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- Genre: Masters Thesis
Description
Objective: Vinegar consumption studies have demonstrated possible therapeutic effects in reducing HbA1c and postprandial glycemia. The purpose of the study was to closely examine the effects of a commercial vinegar drink on daily fluctuations in fasting glucose concentrations and postprandial glycemia, and on HbA1c, in individuals at risk for Type 2 Diabetes Mellitus (T2D). Design: Thirteen women and one man (21-62 y; mean, 46.0±3.9 y) participated in this 12-week parallel-arm trial. Participants were recruited from a campus community and were healthy and not diabetic by self-report. Participants were not prescribed oral hypoglycemic medications or insulin; other medications were allowed if use was stable for > 3 months. Subjects were randomized to one of two groups: VIN (8 ounces vinegar drink providing 1.5 g acetic acid) or CON (1 vinegar pill providing 0.04 g acetic acid). Treatments were taken twice daily immediately prior to the lunch and dinner meals. Venous blood samples were drawn at trial weeks 0 and 12 to measure insulin, fasting glucose, and HbA1c. Subjects recorded fasting glucose and 2-h postprandial glycemia concentrations daily using a glucometer. Results: The VIN group showed significant reductions in fasting capillary blood glucose concentrations (p=0.05) that were immediate and sustained throughout the duration of the study. The VIN group had reductions in 2-h postprandial glucose (mean change of −7.6±6.8 mg/dL over the 12-week trial), but this value was not significantly different than that for the CON group (mean change of 3.3±5.3 mg/dL over the 12-week trial, p=0.232). HbA1c did not significantly change (p=0.702), but the reduction in HbA1c in the VIN group, −0.14±0.1%, may have physiological relevance. Conclusions: Significant reductions in HbA1c were not observed after daily consumption of a vinegar drink containing 1.5 g acetic acid in non-diabetic individuals. However, the vinegar drink did significantly reduce fasting capillary blood glucose concentrations in these individuals as compared to a vinegar pill containing 0.04 g acetic acid. These results support a therapeutic effect for vinegar in T2D prevention and progression, specifically in high-risk populations.
ContributorsQuagliano, Samantha (Author) / Johnston, Carol (Thesis advisor) / Appel, Christy (Committee member) / Dixon, Kathleen (Committee member) / Arizona State University (Publisher)
Created2013
Description
Type 2 diabetes affects approximately 7.3% of Americans, leading to debilitating and life-threatening comorbidities. Estrogen and testosterone levels have been linked to inflammatory and oxidative stress markers, as well as glucose and insulin concentrations. The present study was designed to determine the link between sex differences, glucose control, and inflammation and oxidative stress related to daily almond ingestion among subjects with type 2 diabetes. Subjects were randomized to an intervention group, which received 1.5 oz. almonds daily for 12 weeks, or to the matched control group, which maintained their current diet. No significant differences were found in changes in glucose control in response to ingestion of almonds. However, CRP was significantly reduced by an average of 36.2% in those that received almonds daily (p = 0.017). Although not significant, women randomized to the intervention group appeared to have improvements in insulin resistance compared to women with no dietary change. Results suggest that the addition of almonds to the diet may be an effective intervention for managing inflammation associated with type 2 diabetes. The addition of almonds to the diet is a low cost intervention that is easily implemented into daily lifestyle. Due to the small sample size, additional studies are needed to determine the impact and mechanisms of almond ingestion in subjects with type 2 diabetes.
ContributorsPetersen, Katherine Nicole (Author) / Karen, Sweazea (Thesis advisor) / Carol, Johnston (Committee member) / Christy, Lespron (Committee member) / Arizona State University (Publisher)
Created2014
Description
The omega-3 fatty acids in fatty fish and fish oil, eicosapentanoic acid (EPA) and docosahexanoic acid (DHA), have been associated with a reduction in risk for cardiovascular disease. Blood type is a known contributor to risk for cardiovascular events. This study evaluated the effect of fish oil supplements on cardiovascular risk markers in adults with blood types A or O. An 8-week parallel-arm, randomized, double-blind trial was conducted in healthy adult men and women with either blood type A (BTA) or blood type O (BTO). Participants were randomized to receive fish oil supplements (n=10 [3 BTA/7 BTO]; 2 g [containing 1.2 g EPA+DHA]/d) or a coconut oil supplement (n=7 [3 BTA/4 BTO]; 2 g/d). Markers that were examined included total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), high-sensitivity C-reactive protein (hsCRP), and hemoglobin A1C (HbA1C). Results indicated that the percent change in LDL cholesterol was significantly greater in the coconut oil group vs the fish oil group (-14.8±12.2% vs +2.8±18.9% respectively, p=0.048). There were no other significant differences between treatment groups, or between blood types A and O, for the other cardiovascular risk markers. Further research with a larger and more diverse sample may yield a more conclusive result.
ContributorsHerring, Dana (Author) / Johnston, Carol (Thesis advisor) / Vega-Lopez, Sonia (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2014
Description
Mexican Americans have an increased risk for type 2 diabetes and premature cardiovascular disease (CVD). The association of hyperglycemia with traditional CVD risk factors in this population has been established, but there is limited data regarding other non-traditional CVD risk factors. Thus, this cross-sectional study was conducted to evaluate CVD risk among Mexican Americans by measuring concentrations of lipids, high-sensitivity C-reactive protein (hsCRP), and cholesterol in low-density-lipoprotein (LDL) and high-density-lipoprotein (HDL) subfractions. Eighty overweight/obese Mexican-American adults participating in the Maricopa Insulin Resistance Initiative were randomly selected from each of the following four groups (n = 20 per group): nomolipidemic
ormoglycemic controls (NC), dyslipidemic
ormoglycemic (DN), dyslipidemic/prediabetic (DPD) and dyslipidemic/diabetic (DD). Total cholesterol (TC) was 30% higher among DD than in NC participants (p<0.0001). The DPD group had 27% and 12% higher LDL-C concentrations than the NC and DN groups, respectively. Similarly, LDL-C was 29% and 13% higher in DD than in NC and DN participants (p=0.013). An increasing trend was observed in %10-year CVD risk with increasing degree of hyperglycemia (p<0.0001). The NC group had less cholesterol in sdLDL particles than dyslipidemic groups, regardless of glycemic status (p<0.0001). When hyperglycemia was part of the phenotype (DPD and DD), there was a greater proportion of total and HDL-C in sHDL particles in dyslipidemic individuals than in NC (p=0.023; p<0.0001; respectively). Percent 10-year CVD risk was positively correlated with triglyceride (TG) (r=0.384, p<0.0001), TC (r=0.340, p<0.05), cholesterol in sdLDL(r=0.247; p<0.05), and TC to HDL-C ratio (r=0.404, p<0.0001), and negatively correlated with HDL-C in intermediate and large HDL(r=-0.38, p=0.001; r=0.34, p=0.002, respectively). The TC/HDL-C was positively correlated with cholesterol in sdLDL particles (r=0.698, p<0.0001) and HDL-C in sHDL particles (r=0.602, p<0.0001), and negatively correlated with cholesterol in small (r=-0.35, p=0.002), intermediate (r=-0.91, p<0.0001) and large (r=-0.84, p<0.0001) HDL particles, and HDL-C in the large HDL particles (r=-0.562, p<0.0001). No significant association was found between %10-year CVD risk and hsCRP. Collectively, these results corroborate that dyslipidemic Mexican-American adults have higher CVD risk than normolipidemic individuals. Hyperglycemia may further affect CVD risk by modulating cholesterol in LDL and HDL subfractions.
ormoglycemic controls (NC), dyslipidemic
ormoglycemic (DN), dyslipidemic/prediabetic (DPD) and dyslipidemic/diabetic (DD). Total cholesterol (TC) was 30% higher among DD than in NC participants (p<0.0001). The DPD group had 27% and 12% higher LDL-C concentrations than the NC and DN groups, respectively. Similarly, LDL-C was 29% and 13% higher in DD than in NC and DN participants (p=0.013). An increasing trend was observed in %10-year CVD risk with increasing degree of hyperglycemia (p<0.0001). The NC group had less cholesterol in sdLDL particles than dyslipidemic groups, regardless of glycemic status (p<0.0001). When hyperglycemia was part of the phenotype (DPD and DD), there was a greater proportion of total and HDL-C in sHDL particles in dyslipidemic individuals than in NC (p=0.023; p<0.0001; respectively). Percent 10-year CVD risk was positively correlated with triglyceride (TG) (r=0.384, p<0.0001), TC (r=0.340, p<0.05), cholesterol in sdLDL(r=0.247; p<0.05), and TC to HDL-C ratio (r=0.404, p<0.0001), and negatively correlated with HDL-C in intermediate and large HDL(r=-0.38, p=0.001; r=0.34, p=0.002, respectively). The TC/HDL-C was positively correlated with cholesterol in sdLDL particles (r=0.698, p<0.0001) and HDL-C in sHDL particles (r=0.602, p<0.0001), and negatively correlated with cholesterol in small (r=-0.35, p=0.002), intermediate (r=-0.91, p<0.0001) and large (r=-0.84, p<0.0001) HDL particles, and HDL-C in the large HDL particles (r=-0.562, p<0.0001). No significant association was found between %10-year CVD risk and hsCRP. Collectively, these results corroborate that dyslipidemic Mexican-American adults have higher CVD risk than normolipidemic individuals. Hyperglycemia may further affect CVD risk by modulating cholesterol in LDL and HDL subfractions.
ContributorsNeupane, Srijana (Author) / Vega-Lopez, Sonia (Thesis advisor) / Shaibi, Gabriel Q (Committee member) / Johnston, Carol S (Committee member) / Arizona State University (Publisher)
Created2011
Description
Many people with or at risk for diabetes have difficulty maintaining normal postprandial blood glucose levels (120-140 mg/dl). Research has shown that vinegar decreases postprandial glycemia. The purpose of this study was to examine a possible mechanism by which vinegar decreases postprandial glycemia, particularly the effect of vinegar ingestion on gut fermentation. In this parallel arm randomized control trial, the effects of daily ingestion of vinegar on gut fermentation markers were observed among adults at risk for type 2 diabetes in Phoenix, Arizona. Subjects (n=14) were randomly assigned to treatments consisting of a vinegar drink (1.5g acetic acid) or a placebo (2 vinegar pills containing 40mg acetic acid each). All participants were required to consume the vinegar drink (16 oz) or 2 placebo pills every day for 12 weeks. At week 12, participants filled out a questionnaire to report gastrointestinal (GI) symptoms and three consecutive breath samples were taken from each subject to measure fasting breath hydrogen (BH2) with a breath analyzer. Fasting BH2 measures for the vinegar drink group (16.1+11.8 ppm) were significantly different than those from the pill group (3.6+1.4) with a partial eta squared of 0.39 (p=0.023). After adjusting for age as a confounding factor (r=0.406) and removing an outlier, fasting BH2 measures for the vinegar drink group (4.3+1.1 ppm) were still significantly different than those from the pill group (3.6+1.4) with a partial eta squared of 0.35 (p=0.045). Participants in both groups reported mild changes in GI symptoms. In conclusion, adults at risk for type 2 diabetes that consume 2 tablespoons of vinegar a day may have increased gut fermentation compared to those who do not consume vinegar.
ContributorsWhite, Serena (Author) / Johnston, Carol (Thesis advisor) / Appel, Christy (Committee member) / Martin, Keith (Committee member) / Arizona State University (Publisher)
Created2013
Description
ABSTRACT This randomized, controlled, double-blind crossover study examined the effects of a preprandial, 20g oral dose of apple cider vinegar (ACV) on colonic fermentation and glycemia in a normal population, with the ultimate intention of identifying the mechanisms by which vinegar has been shown to reduce postprandial glycemia and insulinemia. Fifteen male and female subjects were recruited, ages 20-60y, who had no prior history of gastrointestinal (GI) disease or resections impacting normal GI function, were non-smokers, were non-vegetarian/vegan, were not taking any medications known to alter (glucose) metabolism, and were free of chronic disease including diabetes. Subjects were instructed to avoid exercise, alcohol and smoking the day prior to their trials and to consume a standardized, high-carbohydrate dinner meal the eve prior. There was a one-week washout period per subject between appointments. Breath hydrogen, serum insulin and capillary glucose were assessed over 3 hours after a high-starch breakfast meal to evaluate the impact of preprandial supplementation with ACV or placebo (water). Findings confirmed the antiglycemic effects of ACV as documented in previous studies, with significantly lower mean blood glucose concentrations observed during ACV treatment compared to the placebo at 30 min (p=0.003) and 60 min (p=0.005), and significantly higher mean blood glucose concentrations at 180 min (p=0.045) postprandial. No significant differences in insulin concentrations between treatments. No significant differences were found between treatments (p>0.05) for breath hydrogen; however, a trend was observed between the treatments at 180 min postprandial where breath hydrogen concentration was visually perceived as being higher with ACV treatment compared to the placebo. Therefore, this study failed to support the hypothesis that preprandial ACV ingestion produces a higher rate of colonic fermentation within a 3 hour time period following a high-carbohydrate meal. Due to variations in experiment duration noted in other literature, an additional study of similar nature with an expanded specimen collections period, well beyond 3 hours, is warranted.
ContributorsMedved, Emily M (Author) / Johnston, Carol (Thesis advisor) / Sweazea, Karen (Committee member) / Shepard, Christina (Committee member) / Arizona State University (Publisher)
Created2012
Description
Diabetes is becoming a serious problem in China. At the same time, China’s medical
system has faced a difficult situation because of the lack of medical resources and the unequal medical resource distribution between the BHs and BLHs. BH doctors are tremendously busy with both serious and minor illnesses while BLH medical providers are worried about a sufficient source of patients. This study aims to find the potential feasibility of a new service model in managing diabetes which will solve these medical problems. The study was conducted using an extensive literature review in addition to employing an interview and survey method to explore the perception and current situation in workload and income of medical providers from one BH and one BLH in China. Furthermore, this study tried to understand the acceptance of online medical technology in these medical provider groups. The results showed that doctors in the BH do not have the time needed to engage in extra work. This population is not satisfied with their work responsibilities and income structure. They want to engage in diagnosing and prescribing tasks, with respect to diabetes management. They would like to distribute the management work to BLH. On the other hand, medical providers in BLH have extra time and enthusiasm in doing extra work to improve their income. They are not satisfied with their workload and income, and want to change it. BLHs are willing to do the management work assisting the BH doctors. Additionally, the study showed that online medical technology requires a broader user education for medical providers from both big and BLHs. The conclusion can be summarized as design research advice for future service design in healthcare management. The proposed online medical service should meet different level medical providers' position and requirements regarding time, payment, and value. BH doctors are more suitable for diagnosing and prescribing and BLH medical providers are more suitable for follow-up service. This service should reflect the value of the BH doctors' professional service and the value of BLH medical providers' health management service. (discuss how design can improve this situation through app development)
system has faced a difficult situation because of the lack of medical resources and the unequal medical resource distribution between the BHs and BLHs. BH doctors are tremendously busy with both serious and minor illnesses while BLH medical providers are worried about a sufficient source of patients. This study aims to find the potential feasibility of a new service model in managing diabetes which will solve these medical problems. The study was conducted using an extensive literature review in addition to employing an interview and survey method to explore the perception and current situation in workload and income of medical providers from one BH and one BLH in China. Furthermore, this study tried to understand the acceptance of online medical technology in these medical provider groups. The results showed that doctors in the BH do not have the time needed to engage in extra work. This population is not satisfied with their work responsibilities and income structure. They want to engage in diagnosing and prescribing tasks, with respect to diabetes management. They would like to distribute the management work to BLH. On the other hand, medical providers in BLH have extra time and enthusiasm in doing extra work to improve their income. They are not satisfied with their workload and income, and want to change it. BLHs are willing to do the management work assisting the BH doctors. Additionally, the study showed that online medical technology requires a broader user education for medical providers from both big and BLHs. The conclusion can be summarized as design research advice for future service design in healthcare management. The proposed online medical service should meet different level medical providers' position and requirements regarding time, payment, and value. BH doctors are more suitable for diagnosing and prescribing and BLH medical providers are more suitable for follow-up service. This service should reflect the value of the BH doctors' professional service and the value of BLH medical providers' health management service. (discuss how design can improve this situation through app development)
ContributorsLiu, Maozhen (Author) / Takamura, John (Thesis advisor) / Doebbeling, Bradley (Committee member) / Herring, Donald (Committee member) / Arizona State University (Publisher)
Created2018
Description
The effects of iron and chromium blood concentrations have been linked to blood glucose control in diabetics. It is suggested that iron causes oxidative stress in the beta cells of the pancreas and adipocytes creating insulin insufficiency and resistance. Chromium is believed to increase the action of insulin through its biologically active molecule chromodulin. Both of these mechanisms are not clear. This 20 week case study tests the feasibility of combining iron depletion therapy followed by chromium supplementation to improve insulin sensitivity. This single case study followed a protocol of two blood donations separated by eight weeks followed by chromium supplementation of 250 µg of chromium picolinate once a day four weeks after the second blood donation. Fasting blood draws were taken at baseline, post blood draws and pre and post chromium supplementation. Results were not promising for the first hypothesis of lowering HbA1c, but the results were promising for the second hypothesis of improving insulin sensitivity by lowering the HOMA score.
ContributorsJarrett, Nia (Author) / Johnston, Carol (Thesis advisor) / Lespron, Christy (Committee member) / Mayol-Kreiser, Sandra (Committee member) / Arizona State University (Publisher)
Created2015
Description
Curcumin is an active ingredient of Curcuma longa (Turmeric) and is studied extensively for its antioxidant, anti-inflammatory, anti-bacterial, anti-viral, and anti-cancer properties. The purpose of this study was to examine the effects of turmeric on blood glucose and plasma insulin levels. The study utilized a placebo-controlled, randomized cross-over design with participants serving as their own control. Eight glucose tolerant healthy participants completed the full study. Three-weeks washout period was kept in between six-weeks. Prior to the test meal day, participants were asked to eat a bagel with their evening dinner. During the day of the test meal, participants reported to the test site in a rested and fasted state. Participants completed mashed potato meal tests with 500 mg of turmeric powder or placebo mixed in water, followed by 3 weeks of 500 mg turmeric or placebo supplement ingestion at home. During this visit blood glucose finger picks were obtained at fasting, 30, 60, 90, and 120 min post-meal. Blood plasma insulin at fasting and at 30 min after the test meal were also obtained. During week 4, participants reported to the test site in a rested and fasted state where fasting blood glucose finger pricks and blood plasma insulin were measured. During week 5 to 7, participants were given a washout time-period. During week 8, entire process from week 1 to 4 was repeated by interchanging the groups. Compared to placebo, reduction in postprandial blood glucose and insulin response were non-significant after ingestion of turmeric powder. Taking turmeric for 3 weeks had no change in blood glucose and insulin levels. However, taking turmeric powder supplements for 3 weeks, showed a 4.4% reduction in blood glucose. Change in insulin at 30 min were compared with baseline insulin level showing no significant change between placebo and turmeric group. Fasting insulin after 3-weeks consumption of turmeric did not show any significant change, but showed a larger effect size (0.08). Future research is essential to examine the turmeric powder supplement benefits over a long period of time in healthy adults and whether it is beneficial in preventing the occurrence of type 2 diabetes.
ContributorsOza, Namrata (Author) / Johnston, Carol (Thesis advisor) / Mayol-Kreiser, Sandra (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2017
Description
The American Diabetes Association reports that diabetes costs $322 billion annually and affects 29.1 million Americans. The high out-of-pocket cost of managing diabetes can lead to noncompliance causing serious and expensive complications. There is a large market potential for a more cost-effective alternative to the current market standard of screen-printed self-monitoring blood glucose (SMBG) strips. Additive manufacturing, specifically 3D printing, is a developing field that is growing in popularity and functionality. 3D printers are now being used in a variety of applications from consumer goods to medical devices. Healthcare delivery will change as the availability of 3D printers expands into patient homes, which will create alternative and more cost-effective methods of monitoring and managing diseases, such as diabetes. 3D printing technology could transform this expensive industry. A 3D printed sensor was designed to have similar dimensions and features to the SMBG strips to comply with current manufacturing standards. To make the sensor electrically active, various conductive filaments were tested and the conductive graphene filament was determined to be the best material for the sensor. Experiments were conducted to determine the optimal print settings for printing this filament onto a mylar substrate, the industry standard. The reagents used include a mixture of a ferricyanide redox mediator and flavin adenine dinucleotide dependent glucose dehydrogenase. With these materials, each sensor only costs $0.40 to print and use. Before testing the 3D printed sensor, a suitable design, voltage range, and redox probe concentration were determined. Experiments demonstrated that this novel 3D printed sensor can accurately correlate current output to glucose concentration. It was verified that the sensor can accurately detect glucose levels from 25 mg/dL to 400 mg/dL, with an R2 correlation value as high as 0.97, which was critical as it covered hypoglycemic to hyperglycemic levels. This demonstrated that a 3D-printed sensor was created that had characteristics that are suitable for clinical use. This will allow diabetics to print their own test strips at home at a much lower cost compared to SMBG strips, which will reduce noncompliance due to the high cost of testing. In the future, this technology could be applied to additional biomarkers to measure and monitor other diseases.
ContributorsAdams, Anngela (Author) / LaBelle, Jeffrey (Thesis advisor) / Pizziconi, Vincent (Committee member) / Abbas, James (Committee member) / Arizona State University (Publisher)
Created2017