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Description
Cardiovascular disease (CVD) is the number one cause of death in the United States and type 2 diabetes (T2D) and obesity lead to cardiovascular disease. Obese adults are more susceptible to CVD compared to their non-obese counterparts. Exercise training leads to large reductions in the risk of CVD and T2D.

Cardiovascular disease (CVD) is the number one cause of death in the United States and type 2 diabetes (T2D) and obesity lead to cardiovascular disease. Obese adults are more susceptible to CVD compared to their non-obese counterparts. Exercise training leads to large reductions in the risk of CVD and T2D. Recent evidence suggests high-intensity interval training (HIT) may yield similar or superior benefits in a shorter amount of time compared to traditional continuous exercise training. The purpose of this study was to compare the effects of HIT to continuous (CONT) exercise training for the improvement of endothelial function, glucose control, and visceral adipose tissue. Seventeen obese men (N=9) and women (N=8) were randomized to eight weeks of either HIT (N=9, age=34 years, BMI=37.6 kg/m2) or CONT (N=8, age=34 years, BMI=34.6 kg/m2) exercise 3 days/week for 8 weeks. Endothelial function was assessed via flow-mediated dilation (FMD), glucose control was assessed via continuous glucose monitoring (CGM), and visceral adipose tissue and body composition was measured with an iDXA. Incremental exercise testing was performed at baseline, 4 weeks, and 8 weeks. There were no changes in weight, fat mass, or visceral adipose tissue measured by the iDXA, but there was a significant reduction in body fat that did not differ by group (46±6.3 to 45.4±6.6%, P=0.025). HIT led to a significantly greater improvement in FMD compared to CONT exercise (HIT: 5.1 to 9.0%; CONT: 5.0 to 2.6%, P=0.006). Average 24-hour glucose was not improved over the whole group and there were no group x time interactions for CGM data (HIT: 103.9 to 98.2 mg/dl; CONT: 99.9 to 100.2 mg/dl, P>0.05). When statistical analysis included only the subjects who started with an average glucose at baseline > 100 mg/dl, there was a significant improvement in glucose control overall, but no group x time interaction (107.8 to 94.2 mg/dl, P=0.027). Eight weeks of HIT led to superior improvements in endothelial function and similar improvements in glucose control in obese subjects at risk for T2D and CVD. HIT was shown to have comparable or superior health benefits in this obese sample with a 36% lower total exercise time commitment.
ContributorsSawyer, Brandon J (Author) / Gaesser, Glenn A (Thesis advisor) / Shaibi, Gabriel (Committee member) / Lee, Chong (Committee member) / Swan, Pamela (Committee member) / Buman, Matthew (Committee member) / Arizona State University (Publisher)
Created2013
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Description
Nationally, African Americans suffer disproportionately from diabetes; with 13.2% of African Americans diagnosed with diabetes compared to 7.6% of non-Hispanic whites (CDC, 2014). Nearly one-half of all people with diabetes are non-adherent to their oral medications; adherence to insulin therapy was 60%-80% (Brunton et al., 2011; Cramer, 2004; Rubin, 2005).

Nationally, African Americans suffer disproportionately from diabetes; with 13.2% of African Americans diagnosed with diabetes compared to 7.6% of non-Hispanic whites (CDC, 2014). Nearly one-half of all people with diabetes are non-adherent to their oral medications; adherence to insulin therapy was 60%-80% (Brunton et al., 2011; Cramer, 2004; Rubin, 2005). This study explored the question, "What mechanisms are associated with adherence to diabetes medication, including insulin, for African Americans in the Southwest?" Twenty-three people participated in the study; 17 participated in interviews and six participated in gendered focus groups. A community-based participatory research (CBPR) approach engaged the African American community as partners in research.

Major themes emerging from the data included illness perception, support, and the process of medication adherence. Acceptance of the diabetes diagnosis was imperative for medication adherence. Stigmatization of diabetes was salient in the recruitment process and as it related to mechanisms for adherence. Furthermore, many informants were not aware of a family history of diabetes before their own diagnosis. Four gendered emerging typologies were identified, which further illuminated major themes. Moreover, an eight-step process of medication adherence model is discussed. The researcher was able to identify culturally compatible strategies that may be extended to those struggling with medication adherence. The implications section suggests a set of strategies that healthcare providers can present to people with diabetes in order to increase medication adherence.
ContributorsWardian, Jana (Author) / Marsiglia, Flavio F (Thesis advisor) / Sun, Fei (Committee member) / Shaibi, Gabriel (Committee member) / Arizona State University (Publisher)
Created2015
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Description
Background: The prevalence of childhood obesity has disproportionately affected Latino youth. This increase in obesity is seen with an increased incidence of Type 2 Diabetes. Objective/Hypothesis: The objective of this study was to determine the effects of a community based lifestyle intervention, which encompassed nutrition education and physical activity, on

Background: The prevalence of childhood obesity has disproportionately affected Latino youth. This increase in obesity is seen with an increased incidence of Type 2 Diabetes. Objective/Hypothesis: The objective of this study was to determine the effects of a community based lifestyle intervention, which encompassed nutrition education and physical activity, on diabetes risk in pre-diabetic Latino adolescents. Diabetes risk was assessed using pancreatic beta cell function as measured by proinsulin: insulin ratio. It was hypothesized that reductions in added sugar intake and reductions in saturated fat intake will be associated with improved beta cell function as measured by proinsulin: insulin ratio. Study Design/Participants: In this quasi-experimental study design, n=17 pre-diabetic Latino adolescents between the ages of 14-16 participated in a lifestyle intervention. Methods: Anthropometric measurements (weight, height, waist circumference, BMI) and body composition (body %) were determined for all participants at baseline and post intervention. Fasting proinsulin (PI), fasting insulin (I) and 2hr-OGTT were also determined. Dietary intake was measured using the Block Kids Food Screener for kids ages 2-17y (2007). The intervention consisted of nutrition education classes and physical activity sessions for 12 weeks. Results: We found significant decreases in body fat % following the intervention. There were no significant decreases in fasting insulin. Proinsulin significantly decreased. However we did no see a significant change in PI/I (p= 0.003). Dietary behaviors of added sugar (p=0.03) and saturated fat (p=0.04) showed significant decreases. No significant associations were found between changes in added sugar to improvements in beta cell function, r=0.072, p-value= 0.7. We also did not observe significant associations between reductions in saturated fat intake and improvements in beta cell function, r=0.152, p-value =0.6. Conclusions: We concluded that a 12-week lifestyle intervention resulted in significant changes in dietary behaviors. These changes were not however associated with improvements in beta cell function.
ContributorsKaur, Manroop (Author) / Shaibi, Gabriel (Thesis director) / Bruening, Meredith (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2015-05
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Description
Background:
Pediatric obesity is associated with lower quality of life (QOL) and populations with high obesity rates, such as Latinos, are especially vulnerable. We examined the effects of a 12-week diabetes prevention program on changes in weight-specific QOL in Latino youth.
Method:
Fifteen obese Latino adolescents (BMI%=96.3±1.1;age=15.0±1.0) completed a 12-week

Background:
Pediatric obesity is associated with lower quality of life (QOL) and populations with high obesity rates, such as Latinos, are especially vulnerable. We examined the effects of a 12-week diabetes prevention program on changes in weight-specific QOL in Latino youth.
Method:
Fifteen obese Latino adolescents (BMI%=96.3±1.1;age=15.0±1.0) completed a 12-week intervention. Youth completed weight-specific QOL measures at baseline, post intervention, and 1-year follow-up. For comparison purposes, intervention youth were matched for age and gender with lean controls.
Results:
At baseline, obese youth exhibited significantly lower weight-specific QOL compared with lean youth (70.8±5.4 to 91.2±2.2, p<0.005). The intervention did not significantly impact weight (90.6±6.8 to 89.9±7.2kg, p=0.44). However, significant increases in weight-specific QOL were observed (70.8±20.9 to 86.2±16.9, p<0.001). Post-intervention QOL scores were no longer significantly different than lean controls (P=0.692). Data from nine youth who returned for follow-up indicated that increases in weight-specific QOL were maintained over time (90.5±4.5 to 85.8±5.9, p=0.74).
Conclusion:
These results indicate that a community-based diabetes prevention program can result in sustained improvements in weight-specific QOL among obese Latino youth. Lifestyle interventions that focus on social interaction and physical activity, rather than weight-loss per se, may help improve the psychosocial health of obese Latino youth.
ContributorsBrito, Elizabeth (Author) / Shaibi, Gabriel (Thesis director) / Barroso, Cristina (Committee member) / Patrick, Donald (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution and Social Change (Contributor)
Created2013-05
Description
The purpose of this study was to examine the association between VLDL and diabetes risk factors, and the impact of a lifestyle intervention on VLDL levels in obese Latino youth. Participants (N=160) in this study were taken from a lager diabetes prevention program for Latino adolescents (Age=14.8±0.8 years, BMI=98.2±1.4). Youth

The purpose of this study was to examine the association between VLDL and diabetes risk factors, and the impact of a lifestyle intervention on VLDL levels in obese Latino youth. Participants (N=160) in this study were taken from a lager diabetes prevention program for Latino adolescents (Age=14.8±0.8 years, BMI=98.2±1.4). Youth participated in a 12-week lifestyle intervention that included physical activity (60 minutes, 3x/week) and nutrition education sessions (60 minutes, 1x/week) that were delivered to families at the downtown Phoenix YMCA. Primary outcomes included VLDL and diabetes risk factors including fasting and 2-hour glucose and insulin which were measured at baseline and 12-weeks post-intervention. Baseline VLDL levels were significantly correlated with fasting insulin (r =.270, P<0.01) and youth who were more insulin resistant displayed higher VLDL levels compared to youth who were less insulin resistant derived from fasting insulin levels (M=29.8±14.7 mg/dl vs. M=21.6±9.6 mg/dl, P<0.01). In total, 77 participants completed the lifestyle intervention. At post-intervention, VLDL levels were significantly reduced (M=26.0±13.3 mg/dl to M=23.3±11.6 mg/dl, P=0.02). Culturally-grounded, community-based, family-focused lifestyle interventions are a promising approach for reducing cardiovascular disease risk factors in high-risk youth at risk for diabetes.
ContributorsNavabi, Neeku Ariana (Author) / Shaibi, Gabriel (Thesis director) / Soltero, Erica (Committee member) / Ryder, Justin (Committee member) / School of Nutrition and Health Promotion (Contributor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
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Description
My aims with this research project were to conduct a network analysis on collaborators in the ¡Viva Maryvale! project, a diabetes prevention program in Maryvale, AZ. The goals of the social network analysis were to measure the connections that collaborating organizations have to each other, the strength of these connections,

My aims with this research project were to conduct a network analysis on collaborators in the ¡Viva Maryvale! project, a diabetes prevention program in Maryvale, AZ. The goals of the social network analysis were to measure the connections that collaborating organizations have to each other, the strength of these connections, and the activities that connected organizations collaborate on. I hypothesized that performing a network analysis would inform me of the strengths and weaknesses of the ¡Viva Maryvale! project in order to advise the next steps of a targeted approach to diabetes prevention among vulnerable populations, thus affecting public health outcomes in the greater Phoenix Valley.
ContributorsKellog, Anna (Author) / Shaibi, Gabriel (Thesis director) / Soltero, Erica (Committee member) / School of Public Affairs (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
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Description

2D fetal echocardiography (ECHO) can be used for monitoring heart development in utero. This study’s purpose is to empirically model normal fetal heart growth and function changes during development by ECHO and compare these to fetuses diagnosed with and without cardiomyopathy with diabetic mothers. There are existing mathematical models describing

2D fetal echocardiography (ECHO) can be used for monitoring heart development in utero. This study’s purpose is to empirically model normal fetal heart growth and function changes during development by ECHO and compare these to fetuses diagnosed with and without cardiomyopathy with diabetic mothers. There are existing mathematical models describing fetal heart development but they warrant revalidation and adjustment. 377 normal fetuses with healthy mothers, 98 normal fetuses with diabetic mothers, and 37 fetuses with cardiomyopathy and diabetic mothers had their cardiac structural dimensions, cardiothoracic ratio, valve flow velocities, and heart rates measured by fetal ECHO in a retrospective chart review. Cardiac features were fitted to linear functions, with respect to gestational age, femur length, head circumference, and biparietal diameter and z-scores were created to model normal fetal growth for all parameters. These z-scores were used to assess what metrics had no difference in means between the normal fetuses of both healthy and diabetic mothers but differed from those diagnosed with cardiomyopathy. It was found that functional metrics like mitral and tricuspid E wave and pulmonary velocity could be important predictors for cardiomyopathy when fitted by gestational age, femur length, head circumference, and biparietal diameter. Additionally, aortic and tricuspid annulus diameters when fitted to estimated gestational age showed potential to be predictors for fetal cardiomyopathy. While the metrics overlapped over their full range, combining them together may have the potential for predicting cardiomyopathy in utero. Future directions of this study will explore creating a classifier model that can predict cardiomyopathy using the metrics assessed in this study.

ContributorsMishra, Shambhavi (Co-author) / Numani, Asfia (Co-author) / Sweazea, Karen (Thesis director) / Plasencia, Jonathan (Committee member) / Economics Program in CLAS (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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Description

2D fetal echocardiography (ECHO) can be used for monitoring heart development in utero. This study’s purpose is to empirically model normal fetal heart growth and function changes during development by ECHO and compare these to fetuses diagnosed with and without cardiomyopathy with diabetic mothers. There are existing mathematical models describing

2D fetal echocardiography (ECHO) can be used for monitoring heart development in utero. This study’s purpose is to empirically model normal fetal heart growth and function changes during development by ECHO and compare these to fetuses diagnosed with and without cardiomyopathy with diabetic mothers. There are existing mathematical models describing fetal heart development but they warrant revalidation and adjustment. 377 normal fetuses with healthy mothers, 98 normal fetuses with diabetic mothers, and 37 fetuses with cardiomyopathy and diabetic mothers had their cardiac structural dimensions, cardiothoracic ratio, valve flow velocities, and heart rates measured by fetal ECHO in a retrospective chart review. Cardiac features were fitted to linear functions, with respect to gestational age, femur length, head circumference, and biparietal diameter and z-scores were created to model normal fetal growth for all parameters. These z-scores were used to assess what metrics had no difference in means between the normal fetuses of both healthy and diabetic mothers, but differed from those diagnosed with cardiomyopathy. It was found that functional metrics like mitral and tricuspid E wave and pulmonary velocity could be important predictors for cardiomyopathy when fitted by gestational age, femur length, head circumference, and biparietal diameter. Additionally, aortic and tricuspid annulus diameters when fitted to estimated gestational age showed potential to be predictors for fetal cardiomyopathy. While the metrics overlapped over their full range, combining them together may have the potential for predicting cardiomyopathy in utero. Future directions of this study will explore creating a classifier model that can predict cardiomyopathy using the metrics assessed in this study.

ContributorsNumani, Asfia (Co-author) / Mishra, Shambhavi (Co-author) / Sweazea, Karen (Thesis director) / Plasencia, Jon (Committee member) / School of Mathematical and Statistical Sciences (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description

This project aimed to identify barriers to participation and develop strategies to increase the accessibility of a diabetes prevention program in the Latino community. Surveys were administered to past participants of a randomized control trial at a community event where study results were shared. The top concerns expressed by respondents

This project aimed to identify barriers to participation and develop strategies to increase the accessibility of a diabetes prevention program in the Latino community. Surveys were administered to past participants of a randomized control trial at a community event where study results were shared. The top concerns expressed by respondents were related to the use of personal information. Primary barriers to participation included work/school commitments and transportation issues. Strategies to increase accessibility included providing flexible class times, having bilingual research staff, and using multiple forms of community outreach such as flyers, health events, phone calls, texts, and social media. Expanding community partners was also identified as a primary strategy for increasing program reach. Researchers should focus on addressing confidentiality concerns, providing financial compensation for attendance, flexible scheduling, and utilizing diverse outreach methods to enhance access to diabetes prevention programs in the Latino community

ContributorsHouck, Kassidy (Author) / Shaibi, Gabriel (Thesis director) / Williams, Allison (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2023-05
Description
Although evidence from previous studies suggests a correlation between Adverse Childhood Experiences (ACEs) and the risk of Type 2 Diabetes (T2D), research efforts have yet to fully explore this association among Latino young adults. The objective of this longitudinal study was to assess the potential influence of ACEs scores on the diabetes

Although evidence from previous studies suggests a correlation between Adverse Childhood Experiences (ACEs) and the risk of Type 2 Diabetes (T2D), research efforts have yet to fully explore this association among Latino young adults. The objective of this longitudinal study was to assess the potential influence of ACEs scores on the diabetes risk among Latino adults who previously engaged in a diabetes prevention lifestyle intervention program. Five years post intervention, 41 individuals out of the original cohort of 91 participants returned for follow-up and answered a 10-question survey assessing ACEs. Diabetes risk (fasting glucose, 2-hour fasting glucose, HbA1c, and BMI) and quality of life were assessed at 5 timepoints (baseline, 3-months, 6-months, 12-months, and 60-months). Utilizing SPSS, T-tests were utilized to assess the relationship between ACEs and T2D risk. Among the 41 participants (age was 20.6 ±0.9), the mean reported ACE score was 1.5 ±1.9, ranging from 0 to 7. The most frequently reported ACEs was emotional abuse (n=12, 30.0%) and the least frequently reported ACEs was sexual abuse (n=3, 7.3%). Individuals who reported 0 ACEs had significantly lower fasting glucose at 12 months and had lower BMI at 60 months compared to those with 1-7 ACEs. In this study, there was a significant relationship between higher ACEs and increased BMI and fasting glucose among Latinos. Implementing culturally-sensitive interventions addressing family dynamics along with health behaviors could prove pivotal in preventing and managing diabetes among Latino youth.
ContributorsChrostowski, Emilia (Author) / Shaibi, Gabriel (Thesis director) / Braxton, Morgan (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2024-05