bluuebunny/crossref_metadata_2025_split huggingface dataset:
Weight Control Practices and Disordered Eating Behaviors Among Adolescent Females and Males With Type 1 Diabetes
Authors: Neumark-Sztainer Dianne , Patterson Joan , Mellin Alison , Ackard Diann M. , Utter Jennifer , Story Mary , Sockalosky Joseph 
Published: March 2007

OBJECTIVE—This study examines the prevalence of specific weight control practices/disordered eating behaviors and associations with sociodemographic characteristics, BMI and weight perceptions, family functioning, and metabolic control among adolescent females and males with type 1 diabetes.
RESEARCH DESIGN AND METHODS—The study population included 70 adolescent females and 73 adolescent males with type 1 diabetes who completed the AHEAD (Assessing Health and Eating among Adolescents with Diabetes) survey. Data on BMI and glycosylated hemoglobin (HbA1c) were drawn from medical records.
RESULTS—Unhealthy weight control practices were reported by 37.9% of the females and by 15.9% of the males. Among the females, 10.3% reported skipping insulin and 7.4% reported taking less insulin to control their weight. Only one male reported doing either of these behaviors. Weight control/disordered eating behaviors were not associated with age, parental level of education, family structure, or race/ethnicity. Higher levels of weight dissatisfaction tended to be associated with unhealthy weight control/disordered eating; associations with BMI were inconsistent. Family cohesion was negatively associated with disordered eating among females (r = −0.52; P &lt; 0.001) and males (r = −0.41; P &lt; 0.001), but correlations with other measures of family environment (control, independence, and responsibility for diabetes management) were not significant. Correlations between disordered eating and HbA1c levels were significant among females (r = 0.33; P &lt; 0.01) and males (r = 0.26; P &lt; 0.05).
CONCLUSIONS—Special attention is needed for youth with weight concerns and those from less cohesive families to assist in the development of healthy diabetes management behaviors.
Blood Pressure, Lipids, and Obesity Are Associated With Retinopathy
Authors: van Leiden Hendrik A. , Dekker Jacqueline M. , Moll Annette C. , Nijpels Giel , Heine Robert J. , Bouter Lex M. , Stehouwer Coen D.A. , Polak Bettine C.P. 
Published: March 2007

OBJECTIVE—To study potential risk factors for retinopathy in diabetic and nondiabetic individuals.
RESEARCH DESIGN AND METHODS—The Hoorn Study is a population-based study including 2,484 50- to 74-year-old Caucasians. A subsample of 626 individuals stratified by age, sex, and glucose tolerance underwent extensive measurements during 1989–1992, including ophthalmologic examination and two-field 45-degree fundus photography. The prevalence of (diabetic) retinopathy was assessed among individuals with normal glucose metabolism (NGM) and impaired glucose metabolism (IGM) and individuals with newly diagnosed diabetes mellitus (NDM) and known diabetes mellitus (KDM) (new World Health Organization 1999 criteria).
RESULTS—The prevalence of retinopathy was 9% in NGM, 11% in IGM, 13% in NDM, and 34% in KDM. Retinopathy worse than minimal nonproliferative diabetic retinopathy was present in 8% in KDM and 0–2% in other glucose categories. The prevalence of retinopathy was positively associated with elevated blood pressure, BMI, cholesterol, and triglyceride serum levels in all glucose categories. The age-, sex-, and glucose metabolism category–adjusted odds ratios were 1.5 (95% CI 1.2–1.9), 1.3 (1.0–1.7), and 1.3 (1.0–1.6) per SD increase of systolic blood pressure, BMI, and total cholesterol concentration, respectively, and 1.2 (1.0–1.5) per 50% increase of triglyceride level. Elevated blood pressure and plasma total and LDL cholesterol levels showed associations with retinal hard exudates.
CONCLUSIONS—Retinopathy is a multifactorial microvascular complication, which, apart from hyperglycemia, is associated with blood pressure, lipid concentrations, and BMI.
Elevated C-Reactive Protein Associates With Early-Stage Carotid Atherosclerosis in Young Subjects With Type 1 Diabetes
Authors: Hayaishi-Okano Rieko , Yamasaki Yoshimitsu , Katakami Naoto , Ohtoshi Kentaro , Gorogawa Shin-Ichi , Kuroda Akio , Matsuhisa Munehide , Kosugi Keisuke , Nishikawa Norikiyo , Kajimoto Yoshitaka , Hori Masatsugu 
Published: March 2007

OBJECTIVE—To evaluate whether low-grade inflammation contributes to early-stage advanced carotid atherosclerosis in young subjects with type 1 diabetes.
RESEARCH DESIGN AND METHODS—The mean and maximum (max) intima-media thicknesses (IMT) of the carotid artery were assessed using ultrasound B-mode imaging in 55 patients with type 1 diabetes (22 men and 33 women, aged 22.1 ± 3.6 years (± SD), duration of diabetes 14.2 ± 5.7 years) and 75 age-matched healthy nondiabetic subjects (28 men and 47 women). High-sensitive C-reactive protein (hs-CRP) levels were measured with a latex-enhanced immunonephelometer.
RESULTS—The patients with type 1 diabetes had significantly higher hs-CRP levels (median 0.35, range 0.05–1.47 mg/l vs. median 0.14, range 0.05–1.44 mg/l; P = 0.001) as well as significantly higher mean IMT and max IMT than the nondiabetic subjects (mean IMT 0.76 ± 0.09 vs. 0.72 ± 0.04 mm, P = 0.003; max IMT 0.84 ± 0.11 vs. 0.77 ± 0.06 mm, P &lt; 0.0001). Hs-CRP levels were significantly correlated with the mean and max IMT of patients with type 1 diabetes and with the max IMT of nondiabetic patients. Multivariate regression analyses for both diabetic and nondiabetic subjects as a single group showed that hs-CRP levels are independently correlated with the mean IMT and max IMT levels (P = 0.002 and P = 0.023, respectively) as well as with diastolic blood pressure, sex, and duration of diabetes.
CONCLUSIONS—Our data indicate that hs-CRP levels are elevated in young patients with type 1 diabetes, possibly corresponding with early-stage advanced carotid atherosclerosis.
Intrarenal Hemodynamic Changes After Captopril Test in Patients With Type 2 Diabetes
Authors: Taniwaki Hiromichi , Ishimura Eiji , Kawagishi Takahiko , Matsumoto Naoki , Hosoi Masayuki , Emoto Masanori , Shoji Tetsuo , Shoji Shigeichi , Nakatani Tatsuya , Inaba Masaaki , Nishizawa Yoshiki 
Published: March 2007

OBJECTIVE—ACE inhibitors are known to be effective in preventing the progression of diabetic nephropathy. Activation of the renin-angiotensin system (RAS) is reported to contribute to intrarenal hemodynamic abnormality in diabetic patients. We examined whether RAS blockade by captopril induces intrarenal hemodynamic changes in normotensive patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—The patients ranged in age from 40 to 65 years (20 men and 20 women). A total of 15 age- and sex-matched healthy individuals served as control subjects. Resistive index (RI) of interlobar arteries was examined by duplex Doppler sonography before and after the oral captopril (25 mg) test.
RESULTS—At baseline, no significant differences in RI values or plasma renin activity (PRA) were seen between the patients and healthy subjects. In healthy subjects, the RI values after the captopril test were significantly higher than baseline values (P &lt; 0.01). However, in patients with type 2 diabetes, both with normoalbuminuria and microalbuminuria, RI values after the test were significantly lower than baseline values (P &lt; 0.001). There were significant negative correlations between ΔRI value and HbA1c (r = −0.458, P &lt; 0.005) and between ΔRI value and baseline PRA in diabetic patients (r = −0.339, P &lt; 0.05). Multiple regression analysis showed that HbA1c and baseline PRA significantly and independently affected the magnitude of decrease in RI values after captopril administration in diabetic patients (R2 = 0.391, P &lt; 0.0001).
CONCLUSIONS—These results indicate that the intrarenal RAS may be activated in diabetic patients, that such activation may be affected by poor glycemic control, and that blockade of RAS activation by ACE inhibitor reduces intrarenal vascular resistance in diabetic patients. The results emphasize the beneficial effects of ACE inhibition in improving intrarenal hemodynamics in diabetic patients.
Non-HDL Cholesterol as a Predictor of Cardiovascular Disease in Type 2 Diabetes
Authors: Lu Weiquan , Resnick Helaine E. , Jablonski Kathleen A. , Jones Kristina L. , Jain Arvind K. , Howard Wm. James , Robbins David C. , Howard Barbara V. 
Published: March 2007

OBJECTIVE—To determine whether non-HDL cholesterol, a measure of total cholesterol minus HDL cholesterol, is a predictor of CVD in patients with diabetes.
RESEARCH DESIGN AND METHODS—The Strong Heart Study, a population-based study of CVD and its risk factors in 13 American Indian communities in three geographic areas in the U.S. The baseline examination, conducted between July 1989 and January 1992, consisted of a personal interview, a physical examination, and laboratory tests. Of the 4,549 women and men aged 45−74 years participating in the study, 2,108 had diabetes but no CVD at baseline. Data on fatal and nonfatal CVD were collected during the follow-up period through 31 December 1998 (average 9 years).
RESULTS—Multivariable analyses indicated that non-HDL cholesterol is a strong predictor of CVD in men and women with diabetes and is particularly indicative of coronary events. Hazard ratios for the highest tertile of non-HDL cholesterol in men and women with diabetes (2.23 and 1.80, respectively) were higher than those for either LDL cholesterol or triglycerides alone in both men and women and were higher than the ratio of total/HDL cholesterol in women. The utility of non-HDL cholesterol in predicting CVD extended over a wide range of triglyceride concentrations.
CONCLUSIONS—This study suggests that non-HDL cholesterol index may be particularly useful in predicting CVD risk in patients with diabetes.
Comparison of an Insulin Analog, Insulin Aspart, and Regular Human Insulin With No Insulin in Gestational Diabetes Mellitus
Authors: Pettitt David J. , Ospina Paulina , Kolaczynski Jerzey W. , Jovanovic Lois 
Published: March 2007

OBJECTIVE—To assess the short-term efficacy of insulin aspart in comparison with regular human insulin in women with gestational diabetes mellitus (GDM) during standardized meal tests.
RESEARCH DESIGN AND METHODS—The study included 15 women with GDM who had inadequate diabetes control with diet alone. On 3 consecutive days, breakfast meal tests were performed—the first with no exogenous insulin and the other two after the injection of either regular insulin or insulin aspart.
RESULTS—The peak insulin concentration was higher and the peak glucose and C-peptide concentrations were lower with both insulin preparations than with no exogenous insulin. Glucose areas under the curve above baseline were significantly lower with insulin aspart (180-min area, 7.1 mg · h · dl−1; P = 0.018), but not with regular insulin (30.2 mg · h · dl−1; P = 0.997), than with no insulin (29.4 mg · h · dl−1).
CONCLUSIONS—This study demonstrates that effective postprandial glycemic control in women with GDM who required insulin was brought about by insulin aspart through higher insulin peak and lower demand on endogenous insulin secretion.
A Cross-Sectional Study of the Effects of Type 2 Diabetes and Other Cardiovascular Risk Factors on Structure and Function of Nonstenotic Arteries of the Lower Limb
Authors: O’Neal David N. , Dragicevic George , Rowley Kevin G. , Ansari Mohamed Z. , Balazs Nicholas , Jenkins Alicia , Best James D. 
Published: March 2007

OBJECTIVE—To compare intimal-medial thickness (IMT) and pulse wave conduction velocity (PWCV) in unstenosed arteries of the lower limb in subjects with and without type 2 diabetes and to determine the contribution of a range of cardiovascular risk factors.
RESEARCH DESIGN AND METHODS—IMT and PWCV were determined in lower-limb arteries of 79 subjects with diabetes and 77 euglycemic subjects. Plasma lipids were determined by enzymatic assays, and LDL particle size was measured by gradient gel electrophoresis. Lag time for copper-induced oxidation of LDL was determined. α-Tocopherol, retinol, and ascorbate levels were determined by high-performance liquid chromatography, soluble E-selectin by enzyme-linked immunosorbent assay, and fibrinogen and factor VII by automated assays.
RESULTS—Subjects with diabetes had greater superficial femoral artery (SFA) IMT, popliteal artery (PA) IMT, and SFA PWCV (all P &lt; 0.0001). In univariate analysis, IMT and PWCV correlated with increased waist-to-hip ratio, triglycerides, and fibrinogen and inversely with HDL cholesterol and LDL size. Ascorbate was inversely associated with IMT, and LDL lag time was inversely correlated with PWCV. Subjects with the greatest number of features of the metabolic syndrome had the highest IMT and PWCV.
CONCLUSIONS—Adverse changes in the structure and function of unstenosed lower-limb arteries are present in type 2 diabetes and are associated with features of the metabolic syndrome.
Effect of Leptin Replacement on Intrahepatic and Intramyocellular Lipid Content in Patients With Generalized Lipodystrophy
Authors: Simha Vinaya , Szczepaniak Lidia S. , Wagner Anthony J. , DePaoli Alex M. , Garg Abhimanyu 
Published: March 2007

OBJECTIVE—To investigate whether leptin-induced improvements in glycemic control, hyperlipidemia, and insulin sensitivity in hypoleptinemic patients with generalized lipodystrophies are accompanied by reduction in intrahepatic and intramyocellular lipid (IMCL) accumulation.RESEARCH DESIGN AND METHODS—We examined the effects 8–10 months of subcutaneous leptin replacement therapy on insulin sensitivity, IMCL, and intrahepatic lipid content in two patients with acquired generalized lipodystrophy and one patient with congenital generalized lipodystrophy. All patients had extreme lack of body fat, low plasma leptin levels, and elevated serum triglycerides, but only two had diabetes. Insulin sensitivity was measured by a high-dose (0.2 IU/kg) insulin tolerance test, as well as by hyperinsulinemic-euglycemic glucose clamp studies in two patients. IMCL and intrahepatic lipid content were measured by 1H magnetic resonance spectroscopy. All measurements were obtained before and during 2–10 months of leptin therapy.RESULTS—Glycemic control and lipoprotein levels markedly improved with leptin therapy in the two diabetic patients, and a slight improvement in lipoprotein levels was seen in the nondiabetic patients. Insulin stimulated glucose uptake during 60–120 min of the euglycemic clamp studies, and the rate of glucose disappearance during the insulin tolerance test nearly doubled with leptin therapy. As compared with the baseline period, after 8–10 months of leptin therapy, the mean intrahepatic lipid content was reduced by ∼80% and the IMCL content was reduced by ∼42%.CONCLUSIONS—Reduction in IMCL and intrahepatic lipid content may partly explain leptin-induced improvement in insulin sensitivity in patients with generalized lipodystrophy.
Life Course Influences on Insulin Resistance
Authors: Lawlor Debbie A. , Davey Smith George , Ebrahim Shah 
Published: March 2007

OBJECTIVE—To assess the independent associations of a broad range of early life risk factors and adult obesity with adult insulin resistance.
RESEARCH DESIGN AND METHODS—This was a cross-sectional study of 1,394 women, aged 60–79 years, from 23 British towns.
RESULTS—There was a strong (independent of confounding factors, other early life factors, and adult waist-to-hip ratio) inverse association between birth weight and insulin resistance in women in the highest third of BMI (&gt;28.77 kg/m2): −0.12 (95% CI −0.19 to −0.04) log homeostasis model assessment (HOMA) score per 1 SD birth weight, but no association between birth weight and insulin resistance in women in the two lowest thirds of BMI (P for interaction = 0.04). Offspring birth weight, own leg length, and childhood manual social class did not interact with adult obesity and were all independently inversely associated with insulin resistance: −0.05 (−0.09 to −0.01) log HOMA score per 1 SD offspring birth weight, −0.09 (−0.12 to −0.06) log HOMA score per 1 SD leg length, and a −0.07 (−0.14 to 0.00) difference in log HOMA score between manual and nonmanual childhood social class. Childhood manual social class and shorter leg length were both independently associated with adverse lipid profiles. BMI and waist-to-hip ratio were independently positively associated with insulin resistance and with all other components of the insulin resistance syndrome.
CONCLUSIONS—Insulin resistance is an important risk factor for type 2 diabetes and coronary heart disease. Our results suggest that genetic factors, intrauterine environment, early childhood, and adult environmental factors are all relevant in determining adult insulin resistance.
Diabetes, Insulin Resistance, and the Metabolic Syndrome in Patients With Acute Myocardial Infarction Without Previously Known Diabetes
Authors: Tenerz Åke , Norhammar Anna , Silveira Angela , Hamsten Anders , Nilsson Göran , Rydén Lars , Malmberg Klas 
Published: March 2007

OBJECTIVE—Individuals with diabetes have an increased morbidity from acute myocardial infarction (AMI). Based on an oral glucose tolerance test (OGTT), 40–45% of patients with AMI have diabetes. The objective of this study was to characterize the glucometabolic profile of patients with AMI without known diabetes and to see if sustained glucometabolic perturbations are predictable during the hospital phase of the disease.
RESEARCH DESIGN AND METHODS—A total of 145 patients with AMI and no previous diagnosis of diabetes were subjected to an OGTT at hospital discharge and 3 months thereafter. Based on the OGTT after 3 months, they were defined as having normal glucose tolerance (NGT; n = 50), impaired glucose tolerance (IGT; n = 59), or diabetes (n = 36). Components of the metabolic syndrome, including insulin resistance assessed by homeostasis model assessment (HOMA-IR), were recorded.
RESULTS—Patients with AMI had no changes in insulin resistance from hospital discharge to follow-up. An OGTT and/or a single blood glucose taken 60 min (BG-60) after ingestion of 75 g glucose at hospital discharge were predictors of the outcome of the OGTT at follow-up. With a cutoff value for BG-60 of 8.6 mmol/l, 70% of the patients were correctly predicted as either belonging to the NGT group or the IGT/diabetes group after 3 months. Age, BMI, antihypertensive treatment, HbA1c, fasting blood glucose, blood lipids, insulin, proinsulin, HOMA-IR, and plasminogen activator inhibitor 1 did not add predictive power.
CONCLUSIONS—Patients with AMI and no previous diagnosis of diabetes have no changes in insulin resistance from hospital discharge to a 3-month follow-up. An OGTT or a single BG-60 performed at hospital discharge predicts the diagnosis of IGT or diabetes 3 months thereafter.
Testing the Accelerator Hypothesis
Authors: Kibirige M. , Metcalf B. , Renuka R. , Wilkin T. J. 
Published: March 2007

OBJECTIVE—Previous reports have predicted greater risk of type 1 diabetes among people who were heavier as young children. The Accelerator Hypothesis predicts earlier onset in heavier people, without necessarily a change in risk, and views type 1 and type 2 diabetes as the same disorder of insulin resistance, set against different genetic backgrounds. Insulin resistance is a function of fat mass, and increasing body weight in the industrialized world has been accompanied by earlier presentation (i.e., acceleration) of type 2 diabetes. We wanted to establish whether increasing body weight was also asociated with the earlier presentation of type 1 diabetes, as the Accelerator Hypothesis would predict.
RESEARCH DESIGN AND METHODS— The relationships between fatness and age at diagnosis were examined in context of birth weight, weight change since birth, weight at diagnosis, BMI at diagnosis, and BMI 12 months later in 94 children aged 1–16 years (49 boys and 45 girls) presenting for management of acute-onset type 1 diabetes.
RESULTS—BMI standard deviation score (SDS) at diagnosis, weight SDS change since birth, and BMI SDS 12 months later were all inversely related to age at presentation (r = −0.39 to −0.40, P &lt; 0.001). The boys were significantly fatter than the girls (BMI SDS 0.56 vs. −0.08, respectively; P = 0.006) and presented with diabetes at a significantly younger age (6.74 vs. 8.32 years, respectively; P &lt; 0.05). The sex difference in age at diagnosis, however, disappeared when corrected for BMI (P = 0.31), suggesting that fatness or something related to it was the responsible factor.
CONCLUSIONS—The data are consistent with the hypothesis that the age at presentation of type 1 diabetes is associated with fatness. The implications for prevention of type 1 diabetes may be important.
Evidence for Heterogeneous Pathogenesis of Insulin-Treated Diabetes in Black and White Children
Authors: Libman Ingrid M. , Pietropaolo Massimo , Arslanian Silva A. , LaPorte Ronald E. , Becker Dorothy J. 
Published: March 2007

OBJECTIVE—We have previously reported differences in the prevalence of β-cell autoantibodies (AAs) in black and white children with insulin-treated diabetes, suggesting that the disease pathogenesis may be more heterogeneous among racial groups than previously thought. To further explore this issue, we compared clinical, biochemical, and autoimmune characteristics at disease diagnosis and follow-up treatment in an expanded number of black and white children with and without the presence of AAs.
RESEARCH DESIGN AND METHODS—The study cohort of 130 black children and adolescents, aged &lt;19 years, diagnosed with diabetes and treated with insulin at time of diagnosis (January 1979 to December 1998) were matched with an equal number of white children by age at onset, sex, and year of diagnosis.
RESULTS—The black children had a higher prevalence of obesity (43 vs. 11%) and acanthosis nigricans (21 vs. 1%) than white children and a lower prevalence of AAs. Compared with black children who had AAs, those with no AAs were older and had a higher prevalence of obesity, acanthosis nigricans, and parental diabetes. However, one of four of the black children with AAs was obese and/or had acanthosis nigricans. Among white children, the absence of AAs was not associated with any differences in terms of obesity or acanthosis nigricans compared with those with AAs. Similar to their black counterparts, white children without antibodies were older and had a higher prevalence of parental diabetes. Although treatment with an insulin sensitizer was used, insulin therapy was rarely discontinued on follow-up.
CONCLUSIONS—These pediatric subjects, irrespective of autoimmunity, often showed characteristics associated with type 2 diabetes. These characteristics were more frequently displayed in black than in white children. Our data suggest that childhood diabetes may constitute a spectrum of pathogenic mechanisms that may overlap, including those typically associated with both type 1 and type 2 diabetes. This finding could have therapeutic implications.