This thesis project will investigate the effects of fasting on the serum levels of two key regulatory hormones, insulin and thyroid hormone (T3) and the effects of these hormones on the trafficking of Glut4 on soleus muscle.

This research explicated the use of exploratory data analysis in describing type II diabetes mellitus among the Navajo Indians. A sample of 98 diagnosed diabetics was obtained from a retrospective chart review and had a 1.3:1 female to male ratio, a median age of 58.6 years, and a mean duration for diabetes of 7.66 years. Other characteristics included a median age at diagnosis of 50 years, a median weight prior to diagnosis (expressed in percent desired weight) of 140%, and a median blood glucose value at time of diagnosis of 241 mg/dl. The distribution patterns for age, weight, and blood glucose revealed several asymmetry problems which had implications for the appropriateness of using parametric statistics in numerical summarizations. Bivariate analyses revealed a negative association between age at diagnosis and percent desired weight prior to diagnosis. This finding identifies the risk that obesity brings to the young and that aging brings to the non-obese, Navajo Indian.

No description available.

Diet recommendations to achieve target metabolic control for prevention of micro and macrovascular complications have been outlined. Although previous studies in individuals with type 2 diabetes have identified certain factors associated with adherence to diet recommendations, adherence is multi-factorial in nature and includes demographic, biological and psychosocial variables. Our main objective was to identify factors associated With dietary behaviour among individuals with type 2 diabetes attending an out-patient clinic. Furthermore, we attempted to identify factors associated with frequency of seeing the dietitian and stages of change far lower fat intake. Principal hypothesis: those who are younger, female, lower in body mass index (BMI), higher in education level, exposed to a dietitian in the past year, higher in stage of change, having greater nutrition knowledge, greater perception of risk and benefits as well as fewer perceived barriers, would consume less total and saturated fat. (Abstract shortened by UMI.)

Postprandial urea production in subjects with insulin dependent diabetes mellitus (IDDM) on conventional insulin therapy is normal when the previous diet is high in protein, but there is an incomplete adaptive reduction in urea production following protein restriction. To evaluate the nutritional implications of restricted protein intake in human diabetes mellitus, it is first necessary to establish a reliable method to measure changes in urea production and amino acid catabolism in response to changes in dietary protein intake. We therefore tested (1) the accuracy of the urea production rate (Ra) to depict changes in urea production, (2) whether sulfate production can be accurately depicted using tracer or nontracer approaches, after establishing the use of electrospray tandem mass spectrometry to measure sulfate concentrations and 34SO4 enrichments following administration of the stable isotope tracer sodium [34S]sulfate, (3) the reproducibility of urea and sulfate measurements following a test meal low in protein (0.25 g/kg) in subjects previously adapted to high (1.5 g/kg.d) and low (0.3 g/kg.d) protein intakes, and compared the metabolic fate of [ 15N]alanine added to the test meal with that of [15N] Spirulina platensis, a 15N-labeled intact protein, and (4) whether we could identify the differences in postprandial urea and sulfate productions between normal subjects and persons with IDDM receiving conventional insulin therapy previously adapted to high protein intake, when the test meal was limiting in protein. Under basal conditions, steady state urea Ra is an accurate measure of urea production. Following changes in urea production, both the tracer and nontracer methods seriously underestimated total urea Ra. The tracer method overestimated sulfate production by 20%, but the nontracer method provided an accurate measure of sulfate production and, hence, sulfur amino acid catabolism. Postprandial changes in urea and sulfate productions following normal ada

Previous studies reported that noncompliance to diabetes treatment may result in a series of health complications. To further understand patients’ noncompliance to meal plans, a study on meal planning strategy was developed. Through a survey Certified Diabetes Educators determined which meal planning strategies were the most effective in encouraging patients’ compliance to meal plan according to age groups (18 and under, 19 to 49, 50 to 70, and 71 and above) and recency of diagnosis (newly- and non-newly diagnosed) with Type 2 diabetes. Results identified that nutrition labels had the greatest mean rating for effectiveness in age groups 18 and under, 19 to 49, and 50 to 70; and healthy food choices had the greatest mean rating for effectiveness with age group 71 and above. / Department of Family and Consumer Sciences

The potential effects of nutritional support with amino acids or dextrose and epidural blockade on the catabolic response to surgery were investigated in diabetic patients undergoing colorectal surgery. Protein and glucose metabolism were assessed with a stable isotope infusion technique using the two stable isotopes L-[1-13C]leucine and [6,6-2H2 ]glucose. / 1. The first intervention of a postoperative infusion of amino acids avoided pronounced hyperglycaemia in diabetic patients after colorectal surgery and achieved a positive protein balance compared to dextrose. / 2. The second intervention of a short term infusion of amino acids postoperatively blunted protein breakdown and stimulated protein synthesis. This resulted in a positive protein balance in patients with epidural blockade compared to patient controlled analgesia with intravenous morphine. With regard to glucose metabolism, amino acid supply after surgery decreased glucose clearance and endogenous glucose production independent from type of analgesia.

Background. Type 2 diabetes is the fifth-leading cause of death in Latinos in the United States. Diabetes is a commonly occurring health condition in older adults, leading to complications that can severely impact quality of life and hasten death. The burden of diabetes is considerable in the older adult population; almost four-fifths of adults with diabetes are older than 59 years. Diabetes mortality can be reduced or delayed with effective management of the illness. Older minority adults are more likely to have higher rates of adult-onset diabetes than non-Hispanic Whites, yet few studies have examined the diabetes self-management practices of this group. These issues are particularly important to investigate in older Dominican adults in Washington Heights/Inwood, New York City, because this group has unique cultural beliefs and practices, is rapidly increasing in population, and has a variety of unmet health-related needs. This study explored specific barriers encountered (cultural and structural) and the extent to which external factors are associated with self-management practices among older Dominican community residents living in mainland US with type 2 diabetes. After 20 years of health disparities research and intervention older adults continue to have problems accessing health care due to structural and socio-cultural barriers. Methods. This investigation utilized qualitative in-depth interviews to examine the cultural and structural barriers to health care and self-management practices existing in this group. Results. Thirty Dominicans 55 years and older were recruited through a community-based senior resource center from the mainland US. Self-management practices for type 2 diabetes vary and are represented by commonly known factors, including: 1) diet modifications; 2) glucose monitoring; 3) medication adherence; 4) exercise, and 5) diabetes classes. Findings from this study illustrate that male and female participants have mixed self-management practices that assist them in managing their diabetes. In addition, participants are interested in “learning” how to manage their diabetes through their participation in classes and diabetes-related workshops. Home remedies (remedies caseros) for type 2 diabetes were identified in this study. Conclusions. Programs and services that promote healthy self-management practices of older Latino adults need to include a focus on the unique cultural beliefs and behaviors of the individual as well as the broader situational context that impacts their diabetes self-management. Such information is invaluable for researchers and health practitioners interested in diabetes self-management practices of older minority adults.

The aim of this study was to gain insight into the exercise practices, in conjunction with dietary habits and medication routine of insulin dependent diabetics. The study design adopted for the study was that of descriptive and analytical survey. The gathering of data was conducted over a period of seven months using a questionnaire as a data collection instrument, which was administered to 200 insulin dependent diabetics utilizing the outpatient facilities at 12 hospitals in Kwa-Zulu Natal. In determining the respondent's attitude towards exercise, the significant (p<0.001) overall majority (85%) had a positive attitude towards exercise. In probing the perceived efficacy of exercise as a therapeutic modality, a significant (p<0.001) majority (93%) of the respondents stated that exercise/sport is beneficial to a diabetic. Of the overall sample, the significant (p<0.001) majority (68%) of respondents were active participants in exercise (exercisers) versus 32% who were not active (non-exercisers). The profile of the exercisers indicated that the significant (p<0.001) majority participated in exercise of an aerobic type at frequency of 4 or more times per week, at an intensity eliciting an approximate heart rate of between 110 to 130 beats per minute corresponding with an RPE of 11 to 13, for a duration of 20 to 45 minutes. A significant (p<0.001) overall majority (98%) stated that a good diet is an important factor when trying to achieve near normoglycemia. In probing the respondent's knowledge as to what group certain types of food belong to, an overall significant (p<0.001) majority (82%) was accurate in this regard, while significantly (p<0.1) more exercisers (84%) were aware of correct food grouping than non-exercisers (67%). In probing their knowledge of the normal range of blood glucose levels, an overall significant (p<0.001) number of respondents (66%) stated a correct response, while exercisers (67%) were significantly (p<0.1) more knowledgeable than non-exercisers (52%) in this regard. The significant (p<0.001) majority of respondents injected themselves three and more times a day (54%), before meals (71%), in the thigh (35%) and abdominal areas (48%), as opposed to the gluteal area (10%) and the arm (8%). The mean overall dosage of long-acting insulin (12.2 units) and short-acting insulin (10.5 units) for lunch was significantly lower (p<0.1) than for breakfast and supper, however there was no significant difference (p>0.1) between the breakfast and supper dosages. The same pattern was observed for non-exercisers and exercisers. The respondent's knowledge of good diabetic management goals reflected that a significant (p<0.001) overall majority (83%) were aware that diet, insulin and exercise are all important constituents in obtaining good diabetic management, while significantly (p<0.1) more exercisers (84%) than non-exercisers (71%) were aware of this. A significant (p<0.001) majority (83%) of non-exercises stated that they were willing to participate in exercise, but cited time constraints and physical discomfort, inter-alia, as antecedents to non-participation. In conclusion, the results indicated that the provision of educational support for insulin dependent diabetics to overcome the perceived barriers to exercise would increase participation, enhance appropriate exercise prescription and compliance to this important aspect of the diabetic regimen. / Dissertation (MA (Human Movement Science))--University of Pretoria, 2002. / Biokinetics, Sport and Leisure Sciences / unrestricted

Background The Chinese famine of 1959–61 has been widely interpreted as an important driver of current and future epidemics of type 2 diabetes (T2D). We conducted a systematic review and meta-analysis of prenatal famine exposure and type 2 diabetes (T2D) in China to summarize study characteristics, examine impacts of control selections on study results, and identify whether study results can be related to any characteristics. Methods We searched PubMed, Embase, Wanfang Data, and CNKI databases for studies that examined the relationship between T2D and prenatal exposure to the Chinese famine up to January, 2021. From included studies, we abstracted information on the number of T2D cases and populations at risk among individuals born during the famine (famine births), born before the famine (pre-famine births), and born after the famine (post-famine births). We examined the quality of studies with the modified Newcastle–Ottawa scale. We compared T2D in famine births to different controls: post-famine births, pre-famine and post-famine births combined (age-balanced), and pre-famine births. Fixed-effects models and random-effects models were used to calculate summary estimates. Heterogeneity across studies was assessed, and subgroup analyses were performed using sex, age at the survey, T2D measurements, famine intensity, residence, and publication language as possible effect modifiers. Findings Of 5,363 studies identified, 18 studies met our inclusion criteria. All studies defined famine exposure based on participants' years and/or months of births. Sample sizes ranged between around 300 and over 80,000 across studies. When post-famine births were used as controls, we found an increased risk of T2D (OR 1.48, 95% CI 1.30–1.68) among famine births based on the random-effects model. Using age-balanced controls, we did not find any increased risk of T2D (1.09, 95% CI 0.98–1.22). When pre-famine births were used as controls, famine was associated with a reduction in risk (0.85, 95% CI 0.75–0.97). Large variations and inconsistencies were identified in study design, famine intensity assessment, and covariate adjustment across studies. Conclusion Our analysis shows that it still remains an open question whether the Chinese famine has contributed substantially to the current T2D epidemic in China. Studies with more rigorous methods will need to quantify this relationship. The four-level famine intensity instrument developed in this study is a robust measure to identify a potential dose-response relation between famine exposure and health outcomes. It is likely to improve the reproducibility and generalizability of future studies.