Matching Items (20)
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- All Subjects: Diabetes
- Creators: Johnston, Carol
- Creators: School of Molecular Sciences
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
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
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
Description
Birds maintain resting plasma glucose concentrations (pGlu) nearly twice that of comparably sized mammals. Despite this, birds do not incur much of the oxidative tissue damage that might be expected from a high pGlu. Their ability to stave off oxidative damage allows birds to serve as a negative model of hyperglycemia-related complications, making them ideal for the development of new diabetes treatments with the potential for human application. Previous studies conducted by the Sweazea Lab at Arizona State University aimed to use diet as a means to raise blood glucose in mourning doves (Zenaida macroura) in order to better understand the mechanisms they utilize to stave off oxidative damage. These protocols used dietary interventions—a 60% high fat (HF) “chow” diet, and a high carbohydrate (HC) white bread diet—but were unsuccessful in inducing pathologies. Based on this research, we hypothesized that a model of an urban diet (high in fat, refined carbohydrates, and sodium) might impair vasodilation, as the effect of this diet on birds is currently unknown. We found that tibial vasodilation was significantly impaired in birds fed an urban diet compared to those fed a seed diet. Unexpectedly, vasodilation in the urban diet group was comparable to data of wild-caught birds from previous research, possibly indicating that the birds had already been eating a diet similar to this study’s urban diet before they were caught. This may constitute evidence that the seed diet improved vasodilation while the urban diet more closely mimicked the diet of the birds before the trial, suggesting that the model of the urban diet acted as the control diet in this context. This study is the first step in elucidating avian mechanisms for dealing with diabetogenic diets and has potential to aid in the development of treatments for humans with metabolic syndrome.
ContributorsRenner, Michael William (Author) / Sweazea, Karen (Thesis director) / Johnston, Carol (Committee member) / Basile, Anthony (Committee member) / Dean, W.P. Carey School of Business (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
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
Description
Diabesity is a global epidemic affecting millions worldwide. Diabesity is the term given to the link between obesity and Type II diabetes. It is estimated that ~90% of patients diagnosed with Type II diabetes are overweight or have struggled with excess body fat in the past. Type II diabetes is characterized by insulin resistance which is an impaired response of the body to insulin that leads to high blood glucose levels. Adipose tissue, previously thought of as an inert tissue, is now recognized as a major endocrine organ with an important role in the body's immune response and the development of chronic inflammation. It is speculated that adipose tissue inflammation is a major contributor to insulin resistance particular to Type II diabetes. This literature review explores the popular therapeutic targets and marketed drugs for the treatment of Type II diabetes and their role in decreasing adipose tissue inflammation. rAGE is currently in pre-clinical studies as a possible target to combat adipose tissue inflammation due to its relation to insulin resistance. Metformin and Pioglitazone are two drugs already being marketed that use unique chemical pathways to increase the production of insulin and/or decrease blood glucose levels. Sulfonylureas is one of the first FDA approved drugs used in the treatment of Type II diabetes, however, it has been discredited due to its life-threatening side effects. Bariatric surgery is a form of invasive surgery to rid the body of excess fat and has shown to normalize blood glucose levels. These treatments are all secondary to lifestyle changes, such as diet and exercise which can help halt the progression of Type II diabetes patients.
ContributorsRobles, Alondra Maria (Author) / Woodbury, Neal (Thesis director) / Redding, Kevin (Committee member) / Allen, James (Committee member) / Hendrickson, Kirstin (Committee member) / Sanford School of Social and Family Dynamics (Contributor) / School of Molecular Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
With the rising prevalence of obesity and diabetes, novel treatments to help mitigate or prevent symptoms of these conditions are warranted. Prior studies have shown that fossilized plant materials found in soil lowers blood sugar in a mouse model of diabetes. The goal of this study is to determine whether a similar organometallic complex (OMC) could prevent insulin resistance in the skeletal muscle brought on by chronic high fat intake by examining the protein expression of key enzymes in the insulin signaling pathway and examining glucoregulatory measures. Six-week-old periadolescent male Sprague-Dawley rats (n=42) were randomly chosen to be fed either a high fat diet (HFD) (20% protein, 20% carbohydrates [6.8% sucrose], 60% fat) or a standard chow diet (18.9% protein, 57.33% carbohydrates, 5% fat) for 10 weeks. Rats from each diet group were then randomly assigned to one of three doses of OMC (0, 0.6, 3.0 mg/mL), which was added to their drinking water and fasting blood glucose was measured at baseline and again at 10 weeks. After 10 weeks, rats were euthanized, and soleus muscle samples were isolated, snap-frozen, and stored at -80°C until analyses. Fasting plasma glucose was measured using a commercially available glucose oxidase kit. Following 6 and 10 weeks, HFD rats developed significant hyperglycemia (p<0.001 and p=0.025) compared to chow controls which was prevented by high dose OMC (p=0.021). After 10 weeks, there were significant differences in fasting serum insulin between diets (p=0.009) where levels were higher in HFD rats. No significant difference was seen in p-PI3K expression between groups. These results suggest that OMC could prevent insulin resistance by reducing hyperglycemia. Further studies are needed to characterize the effects of diet and OMC on the insulin signaling pathway in skeletal muscle, the main site of postprandial glucose disposal. This study was supported by a grant from Isagenix International LLC as well as funds from Barrett, the Honors College at Arizona State University, Tempe Campus.
ContributorsStarr, Ashlee (Author) / Sweazea, Karen (Thesis director) / Johnston, Carol (Committee member) / Hyatt, JP (Committee member) / Sanford School of Social and Family Dynamics (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
Description
Brown adipose tissue (BAT) is thought to be important in combating obesity as it can expend energy in the form of heat, e.g. thermogenesis. The goal of this study was to study the effect of injected norepinephrine (NE) on the activation of BAT in rats that were fed a high fat diet (HFD). A dose of 0.25 mg/kg NE was used to elicit a temperature response that was measured using transponders inserted subcutaneously over the BAT and lower back and intraperitoneally to measure the core temperature. The results found that the thermic effect of the BAT increased after the transition from low fat diet to a high fat diet (LFD) yet, after prolonged exposure to the HFD, the effects resembled levels found with the LFD. This suggests that while a HFD may stimulate the effect of BAT, long term exposure may have adverse effects on BAT activity. This may be due to internal factors that will need to be examined further.
ContributorsSion, Paul William (Author) / Herman, Richard (Thesis director) / Borges, Chad (Committee member) / School of Molecular Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
The purpose of this study is to examine the effect of an existing medication management program in Hispanic individuals with diabetes, focusing on overall management and perceived quality of life (QOL). Diseases such as diabetes affect an individual's physical health, mental health, and social life. The degree to which these diseases affect an individual's life depend on how well they control and self-manage care needs. It has been found that Hispanic patients report and demonstrate inadequacy with controlling their diabetes compared to other ethnicities, making this an important public health topic (Schneiderman eta al., 2014). One of the greatest issues the Hispanic population reports as causing most concern is medication management and compliance. Poor medication adherence can increase complications of diabetes and depression, thus increasing poor overall health status and perception. Medication therapy management (MTM) programs run by clinical pharmacists are available to help with medication adherence, aiding in developing a tailored plan to help individuals manage the disease. This study is a cross-sectional study which assess reported QOL and functionality of diabetics enrolled in an MTM program. Participants were recruited from a clinic in Phoenix, Az. Patients completed a questionnaire that included demographics, a QOL questionnaire and a health belief questionnaire. A total of sixteen participants completed the study. The association between time in the medication therapy management program and its effect on general health, social functioning, emotional well-being, and hemoglobin A1C were reviewed. Though no significance was found, means were similar in all groups indicating functionality and A1C control through the diabetes support program may exist.
ContributorsVarela, Zury Arely (Author) / Flom-Racoma, Kehart (Thesis director) / Ohri-Vachaspati, Punam (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05