Abstract According to recent clinical treatment, doctors give patients medicines based on clinical experience and biochemical data. However, biochemical data simply provides an initial physiology reaction. Although the data is enough for doctors to diagnose diseases, it does not help much for doctors to indicate the most useful medicine. Therefore, doctors will use the first line, cheap or low dose medicine to cure patients by previous clinical experience. It will not only extend the time of treatment but also lower the medical quality. Not to mention the side effects and increases the cost. Consequently, using SNP¡]Single Nucleotide Polymorphism¡^will help doctors to find out different patients¡¦ genotype and forecast the result of medicine. It will control disease efficiently and decrease the medical costs. Methods: This study will be discussed with an accurate test of how to check the genotypes of diabetes mellitus and predict the result of treatment from pharmacogenetic. The method was using PCR (Polymerase Chain Reaction) and RFLP (Restriction Fragment Length Polymorphism) to analyze patients¡¦ different genotype. Besides, this study uses the One-Way ANOVA to interpret the relationship between ABCC8-E16 and type 2 diabetes. In conclusion, the antidiabetic drugs- Sulfonylurea derivatives are suitable for ABCC8-E16 genotype patients. This result can be a reference for doctors to remedy diabetics. It will not only save the cost but also shorten the time of treatment, and it will impact deeply for personalized medicine in the future. type 2 diabetes, Sulfonylurea, SNP, PCR, RFLP, pharmacogenetic, personalized medicine

This qualitative descriptive study examined the day-to-day self-management decision making in Cuban Americans with type 2 diabetes including major decisions, resources and influences to decisions, desired amount of control and advice, and the role of the health care provider. The sample consisted of 20 English speaking, Cuban-American adults between the ages of 45 to 65 years. The mean A1C was 7.49%; mean diabetes duration 4.5 years. Data were collected through discussion of a short self-management decision-making scenario, a semi-structured interview, and demographic questionnaire. Interviews were analyzed using Miles and Huberman’s method of content analysis framed by the concepts of Paolo Freire’s empowerment theory. Self-management tasks of exercise, diet, medication administration, and glucose monitoring were all thought to be important by the participants. Cost, time, structural barriers, social environment, symptoms, and medical information influenced self-management decisions. Challenges included negotiating social occasions, acknowledgement of friends and family, structural barriers, and available resources. Most participants felt they had some personal control and responsibility in decision making. Health care providers, friends, and family were sources of advice. Attempts were made to integrate health care providers’ advice into day-to-day self-management. The aspects of Freire’s theory (dialogue, reflection, and praxis) were reflected in participants’ descriptions of self-management decisions. The findings of this study suggest the challenges of balancing self-management practices with everyday life should be considered when caring for Cuban Americans with diabetes. Culturally sensitive interventions that facilitate the integration of glucose monitoring, exercise, diet, and mediations need to be developed. / text

Cardiovascular disease is the most common cause of morbidity and mortality in type 2 diabetes. Short-term studies of glucagon-like peptide-1 (GLP-1)-targeted therapies suggest potential beneficial effects on cardiovascular outcomes. The mechanism behind this unexpectedly rapid effect is not known. In this study, full-length human GLP-1 receptor (GLP-1R) mRNA was cloned and sequenced from a human megakaryocyte cell line. Quantitative RT-PCR results showed that expression levels were comparable to other GLP-1R expressing tissues. Furthermore, incubation with GLP-1 and the GLP-1R agonist exenatide elicited a cAMP response in these cells. As megakaryocytes are the cellular precursors of platelets, the effect of GLP-1 and exenatide were studied in gel-filtered human platelet aggregation, where they were both shown to have an inhibitory effect on thrombin-stimulated platelet aggregation. Platelet inhibition by GLP-1 and GLP-1R agonists presents a potential mechanism for the reduced incidence of atherothrombotic events thought to be associated with GLP-1-targeted therapies.

There is some evidence to suggest that oxygen consumption (VO2) and oxygen delivery to muscle are reduced at exercise onset and steady state in individuals with type 2 diabetes (T2D), although no studies have combined measurements of both muscle blood flow and VO2 during exercise in this population. OBJECTIVES: 1) To determine whether a reduction in VO2 during exercise would be accompanied by reduced leg blood flow (LBF). 2) To examine the dynamic response characteristics of LBF to determine whether feedforward and/or feedback control systems of blood flow regulation are impaired. METHODS: Four men with T2D and six healthy, activity matched controls (CON) performed supine, two-leg knee extension/flexion exercise tests involving progressive increase in exercise intensity to exhaustion and step increases to a low intensity equivalent to lifting 7.5 kg (LO7.5kg), and a moderate intensity equivalent to 90% of ventilatory threshold (VT90%). MEASUREMENTS: LBF, VO2, mean arterial pressure, heart rate, and stroke volume were measured continuously. RESULTS: Means ± SE, CON vs. T2D. 1) ∆VO2 was not different between groups during the incremental test (P= 0.264), ∆LBF in T2D tended to be lower (P = 0.098). 2) ∆VO2 was not different between groups at any time during LO7.5kg (P = 0.351). Individuals with T2D demonstrated a lower ∆LBF at time = 15 s (3435.6 ± 275.0 vs. 2120.4 ± 218.4 ml/min, P = 0.018). 3) Gains for baseline (G0) and phase I (G1) LBF adaptation to LO7.5kg were lower in T2D compared to CON (G0: 959.8 ± 111.3 vs. 617.0 ± 22.1 ml/min, P = 0.044; G1: 3662.1 ± 229.0 vs. 2128.1 ± 161.6 ml/min, P = 0.002). 4) The time required to achieve 63% of the total response magnitude tended to be slower in T2D (LO7.5kg: 14.3 ± 1.7 vs. 23.1 ± 4.2 s; VT90%: 26.2 ± 3.5 vs. 40.0 ± 7.5 s; P = 0.095). CONCLUSIONS: 1) The initiatory rise in LBF is significantly lower in individuals with T2D, likely due to impairments in feedforward control mechanisms of blood flow regulation, 2) Individuals with T2D do not demonstrate lower VO2 responses to exercise despite an impaired LBF response. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2009-10-09 17:52:31.708

Objectives: To determine whether for a given waist circumference (WC), a larger hip circumference (HC) was associated with a reduced risk of insulin resistance, type 2 diabetes (T2D), hypertension and cardiovascular disease (CVD) in HIV-infected patients. A second objective was to determine whether, for a given WC, the addition of HC improved upon estimates of abdominal adiposity, in particular visceral adipose tissue (VAT), compared to those obtained by WC alone. Methods: HIV-infected men (N=1481) and women (N=841) were recruited between 2005 and 2009. WC and HC were obtained using standard techniques and abdominal adiposity was measured using computed tomography. Results: After control for WC and covariates, HC was associated with a lower risk of HOMA-IR (p<0.05) and T2D [Men: OR=0.91 (95% CI: 0.86-0.96); Women: OR=0.91 (95% CI: 0.84-0.98)]. For a given WC, HC was also associated with a lower risk of hypertension (p<0.05) and CVD [OR=0.94 (95% CI: 0.88-0.99)] in men, but not women. Although HC was negatively associated with VAT in men and women after control for WC (p<0.05), the addition of HC did not substantially improve upon the prediction of VAT compared to WC alone. Conclusions: The identification of high-risk HIV-infected individuals by WC alone is substantially improved by the addition of HC. Estimates of VAT by WC are not substantially improved by the addition of HC and thus variation in visceral adiposity may not be the conduit by which HC identifies increased health risk. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2012-09-04 16:27:16.249

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Background. Estimates are that one third of children will develop type 2 diabetes in their lifetime. Lifestyle changes, including physical activity are established effective tools to prevent and manage type 2 diabetes in adults but the evidence in youth is lacking. Several key questions remain including: (1) Can youth with type 2 diabetes achieve target glycemic control with lifestyle changes alone? (2) Is type 2 diabetes in youth associated with low physical activity and cardiorespiratory fitness? and (3) What is the appropriate intensity of physical activity to reduce the risk for type 2 diabetes in overweight youth? Methods. Three studies were conducted to answer these questions: i) a retrospective chart review to determine the clinical efficacy of lifestyle monotherapy to manage glycemia in youth newly diagnosed with type 2 diabetes; ii) a cross sectional study to test the association between physical activity, cardiorespiratory fitness and type 2 diabetes risk factors in youth; and iii) a randomized controlled trial of physical activity designed to determine the training intensity required to improve insulin resistance and reduce intrahepatic lipid content in overweight youth at risk for type 2 diabetes (interim results presented). Results. Study A. Over 50% of youth newly diagnosed with type 2 diabetes and glycosylated hemoglobin ≤9% were able to achieve target glycemic control for as long as 12 months with lifestyle monotherapy. Study B. Physical activity levels (4905±2075 vs. 6937±2521 vs. 8908±2949 steps/day, p<0.05 vs. healthy weight youth) and cardiorespiratory fitness (23.4±5.9 vs. 26.7±6.0 vs. 36±6.6 ml/kg/min, ii p<0.05) are lower in youth with type 2 diabetes versus overweight and healthy weight controls. Intrahepatic lipid is significantly higher (13.0%±14.1 vs. 5.6%±6.2 vs. 1.4%±1.4, p<0.05) and inversely associated with insulin sensitivity (r = -0.40, p<0.001). Study C. Interim analyses present promising trends from a 6-month physical activity intervention. Conclusions. Lifestyle therapy can be an effective tool to manage new-onset diabetes in certain youth, and is also important in the prevention of type 2 diabetes in youth. Youth with type 2 diabetes are characterized by low levels of physical activity and cardiorespiratory fitness. Interim results are presented from a randomized controlled physical activity trial that we anticipate at completion will provide promising data to guide development of community-based programming to reduce risk for type 2 diabetes in overweight youth.