bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Health Care Providers on the Development of Diabetes Complications
Authors: Zgibor Janice C. , Songer Thomas J. , Kelsey Sheryl F. , Drash Allan L. , Orchard Trevor J. 
Published: March 2007

OBJECTIVE—To quantify total diabetes care received (generalist or specialist) from diagnosis onward and its association with the incidence of diabetes complications in a representative cohort of patients with type 1 diabetes.
RESEARCH DESIGN AND METHODS—A total of 429 subjects from the Pittsburgh Epidemiology of Diabetes Complications Study, a prospective follow-up study of childhood-onset type 1 diabetic subjects first seen between 1986 and 1988 (mean age 28 years, mean duration 19 years), followed biennially for up to 10 years were studied. Specialist care was defined as care received from a board-certified endocrinologist, diabetologist, or diabetes clinic and quantified as the percent of diabetes duration spent in specialist care.
RESULTS—There was a significant trend for a higher incidence of neuropathy, overt nephropathy, and coronary artery disease with lower use of specialist care. Multivariate analyses controlling for diabetes duration, demographic characteristics, health care practices, and physiological risk factors demonstrated that higher past use of specialist care was found to be significantly protective against the development of overt nephropathy (risk ratio 0.43, 95% CI 0.21–0.88) and neuropathy (0.54, 0.35–0.83) and weakly protective against coronary artery disease (0.65, 0.37–1.1).
CONCLUSIONS—A higher proportion of diabetes duration spent in specialist care may result in delayed development of certain diabetes complications independent of other risk factors. This study thus supports the concept that the benefits of specialist care should be available to all patients with type 1 diabetes.
Evaluation of Conventional Blood Glucose Monitoring as an Indicator of Integrated Glucose Values Using a Continuous Subcutaneous Sensor
Authors: Zavalkoff Samara R. , Polychronakos Constantin 
Published: March 2007

OBJECTIVE—To use a portable continuous glucose monitoring system (CGMS) to evaluate how well the customary intermittent self-monitoring of blood glucose (SMBG) correlates with integrated values during the surrounding time periods in ambulatory patients with type 1 diabetes.
RESEARCH DESIGN AND METHODS—In the study, 18 young patients with type 1 diabetes were monitored with CGMS for up to 72 h, during which they continued to perform the four standard SMBG tests (preprandial and bedtime). Correlations were examined between each of the four standard SMBG tests and the mean CGMS values from defined periods that preceded and followed. We also tested how well a low bedtime SMBG predicted nocturnal hypoglycemia.
RESULTS—Strong correlations were found between 1) SMBG at breakfast and the mean CGMS value for the preceding 8 h (r = 0.7514), 2) SMBG at dinner and the CGMS from lunch to dinner (r = 0.7538), 3) SMBG at bedtime and the CGMS from dinner to bedtime (r = 0.8145), and 4) SMBG at bedtime and the CGMS from bedtime to breakfast (r = 0.6463). The remaining correlations were weak and not statistically significant. These correlations seem independent of insulin-delivery method as virtually identical results were obtained when data from patients on conventional versus intensive regimes were separately analyzed. A bedtime SMBG &lt;7 mmol/l did not predict nocturnal hypoglycemia (defined as at least one CGMS value &lt;3).
CONCLUSIONS—The breakfast and dinnertime SMBG values are good indicators of integrated glucose values in the time period preceding them, while the bedtime test correlates well with the integrated values both preceding and following it. This information should aid in the meaningful use of SMBG to evaluate glycemic control and make insulin dose adjustments.
Prevalence of Diabetes Is Higher Among Female than Male Zuni Indians
Authors: Scavini Marina , Stidley Christine A. , Shah Vallabh O. , Narva Andrew S. , Tentori Francesca , Kessler David S. , Bobelu Arlene , Albert Carleton P. , Bobelu Jeanette , Jamon Eunice , Natachu Kathy , Neha Donica , Waikaniwa Mildred , Welty Thomas K. , MacCluer Jean W. , Zager Philip G. 
Published: March 2007

OBJECTIVE—Test the hypothesis that diabetes and related risk factors are more common among female than male Zuni Indians.
RESEARCH DESIGN AND METHODS—We conducted a population-based, cross-sectional survey of the Zuni Indians aged ≥5 years. We used households within neighborhood clusters as the sampling frame. We administered a questionnaire, collected blood and urine, and measured height and weight. Self-reported diabetes was used to assess previously diagnosed diabetes. Participants without a prior history of diabetes were classified as having newly diagnosed diabetes if they had HbA1c &gt;7.0% or random glucose ≥11.1 mmol/l during the survey.
RESULTS—The prevalence of previously diagnosed diabetes among Zuni Indians aged ≥5 years (n = 1,503) was higher among female Zuni Indians (16.7% [95% CI 14.1–19.3]) than male Zuni Indians (9.7% [7.4–12.1]) (P &lt; 0.001). The prevalence of newly diagnosed diabetes was similar among female Zuni Indians (2.4% [1.4–3.4]) and male Zuni Indians (2.4% [1.2–3.6]). The prevalence of previously and newly diagnosed diabetes was higher among female Zuni Indians (19.1% [16.4–21.9]) than male Zuni Indians (12.2% [9.5–14.8]) (P &lt; 0.001). The prevalence of obesity was higher among female Zuni Indians (34.3% [30.9–37.7]) than male Zuni Indians (21.5% [18.4–24.7]) (P &lt; 0.001). Obesity was associated with diabetes among female and male Zuni Indians. Physical inactivity was more common among female Zuni Indians (44.2% [40.7–47.8]) than male Zuni Indians (35.1% [31.5–38.7]) (P &lt; 0.001). However, physical inactivity was not associated with diabetes among either female or male Zuni Indians. Gestational diabetes was a risk factor among female Zuni Indians.
CONCLUSIONS—Among the Zuni Indians, the prevalence of diabetes was 57% higher among female than male members of the population. Culture, tradition, and lifestyle differences may contribute to the higher prevalence of diabetes and obesity among female Zuni Indians.
Alcohol Consumption and the Incidence of Type 2 Diabetes
Authors: Carlsson Sofia , Hammar Niklas , Grill Valdemar , Kaprio Jaakko 
Published: March 2007

OBJECTIVE—The aim of this study was to investigate alcohol consumption in relation to the incidence of type 2 diabetes.
RESEARCH DESIGN AND METHODS—The study population consisted of 22,778 twins of the Finnish Twin Cohort. This cohort was compiled in 1975 and includes all same-sexed twins born in Finland before 1958. Information on alcohol, smoking, diet, physical activity, medical, and social conditions was obtained by questionnaires administered in 1975, 1981, and 1990. By record linkage to national registers of hospital discharge and prescribed medication, 580 incident cases of type 2 diabetes were identified during 20 years of follow-up.
RESULTS—Moderate alcohol consumption (5–29.9 g/day in men and 5–19.9 g/day in women) tended to be associated with a reduced incidence of type 2 diabetes compared with low consumption (&lt;5 g/day). The estimates were lower in overweight (BMI ≥25.0 kg/m2) subjects (relative risk 0.7, 95% CI 0.5–1.0 [men]; 0.6, 0.3–1.1 [women]). High alcohol consumption (≥20 g/day) was associated with an increased incidence of type 2 diabetes in lean women (2.9, 1.1–7.5) but not in overweight women or in men. In women, binge drinking was associated with an increased incidence of type 2 diabetes (2.1, 1.0–4.4). Analyses of alcohol-discordant twin pairs supported a reduced risk in moderate consuming twins compared with their low-consuming cotwins (odds ratio 0.5, 95% CI 0.2–1.5).
CONCLUSIONS—The results of this study suggested that moderate alcohol consumption may reduce the risk of type 2 diabetes. On the other hand, binge drinking and high alcohol consumption may increase the risk of type 2 diabetes in women.
Signs of Nephropathy May Occur Early in Young Adults With Diabetes Despite Modern Diabetes Management
Authors: Svensson Maria , Sundkvist Göran , Arnqvist Hans J. , Björk Elisabeth , Blohmé Göran , Bolinder Jan , Henricsson Marianne , Nyström Lennarth , Torffvit Ole , Waernbaum Ingeborg , Östman Jan , Eriksson Jan W. 
Published: March 2007

OBJECTIVE—To estimate the occurrence of early-onset renal involvement in a nationwide population-based cohort of young adults with diabetes in Sweden and relate the findings to glycemic control, type of diabetes, sex, smoking, and blood pressure.
RESEARCH DESIGN AND METHODS—The Diabetes Incidence Study in Sweden aims to register all incident cases of diabetes in the age-group 15–34 years. In 1987–1988, 806 patients were reported and invited to participate in a follow-up study focusing on microvascular complications. Of them, 469 subjects participated. The assessment was based on questionnaires (n = 469), blood samples (n = 424), urine samples (n = 251) and, when appropriate, medical records (n = 186).
RESULTS—During the follow-up time, median 9 years (range 6–12), 31 of 469 patients (6.6%) with incipient or overt diabetic nephropathy (i.e., micro- or macroalbuminuria) were found, 24 of 426 (5.6%) in type 1 and 7 of 43 (16%) in type 2 diabetic subjects (P = 0.016). Additionally, 24 of 31 patients (77%) had microalbuminuria and 7 (23%) had macroalbuminuria, which mainly occurred in patients with type 2 diabetes. In a Cox regression analysis, high mean HbA1c during the follow-up period and high blood pressure at follow-up increased the risk of developing signs of nephropathy (P = 0.020 and P = 0.003, respectively). Compared with patients with type 1 diabetes, those with type 2 diabetes tended to have an increased risk of renal involvement (P = 0.054) when adjusting for sex, tobacco use, glycemic control, and blood pressure.
CONCLUSIONS—Despite modern treatment and self-monitoring of blood glucose, young adult patients with diabetes may still develop renal involvement during the first 10 years of diabetes duration. Inadequate HbA1c, high blood pressure, and type 2 diabetes appear to be risk markers for early occurrence of diabetic nephropathy.
Diabetes Is Associated With Subclinical Functional Limitation in Nondisabled Older Individuals
Authors: de Rekeneire Nathalie , Resnick Helaine E. , Schwartz Ann V. , Shorr Ronald I. , Kuller Lewis H. , Simonsick Eleanor M. , Vellas Bruno , Harris Tamara B. 
Published: March 2007

OBJECTIVE—The aim of this study was to examine the role of comorbid conditions and body composition in the association between diabetes and subclinical functional limitation, an indication of early functional decline, in well-functioning older individuals.
RESEARCH DESIGN AND METHODS—This was a cross-sectional analysis of 3,075 well-functioning black and white men and women aged 70–79 years, enrolled in the Health, Aging, and Body Composition study. Diabetes was defined by self-report and/or hypoglycemic medication use or fasting glucose ≥126 mg/dl. Subclinical functional limitation was defined using self-report of capacity and objective performance measures. Comorbid conditions were identified by self-reported diagnoses, medication use, and clinical measures. Body composition measures included anthropometry and total fat (dual X-ray absorptiometry).
RESULTS—Of 2,926 participants, 1,252 (42.8%) had subclinical functional limitation at baseline. Among 2,370 individuals without diabetes, 40% had subclinical functional limitation, whereas the prevalence was 53% among the 556 diabetic participants with an age/sex/race-adjusted odds ratio (OR) 1.70 (95% CI 1.40–2.06). This association remained significant when adjusted for body composition measures (OR 1.54 [1.26–1.88]), diabetes-related comorbidities, and other potential confounders (OR 1.40 [1.14–1.73]). In the fully adjusted model, consideration of HbA1c (&lt; or ≥7%) and diabetes duration showed that poor glycemic control in diabetic individuals explained the association with subclinical functional limitation.
CONCLUSIONS—In a well-functioning older population, diabetes is associated with early indicators of functional decline, even after accounting for body composition and diabetes-related comorbidities. Poor glycemic control contributes to this relationship. Whether improvement in glycemic control in older people with diabetes would change this association should be tested.
Atorvastatin Dose-Dependently Decreases Hepatic Lipase Activity in Type 2 Diabetes
Authors: Berk-Planken Ingrid I.L. , Hoogerbrugge Nicoline , Stolk Ronald P. , Bootsma Aart H. , Jansen Hans ,   on behalf of the DALI study group
Published: March 2007

OBJECTIVE—Hepatic lipase (HL) is involved in the metabolism of several lipoproteins and may contribute to the atherogenic lipid profile in type 2 diabetes. Little is known about the effect of cholesterol synthesis inhibitors on HL activity in relation to sex and the hepatic lipase gene, the LIPC promoter variant in type 2 diabetes. Therefore, we studied the effect of atorvastatin 10 mg (A10) and 80 mg (A80) on HL activity in 198 patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—Patients (aged 45–75 years, without manifest coronary artery disease, total cholesterol 4.0–8.0 mmol/l, and fasting triglycerides [TG] 1.5–6.0 mmol/l) were included in a double-blind, randomized, placebo-controlled trial for 30 weeks (Diabetes Atorvastatin Lipid Intervention study).
RESULTS—HL activity at baseline was significantly higher in our population compared with an age-matched control group without type 2 diabetes (406 ± 150 vs. 357 ± 118 units/l). HL activity in men versus women (443 ± 158 vs. 358 ± 127 units/l), in carriers of the LIPC C/C allele versus carriers of the T/T allele (444 ± 142 vs. 227 ± 96 units/l), and in Caucasians versus blacks (415 ± 150 vs. 260 ± 127 units/l) all differed significantly (P &lt; 0.001). Atorvastatin dose-dependently decreased HL (A10, −11%; A80, −22%; both P &lt; 0.001). Neither sex nor the LIPC C→T variation influenced the effect of atorvastatin on HL activity.
CONCLUSIONS—Sex, LIPC promoter variant, and ethnicity significantly contribute to the baseline variance in HL activity. Atorvastatin treatment in diabetic dyslipidemia results in a significant dose-dependent decrease in HL activity, regardless of sex or the LIPC promoter variant.
Insulin Detemir Is Associated With More Predictable Glycemic Control and Reduced Risk of Hypoglycemia Than NPH Insulin in Patients With Type 1 Diabetes on a Basal-Bolus Regimen With Premeal Insulin Aspart
Authors: Vague Philippe , Selam Jean-Louis , Skeie Svein , De Leeuw Ivo , Elte Jan W.F. , Haahr Hanne , Kristensen Allan , Draeger Eberhard 
Published: March 2007

OBJECTIVE—Insulin detemir is a soluble basal insulin analog with a unique mechanism of protracted action designed to reduce the variability associated with conventional basal insulins. This trial compared the glycemic control, risk of hypoglycemia, and effect on body weight of insulin detemir and NPH insulin in patients with type 1 diabetes treated with rapid-acting insulin aspart at meals.
RESEARCH DESIGN AND METHODS—This study was a 6-month multinational open parallel-group comparison conducted at 46 centers in five countries and included 448 patients with type 1 diabetes randomized 2:1 to insulin detemir or NPH insulin, respectively.
RESULTS—After 6 months, comparable HbA1c levels were found between the two treatment groups. Fasting plasma glucose tended to be lower in patients treated with insulin detemir, but this difference was not statistically significant (−0.76 mmol/l, P = 0.097). Within-subject variation in self-measured fasting blood glucose was lower with insulin detemir than with NPH insulin (SD 3.37 vs. 3.78 mmol/l, P &lt; 0.001). Risk of hypoglycemia was 22% lower with insulin detemir than with NPH insulin (P &lt; 0.05) and 34% lower for nocturnal (2300–0600) hypoglycemia (P &lt; 0.005). Nightly plasma glucose profiles were smoother and more stable with insulin detemir (P = 0.05). Body weight was significantly lower with insulin detemir at the end of the trial (P &lt; 0.001).
CONCLUSIONS—Treatment with insulin detemir resulted in more predictable glycemic control, with smoother plasma glucose profiles than NPH insulin and a significant reduction in the risk of hypoglycemia. The reduction in body weight with insulin detemir is a potential additional advantage. Regimens optimized for insulin detemir may be able to improve glycemic control beyond that possible with NPH insulin.
Incidence of Type 1 Diabetes in Lithuanians Aged 0–39 Years Varies by the Urban-Rural Setting, and the Time Change Differs for Men and Women During 1991–2000
Authors: Pundziute-Lyckå Auste , Urbonaite Brone , Ostrauskas Rytas , Zalinkevicius Rimas , Dahlquist Gisela G. 
Published: March 2007

OBJECTIVE—Type 1 diabetes has been associated with factors related to welfare and social class. During the past decade, Lithuania has experienced a transition period, leading to dramatic changes in the socioeconomic structure of the society.
RESEARCH DESIGN AND METHODS—Incidence in the group aged 0–39 years by urban-rural setting (cities &gt;100,000 inhabitants, towns, and rural areas), period (1991–1995 and 1996–2000), age, and sex were studied using Poisson regression.
RESULTS—The age- and sex-standardized incidence per 100,000 inhabitants per year was higher in men aged 0–39 years than in women (9.5 and 6.9, respectively, incidence rate ratio [IRR] = 1.39, P &lt; 0.001). Incidence was lower in rural areas than in towns and cities (7.1, 9.0, and 8.8, respectively, P &lt; 0.001). The urban-rural differences in incidence were most marked among children aged 0–9 years. From 1991–1995 to 1996–2000, the overall incidence increased from 8.7 to 10.5 (IRR = 1.22, P = 0.001) in men and from 6.2 to 7.8 (IRR = 1.25, P = 0.002) in women. For men, the increase over time occurred predominantly in the cities, from 8.4 to 11.8 (IRR = 1.40, P &lt; 0.001), and in the older age-groups. In contrast, for women, the incidence increased more in small towns and rural areas, from 5.8 to 7.7 (IRR = 1.33, P = 0.003), and in the younger age-groups.
CONCLUSIONS—The incidence of type 1 diabetes in Lithuania differs depending on the urban-rural setting, and the pattern of change over time differs between the sexes, both by urban-rural setting and age-group. The findings support the theory that lifestyle-related factors connected to socioeconomic status are important for the occurrence of type 1 diabetes.
The Confidence in Diabetes Self-Care Scale
Authors: van der Ven Nicole C.W. , Weinger Katie , Yi Joyce , Pouwer Frans , Adèr Herman , van der Ploeg Henk M. , Snoek Frank J. 
Published: March 2007

OBJECTIVE—To examine psychometric properties of the Confidence in Diabetes Self-Care (CIDS) scale, a newly developed instrument assessing diabetes-specific self-efficacy in Dutch and U.S. patients with type 1 diabetes.
RESEARCH DESIGN AND METHODS—Reliability and validity of the CIDS scale were evaluated in Dutch (n = 151) and U.S. (n = 190) outpatients with type 1 diabetes. In addition to the CIDS scale, assessment included HbA1c, emotional distress, fear of hypoglycemia, self-esteem, anxiety, depression, and self-care behavior. The Dutch sample completed additional measures on perceived burden and importance of self-care. Test-retest reliability was established in a second Dutch sample (n = 62).
RESULTS—Internal consistency (Cronbach’s α = 0.86 for Dutch patients and 0.90 U.S. patients) and test-retest reliability (Spearman’s r = 0.85, P &lt; 0.0001) of the CIDS scale were high. Exploratory factor analysis showed one strong general factor. Spearman’s correlations between the CIDS scale and other measures were moderate and in the expected directions, and high HbA1c levels were associated with low CIDS scores in the U.S. sample only. Low CIDS scores were positively associated with self-care but not with glycemic control in the original samples. CIDS scores in the U.S. and Dutch samples did not show any statistically significant differences. U.S. men had higher CIDS scores than U.S. women.
CONCLUSIONS—The CIDS scale is a reliable and valid measure of diabetes-specific self-efficacy for use in patients with type 1 diabetes. High psychometric similarity allows for cross-cultural comparisons.
Changes in Diabetes Self-Care Behaviors Make a Difference in Glycemic Control
Authors: Jones Helen , Edwards Lynn , Vallis T. Michael , Ruggiero Laurie , Rossi Susan R. , Rossi Joseph S. , Greene Geoffrey , Prochaska James O. , Zinman Bernard 
Published: March 2007

OBJECTIVE—This study compared diabetes Treatment As Usual (TAU) with Pathways To Change (PTC), an intervention developed from the Transtheoretical Model of Change (TTM), to determine whether the PTC intervention would result in greater readiness to change, greater increases in self-care, and improved diabetes control.
RESEARCH DESIGN AND METHODS—Participants were stratified by diabetes treatment and randomized to treatment with PTC or TAU as well as being randomized regarding receipt of free blood testing strips. The PTC consisted of stage-matched personalized assessment reports, self-help manuals, newsletters, and individual phone counseling designed to improve readiness for self-monitoring of blood glucose (SMBG), healthy eating, and/or smoking cessation. A total of 1,029 individuals with type 1 and type 2 diabetes who were in one of three pre-action stages for either SMBG, healthy eating, or smoking were recruited.
RESULTS—For the SMBG intervention, 43.4% of those receiving PTC plus strips moved to an action stage, as well as 30.5% of those receiving PTC alone, 27.0% of those receiving TAU plus strips, and 18.4% of those receiving TAU alone (P &lt; 0.001). For the healthy eating intervention, more participants who received PTC than TAU (32.5 vs. 25.8%) moved to action or maintenance (P &lt; 0.001). For the smoking intervention, more participants receiving PTC (24.3%) than TAU (13.4%) moved to an action stage (P &lt; 0.03). In intention-to-treat (ITT) analysis of those receiving the SMBG intervention, PTC resulted in a greater reduction of HbA1c than TAU, but this did not reach statistical significance. However, in those who moved to an action stage for the SMBG and healthy eating interventions, HbA1c was significantly reduced (P &lt; 0 0.001). Individuals who received the healthy eating intervention decreased their percentage of calories from fat to a greater extent (35.2 vs. 36.1%, P = 0.004), increased servings of fruit per day (1.89 vs. 1.68, P = 0.016), and increased vegetable servings (2.24 vs. 2.06, P = 0.011) but did not decrease weight. However, weight loss for individuals who received the healthy eating intervention and who increased SMBG frequency as recommended was significantly greater, with a 0.26-kg loss in those who remained in a pre-action SMBG stage but a 1.78-kg loss in those performed SMBG as recommended (P ≤ 0. 01).
CONCLUSIONS—This study demonstrates that this intervention has the potential of positively impacting the health of broad populations of individuals with diabetes, not just the minority who are ready for change.