Browsing by Subject "Diabetes Mellitus"
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Item Acres of Diamonds: Rediscovering Community Assets in Dallas Backyards(2016-04-01) Chavda, Avinash Suresh; Rhee, Chanhaeng; Reed, W. GaryBACKGROUND: Diabetes directly affects 8% of the US population and poses a growing burden to healthcare providers, to the health system, and to society. Cultivating self-efficacy enhances personal agency and enables patients to take an active role in the management of their disease. Effectively cultivating self-efficacy among patients from diverse backgrounds requires a patient-tailored assessment of existing gaps in patients' diabetes self-management skills. Tying patients to existing community health resources through ZIP code-based mapping is an effective patient-tailored intervention that creates long lasting change in diabetes self-management. To this end, a two-armed approach to community resource mapping was taken: In the first arm, existing resources in the categories of exercise, nutrition, and diabetes management were catalogued and mapped across Dallas County ZIP codes; in the second arm, patient awareness of existing resources across the same three categories was mapped across Dallas County ZIP codes. A comparison of each study arm across overlapping ZIP codes showed that resources abound in Dallas, but awareness of these resources is the limiting factor in fostering increased patient self-efficacy. To increase self-efficacy and empower patients to improve self-management of their diabetes, patients should be connected with community resources to tackle the issue of underutilization of community resources and thereby gain "mastery experiences." OBJECTIVE: This project hypothesizes that community resources are plentiful in Dallas and that there is a relative lack of awareness of community resources, limiting patient self-management of diabetes. METHODS: This study mapped community assets in the categories of exercise, nutrition, and diabetes management across the Dallas ZIP codes with the heaviest burden of diabetes. This study then mapped awareness of these same resources and compared both maps to identify a disconnect between community resources and the communities they serve. RESULTS: Sample maps of community assets in several of 14 target ZIP codes were produced with the aid of Google maps, showcasing the abundance of community resources throughout the ZIP codes of Dallas County, including those with poor clinical and socioeconomic measures. Though results may not be representative of individual ZIP codes, awareness of resources appears to vary more directly with these clinical and socioeconomic measures than does true resource distribution. CONCLUSION: This study applies quality improvement and process analysis tools to empirically advance theoretical population health frameworks. Asset cataloguing and geospatial mapping demonstrate an abundance of community resources evenly distributed throughout Dallas but a dearth of resource awareness that loosely correlates with negative community measures. Such measures include median household income, BMI, HbA1C, and crime index. Continued indexing of Dallas County resources with more sophisticated mapping software will yield asset catalogues more consistent in their value to society; and continued awareness surveying is necessary to develop representative ZIP code awareness maps for deep comparison of these objective resource and subjective awareness measures.Item Adipose tissue in health and disease: why should we care?(2019-01-25) Scherer, Philipp E.Item Aldose reductase inhibitor drugs: new hope for diabetic patients?(1989-01-05) Raskin, PhilipItem Atypical diabetes mellitus: beginning of precision medicine(2018-01-19) Garg, AbhimanyuItem Cardiac manifestations of diabetes: a mixed bag without sweetheart deals(1995-09-21) Benjamin, Ivor J.Item Cerebral edema complicating the treatment of diabetic ketoacidosis(1970-05-14) Madison, Leonard L.Item Decentralizing outpatient diabetes care: a collaborative approach(2020-09-18) Gunasekaran, UmaItem Deep Venous Thrombosis and Pulmonary Embolism after Lower Extremity Amputation in Patients with Diabetes(2018-01-23) Gallaway, Kathryn E.; Ahn, Junho; Raspovic, Katherine M.; Wukich, Dane K.This study aims to identify risk factors for deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients with diabetes mellitus (DM) undergoing a lower extremity amputation (LEA). A retrospective analysis of 36,445 LEA cases from the American College of Surgeons-National Surgical Quality Improvement Program (ACSNSQIP) database was performed. 23,380 patients with DM and 13,065 patients without DM were evaluated to determine whether DM is correlated with an increased risk of DVT and PE. Specific risk factors for DVT and PE in this population were also evaluated. The incidence of DVT in post-LEA patients with DM was 0.94% compared to 1.36% in patients without DM (p=0.0002). The incidence of PE in patients with DM was 0.37% compared to 0.54% in patients without DM (p<0.0001). Although statistically significant, this small increase in DVT/PE risk appears to be driven by a higher proportion of "completely dependent" patients without DM (p<0.0001). Patients with "completely dependent" pre-op functional status were 2.59 times more likely to develop a DVT (95% CI: 1.81-3.70) and 3.36 times more likely to experience a PE (95% CI: 1.97-5.72), while "independent" patients were significantly less likely to experience either complication. Level of amputation (LOA) was also associated with an increased risk of DVT and PE. Patients who underwent a below knee amputation (BKA) were 2.12 times more likely to experience a DVT/PE (95% CI: 1.40-3.12) and patients with an above knee amputation (AKA) were 1.82 times more likely to experience a DVT/PE (95% CI: 1.40-3.21). Patients who underwent a transmetatarsal amputation (TMA) were significantly less likely to experience either complication. Other statistically significant risk factors identified in this study include prior myocardial infarction, ASA classification of III-V, and female sex. Patients with a history of dialysis within 2 weeks of surgery had an increased risk of DVT (OR: 1.52, 95% CI: 1.15-2.02); however, no increased risk of DVT/PE in patients with Chronic Kidney Disease (CKD) stage III-V was found (OR: 1.19, 95% CI: 0.97, 1.45). Although DM is not associated with increased risk of DVT/PE, LOA is a significant predictor of DVT/PE risk. Diabetics with peripheral neuropathy may delay seeking treatment due to lack of pain, potentially resulting in higher LOA. Physicians should emphasize rapid evaluation and management of pressure sores to minimize LOA. Prophylactic antithrombotic protocols should also be considered for patients undergoing a high level amputation and for patients with comorbid risk factors such as cardiovascular disease or dependent functional status.Item Diabetes and coronary artery disease: therapy and outcomes(2000-09-07) Rutherford, John D.Item Diabetes and pregnancy(1979-10-18) Raskin, PhilipItem Diabetes control and complications: update 1984(1984-11-01) Raskin, PhilipItem Diabetes in Latinas : Depression, Metabolic Control, and the Roles of Acculturation and Social Support(2005-12-20) Olvera, Anna E.; Stewart, Sunita M.Diabetes is steadily becoming an epidemic among Latinos. This study sought to more fully understand the rarely studied population of Latinas with diabetes and the associations between and among diabetes, depression, social support, metabolic control and acculturation. Ninety-six participants from a large publicly funded teaching hospital's community clinic took part in a brief interview that involved demographic questions, a depression screening toll, a measure for Latino and non-Latino acculturation, and a measure to assess perceived social support. The participants agreed to share their most recent metabolic blood sugar reading. The results demonstrated high levels of depression in the urban Latina with diabetes. A high number of the participants met the criteria for likely depression (32.3%). A one-tailed Pearson correlation yielded a strong significant relationship between perceived social support and depression (r = -0.63, p = 0.00). Additionally, CES-D and a recent HbA1c reading (within six months of the interview) were determined to be significantly related (r(N = 80) = 0.20, p = .03). Exposure to U.S. culture measured in years correlated significantly with diagnosis of depression by a medical professional (rs = 0.22, p = 0.04). There was an additional finding that years of living with diabetes was significantly correlated with being considered depressed (CES-D score = 24; [rs = 0.23, p = 0.03]). These and other findings support possible interventions to improve the quality of health for Latinas at an urban publicly funded clinic.Item Diabetes mellitus: a cardiologist's perspective(1998-04-02) Radford, Nina ButwellItem Diabetes Mellitus: classification, characteristics, and diagnosis(1979-10-04) Foster, Daniel W.Item Diabetic cardiomyopathy(1988-08-04) Lawson, J. W. R.Item The diabetic foot(1970-12-10) Wilson, Jean D.Item Diagnosis of diabetes mellitus(1969-05-22) UnknownItem The end of diabetes and kidney failure: pancreas and kidney transplantation(2004-04-08) Vazquez, Miguel A.Item The etiology of type 2 diabetes mellitus: follow your nose(2001-12-20) Dobbins, Robert L.