeas es más elevado en los que tienen RD en comparación con los pacientes sin RD (44,7% vs. 24,1%, p <0,001). Los pacientes con RD también presentan una mayor frecuencia de ≥ 2 placas carotídeas en comparación con aquellos RD (25,5% vs. 11,1%, p <0,001). La presencia de etapas avanzadas de RD se asocia de manera independiente con la presencia (p = 0,044) y la carga (p = 0,009) de aterosclerosis carotídea subclínica. Por otra parte, el análisis estructural de la retina con SD-OCT muestra que en los pacientes con DM1 el grosor de la capa de fibras nerviosas (RNFL) es menor en los pacientes sin RD (p <0,001), RD leve (p <0,001) y RD avanzada (p <0,001) en comparación con sujetos normoglucémicos. El grosor de la capa de células ganglionares (GCL) es menor en pacientes con DM1 y RD avanzada en comparación con pacientes sin RD (p <0,001) y RD leve (p = 0,003) y con sujetos normoglucémicos (p <0,001 ). Finalmente, los pacientes con DM1 sin RD y con RD leve tienen un grosor coroideo (GC) más elevado que los sujetos normoglucémicos, pero el GC en los pacientes con DM1 y RD avanzada es menor (p = 0,038) que en los pacientes DM1 y RD leve y no es significativamente diferente del GC de los sujetos normoglucémicos. En conclusión, en pacientes con DM1 sin enfermedad CV previa ni MRC establecida, la presencia de retinopatía, especialmente en las etapas avanzadas, se asocia a una mayor carga de enfermedad aterosclerótica carotídea en comparación con los pacientes sin RD. Este hallazgo podría explicar, en parte, el riesgo incrementado de enfermedad cardiovascular descrito en pacientes con DM1 y RD ya que la presencia y la carga de enfermedad aterosclerótica carotídea se han descrito como factores de riesgo para presentar eventos CV. Por otra parte, los pacientes con DM1 muestran un adelgazamiento significativo del grosor de RNFL nasal en las primeras etapas de la RD, incluso antes de la aparición de cambios vasculares. Se observa una disminución del grosor de GCL en etapas avanzadas de la RD. El GC es mayor en pacientes con DM1 sin RD y con RD leve, pero disminuye en los estadios avanzados.<br>Diabetic retinopathy (RD) is the main microvascular complication in patients with diabetes mellitus (DM). In addition, patients with DM and RD have an increased risk of cardiovascular (CV) disease. In this sense, CV disease due to atherosclerosis is the leading cause of morbidity and mortality in patients with DM. On the other hand, there is evidence that retinal neurodegeneration can precede visible vascular changes in RD. Finally, the relationship of choroidal thickness (GC) with RD stage is not well defined.
The aim of the study was to assess the association of the presence and the burden of subclinical carotid atherosclerotic disease in patients with type 1 DM (DM1) according to the presence and severity of RD, as well as to asses the inner retina and choroidal structural changes in DM1 subjects and normoglycaemic subjects.
A cross-sectional study was conducted in 340 patients with DM1 without prior CV disease and no established chronic kidney disease (MRC) (41.5% with RD) and 304 normoglycaemic subjects matched by sex and age, in order to evaluate the association of subclinical carotid atherosclerotic disease with the presence and severity of RD. For the purpose to assess retinal and choroidal structural changes, 242 patients with DM1 and 69 normoglycaemic subjects were included.
The results presented in this Thesis show that in patients with DM1, the percentage of patients with carotid plaques is higher in those with RD compared to those without RD (44.7% vs. 24.1%, p<0.001). Patients with RD also have a higher frequency of ≥2 carotid plaques compared to patients without RD (25.5% vs. 11.1%, p<0.001). The presence of advanced stages of RD is independently associated with the presence (p=0.044) and the burden (≥2 carotid plaques; p=0.009) of subclinical carotid atherosclerosis. On the other hand, the structural analysis of the inner retinal layers by SD-OCT shows that in patients with DM1 the nasal retinal nerve fibre layer (RNFL) thickness is lower in patients without RD (p<0.001), with mild RD (p<0.001) and with advanced RD (p<0.001) compared with normoglycaemic subjects. The ganglion cell layer (GCL) thickness is lower in patients with DM1 and advanced RD compared to patients without RD (p<0.001) and with mild RD (p=0.003) and compared to controls (p<0.001). Finally, patients with DM1 without RD and with mild RD have a higher GC than normoglycaemic subjects, but GC in patients with DM1 and advanced RD is lower (p=0.038) than in patients with DM1 and mild RD and is not significantly different from that of normoglycaemic subjects.
In conclusion, in patients with DM1 without previous CV disease or established MRC, the presence of RD, especially in advanced stages, is associated with a higher burden of atherosclerotic carotid disease compared to patients without RD. This finding could partly explain the increased risk of CV disease described in patients with DM1 and RD since the presence and especially the burden of carotid atherosclerotic disease have been described as risk factors for presenting CV events. On the other hand, patients with DM1 show a significant thinning of the nasal RNFL in the early stages of the RD, even before any vascular changes in the retina. A decrease in the GCL thickness during the advanced RD stages is observed. The GC is higher in patients with DM1 without RD and in the early stages of DR, but decreases in advanced stages.
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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.
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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.
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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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Vég, Anikó. "Teaching and learning in type 2 diabetes : the importance of self-perceived roles in disease management /." Uppsala : Acta Universitatis Upsaliensis, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7122.
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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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Rydgren, Tobias. "Experimental Studies Aiming to Prevent Type 1 Diabetes Mellitus." Doctoral thesis, Uppsala University, Department of Medical Cell Biology, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8292.
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<p>Type 1 diabetes mellitus (T1DM) is an autoimmune disease in which T-cells and macrophages invade the islets of Langerhans and selectively destroy the insulin producing β-cells, either directly or through the secretion of e.g. cytokines and nitric oxide (NO). This thesis has studied possible strategies to prevent T1DM. In β-cells and macrophages, NO is produced by inducible nitric oxide synthase (iNOS). </p><p>In the first study, we found that 1400W, a highly selective inhibitor of iNOS could prevent interleukin (IL)-1β induced suppression of rat islet function <i>in vitro</i>, but not diabetes induced by multiple low dose streptozotocin (MLDS), a well established animal model for autoimmune diabetes, <i>in vivo</i>. </p><p>Next, we wanted to test a new type of high affinity blocker of IL-1 action, called IL-1 trap, <i>in vitro</i>. Here we found that an IL-1 trap could prevent the suppressive effects by IL-1β on rat pancreatic islet function. Also, it was sufficient to block the action of IL-1β to prevent islet cell death induced by a combination of IL-1β, tumor necrosis factor-α and interferon-γ.</p><p>In study III, a murine IL-1 trap was found to prolong islet graft survival in the recurrence of disease (ROD) model, a T1DM model that involves syngeneic transplantation of healthy pancreatic islets to diabetic nonobese diabetic mice. Mice treated with IL-1 trap displayed an increased mRNA level of the cytokine IL-4 in isolated spleen cells. This suggests a shift towards Th2-cytokine production, which in part could explain the results. </p><p>Finally, simvastatin an anti-hypercholesterolemic drug that possesses anti-inflammatory properties e.g. by interfering with transendothelial migration of leukocytes to sites of inflammation was studied. We found that the administration of simvastatin could delay, and in some mice prevent, the onset of MLDS-diabetes, and prolong islet graft survival in the ROD model. </p>
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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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Holstad, Maria. "Prevention of type 1 diabetes mellitus in experimental studies." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2001. http://publications.uu.se/theses/91-554-4972-7/.
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Copeman, James Benjamin. "The genetics of type 1 (insulin dependent) diabetes mellitus." Thesis, University of Oxford, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.294271.
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Lord, Christopher James. "The genetics of type 1 (insulin-dependent) diabetes mellitus." Thesis, University of Oxford, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.363956.
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