Miracle-dz/UniFAR-FTUs huggingface dataset:
Adherence to Oral Glucose-Lowering Therapies and Associations With 1-Year HbA1c: A Retrospective Cohort Analysis in a Large Primary Care Database

OBJECTIVE The impact of taking oral glucose-lowering medicines intermittently, rather than as recommended, is unclear. We conducted a retrospective cohort study using community-acquired U.K. clinical data (Clinical Practice Research Database [CPRD] and GoDARTS database) to examine the prevalence of nonadherence to treatment for type 2 diabetes and investigate its potential impact on HbA1c reduction stratified by type of glucose-lowering medication. RESEARCH DESIGN AND METHODS Data were extracted for patients treated between 2004 and 2014 who were newly prescribed metformin, sulfonylurea, thiazolidinedione, or dipeptidyl peptidase 4 inhibitors and who continued to obtain prescriptions over 1 year. Cohorts were defined by prescribed medication type, and good adherence was defined as a medication possession ratio ≥0.8. Linear regression was used to determine potential associations between adherence and 1-year baseline-adjusted HbA1c reduction. RESULTS In CPRD and GoDARTS, 13% and 15% of patients, respectively, were nonadherent. Proportions of nonadherent patients varied by the oral glucose-lowering treatment prescribed (range 8.6% [thiazolidinedione] to 18.8% [metformin]). Nonadherent, compared with adherent, patients had a smaller HbA1c reduction (0.4% [4.4 mmol/mol] and 0.46% [5.0 mmol/mol] for CPRD and GoDARTs, respectively). Difference in HbA1c response for adherent compared with nonadherent patients varied by drug (range 0.38% [4.1 mmol/mol] to 0.75% [8.2 mmol/mol] lower in adherent group). Decreasing levels of adherence were consistently associated with a smaller reduction in HbA1c. CONCLUSIONS Reduced medication adherence for commonly used glucose-lowering therapies among patients persisting with treatment is associated with smaller HbA1c reductions compared with those taking treatment as recommended. Differences observed in HbA1c responses to glucose-lowering treatments may be explained in part by their intermittent use.
Korelasi antara Usia,indeks Massa Tubuh (Imt), Kadar Gula Darah Puasapada Komunitas Vegetarian Dewasa di Kota Pekanbaru

Vegetarian diet has many benefits, especially in the field of health, such as, lowering the risk for diabetes mellitus and obesity. Research has also shown that vegetarians have a body mass index lower than non-vegetarians. However, high carbohydrate consumption, and several types of vegetarians who still consume milk in excessive amounts, can contribute to blood glucose levels. This diet can affect nutritional status too. In addition, age can also affect nutritional status, by increasing of age, the body composition will be changed and metabolic rate will be decreased. This study was aimed to determine the correlation between age, BMI , and fasting blood glucose levels in adult vegetarian community in Pekanbaru . This is a correlative study with cross sectional design. The data included the age, type and duration of being a vegetarian, BMI, and fasting blood glucoselevels . The samples were taken by purposive sampling technique with 32 people who met the inclusions criteria. The results of this study indicate that there were no different of BMI (p= 0.734), and fasting blood glucose levels ( p = 0.804) between vegans and non - vegans . This study also showed that there was no significant correlation between age and fasting blood glucose levels in adult vegetarian community (r= 0,075; p=0,682). In addition , the results showed that there was no significant correlation between BMI and fasting blood glucose levels (p=0.414; r=0.149 ) in the adult vegetarian community. There was no significant correlation between BMI and fasting blood sugar levels in the vegan group (p=0.793; r= -0.207 ) and the non- vegan (p=0.394; r=0.184) in adult vegetarian community in Pekanbaru . Key words :Vegetarian,Vegan, Non-vegan, Body Mass Index (BMI), FastingBlood Glucose Levels
Extra-Virgin Olive Oil Reduces Glycemic Response to a High–Glycemic Index Meal in Patients With Type 1 Diabetes: A Randomized Controlled Trial

OBJECTIVE To evaluate whether fat quality, in the context of meals with high– (HGI) or low–glycemic index (LGI), influences postprandial blood glucose (PPG) response in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS According to a randomized crossover design, 13 patients with type 1 diabetes on insulin pump consumed two series (HGI or LGI) of meals with the same carbohydrate quantity while differing for amount and quality of fat: 1) low in fat (“low fat”), 2) high in saturated fat (butter), or 3) high in monounsaturated fat (extra-virgin olive oil) (EVOO). Premeal insulin doses were based on insulin–to–glycemic load ratios. Continuous glucose monitoring was performed and 6-h PPG evaluated. RESULTS PPG was significantly different between HGI and LGI meals (P = 0.005 for time × glycemic index interaction by repeated-measures analysis [RMA]), being significantly higher during the first 3 h after the HGI meals with a later tendency to an opposite pattern. In the context of HGI meals, PPG was significantly lower after EVOO than after low fat or butter (P < 0.0001 for time × meal interaction by RMA), with a marked difference in the 0- to 3-h glucose incremental area under the curve between EVOO (mean ± SD 198 ± 274 mmol/L × 180 min) and either low fat (416 ± 329) or butter (398 ± 355) (P < 0.05). No significant differences were observed in PPG between the three LGI meals. CONCLUSIONS Carbohydrate quality of a mixed meal influences shape and extent of PPG. Besides, using EVOO in a HGI meal attenuates the early postprandial glucose response observed when this meal is consumed with either low fat or butter. Therefore, an optimal prandial insulin administration would require considering, in addition to the quantity of carbohydrates, the quality of both carbohydrate and fat.
Folic Acid Supplement Intake in Early Pregnancy Increases Risk of Gestational Diabetes Mellitus: Evidence From a Prospective Cohort Study

Folic acid (FA) is well known for its preventive effect on neural tube defects, and recommendations for FA supplement before and during pregnancy have been well established all over the world. Since increased consumption of FA has been prevalent, concerns about its negative consequences have been raised. Diverse adverse effects of FA have been identified, ranging from an increased risk of oral cleft malformations, asthma/respiratory tract infections, and small-for-gestational-age infants to the more serious effect of a potential increased risk of cancers. Previous studies have suggested that a high maternal folate concentration is associated with an increased risk of insulin resistance in children and gestational diabetes mellitus (GDM) (1). In addition, animal experiments have reported that maternal high-FA supplement promotes glucose intolerance and insulin resistance in male mouse offspring fed a high-fat diet (2). However, …
Association Between Use of Lipid-Lowering Therapy and Cardiovascular Diseases and Death in Individuals With Type 1 Diabetes

OBJECTIVE To evaluate the effect of lipid-lowering therapy (LLT) in primary prevention on cardiovascular disease (CVD) and death in type 1 diabetes. RESEARCH DESIGN AND METHODS We used the Swedish National Diabetes Register (NDR) to perform a propensity score–based study. Propensity scores for treatment with LLT were calculated from 32 baseline clinical and socioeconomic variables. The propensity score was used to estimate the effect of LLT in the overall cohort (by stratification). We estimated risk of acute myocardial infarction, stroke, coronary heart disease, and cardiovascular and all-cause mortality in individuals with and without LLT using Cox regression. A total of 24,230 individuals included in 2006–2008 NDR with type 1 diabetes without a history of CVD were followed until 31 December 2012; 18,843 were untreated and 5,387 treated with LLT (97% statins). The mean follow-up was 6.0 years. RESULTS The propensity score allowed balancing of all 32 covariates, with no differences between treated and untreated after accounting for propensity score. Hazard ratios (HRs) for treated versus untreated were as follows: cardiovascular death 0.60 (95% CI 0.50–0.72), all-cause death 0.56 (0.48–0.64), fatal/nonfatal stroke 0.56 (0.46–0.70), fatal/nonfatal acute myocardial infarction 0.78 (0.66–0.92), fatal/nonfatal coronary heart disease 0.85 (0.74–0.97), and fatal/nonfatal CVD 0.77 (0.69–0.87). CONCLUSIONS This observational study shows that LLT is associated with 22–44% reduction in the risk of CVD and cardiovascular death among individuals with type 1 diabetes without history of CVD and underlines the importance of primary prevention with LLT to reduce cardiovascular risk in type 1 diabetes.
Variability of Insulin Requirements Over 12 Weeks of Closed-Loop Insulin Delivery in Adults With Type 1 Diabetes

OBJECTIVE To quantify variability of insulin requirements during closed-loop insulin delivery. RESEARCH DESIGN AND METHODS We retrospectively analyzed overnight, daytime, and total daily insulin amounts delivered during a multicenter closed-loop trial involving 32 adults with type 1 diabetes. Participants applied hybrid day-and-night closed-loop insulin delivery under free-living home conditions over 12 weeks. The coefficient of variation was adopted to measure variability of insulin requirements in individual subjects. RESULTS Data were analyzed from 1,918 nights, 1,883 daytime periods and 1,564 total days characterized by closed-loop use over 85% of time. Variability of overnight insulin requirements (mean [SD] coefficient of variation 31% [4]) was nearly twice as high as variability of total daily requirements (17% [3], P < 0.001) and was also higher than variability of daytime insulin requirements (22% [4], P < 0.001). CONCLUSIONS Overnight insulin requirements were significantly more variable than daytime and total daily amounts. This may explain why some people with type 1 diabetes report frustrating variability in morning glycemia.
Vincristine drug safety administration survey: results from hospitals in Shanghai, China

Objectives To determine whether practitioners had implemented WHO recommended safety practices for intravenous (IV) vincristine administration in Shanghai. Methods A questionnaire, which mainly included WHO recommendations on safe practices for IV vincristine administration, was distributed to 73 hospitals to obtain information regarding the current practice in Shanghai. The association between hospital information and implementation of the recommendations on vincristine was evaluated using logistic regression and univariate analyses. Results Fifty-nine hospitals provided effective feedback on the questionnaire. The results indicated that compliance with recommendations, such as vincristine doses diluted in an IV minibag, double-checked before dispensing and independently double-checked by another pharmacist after preparation, were all >80%. However, for rules such as packaging intrathecal (IT) medications differently from IV vincristine, over-wrapping IV vincristine with a special warning, administering IT medications before dispensing IV vincristine and providing the medical staff with related education and training, the compliance rates were <40%. The results also showed that the main related factors affecting standardised operations included the classification of the hospital, whether a Pharmacy Intravenous Admixture Service (PIVAS) was established and the type of medical orders. Establishment of a PIVAS did not demonstrate a significantly positive role in the implementation of vincristine safety measures. Conclusions This survey provides basic information about the adoption rate of safe medication practice recommendations related to vincristine administration in Shanghai. Further work addressing barriers in implementing identified safe practice recommendations should be conducted.
Differences in Regional Brain Responses to Food Ingestion After Roux-en-Y Gastric Bypass and the Role of Gut Peptides: A Neuroimaging Study

OBJECTIVE Improved appetite control, possibly mediated by exaggerated gut peptide responses to eating, may contribute to weight loss after Roux-en-Y gastric bypass (RYGB). This study compared brain responses to food ingestion between post-RYGB (RYGB), normal weight (NW), and obese (Ob) unoperated subjects and explored the role of gut peptide responses in RYGB. RESEARCH DESIGN AND METHODS Neuroimaging with [18F]-fluorodeoxyglucose (FDG) positron emission tomography was performed in 12 NW, 21 Ob, and 9 RYGB (18 ± 13 months postsurgery) subjects after an overnight fast, once FED (400 kcal mixed meal), and once FASTED, in random order. RYGB subjects repeated the studies with somatostatin infusion and basal insulin replacement. Fullness, sickness, and postscan ad libitum meal consumption were measured. Regional brain FDG uptake was compared using statistical parametric mapping. RESULTS RYGB subjects had higher overall fullness and food-induced sickness and lower ad libitum consumption. Brain responses to eating differed in the hypothalamus and pituitary (exaggerated activation in RYGB), left medial orbital cortex (OC) (activation in RYGB, deactivation in NW), right dorsolateral frontal cortex (deactivation in RYGB and NW, absent in Ob), and regions mapping to the default mode network (exaggerated deactivation in RYGB). Somatostatin in RYGB reduced postprandial gut peptide responses, sickness, and medial OC activation. CONCLUSIONS RYGB induces weight loss by augmenting normal brain responses to eating in energy balance regions, restoring lost inhibitory control, and altering hedonic responses. Altered postprandial gut peptide responses primarily mediate changes in food-induced sickness and OC responses, likely to associate with food avoidance.
HLA-A*24 Carrier Status and Autoantibody Surges Posttransplantation Associate With Poor Functional Outcome in Recipients of an Islet Allograft

OBJECTIVE We investigated whether changes in islet autoantibody profile and presence of HLA risk markers, reported to predict rapid β-cell loss in pre–type 1 diabetes, associate with poor functional outcome in islet allograft recipients. RESEARCH DESIGN AND METHODS Forty-one patients received ≥2.3 million β-cells/kg body wt in one to two intraportal implantations. Outcome after 6–18 months was assessed by C-peptide (random and stimulated), insulin dose, and HbA1c. RESULTS Patients carrying HLA-A*24-positive or experiencing a significant autoantibody surge within 6 months after the first transplantation (n = 19) had lower C-peptide levels (P ≤ 0.003) and higher insulin needs (P < 0.001) despite higher HbA1c levels (P ≤ 0.018). They became less often insulin independent (16% vs. 68%, P = 0.002) and remained less often C-peptide positive (47% vs. 100%, P < 0.001) than recipients lacking both risk factors. HLA-A*24 positivity or an autoantibody surge predicted insulin dependence (P = 0.007). CONCLUSIONS HLA-A*24 and early autoantibody surge after islet implantation associate with poor functional graft outcome.
Identification of Functional Immunological Indicators of Nutritional Status During Acute Nutritional Deprivation

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Relationships between physical qualities and key performance indicators during match-play in senior international rugby union players

The use of physical tests to profile physical capabilities, and provide training direction to athletes is common practice. Likewise, in professional team sports, notational analysis codes the key contributions of each player during competition. Limited studies have however investigated relationships between physical capabilities and key performance indicators (KPIs) of rugby union match-play. Elite professional players, categorised as forwards (n = 15) or backs (n = 14), from an international rugby union squad (n = 29) undertook assessments of isometric mid-thigh pull (IMTP), bilateral and unilateral countermovement jumps (CMJ) and drop jumps (DJ; from 40 and 20 cm, respectively), and assessment of acceleration (10 m), a 5 m weighted sled drive, and a Yo-Yo intermittent recovery test level 1 (Yo-Yo IRTL1). Game statistics of the same players from 92 matches (~23 matches per player) during the 2014–15 season were analysed for effort and performance-based metrics. For forwards, Yo-Yo IRTL1 correlated significantly with; number of tackles made (r = 0.717), first three players at a ruck in both attack (r = 0.568) and defence (r = 0.581), number of effective rucks (r = 0.630), total possessions (r = 0.522), passes made (r = 0.651), percentage of carries over the gainline (r = 0.610), effective ruck success (r = 0.600), tackle success (r = 0.540), and the number of turnovers made (r = 0.518). Drop jump performance in forwards was associated with; the number of clean breaks (r = 0.558), dominant collisions (r = 0.589), and offloads (r = 0.594). For backs, the sled-drive test correlated with; number of carries (r = -0.751), first three players at an attacking ruck (r = -0.613), effective attacking rucks (r = -0.584), number of dominant collisions (r = -0.792) and offloads (r = -0.814). Likewise, for backs, IMTP peak force was related to; the number of possessions (r = 0.793), passes made (r = 0.792), effective attacking ruck percentage (r = 0.628), and the number of offloads (r = 0.621) whilst relative peak force correlated with; the percentage of carries over the gainline (r = 0.533), percent tackle success (r = 0.603) and effective attacking ruck percentage (r = 0.584). Regression analyses highlighted that only a small number of variables (i.e., carries, tackles, attacking and defensive first three at ruck) returned practically achievable changes (<20%) in physical qualities. In spite of this, and while leaving scope identification of further physical and/or performance predictors, greater strength, power and intermittent running performance were positively related to match-derived KPIs during competition. This may provide a basis for better integrating the strategies used by physical and technical performance-focused coaching staff to improve key performance indicators, and thus match performance, of rugby union players.
Exhaled Breath Isoprene Rises During Hypoglycemia in Type 1 Diabetes

Hypoglycemia and/or fear of hypoglycemia are major challenges for many with type 1 diabetes (T1D), limiting ability to lower glycemia. Given anecdotal reports of domestic pets alerting owners to blood glucose changes, especially hypoglycemia (1), we hypothesized that volatile organic compounds (VOCs) in exhaled breath might change at low glucose. We studied eight female nonsmoking participants with T1D (aged 46 ± 5 years, diabetes duration 23 ± 7 years, none treated with statins) twice using a single-blinded, computer code–randomized crossover design. An independent research ethics committee approved studies in advance, and subjects provided written consent. Using a stepped insulin clamp (Actrapid; Novo Nordisk, Crawley, U.K.; 0.3 mU/kg/min increasing to 1.5 mU/kg/min), on one occasion (STEP), arterialized plasma glucose (Yellow Springs Instrument 2300 STAT Plus Analyzer) was raised sequentially (7.1 ± 0.8, 8.7 ± 0.4, and 10.7 ± 0.1 mmol/L) then lowered with higher insulin infusion to 4.3 ± 0.3 and 2.8 ± …
Indirect (implicit) and direct (explicit) self-esteem measures are virtually unrelated: A meta-analysis of the initial preference task

Background The initial preference task (IPT) is an implicit measure that has featured prominently in the literature and enjoys high popularity because it offers to provide an unobtrusive and objective assessment of self-esteem that is easy to administer. However, its use for self-esteem assessment may be limited because of weak associations with direct personality measures. Moreover, moderator effects of sample- and study-related variables need investigation to determine the value of IPT-based assessments of self-esteem. Methods Conventional and grey-literature database searches, as well as screening of reference lists of obtained articles, yielded a total of 105 independent healthy adult samples (N = 17,777) originating from 60 studies. Summary effect estimates and subgroup analyses for potential effect moderators (e.g., administration order, algorithm, rating type) were calculated by means of meta-analytic random- and mixed-effects models. Moreover, we accounted for potential influences of publication year, publication status (published vs. not), and participant sex in a weighted stepwise hierarchical multiple meta-regression. We tested for dissemination bias through six methods. Results There was no noteworthy correlation between IPT-based implicit and explicit self-esteem (r = .102), indicating conceptual independence of these two constructs. Effects were stronger when the B-algorithm was used for calculation of IPT-scores and the IPT was administered only once, whilst all other moderators did not show significant influences. Regression analyses revealed a somewhat stronger (albeit non-significant) effect for men. Moreover, there was no evidence for dissemination bias or a decline effect, although effects from published studies were numerically somewhat stronger than unpublished effects. Discussion We show that there is no noteworthy association between IPT-based implicit and explicit self-esteem, which is broadly consistent with dual-process models of implicit and explicit evaluations on the one hand, but also casts doubt on the suitability of the IPT for the assessment of implicit self-esteem on the other hand.
Microvascular and Macrovascular Disease and Risk for Major Peripheral Arterial Disease in Patients With Type 2 Diabetes

OBJECTIVE Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis in type 2 diabetes, but the relationship between other vascular diseases and PAD has been poorly investigated. We examined the impact of previous microvascular and macrovascular disease on the risk of major PAD in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS We analyzed 10,624 patients with type 2 diabetes free from baseline major PAD in the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) clinical trial. The primary composite outcome was major PAD defined as PAD-induced death, peripheral revascularization, lower-limb amputation, or chronic ulceration. The secondary end points were the PAD components considered separately. RESULTS Major PAD occurred in 620 (5.8%) participants during 5 years of follow-up. Baseline microvascular and macrovascular disease were both associated with subsequent risk of major PAD after adjustment for age, sex, region of origin, and randomized treatments. However, only microvascular disease remained significantly associated with PAD after further adjustment for established risk factors. The highest risk was observed in participants with a history of macroalbuminuria (hazard ratio 1.91 [95% CI 1.38–2.64], P < 0.0001) and retinal photocoagulation therapy (1.60 [1.11–2.32], P = 0.01). Baseline microvascular disease was also associated with a higher risk of chronic lower-limb ulceration (2.07 [1.56–2.75], P < 0.0001) and amputation (1.59 [1.15–2.22], P = 0.006), whereas baseline macrovascular disease was associated with a higher rate of angioplasty procedures (1.75 [1.13–2.73], P = 0.01). CONCLUSIONS Microvascular disease, particularly macroalbuminuria and retinal photocoagulation therapy, strongly predicts major PAD in patients with type 2 diabetes, but macrovascular disease does not.