Anorexia nervosa with concealed hyperphagia and self-induced vomiting, hypokalemic alkalosis and normal aldosterone excretion.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to N W Rodger.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
PURPOSE: This article describes a theory-driven approach to developing a physical activity intervention for sedentary individuals with type 2 diabetes. METHODS: Development of the intervention was based on 6 essential elements of program theory: problem definition, critical inputs, mediating processes, expected outcomes, extraneous factors, and implementation issues. Each element was formulated based on available literature and in collaboration with both intended service deliverers (diabetes educators) and recipients (sedentary persons with type 2 diabetes). RESULTS: Diabetes education requires a simple physical activity intervention template that is feasible, acceptable, and effective in a variety of settings. Successful programs are individualized, specific, flexible, and based on walking. Pedometers have potential as self-monitoring and feedback tools. The primary expected outcome is an increase in physical activity, specifically walking. Behavior modification and social support are critical to adoption and adherence. CONCLUSIONS: Theory-driven interventions specify what works for whom and under what conditions of delivery. The underlying theory guides the evaluation, refinement, and clinical replication of an intervention. Recruitment, delivery, and follow-up are real-world implementation issues.
PURPOSE: This research was the first phase of a study designed to develop and pilot test an educational program to increase self-awareness of salient body cues in adults with Type 1 diabetes. The purpose of this study was to identify (1) the cues, sensations, and circumstances that people with diabetes and their families associate with hypoglycemia, euglycemia, and hyperglycemia; and (2) the types of strategies that people with diabetes use to tune in to body cues and sensations. METHODS: A series of four focus group sessions were held at monthly intervals with four female participants and four family members. These sessions were audiotaped and transcribed verbatim. RESULTS: Participants described the existence of unique as well as usual body cues for hyperglycemia and hypoglycemia and the circumstances associated with these cues. Subjective and objective strategies were identified for tuning into these body cues and sensations. CONCLUSIONS: People with diabetes should be encouraged to identify their own body cues that signify different levels of glycemia because these personal cues may be different than classical textbook symptoms. Even people with hypoglycemia unawareness may recognize unique cues that replace the autonomic ones they have lost.
Explore the source record for details and available documents.
Continuous subcutaneous insulin infusion (CSII) has been compared with conventional insulin injection treatment (CIT) supplemented by self-monitoring of capillary blood glucose (SMBG) in 18 nonobese adults with insulin-dependent diabetes mellitus (IDDM). Mean daily insulin dosage and rates of hypoglycemia were similar during CSII (duration of treatment 36 +/- 2 wk mean +/- SE) and CIT (31 +/- 1.6 wk). On the basis of fasting C-peptide concentrations and postintravenous glucagon increments of less than 0.1 pmol/ml, subjects were classified C-peptide negative (CP NEG) (N = 11), or C-peptide positive (CP POS) (N = 7). Relative to CIT, CP NEG subjects on CSII had significant decreases in premeal/bedtime and postmeal plasma glucose concentrations and glycosylated hemoglobin (percent of total). CP POS patients during each of CSII and CIT showed glycemic responses equivalent to those of CP NEG patients on CSII. In neither group could results be explained on the basis of improved beta cell function. Thus, therapeutic advantage of CSII was not apparent in IDDM adults retaining significant C-peptide activity.