Matching Items (4)
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
Self-monitoring of blood glucose (SMBG) is the standard of care in diabetes management. Current technologies for SMBG are based upon enzymatic electrochemical (amperometric) sensing. To increase the sensitivity and specificity of current devices, a novel method of detecting glucose using electrochemical impedance spectroscopy (EIS) technology is explored. To test the ability of EIS methods to detect glucose, the enzyme glucose oxidase (GOx) was fixed to gold electrodes through the means of a specific immobilization process. Once GOx was fixed to the gold electrode surface, a 5 mV sine wave sweeping frequencies from 100 kHz to 1 Hz was induced at a glucose range 0-500 mg/dL mixed with a ferricyanide redox mediator. Each frequency in the impedance sweep was analyzed for highest response and R-squared value. The frequency with both factors optimized is specific for the glucose-GOx binding interaction, and was determined to be 1.17 kHz in purified solutions. Four separate electrodes were constructed and date from each were averaged. The correlation between the impedance response and concentration at the low range of detection (0-100 mg/dL of gluose) was determined to be 3.19 ohm/ln (mg/dL) with an R-squared value of 0.86. Its associated lower limit of detection was found to be 41 mg/dL. The same frequency of 1.17 kHz was then verified in whole blood under the glucose range of 0-100 mg/dL while diluting the blood to observe effect. As the blood concentration increased, the response of the sensor decreased logarithmically. The maximized blood detection volume was determined to be 25% whole blood suggesting dilution, coatings, or filtration is required for future adaptation. The above data confirms that EIS offers a new method of glucose detection as an alternative technology for SMBG and offers improved detection at lower concentrations of glucose. The unique frequency response of individual markers allows for modulation of signals so that several markers could be measured with a single sensor. Future work includes assessment of other diabetes associated biomarkers that can be measured on a single sensor, integration testing and tuning of the biomarkers, impedance-time sensing development, and finally, testing on control subjects.
ContributorsAdamson, Teagan (Author) / LaBelle, Jeffrey (Thesis director) / Pizziconi, Vincent (Committee member) / Cook, Curtiss (Committee member) / Barrett, The Honors College (Contributor)
Created2012-05
Description
The purpose of this study, which was done in conjunction with the Arizona Heart Foundation, was to evaluate whether pyridoxine accelerates ulcer wound healing in diabetic patients with ulcers in the lower extremities. In this study, 100 mg of pyridoxine per day was given to patients in the experimental group (while they receive normal wound treatment) while patients in the control group received normal treatment of wounds without the pyridoxine. Over time, wound healing was evaluated by photographing and then measuring the size of patients' ulcer wounds on the photographs. Results from the experimental group were compared with those of the control group to evaluate the efficacy of the pyridoxine treatment. In addition, comparisons of the healing rates were made with respect to whether the patients smoked, had hypertension or hypotension, and the patients' body mass indexes. It has been found that there was no statistically significant difference in the mean healing rates between the control groups and experimental groups. In addition, it has been found that smoking, BMI and blood pressure did not have a statistically appreciable effect on the difference in mean healing rates between the control and experimental groups. This is evidence that pyridoxine did not have a statistically significant effect on wound healing rates.
ContributorsHaupt, Shawn Anthony (Author) / Caplan, Michael (Thesis director) / Pauken, Christine (Committee member) / Pagan, Pedro (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)
Created2013-05
Description
Type 2 diabetes mellitus (T2DM) is a chronic disease affecting more than ten percent of the U.S. adults. Approximately 50 percent of people with diabetes fail to achieve glycemic targets of A1C levels below seven percent. Poor glycemic control disproportionately affects minority populations such as Korean Americans (KAs). Successful diabetes self-management requires a comprehensive approach that takes into account depression, sleep, and acculturation to achieve good glycemic control. Therefore, the purposes of this study were to: 1) describe the levels of glycemic control, depressive symptoms, sleep quality and duration, and acculturation; 2) examine an association of depressive symptoms with glycemic control; 3) identify mediational roles of sleep quality and sleep duration of less than 6 hours between depressive symptoms and glycemic control; and 4) explore a moderation role of acculturation between depressive symptoms and glycemic control in KAs with T2DM. This is a cross-sectional, descriptive correlational study. A total of 119 first generation KAs with T2DM were recruited from Korean communities in Arizona. A1C levels, the Center for Epidemiological Studies Depression Scale, the Pittsburgh Sleep Quality Index, the Suinn-Lew Asian Self-Identity Acculturation scale, the International Physical Activity Questionnaire, and the Berlin Questionnaire were measured. Descriptive statistics, multiple regression analyses, path analyses, and the Sobel tests were conducted for data analyses of this study. Poor glycemic control (A1C ≥ 7 %), high depressive symptoms (CES-D ≥ 16), poor sleep quality (PSQI > 5), and short sleep duration (< 6 hours) were prevalent among KAs with T2DM. The mean score of acculturation (2.18) indicated low acculturation to Western culture. Depressive symptoms were revealed as a significant independent predictor of glycemic control. Physical activity was negatively associated with glycemic control, while cultural identity was positively related to glycemic control. Sleep quality and sleep duration of less than 6 hours did not mediate the relationship between depressive symptoms and glycemic control. Acculturation did not moderate the association between depressive symptoms and glycemic control. Diabetes self-management interventions of a comprehensive approach that considers depressive symptoms, sleep problems, and cultural differences in minority populations with T2DM are needed.
ContributorsJeong, Mihyun (Author) / Reifsnider, Elizabeth G. (Thesis advisor) / Belyea, Michael (Committee member) / Petrov, Megan (Committee member) / Kelly, Lesly (Committee member) / Arizona State University (Publisher)
Created2017