Transitioning Through College With Diabetes: Themes Found in Online Forums

Abstract

Objective: Content analysis of Internet-based diabetes forum text was used to examine the experiences encountered by students with diabetes transitioning into and through college. Participants: Forum posts (N = 238) regarding attending college with diabetes were collected and analyzed. Methods: Thematic coding was used to identify prominent topics, followed by analysis of theme distribution across college transitional stages. Three students with diabetes were recruited to review results and corroborate findings. Results: Twenty thematic categories were identified. Preparation for college involved efforts to move toward autonomous diabetes management. Transitioning in was marked by adjusting to a college lifestyle, then working to manage issues such as busy schedules and alcohol use as continuing students, and turning attention toward future career options and finances while transitioning out. Conclusions: As they move into and through college, students with diabetes negotiate developmental and diabetes-specific tasks within an environment that presents unique logistical, lifestyle, and psychological challenges.     

Influence of testosterone substitution on glycemic control and endothelial markers in men with newly diagnosed functional hypogonadism and type 2 diabetes mellitus: a randomized controlled trial

Abstract

Effects of testosterone (T) on the cardiovascular system of men remain controversial. The impact of T-replacement therapy (TRT) in men with functional hypogonadism and type 2 diabetes mellitus (T2DM) has to be elucidated. This study included 80 men (mean age 51.5?±?6.3 years) with newly diagnosed T2DM (according to ADA criteria) and functional hypogonadism (according to EAU criteria). Randomization: Group1 (n?=?40): TRT using 1%-transdermal T-gel (50?mg/day), Group2 (n?=?40) no TRT (controls). Dietary treatment applied to both. Parameters at baseline/after 9?months: anthropometric parameters, lipids and indicators of carbohydrate metabolism (fasting glucose, insulin, HbA1c, HOMA-IR), markers of adipose tissue and EnD (leptin, resistin, p- and e-selectin, ICAM- 1, VCAM- 1 and CRP). ANCOVA for repeated measurements revealed TRT to cause a significant decrease in waist circumference (WC), HOMA-IR and HbA1c vs controls (p?<?.001, p?=?.002, p?=?.004, respectively). Leptin declined in subjects receiving TRT vs controls (p?=?.04). Concentrations of resistin, ICAM-1, p-selectin and CRP decreased significantly vs controls (all p?<?.001); no effects for e-selectin and VCAM-1. Advanced age attenuated effects, higher delta testosterone levels augmented effects. Decrement of WC was related to decreasing markers of adipose tissue secretion/EnD. TRT in men with functional hypogonadism and T2DM improved carbohydrate metabolism and markers of endothelial dysfunction.     

Chapter 9. Self-Care Practices and Hispanic Women with Diabetes

SUMMARY

Diabetes is a major public health problem in the United States, and a dangerous disease that can lead to serious long term complications. Left uncontrolled, diabetes can lead to blindness, heart failure, kidney failure, and low extremity amputations. This challenge is further magnified by the fact that Hispanics already constitute the largest minority group in the U.S., which suggests the potential of diabetes to reach epidemic proportions. This chapter explores the role of culture and self-care practices among Hispanic women with diabetes.     

Telomere length and type 2 diabetes in males,a premature aging syndrome

Background: Increased telomere shortening has been demonstrated in several diseases including type 2 diabetes. However, it is not known whether telomere length changes during the course of type 2 diabetes. Objective: To determine telomere length at different stages of type 2 diabetes, including early and late stages. Methods: A total of 93 males with type 2 diabetes and 10 years or more since original diagnosis; 96 males with less than one year of diagnosis; 98 age matched healthy males. Telomere length was estimated by means of real-time polymerase chain reaction. Fasting venous blood samples were obtained for measurement of lipid peroxidation and inflammation markers.Results: We found a greater telomere shortening in group (A) with type 2 diabetes of 10 years or more since original diagnosis, compared with the control group (C) of healthy males (5.4 vs 9.6 Kb) (p?=?0.04) and with group B (5.4 vs 8.7kb) (p?=?0.05). With regard to inflammatory markers TNF-α, malondialdehyde peroxidation and adiponectin we found significant differences. Conclusion: Telomere shortening increases with the duration of diabetes. The time of exhibition suggests in parallel that the progressive increase of inflammation and/or oxidative stress plays a direct role in telomere shortening.     

The effect of lifestyle modification and glycemic control on the efficiency of sildenafil citrate in patients with erectile dysfunction due to type-2 diabetes mellitus

Abstract

Objectives: We evaluated the effect of lifestyle modifications and glycemic control on the efficiency of sildenafil citrate in patients with type-2 diabetes (T2DM) and erectile dysfunction (ED).

Methods: Eighty-three men with ED due to T2DM were included in the study. The Group 1 (n?=?41) patients received lifestyle modifications (diet and exercise), and medical treatment for intensive glycemic control. In Group 2 (n?=?42), in addition to the intensive glycemic control, the patients were given sildenafil citrate® 100?mg for 2–3 per weeks. The changes in ED were compared between the two groups after three months of treatment.

Results: The mean age was 54.9?±?9.1 (26–75) years. An increase in the IIEF-5 scores was observed in 23 of 41 patients in Group 1 (44.2%) and 29 of 42 in Group 2 (55.8%). When the changes of the IIEF-5 scores were evaluated, the mean increase was 2.5 in Group 1, and 5.0 in Group 2 (p?=?0.012). The mean IIEF changes according to the duration of diabetes were 4.8 in <5 years, 3.6 in 5–10 years and 1.6 in >10 years (p?=?0.021).

Conclusions: Glycemic control and lifestyle changes are not solely adequate for a better sexual function in ED due to diabetes, and sildenafil citrate should be used additionally.     

ACE基因多态性与2型糖尿病的关联研究

目的探讨血管紧张素转化酶(ACE)基因I/D多态性在湖北汉族2型糖尿病发生发展中的作用。方法采用同胞对和随机病例-对照两种实验设计。征集湖北地区汉族49个同胞对及163例随机病例-对照,测定身高、体重、血压、空腹血糖等生理生化指标,应用聚合酶链反应(PCR)方法测定基因型。结果两种实验设计中对照组与病例组的基因型和基因频率均无显著差异。结论ACE基因在湖北汉族人群2型糖尿病的发生发展中可能不起主要作用。     

Estimating the impact of change in pre-pregnancy body mass index on development of Gestational Diabetes Mellitus: An Australian population-based cohort

BackgroundInternational studies examining maternal overweight and obesity have found GDM risk increases with increasing weight gain between pregnancies.AimThe study aimed to estimate the association between pre-pregnancy maternal body mass index (BMI), change in BMI between pregnancies and Gestational Diabetes Mellitus (GDM) amongst women with consecutive births in an Australian cohort.MethodsWe used a population cohort of women who had at least two consecutive singleton births between 2010 and 2017 in one NSW health district to investigate the risk of GDM in the pregnancy after the index pregnancy, BMI change between pregnancies and the impact of BMI change on risk of GDM.FindingsOf 10,074 women 1987 (16.7%) had no GDM in the index pregnancy but GDM in the subsequent one while 823 (8.2%) had GDM in both pregnancies. No change in BMI between pregnancies occurred in 47% of women, while 12% had a decrease and 41% an increase. After adjusting for socio-demographic characteristics and selected maternal and perinatal confounders, a reduction in BMI between births in women without GDM in the index pregnancy was associated with a 36% lower risk in GDM (aRR: 0.64; 95% CI: 0.49?0.85), while an increase in BMI was associated with increased risk of GDM with the greatest risk amongst those who gained 4+ kg/m² (aRR 2.27; 95%CI: 1.88–2.75).ConclusionInterpregnancy weight change is an important modifiable risk factor for the risk of GDM in a subsequent pregnancy. Clinical guidelines and health messages about interpregnancy weight change are important for all women.     

淮安农村地区糖尿病患者家庭灾难性卫生支出分析

基于江苏省淮安市农村地区的实地调研数据，分析了农村地区糖尿病患者家庭灾难性卫生支出风险与相关影响因素，采用集中指数这一指标测算了灾难性卫生支出风险的不平等性。江苏省农村地区糖尿病患者家庭发生灾难性卫生支出风险较大。糖尿病患者家庭的收入越低，灾难性卫生支出的发生率与发生强度越高，表明灾难性卫生支出具有不平等性且低收入家庭更易发生。政府应该进一步完善农村地区的医疗保险制度，为农村地区糖尿病患者家庭提供一定的经济保护，减轻患者的疾病经济负担。