Diet, inflammation, and glycemic control in type 2 diabetes: an integrative review of the literature.Nowlin, S. Y., Hammer, M. J., & D'Eramo Melkus, G. (2012). Journal of nutrition and metabolism, 2012, 542698, 10.1155/2012/542698
Type 2 diabetes (T2D) is a growing national health problem affecting 35% of adults ≥20 years of age in the United States. Recently, diabetes has been categorized as an inflammatory disease, sharing many of the adverse outcomes as those reported from cardiovascular disease. Medical nutrition therapy is recommended for the treatment of diabetes; however, these recommendations have not been updated to target the inflammatory component, which can be affected by diet and lifestyle. To assess the current state of evidence for which dietary programs contain the most anti-inflammatory and glycemic control properties for patients with T2D, we conducted an integrative review of the literature. A comprehensive search of the PubMed, CINAHL, Scopus, and Web of Science databases from January 2000 to May 2012 yielded 786 articles. The final 16 studies met the selection criteria including randomized control trials, quasiexperimental, or cross-sectional studies that compared varying diets and measured inflammatory markers. The Mediterranean and DASH diets along with several low-fat diets were associated with lower inflammatory markers. The Mediterranean diet demonstrated the most clinically significant reduction in glycosylated hemoglobin (HbA(1c)). Information on best dietary guidelines for inflammation and glycemic control in individuals with T2D is lacking. Continued research is warranted.
Glycemic control among older adult hematopoietic cell transplant recipients.Hammer, M. J., Motzer, S. A., Voss, J. G., & Berry, D. L. (2010). Journal of gerontological nursing, 36, 40-50, 10.3928/00989134-20091207-99
Adults age 55 and older with hematological malignancies who require hematopoietic cell transplantation (HCT) for survival are at risk for a number of nonmalignancy-related, potentially life-threatening outcomes, often due to suboptimal immune function. Evidence is emerging regarding how abnormal glycemic levels-newly termed malglycemia-impair cells of the immune system. Further, older adult HCT recipients appear highly susceptible to malglycemic states, particularly hyperglycemia, due to treatment regimens, nutritional imbalances, states of immobility, and stress, all coupled with the natural aging process. Patients with preexisting diabetes may be at further risk for malglycemic states. The growing number of older adults receiving HCT will substantially increase the likelihood nurses will have to provide care to HCT survivors. Therefore, it is important nurses in all practice settings have an understanding of the short-and long-term effects of glycemic status on immune function.
Malglycemia and cancer: introduction to a conceptual model.Hammer, M. J., & Voss, J. G. (2012). Oncology nursing forum, 39, E275-87, 10.1188/12.ONF.E275-E287
To introduce a conceptual model detailing the physiologic contributions of malglycemia to cancer formation and increased morbidity and mortality.
Stress, coping, and adaptationHammer, M.J. (2012). Fundamentals of nursing: Human health and function, 1308-1336,
Success storiesAuerhahn, C., Dorsen, C., Hammer, M.J., Meyer, K., Taub, L.F.M. & Wollman, M.C. (2010). Integrating gerontological content into advanced practice nursing education, 147-174,
The contribution of malglycemia to mortality among allogeneic hematopoietic cell transplant recipients.Hammer, M. J., Casper, C., Gooley, T. A., O'Donnell, P. V., Boeckh, M., & Hirsch, I. B. (2009). Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 15, 344-51, 10.1016/j.bbmt.2008.12.488
Allogeneic hematopoietic cell transplantation (HCT) continues to be associated with substantial rates of nonrelapse mortality (NRM). Numerous factors influence glucose metabolism among HCT recipients. We hypothesized that "malglycemia," defined as hyperglycemia, hypoglycemia or increased glycemic variability, is associated with increased mortality in HCT patients. In a retrospective cohort study Cox regression was used to assess the association of malglycemia after transplant with day 200 NRM. A total of 66,062 blood glucose (BG) measurements from 1175 adult allogeneic HCT recipients between 2000 and 2005 at the Fred Hutchinson Cancer Research Center were evaluated (median 0.55 values per patient-day, range: 0.09-3.62). Overall, there were 215 cases of NRM by day 200 post-HCT and 601 deaths from any cause throughout observation. After adjustment for previously identified factors associated with NRM, all 3 components of malglycemia were associated with increased NRM when individually modeled as time-dependent covariates. Specifically, the hazard ratio for death was 1.93 for BG >200 mg/dL (P = .0009) and 2.78 for BG >300 (P = .0004) compared with BG 101-150 mg/dL. A minimum BG </=89 was associated with a risk of day 200 NRM 2.17 times that of a minimum BG >89 (P < .0001). The upper quartile of glucose variability was associated with a 14.57-fold increase in risk of NRM by day 200 relative to the first quartile (P < .0001). These retrospective data indicate that malglycemia is associated with mortality following HCT. The applicability of these findings to other situations and whether correcting malglycemia in HCT can lead to reductions in mortality remain to be determined.