Immunomodulatory Roles of CTRP3 in Endotoxemia and Metabolic Stress

C1q/TNF-related protein 3 (CTRP3) is a secreted hormone that modulates hepatic glucose and lipid metabolism. Its circulating levels are reduced in human and rodent models of obesity, a metabolic state accompanied by chronic low-grade inflammation. Recent studies have demonstrated an anti-inflammatory role for recombinant CTRP3 in attenuating LPS-induced systemic inflammation, and its deficiency markedly exacerbates inflammation in a mouse model of rheumatoid arthritis. We used genetic mouse models to explore the immunomodulatory function of CTRP3 in response to acute (LPS challenge) and chronic (high-fat diet) inflammatory stimuli. In a sublethal dose of LPS challenge, neither CTRP3 deficiency nor its overexpression in transgenic mice had an impact on IL-1β, IL-6, TNF-α, or MIP-2 induction at the serum protein or mRNA levels, contrary to previous findings based on recombinant CTRP3 administration. In a metabolic context, we measured 71 serum cytokine levels in wild-type and CTRP3 transgenic mice fed a high-fat diet or a matched control low-fat diet. On a low-fat diet, CTRP3 transgenic mice had elevated circulating levels of multiple chemokines (CCL11, CXCL9, CXCL10, CCL17, CX3CL1, CCL22 and sCD30). However, when obesity was induced with a high-fat diet, CTRP3 transgenic mice had lower circulating levels of IL-5, TNF-α, sVEGF2, and sVEGFR3, and a higher level of soluble gp130. Contingent upon the metabolic state, CTRP3 overexpression altered chemokine levels in lean mice, and attenuated systemic inflammation in the setting of obesity and insulin resistance. These results highlight a context-dependent immunomodulatory role for CTRP3

Development and implementation of a workshop for young adults with diabetes entering college and the workforce

The process of transitioning from pediatric to adult diabetes care for adolescents and young adults is challenging. This transition period may include many life changes, and can be fraught with worsening glycemic control leading to increased risk for diabetes-related hospitalizations and complications. Research has demonstrated that increased support during this period can help maintain engagement in diabetes care. Transition guidelines highlight the importance of preparation and readiness for transition. In this article, we discuss the development, implementation and content of a workshop for patients and parents/caregivers preparing for the transition to college, the workforce and adult diabetes care

Framing the discussion of microorganisms as a facet of social equity in human health

What do “microbes” have to do with social equity? These microorganisms are integral to our health, that of our natural environment, and even the “health” of the environments we build. The loss, gain, and retention of microorganisms—their flow between humans and the environment—can greatly impact our health. It is well-known that inequalities in access to perinatal care, healthy foods, quality housing, and the natural environment can create and arise from social inequality. Here, we focus on the argument that access to beneficial microorganisms is a facet of public health, and health inequality may be compounded by inequitable microbial exposure

Assessing Disparities in Barriers to Attending Pediatric Diabetes Camp

OBJECTIVES: While the benefits of diabetes camp programs are well established, minority youth are underrepresented in camp attendance. No research to date has explored barriers to camp attendance or potential disparities in those barriers. Further, little is known about sources families prioritize in seeking diabetes information and support. METHODS: This was a prospective survey of families of children with type 1 diabetes (T1D) using convenience sampling during normally-scheduled clinic visits. Thirty-nine children and their caregivers completed the survey. Results were analyzed for prevalence and mean number of reported barriers, benefits, and diabetes information networks. RESULTS: Age range was 5-15 years and mean duration of diabetes was 2.9 years (0.4-9y). The most prevalent barriers were location, cost, and concern about sending children to overnight camp. Caregivers had high level of knowledge of camp benefits. Participants reported engaging with the diabetes community through interactions with their diabetes team, Facebook groups, and the JDRF. CONCLUSION: Increasing awareness, transportation assistance, and scholarship funding all may increase accessibility of diabetes camps. Diabetes clinic and online or social media groups are both acceptable means of disseminating information about diabetes camp. Further research is indicated to verify if these results are applicable to the larger diabetes community

Racial Ethnic Disparities in Youth With Type 1 Diabetes Participating in Diabetes Summer Camps

Objective: Diabetes camps are beneficial for campers and include benefits such as increases in diabetes knowledge, glycemic control, and psychological functioning. Racial/ethnic minority youth are likely to have poorer disease management and glycemic control. We hypothesized that minority youth with type 1 diabetes have reduced participation in diabetes summer camps. Research design and methods: We analyzed deidentified data from 5,256 campers with type 1 diabetes who participated in a network of 48 American Diabetes Association-affiliated summer camps in 2018, and we compared participation rates by racial/ethnic category to the most recent SEARCH for Diabetes in Youth study prevalence rates. Results: Camper demographics were significantly different than in the general population of children with type 1 diabetes (P \u3c 0.001). Minority youth were more likely to attend day camp, be first-time campers, and request financial aid, and they were less likely to be on insulin pump therapy or use continuous glucose monitors. Conclusions: Racial/ethnic minority youth with diabetes are underrepresented in diabetes camps nationwide

DataSheet_2_Development and implementation of a workshop for young adults with diabetes entering college and the workforce.pdf

The process of transitioning from pediatric to adult diabetes care for adolescents and young adults is challenging. This transition period may include many life changes, and can be fraught with worsening glycemic control leading to increased risk for diabetes-related hospitalizations and complications. Research has demonstrated that increased support during this period can help maintain engagement in diabetes care. Transition guidelines highlight the importance of preparation and readiness for transition. In this article, we discuss the development, implementation and content of a workshop for patients and parents/caregivers preparing for the transition to college, the workforce and adult diabetes care.</p

DataSheet_1_Development and implementation of a workshop for young adults with diabetes entering college and the workforce.pdf

The process of transitioning from pediatric to adult diabetes care for adolescents and young adults is challenging. This transition period may include many life changes, and can be fraught with worsening glycemic control leading to increased risk for diabetes-related hospitalizations and complications. Research has demonstrated that increased support during this period can help maintain engagement in diabetes care. Transition guidelines highlight the importance of preparation and readiness for transition. In this article, we discuss the development, implementation and content of a workshop for patients and parents/caregivers preparing for the transition to college, the workforce and adult diabetes care.</p

Racial Ethnic Disparities in Diabetes Youth Participating in Diabetes Summer Camps

Background: Diabetes camps are beneficial for campers, including increases in diabetes knowledge, glycemic control and psychological functioning. Racial/ethnic minority youth are likely to have poorer disease management and glycemic control, more complications, and are often managed with less intensive, less technologically advanced regimens. We hypothesized that racial/ethnic minority youth with type 1 diabetes (T1D) would have reduced participation in diabetes summer camps. Methods: We reviewed de-identified data from 5033 campers with T1D who participated in a network of 46 ADA-affiliated summer camps during the 2017 season. We performed t-tests and chi-square analysis to analyze the demographic characteristics of white vs. non-white campers. Results: Campers with T1D came from all over the U.S. (49 states), 68.4% were return campers, 55% were female, ages ranging from 4-18 (m =11.7 ±2.8). Of campers, 73.2% were on insulin pump regimens. Camps cost $0 to$1400 (Day Camps M=$158.83 ±$103.69, Residential Camps M=$622.73 ±$274.26). Campers identified as caucasian (83.9%), black (4.8%), Hispanic (3.9%), Asian/Pacific Islander (2.7%), and Multiracial (3.9%). We compared ethnicity data to the 2009 SEARCH data from children and adolescents where T1D prevalence was 72% in caucasians, 9% black, 15% Hispanic and 2% Asian/Pacific Islander. Camper demographics were significantly different than the general population of children with T1D (p\u3c0.001). Racial/ethnic minority status was associated with type of camp attended (day vs. residential), and minority campers were less likely to be on insulin pump therapy. Conclusions: Children of ethnic minorities with diabetes are underrepresented in diabetes camps nationwide compared to the prevalence of diabetes in each minority group as described by the SEARCH study. This highlights the need to assess barriers to camp attendance in these communities and to design outreach programs to increase minority youth participation in the diabetes camp experience

Social Determinants of Health and Impact on Screening, Prevalence, and Management of Diabetic Retinopathy in Adults: A Narrative Review

Diabetic retinal disease (DRD) is the leading cause of blindness among working-aged individuals with diabetes. In the United States, underserved and minority populations are disproportionately affected by diabetic retinopathy and other diabetes-related health outcomes. In this narrative review, we describe racial disparities in the prevalence and screening of diabetic retinopathy, as well as the wide-range of disparities associated with social determinants of health (SDOH), which include socioeconomic status, geography, health-care access, and education