Thesis submitted in fulfillment of the requirements for the degree of Masters in Technology: Biomedical Sciences in the Faculty of Health and Wellness Sciences at the Cape Peninsula University of Technology 2015 / Background: The Mixed Ancestry population of South Africa has recently been reported to have a higher prevalence of type 2 diabetes (T2DM). However, the genetic risk factors that may contribute to the development of T2DM are currently unknown. We investigated the association of fat mass and obesity-associated gene (FTO), ectonucleotide pyrophosphatase/phosphodiesterase gene (ENPP1) and transcription factor 7-like 2 gene (TCF7L2) with T2DM risk in a community residing in Bellville South, Cape Town. Methods: Five hundred and sixty six participants (11.7% males) who consented to genetic analyses were genotyped for six single nucleotide polymorphisms (SNPs): ENPP1-rs997509 and -rs1044498, FTO-9941349 and -rs3751812, TCF7L2-rs12255372 and -rs7903146. The SNPs were genotyped using their corresponding Taqman genotyping assays, and validated by automated sequencing. Allele and genotype frequencies were determined and regression analyses was conducted to assess the association of the polymorphisms with T2DM and its related,traits. Results: Overall and in subgroups defined by diabetes and obesity statuses, there were present no significant differences in the distribution of alleles and genotypes, except for the polymorphisms observed in the FTO and ENPP1 genes. In logistic regression models adjusted for age, sex, body mass index (BMI) and insulin resistance, minor alleles of ENPP1-rs997509 and ENPP1-rs1044498 were associated with risk for T2DM respectively, 4.55 (1.06-19.49) (p=0.041) and 1.81 (1.09-2.98) (p=0.021) assuming a recessive genetic model. Furthermore, the FTO rs9941349 minor allele was associated with the prevalent T2DM under the log-additive model: 1.40 (1.00 to 1.96) (0.049). The TCF7L2 polymorphisms showed no evidence of association with T2DM and/or insulin sensitivity/resistance indicators. Conclusion: Our results demonstrate that ENPP1 and FTO polymorphisms may contribute to T2DM susceptibility in this population, confirming previous findings that insulin resistance may mediate the development of the disease in the Mixed Ancestry population group of South Africa.

Individuals with NIDDM and low insulin sensitivity (Si) have altered fuel use, which may appear in NIDDM relatives. Adolescent males, six with NIDDM relatives (POS) and six controls (CON), matched for fitness and fatness, participated. Peak oxygen uptake (V02pea), ventilatory threshold (VT) and body composition were measured. Insulin and glucose values were used for Si estimates. Oxygen consumption (V02) and respiratory exchange ratio (RER) measurements were made at rest and during exercise at 80,100 and 120% of VT for substrate use. No group differences were found in anthropometric data, V02pea, VT or blood measurements, although fat free mass (FFM) tended to be greater in CON. CON tended to use a higher percentage carbohydrate and a lower percentage of fat than POS, but differences were no longer present after normalization to FFM. Trends towards fuel use differences may suggest metabolic abnormalities are present in POS, but further investigation is necessary. / School of Physical Education, Sport, and Exercise Science

Background: Diabetes is an increasing problem in Hong Kong. Physical activity is an integral part of diabetes care but received surprisingly few attention locally. This study is the first study with focus on physical activity in Type 2 diabetes in Hong Kong. / Conclusion: There is a need to implement physical activity programs for the diabetes patients in Hong Kong. Stage-matched intervention for increasing physical activity level should be introduced into the current diabetes management routine. / Methods: For this cross-sectional study, 576 patients were recruited from two specialized diabetes clinics in Hong Kong for telephone interview. The interview included measures of physical activity (by IPAQ), mental distress (by DASS21), diabetes self-care (by SDSCA), self-care self-efficacy (by DES), exercise efficacy, attitude and subjective norm towards exercise, time-spent on exercise, instrumental social support, and various indicators of diabetes control (HbA1c, blood pressure, LDL-cholesterol). Regression models were fitted to identify determinants of physical activity, mental distress, and diabetes self-care. Structural equation modeling was used to model the inter-relationships between the variables. / Results: About half of the patients did not meet international guidelines of physical activity for diabetes patients. Exercise efficacy and attitudes towards exercise are the two dominant factors that predict physical activity level and exhibit significant difference between key stages of change. Level of mental distress was very low and did not correlate with physical activity or diabetes self-care. / Mui, Wai Ho. / Adviser: Joseph T.F. Lau. / Source: Dissertation Abstracts International, Volume: 73-02, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 167-191). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

The purpose of this study was twofold. First, the study evaluated Loma Linda University Medical Center's (LLUMC) Diabetes Treatment Center's (DTC) effectiveness in providing diabetes education and services to high risk minority populations. Second, the results of the study helped the DTC determine the need for expanding its present efforts in the form of community health prevention services to San Bernardino County residents.