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Potts, Nicolette. "A community based approach to glucose optimisation for type 2 diabetes." Thesis, University of Oxford, 2003. http://ora.ox.ac.uk/objects/uuid:11f0242c-97fc-4b29-9631-ac4ca6f45281.
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Background: Attaining optimal glucose control in type 2 diabetes (T2DM) is essential to minimise complications, but difficult to achieve in practice with declining β-cell function in patients. Aim: To evaluate the efficacy and feasibility of a protocol-led, treat-to-target approach emphasising earlier oral hypoglycaemic agent (OHA) combination and insulin use to target basal and prandial glucose in primary care. Methods: T2DM patients aged 40-75 years, with glycosylated haemoglobin (HbA<sub>1C</sub>) 6.4-10.0% on diet or oral monotherapy in 7 practices were asked to participate in a protocol-led, target-driven programme of care using early OHA and insulin therapy combinations to target basal and prandial glucose. Recruited patients were randomised to pre-specified algorithms with monthly therapy adjustment aiming for fasting plasma glucose values (FPG) <6mmol/L and 2-hour post-prandial (PPG) <8mmol/L. Isophane or humalog insulin was added where glucose targets were not attained. All patients were reviewed at one year. Glucose, weight and cardiovascular (CVS) risk factor outcomes were measured and the feasibility, acceptability and safety of the programme evaluated with validated questionnaires. Results: 345 patients were studied. 60 participated in the glucose study and 285 received standard care. 65% of recruited patients were male, with mean (SD) age 61.0 (8.2) years, BMI 29.8 (5.3) kg/m2, HbA<sub>1C</sub> 7.5 (0.9)% and median (IQR) T2DM duration 3 (1-5) years. 41 completed the study. Glucose control was significantly improved in recruited compared to non-recruited patients with a mean overall 0.8% HbA<sub>1C</sub> reduction and 72% patients achieving HbA<sub>1C</sub><7% and 64% <6.5% at 1 year. Therapy use was also significantly increased with 50% requiring 3 therapies, 30% 2 and 10% monotherapy. 24 (59%) of recruited patients received isophane and 16 (39%) humalog to achieve targets. Glucose optimisation was achieved without significant hypoglycaemia or adverse events and patient quality of life (QoL) and therapy satisfaction remained high. CVS risk was reduced in recruited patients. Conclusions: A more structured, target-driven approach to glucose optimisation can successfully achieve normoglycaemia in a selected primary care T2DM population without significant adverse events, hypoglycaemia. or QoL impairment in patients. A principal barrier to wider implementation of this programme appears to be practice and patient participation.
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Xiao, Shan, and 肖珊. "Systematic review on self-monitoring of blood glucose for non-insulin-using type 2 diabetes patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48426738.
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The increasing prevalence causes great burden to global health. Although there is not yet an agreement on the effect of SMBG for non-insulin-treating type 2 DM patients in comprehensive management, some guidelines recommended all diabetes patients should conduct SMBG.
This literature review of 5 meta-analyses and 13 randomized controlled clinical trials assessed the effectiveness of SMBG in glucose control (HbA1c), detection of hypoglycemia, non-glycemic outcomes and potential influence factors(duration of diabetes, baseline HaB1c level, SMBG frequency, SMBG duration, co-interventions) of SMBG efficacy on type 2 diabetes patients not using insulin.
The method of this literature review is through a comprehensive electronic literature search of Ovid MEDLINE, EMBASE, the Cochrane Library and China Journals Full-text Database. Both English and Chinese language literatures were reviewed. All meta-analysis and randomized controlled trials of type 2 diabetes non-insulin-using patients taking SMBG to improve the glycemic control and other outcomes were included. In these studies, absolute HbA1c reduction, recognized episodes of hypoglycemia, wellbeing, QALY, DALY, complication morbidity, mortality were used as outcome measures if available. A score list based on the PRISMA Statement was used to evaluate the quality of meta-analyses.
5 meta-analysis all reported a statistical significant but clinical modest-moderate difference in HbA1c reduction between SMBG and non-SMBG group, a new published randomized controlled trial with small cohort enrolled in none of the meta- analyses did not support this conclusion. Evidence showed frequency of SMBG did not influence the efficacy of SMBG, co-interventions as education/consultation, regimen change played a positive roll on SMBG efficacy. Whether baseline HbA1c, duration of diabetes or SMBG itself have an effect on SMBG efficacy was still unknown. There is inadequate evidence of SMBG efficacy of detection of hypoglycemia of patient-oriented outcomes. No eligible Chinese article was defined to enroll in this review.
This review did not support to suggest all type 2 diabetes patients not using insulin to conduct SMBG at the frequency the guidelines recommended. Carefully designed and longer-term trials are needed to obtain evidence that is more robust. Further investigation would provide more evidence of the characteristics of potential influence factors, which may help to define the specific population or optimal mode that guarantee the greatest efficacy of SMBG.<br>published_or_final_version<br>Public Health<br>Master<br>Master of Public Health
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梁心銘 and Sum-ming Leung. "Use of self monitoring of blood glucose in glycaemic control of non-insulin treated type 2 diabetes mellitus patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B40721127.
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Leung, Sum-ming. "Use of self monitoring of blood glucose in glycaemic control of non-insulin treated type 2 diabetes mellitus patients." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B40721127.
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Daramola, Oyekemi Funke. "Assessing the validity of random blood glucose testing for monitoring glycemic control and predicting HbA1c values in type 2 diabetics at Karl Bremer hospital." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/80458.
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Thesis (MFamMed)--Stellenbosch University, 2012.<br>ENGLISH ABSTRACT: Background: The number of adults affected by diabetes mellitus in developing countries, such as South Africa, is projected to grow by 170%, from 84 to 228 million people between 1995 and 2025 .This high and increasing prevalence of diabetes worldwide, and the economic burden of diabetes on developing countries like South Africa emphasizes the importance of ensuring good glycemic control so as to slow down the rate of disease progression and prevent complications. The district health care facilities are the foundation of the health care system of South Africa. The current practice is that diabetics have a point of care random blood glucose (RBG) done on the morning of their clinic appointment and this is used as a form of assessment of glycemic control during the consultation. For further clinical decision making a HbA1c is done once a year as a benchmark of glycemic control. The practical clinical question that arises is whether the assumptions underlying local clinical decision making using the RBG are valid and to what extent RBG can be used to guide clinical management.
Aim and Objectives: The aim of this study was to assess the strength of the correlation between RBG and HbA1c and to make recommendations for the interpretation of RBG results in adult patients with Type 2 Diabetes taken at Karl Bremer District Hospital out-patient department. The objectives were: To determine glycaemic control in the study population and compare differences between age, sex and racial groups , and determine the RBG cut-off with the best sensitivity and specificity for predicting poor glycaemic control (HbA1c>7.0% ) as well as the predictive value, likelihood ratio and pre/post-test odds and probability at this cut off.
Methods: A retrospective analysis of existing hospital data and the HbA1c tests requested from the NHLS by Karl Bremer Hospital over the 2011 year period. The data was analysed by means of a receiver operating characteristic (ROC) curve analysis to determine the value of RBG with the best combination of sensitivity and specificity to predict poor control of diabetes. A p-value of < 0.05 was assumed to represent statistical significance and 95% confidence intervals were used to describe the estimation of unknown parameters. HbA1c level of < = 7% was taken as representing good control and > 7% poor control.
Results: Data was obtained on 349 diabetic patients of whom 203 (58.2%) were female and 146 (41.8%) male. This study population had a mean age of 54.7 years, mean RBG of 13.0mmol/l and mean HBA1c of 9.4%. The total number of black patients was 79 (23%), coloured patients 147 (42%) and white patients 122 (35) % and their mean RBG were 15.4 mmol/l, 12.8 mmol/l and 11.9 mol/l respectively. There was a statistically significant correlation between increasing RBG and increasing HbA1c (p< 0.01). The best value obtained on the ROC curve was an RBG of 9.8 mmol/l, which had a sensitivity of 77% and a specificity of 75%, positive predictive value of 0.88, positive likelihood ratio 3.08 and post-test probability of 88.2% for predicting an HbA1c above 7%.
Conclusion: It was concluded that a moderate correlation exists between RBG and HbA1c in this population of diabetic patients. .The best RBG for determining poor control, defined as a HbA1c>7.0%, was found to be 9.8mmol/l and this RBG had a sensitivity of 77% , specificity of 75% and positive predictive value of 88%. Significant differences were found in pre- and post -test probability for different racial groups. Point of care testing using this level of RBG for clinical decision making will inappropriately categorise 23% of patients in this population and therefore introducing point of care testing for HbA1c is recommended.
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Htoo, Zaw Wai. "Is lifestyle modification effective for glycemic control among type II diabetic adults in Southeast Asia?" Thesis, Kansas State University, 2015. http://hdl.handle.net/2097/19191.
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Master of Public Health<br>Human Nutrition<br>Richard R. Rosenkranz<br>Background: Type 2 diabetes mellitus (T2DM) is a costly and burdensome lifelong disease, and without proper glycemic control, severe life-threatening complications result. In Southeast Asia, the prevalence of T2DM is forecast to increase markedly from 2000 to 2030. Although literature reviews on lifestyle modification for glycemic control are available, these are mainly for the Western context, and there is a dearth of evidence for Southeast Asians who are at greater risk of T2DM and have differing patterns of diet, physical activity and body composition than Western populations.
Objective: To systematically review literature on the effectiveness of lifestyle modification interventions for glycemic control in T2DM patients from Southeast Asia.
Methods: Randomized controlled trials (RCT) with interventions ≥ 8 weeks that compared HbA1c or blood glucose for intervention (lifestyle modification) versus control groups were identified from searches in Cochrane Library, CINAHL, PubMed, ProQuest, Science Direct, SPORTDiscus, Scopus and Web of Science.
Results: Seven RCTs (679 participants) meeting inclusion and exclusion criteria were identified. There was a significant reduction in HbA1c% (MD = -0.56%; 95% CI = -0.95,-0.16%; p = 0.006; n = 5 studies) and in blood glucose mg/dl (MD = -16.76 mg/dl; 95% CI = -31.36, -2.17 mg/dl; p = 0.02; n = 4 studies) over 3 months for lifestyle modification intervention groups. Lifestyle interventions included diet (n = 2), exercise (n = 2), and general lifestyle interventions (n = 3). Duration of interventions ranged from 12 weeks to 6 months. Studies included populations from Thailand (n = 5) and Malaysia (n = 2).
Conclusion: Overall, lifestyle modification interventions are effective for the glycemic control of T2DM patients in countries of Southeast Asia.
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Advani, Andrew. "The blood cell cytoskeleton in type 2 diabetes." Thesis, University of Newcastle Upon Tyne, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.289211.
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Chaufan, Claudia. "Sugar blues : issues and controversies concerning the type 2 diabetes epidemic /." Diss., Digital Dissertations Database. Restricted to UC campuses, 2006. http://uclibs.org/PID/11984.
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Tengblad, Anders. "Monitoring blood glucose and obesity in type 2 diabetes in primary care." Doctoral thesis, Linköpings universitet, Allmänmedicin, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-20049.
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Background: Type 2 diabetes is a common chronic disease worldwide. An important part of the treatment is monitoring and treating the elevated levels of blood glucose. But there is also a need for monitoringother risk factors that confer an increased risk for vascular complications. This thesis is based on four studies that explore different aspectsof monitoring blood glucose and obesity in patients with type 2 diabetes in primary care. Methods: To examine the cost and effect on glycaemic control of patients performing self-monitoring of blood glucose (SMBG) an observationalstudy was performed in the county of Östergötland and Jönköping 2003-2004. The study included all known patients with type 2 diabetes at 18 primary health care centres (PHCC), excluding patients in nursery homes. A structured observational intervention study of 98 patients with type 2 diabetes living at 17 nursery homes were done with monitoringof hypoglycaemic episodes followed by a controlled withdrawal of diabetes medication in patients with HbA1c ≤ 6.0 %. Baseline data from the cohort study; Cardiovascularrisk in type 2 diabetes – a prospectivestudy in primary care (CARDIPP), was analysed for correlation analyses between anthropometric status and early cardiovascular organ damage, measured by pulse wave velocity (PWV) and left ventricular mass index (LVMI). Results: When comparing users of SMBG to non-users, there was no association between improvedglycaemic control and use of SMBG. A plasma glucose profile for three consecutive days of the patients at nursery homes, indentified 31 episodes of plasma glucose levels≤ 4.4 mmol/l. A withdrawal of insulin and oral antiglycaemic medicine was performed, which after 3 months follow up was successful in 24 (75 %) of the patients. The mean annual cost per PHCC for visits to general practitioner and nurse, insulin, SMBG and oral antiglycaemic agents was586 € (SD 435) per patient. There was no correlationbetween costs and glycaemic control at PHCC level. In the CARDIPP study, both increased sagittalabdominal diameter and increased waist circumference were, independently of sex, age, blood pressure and HbA1c, associated to increasedPWV and LVMI. Conclusions: Use of SMBG in primary care confers a substantialpart of the treatment costs, but is not associated with improved glycaemic control. Systematic use of SMBG for patients not treated with insulin should not be recommended. At nursery homes, patients with type 2 diabetes are at risk for harmful hypoglycaemia and may benefit from a more frequent control of plasma glucose and a less strict glycaemic control. Increased abdominal obesity measured with either sagittal abdominal diameter or waist circumference is associated with early cardiovascularorgan damage. In addition to analyses of blood glucose, blood pressure and lipids, the monitoring of abdominal obesity is a feasible risk factor assessment tool, that provides further information about cardiovascular risk that goes beyond that of traditional risk factors.
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Kappala, Shanthi Sharon. "Risk factors and blood-borne biochemical markers in type 2 diabetes mellitus." Thesis, University of Central Lancashire, 2012. http://clok.uclan.ac.uk/6723/.
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The burden of Diabetes Mellitus (DM) is increasing worldwide and it is estimated to reach indefinite proportions of about 450 million by year 2030. Patients with type 2 diabetes mellitus (T2DM) have a significantly increased risk of developing cardiovascular diseases (CVD). Moreover, CVD is the major cause of mortality and morbidity (75%) in T2DM patients. DM itself has been long recognised as an independent risk factor for several forms of CVD including coronary heart disease (CHD), peripheral arterial disease, cardiomyopathy and congestive heart failure in both men and women. It is well-known that T2DM is associated with several factors including hyperglycaemia, hypertension, dyslipidemia, obesity all of which contribute to CVD. In order to prevent CVD, early intervention on cardiovascular risk factors is vital during clinical assessment of T2DM patients. A major role of inflammation has been well described in the development of CVD in T2DM patients. Inflammatory process and factors which contribute to CVD in T2DM patients have recently become a focus in diabetic research. Elucidation of common patho-physiological mechanisms among T2DM patients might emphasize the role of inflammation in CVD. The main purpose of this study was to investigate any patho-physiological changes in red blood cells (RBC), white blood cells (neutrophils and lymphocytes) and plasma, measuring RBC membrane fragility and proteins, intracellular free calcium concentrations [Ca2+]i and several cations including Na+, Mg2+, Ca2+, Fe2+, Zn2+ and Cu2+, biochemical parameters and inflammatory mediators which normally serve as independent predisposing risk factors for CVD among T2DM patients compared to age-match healthy controls. The results have shown that fura-2 loaded neutrophils and lymphocytes in blood from T2DM patients contain significantly (p<0.05) less [Ca2+]i than neutrophils and lymphocytes from healthy subjects upon stimulation with physiological doses of either fMLP or thapsigargin indicating a derangement in cellular calcium homeostasis during T2DM. Similarly, RBC membranes from T2DM patients contained significantly (p<0.05) more spectrin, ankyrin, band 3, band 4.1, glycophorin etc compared to RBC membranes from age-matched healthy control subjects. The results also show that the RBCs from T2DM patients were more fragile compared to RBC from healthy controls. Measurement of protein glycation in plasma have revealed significantly (p<0.05) more fluorescence in proteins form T2DM patients compared to control. In relation to plasma cations and intracellular markers and mediators, the results show that plasma from T2DM patients contain significantly (p<0.05) more Na+, Mg2+ , Ca2+, Fe2+, Zn2+ and Cu2+ compared to plasma levels from age-match healthy controls. Similarly, the concentrations of kidney and liver function markers such as urea, creatinine, alkaline phosphatase, ALT, AST, GGT, total protein and albumin increased significantly (p<0.05) compared to healthy controls. The same is also true for glucose, total cholesterol, triglycerides, CRP, HBA1C, WBC where the blood from T2DM patients contained elevated concentrations compared to blood from healthy age-matched control patients. Together, the results of this study have clearly demonstrated marked and significant changes in cellular calcium homeostasis in white blood cells, RBC membrane proteins and fragility, plasma protein glycation and in plasma levels of cations, intracellular markers and mediators of T2DM patients compared to healthy controls. Therefore, it is proposed that an early integrated and multi-factorial intervention of risk factors and inflammatory markers must be done in order to reduce the risk of CVD and possible mortality of T2DM patients.
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Tientcheu, Sylvain N. "Barriers to Daiy Blood Glucose Self-monitoring in Type 2 Diabetes Mellitus." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5667.
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Routine blood glucose monitoring by patients with Type 2 diabetes mellitus (T2DM) is needed for effective management of T2DM; however, 75% of monitoring logs are returned incomplete during monthly provider follow-up appointments. As a result, effective management of the patient's medical condition is limited. To better understand the reasons for noncompliance, a quality improvement project (QIP) was initiated between July 01, 2017 and September 30, 2017, to identify barriers that prevented patients from self-monitoring of blood glucose (SMBG). No formal assessment of the patients' responses had been done, and, as a result, the deidentified, qualitative responses from the QIP were obtained for this project. The purpose of this project was to explore barriers to SMBG and to use a literature search to identify strategies for improving compliance with SMBG. The health belief model was the framework used to guide the project. Secondary data obtained from the QIP (n = 19) were analyzed and coded. Results indicated that patients' financial concerns, social support, emotional needs, and lack of diabetes education were the main barriers to daily SMBG. Recommendations to the providers were to consider each barrier before ordering the use and frequency of SMBG and to consider an appropriate strategy for promoting SMBG adherence. Addressing low compliance with SMBG may promote positive social change through improved T2DM management, self-care, adherence to daily SMBG and treatment, and improved patient quality of life.
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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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Elshawesh, Mohamed Abdallah. "The effects of hypoxis hemerocallidea on blood glucose levels in rats with Type 2 diabetes." Thesis, University of the Western Cape, 2015. http://hdl.handle.net/11394/5327.
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>Magister Scientiae - MSc<br>About 180 million people have been estimated to suffer from type 2 diabetes (T2DM) in 2006 and the annual death rate due to this disease was 3 million by that time. More than
400 medicinal plants used for the treatment of diabetes mellitus have been recorded, but only a small number of these plants have received scientific and medical evaluation to assess their efficacy. The most common plant used to treat diabetes mellitus is Hypoxis hemerocallidea (HH). The present study was undertaken to investigate the effects of Hypoxis hemerocallidea (HH) on T2DM in rats. Male Wistar rats weighing 200-250 g were used in this experiment. Hypoxis hemerocallidea (HH) corm was used as plant material in the experiment. The study was based on three parts, an acute diabetes study, chronic diabetes study and insulin secretion study. In the acute study, the rats were randomly divided into 2 groups (control and diabetes). The saline solution was added to different concentrations of HH corm to produce concentration of (50, 200, 400, 800 mg/ml). Diabetes was induced by intraperitoneal injections of STZ (65mg/kg). Two weeks after the injection (STZ 65 mg/kg), different concentrations of HHS was administered
intraperitoneally after an overnight fast. The blood glucose levels were monitored in the diabetic and control rats at, 30, 60, 120, 180 and 240 minutes post injection. In the chronic study, the rats were randomly divided into 6 different groups (control, HFD, DM,
DM-HH, DM-PTHH, and HH). Diabetes mellitus was then induced in the groups of diabetic rats by intraperitoneal injections of STZ (40 mg/kg) and rats were fed a high fat diet (HFD). The body weight of the rats were measured weekly for 7 weeks. An intraperitoneal glucose tolerance test (IPGTT) was performed at the end of week 6. At the end of week 7, rats were killed and serum sample were collected for determination of fatty acid and insulin. Liver and pancreatic tissue was collected for histological evaluation. In the insulin secretion study, Hypoxis hemerocallidea was tested for its effects on insulin secretion by
pancreatic islet cells exposed to low (3mM) and high (20mM) glucose medium. Results of the acute study indicated that HHS at a dose 800 mg/ml decreased blood glucose levels fastest in both normal and diabetic rats reaching significance after 30 minutes and 60 minutes respectively and remained below the baseline value until 240 minutes. In the chronic study, it was illustrated that HH had no effect in normal rats on any of the parameters evaluated. Animals in the DM group gained weight the first two weeks, but thereafter began to lose weight. At the end of seven weeks the animals gained significantly less weight than the rest. Animals fed a HFD have more visceral fat compared to the control group. The visceral fat gain occurred in the absence of a significant increase in body weight. We found a markedly lower fasting glucose level in HH treated diabetic animals compared to untreated DM animals. At time zero the blood glucose level of the HFD group (5.8±0.5mmol/l) and the HH group (4.9±0.7mmol/l) were in the normal range, and were not significantly different (P > 0.05) from the control group (5.0±0.2mmol/l). After glucose load peak blood glucose levels was measured after 30 minutes in the control group (9.0±0.6mmol/l), the HFD group (9.8±0.4 mmol/l), the DM-HH
group (21±5.7 mmol/l) and the DM-HHPT group (27.8±5.3 mmol/l). In the HH group the blood glucose level reached a peak at 60 minutes (7.6±0.6 mmol/l). In the DM group two peaks were recorded one after 10 minutes (27.2±7.1mmol/l) and another after 60 minutes (31±5.2 mmol/l). In the groups control, HFD, DMHH, DM-HHPT and HH groups the blood glucose level after 120 minutes were not significantly different from the time zero value. The blood glucose level after 120 minutes in the DM group (28.2±7.1 mmol/L) was significantly higher (P ≤ 0.01) than from the time zero value. Serum fatty acid levels were increased in all groups fed a high fat diet. The serum insulin levels in the HFD group (6.2 ± 0.76 μUI/ml protein; P ≤ 0.05 ), the DM group (2.0 ± 0.9 μUI/ml protein; P ≤ 0.001), the DMHH group (3.4 ± 0.7 μUI/ml protein; P ≤ 0.001) and the DM-HHPT group (3.0 ±
1.1 μUI/ml protein; P ≤ 0.001) were significantly lower than the control group. The β-cell function in the HFD group (62 ± 8 %; P ≤ 0.001), the DM group (3 ± 1 %; P ≤ 0.001), the DM-HH (11 ± 9 %; P ≤ 0.001) group and the DM-HHPT group (4 ± 2 %; P ≤ 0.001) were significantly lower than the control group. The histological observation of the liver and the pancreas in rats after 7 weeks on different dietary regimes showed some morphological changes within the liver and pancreas parenchyma of some rats. In the insulin secretion study, glucose stimulated insulin secretion in low (3mM) and high (2mM) glucose concentration. Furthermore, insulin secretion was significantly higher when the glucose concentration was increased from 3mM to 20 mM (1.10 ± 0.13 μUI/ml protein and 1.5 ± 0.17 mIU/mg protein respectively P≤ 0.01). In the presence of low HH (100 µg/ml), there was a marked increase in insulin secretion when exposure to high glucose compared to low glucose concentration, while in the presence of high HH (500 µg/ml), there was no
significant different in insulin secretion in the presence of low or high glucose. In conclusion, the results of this experimental study indicate that a concentration 800 mg/kg of HHS produces maximal hypoglycaemic effect in fasted normal and diabetic rats. HH has an antidiabetic activity as it lowers serum glucose levels in T2DM rats and significantly increases glucose tolerance. It also increases body weight of diabetic rats. HH treatment was found to improve insulin secretion in pancreatic islet cells.
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Al-Ghamdi, Yasser. "The Effects of Probiotics on High Sugar-Induced Type 2 Diabetes Mellitus Symptoms in Drosophila melanogaster." Thesis, Högskolan i Skövde, Institutionen för hälsa och lärande, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-17817.
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Background: Type 2 diabetes mellitus is a metabolic disorder characterized by the rise of fasting plasma glucose from its normal range (≥125mg/dl). It is marked by insufficient production of insulin from pancreatic β-cells as a result of failed compensation due to insulin resistance. Several treatments are available for the disorder, which mainly focus on improving the sensitivity of insulin in different body tissues. Recently, probiotics were suggested as candidate treatments for type 2 diabetes and for extending lifespan as well. This experiment aims to investigate such claims using Drosophila melanogaster as a disease model. Results: Other than the observed low average weights in treated larva samples, probiotics did not show any other significant results in affecting the length, glucose, glycogen, and trehalose levels (One-Way ANOVA and Kruskal-Wallis, p>0.05). Real-time PCR was only carried out once. Thus, no statistical tests were reliable enough to analyse the data obtained. The longevity study, on the other hand, did show significance (Log-rank (Mantel-Cox) test and Gehan-Breslow-Wilcoxon test, p<0.0001), as the probiotic Bifidobacterium lactis extended the lifespan of adult flies feeding on a high sugar diet significantly when compared to the control ones feeding on only high sugar diet without probiotics. Conclusion: Except for weight measurements, none of the other results was reliable enough to make a concrete conclusion on whether the treatments indeed worked in reversing type 2 diabetes symptoms or not. Real-time PCR results did show some effects of some of the treatments at different developmental stages. However, unless Real-time PCR is repeated at least once using the same protocol, no deduction can be made. Additionally, the data obtained hint that the dosage used (0.025 g) was too high for larvae and adult flies and might have caused malnutrition by blocking their midgut and decreasing food absorption. Hence, false significant or non-significant results were acquired instead. Further studies are required using a much lower probiotic dosage if Drosophila is used as a disease model. Although, other models such as mice or rats are recommended in this case, in order to reach a solid conclusion about the effectiveness of probiotics in treating type 2 diabetes mellitus. Baring these thoughts in mind and based on the results of this experiment, the null hypothesis indicating that there is no significant relationship between the use of probiotics and reversing type 2 diabetes mellitus symptoms is therefore accepted.
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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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CAMPBELL, BROOKE MADISON. "SUGAR SWEETENED BEVERAGES INTAKE IN 9-12 YEAR OLD CHILDREN AT RISK OF TYPE 2 DIABETES." Thesis, The University of Arizona, 2016. http://hdl.handle.net/10150/612624.
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Over the past few decades, the consumption of sugar-sweetened beverages (SSBs) in adolescents has increased dramatically. There has also been a rise in Type 2 Diabetes (T2D). The E.P.I.C. (Encourage Practice Inspire Change) Kids Intervention program is among the first community- and family-based diabetes prevention interventions for children, ages 9-12, who are at risk of developing T2D. The purpose of EPIC Kids program is to provide information, resources, and strategies for children and their parents regarding nutrition, physical activity, and healthy behaviors that can improve their wellbeing, help manage their weight, and prevent T2D.
Researchers are investigating the link between increased SSB consumption and T2D risk. To assess SSB consumption, two, 24-hour diet recalls were conducted at baseline and 12-week measurement sessions with the 28 youth. One weekday recall and one weekend day recall were collected. At baseline, the average total SSB consumption was 0.9 servings (8oz) and at12 weeks, 0.73 servings. There was no significant change in SSB consumption. Future activities include analysis of the entire sample of EPIC Kids participants (n=48), which will allow for a more robust evaluation of intervention-related changes in SSBs, and provide contextual data on factors associated with SSB consumption and determinants of change.
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Smith, Chrystal A. S. "Living with Sugar: Socioeconomic Status and Cultural Beliefs About Type 2 Diabetes Among Afro-Caribbean Women." [Tampa, Fla] : University of South Florida, 2009. http://purl.fcla.edu/usf/dc/et/SFE0003253.
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Stanley-Fuller, Tricia. "Impact of a certified diabetes education program with telephonic follow-up on glucose levels of type II diabetics." Virtual Press, 2000. http://liblink.bsu.edu/uhtbin/catkey/1191720.
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Maintaining appropriate glucose levels is important to patients with diabetes because it helps to improve patients' quality of life and prevents medical complications. This study was designed to determine if there was a statistically significant difference in blood glucose levels between a treatment group that completed a certified diabetes education program with telephonic follow-up by a diabetes educator and a comparison group that also received the certified diabetes education program but without telephonic follow-up. A pretest/posttest control group design was used which randomly assigned subjects to groups by clusters. From the analysis of data it was determined that there was no statistical difference in blood glucose levels between the treatment and the comparison groups. Therefore, weekly telephonic follow-up did not statistically impact blood glucose levels in the treatment group. However, the results did indicate that the telephonic follow-up may have impacted the proportion of patients who returned for post blood glucose testing and sought treatment for other related health concerns.<br>Department of Physiology and Health Science
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Chan, Yim-ting Tina, and 陳艷婷. "Effect of a diabetes specific formula in the blood sugar and blood lipid profiles and nutritional status of type II diabetes living innursing homes : a prospective randomized trial." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B31971507.
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Chan, Yim-ting Tina. "Effect of a diabetes specific formula in the blood sugar and blood lipid profiles and nutritional status of type II diabetes living in nursing homes : a prospective randomized trial." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31971507.
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Nadeau, Julie. "The impact of introducing dietary sugar in the meal plan of free-living subjects with type 2 diabetes." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0006/MQ44229.pdf.
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Van, der Westhuizen Johan Albert. "A novel blood glucose characterisation system for type 1 diabetes / Johan Albert van der Westhuizen." Master's thesis, North-West University, 2008. http://hdl.handle.net/10394/4186.
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The correct administration of insulin is a constant challenge for type 1 diabetics. The
correct insulin regime leads to fewer complications and an easier way of life. The
amount of insulin administered must take into account the meals eaten, previous
administered insulin, exercise etc.
A rapid process for determining insulin regimes that is accessible to type 1 diabetics
will greatly reduce diabetic complications later in life. This study researches such a
process. Software is developed to use the ets-concept to simulate blood glucose
levels. From these simulations blood glucose characterisation can be done to propose
insulin regimes.
Data gathered in previous studies is used to verify the results of this process. These
results are compared to factors that describe the accuracy of a person's blood glucose
control. The effects the new regimes will have are used to make recommendations to
the end-user.
Accurate characterisation leads to insulin regImes that will Improve the control
performance of type 1 diabetes.<br>Thesis (M.Ing. (Electronical Engineering)--North-West University, Potchefstroom Campus, 2008.
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Lee, Brian Chihung. "Vascular function with particular emphasis on the endothelium in subjects at risk of type 2 diabetes." Thesis, Queen's University Belfast, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.343101.
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Wade, Alisha. "The effect of blood glucose self-monitoring in patients with non-insulin treated type 2 diabetes." Thesis, University of Oxford, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.517114.
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Bernabe, Ortiz A. "Blood-free risk scores and neuropathy assessment tools to detect undiagnosed type 2 diabetes in Peru." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2018. http://researchonline.lshtm.ac.uk/4649430/.
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The prevalence of type 2 diabetes mellitus is rising, especially in low- and middle-income countries, where the situation is worsened because around half of cases are unaware of the disease. Universal screening utilizing blood markers can be challenging in resource-constrained settings. The identification of these individuals can be potentially addressed using risk scores and neuropathy assessment tools. This study aimed to assess the diagnostic accuracy of the FINDRISC, a blood-free risk score, three neuropathy assessment tools (EZSCAN, pupillometer, and biothesiometer), alone and in combination. A population-based study was conducted enrolling a sex-stratified random sample of participants from Tumbes, a semiurban area in the north of Peru. Undiagnosed T2DM was the outcome, defined using WHO OGTT thresholds. Diagnostic accuracy of the FINDRISC and neuropathy tools was evaluated using the area under the ROC curve (aROC) and respective 95% confidence intervals (95%CI). Data from 1609 participants were analysed, mean age 48.2 (SD: 10.6) years, 810 (50.3%) females. A total of 176 (10.9%) individuals had T2DM, and only 71 (4.7%) had undiagnosed T2DM. The diagnostic accuracy of the FINDRISC was aROC = 0.69 (95% CI: 0.64–0.74), with a sensitivity of 69% and specificity of 67%. Among devices, the EZSCAN (aROC = 0.59; 95%CI: 0.53–0.66; sensitivity of 59% and specificity of 54%) and biothesiometer in the third metatarsal head (aROC = 0.60; 95%CI: 0.53–0.67; sensitivity of 31% and specificity of 85%) performed best. A combination of the FINDRISC and the biothesiometer had the best diagnostic accuracy, with a similar aROC of FINDRISC alone (AROC = 0.69; 95%CI: 0.68–0.78), with a sensitivity of 79% and a specificity of 59%. Our results confirm that combination of the FINDRISC and biothesiometer can improve diagnostic accuracy of the FINDRISC and biothesiometer alone, increasing sensitivity without affecting specificity or the area under the ROC curve.
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Zakutansky, Donald W. "The effect of limb blood flow on peripheral nerve function in adults with type 2 diabetes." [Bloomington, Ind.] : Indiana University, 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3324509.
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Thesis (Ph.D.)--Indiana University, School of Health, Physical Education and Recreation, 2008.<br>Title from PDF t.p. (viewed on May 13, 2009). Source: Dissertation Abstracts International, Volume: 69-08, Section: B, page: 4596. Adviser: Janet P. Wallace.
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Rudenski, A. "Development of a model of insulin/glucose regulation to assist elucidation of the pathophysiology of type 2 diabetes mellitus." Thesis, University of Oxford, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.382881.
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Kalweit, Kerry Leigh. "The effect of a structured self-monitoring blood glucose regimen on glycaemic control for type 2 diabetes patients using insulin." Diss., University of Pretoria, 2016. http://hdl.handle.net/2263/58769.
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Background: Self-monitoring of blood glucose (SMBG) can inform on the timing of hyperglycaemia; however there is currently no standardised approach to utilise these data to improve glycaemic control in type 2 diabetes patients.
Aims: To assess the efficacy of structured blood glucose testing in guiding an insulin titration algorithm in poorly controlled, insulin-treated type 2 diabetes patients. The secondary aim was to compare change in HbA1c between the study subjects and matched controls receiving standard treatment.
Methods: This six-month prospective intervention recruited 39 poorly controlled (HbA1C ≥ 8.5% or 69.4 mmol/mol), type 2 diabetes subjects using twice-daily biphasic insulin from two public hospitals in Tshwane, South Africa. Patients were asked to perform structured SMBG over 4 weeks and return monthly for consultations where physicians titrated insulin doses using a standardised algorithm guided by the data collected. Post-hoc analysis was performed to assess glycaemic control of study participants compared to those receiving standard treatment.
Results: It was found that mean HbA1c decreased over the study period by 1.89% (95% CI: -2.46 to -1.33, p-value<0.001). Mean SMBG and mean fasting plasma glucose (FPG) decreased by 1.6 mmol/L (95% CI: -2.5 to -0.6 mmol/L, p-value: 0.002) and 1.5 mmol/L (95% CI: -2.2 to -0.2 mmol/L, p-value: 0.024), respectively. Hypoglycaemic event rate (≤3.9 mmol/L) was 33.08 events per patient-year. Total daily insulin use increased by a mean 40.12 units.day-1 (SE: 7.7, p-value<0.001); weight increased by an average 3.98 kg (95% CI: 2.56 to 5.41, p-value <0.001) over the study period. Study participants were found to have a greater mean (SE) reduction of 0.777% (0.404) in HbA1c compared to patients receiving standard care, which fell short of statistical significance (95% CI: -1.569 to 0.015%, p-value: 0.054) due to lack of power (56.5%) in the post-hoc comparison.
Conclusion: A structured SMBG programme that advises monthly algorithmic insulin titration can improve glucose control in type 2 diabetes patients using insulin, with moderate hypoglycaemic events and weight gain.<br>Dissertation (MSc)--University of Pretoria, 2016.<br>National Research Foundation (NRF)<br>Roche Products (South Africa)<br>School of Health Systems and Public Health, University of Pretoria<br>School of Medicine, University of Pretoria<br>School of Health Systems and Public Health (SHSPH)<br>MSc<br>Unrestricted
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Bader, Abeer. "Internet-based menu planning in type 2 diabetes and its impact on weight, A1C and blood pressure." Thesis, McGill University, 2012. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=106334.
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Weight loss in overweight and obese persons with type 2 diabetes mellitus (T2DM) decreases risk of cardiovascular disease. There is some evidence that written menu plans and Internet-based menu programs advocating healthy eating are associated with weight loss in non-diabetic obese persons, particularly in those who frequently log-into such programs, but this approach has not been assessed in T2DM. To address this gap in knowledge, the objective of this study was to determine whether the number of weeks participants logged-into SOSCuisine, an Internet-based menu program, over a 24-week period was predictive of weight loss in overweight/obese adults with T2DM. Data were collected on 33 adults (57.8 ±7.4 years) recruited through collaborating registered dietitians at outpatient diabetes clinics of McGill University-affiliated hospitals (Montréal, Québec, Canada). Each participant's dietitian consulted with the SOSCuisine dietitian to individualize the menu plan. Body weight, other adiposity markers, blood pressure and A1C were measured at baseline and 24-weeks after initiating the program. The number of weeks participants logged-into the program was tracked electronically. After adjustment for age and sex and using multiple imputations to account for missing data, a 10-week increase in log-ins to the program was associated with a -2.0% [95% CI, -3.0 to -1.0%] weight change. A 5% or greater weight reduction was achieved by 18.0% of participants overall and 27.8% of those defined as adherent (i.e., those who accessed the web-based program once per week for a minimum of 18/24 weeks). A 1% weight reduction was associated with a -2.4 mm Hg change in systolic blood pressure [95% CI, -3.5 to -1.2 mm Hg] and a -0.8 mm Hg change in diastolic blood pressure [95% CI, -1.4 to -0.2 mm Hg]. Weight changes were not conclusively related to A1C changes (glycemic control). Our findings indicate that an Internet-based menu program leads to a clinically important weight loss in 1/5 of those who enroll and 1/3 of those who adhere. We have demonstrated a clear association between log-in frequency and weight change, again emphasizing the importance of adherence. The weight change was conclusively related to reductions in blood pressure, confirming clinically important effects.<br>La perte de poids chez les personnes en surpoids/obèses souffrant de diabète sucré de type 2 (DST2) réduit le risque de maladies cardiovasculaires. Certaines données indiquent que les plans-repas écrits et les programmes de plans-repas sur Internet pour une alimentation plus saine sont associés à une perte de poids chez les personnes non-diabétiques, surtout ceux qui fréquentent ces programmes en ligne, mais ce phénomène n'avait pas été évalué chez les personnes atteintes de DST2. Pour combler cette lacune, on a cherché à déterminer si le nombre de semaines de fréquentation du site SOSCuisine, des plans-repas sur Internet, pendant 24 semaines, permettait de prédire la perte de poids chez les adultes en surpoids/ obèses atteints de DST2. Les données ont été recueillies auprès de 33 adultes (57,8 ±7,4 ans) par des diététistes d'hôpitaux affiliés à l'Université McGill. Ces diététistes ont consulté celui de SOSCuisine pour personnaliser le plan-repas du sujet. Le poids corporel, d'autres marqueurs de l'adiposité, la tension artérielle et l'A1C ont été mesurés au début de l'étude et après 24 semaines, le taux de fréquentation faisant l'objet d'une surveillance électronique. En tenant compte de l'âge et du sexe des participants et à l'aide d'imputations multiples pour compenser les données manquantes, il ressort qu'une augmentation de 10 semaines de fréquentation de SOSCuisine est associée à une baisse du poids de -2,0% [IC 95%, de -3,0 à 1,0%]. Une réduction de 5% ou plus a été observée chez 18.0% (1/3) de tous les participants et chez 27,8% (1/5) des « adhérents » – les personnes ayant fréquenté le site au cours d'au moins 18 des 24 semaines de l'étude. Une perte de poids de 1% était associée à une variation de la tension artérielle systolique de -2,4 mm Hg [IC 95%, de -3,5 à 1,2 mm Hg] et de la tension artérielle diastolique de -0,8 mm Hg [IC 95%, de 1,4 à -0,2 mm Hg]. Il n'a pas été possible de relier la variation de poids à celle de l'A1C (le contrôle de la glycémie) de manière concluante. Nous avons démontré une association claire entre la fréquence d'accès au site et la perte de poids, ce qui souligne l'importance de l'adhésion. La perte de poids a pu être reliée irréfutablement à des réductions de la tension artérielle, confirmant ainsi d'importants effets sur le plan clinique.
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Abramova, N. O., and N. I. Stankova. "Dependence of antithyroid autoimmunity parameters on leptyn level in blood in patients with diabetes mellitus type 2." Thesis, БДМУ, 2021. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/18024.
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E:son, Jennersjö Pär. "Risk factors in type 2 diabetes with emphasis on blood pressure, physical activity and serum vitamin D." Doctoral thesis, Linköpings universitet, Avdelningen för samhällsmedicin, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-125911.
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Background Type 2 diabetes is a common chronic disease with a two-fold increased risk for cardiovascular morbidity and mortality and has an increasing prevalence worldwide. This thesis is based on a study conducted in primary health care in Östergötland and Jönköping, Sweden. The aim of the thesis was to evaluate new risk markers to identify patients with high risk of developing cardiovascular disease in middle-aged men and women with type 2 diabetes. Methods Data from the cohort study CArdiovascular Risk in type 2 DIabetes – a Prospective study in Primary care (CARDIPP) was used. In paper III data were also used from CARDIPP-Revisited where all participants in the CARDIPP study were invited four years after the baseline investigation for a re-investigation. In paper IV data were used from CAREFUL which is a control group of 185 subjects without diabetes. The investigation included a standard medical history including data on diabetes duration and on-going medication. Anthropometric data were recorded and both office and ambulatory blood pressure were measured. The patients filled out a detailed questionnaire and physical activity was measured by using waist-mounted pedometers. Pedometer-determined physical activity was classified in four groups: Group 1: <5000 steps/day (‘sedentary’); Group 2: 5000-7499 steps/day (‘low active’); Group 3: 7500-9999 steps/day (‘somewhat active’); Group 4: and ≥10 000 steps/day (‘active’). Blood samples were drawn for routine analyses and also frozen for later analyses. The investigations at the departments of physiology included echocardiography, measurements of the carotid intima-media thickness, applanation tonometry and measurements of sagittal abdominal diameter. Results Paper 1: Patients with a non-dipping systolic blood pressure pattern showed higher left ventricular mass index and pulse wave velocity (PWV) compared with patients with ≥10% decline in nocturnal systolic blood pressure. Patients with <10% decline in nocturnal systolic blood pressure had higher BMI and sagittal abdominal diameter, lower GFR and higher albumin:creatinine ratio and also higher levels of NT-proBNP than patients with a dipping pattern of the nocturnal blood pressure. Paper 2: The number of steps/day were inversely significantly associated with BMI, waist circumference and sagittal abdominal diameter, levels of CRP, levels of interleukin-6 and PWV. Paper 3: At the 4-year follow-up the change in PWV (ΔPWV) from baseline was calculated. The group with the lowest steps/day had a significantly higher increase in ΔPWV compared with the group with the highest steps/day. The associations between baseline steps/day and ΔPWV remained after further adjustment in a multivariate linear regression statistically significant (p=0.005). 23% of the variation in the study could be explained by our model. Every 1000 extra steps at baseline reduced the change in ΔPWV by 0.103 m/s between baseline and follow-up. Paper 4: Low vitamin D levels were associated with significantly increased risk for premature mortality in men with type 2 diabetes. High levels of parathyroid hormone were associated with significantly increased risk for premature mortality in women with type 2 diabetes. These relationships were still statistically significant also when two other well-established risk markers for mortality, PWV and carotid intima-media thickness, were added to the analyses. Conclusions Ambulatory blood pressure recording can by addressing the issue of diurnal blood pressure variation, explore early cardiovascular organ damage and microvascular complications that goes beyond effects of standardised office blood pressure measurements. Pedometer-determined physical activity may serve as a surrogate marker for inflammation and subclinical organ damage in patients with type 2 diabetes. There is novel support for the durable vascular protective role of a high level of daily physical activity, which is independent of BMI and systolic blood pressure. The use of pedometers is feasible in clinical practice and provides objective information not only about physical activity but also the future risk for subclinical organ damage in middle-aged people with type 2 diabetes. Our results indicate that low vitamin D levels in men or high parathyroid hormone levels in women give independent prognostic information of an increased risk for total mortality.
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Alnajjar, Mahasin. "An investigation into the effects of soft fruit extracts with high anthocyanin content on glycaemia in overweight or obese people with or without Type II Diabetes, and an exploration of their potential use to make healthier food products." Thesis, University of Aberdeen, 2016. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=231031.
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Guldbrand, Hans. "Trials of Diets for Treatment of Diabetes : A comparison of diets for treatment of type 2 diabetes, aspects on long and short term effects." Doctoral thesis, Linköpings universitet, Institutionen för medicin och hälsa, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-116691.
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Background Type 2 diabetes is a common disease and the prevalence has increased in large parts of the world. In treatment of diabetes the type of diet is of great importance considering metabolic factors such as glucose level and blood lipids. Which diet that is most beneficial to avoid diabetic complications has been heavily debated in recent decades. This thesis is based on two clinical studies designed to compare the effects of different macronutrients. Methods A clinical trial was designed to compare a low-carbohydrate diet (LCD) to a low-fat diet (LFD) in treatment of patients with type 2 diabetes. Sixty-one patients at two health care centres were included and randomized to get advice to eat a LCD or a LFD. The LCD had an energy content where 50 energy percent (E%) where from fat, 20 E% from carbohydrates and 30 E% from protein. For the LFD the nutrient composition was similar to what is traditionally recommended for treatment of type 2 diabetes in Sweden. Metabolic factors, anthropometrics and questionnaires were analysed. To study postprandial effects a trial was designed to compare three different diets. Twentyone patients with type 2 diabetes were included to in randomized order test the three types of diets on separate test days. On each test day the patients were served breakfast and lunch and blood samples were taken at six times these days. Glucose, lipids and hormones were analysed. Results There were equal weight reduction in the two groups in the first trial during the two-year study period. At six month when compliance was good according to diet-records, the glucose level (HbA1c) was lowered and the HDL-cholesterol was increased in the LCD group. The inflammatory markers IL-6 and IL-1Ra were significantly lower in the LCD group than in the LFD group. At 12 months the physical function, bodily pain and general health scores improved within the LCD group only. In the second trial the postprandial glucose and insulin levels were lower on the LCD compared to the LFD. However, the LCD resulted in a tendency to higher postprandial triglyceride levels. The Mediterranean type of diet with all energy intake at lunch resulted in a more pronounced insulin response and a glucose level at lunch similar to that of the low-fat diet. The increase-ratio of insulin correlated to the elevation of the incretin glucose-dependent insulinotropic peptide (GIP). Conclusions In the two-year study we found benefits for the LCD group regarding glucose control and insulin doses. Furthermore, only the LCD was found to improve the subclinical inflammatory state and there were some aspects of improved well-being in this group. Aiming for 20% of energy intake from carbohydrates is safe with respect to cardiovascular risk factors compared with the traditional LFD and this approach could constitute a treatment alternative. In the postprandial state, the LCD induced lower insulin and glucose excursions than the LFD but at the same time a tendency of higher triglycerides. The long-term significance needs to be further examined. The accumulation of caloric intake from breakfast to lunch to a single large Mediterranean-style lunch-meal in type 2 diabetes might be advantageous from a metabolic perspective.
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Dlugasch, Lucie. "The Experiences of Self-Monitoring of Blood Glucose Usage of Adults with Type 2 Diabetes Mellitus who are not using Insulin." Scholarly Repository, 2009. http://scholarlyrepository.miami.edu/oa_dissertations/262.
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The purpose of this study was to analyze the experiences of self-monitoring of blood glucose (SMBG) usage of adults with type 2 diabetes mellitus (T2DM) who are not using insulin. The sample consisted of 11 women and 8 men who were Caucasian Americans, 38 to 79 years of age. Data were analyzed using the grounded theory method including open and axial coding and the constant comparative method. The theory of "SMBG as a Cue in T2DM Self-Care" emerged from the data and is composed of four categories (a) Engaging, (b) Checking, (c) Responding, and (d) Establishing a Pattern. Engaging marks the beginning of SMBG. Participants began on the recommendation of their physician and monitored between 2-6 times a day. Participants monitored because of curiosity and over time reduced or kept their initial frequency. Checking occurs when the blood glucose is obtained. Two subcategories emerged: Evaluating and Validating. The main items participants evaluated or validated were the effects of foods in relation to blood glucose levels. Responding involves reacting to SMBG. Two subcategories emerged: Taking Action and Experiencing Emotion. Most actions involved changing foods consumed. Participants described feeling conflicted and "being bad" when not following through with an action. Emotions such as blame and fear were experienced when blood glucose levels were higher than normal, while happiness was experienced with normal levels. Establishing a Pattern occurs when participants decide on how often to monitor. Two subcategories emerged: Using Regularly and Using Sporadically. The pattern developed was based on obtaining "normal" blood glucose patterns or on the absence of ill symptoms of T2DM. Healthcare provider disinterest in SMBG and fingertip pain contributed to a decreased monitoring frequency. Participants described cyclical, iterative episodes of Checking, Responding, and varying their established patterns throughout their experiences with monitoring. Participants discussed the value and struggles of SMBG in a T2DM self-care regimen. The theory of SMBG as a Cue in T2DM Self-Care could be used to guide the development of effective intervention strategies to help individuals with T2DM achieve blood glucose control which, in turn, leads to avoidance of ill symptoms and complications of T2DM.
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Abrahim, Mehammedsrage. "SELF-CARE IN TYPE 2 DIABETES : A Systematic Literature Review on Factors Contributing to Self-Care among Type 2Diabetes Mellitus Patients." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap, HV, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-17705.
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Background: Self-care is a multi-dimensional concept and has different definitions. Amongthe definitions, Orem’s definition of self-care is more consistent. Orem (1995) argues that,self-care is a personal activity to take care and maintain of own self health and illness andprevention of disease related complications. Aim: The aim of the paper was to investigate the factors that contribute to self-care behavioramong patients with Type 2 DM as argued in the literature. Method: data was collected from the following electronic databases: CINAHL, PubMed,LibHub, SweMed and Google Scholar-to find full texts. Data was analyzed through CriticalAppraisal Skill Programme. To ensure validity and reliability the author were blinded toreduce study bias and articles were selected according their quality. Result: 31 relevant studies were included in the review, among the major findings of the studywere; Age, Social support/network, high income level, high educational attainment and longType 2 DM diagnosis history had a positive predictor in Type 2 DM patients self-carecontributing factors. Conclusion: To improve a Type 2 DM patients self-care activities the present study concludedthat Demographic, Socio-Economic and Social support factors are among the positivecontributors in patients of Type 2 DM successful Self-Care activities. Key words; Blood glucose self-monitoring, self-administration, Self-care, self-medication,Type 2 Diabetes.<br>The aim of the paper was to investigate the factors that contribute to self-care behavior among patients with Type 2 DM as argued in the literature.
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Shepherd, Anthony Ian. "The therapeutic effect of dietary nitrate supplementation in healthy adults, individuals with type 2 diabetes mellitus and chronic obstructive pulmonary disease." Thesis, University of Exeter, 2015. http://hdl.handle.net/10871/17957.
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Introduction and aim: Increases in the bioavailability of nitric oxide have been shown to reduce the oxygen (O2) cost of exercise, improve exercise performance, alter gastric blood flow and mediate glucose uptake in healthy individuals. Aim: Does dietary nitrate reduce the O2 cost of exercise, improve walking performance in individuals with type 2 diabetes mellitus (T2DM) and chronic obstructive pulmonary disease (COPD) or alter hepatic diffusion and positively affect glucose homeostasis in healthy adults? Methods: Experimental chapters utilised a double-blind, placebo-controlled, randomised, experimental design. Breath by breath pulmonary gas analysis was utilised to assess the O2 cost of exercise in 48 individuals with T2DM and 13 with COPD. Walking performance was assessed via the six minute walk test (6MWT) in cohorts 1 and 2. Magnetic resonance imaging was used to assess portal vein flux, velocity and the apparent diffusion coefficient, in order to assess hepatic microvascular diffusion (apparent diffusion coefficient (ADC)). Blood pressure (BP) was measured in all trials. Results: Relative to placebo, beetroot juice resulted in a significant increase in plasma nitrate and nitrite. There were no differences between placebo vs. beetroot juice for the O2 cost of walking (T2DM: placebo; 946 ± 221 vs. beetroot juice; 939 ± 223 ml.min-1; P=0.59) or cycling (COPD: placebo; 933 ± 323 vs. beetroot juice; 939 ± 302 ml: min-1; P=0.88), distance covered in the 6MWT (T2DM: placebo; 550 ± 83 vs. beetroot juice; 554 ± 90m; P=0.17 or COPD: placebo; 456 ± 86 vs. beetroot juice; 449 ± 79 m; P=0.37) or BP (T2DM: systolic: placebo; 134 ± 10 vs. beetroot juice; 132 ± 12 mmHg, P=0.17; diastolic: placebo; 77 ± 7: vs. beetroot juice; 76 ± 11 mmHg, P=0.27. COPD: systolic: placebo; 123 ± 14 vs. beetroot juice; 123 ± 14 mmHg; P=0.91; diastolic: placebo; 77 ± 9 vs. beetroot juice; 79 ± 9 mmHg; P=0.27). No differences were seen between placebo and beetroot juice for ADC (young adults: F(3, 45) = 0.25, P = 0.74; older adults; F(3, 42) = 1.3, P = 0.28), portal vein flux (young adults: F(3, 45) = 0.339, P = 0.79; older adults; F(3, 42) = 1.65, P = 0.19) however, there was an interaction effect in the young adults: (F(3, 45) = 2.9, P = 0.04) but not in the older adults; F(3, 42) = 1.8, P = 0.16) between visits for portal vein velocity. Nitrate supplementation did not reduce plasma glucose concentrations (young adults: F(3, 45) = 0.96, P = 0.42; older adults; F(3, 42) = 0.04, P = 0.99). Nitrate supplementation did not reduce systolic blood pressure (young adults: F(3, 45) = 0.20, P = 0.89; older adults; F(3, 42) = 1.7, P = 0.18) or diastolic blood pressure (young adults: F(3, 45) = 0.25, P = 0.86; older adults; F(3, 42) = 0.45, P = 0.72). Conclusion Dietary nitrate supplementation does not alter the O2 cost of exercise, improve walking performance or reduce BP in individuals with T2DM or COPD. Nitrate supplementation does not alter hepatic diffusion, glucose homeostasis or BP.
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Gilchrist, Mark. "The effect of dietary nitrate on blood pressure, endothelial function, and insulin sensitivity in type 2 diabetes mellitus." Thesis, Exeter and Plymouth Peninsula Medical School, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.553689.
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Introduction Diets rich in green leafy vegetables have been shown to lower blood pressure and lower the risk of cardiovascular disease. Green leafy vegetables are particularly rich in inorganic nitrate. Dietary nitrate supplementation, via sequential reduction to nitrite and nitric oxide, has previously been shown to lower blood pressure and improve endothelial function in healthy humans. Aims To develop a nitrate-depleted beetroot juice placebo in order to conduct a randomised double blind control trial. To determine if supplementing dietary nitrate with beetroot juice, a rich source of nitrate, will lower BP, improve endothelial function and insulin sensitivity in individuals with type 2 diabetes (T2DM). To determine if supplementing dietary nitrate will lower BP in healthy older adults. Methods The beetroot juice nitrate concentration was lowered using an ion exchange resin. The nitrate content of 250 ml of active juice was 7.5 mmol, whilst nitrate- depleted juice had 0.002 mmol of nitrate in 250ml. Twenty-seven patients, age 67.2 +/-4.9 years, (18 male) were recruited for a double blind, randomised, placebo-controlled crossover trial. Participants were randomised to begin in either order a 2 week period of supplementation with 250 ml beetroot juice daily (active, 7.5 mmol of nitrate) or 250 ml nitrate-depleted beetroot juice (placebo 0.002 mmol of nitrate) followed by a 4 week washout period before entering the second arm of the study. At the conclusion of each intervention period 24 hour ambulatory blood pressure monitoring, vascular tests and a hyperinsulinaemic euglycaemic clamp were performed. Seventeen healthy controls, age 60.5 ± 3.6 (11 male) were recruited to a more limited protocol examining the effect of dietary nitrate supplementation on blood pressure. Results The mean systolic BP was unchanged: 134.6 ± 8.4 mm Hg vs 135.1 ± 7.8 mm Hg (mean±SD) placebo vs active - mean difference of -0.5 mm Hg (placebo- active) p=0.737 (95% Cl -3.9 to 2.8) in the T2DM group. The plasma nitrate concentration was 31IJM (median, IOR; 19.8-41.6) vs 150IJM (122.7, 200), p<0.001. The plasma nitrite concentration was 232 nM (200, 265) vs 390nM (312, 537), p<0.001, for placebo vs active. There were no differences in endothelial function or insulin sensitivity between supplementation arms. The healthy control group mean systolic BP was unchanged at 129.2 ± 9.8 mm Hg vs 131.0 ± 13.1 mm Hg, with a mean difference of -1.8 mm Hg, p=0.320 (95% CI-5.4 to 1.9). The plasma nitrate concentration was 19.81JM (10.6, 37.7) vs 116.6 IJM (91.9, 158.9), p<0.001, and the plasma nitrite concentration 285 nM (245,348) vs 335 nM (296, 357), p=0.127. Conclusion Supplementation of the diet with 7.5 mmol of nitrate per day caused an increase in the plasma nitrite concentration, but did not lower blood pressure, improve endothelial function or improve insulin sensitivity in individuals with T2DM in this study. Dietary nitrate supplementation did not lower BP in healthy older adults in this study.
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Balasubramaniam, Karthik. "Platelet dependent thrombosis, blood thrombogenicity and response to antiplatelet therapy in health, ageing and type 2 diabetes mellitus." Thesis, University of Newcastle upon Tyne, 2016. http://hdl.handle.net/10443/3499.
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Elderly and type 2 diabetes mellitus (T2DM) patients with stable coronary artery disease (CAD) have increased risk of atherothrombotic events despite recommended secondary prevention therapy. High platelet reactivity drives this risk. Novel approaches to antiplatelet therapy are needed. Objectives: To: determine the effect of age and T2DM on blood thrombogenicity and response to dual antiplatelet therapy in stable CAD assess the effect of changes in platelet count on thrombus quantity and quality with Rafigrelide Methods: Study 1: Patients with stable CAD, 4 groups: age < 75 non-DM, age≥75 T2DM, age≥75 non-DM and age<75 T2DM studied at baseline and one week after clopidogrel. I performed Badimon chamber study, thromboelastography, VerifyNow® and Multiplate® aggregometry, coagulation and inflammatory biomarkers and scanning electron microscopy. Study 2: Twelve volunteers took Rafigrelide (novel platelet lowering agent) singly and then with aspirin. I performed Badimon chamber study and thromboelastography at pre-defined intervals. Results: Study 1: At baseline and after clopidogrel therapy, there was no difference in thrombus area between the four groups. Serum TNFα levels were higher in elderly T2DM patients. Other coagulation and inflammatory markers were similar between the groups. Clopidogrel reduced thrombus area, lowered platelet content of thrombus and increased fibrin diameter and density in all four groups. Elderly and T2DM patients demonstrated high platelet reactivity and hyporesponsiveness to clopidogrel. Significant reduction in thrombus area was demonstrated both in good- and hypo-responders to clopidogrel. Point of care tests and thrombus area showed no correlation. Post chamber blood confirmed release of P selectin, CD40 ligand and PAI-1 from activated platelets. ii Study 2: Rafigrelide reduced platelet count and thrombus area, delayed initiation of clot formation and reduced over all clot strength. Platelet count positively correlated with thrombus area. Conclusion: Elderly and T2DM patients had similar over all blood thrombogenicity but higher platelet reactivity when compared to young and non-diabetic patients. Addition of clopidogrel reduced thrombus area with ultrastructural changes in fibrin favouring fibrinolysis. Reduction in platelet count with Rafigrelide reduced thrombus formation and lowered viscoelastic strength. Dual antiplatelet therapy and novel therapeutic strategies may reduce future thrombotic risk in these high risk populations.
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Russell, Danielle, and Patricia Ritz. "Effects of Prickly Pear Nectar on Blood Glucose and Platelet Aggregation in a Type 2 Model of Diabetes." The University of Arizona, 2009. http://hdl.handle.net/10150/623996.
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Class of 2009 Abstract<br>OBJECTIVES: An estimated 26.3 million Americans have Diabetes Mellitus (DM). Currently six classes of agents are approved for the treatments of Type 2 DM. Problems with current options have led to searches for new medications and adjunctive therapy. Prickly pear (Opuntia species) has been traditionally used by Mexicans and Pima Indians for the treatment of DM. This is a retrospective analysis of data obtained from a randomized placebo-controlled prospective experiment in 28 Type 2 DM rodents (ZDF). There were 2 negative control groups which consisted of non-DM rodents and ZDFs; each receiving water. The positive control group consisted of ZDFs who received rosiglitazone 4.75 mg/kg/day. The treatment group consisted of ZDFs who received 5-10 mL/kg/dose of Opuntia ficus indica (Jugo De Nopal) liquid, given twice daily. Weight, blood glucose and platelet aggregation were recorded and analyzed. At baseline, there were no significant differences in weight or blood glucose among ZDF groups. The lean control rodents had significantly lower blood glucose compared to the ZDF rodents (p<0.001). Treatment with Jugo de Nopal resulted in a statistically significant reduction in blood glucose (p<0.001), with a mean decrease in blood glucose of 7%. All treatment groups demonstrated a significant weight gain, however, the prickly pear group had significantly less weight gain than the rosiglitazone group (p=0.028).
CONCLUSIONS: There was not a significant difference among the treatment groups with regard to platelet responsiveness. Further studies are necessary to determine the efficacy of prickly pear as a blood glucose lowering agent.
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Marinik, Elaina. "Angiotensin II receptor blockade and insulin sensitivity in overweight and obese adults with elevated blood pressure." Diss., Virginia Tech, 2012. http://hdl.handle.net/10919/37369.
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Currently, it is reported that ~65% and 34% of the U.S. population is overweight and obese, respectively. Obesity is a major risk factor for cardiovascular disease. Overweight and obese individuals are also at an increased risk of developing hypertension. Whole-body insulin sensitivity is reduced in obesity, resulting in insulin resistance and increased risk of type 2 diabetes. One possible mechanism contributing to insulin resistance in obesity hypertension is renin-angiotensin system (RAS) overactivation. The RAS exhibits vasocontricting and sodium-retaining properties, yet in vivo and in vitro animal experiments suggest impairment of whole-body insulin sensitivity with increased angiotensin II (Ang II) exposure. Furthermore, evidence from clinical studies indicates Ang II receptor blockers (ARBs) may reduce the incidence of new-onset diabetes compared to other antihypertensive agents in at-risk hypertensive patients. However, it is unclear if whole-body insulin sensitivity is improved with Ang II receptor blockade in humans. Thus, we tested the hypothesis that 8-week Ang II receptor blockade with olmesartan would improve whole-body insulin sensitivity in overweight and obese individuals with elevated blood pressure (BP). Olmesartan was selected for the present study because it is devoid of partial PPARγ agonist activity. To test our hypothesis, intravenous glucose tolerance tests were performed to measure insulin sensitivity before and after control and ARB treatment in a randomized crossover manner. Because skeletal muscle tissue accounts for ~75-90% of insulin-stimulated glucose uptake, a secondary exploratory aim was to examine skeletal muscle inflammatory and collagen response in relation to insulin sensitivity during ARB treatment. No baseline differences were observed between treatments (P>0.05). Both systolic (-11.7 mmHg; P=0.008) and diastolic (-12.1 mmHg; P=0.000) BP were reduced with ARB treatment. Insulin sensitivity was not different between treatments (P>0.05). No correlates of insulin sensitivity were identified. In addition, skeletal muscle inflammatory and collagen gene expression did not change from pre- to post-ARB treatment (P>0.05). Our findings suggest that short-term RAS blockade in overweight and obese adults with elevated BP does not improve whole-body insulin sensitivity, despite a significant BP reduction. Further studies are needed to clarify the role of individual RAS blockers on insulin sensitivity during RAS inhibition in obesity hypertension.<br>Ph. D.
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Sambo, Rasiat Umar. "The Effect of Probiotic Bacteria on High Sugar Diet Induced Diabetes Type-2 Symptoms in Fruit Fly : With Focus on Lipid Metabolism." Thesis, Högskolan i Skövde, Institutionen för hälsa och lärande, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-17322.
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As the prevalence of type 2 diabetes has increased globally, so has the need to further investigate the disorder’s underlying features and a potential target for treatment. Drosophila melanogaster has proven to be an excellent model organism to study type 2 diabetes (T2D). To see whether it can serve as a model organism to identify the treatment of T2D, a type 2 diabetes like model were created in Drosophila through high sugar diet (HSD). The aim of the study was to investigate the therapeutic effects of six different probiotic bacteria strains on T2D characteristics markers. Longevity, size, and weight measurement were performed. Followed by verification of HSD effects on these phenotypes. It was demonstrated that probiotics could improve weight and lifespan. Treatment using probiotics showed statistically increased body weight in both 3rd instar larvae and adult flies (p-value <0.05). There was no statistically significant difference in length between any of the groups including controls (p-value 0.25). However, the triglyceride assay showed a slightly significant difference between control low sugar diet and few of the treatment groups (L. paracasei with p-value 0.037, and L. acidophilus with p-value 0.025) fed larvae/adult flies, and there was no statistically significant difference between controls (high and low sugar diets), and probiotics treatment groups (L. plantarum, B. animalis and B. breve) fed larvae/adult flies with a p-value >0.05. To investigate the effect on gene expression of four genes (FASNCG3523, FASNCG3524, FASNCG17374 & dsREBP) important in lipid metabolism, qPCR was performed using the Taqman method. All probiotic treatment groups had significantly decreased gene expression of FASN compared to the control groups. Findings of this study suggest that Drosophila melanogaster can be utilized as a model organism to study T2D and that further studies concerning the effects of probiotic treatment in Drosophila are required to fully understand the interactions and mechanism of action.
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Steigerwalt, Abby. "The effects of aerobic exercise and extended-release niacin on lipoprotein subfractions in individuals with type 2 diabetes." Virtual Press, 2006. http://liblink.bsu.edu/uhtbin/catkey/1339461.
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Diabetes has become a nationwide epidemic affecting 18.2 million Americans, and the incidence is expected to increase 122% by the year 2025. The dyslipidemia associated with type 2 diabetes—low HDL-C; high TG; and small, dense LDL-C—contributes to the 2 to 4 times greater risk of individuals with diabetes to have a major cardiovascular event. Niacin, a B vitamin, and aerobic exercise have been shown separately to favorably alter the lipid profile. The present study examined a combination therapy of Niaspan®, an extended-release formulation of niacin, and 16 weeks of aerobic exercise in 23 individuals with type 2 diabetes. The dosage of Niaspan® began at 500 mg/day and increased 500 mg/day every 4 weeks up to a maximum dose of 2000 mg/day. Subjects were advised to gradually progress their frequency, intensity, and duration of aerobic exercise until they were expending at least 1500 kilocalories by week 8. Subjects were instructed to make no changes to their diet or diabetes medication regimen. Lipoproteins and subfractions and selected measures of physical fitness were examined before and after the 16 week intervention. Following the 16 week intervention period, there were significant changes (p<0.05) in HDL-C (+28%), TG (-19%), VLDL-C (-12%), and LDL-C (-9%). There were also significant changes in the larger, more buoyant subfractions HDL2 (+48%), VLDL2 (-15%) and LDL1 (-48%). Other subfractions that are smaller and more dense also changed favorably: HDL3 (+24%) and LDL4 (-15%). Although there was no significant weight loss in this population as a result of the intervention, there were significant changes in submaximal heart rate (124.9±17.6 vs. 116.7±16.3 bpm) and resting systolic (136.8±17.5 vs. 128.3±13.8 mmHg) and diastolic (80.3±12.5 vs. 73.2±9.8 mmHg) blood pressure, adaptations that occur with improvement in physical fitness. There were no changes in fasting plasma glucose or glycosylated hemoglobin, contradicting any deterioration in glucose control. Therefore, the combination of Niaspan® and aerobic exercise is effective at altering the lipid profile in individuals with type 2 diabetes. In addition, this intervention is safe in that it does not adversely affect glucose control.<br>School of Physical Education, Sport, and Exercise Science
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Laffoon, Scott Bradley. "Type-2 diabetes and innate immunity: new connections revealed by multi-dimensional fractionation of blood plasma prior to proteomic analysis." Diss., Montana State University, 2010. http://etd.lib.montana.edu/etd/2010/laffoon/LaffoonS1210.pdf.
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We compared levels of protein isoforms in human blood plasma from patients with newly diagnosed and untreated type-2 diabetes (T2DM) with non-diabetic controls in samples obtained from US NIH. We immunodepleted fourteen of the most abundant proteins from pooled plasma samples and separated the depleted samples into six fractions by reverse-phase liquid chromatography at 80°C. Proteins from these fractions were labeled with new high quantum yield, hydrophilic and spectrally resolved fluorescent detection dyes developed at MSU and resolved on large-format (24cm x 20cm) two-dimensional gels. By fluorescence analysis of 2D gels, using >1.4 fold change and p<0.05 acceptance criteria, we have identified five T2DM associated proteins and isoforms, including: two isoforms of zinc-alpha glycoprotein (ZAG), one isoform of serum amyloid A-1 (SAA-1) preprotein, one isoform of cysteine-rich secreted protein-3 (CRISP-3), one isoform of haptoglobin, and an A1-apolipoprotein fragment. Complement factor H related-5 (CFHR-5) is the likely identification of a sixth protein found significantly down in T2DM. Changes in the plasma levels of CRISP-3 and CFHR-5 strengthen the hypothesis that T2DM is a disease involving innate immunity. Three of these proteins are known to specifically bind to the transport protein, human serum albumin (HSA). Also, CRISP-3 is a specific and high-affinity ligand of alpha 1 beta glycoprotein, which is an HSA binder. To investigate HSA binding properties, we quantitatively measured the binding of a dye probe by HSA at neutral pH. These measurements revealed that HAS binding of the probe correlates with several metabolic parameters of central importance to the diagnosis of T2DM, including fasting plasma glucose (FPG). Therefore, this assay may reveal altered properties of HSA that could be developed for the clinical assessment of individuals' metabolic status. We sought modifications of HSA or altered cargo of HSA that may cause the difference in binding. 1D gels of plasma proteins reacted with maleimide dye showed no changed levels of the oxidation state of HSA's lone thiol, Cys-34. However, 1D blots of plasma proteins reacted with the oxidative carbonyl probe, hydrazide-biotin conjugate, and probed with luminol reactive HRP-neutravidin showed a surprising anti-correlation of HSA oxidation with hemoglobin A1c, an indicator of glycemic control.
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Rosado, Julieta. "A Study to Determine the Effects of Cinnamon on Blood Glucose and Lipid Levels in Person's with Type - 2 Diabetes." Diss., University of Hawaii at Manoa, 2010. http://hdl.handle.net/10125/22065.
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Diabetes is the most common metabolic disease worldwide; one in twenty Americans are affected. This chronic disease can lead to a host of complications including blindness, amputations, stroke, nerve damage, heart disease and kidney failure. Many of
these complications can be avoided by maintaining normal blood glucose and lipid levels. Researchers have speculated that certain spices such as cinnamon may help to normalize.
The objective of this double blind, placebo-controlled study was to determine whether cinnamon improves blood glucose, triglyceride, total cholesterol, and low density lipoprotein (LDL) cholesterol levels in persons with type-2 diabetes. The population included 40 men and women diagnosed with type-2 diabetes, who had a fasting blood glucose level between 126-300 mg/dl, or a glycosylated hemoblogbin (HgbAlc) level greater than 7% despite metformin treatment for glucose control. The subjects were randomly assigned to a treatment or control group. The treatment group received lgm of the water-soluble extract of cinnamon in capsule form daily. Their fasting blood glucose, total cholesterol, triglyceride, high density lipoprotein (HDL) cholesterol, LDL cholesterol and postprandial glucose levels were measured on days 0, 20, 40, & 60 of the study. Expected outcomes included normalization of all measured blood levels, except HDL cholesterol levels, for which no significant changes were expected.
After 40 days of supplementation, fasting glucose levels were similarly decreased in both groups, an 8% decrease was found in the treatment group and a 5% decrease in the control group. Postprandial glucose levels decreased by 3% in both the treatment and control groups. Total cholesterol levels decreased by 4% in the treatment group and by 3% in the control group. LDL cholesterol levels decreased by 12% in the treatment group and by 15% in the control group. Triglyceride levels decreased by 18% in the treatment group and increased by 7% in the control group. HDL cholesterol levels did not change over time in the treatment nor in the control group. No significant differences were found between treatment and control in any of the end points of this study.
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Covic, Namukolo Margaret. "The effect of blood glucose control on fibrin network characteristics of African subjects with uncontrolled type 2 diabetes / N.M. Covic." Thesis, North-West University, 2008. http://hdl.handle.net/10394/2027.
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Pelzer, Ruaan. "A new approach to improving the control of type 1 diabetes / Ruaan Pelzer." Phd thesis, North-West University, 2006. http://hdl.handle.net/10394/4167.
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Blood glucose management in Type 1 diabetes is crucial in preventing several diabetic complications. Blood glucose management is a complex task requiring diabetics too carefully
administer the correct dosages of insulin by taking their blood glucose levels, food
consumption, exercise, stress, illnesses and several other factors into account. Improved bolus calculation greatly aids in controlling blood glucose levels within a tight range. This study investigates how the ets-concept (Equivalent Teaspoons Sugar-concept) can be used to develop products to calculate insulin boluses. A cellular phone based software application was developed to calculate insulin boluses using the ets-concept. This product was tested in a clinical trial. A blood glucose characterization procedure was also developed to characterize the blood glucose response of a Type 1 diabetic to carbohydrate ingestion and insulin administration. The characterization procedure was used during the clinical trial to characterize patients in order to customize the bolus calculation products for the specific diabetic user.<br>Thesis (Ph.D. (Mechanical Engineering)--North-West University, Potchefstroom Campus, 2006
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Lemos, Virgínia Carvalho. "Evaluation of the effect of A. unedo L. extracts on blood indices and microelements status in high-fat STZ-induced diabetic rats." Master's thesis, Universidade de Aveiro, 2015. http://hdl.handle.net/10773/15469.
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Mestrado em Bioquímica - Métodos Biomoléculares<br>The strawberry tree (Arbutus unedo L.) is an endemic shrub, which grows in the Mediterranean region. In Portugal, it can be found through all the country but mostly in the south. The fruit is used to produce hams and jellies and firewater, reason why the fruit’s chemical composition is relatively well known, when compared to the leaves. Until now, there are only a few studies concerning the leaves’ chemical composition and the existing mainly focus on their phenolic content. This plant has long been used in folk medicine to treat a vast amount of illnesses like gastrointestinal disorders, gastritis, dermatologic and urological problems, kidney problems and cardiovascular diseases. However, very few studies in vivo have been performed about these medicinal properties until now. Diabetes is a pandemic disease that affects millions of people. There are only two studies about A. unedo root’s aqueous extract antidiabetic properties. This study evaluated the anti-diabetic effect of strawberry tree (Arbutus unedo L.) fruit and leaf aqueous extracts in streptozotocin (STZ) induced diabetic rats fed with a high-fat diet. Firstly the optimal parameters to obtain the fruit aqueous extract were established. After that, the leaves and fruits aqueous extracts were characterized in terms of total phenolic content (TPC). Leaf aqueous extracts presented a higher TPC concentration than the fruit aqueous extract. Male Wistar rats were injected with STZ, after a 2 week feeding with high-fat diet in order to induce non-insulin dependent type 2 diabetes. After confirmation of the rats’ diabetic state, the animals were fed with Arbutus unedo L. fruit aqueous extract or leaf aqueous extract added to the high-fat diet for 4 weeks. The extracts were given in the following doses: 1.25g /kg b.w./day for leaf extract and 0.5g /kg b.w./day for fruit extract. After the animals were sacrificed analyses were perform for blood indices, haematological indices, mineral tissular status and gene expression. Arbutus unedo L. fruit extract presented a tendency to lower blood glucose levels. More beneficial effects were seen for this extract in terms of regulating TNF-α gene expression in muscular tissue. Some effects in zinc renal homeostasis were also shown, although they were not very significant. The leaf extract, appeared to be more efficient in regulating insulin levels and improving HOMA-IR index. It also presented a tendency towards lowering blood glucose levels. Both extracts proved to efficiently improve insulin sensitivity (leaf extract in a larger extent). In this study, there were also some good preliminary results, as the groups supplemented with this extracts showed a tendency in decreasing serum creatinine and/or phosphatase concentration, improving the Red Cell Distribution Width measured with standard deviation (RDW-SD) and lymphocytes concentration. Positive antidiabetic and anti-inflammatory aspects were found for both aqueous extracts. The results obtained confirm the mid-therapeutically effects of A. unedo as the plant’s material effectively improved insulin sensitivity (HOMA-IR index) although failed to significantly modulate glucose metabolism. This study was the first in vivo trial on a type 2 diabetes animal model that evaluated the antidiabetic potential of Arbutus unedo L. fruits and leaves aqueous extracts.<br>O medronheiro (Arbutus unedo L.) é um arbusto endémico que cresce em toda a região Mediterrânica. Em Portugal, pode ser encontrado em todo o território continental, principalmente na zona sul do país. O fruto é utilizado na produção de compotas, marmeladas e aguardente, pelo que a composição química deste é relativamente bem conhecido quando comparado com as folhas. Actualmente, existem poucos estudos sobre a composição química das folhas, sendo que a maioria visa apenas o seu conteúdo em compostos fenólicos. Esta planta tem sido utilizada na medicina popular para tratar diversas doenças tais como distúrbios gastrointestinais, gastrite, problemas dermatológico, urológicos, renais e cardiovasculares. No entanto, até ao momento existem poucos estudos in vivo que atestem estas propriedades medicinais, o que justifica a realização deste tipo de ensaios. No caso da diabetes, que afecta milhões de pessoas em todo o mundo, existem apenas dois estudos sobre as propriedades antidiabéticas do extrato aquoso das raízes de A. unedo. O presente trabalho de mestrado avaliou o potencial antidiabético dos extractos aquosos das folhas e frutos do medronheiro. O estudo foi efectuado em ratos diabéticos (diabetes induzida por Estreptozotocina - STZ) alimentados com uma ração rica em gordura. Primeiramente foram optimizados os parâmetros de extracção para a obtenção do extrato aquosos do fruto. De seguida os extratos aquosos de folhas e frutos foram caracterizados em termos de teor em fenóis totais. O extrato aquoso das folhas apresentou uma maior concentração de fenóis totais do que o extrato aquoso do fruto. Ratos Wistar do sexo masculino foram injectados com STZ após serem alimentados durante 2 semanas com uma dieta rica em gordura. Desta forma induziu-se diabetes tipo 2, não dependente de insulina. Após a confirmação da condição diabética dos ratos, a dieta rica em gordura continuou a ser administrada aos animais. No entanto, as dietas foram suplementadas com extrato aquoso ou do fruto ou das folhas de Arbutus unedo L., num tratamento com a duração de 4 semanas. Os extratos foram administrados nas seguintes doses: 1.25g /kg peso corporal/dia no caso do extrato da folhas 0.5g /kg peso corporal/dia no caso do extrato do fruto. Efectuaram-se análises a parâmetros do sangue, hematológicos, à homeostasia mineral dos tecidos e à expressão de determinados genes após os animais serem sacrificados. O extrato do fruto apresentou uma tendência a regular os níveis de glucose no sangue. Outros efeitos benéficos foram atribuídos a este extrato, nomeadamente ao nível da regulação da expressão do gene de TNF-α a nível muscular. Este extrato também apresentou alguns efeitos ao nível da regulação da homeostase renal de zinco, embora não muito significativos. O extrato da folha provou ser mais eficiente a regular os níveis de insulina, a melhorar a resistência à insulina (HOMA-IR). Também apresentou uma tendência a regular os níveis de glucose no sangue. Ambos os extratos aumentaram de forma eficiente a sensibilidade à insulina (embora o extrato da folha o tenha feito de forma mais pronunciada). Obtiveram-se ainda bons resultados preliminares, uma vez que estes extratos demostraram que ocorreu uma tendência em termos de diminuição da concentração de creatinina e/ou fosfatase, de aumento do valor do parâmetro de Amplitude de Distribuição dos Eritrócitos medido como Desvio Padrão (RDW-SD), de aumento da concentração de linfócitos e diminuíram. Para ambos os extratos foram detectados efeitos antidiabéticos e anti-inflamatórios. Os resultados obtidos confirmam que A. unedo apresenta alguns efeitos terapêuticos, embora ligeiros. Os extratos desta planta melhoraram significativamente a sensibilidade à insulina mas não conseguiram regular significativamente o metabolismo da glucose. Este estudo foi o primeiro, num modelo animal de diabetes tipo 2 que avaliou o potencial antidiabético dos extratos aquosos dos frutos e folhas de Arbutus unedo L.
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Wells, Kristen Jennifer. "An evaluation of the relationship between stress, depression, and glycemic control in low-income patients with type 2 diabetes." [Tampa, Fla] : University of South Florida, 2006. http://purl.fcla.edu/usf/dc/et/SFE0001629.
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McMahon, Sarah Kate. "Glucose requirements to maintain euglycaemia during and following moderate intensity afternoon exercise in adolescents with type 1 diabetes mellitus : an insight to the risk of exercise-associated hypoglycaemia." University of Western Australia. School of Paediatrics and Child Health, 2009. http://theses.library.uwa.edu.au/adt-WU2010.0084.
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Exercise has a wide range of benefits for patients with type 1 diabetes, including improvements in body composition, cardiovascular risk profile and glycaemic control. Unfortunately, exercise also increases the risk of hypoglycaemia in children with type 1 diabetes, both at the time of exercise and for many hours afterwards. The availability of clear, evidence-based guidelines regarding appropriate adjustments in carbohydrate intake or insulin doses may help to prevent this exercise associated hypoglycaemia. However, current guidelines regarding exercise in children with type 1 diabetes rely heavily on adult literature or the consensus of experts. Therefore, further studies are needed in young people with diabetes to document the metabolic responses during and following exercise. In particular, the mechanisms underlying hypoglycaemia occurring many hours after exercise require further exploration. In addition, as children often exercise in the afternoon, studies performed at this time of the day are more likely to be transferrable to a real life situation. For this reason, we studied adolescents with type 1 diabetes to investigate physiological responses to exercise, focusing on afternoon activity and employing a novel variation of the euglycaemic insulin clamp technique. The core experiments involved studying diabetic adolescents on two occasions in a counterbalanced, paired design during and after afternoon exercise. Insulin was infused at a constant rate based on the subjects' usual daily insulin dose and glucose was infused to maintain euglycaemia. At 1600 hrs subjects either exercised at a moderate intensity (95% of their lactate threshold) for 45 minutes on a cycle ergometer (exercise study), or sat on the ergometer without exercising (rest study). Using this experimental design, it was found that glucose infusion rates (GIR) to maintain euglycaemia were elevated during and shortly following exercise and again from 7-11 hours after exercise compared with the rest study. Counterregulatory hormone levels were similar between the exercise and rest studies except for peaks in noradrenaline, cortisol and growth hormone levels at the end of exercise. Glucagon and adrenaline levels did not increase with exercise. The observed biphasic increase in glucose requirements paralleled the observed clinical risk of hypoglycaemia immediately during exercise and the delayed risk of hypoglycaemia which often occurs overnight.
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Glover, David A. "The effects of dietary supplementation with Gum arabic on blood pressure and renal function in subjects with Type 2 diabetes mellitus." Thesis, Cardiff University, 2012. http://orca.cf.ac.uk/39863/.
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Type 2 diabetes mellitus is associated with a significant increased morbidity and mortality resulting from microvascular and macrovascular complications, in particular diabetic nephropathy and cardiovascular disease. Treatment of these conditions has involved improving diabetic control, reducing blood pressure and addressing other cardiovascular risk factors. Dietary fibre has wide reaching health benefits, including improvement of diabetic control and blood pressure, potentially by alterations in colonic bacterial populations that result in changes in serum short chain fatty acids. An open labelled study with a washout period was undertaken to examine the potential effects of Gum arabic on blood pressure and renal function. A daily supplement of gum arabic (25g), a soluble dietary fibre, was administered for a period of 12 weeks. An initial pilot study was conducted in healthy subjects (n=10) and subjects with overt nephropathy (n=14). A follow on study investigated subjects with incipient nephropathy (n=23) in more detail. Measurements of renal function, including isotope GFR and ERPF, blood pressure and vascular stiffness (follow on only), and short chain fatty acids were measured. A significant drop in GFR was seen in the healthy individuals with no associated change in filtration fraction, which could convey some renal protective effect. No changes were seen in the diabetic subjects. Significant drops in blood pressure were seen each of the individual groups. Results of pulse wave analysis and central blood pressure measurements suggest this is not as a result of changes in vascular stiffness. Significant changes in short chain fatty acid production were seen, in particular an increase in acetate (p=0.033) in the incipient nephropaths and butyrate (p=0.03) in the healthy subjects. This study suggests that Gum arabic has beneficial effects on blood pressure but no immediate beneficial effects on renal function in either diabetic cohort.