bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glucose Metabolism in Pregnancy at High Altitude
Authors: Krampl Elisabeth , Kametas Nikolaos A. , Nowotny Peter , Roden Michael , Nicolaides Kypros H. 
Published: March 2007

OBJECTIVE—To assess insulin sensitivity and β-cell function associated with lower maternal fasting plasma glucose levels at high altitude compared with sea level.
RESEARCH DESIGN AND METHODS—We studied 215 pregnant women at 8–42 weeks of gestation in Peru. The women were recruited from Cerro de Pasco, which is situated 4,370 m (14,340 feet) above sea level, and Lima, which is at sea level. We also examined 53 nonpregnant control subjects (22 in Cerro de Pasco and 31 in Lima). Fasting plasma glucose, insulin, C-peptide, and proinsulin concentrations were measured in samples obtained from the antecubital vein between 8:00 a.m. and 10:00 a.m. after an overnight period of fasting for 10–14 h. Insulin resistance and β-cell function were calculated using homeostasis model assessment.
RESULTS—Fasting C-peptide levels and β-cell function were similar, fasting concentrations of insulin and proinsulin were lower, and insulin sensitivity was higher at high altitude compared with sea level.
CONCLUSIONS—Maternal fasting plasma glucose that is lower at high altitude than at sea level in the presence of similar insulin secretion is associated with higher peripheral insulin sensitivity. This may partly explain the lower birth weights at high altitudes.
Hyperinsulinemia Predicts Fatal Liver Cancer but Is Inversely Associated With Fatal Cancer at Some Other Sites
Authors: Balkau Beverley , Kahn Henry S. , Courbon Dominique , Eschwège Eveline , Ducimetière Pierre 
Published: March 2007

OBJECTIVE—To investigate whether insulin is a risk factor for death by site-specific cancers.
RESEARCH DESIGN AND METHODS—This was a prospective cohort study of 6,237 nondiabetic French working men between ages 44 and 55 years at baseline from the Paris Prospective Study cohort. Death by site-specific cancers was investigated in relation to baseline insulin concentrations during fasting and 2 h after a 75-g oral glucose tolerance test.
RESULTS—Of the original 6,237 men in the cohort, 1,739 died over the 23.8 years of follow-up, 778 (45%) from cancer. Baseline hyperinsulinemia, both fasting and 2-h, was significantly associated with fatal liver cancer, with age-adjusted standardized hazards ratios of 2.72 (95% CI 1.87–3.94) and 3.41 (2.23–5.21). In contrast, fasting hyperinsulinemia was inversely associated with fatal lip, oral cavity, and pharynx cancer and larynx cancer, with hazards ratios of 0.55 (0.41–0.75) and 0.63 (0.47–0.83), respectively; 2-h insulin concentrations were inversely associated with stomach and larynx cancers (hazards ratios 0.62 [0.43–0.90] and 0.66 [0.50–0.89], respectively). These relationships were stable after adjusting for other risk factors. Insulin concentrations remained negatively associated with deaths from these cancers in analyses restricted to men who smoked and in those who were not chronic alcohol consumers.
CONCLUSIONS—Peripheral hyperinsulinemia, indicative of very high portal insulin concentrations, predicted fatal liver cancer in these nondiabetic men, but was inversely associated with fatal lip, oral cavity, and pharynx cancer; stomach cancer; and larynx cancer.
Detection of Hypoglycemia With the GlucoWatch Biographer
Authors: Pitzer Kenneth R. , Desai Shashi , Dunn Tim , Edelman Steve , Jayalakshmi Yalia , Kennedy John , Tamada Janet A. , Potts Russell O. 
Published: March 2007

OBJECTIVE—Hypoglycemia is a common acute complication of diabetes therapy. The GlucoWatch biographer provides frequent and automatic glucose measurements with an adjustable low-glucose alarm. We have analyzed the performance of the biographer low-glucose alarm relative to hypoglycemia as defined by blood glucose ≤3.9 mmol/l.
RESEARCH DESIGN AND METHODS—The analysis was based on 1,091 biographer uses from four clinical trials, which generated 14,487 paired (biographer and blood glucose) readings.
RESULTS—The results show that as the low-glucose alert level of the biographer is increased, the number of true positive alerts (alarm sounds and blood glucose ≤3.9 mmol/l) and false positive alerts (alarm sounds but blood glucose &gt;3.9 mmol/l) increased. When analyzed as a function of varying low-glucose alert levels, the results show receiver operator characteristic curves consistent with a highly useful diagnostic tool. Setting the alert level from 1.1 to 1.7 mmol/l above the level of concern is likely to optimize the trade-off between true positives and false positives for each user. When the same blood glucose data are analyzed for typical monitoring practices (two or four measurements per day), the results show that fewer hypoglycemic events are detected than those detected with the biographer.
CONCLUSIONS—The frequent and automatic nature of the biographer readings allows more effective detection of hypoglycemia than that achieved with current medical practice.
Increased Collagen IV Excretion in Diabetes
Authors: Cohen Margo P. , Lautenslager Gregory T. , Shearman Clyde W. 
Published: March 2007

OBJECTIVE—Increased albumin excretion in diabetes is believed to be derived from hemodynamic and/or permeability abnormalities, whereas mesangial matrix expansion gives rise to the reduction in glomerular filtration surface and decline in renal function in diabetic nephropathy. We postulated that the overproduction of extracellular matrix proteins underlying glomerulosclerosis in diabetes might be associated with the excretion of increased amounts of type IV collagen in the urine.
RESEARCH DESIGN AND METHODS—To explore this hypothesis, we measured the urinary excretion of (human) collagen IV by immunoassay in 65 patients with type 1 or type 2 diabetes and various degrees of albuminuria and examined its relationship to filtration function assessed by the reciprocal of the serum creatinine (RSC).
RESULTS—Collagen IV excretion showed a significant (P &lt; 0.001) inverse correlation (r = −0.62) with the RSC, and this correlation pertained regardless of whether albumin excretion was in the low (≤100 μg/mg creatinine; r = −0.73) or high (&gt;100 μg/mg; r = −0.53) range. In contrast, albumin excretion showed insignificant correlation with either collagen IV excretion (r = 0.12) or with the RSC (r = −0.20). Urinary collagen IV was significantly higher (P &lt; 0.05) in patients with an RSC value ≤100 (28.3 ± 2.4 ng/mg creatinine) than in patients with an RSC value &gt;100 (16.0 ± 0.8 ng/mg creatinine).
CONCLUSIONS—Because not all patients with microalbuminuria progress to declining renal function and some patients who develop nephropathy do not manifest albuminuria, the findings in this cross-sectional analysis suggest that measurement of urine collagen IV may be a useful noninvasive indicator to detect diabetic renal disease entering a phase of compromised renal function.
Type 2 Diabetes and Cognitive Function in Community-Dwelling Elderly Women
Authors: Grodstein Francine , Chen Jennifer , Wilson Robert S. , Manson JoAnn E. 
Published: March 2007

OBJECTIVE—To examine the relationship of type 2 diabetes to cognitive function in community-dwelling women.RESEARCH DESIGN AND METHODS—From 1995 to 1999, we administered four tests of cognitive function (Telephone Interview of Cognitive Status [TICS], immediate and delayed recall of the East Boston Memory Test, and verbal fluency) by telephone to 2,374 participants (70–78 years of age) of the Nurses’ Health Study. Information on diabetes was collected biennially beginning in 1976; 82 women reported type 2 diabetes before their cognitive testing. We used linear and logistic regression models to calculate multivariate-adjusted mean differences in scores and relative risks of a low score (bottom 10% of the distribution) for diabetic women compared with nondiabetic women.RESULTS—After multivariate adjustment, women with type 2 diabetes scored lower on all our cognitive tests than women without diabetes. On the general test of cognition (TICS), the mean difference in score between women with and without diabetes was −0.60 (95% CI −1.18 to –0.03, P = 0.04) and the relative risk of a low TICS score was 1.98 (95% CI 1.06 to 3.69). On a global score combining results of the four tests, the mean for diabetic women was lower than that among women without diabetes (adjusted difference in score −0.73, 95% CI −1.42 to −0.04, P = 0.04), and the relative risk of a low global score was 2.16 (95% CI 1.10 to 4.21). Relative to women without diabetes, longer duration of diabetes was associated with lower scores. Few diabetic women were pharmacologically treated (n = 31), but those taking medication had scores similar to those of women without diabetes.CONCLUSIONS—In these women, diabetes was related to lower scores on several aspects of cognitive function. Longer duration of diabetes may be associated with poorer scores, but hypoglycemic therapy may ameliorate scores.
Peripheral Nerve Function Is Increasingly Impaired During Puberty in Adolescents With Type 1 Diabetes
Authors: Riihimaa Päivi H. , Suominen Kalervo , Tolonen Uolevi , Jäntti Ville , Knip Mikael , Tapanainen Päivi 
Published: March 2007

OBJECTIVE—To evaluate the impact of puberty on peripheral nerve function in adolescents with type 1 diabetes.
RESEARCH DESIGN AND METHODS—Of 138 eligible patients with type 1 diabetes, 100 patients (age &gt;9 years and diabetes duration &gt;2 years) attending an outpatient diabetes clinic and 100 age- and sex-matched healthy control subjects took part in this cross-sectional study. Peripheral motor and sensory nerve conduction tests, cardiovascular reflex tests on the autonomic nervous system, and measurements of vibration-perception threshold (VPT) were performed.
RESULTS—Nerve conduction velocity (NCV) in the distal motor and sensory nerves, the motor nerve distal latency, and the sensory nerve action potential (SNAP) amplitude were impaired in the adolescent patients with type 1 diabetes. The deterioration in motor NCV, H-reflex latency, and SNAP amplitude became more conspicuous in late puberty and postpuberty and was related to poor metabolic control. A total of 10 patients had distal diabetic polyneuropathy (DP) neurophysiologically, and these patients had significantly lower heart-rate variation in the deep breathing test than the other patients. Three of the patients with DP had peripheral neurological signs or symptoms. A slight difference in the VPT between the patients and control subjects was observed after puberty.
CONCLUSIONS—Increasing subclinical motor nerve impairment can be detected during late puberty and after puberty, and sensory NCV and SNAP amplitude are reduced in adolescents with type 1 diabetes. Poor metabolic control during puberty appears to induce deteriorating peripheral neural function in young patients with type 1 diabetes.
Aldose Reductase Inhibition Ameliorates Pupillary Light Reflex and F-Wave Latency in Patients With Mild Diabetic Neuropathy
Authors: Nakayama Mikihiro , Nakamura Jiro , Hamada Yoji , Chaya Sadao , Mizubayashi Ryuichi , Yasuda Yutaka , Kamiya Hideki , Koh Naoki , Hotta Nigishi 
Published: March 2007

OBJECTIVE—The present study was conducted to investigate the effect of an aldose reductase inhibitor, epalrestat, on autonomic and somatic neuropathy at an early stage in type 2 diabetic patients by assessing the pupillary light reflex and minimum latency of the F-wave.
RESEARCH DESIGN AND METHODS—A total of 30 diabetic patients with subclinical or mild diabetic neuropathy were randomly allocated to a control group (n = 15) and epalrestat (150 mg/day) group (n = 15). After 24 weeks, the pupillary light reflex test, cardiovascular autonomic function tests, and nerve conduction study were performed.
RESULTS—The beneficial effect of epalrestat on the pupillary light reflex was observed in the minimum diameter after light stimuli (P = 0.044), constriction ratio (P = 0.014), and maximum velocity of constriction (P = 0.008). Among cardiovascular autonomic nerve functions, the ratio of the longest expiratory R-R interval to the shortest inspiratory R-R interval during deep breathing was significantly improved by epalrestat (P = 0.037). Minimum latencies of F-wave of median and tibial motor nerves were significantly shortened by epalrestat (P = 0.002 and P = 0.001, respectively); however, no significant effects were observed in motor or sensory nerve conduction velocity.
CONCLUSIONS—These observations suggest that epalrestat may have therapeutic value at the early stage of diabetic neuropathy and that the pupillary light reflex and minimum latency of F-wave may be useful indicators of diabetic neuropathy.
Frequency of Blood Glucose Monitoring in Relation to Glycemic Control in Patients With Type 2 Diabetes
Authors: Harris Maureen I. 
Published: March 2007

OBJECTIVE—The aim of the study was to investigate the relationship between blood glucose level, measured as HbA1c, and frequency of self-monitoring in patients with type 2 diabetes. Daily self-monitoring is believed to be important for patients treated with insulin or oral agents to detect asymptomatic hypoglycemia and to guide patient and provider behavior toward reaching blood glucose goals.
RESEARCH DESIGN AND METHODS—A national sample of patients with type 2 diabetes was studied in the third National Health and Nutrition Examination Survey. Data on therapy for diabetes, frequency of self-monitoring of blood glucose, and HbA1c values were obtained by structured questionnaires and by clinical and laboratory assessments.
RESULTS—According to the data, 29% of patients treated with insulin, 65% treated with oral agents, and 80% treated with diet alone had never monitored their blood glucose or monitored it less than once per month. Self-monitoring at least once per day was practiced by 39% of those taking insulin and 5–6% of those treated with oral agents or diet alone. For all patients combined, the proportion of patients who tested their blood glucose increased with an increasing HbA1c value. However, when examined by diabetes therapy category, there was little relationship between HbA1c value and the proportion testing at least once per day or the proportion testing at least once per week.
CONCLUSIONS—In this cross-sectional study of patients with type 2 diabetes, the increase in frequency of self-monitoring of blood glucose with increasing HbA1c value was associated with the higher proportion of insulin-treated patients in higher HbA1c categories. Within diabetes therapy categories, the frequency of self-monitoring was not related to glycemic control, as measured by HbA1c level.
Hormone Replacement Therapy Is Associated With Better Glycemic Control in Women With Type 2 Diabetes
Authors: Ferrara Assiamira , Karter Andrew J. , Ackerson Lynn M. , Liu Jennifer Y. , Selby Joseph V. 
Published: March 2007

OBJECTIVE—In women with diabetes, the changes that accompany menopause may further diminish glycemic control. Little is known about how hormone replacement therapy (HRT) affects glucose metabolism in diabetes. The aim of this study was to examine whether HbA1c levels varied by current HRT among women with type 2 diabetes.
RESEARCH DESIGN AND METHODS—In a cohort of 15,435 women with type 2 diabetes who were members of a health maintenance organization, HbA1c and HRT were assessed by reviewing records in the health plan’s computerized laboratory and pharmacy systems. Sociodemographic and clinical information were collected by survey.
RESULTS—The mean age was 64.7 years (SD ± 8.7). The study cohort comprised 55% non-Hispanic whites, 14% non-Hispanic blacks, 12% Hispanics, 11% Asians, 4% “other” ethnic groups, and 4% with missing ethnicity data. Current HRT was observed in 25% of women. HbA1c levels were significantly lower in women currently using HRT than in women not using HRT (age-adjusted mean ± SE: 7.9 ± 0.03 vs. 8.5 ± 0.02, respectively, P = 0.0001). No differences in HbA1c level were observed between women using unopposed estrogens and women using opposed estrogens. In a Generalized Estimating Equation model, which took into account patient clustering within physician and adjusted for age, ethnicity, education, obesity, hypoglycemic therapy, diabetes duration, self-monitoring of blood glucose, and exercise, HRT remained significantly and independently associated with decreased HbA1c levels (P = 0.0001).
CONCLUSIONS—HRT was independently associated with decreased HbA1c level. Clinical trials will be necessary to understand whether HRT may improve glycemic control in women with diabetes.
Association of the Ala54-thr Polymorphism in the Intestinal Fatty Acid–Binding Protein With 2-h Postchallenge Insulin Levels in the Framingham Offspring Study
Authors: Galluzzi Jennifer R. , Cupples L. Adrienne , Meigs James B. , Wilson Peter W.F. , Schaefer Ernst J. , Ordovas Jose M. 
Published: March 2007

OBJECTIVE—To investigate the association of variants of the intestinal fatty acid–binding protein gene (FABP2) with fasting and postchallenge glucose and insulin levels, HbA1c, and prevalence of type 2 diabetes in a separate sample of men and women.
RESEARCH DESIGN AND METHODS—Subjects were participants in the Framingham Offspring Study, a long-term community-based prospective observational study of risk factors for cardiovascular disease. The study sample consisted of 762 men and 922 women.
RESULTS—In women, carriers of the thr54 allele had significantly higher 2-h postchallenge insulin levels than noncarriers (104.4 ± 73.0 vs. 93.4 ± 61.5 μU/ml; P = 0.0139). This relationship remained significant after adjustment for familial relationship, age, BMI, triglycerides, APOE genotype, smoking, alcohol intake, the use of β-blockers, menopausal status, and estrogen therapy. No such significant association was observed in men. In both men and women, there were no statistical associations between the FABP2 polymorphism and BMI, fasting glucose, fasting insulin, 2-h postchallenge glucose levels, HbA1c, and prevalence of type 2 diabetes.
CONCLUSIONS—These results suggest that the FABP2 thr54 allele may have a minor contribution to the insulin resistance syndrome in a white general population.
Association of Physical Activity and Serum Insulin Concentrations in Two Populations at High Risk for Type 2 Diabetes but Differing by BMI
Authors: Kriska Andrea M. , Pereira Mark A. , Hanson Robert L. , de Courten Maximilian P. , Zimmet Paul Z. , Alberti K. George M.M. , Chitson Pierrot , Bennett Peter H. , Narayan K.M. Venkat , Knowler William C. 
Published: March 2007

OBJECTIVE—Physical activity and insulin sensitivity are related in epidemiological studies, but the consistency of this finding among populations that greatly differ in body size is uncertain. The present multiethnic epidemiological study examined whether physical activity was related to insulin concentrations in two populations at high risk for diabetes that greatly differ by location, ethnic group, and BMI.
RESEARCH DESIGN AND METHODS—The study populations consisted of 2,321 nondiabetic Pima Indian men and women aged 15–59 years from Arizona and 2,716 nondiabetic men and women aged 35–54 years from Mauritius. Insulin sensitivity was estimated by mean insulin concentration (average of the fasting and postload insulin), and total (i.e., leisure and occupational) physical activity was assessed by questionnaire.
RESULTS—Pima men and women who were more active had significantly (P &lt; 0.05) lower mean insulin concentrations than those less active (BMI and age-adjusted means were 179 vs. 200 and 237 vs. 268 pmol/l). Similar findings were noted in Mauritian men and women (94 vs. 122 and 127 vs. 148 pmol/l). In both populations, activity remained significantly associated with mean insulin concentration controlled for age, BMI, waist-to-thigh or waist-to-hip ratio, and mean glucose concentrations.
CONCLUSIONS—Physical activity was negatively associated with insulin concentrations both in the Pima Indians, who tend to be overweight, and in Mauritians, who are leaner. These findings suggest a beneficial role of activity on insulin sensitivity that is separate from any influence of activity on body composition.
Diminished Insulin Secretory Response to Glucose but Normal Insulin and Glucagon Secretory Responses to Arginine in a Family With Maternally Inherited Diabetes and Deafness Caused by Mitochondrial tRNALEU(UUR) Gene Mutation
Authors: Brändle Michael , Lehmann Roger , Maly Friedrich E. , Schmid Christoph , Spinas Giatgen A. 
Published: March 2007

OBJECTIVE—The effects of glucose, arginine, and glucagon on β-cell function as well as α-cell response to arginine were studied in a family with mitochondrial diabetes.
RESEARCH DESIGN AND METHODS—The function of α- and β-cells was assessed in all five siblings carrying the mitochondrial tRNA Leu(UUR) gene mutation at position 3243 and compared with six sex-, age-, and weight-matched control subjects. Insulin and C-peptide responses were evaluated by intravenous glucagon application, intravenous arginine stimulation test, and intravenous glucose tolerance test. Glucagon secretion was assessed during the arginine stimulation test.
RESULTS—The glucose disappearance constant (Kg) value (mean ± SEM 0.61 ± 0.04 vs. 1.1 ± 0.04, P = 0.0002) as well as the acute insulin response to glucose (area under the curve [AUC] 0–10 min, 77.7 ± 50.7 vs. 1,352.3 ± 191.5 pmol/l, P = 0.0004) were decreased in all patients. Similarly, glucagon-stimulated C-peptide response was also impaired (728 ± 111.4 vs. 1,526.7 ± 157.7 pmol/l, P = 0.005), whereas the insulin response to arginine (AUC) was normal (1,346.9 ± 710.8 vs. 1,083.2 ± 132.5 pmol/l, P = 0.699). Acute glucagon response to arginine (AUC) was normal but tended to be higher in the patients than in the control subjects (181.7 ± 47.5 vs. 90.0 ± 21.1 pmol/l, P = 0.099).
CONCLUSIONS—This study shows impaired insulin and C-peptide secretion in response to a glucose challenge and to glucagon stimulation in diabetic patients with mitochondrial tRNA Leu(UUR) gene mutation, although insulin and glucagon secretory responses to arginine were normal.
Long-Term Trends in Childhood Diabetes Mortality: 1968–1998
Authors: DiLiberti John H. , Lorenz Rodney A. 
Published: March 2007

OBJECTIVE—In the context of recent improvements in type 1 diabetes therapy, to describe longitudinal trends in mortality attributable to childhood diabetes and to investigate socioeconomic and health services correlates of mortality.
RESEARCH DESIGN AND METHODS—We extracted mortality data for 1968–1998 from National Center for Health Statistics files and covariates from the Bureau of Health Professions Area Resource File. Analytical techniques included linear and Poisson regression and standard descriptive statistics.
RESULTS—Childhood (defined as 0–19 years of age) age-adjusted mortality from diabetes declined from 9.5 (1968) to 3.0 (1984) deaths per 10 million but remained relatively constant subsequently. All-cause childhood mortality, however, continued to decline. Older children experienced higher mortality rates, as did those living in counties with higher levels of unemployment.
CONCLUSIONS—Despite recent improvements in therapy, diabetes-related mortality among children has not declined for 14 years. This finding may be partially attributable to sociodemographic factors influencing access to care, but the remaining mortality may defy available treatment methods. Reducing childhood diabetes mortality rates below the current apparent plateau may require new prevention and/or treatment strategies.