bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-Rated Health and Diabetes of Long Duration: The Wisconsin Epidemiologic Study of Diabetic Retinopathy
Authors: Klein Barbara EK , Klein Ronald , Moss Scot E 
Published: March 2007

OBJECTIVE
To evaluate the self-reported quality of life in individuals with diabetes of long duration.

RESEARCH DESIGN AND METHODS
An interview was administered 14 years after baseline to two cohorts of individuals with diabetes who have been followed in an epidemiological study periodically since 1980. Responses to the Medical Outcomes Study Short Form 36 as related to complications of diabetes, age, glycosylated hemoglobin level, and other characteristics were assessed.

RESULTS
Physical function, physical role, general health scales, and a general question about health were related to diabetes characteristics in older- and younger-onset individuals. Symptoms of sensory neuropathy were associated with the four measures in both younger- (n = 645) and older-onset (n = 292) individuals. Other descriptive variables in the younger-onset group were the presence of nephropathy, cardiovascular disease, smoking, peak expiratory flow, physical activity, and glycosylated hemoglobin. Hypoglycemic reactions were of only borderline significance and that for only one scale (physical role). In older-onset individuals, cardiovascular disease, physical activity, and sex were descriptive of responses to the quality-of-life questions.

CONCLUSIONS
Factors related to diabetes contribute to self-assessed health. Some of these factors may be modifiable, which, if altered, may lead to improved quality of life.
Ethnic Differences in the Glycemic Response to Exogenous Insulin Treatment in the Veterans Affairs Cooperative Study in Type 2 Diabetes Mellitus (VA CSDM)
Authors: Agrawal Lily , Emanuele Nicholas V , Abraira Carlos , Henderson William G , Levin Seymour R , Sawin Clark T , Silbert Cynthia K , Nuttall Frank Q , Comstock John P , Colwell John A ,   VA CSDM Group
Published: March 2007

OBJECTIVE
The Veterans Affairs Cooperative Study in Type 2 Diabetes Mellitus was conducted in NIDDM patients to determine if a significant difference in HbA1c could be achieved between groups receiving standard and intensive treatment. We observed differences in the response to exogenous insulin between African-Americans and other intensively treated patients. Therefore, we assessed the variations of response and correlated factors that might explain such differences.

RESEARCH DESIGN AND METHODS
One hundred fifty-three men aged 40–69 years with NIDDM for ≤15 years were randomized to either the standard therapy (n = 78) or the intensive therapy (n = 75) arm. Of the 75 patients in the intensive therapy group, 57 completed the study on insulin therapy alone. Of these, 18 were African-Americans and 39 were non-African-Americans. We conducted an analysis of the data collected to determine differences in baseline characteristics, glycemic response, insulin requirement, body weight, exercise, and basal C-peptide level, factors that may explain a difference in response to insulin therapy.

RESULTS
Glycemic control improved in all patients with intensive insulin therapy. African-Americans achieved a greater improvement in HbA1c compared with non-African-Americans with a similar increment in insulin. This difference could not be explained by differences in body weight, activity, concomitant use of other medicines, or insulin-secretory capacity of the pancreas.

CONCLUSIONS
We conclude that ethnic differences may exist in the response to insulin therapy. A knowledge of such differences may aid in achieving good glycemic control, especially since minorities have a greater prevalence of and burden from the microvascular complications of diabetes.
Outcome Results of the Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial (FACET) in Patients With Hypertension and NIDDM
Authors: Tatti Patrizio , Pahor Marco , Byington Robert P , Mauro Patrizia Di , Guarisco Riccardo , Strollo Giovanna , Strollo Felice 
Published: March 2007

OBJECTIVE
ACE inhibitors and calcium antagonists may favorably affect serum lipids and glucose metabolism. The primary aim of the Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial (FACET) was to compare the effects of fosinopril and amlodipine on serum lipids and diabetes control in NIDDM patients with hypertension. Prospectively defined cardiovascular events were assessed as secondary outcomes.

RESEARCH DESIGN AND METHODS
Inclusion criteria included a diagnosis of NIDDM and hypertension (systolic blood pressure of &gt;140 mmHg or diastolic blood pressure of &gt;90 mmHg). Exclusion criteria included a history of coronary heart disease or stroke, serum creatinine &gt;1.5 mg/dl, albuminuria &gt;40 μg/min, and use of lipid-lowering drugs, aspirin, or antihypertensive agents other than beta-blockers or diuretics. A total of 380 hypertensive diabetics were randomly assigned to open-label fosinopril (20 mg/day) or amlodipine (10 mg/day) and followed for up to 3.5 years. If blood pressure was not controlled, the other study drug was added.

RESULTS
Both treatments were effective in lowering blood pressure. At the end of followup, between the two groups there was no significant difference in total serum cholesterol, HDL cholesterol, HbA1c, fasting serum glucose, or plasma insulin. The patients receiving fosinopril had a significantly lower risk of the combined outcome of acute myocardial infarction, stroke, or hospitalized angina than those receiving amlodipine (14/189 vs. 27/191; hazards ratio = 0.49, 95% CI = 0.26–0.95).

CONCLUSIONS
Fosinopril and amlodipine had similar effects on biochemical measures, but the patients randomized to fosinopril had a significantly lower risk of major vascular events, compared with the patients randomized to amlodipine.
The Association Between a Family History of Type 2 Diabetes and Coronary Artery Disease in a Type 1 Diabetes Population
Authors: Erbey John R , Kuller Lewis H , Becker Dorothy J , Orchard Trevor J 
Published: March 2007

OBJECTIVE
To examine whether a potential marker for type 2 diabetes (family history) is related to CAD in type 1 diabetic subjects. The two major types of primary diabetes, type 1 and type 2, are both associated with an increased risk of developing coronary artery disease (CAD). However, the etiology and associated risk factors may differ by type of diabetes. In type 2 diabetes, CAD is likely to be linked with the insulin resistance associated with the type 2 “process,” while CAD in type 1 diabetes has, so far, been more closely linked to renal disease. Because the etiologies of type 1 and type 2 diabetes are different, it is possible that some CAD in type 1 diabetes may be related to the coexistence of type 2 diabetes susceptibility (i.e., insulin resistance).

RESEARCH DESIGN AND METHODS
We evaluated the interrelationships between family history of type 2 diabetes (age at onset &gt;30 years, no insulin for 1st year) and presence of CAD in a cohort of childhood-onset type 1 diabetic subjects using the Pittsburgh Epidemiology of Diabetes Complications study (n = 658).

RESULTS
A first-degree family history of type 2 diabetes was reported in 112 subjects, and CAD was present in 119 subjects. Those subjects reporting a family history of type 2 diabetes were significantly older, had a longer duration of type 1 diabetes, had higher triglyceride and LDL cholesterol levels, and had a borderline significantly increased Beck depression inventory. Sex differences in CAD risk factors were also noted. Using logistic regression analysis, the odds ratio (95% CI) for the presence of CAD in association with a family history of NIDDM was 1.89 (1.27–2.84). The odds ratio (95% CI) after adjusting for disease duration, triglycerides, hypertension, Beck depression, and nephropathy status was 1.45 (0.87–2.28).

CONCLUSIONS
We conclude that a family history of type 2 diabetes is a risk factor for CAD in type 1 diabetic subjects. This supports the concept that insulin resistance may contribute to development of CAD in type 1 diabetes.
The Determinants of Glycemic Responses to Diet Restriction and Weight Loss in Obesity and NIDDM
Authors: Markovic Tania P , Jenkins Arthur B , Campbell Lesley V , Furler Stuart M , Kraegen Edward W , Chisholm Donald J 
Published: March 2007

OBJECTIVE
To examine the mechanisms by which weight loss improves glycemic control in overweight subjects with NIDDM, particularly the relationships between energy restriction, improvement in insulin sensitivity, andregional and overall adipose tissue loss.

RESEARCH DESIGN AND METHODS
Hyperinsulinemic glucose clamps wereperformed in 20 subjects (BMI = 32.0 ± 0.5 [SEM] kg/m2, age = 48.4 ± 2.7 years) with normal glucose tolerance (NGT) (n = 10) or mild NIDDM (n = 10) before and on the 4th (d4) and 28th (d28) days of a reduced-energy (1,100 ± 250 [SD] kcal/day) formula diet. Body composition changes were assessed by dual energy x-ray absorptiometry and insulin secretory changes were measured by insulin response to intravenous glucose before and after weight loss.

RESULTS
In both groups, energy restriction (d4) reduced fasting plasma glucose (FPG) (ΔFPG: NGT = −0.4 ± 0.2 mmol/1 and NIDDM = −1.1 ± 0.03 mmol/1, P = 0.002), which was independently related to reduced carbohydrate intake (partial r = 0.64, P = 0.003). There was a marked d4 increase in percent of insulin suppression of hepatic glucose output(HGO) in both groups (ΔHGO suppression: NGT = 28 ± 15% and NIDDM = 32 ± 8%, P = 0.002). By d28, with 6.3 ± 0.4 kg weight loss, FPG was further reduced (d4 vs. d28) in NIDDM only (P = 0.05), and insulin sensitivity increased in both groups (P = 0.02). Only loss of abdominal fat related to improvements in FPG (r = 0.51, P = 0.03) and insulin sensitivity afterweight loss (r = 0.48, P = 0.05). In contrast to insulin action, there were only small changes in insulin secretion.

CONCLUSIONS
Both energy restriction and weight loss have beneficial effects on insulin action and glycemic control in obesity and mild NIDDM. The effect of energy restriction is related to changes in individual macronutrients, whereas weight loss effects relate to changes in abdominal fat.
Incidence of IDDM in Children Living in Puerto Rico
Authors: de Llado Teresa E Frazer , de Pijem Lilliam Gonzalez , Hawk Barbara ,   The Puerto Rican IDDM Coalition
Published: March 2007

OBJECTIVE
To determine incidence, geographic distribution, and seasonal variation of IDDM in children 0–14 years of age living in Puerto Rico. Because these data have been collected through the infrastructure of the World Health Organization's DiaMond project, these results are direcdy comparable widi incidence data from other populations worldwide involved in this study.

RESEARCH DESIGN AND METHODS
Beginning in 1990, new cases of IDDM were registered retrospectively from 1985 and prospectively to 1994 by review of medical records from island hospitals. Included in the hospital registry are 1,527 cases of IDDM. Validation of the primary source was by three secondary lists of cases obtained through diabetic camps, surveys of schools, and a government registry. Log linear modeling (capture-recapture) was used to correct incidence.

RESULTS
Mean incidence of IDDM from 1985–1994 was 18.0 cases/100,000 children per year (95% CI 17.6–18.3). There was a slight female rather than male predominance: 51% of the cases were girls, and 49% were boys. Although Puerto Rico has marked variation in rainfall, altitude, and geneticmarkers, no significant differences are found in the incidence rates of different areas or seasons of the island.

CONCLUSIONS
This registry of Puerto Rican children is the largest IDDM registry of minority children in the U.S. The results of this study indicate that the annual incidence of IDDM of children living in Puerto Rico is higher than the incidence of other multiracial ethnic groups living in the U.S.
Plasma Adrenomedullin Levels in Type 1 Diabetes: Relationship with clinical parameters
Authors: García-Unzueta M T , Montalbán C , Pesquera C , Berrazueta J R , Amado J A 
Published: March 2007

OBJECTIVE
To assess the relationship between plasma adrenomedullin (AM) levels and the presence of microvascular complications in type 1 diabetic patients.

RESEARCH DESIGN AND METHODS
We measured plasma AM and cAMP levels in 103 type 1 diabetic patients (46 without complications, 24 with retinopathy only, 14 with microalbuminuria but normal kidney function, and 19 with renal insufficiency) and 41 matched healthy control subjects.

RESULTS
Patients with renal insufficiency had higher levels of AM and cAMP than all other groups. Patients with only retinopathy showed a trend to have higher levels than patients without complications. There were no differences among all other groups. There was a significant correlation between AM and cAMP in the total diabetic group (rs = 0.36, P &lt; 0.001) but not in the control group. In multiple regression analysis, plasma AM demonstrated significant relationships with creatinine clearance (β = −0.31, P = 0.004) and duration of the disease (β = 0.28, P = 0.008).

CONCLUSIONS
Plasma AM and cAMP are increased in type 1 diabetic patients with renal insufficiency. Creatinine clearance (CrClc) and duration of the disease are related to plasma AM levels in these patients.
Isolated Postchallenge Hyperglycemia and the Risk of Fatal Cardiovascular Disease in Older Women and Men: The Rancho Bernardo Study
Authors: Barrett-Connor Elizabeth , Ferrara Assiamira 
Published: March 2007

OBJECTIVE
To determine whether diabetes defined by isolated postchallenge hyperglycemia (IPH) (2-h postchallenge plasma glucose ≥ 11.1 mmol/l with fasting plasma glucose [FPG] &lt; 7.0 mmol/l) increases the risk of fatal cardiovascular disease (CVD) in older women and men.

RESEARCH DESIGN AND METHODS
In a prospective study, we followed 769 men and 1,089 women, aged 50–89 years, who had no history of diabetes or myocardial infarction and demonstrated no fasting hyperglycemia (i.e., FPG &lt; 7.0 mmol/l) when they underwent oral glucose tolerance testing at baseline in 1984–1987.

RESULTS
At baseline, 70% of 125 women and 48% of 133 men with previously undiagnosed diabetes had IPH. Over the next 7 years, women with IPH had a significantly increased risk of fatal CVD and heart disease compared with nondiabetic women. This increased risk was not observed in men with IPH. This association was independent of age, hypertension, central obesity, cigarette smoking, HDL cholesterol, and triglycerides (multiply adjusted hazard ratio and 95% CI: 2.6 and 1.4–4.7 for CVD; 2.9 and 1.3–6.4 for heart disease).

CONCLUSIONS
Diabetes defined by IPH alone is common in older adults and more than doubles the risk of fatal CVD and heart disease in older women. Because the prevalence of IPH increases with age, the use of fasting glucose alone for diabetes screening or diagnosis may fail to identify most older adults at high risk for CVD and should be reevaluated.
Relationship of Blood Thromboxane-B2 (TxB2) With Lipid Peroxides and Effect of Vitamin E and Placebo Supplementation on TxB2 and Lipid Peroxide Levels in Type 1 Diabetic Patients
Authors: Jain Sushil K , Krueger K Stephan , McVie Robert , Jaramillo John J , Palmer Melissa , Smith Tiney 
Published: March 2007

OBJECTIVE
To study the effect of vitamin E supplementation on platelet hyperaggregability in type 1 diabetic patients.

RESEARCH DESIGN AND METHODS
Written informed consent according to the Institutional Review Board on Human Experimentation guidelines was obtained from diabetic patients (n = 29) and their age-matched normal siblings (n = 21) to participate in this study. Diabetic patients were supplemented with DL-α-tocopherol (vitamin E) capsule (orally, 100 IU/day) or placebo for 3 months in a double-blind clinical trial. Alternate diabetic patients were assigned to vitamin E or placebo during regular visits to the clinic. Fasting blood was collected from each diabetic patient before the start and after the vitamin E or placebo supplementation. Platelet aggregability was assessed by competitive enzyme-linked immunosorbent assay of the blood TxB2 (a stable thromboxane metabolite). Plasma vitamin E and MDA (malondialdehyde, a product of lipid peroxidation) was assessed by high-performance liquid chromatography. Data were analyzed statistically on 12 diabetic patients on vitamin E and 12 on placebo supplementation.

RESULTS
Diabetic patients (n = 29) had 62% higher (P &lt; 0.05) levels of TxB2 and 15% higher levels (P &lt; 0.05) of MDA in comparison to normal subjects (n = 21). Plasma TxB2 levels had a significant correlation with MDA levels (r = 0.45, P &lt; 0.02) but not with the HbA1 (r = −0.08), glucose (r = −0.13), duration of diabetes (r = −0.04), or age (r = 0.12) of diabetic patients. Vitamin E supplementation lowered MDA levels by 30% (P &lt; 0.04), TxB2 levels by 51% (P &lt; 0.03), and triglyceride levels by 22% (P &lt; 0.04) in diabetic patients. There were no differences in these parameters before versus after placebo supplementation.

CONCLUSIONS
The elevated blood level of TxB2 (hyperaggregability of platelets) is significantly related to the level of lipid peroxidation products (oxidative stress) in type 1 diabetic patients. Supplementation of modest doses of vitamin E (100 IU/day) significantly lowers blood TxB2 and lipid peroxidation products levels in type 1 diabetic patients.
Intensive Insulin Therapy With Insulin Lispro
Authors: Tsui Elaine , Barnie Annette , Ross Sue , Parkes Robert , Zinman Bernard 
Published: March 2007

OBJECTIVE—To evaluate glycemic control, hypoglycemic events, and quality of life in patients treated with continuous subcutaneous insulin infusion (CSII) and multiple daily insulin injection (MDI), with insulin lispro as the principal insulin.
RESEARCH DESIGN AND METHODS—This clinical trial enrolled 27 patients with type 1 diabetes. They were randomly assigned to CSII (n = 13) or MDI (n = 14) treatment regimens. Glycemic control (HbA1c level) was the primary outcome and was measured monthly for 9 months. Secondary outcomes were patient reports of hypoglycemic events (recorded monthly for 9 months) and quality of life assessed at 9 months using the Diabetes Quality of Life (DQOL) questionnaire.
RESULTS—A significant decrease in HbA1c from baseline was shown for both groups. However, the overall treatment effect (CSII − MDI) for HbA1c was +0.08% (95% CI −0.23 to +0.39, P &gt; 0.10). This was significantly less than the a priori limit of ±0.5% (P = 0.004). The relative treatment effect ([CSII − MDI]/MDI) for the overall number of hypoglycemic events was +9% (95% CI −37 to +87, P &gt; 0.10). There were no statistically significant differences between treatment groups for any of the DQOL subscales.
CONCLUSIONS—No statistically significant differences in glycemic control, reported hypoglycemic events, or quality of life were found in this study. Furthermore, a clinically significant difference of more than ±0.5% HbA1c between the two regimens can be confidently ruled out. We conclude that the choice of intensive insulin therapy should be a matter of patient preference, consistent with lifestyle.
Impaired Autonomic Function Is Associated With Increased Mortality, Especially in Subjects With Diabetes, Hypertension, or a History of Cardiovascular Disease
Authors: Gerritsen Jeanet , Dekker Jacqueline M. , TenVoorde Ben J. , Kostense Piet J. , Heine Robert J. , Bouter Lex M. , Heethaar Rob M. , Stehouwer Coen D.A. 
Published: March 2007

OBJECTIVE—Measures of baroreflex sensitivity, heart rate variability (HRV), and the classical Ewing test parameters are currently used for the diagnosis of diabetic autonomic neuropathy and for mortality risk stratification after myocardial infarction. However, the strengths of the associations of these measures of autonomic function with risk of mortality have never been compared in one study population. Furthermore, no evidence is available on the possible effect of glucose tolerance on these associations.
RESEARCH DESIGN AND METHODS—The study population (n = 605) consisted of a glucose tolerance–stratified sample from a general population (50–75 years of age). Cardiac cycle duration and continuous finger arterial pressure were measured under two conditions: at rest and on metronome breathing. From these readings, seven parameters of autonomic function were assessed (one Ewing, five HRV, and one baroreflex sensitivity).
RESULTS—During 9 years of follow-up, 101 individuals died, 43 from cardiovascular causes. Subjects with diabetes and low levels of the autonomic function parameters, indicating impaired autonomic function, had an approximately doubled risk of mortality. This association was consistent, though not statistically significant, for all parameters. The elevated risk was not observed in subjects without diabetes, hypertension, or prevalent cardiovascular disease.
CONCLUSIONS—Impaired autonomic function is associated with all-cause and cardiovascular mortality. Moreover, the results of the present study suggest that cardiac autonomic dysfunction in patients already at risk (diabetes, hypertension, or history of cardiovascular disease) may be especially hazardous.
Good Metabolic Control Is Associated With Better Quality of Life in 2,101 Adolescents With Type 1 Diabetes
Authors: Hoey Hilary , Aanstoot Henk-Jan , Chiarelli Francesco , Daneman Denis , Danne Thomas , Dorchy Harry , Fitzgerald Michael , Garandeau Patrick , Greene Stephen , Holl Reinhard , Hougaard Philip , Kaprio Eero , Kocova Mirjana , Lynggaard Helle , Martul Pedro , Matsuura Nobuo , McGee Hannah M. , Mortensen Henrik B. , Robertson Kenneth , Schoenle Eugen , Sovik Oddmund , Swift Peter , Tsou Rosa Maria , Vanelli Maurizio , Åman Jan ,   For the Hvidøre Study Group on Childhood Diabetes
Published: March 2007

OBJECTIVE—It is unclear whether the demands of good metabolic control or the consequences of poor control have a greater influence on quality of life (QOL) for adolescents with diabetes. This study aimed to assess these relations in a large international cohort of adolescents with diabetes and their families.RESEARCH DESIGN AND METHODS—The study involved 2,101 adolescents, aged 10–18 years, from 21 centers in 17 countries in Europe, Japan, and North America. Clinical and demographic data were collected from March through August 1998. HbA1c was analyzed centrally (normal range 4.4–6.3%; mean 5.4%). Adolescent QOL was assessed by a previously developed Diabetes Quality of Life (DQOL) questionnaire for adolescents, measuring the impact of diabetes, worries about diabetes, satisfaction with life, and health perception. Parents and health professionals assessed family burden using newly constructed questionnaires.RESULTS—Mean HbA1c was 8.7% (range 4.8–17.4). Lower HbA1c was associated with lower impact (P &lt; 0.0001), fewer worries (P &lt; 0.05), greater satisfaction (P &lt; 0.0001), and better health perception (P &lt; 0.0001) for adolescents. Girls showed increased worries (P &lt; 0.01), less satisfaction, and poorer health perception (P &lt; 0.01) earlier than boys. Parent and health professional perceptions of burden decreased with age of adolescent (P &lt; 0.0001). Patients from ethnic minorities had poorer scores for impact (P &lt; 0.0001), worries (P &lt; 0.05), and health perception (P &lt; 0.01). There was no correlation between adolescent and parent or between adolescent and professional scores.CONCLUSIONS—In a multiple regression model, lower HbA1c was significantly associated with better adolescent-rated QOL on all four subscales and with lower perceived family burden as assessed by parents and health professionals.