An estimated 215,000 children and adolescents younger than 20 years old were diagnosed with Type 1 or Type 2 diabetes in 2011. Management of children with Type 2 diabetes requires 24-hour care provided by health care providers, parents, and school nurses. Guided by the health belief model (HBM), the purpose of this qualitative case study was to explore and describe beliefs, attitudes, and practices of school nurses who manage children with Type 2 diabetes. A pilot study with 2 nurses was conducted to finalize interview guide. Volunteer school nurses were recruited through an e-mail announcement from their school district. Face-to-face, in-depth interviews with 10 female school nurses were conducted. School nurse work experience ranged from 4 to 20 years, selected from 4 school districts, including 8 European, 1 Asian, and 1 Hispanic American. Transcripts from digitally recorded interviews were analyzed using NVivo software version 11. Thematic analysis led to 5 themes of communication, education, management, perceived barriers (multiple schools assigned/student demand), and enablers (school aides). Individually and collectively, themes reflect a synergistic positive attitude in management of children with Type 2 diabetes. HBM constructs elucidated school nurses' behaviors and attitudes regarding severity and susceptibility to illness, benefits students received from preventive care, and barriers they encountered. The positive implications for social change include recommendations for increasing the number of school nurses per district to meet the demand in managing children with chronic diseases, and intensification of positive attitude interventions in diabetes management.

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Bakgrunn: Diabetes er globalt økende, og et voksende folkehelseproblem. Hovedårsakene er den raske økningen av fedme, fysisk inaktivitet og et økende antall eldre. Samtidig med økt inntakav sukker og kunstige søtningsstoffer, brus og lettbrus, har fedme og diabetestilfeller også økt. Hensikten med denne studien var å undersøke om det er en sammenheng mellom inntak av brus og lettbrus og insidensav diabetes type 2. Metode: Data ble samlet fra Adventist Health Study-2, en prospektiv kohortstudie. Data benyttet varbasert på et spørreskjema ved studiestart, og et oppfølgingsskjema, Hospital History Form(HHF-3). HHF-3 ble benyttetopptil 6 år senere med spørsmål om en evt. diabetesdiagnose, og tidspunkt for diagnosen. Deltakere med diabetes ved studiestart ble ekskludert. Antall deltakere i diabetesstudien var 45777. Nye diabetestilfeller under studien var 1277. Analysene ble gjort både med og uten kroppsmasseindeks (KMI). Det ble benyttet komplementær log-log-Cox analyse for å beregne hazard ratioer (HR) og tilhørende 95 % konfidensintervaller. Resultater: I multivariate analyser justert for demografiske variabler, KMI, type kosthold, fysisk aktivitet, inntak av fiberog magnesium, var inntak av≥1 boks ( = 355 ml) lettbrus daglig assosiert med insidens av diabetes type 2(HR=1,46, 95% CI, 1,19-1,78),p(trend)&lt; 0,0001. Inntak av ≥ 1 boksvanlig brusdagligvar ikke forbundet med økt risiko for diabetes, (HR=1,20, 95 %Cl 0,95-1,50). Sammenhengene ble styrketog statistisk signifikant for begge typer brus når det ikke blejustert for KMI. Andre risikofaktorer for utvikling av diabetes var alder, mannlig kjønn, ikke-hvit etnisitet, og KMI. Et høyt magnesiuminntak, et høytfiberinntak, høyere utdanningog et vegetarisk kostholdvar beskyttende mot sykdommen. Konklusjon: Inntak av lettbrus men ikkevanlig brus,var signifikant assosiert med utvikling av diabetes type 2. / Background: Diabetes is increasing globally,presenting a growing public health problem. The rapid rise of obesity, physical inactivity, and an increasinglyelderly populationcontribute to this epidemic. The increase in obesity and diabetes coincide with increased intake of sugary and artificially sweetened drinks. Aim: This study aimed to investigate whether the consumption of regularor diet soft drinks predicts the incidence of type2 diabetes. Method: We used data collected from the Adventist Health Study-2, a prospective cohort study. The data was based on a baseline questionnaire, as well as a follow-up form (i.e., hospital history form-3) distributed to previous respondents up to 6 years later. Both questionnaire and follow-upformasked about a possible diabetes diagnosis and date of diagnosis. Importantly, Adventist Health Study-2 excluded individiuals who presented with diabetes at baseline. Among 45,777 subjects, the study detected 1,277 new cases of diabetes. Analyses were conducted both with and without body mass index. Complementary log-log Cox analysis was used to calculate hazard ratios(HR)and corresponding 95% confidence intervals. Results: Adjusted for demographic variables, body mass index, type of diet, physical activity, and fiber and magnesiumintake, multvariateanalysis showed that consumptionof ≥1 can (355 ml) of diet soda/day was associated with the incidence of type 2 diabetes (HR=1.46, 95% CI, 1.19 to 1.73;p&lt;0.001). In comparison,consumptionof ≥ 1 can of regular soda/daydid not increaserisk of diabetes (HR = 1.20, 95% CI, 0.95 to 1.50). The associations were strengthened and statistically significant for both types of soda when not adjusted for BMI. Other risk factors for developing diabetes included age, male gender, non-white ethnicity, and body mass index. High intake of magnesiumandfiber, higher education,and a vegetarian diet were protective against the disease. Conclusion:  Consumption of diet soda was significantly associated with the development of type 2 diabetes. / <p>ISBN 978-91-982282-0-5</p>

Title: Physical education of individuals with type 2 diabetes mellitus Objectives: The aim of this thesis is to evaluate the effect of physical education of individuals with type 2 diabetes mellitus cured in diabetologic outpatient clinic of Genereal University Hospital in Prague. The physical education was focused on nordic walking. Methods: Eight patients of diabetological outpatient clinic were chosen by the doctor for this survey. The physical examination was carried out with seven patients. It involved anthropometrical measurements (weight, waist circumference) and blood collection for biochemical parameters assessment (glycemia, glycated hemoglobin). Two-minute step test was chosen for assessment of subject's physical fitness. Results: The physical activity education of individuals with type 2 diabetes mellitus doesn't increase the amount of their physical activity. The physical activity of type 2 diabetes mellitus individuals is rather low as well as their exercise adherence. Nordic walking exercise program can improve anthropometrical parametres (weight, waist circumference) and can reduce HbA1c levels. Lower health-related quality of life in physical and physological aspects wasn't proved in type 2 diabetes patients. Key words: nordic walking, physical activity, type 2 diabetes management,...

Detailed characterization of human pancreatic islets is key to elucidating the pathophysiology of all forms of diabetes, especially type 2 diabetes. However, access to human pancreatic islets is limited. Pancreatic tissue for islet retrieval can be obtained from brain-dead organ donors or from individuals undergoing pancreatectomy, often referred to as ‘living donors’. Different protocols for human islet procurement can substantially impact islet function. This variability, coupled with heterogeneity between individuals and islets, results in analytical challenges to separate genuine disease pathology or differences between human donors from experimental noise. There are currently no international guidelines for human donor phenotyping, islet procurement and functional characterization. This lack of standardization means that substantial investments from multiple international efforts towards improved understanding of diabetes pathology cannot be fully leveraged. In this Perspective, we overview the status of the field of human islet research, highlight the challenges and propose actions that could accelerate research progress and increase understanding of type 2 diabetes to slow its pandemic spreading.

Bakgrund: Diabetes typ 2 är en endokrin sjukdom och ett globalt hälsoproblem, där antalet insjuknande personer ökar kraftigt. Behandlingen vid diabetes typ 2 utgörs till största del av egenvård vilket ställer stora krav på patienten och på sjukvården. En bristande följsamhet till råd om egenvård kan leda till sämre hälsa för patienten och ökade kostnader för samhället. Syfte: Syftet med denna litteraturöversikt var att beskriva vilka faktorer som påverkar följsamheten till råd om egenvård hos patienter med diabetes typ 2. Metod: En litteraturöversikt baserad på 15 vetenskapliga artiklar där både kvalitativa och kvantitativa artiklar har granskats. Databaserna CINAHL och PubMed har använts. Resultat: Faktorer som påverkade följsamheten till råd om egenvård identifierades och resulterade i fem huvudkategorier: Information; Kunskap; Socialt stöd; Teknologiskt stöd och Livssituation. Dessa faktorer framkom som viktiga för en god följsamhet till råd om egenvård. Slutsats: Det är av stor betydelse att försöka identifiera varje individs olika förutsättningar, för att på så sätt ha möjlighet att anpassa både information, utbildning och egenvårdsplanering utifrån individen. / Background: Type 2 diabetes is an endocrine disorder and a global health problem, with the number falling ill persons greatly increases. Treatment of type 2 diabetes consists mainly of self-care, which places great demands on the patient and the healthcare system. A lack of compliance to advice on self-care can lead to poorer health for the patient and increased costs for society. Aim: The purpose of this literature review was to describe the factors that influence compliance to advice on self-care in patients with type 2 diabetes. Method: A literature review based on 15 scientific articles, both qualitative and quantitative articles were reviewed. The databases CINAHL and PubMed were used. Results: Factors affecting compliance to advice on self-care were identified and resulted in five broad categories: Information; Knowledge; Social support; technological support and Life situation revealed as important factors for low compliance to advice on self-care. Conclusion: It is very important to try to identify each individual's different conditions, in order to thus be able to cu

Introduction: The continual increase of type 2 diabetes (T2D) prevalence is a global public health concern. The aetiology of T2D has not been fully elucidated and this is hampering the development of effective preventative and curative interventions to curb the T2D burden. Although much has been done to elucidate the environmental risk factors associated with T2D, little is known about the precise genetic risk factors that predispose people to it. There is limited knowledge about the common variants associated with T2D risk in the black South African population. However, evidence of shared common variants associated with T2D among people of different ethnicities has been documented. Nonetheless, the majority of the common variants that have been reported to be associated with T2D in other ethnicities are still yet to be evaluated in the black South African population. Objectives: The aim of this study was to evaluate the association of previously reported common genetic variants with T2D susceptibility, as indicated by impaired glucose tolerance (IGT), in a black South African population of Tswana descent. Methods: This study was a case-control study of 180 cases and 180 controls nested in the Prospective Urban Rural Epidemiology (PURE) study baseline data, which was collected in 2005. The DNA samples of the participants were genotyped for 77 single nucleotide polymorphisms (SNPs), using Illumina® VeraCode technology on the BeadXpress® platform. The gPlink software was used to evaluate the standard genetic models of disease penetrance for the association of the common variants with impaired glucose tolerance (IGT) while adjusting for age, sex and body mass index. Results: Four out of the 66 SNPs that were evaluated through the genetic association tests in this study were noted to be significantly associated with IGT (p< 0.05). Of the four SNPs, only rs1436955 was associated with an increase in T2D risk, while the other three variants, rs831571, rs8050136 and rs7542900, were noted to be associated with a decreased risk of T2D. However, none of the four SNPs was significantly associated with IGT after correcting for multiple testing (p <0.05). Conclusions: Black South Africans of Tswana descent might not share common variants associated with T2D risk, as indicated by IGT in other ethnicities. Wellpowered studies are required to evaluate the association of common variants with T2D risk in this population group. The results from this study emphasise the need for population-specific variants to assess the genetic susceptibility of complex diseases such as T2D in the black South African population. / MSc (Nutrition), North-West University, Potchefstroom Campus, 2014

Introduction: The continual increase of type 2 diabetes (T2D) prevalence is a global public health concern. The aetiology of T2D has not been fully elucidated and this is hampering the development of effective preventative and curative interventions to curb the T2D burden. Although much has been done to elucidate the environmental risk factors associated with T2D, little is known about the precise genetic risk factors that predispose people to it. There is limited knowledge about the common variants associated with T2D risk in the black South African population. However, evidence of shared common variants associated with T2D among people of different ethnicities has been documented. Nonetheless, the majority of the common variants that have been reported to be associated with T2D in other ethnicities are still yet to be evaluated in the black South African population. Objectives: The aim of this study was to evaluate the association of previously reported common genetic variants with T2D susceptibility, as indicated by impaired glucose tolerance (IGT), in a black South African population of Tswana descent. Methods: This study was a case-control study of 180 cases and 180 controls nested in the Prospective Urban Rural Epidemiology (PURE) study baseline data, which was collected in 2005. The DNA samples of the participants were genotyped for 77 single nucleotide polymorphisms (SNPs), using Illumina® VeraCode technology on the BeadXpress® platform. The gPlink software was used to evaluate the standard genetic models of disease penetrance for the association of the common variants with impaired glucose tolerance (IGT) while adjusting for age, sex and body mass index. Results: Four out of the 66 SNPs that were evaluated through the genetic association tests in this study were noted to be significantly associated with IGT (p< 0.05). Of the four SNPs, only rs1436955 was associated with an increase in T2D risk, while the other three variants, rs831571, rs8050136 and rs7542900, were noted to be associated with a decreased risk of T2D. However, none of the four SNPs was significantly associated with IGT after correcting for multiple testing (p <0.05). Conclusions: Black South Africans of Tswana descent might not share common variants associated with T2D risk, as indicated by IGT in other ethnicities. Wellpowered studies are required to evaluate the association of common variants with T2D risk in this population group. The results from this study emphasise the need for population-specific variants to assess the genetic susceptibility of complex diseases such as T2D in the black South African population. / MSc (Nutrition), North-West University, Potchefstroom Campus, 2014

High circulating glucose and non-esterified free fatty acid (NEFA) levels can cause pancreatic β-cell failure. The molecular mechanisms of this β-cell glucolipotoxicity are yet to be established conclusively. In this thesis by exploring mitochondrial energy metabolism in INS-1E insulinoma cells and isolated pancreatic islets, a role of mitochondria in pancreatic β-cell glucolipotoxicity is uncovered. It is reported that prolonged palmitate exposure at high glucose attenuates glucose-stimulated mitochondrial respiration which is coupled to ADP phosphorylation. These mitochondrial defects coincide with an increased level of mitochondrial reactive oxygen species (ROS), impaired glucose-stimulated insulin secretion (GSIS) and decreased cell viability. Palmitoleate, on the other hand, does not affect mitochondrial ROS levels or cell viability and protects against the adverse effects of palmitate on these phenotypes. Interestingly, palmitoleate does not significantly protect against mitochondrial respiratory or insulin secretion defects and in pancreatic islets tends to limit these functions on its own. Furthermore, strong evidence suggests that glucolipotoxic-induced ROS are of a mitochondrial origin and these ROS are somehow linked with NEFA-induced loss in cell viability. To explore the mechanism of glucolipotxic-induced mitochondrial ROS and associated cell loss, uncoupling protein-2 (UCP2) protein levels and activity were probed in NEFA exposed INS-1E cells. It is concluded that UCP2 neither mediates palmitate-induced mitochondrial ROS production and the related cell loss, nor protects against these deleterious effects. Instead, UCP2 dampens palmitoleate protection against palmitate toxicity. Collectively, these data shed important new light on the area of glucolipotoxicity in pancreatic β-cells and provide novel insights into the pathogenesis of Type 2 diabetes.

Aim: To test the interactive effects of the constructs of Modified Social Learning Theory (MSLT) in relation to predicting health behaviour in Type 2 Diabetes. Methods: The study is mixed methods and employs an exploratory sequential design. Qualitative Phase: (N=12) Semi-structured interviews with adults with insulin-treated type 2 diabetes, explored how beliefs and values influence self-management behaviour. Interim Phase: Thematic analysis allowed development of an adapted Health Value Measure. Quantitative phase: (N=107) Valid questionnaires measured Health Value, Health Locus of Control (HLC) and Self-efficacy (SE). Health Value was measured pre and post diagnosis in order to compare any changes with time. Anxiety and depression was controlled for using the Hospital Anxiety and Depression(HAD) scale. Five subscales measured diabetes outcome behaviour: general diet, specific diet, exercise, blood sugar and foot care. Hierarchical Multiple Regression(HMR) analyses consisted of four blocks, including three two-way interaction terms and one three-way interaction term to test the interactive effects of the three-predictor variables on outcome behaviours. ANOVA’s were conducted in an effort to add support to HMR results. Results: The interviews suggest that people may hold terminal (beliefs about desired end states)/instrumental health values (beliefs about desired modes of action) pre-diagnosis but these are mainly instrumental post-diagnosis in order to meet their new needs and maintain quality of life. The qualitative data also drew attention to the way in which LOC and SE beliefs impact on behaviour. Additionally, differing dimensions of various emergent themes highlight the demands Type 2 diabetes places on a person and how this influences beliefs and values. Interim phase results resulted in the new items being removed from the adapted health value measure prior to the quantitative data analysis, as item 5 was deemed problematic. Sensitivity analysis was carried out to increase the robustness of the quantitative findings due to removing 29 cases with missing data from Dataset 1. Dataset 1 includes 78 complete cases and Dataset 2 contains 107 cases, 29 of which had missing values and were replaced using regression imputation. HMR analyses produced significant results that support MSLT when the three-way interaction variable was added to block 4. ANOVA results produced minimum support for MSLT. Conclusion: Support for MSLT has been found and can be used to inform interventions to change self-management behaviours of patients with poor diabetes control. Change in health value orientation post-diagnosis purports further investigation, as it is supported by qualitative results but not quantitative.