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- All Subjects: Diabetes
- Creators: Shaibi, Gabriel
- Creators: Department of Chemistry and Biochemistry
- Resource Type: Text
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. 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
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). 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.
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
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 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
There has been an alarming rise in the prevalence of obesity which has been attributed to the paralleled rise in consumption of high-fat foods. It’s commonly accepted that high-fat diets can lead to increased weight gain, however not all fats have the same physiological action. This study primarily focuses on the effect of canola oil, a monounsaturated fat, on energy homeostasis and body composition when it’s given as a supplement to a high-fat diet composed of saturated fatty acid. Rodent models were divided into three dietary groups: 1) low-fat diet (LFD), 2) high-fat diet (HFD) and 3) canola oils supplemented HFD (HF+CAN). After 4 weeks of dietary intervention, samples of epididymal fat, perinephric fat, and liver were analyzed across the three groups to see if the changes in energy homeostasis could be explained by the cellular behavior and composition of these tissues. Interestingly, the supplement of canola oil appeared to reverse the deleterious effects of a saturated fat diet, reverting energy intake, body weight gain and adipose tissue sizes to that (if not lower than that) of the LFD group. The only exception to this effect was the liver: the livers remained larger and fattier than those of the HFD. This occurrence is possibly due to a decrease in free fatty acid uptake in the adipose tissues—resulting in smaller adipose tissue sizes—and increased fatty acid uptake in the liver. The mechanism by which this occurs has yet to be elucidated and will be the primary focus of upcoming studies on the effect of monounsaturated fat on other diets.
ContributorsZuo, Connie Wanda (Author) / Washo-Krupps, Delon (Thesis director) / Deviche, Pierre (Committee member) / Herman, Richard (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor) / School of Life Sciences (Contributor)
Created2015-05
Description
Sickle Cell Disease (SCD) is a prevalent genetic disease in Africa, and specifically in Kenya. The lack of available relevant disease education and screening mean that most don't understand the importance of getting testing and many children die before they can get prophylactic care. This project was designed to address the lack of knowledge with supplemental educational materials to be partnered with an engineering capstone project that provides a low cost diagnostic test.
ContributorsShawver, Jamie Christine (Author) / Caplan, Michael (Thesis director) / Snyder, Jan (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor) / Harrington Bioengineering Program (Contributor)
Created2014-05
Description
The pathogenesis of type 1 diabetes (T1D) is still not fully understood in the scientific community. Evidence has shown that viral infections are one of the important environmental factors associated with the disease development. Seven of the top T1D related viruses were selected to study the prevalence of viral humoral response in T1D patients using our innovative protein array platform called Nucleic Acid Programmable Protein Array (NAPPA). In this study, each viral gene was individually captured using various PCR based techniques, cloned into a protein expression vector, and assembled as the first version of T1D viral protein array. Humoral responses of IgG, IgA, and IgM were examined. Although each class of immunoglobulin generated a wide-range of reactivity, responses to various viral proteins from different proteins were observed. In summary, we captured most of the T1D related viral genes, established viral protein expression on the protein array, and displayed the serum response on the viral protein array. The successful progress will help to fulfill the long term goal of testing the viral infection hypothesis in T1D development.
ContributorsDavis, Amy Darlene (Author) / LaBaer, Joshua (Thesis director) / Qiu, Ji (Committee member) / Desi, Paul (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor)
Created2013-05
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 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
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.
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.
ContributorsDilli, Christopher Joe (Author) / Castro, Felipe Gonzalez (Thesis director) / Shaibi, Gabriel (Committee member) / School of Molecular Sciences (Contributor) / School of International Letters and Cultures (Contributor) / School of Mathematical and Statistical Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05