bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility and Acceptability of a Proposed Infant Feeding Intervention Trial for the Prevention of Type I Diabetes
Authors: Gerstein Hertzel C , Simpson Janis Randall , Atkinson Stephanie , Taylor D Wayne , VanderMeulen John 
Published: March 2007

OBJECTIVE
To determine the feasibility of a randomized double-blind controlled trial of an infant formula without intact cow's-milk protein for preventing type I diabetes in high-risk children.

RESEARCH DESIGN AND METHODS
We surveyed 83 people who either were parents of a child with type I diabetes or were pregnant women with type I diabetes in the ambulatory diabetes and obstetrics clinics in a university hospital. After a written and verbal description of the cow's milk-diabetes hypothesis, participants were asked to sign a sham consent form. A questionnaire designed to explore factors affecting their decision to either sign or not sign the consent form, as well as infant-feeding patterns, was subsequently administered.

RESULTS
Overall, 69.9% (95% confidence interval, 60.0–79.8%) consented to participation in the proposed randomized trial. The decision to consent was not affected by the degree of belief in the cow's milk-diabetes hypothesis, the child's risk of diabetes, the respondent's demographic data, or infant feeding habits.

CONCLUSIONS
A randomized feeding intervention study is an acceptable and feasible way to determine whether avoidance of cow's-milk protein during the first 6 months of life prevents type I diabetes in North American children.
Patient Empowerment: Results of a randomized controlled trial
Authors: Anderson Robert M , Funnell Martha M , Butler Patricia M , Arnold Marilynn S , Fitzgerald James T , Feste Catherine C 
Published: March 2007

OBJECTIVE
The purpose of this study was to determine if participation in a patient empowerment program would result in improved psychosocial self-efficacy and attitudes toward diabetes, as well as a reduction in blood glucose levels.

RESEARCH DESIGN AND METHODS
This study was conducted as a randomized, wait-listed control group trial. The intervention group received a six-session (one session per week) patient empowerment education program; the control group was assigned to a wait-list. At the end of 6 weeks, the control group completed the six-session empowerment program. Six weeks after the program, both groups provided follow-up data.

RESULTS
The intervention group showed gains over the control group on four of the eight self-efficacy subscales and two of the five diabetes attitude subscales. Also, the intervention group showed a significant reduction in glycated hemoglobin levels. Within groups, analysis of data from all program participants showed sustained improvements in all of the self-efficacy areas and two of the five diabetes attitude subscales and a modest improvement in blood glucose levels.

CONCLUSIONS
This study indicated that patient empowerment is an effective approach to developing educational interventions for addressing the psychosocial aspects of living with diabetes. Furthermore, patient empowerment is conducive to improving blood glucose control. In an ideal setting, patient education would address equally blood glucose management and the psychosocial challenges of living with diabetes.
The Prevalence and Severity of Microvascular Complications in Pancreatic Diabetes and IDDM
Authors: Levitt Naomi S , Adams Ganief , Salmon John , Marks I N Solly , Musson Gregory , Swanepoel Charles , Levy Margaret , Byrne Michael J 
Published: March 2007

OBJECTIVE
To investigate and compare the prevalence, associations, and severity of retinopathy and nephropathy in patients with pancreatic diabetes (PD) and insulin-dependent diabetes mellitus (IDDM).

RESEARCH DESIGN AND METHODS
Thirty patients with PD due to alcohol-induced chronic pancreatitis were matched for age, sex, and duration of diabetes with 30 patients with IDDM. Retinopathy was assessed by fluorescein angiography using the Wisconsin classification. Renal function was assessed by albumin excretion rates (AERs) in at least two timed overnight urine collections and glomerular filtration rates (GFRs) by single injection of 51Cr-EDTA. Microalbuminuria was defined as AER 20–200 μg/min and nephropathy as AER &gt; 200 μg/min.

RESULTS
Retinopathy was found in 33% of patients with PD and in 40% with IDDM. The spectrum of disease was similar in the two groups. The geometric mean of AER was 15 μg/min (range 1–1,541) in the PD group and 24 μg/min (2–2,288) in the IDDM group. Nephropathy was found in 7 PD and in 5 IDDM patients, and a reduced GFR was present in 8 (26%) and 4 (13%) of the two groups, respectively. Microalbuminuria occurred in 9 (33%) and hyperfiltration in 3 (10%) in each group. These differences were insignificant. Retinopathy correlated with AER in both groups. Retinopathy and AER correlated with duration of diabetes in the IDDM but not in the PD group.

CONCLUSIONS
Microvascular complications are equally common and severe in PD and IDDM, and improved glycemic control should be the goal in both.
Noninvasive Detection of Functional Alterations of the Arterial Wall in IDDM Patients With and Without Microalbuminuria
Authors: Zenere Beatrice M , Arcaro Guido , Saggiani Francesca , Rossi Luca , Muggeo Michele , Lechi Alessandro 
Published: March 2007

OBJECTIVE
To test endothelial function in a group of 10 normoalbuminuric and eight microalbuminuric insulin-dependent diabetes mellitus patients (ages 28 ± 3 [mean ± SE] and 28 ± 1 years, respectively), in comparison with 16 control subjects (age 35 ± 2 years, normal subjects vs. diabetic subjects P = NS), to identify prestructural abnormalities of the arterial wall. An early stage of vascular involvement seems in fact to be characterized by functional alterations of endothelial control on vascular tone and wall interaction with circulating cells. Furthermore, many recent studies suggest the importance of microalbuminuria as an early marker not only of nephropathy but also of retinopathy and macroangiopathy.

RESEARCH DESIGN AND METHODS
Endothelium-mediated flow-dependent vasodilation and endothelium-independent vasodilation (induced by glyceryl trinitrate administration) were evaluated in the right common femoral artery by echo-Doppler ultrasound. Arterial wall distensibility was evaluated at the common femoral artery by an echo-tracking system.

RESULTS
In spite of a comparable increase in flow velocity, endothelium-mediated vasodilation was significantly reduced in diabetic subjects, particularly in microalbuminuric patients. Endothelium-independent vasodilation was also significantly impaired in diabetic subjects, particularly in microalbuminuric subjects; whereas arterial wall distensibility, an index of the viscoelastic properties of the wall, was similar in the three groups.

CONCLUSIONS
These results confirm a reduced vasodilatory capacity in diabetes mellitus, with a more marked alteration in microalbuminuric diabetic subjects. This reliable, noninvasive evaluation of arterial function is particularly useful for early diagnosis of vascular involvement.
Absorption of Rapid-Acting Insulin in Obese and Nonobese NIDDM Patients
Authors: Clauson Per G , Linde Birgitta 
Published: March 2007

OBJECTIVE
To study the absorption rate of rapid-acting insulin from subcutaneous injection sites in nonobese and obese non-insulin-dependent diabetes mellitus (NIDDM) patients.

RESEARCH DESIGN AND METHODS
Ten nonobese and 10 obese NIDDM patients (body mass indexes 24.1 ± 0.4 and 31.4 ± 0.8 kg/m2, respectively) received four subcutaneous injections of 125I-labeled rapid-acting insulin (Actrapid Human, 5 U): three in the abdominal wall above, lateral to, and below the umbilicus; and one in the thigh. The depth of the subcutaneous fat layer was measured using ultrasound techniques. The residual radioactivity was monitored externally for 270 min.

RESULTS
The disappearance half-life of 125I-insulin was between 4 and 6 h from all injection sites, with the exception of the upper abdominal area in the nonobese subjects, where it measured ∼ 3 h. The residual radioactivity did not differ between nonobese and obese patients measured from any of the sites. In the nonobese group, the most rapid absorption of 125I-insulin was found from the upper abdominal area and the slowest from the thigh. In the obese group, the absorption rates did not differ between sites. No correlation was found between the depth of the fat layer and the residual radioactivity when measured at any site.

CONCLUSIONS
Our results indicate that the absorption of rapid-acting insulin is markedly slow in both obese and nonobese NIDDM patients compared with IDDM patients and healthy subjects studied previously. In the nonobese group, the most rapid absorption of 125I-insulin is obtained after injection into the upper abdominal area. Inter- and intraregional differences are small in the obese patients. Consequently the choice of injection site is of little importance in this group.
Release of Platelet Plasminogen Activator Inhibitor 1 in Whole Blood Is Increased in Patients With Type II Diabetes
Authors: Jokl Rudolf , Klein Richard L , Lopes-Virella Maria F , Colwell John A 
Published: March 2007

OBJECTIVE
To compare platelet plasminogen activator inhibitor 1 (PAI-1) release in type II diabetic patients and healthy control subjects.

RESEARCH DESIGN AND METHODS
We studied a group of 27 diabetic patients and a group of 16 nondiabetic control subjects. Whole-blood platelet aggregation, defined as a decrease in platelet count during shaking (180 rpm) of blood samples at 37°C, and plasma PAI-1 antigen concentrations were measured in parallel at time 0, 7.5, 15, 30, 60, 120, and 180 min.

RESULTS
Platelet aggregation did not differ significantly between the two groups at any time period. However, the increase in plasma PAI-1 antigen concentration over basal levels at time 0 was higher for the group of diabetic patients when compared with their matched control subjects. The increment of PAI-1 antigen was 61.8 ± 29.4 vs. 35.9 ± 13.4 ng/ml (P &lt; 0.005, means ± SD) after 180 min for the diabetic and control subjects, respectively. Platelet PAI-1 release was correlated to very-low-density lipoprotein cholesterol and triglyceride plasma levels, but not to HbA1c levels.

CONCLUSIONS
Platelets of patients with type II diabetes release significantly more PAI-1 than platelets of healthy subjects at the same level of platelet aggregation. This may contribute to enhanced thrombosis in diabetes.
Lipoic Acid Improves Nerve Blood Flow, Reduces Oxidative Stress, and Improves Distal Nerve Conduction in Experimental Diabetic Neuropathy
Authors: Nagamatsu Masaaki , Nickander Kim K , Schmelzer James D , Raya Angel , Wittrock Debra A , Tritschler Hans , Low Phillip A 
Published: March 2007

OBJECTIVE
To determine whether lipoic acid (LA) will reduce oxidative stress in diabetic peripheral nerves and improve neuropathy.

RESEARCH DESIGN AND METHODS
We used the model of streptozotocin-induced diabetic neuropathy (SDN) and evaluated the efficacy of LA supplementation in improving nerve blood flow (NBF), electrophysiology, and indexes of oxidative stress in peripheral nerves affected by SDN, at 1 month after onset of diabetes and in age-matched control rats. LA, in doses of 20, 50, and 100 mg/kg, was administered intraperitoneally five times per week after onset of diabetes.

RESULTS
NBF in SDN was reduced by 50% LA did not affect the NBF of normal nerves but improved that of SDN in a dose-dependent manner. After 1 month of treatment, LA-supplemented rats (100 mg/kg) exhibited normal NBF. The most sensitive and reliable indicator of oxidative stress was reduction in reduced glutathione, which was significantly reduced in streptozotocin-induced diabetic and alpha-tocopherol-deficient nerves; it was improved in a dose-dependent manner in LA-supplemented rats. The conduction velocity of the digital nerve was reduced in SDN and was significantly improved by LA.

CONCLUSIONS
These studies suggest that LA improves SDN, in significant part by reducing the effects of oxidative stress. The drug may have potential in the treatment of human diabetic neuropathy.
Phospholipid and Glutamic Acid Decarboxylase Autoantibodies in Diabetic Neuropathy
Authors: Vinik Aaron I , Leichter Steven B , Pittenger Gary L , Stansberry Kevin B , Holland Marie T , Powers Alvin C , Suwanwalaikorn Sompongse 
Published: March 2007

OBJECTIVE
To determine the prevalence and significance of phospholipid autoantibodies (PLAs) and glutamic acid decarboxylase (GAD) autoantibodies in the circulation of normal patients and diabetic patients with and without neuropathy.

RESEARCH DESIGN AND METHODS
We measured PLAs in a total of 78 patients (a diabetic group with somatic or autonomic neuropathy [n = 40] another group without neuropathy [n = 38]), and GAD autoantibodies in a subset of 22 patients.

RESULTS
PLAs are found in 2% of the general population. We found PLAs in 32% of the diabetic population without neuropathy, in 88% of those with neuropathy, in 55% of those with retinopathy, and in 25% of those with established nephropathy. The frequencies of immunoglobulins in the neuropathic group were: IgG = 78%, IgM = 33%, and IgA = 23%. There was no correlation between PLAs and microalbuminuria, macrovascular disease, fibrinogen, duration of diabetes, or neuropathy, but there was a strong correlation with total neuropathy score. Sera with high PLA IgG titers bound to the surface of neuroblastoma cells and inhibited cell growth. Antibodies to GAD65 were present in 32% and to GAD67 in 0% of patients. No titers of GAD65, GAD67, or the GAD65 ratio were associated with the degree of neuropathy of the presence of PLAs.

CONCLUSIONS
PLAs occur frequently in the sera of patients with diabetes and correlate with the extent of neuropathy, suggesting a role for PLAs in the etiology thereof. The measurement of PLAs may constitute a marker for ongoing damage to nerves.
Renal, Metabolic, and Hormonal Responses to Proteins of Different Origin in Normotensive, Nonproteinuric Type I Diabetic Patients
Authors: Kontessis Panayotis A , Bossinakou Irini , Sarika Leda , Iliopoulou Elsa , Papantoniou Antonis , Trevisan Roberto , Roussi Demetra , Stipsanelli Katherine , Grigorakis Stelios , Souvatzoglou Athanasios 
Published: March 2007

OBJECTIVE
Whether the differences in renal function found in vegetarian compared with omnivorous subjects are related to quantity or quality of the protein is unknown. We have studied the renal function of nine normotensive, nonproteinuric type I diabetic patients who were fed in random order for 4 weeks either an animal protein diet (APD) (protein intake 1.1 g · kg−1 · day−1) or a vegetable protein diet VPD (protein intake 0.95 g · kg−1 · day−1). The two diets were isocaloric.

RESEARCH DESIGN AND METHODS
In a crossover study, we measured glomerular filtration rate (GFR) (inulin clearance), renal plasma flow (RPF) (p-aminohippurate clearance), plasma amino acids, growth hormone, glucagon, insulin-like growth factor I-(IGF-I), and microalbuminuria.

RESULTS
GFR and RPF were lower with the VPD than with the APD (89.9 ± 4.1 vs. 105.6 ± 5.1 ml · min−1 · 1.73 m−2, P &lt; 0.05, and 425.7 ± 22.2 vs. 477.8 ± 32.2 ml · min−1 1.73m−2, P &lt; 0.05, respectively). Renal vascular resistance (RVR) was higher with the VPD than with the APD (101 ± 25 vs. 91 ± 10 mmHg · min−1 · ml−1, P &lt; 0.05). Filtration fraction (FF) remained unchanged after either diet. Fractional clearance of albumin fell with the VPD to 2.0 ± 0.65 from 3.4 ± 1.15 × 10−6 (P &lt; 0.05). At the end of the APD and VPD, the plasma levels of growth hormone and glucagon did not differ significantly. Plasma levels of IGF-I were higher with the APD than with the VPD (1.1 ± 0.6 vs. 0.9 ± 0.13 U/ml, P &lt; 0.05). Plasma concentrations of valine and lysine were significantly higher with the APD than with the VPD (234.6 ± 30.3 vs. 164.5 ± 25.4 mmol/1, P &lt; 0.05, and 565 ± 45.1 vs. 430 ± 56.1 mmol/l, P &lt; 0.05, respectively), whereas plasma valine was strongly correlated to the GFR (r = 0.832, P &lt; 0.01). No differences were found in other amino acids.

CONCLUSIONS
A VPD has significantly different renal effects from an APD equal in protein intake in normotensive type I diabetic patients. This could be explained partly by differences in plasma concentrations of amino acids and IGF-I.
Prevalence Estimates of Diabetes and of Other Cardiovascular Risk Factors in the Two Largest Algonquin Communities of Quebec
Authors: Delisle Hélène F , Rivard Michèle , Ekoé Jean-Marie 
Published: March 2007

OBJECTIVE
To compare the prevalence of non-insulin-dependent diabetes mellitus (NIDDM) in the two largest Algonquin communities of Quebec (Canada) with that of other native groups and to describe the different patterns of NIDDM and other cardiovascular risk markers in these communities (River Desert [RD] and Lac Simon [LS]).

RESEARCH DESIGN AND METHODS
The population-based study targeted all residents aged 15 years and older. In the age-group considered here (30-64 years), there were 480 eligible subjects and 299 participants (50.8% in RD and 86.9% in LS). All except those with confirmed diabetes underwent an oral glucose tolerance test. Serum triglyceride and lipoprotein cholesterol levels, blood pressure, body mass index (BMI), and waist-to-hip ratio (WHR) were measured.

RESULTS
The age-standardized (world population) prevalence of NIDDM in women was twice as high in LS as in RD (48.6% vs. 23.9%). In men, it was 23.9% in LS and 16.3% in RD. Upper-body obesity followed the same pattern. In contrast, high-risk serum low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol levels were significantly more prevalent in RD than in LS, particularly among men. The rate of high blood pressure was twice as high in men as in women, with little community differences. When we controlled for age, sex, diabetic, and obesity status, mean fasting serum glucose remained significantly higher triglycerides and LDL cholesterol lower in LS than in RD. There was also an independent community effect on WHR but no on BMI.

CONCLUSIONS
The prevalence of NIDDM in LS women reaches the rate observed in Pima Indian women. The observed differences between two Algonquin communities suggest a highly heterogeneous pattern of NIDDM and cardiovascular disease risk factors in Amerindian populations, even within a given tribe and a limited geographic area.
Lack of Long-Term Diabetic Complications in Spite of Poor Glycemic Control in Twins With Pure Gonadal Dysgenesis
Authors: Bell David S H 
Published: March 2007

BACKGROUND
The prepubertal years have little effect on the chronic complications of diabetes. Animal studies have shown castration prevents diabetic complications. No previous data on untreated agonadal human diabetic subjects is available.

CASE HISTORY
Clinical study of untreated agonadal twins with insulin-dependent diabetes for presence of chronic complications of diabetes. In spite of the twins' poor glycemic control, no evidence of the chronic complications of diabetes was found.

CONCLUSIONS
The absence of gonadal sex steroids in the diabetic patient may have a protective effect against the development of the chronic complications of diabetes.
Erythrocyte Sodium-Lithium Countertransport Activity in Non-Nephropathic Diabetic Twins
Authors: Hardman Timothy C , Dubrey Simon W , Leslie R David G , Lant Ariel F 
Published: March 2007

OBJECTIVE
It has proved difficult to separate the role of the diabetic state as distinct from its complications in causing the elevation in erythrocyte sodium-lithium (Na-Li) countertransport activity that has been observed in diabetes. The present study sought to isolate the impact of diabetes on the countertransporter by studying groups of non-nephropathic identical-twin pairs both discordant and concordant for diabetes.

RESEARCH DESIGN AND METHODS
We studied erythrocyte Na-Li countertransport activity in 49 identical-twin pairs who were discordant for IDDM and 26 identical twin pairs who were concordant for IDDM. Similar numbers of healthy control subjects, matched with the nondiabetic twins from the discordant pairs in respect to sex, BMI, and age were also studied.

RESULTS
The clinical and laboratory characteristics of both sets of twins were very similar to those of the control subjects with the exception that whole-blood glucose and glycated hemoglobin concentrations were higher in diabetic twins, whether from discordant or concordant pairs (P &lt; 0.001), and that systolic blood pressure (P &lt; 0.05) and serum HDL cholesterol (P &lt; 0.05) were higher in the discordant diabetic twins than in their nondiabetic co-twins. Median (95% CI) Na-Li countertransport activities (in millimoles of lithium released from 1 liter of erythrocytes per hour) in the nondiabetic discordant twin [0.237 (0.192–0.284)], the diabetic discordant twin [0.284 (0.254–0.326)], and the concordant twin [0.262 (0.207–0.358)] groups were similar to each other and higher than in the control subjects [0.172 (0.138–0.203)]. Countertransport activities in the discordant diabetic twins correlated significantly with their nondiabetic co-twins (r = 0.34; P = 0.015; n = 49), as did those between the concordant diabetic twin pairs (r = 0.68; P &lt; 0.005; n = 26); activity levels were not related to either disease duration or blood glucose control.

CONCLUSIONS
An elevation in Na-Li countertransport activity has been noted in non-nephropathic normotensive twin pairs both discordant and concordant for IDDM. The potential genetic contribution to the altered behavior of the countertransporter was similar in both types of twins studied, and individual Na-Li countertransport activities were not significantly related to either duration of diabetes or metabolic control.
LDL Apheresis Reduces the Susceptibility of LDL to in Vitro oxidation in a Diabetic Patient With Hemodialysis Treatment
Authors: Inoue Ikuo , Takahashi Keiichi , Kikuchi Chitose , Katayama Shigehiro 
Published: March 2007

OBJECTIVE
We studied whether LDL apheresis would alter the susceptibility of LDL to in vitro oxidative modification induced by copper ion in a diabetic patient undergoing hemodialysis treatment.

RESEARCH DESIGN AND METHODS
Isolated LDL was dialyzed against phosphate-buffered saline and resuspended at a concentration of 0.3 mg cholesterol mass/ml buffer LDL oxidation was then initiated by addition of 1.66 μmol/l CuSO4, and the formation of conjugated dienes was continuously monitored spectrophotometrically at 234 nm.

RESULTS
The duration of the lag phase of LDL obtained after LDL apheresis was markedly longer than that of LDL obtained before LDL apheresis. The propagation rate and the maximum conjugated diene formation of LDL oxidation were not changed after LDL apheresis.

CONCLUSIONS
A LDL subfraction that was susceptible to oxidation was removed by LDL apheresis, resulting in reduction of susceptibility of LDL to in vitro oxidation remaining in plasma. LDL apheresis may be of clinical importance for preventing atherosclerotic disease in diabetic patients undergoing hemodialysis.