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According to the CDC, diabetes is the 7th leading cause of death in the U.S. and rates are continuing to rise nationally and internationally. Chronically elevated blood glucose levels can lead to type 2 diabetes and other complications. Medications can be used to treat diabetes, but often have side effects.

According to the CDC, diabetes is the 7th leading cause of death in the U.S. and rates are continuing to rise nationally and internationally. Chronically elevated blood glucose levels can lead to type 2 diabetes and other complications. Medications can be used to treat diabetes, but often have side effects. Lifestyle and diet modifications can be just as effective as medications in helping to improve glycemic control, and prevent diabetes or improve the condition in those who have it. Studies have demonstrated that consuming vinegar with carbohydrates can positively impact postprandial glycemia in diabetic and healthy individuals. Continuous vinegar intake with meals may even reduce fasting blood glucose levels. Since vinegar is a primary ingredient in mustard, the purpose of this study was to determine if mustard consumption with a carbohydrate-rich meal (bagel and fruit juice) had an effect on the postprandial blood glucose levels of subjects. The results showed that mustard improved glycemia by 17% when subjects consumed the meal with mustard as opposed to the control. A wide variety of vinegars exists. The defining ingredient in all vinegars is acetic acid, behind the improvement in glycemic response observed with vinegar ingestion. Vinegar-containing foods range from mustard, to vinaigrette dressings, to pickled foods. The benefits of vinegar ingestion with carbohydrates are dose-dependent, meaning that adding even small amounts to meals can help. Making a conscious effort to incorporate these foods into meals, in addition to an overall healthy lifestyle, could provide an additional tool for diabetics and nondiabetics alike to consume carbohydrates in a healthier manner.
ContributorsJimenez, Gabriela (Author) / Johnston, Carol (Thesis director) / Lespron, Christy (Committee member) / School of Nutrition and Health Promotion (Contributor) / School of International Letters and Cultures (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
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The development of the Diabetic Physiological state is influenced by the Receptor for Advanced Glycation End Products (RAGE). This receptor was discovered in 1992, and the accumulation of research on this subject has been extensive. Structural characterization studies of the RAGE protein have shown that it is a transmembrane protein

The development of the Diabetic Physiological state is influenced by the Receptor for Advanced Glycation End Products (RAGE). This receptor was discovered in 1992, and the accumulation of research on this subject has been extensive. Structural characterization studies of the RAGE protein have shown that it is a transmembrane protein that binds a number of different motile ligands. The diversity of ligands that can attach to the binding domain is the primary factor that allows for RAGE to exhibit its wide-range effects on host cells. Two different studies were completed: one study dealt with the role of IAPP in beta cell death, and the second study was related to RAGE influence on cardiomyocytes and, more specifically, it was related to cardiac cell death. After the completion of the two studies, a comprehensive report was written for each topic. The two papers were merged into a single document. Molecular studies are important for understanding the underlying mechanisms that motivate pathophysiological presentation. In addition to a molecular understanding of the development of diabetes, a clinical research study was completed through the examination of appropriate literature sources. This clinical aspect allowed for the progression of different phases in the research process. A relationship between vinegar and lower plasma glucose was found. The exact mechanism behind this relationship will be studied in the future.
ContributorsGonzalez, Matthew Joseph (Author) / Johnston, Carol (Thesis director) / Collins, Michael (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2015-05
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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
Description
The purpose of this cookbook is to provide pre-diabetic, type 1 and type 2 diabetics with a foundation of recipes. These recipes have been created with the intent of regulating inflammation which can be caused by such metabolic abnormalities. I want to educate patients who suffer from these conditions that

The purpose of this cookbook is to provide pre-diabetic, type 1 and type 2 diabetics with a foundation of recipes. These recipes have been created with the intent of regulating inflammation which can be caused by such metabolic abnormalities. I want to educate patients who suffer from these conditions that there are several ingredients that work alongside their condition rather than feeling that they are limited to foods and recipes. I want to increase patients moral and self-efficacy to explore and work with new ingredients. These series of recipes should be used as a guide to trying new foods however patients should know that they are able to add their own ingredients that are suitable to their liking or condition.
ContributorsBhuyan, Nikita (Author) / Grant, Shauna (Thesis director) / Morse, Lisa (Committee member) / School of Nutrition and Health Promotion (Contributor, Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
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

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
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Description
Background.
Type 2 Diabetes Mellitus (T2DM) is a leading cause of health disparities, among Hispanic populations, which are disproportionately afflicted by T2DM. The growing research strongly argues that diabetes treatment interventions should be culturally sensitive to address the needs of their target populations. Nonetheless, there is little consensus regarding the

Background.
Type 2 Diabetes Mellitus (T2DM) is a leading cause of health disparities, among Hispanic populations, which are disproportionately afflicted by T2DM. The growing research strongly argues that diabetes treatment interventions should be culturally sensitive to address the needs of their target populations. Nonetheless, there is little consensus regarding the necessary components of a culturally sensitive intervention. This review will examine the intervention contents and activities, and the strategies that have been implemented into culturally sensitive diabetes treatment interventions. This review will also to observe how interventions handle complex issues such as the heterogeneity of Hispanic populations and communities. The overarching research questions examined in this study were, “What are the core components of the culturally tailored diabetes interventions currently implemented with Hispanic populations in the US, and why are they needed?” and 2) “How are studies evaluating the impact of their interventions, and how can the proposed study designs be improved?”
Method.
A systematic review across 3 databases was used to identify culturally sensitive diabetes treatment interventions (CSDTI) developed for Hispanic populations. Accordingly, we searched for studies designed to treat Hispanic individuals already diagnosed with having T2DM. All identified studies provided information on the core components of these culturally sensitive interventions, while only studies that included a control or comparison group were used to assess how the studies evaluated outcomes.
Results.
First, we examined intervention effects as examined from two study designs. We examined a total of [17] interventions in this section. Our review of one study design (Design #1 Studies) includes 12 studies that developed a culturally sensitive intervention and evaluated it using a one-group pretest posttest design, or did not evaluate their intervention at all. A second study design (Design #2 Studies) includes 5 studies. These consisted of a two-group randomized controlled field study that conducted pre-post analyses of the culturally adapted intervention comparing it against a control or comparison group. The heterogeneity of all studies made a conventional meta-analysis impossible.
Second, another review section focused on examining and describing various culturally sensitive core components, we examined a total of 17 studies to describe the types of culturally sensitive components that were incorporated into the diabetes treatment intervention. This analysis resulted in a list of 11 general types of culturally sensitive components as included within these 17 interventions. Of the articles that used control or comparison groups, the manner in which interventions evaluated different outcome measures and their conclusions regarding success were examined.
Discussion.
The culturally sensitive aspects identified from these articles were used to address diverse issues that included: (a) communication barriers, (b) the inclusion of cultural relevant content, for relevance to Hispanic/Latinx patients’ lives, (c) selecting appropriate channels and settings for interventions, and (d) addressing specific cultural values, traditions, and beliefs that can either help or hinder healthy behaviors. It should be noted that the Hispanic populations are extremely heterogeneous, and so interventions that would be sensitive culturally to some sectors of a Hispanic community may not be sensitive to other Hispanic sectors of that same community. The issue of heterogeneity of Hispanic communities was addressed well by the authors of some articles and ignored by others.
Conclusions.
It was ultimately impossible draw quantitative conclusions regarding the efficacy or effectiveness of these two types of diabetes treatment interventions (CSDTIs) as delivered to their targeted sample of Hispanic participants. An emerging conclusion is that factors including ethics, cost, and lack of community acceptance, may constitute factors contributing to the higher proportion of one-group pre-test post-test designs and lower proportion of rigorous scientific designs. In the latter case, some communities oppose the use of randomized controlled studies within their community, and thus that objection may explain the low numbers of these randomized controlled studies. The use of viable and rigorous alternatives to RCTs have been proposed to address this community concern. In this review, the author sought to conduct comparative studies between culturally adapted interventions and their associated unaltered or minimally altered evidence-based interventions, although there exists various difficulties that are associated with the conduct of these analyses.
Core components of CSDTIs for Hispanic adults were identified, and their purposes were explained. Additionally, suggestions for improvement to studies were made, to aid in improving our knowledge of CSDTIs through future studies.
Created2019-05