bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short-Term Effect of Red Wine (Consumed During Meals) on Insulin Requirement and Glucose Tolerance in Diabetic Patients
Authors: Gin Henri , Morlat Philippe , Ragnaud Jean M , Aubertin Jean 
Published: March 2007

Objectives
To determine the effect of wine on insulin requirement or glucose tolerance.

Research Design and Methods
Five men with insulin-treated diabetes and 10 men with non-insulin-treated diabetes ate the same lunch with the same volume of either water or red wine (2 glasses). Insulin requirement was determined with an artificial pancreas (Biostator). Glucose tolerance was evaluated from the postprandial glycemic level.

Results
There was no significant difference in insulin requirement determined with an artificial pancreas in the insulin-treated patients after the two meals (31.5 ± 4.21 U with water and 31.8 ± 4.3 U with wine). Glucose tolerance in the non-insulin-treated patients was lower after the meal with wine.

Conclusions
Moderate prandial wine consumption has no adverse effect on the glycemic control of diabetic patients. Thus, it appears unnecessary to proscribe the consumption of red wine in moderation with meals to diabetic patients. Wine contains tannins and phytates that can explain its action.
Role of Industry Representatives in Providing Assistance to Certified Diabetes Educators
Authors: Daughtry Sue B , O'Brien Kevin F , Long Stuart D , Scharf Daniel R 
Published: March 2007

Objectives
As diabetes educators have become more frequently involved in decisions regarding medications, equipment, and supplies, industry representatives have increasingly provided various types of assistance. The major objectives of this survey were to determine 1) the types of assistance being provided to certified diabetes educators (CDEs) by industry representatives, 2) whether product recommendations are based on assistance provided, and 3) the types of assistance that CDEs consider appropriate.

Research Design and Methods
We developed the survey instrument and it was mailed to every fifth person listed in the 1989 directory of CDEs. Three hundred twenty-five (51%) of the active surveys were returned.

Results
Those responding indicated that 1) the types of support provided most frequently by industry representatives include instructional materials, samples, supplies, and equipment for patient care and education; 2) the number of types of support provided is directly related to the number of industry representatives seen on a regular basis and the frequency of interaction; 3) 22% of the educators state that they make product recommendations based on support provided; and 4) the role of the industry reps should be to continue support for patient care and education, to provide more support for public and professional education, and to minimize support for personal items, e.g., gifts or meals.

Conclusions
The survey indicates that CDEs are receiving many types of assistance from industry representatives and that they prefer that such assistance be targeted toward patient and professional education.
Glycosylated Serum Protein Levels Assayed With Highly Sensitive Immunoradiometric Assay Accurately Reflect Glycemic Control of Diabetic Patients
Authors: Gordon Amirav , Glaser Benjamin , Wald Moshe , Rio Graziano Del , Casa Luciano Della , Gross Jack , Cerasi Erol 
Published: March 2007

Objective
To develop a sensitive and reliable immunoreadiometric assay to measure glycosylated lysine residues on serum proteins (GSP) and to evaluate its efficacy in monitoring glycemic control.

Research Design
The effect of acute and chronic in vitro and in vivo changes in glucose levels on GSP concentration was evaluated. GSP determinations from insulin-dependent diabetic (IDDM) patients, non-insulin-dependent diabetic (NIDDM) patients, and control subjects were correlated with other indices of glycemic control.

Results
The GSP levels were unaffected by acute glucose changes after food or intravenous glucose administration but increased during storage at−20°C due to in vitro glycosylation by endogenous glucose. Immediate acidification of the serum prevented this, permitting long-term storage despite high ambient glucose levels. In randomly selected diabetic patients, 96% of GSP values were greater than the mean +3SD of nondiabetic control subjects. In diabetic patients, GSP levels correlated with mean plasma glucose concentrations (Kendall correlation statistics 0.47, P &lt;0.001), fasting plasma glucose levels (Kendall statistics 0.42, P &lt;0.001), and glycosylated hemoglobin (GHb, Kendall statistics 0.30, P &lt;0.005). Induction of near-normal glycemia in poorly controlled NIDDM patients reduced GSP levels with a slope consistent with a half time of disappearance of 4.7 ± 0.4 days. GSP levels remained elevated in 6 of 10 well-controlled NIDDM patients, despite normal GHb concentrations. Chronic hypoglycemic states, like pregnancy and hyperinsulinemic hypoglycemia, were associated with significantly low GSP levels.

Conclusion
We describe a reproducible and sensitive immunoradiometric assay for GSP that closely reflects the degree of glycemic control in diabetic patients. Further studies are needed to determine whether this assay may be useful in screening for glucose intolerance or gestational diabetes.
Biosynthetic Human Proinsulin: Review of Chemistry, in Vitro and in Vivo Receptor Binding, Animal and Human Pharmacology Studies, and Clinical Trial Experience
Authors: Galloway John A , Hooper Susan A , Spradlin C Thomas , Howey Daniel C , Frank Bruce H , Bowsher Ronald R , Anderson James H 
Published: March 2007

Objective
To describe the rationale for the preclinical and clinical developmental course of human proinsulin (HPI), the second product after human insulin for the treatment of diabetes mellitus to be manufactured by DNA technology.

Research Design and Methods
The relevant and available published and unpublished preclinical and clinical information generated on pork proinsulin and human proinsulin has been integrated to demonstrate how certain clinically attractive features of pork proinsulin (a soluble intermediate-acting and possibly hepatospecific insulin agonist) led to the development of HPI.

Results
Clinical pharmacology studies demonstrated that HPI was definitely, although marginally, hepatospecific. More striking was the finding that the intrasubject/patient coefficient of variation of response to HPI was significantly less than that observed with NPH insulin. However, the fact that unique efficacy in controlled multicenter studies was not demonstrated suggested that these pharmacological features were not translated into clinical benefit. In one multicenter new patient study there were six myocardial infarctions, including two deaths, in patients treated for ≥1 yr with HPI and none in the control group.

Conclusions
To obtain an independent review of the risks and benefits of HPI, in February 1988, Lilly convened a consultant group that examined all relevant information on HPI available. These experts shared our concerns about the safety of HPI in light of the failure to demonstrate unique efficacy. Accordingly, clinical trials with HPI were suspended in February 1988. Experience with HPI demonstrates the challenge associated with the development of new drugs in general and insulin agonists in particular.
Intracellular Free Magnesium Deficiency Plays a Key Role in Increased Platelet Reactivity in Type II Diabetes Mellitus
Authors: Nadler Jerry L , Malayan Sam , Luong Helen , Shaw Sylvia , Natarajan Rama D , Rude Robert K 
Published: March 2007

Objective
Mg deficiency may be an important factor leading to cardiovascular disease. Diabetic subjects show an increase in platelet reactivity that can enhance the risks of vascular disease. In addition, diabetic patients have been reported to be at risk of developing extracellular Mg deficiency. However, the intracellular free Mg concentration and its role in the enhanced platelet reactivity in diabetes is not known.

Research Design and Methods
We evaluated the intracellular erythrocyte (RBC) Mg2+ concentration in 20 non-insulin-dependent (type II) diabetics. In addition, the effects of intravenous 3-h drip or 8 wk of oral Mg supplementation on intracellular RBC Mg2+ levels and platelet reactivity was studied. To more clearly evaluate the direct role of Mg in these effects, we induced isolated Mg deficiency in 16 nondiabetic control subjects with an Mg-free liquid diet for 3 wk.

Results
The intracellular RBC Mg2+ concentration of diabetic patients was significantly reduced compared with values in nondiabetic control subjects (166 ± 7 vs. 204 ± 7 μM, P &lt; 0.01). Serum Mg levels were also reduced in the diabetic patients compared with the control subjects (1.59 ± 0.04 vs. 1.9 ± 0.1 mEq/L, P &lt; 0.05). Oral Mg supplementation for 8 wk (400 mg/day) restored RBC Mg2+ concentration to normal without significantly changing serum Mg concentration. Both intravenous and oral Mg supplementation markedly reduced platelet reactivity in response to the thromboxane A2 analog, U46619. The Mg-free diet resulted in a significant reduction in RBC Mg2+ concentration and markedly enhanced the sensitivity of platelet aggregation to U46619 and ADP.

Conclusions
These results suggest that type II diabetic patients have intracellular Mg2+ deficiency and that Mg deficiency may be a key factor in leading to enhanced platelet reactivity in type II diabetes. Therefore, Mg supplementation may provide a new therapeutic approach to reducing vascular disease in patients with diabetes.
Sensory Function at Diagnosis and in Early Stages of NIDDM in Patients Detected Through Screening
Authors: Sosenko Jay M , Kato Marta , Soto Ramon , Goldberg Ronald B 
Published: March 2007

Objective
We studied whether sensory function abnormalities are present at diagnosis and whether they develop in the early stages of non-insulin-dependent diabetes (NIDDM).

Research Design and Methods
Quantitative assessments of vibration sensitivity at the hallux and index fingers, and thermal sensitivity at the hallux were performed at screening (2-h oral glucose tolerance tests) for diabetes in 364 individuals. Twenty-five subjects diagnosed with NIDDM and 25 matched nondiabetic subjects were restudied after an interval of 12–41 mo.

Results
When those with NIDDM (n = 41) or impaired glucose tolerance (IGT) (n = 38) were compared with nondiabetic subjects, there were no significant differences in sensory function indices. However, the vibration threshold and HbA1c were related among those found to be hyperglycemic (IGT and NIDDM combined P &lt; 0.05; NIDDM alone P &lt; 0.05). Among diabetic subjects, the vibration threshold and interaction term of height and Hba1c were positively related in a multiple regression analysis (P &lt; 0.01). There were increments in all sensory thresholds in diabetic patients at follow-up (P &lt; 0.05 for all). Increments were smaller in control subjects.

Conclusions
These data suggest that although sensory function tends to be normal at diagnosis in NIDDM patients, there appears to be a diminution in sensory function as the disease progresses. An interaction between metabolic factors and height may influence sensory function early in the course of NIDDM.
Effect of Thermal Biofeedback-Assisted Relaxation Training on Blood Circulation in the Lower Extremities of a Population With Diabetes
Authors: Rice Birgitta I , Schindler Jay V 
Published: March 2007

Objective
Investigate the effect of relaxation training/thermal biofeedback on blood circulation in the lower extremities of diabetic subjects.

Research Design and Methods
Diabetic subjects (n = 40) aged 17–73 yr were volunteers recruited through the University of Wisconsin-La Crosse, the local ADA Chapter, and a medical clinic. A within-subjects experimental design was used. During phase 1, all subjects used a self-selected relaxation method and recorded toe temperatures daily. During phase 2, subjects were taught a biofeedback-assisted relaxation technique designed to elicit sensations of warmth in the lower extremities and increase circulation and temperature. Subjects relaxed at home with the use of a designated relaxation tape. They measured and recorded toe temperatures. Each phase lasted 4 wk.

Results
Toe temperature and blood volume pulse (BVP) data were gathered at the beginning and end of phases 1 and 2. Paired t tests compared the means of temperature percent change scores between 1 and 2. Mean temperature change scores were 8.73% (phase 1) and 31.38% (phase 2) (t = −8.00, df = 39, P &lt; 0.001). Mean BVP change scores were 2.33% (phase 1) and 22.47% (phase 2) (t = −9.24, df = 35, P &lt; 0.001). Based on eta squared, 71% of the BVP increase in phase 2 was attributed to the relaxation technique. A multiple regression analysis indicated that none of the other examined variables affected by diabetes were significant predictors of BVP increase.

Conclusions
Data indicate that diabetic patients show significant increases in peripheral blood circulation with this technique. This noninvasive method could serve as an adjunct treatment for limited blood flow in some complications of diabetes.
Twice-Daily Humulin Ultralente Insulin Decreases Morning Fasting Hyperglycemia
Authors: Johnson Nnacy B , Kronz Kathleen K , Fineberg Naomi S , Golden Michael P 
Published: March 2007

OBJECTIVE
To test whether a two-injection regimen of HUL/R would improve FBG and metabolic control in pediatric IDDM patients with a dawn rise in FBG compared with our standard twice-daily therapy, HL/R.

RESEARCH DESIGN AND METHODS
Seventy-seven patients with fasting hyperglycemia (prebreakfast mean FBG ≥ 8.3 mM (150 mg/dl) during the preceding 2 wk) were evaluated with twice-weekly midsleep (0230–0330) FBG for 2 wk. Forty-seven patients (61%) had a mean dawn rise between midsleep and prebreakfast of ≥ 2.8 mM (50 mg/dl). Patients continued on HL/R for an additional 4 wk, after which 31 patients were then randomized into a double-blind 12-wk trial of either HUL/R (n = 14) or HL/R (n = 17) administered before breakfast and the evening meal. Midsleep FBG was obtained twice weekly with weekly insulin adjustment as needed to optimize glycemic control. FBG was monitored and verified with memory glucometers (Glucometer M). HbA1c levels were measured at the time of physician visits at 0, 6, and 12 wk.

RESULTS
Prebreakfast FBG was lower in the HUL/R-treated patients (10.6 ± 0.6 vs. 12.6 ± 0.6 mM [191 ± 6.4 vs. 227 ± 11.2 mg/dl], P &lt; 0.02). The dawn rise was diminished in the HUL/R patients (0.5 ± 0.5 vs. 2.6 ± 0.7 mM [9 ± 8.3 vs. 46 ± 11.7 mg/dl], P &lt; 0.02). FBG at lunch, dinner, bedtime, and midsleep were similar in both groups, and HbA1c did not differ between groups or change significantly in either group during the 12-wk trial. Insulin dose, percentage R, day-night dosage split, and episodes of hypoglycemia (FBG &lt; 3.3 mM [60 mg/dl]) were similar in both groups.

CONCLUSIONS
A 12-wk trial of twice-daily HUL/R improved fasting glycemia in pediatric patients with a dawn rise but did not improve metabolic control as measured by HbA1c.
Restoration of Fuel Homeostasis in IDDM Patients During Pregnancy by an Open-Loop Insulin Infusion System
Authors: Foss Milton C , Aoki Thomas T 
Published: March 2007

Objective— To characterize the effects of subcutaneous insulin pump therapy on the metabolic response (CHO and lipid oxidation, and nonoxidative glucose metabolism) to a glucose challenge of diabetic women at early pregnancy.
Research Design and Methods— Seven nondiabetic and seven IDDM pregnant patients on insulin pump therapy were studied at the first trimester. Fuel oxidation rates were determined by indirect calorimetry, and blood levels of substrates and hormones were measured before and for 2 h after ingestion of a 50 g oral glucose load.
Results— The increments in npRQ and CHO oxidation rates after the glucose meals in the diabetic women on insulin pump therapy were similar to those in the normal subjects. The glucose disposal data during the 2 h of the studies revealed that the amounts of oxidative and nonoxidative glucose utilization in the control subjects and in the IDDM patients on insulin pump therapy did not show significant differences.
Conclusions— This investigation demonstrated that the treatment of IDDM patients during early pregnancy by an open-loop insulin infusion system is sufficient to normalize their glucose-processing capability with respect to cellular oxidative and nonoxidative glucose metabolism in response to an oral glucose challenge, but some abnormalities in their blood profiles of glucose, lactate, and pyruvate persisted.
Diabetes and Its Complications Among Selected Tribes in North Dakota, South Dakota, and Nebraska
Authors: Stahn Ruggles M , Gohdes Dorothy , Valway Sarah E 
Published: March 2007

Objective— To determine the prevalence and incidence rates of diabetes and two specific complications for selected American-Indian tribes in North Dakota, South Dakota, and Nebraska.
Research Design and Methods— A descriptive epidemiological study was conducted using ambulatory care data during 1987 for prevalence and diabetes registries and complication case reporting during 1988 from IHS facilities on reservations in these states.
Results— The Winnebago and Omaha tribes had the highest age-adjusted diabetes rates, with prevalence 8.8 times and incidence 7.7 times the respective U.S. rates. The diabetes prevalence rate of combined data for the Sioux was 3.7 times the U.S. rate. Among Sioux Indians, the age-adjusted incidence rate for ESRD was 4.8 times the American-Indian/Alaska-Native rate and 13.4 times the rate for U.S. whites. The proportion of new diabetes-related ESRD (86%) was almost 3 times greater than the general U.S. population rate (30%). Also, among the Sioux, the age-adjusted incidence rate for LEA (86.7/10,000 diabetic population) was 1.5 times higher than the U.S. rate; the proportion of diabetes-related LEA (84%) was 1.8 times higher than the general U.S. population rate (45%).
Conclusions— The age-adjusted rates of diabetes and certain complications among these Northern Plains tribes are greater than the U.S. rates. Improved health services to detect and monitor diabetes and its complications and community-based prevention activities directed at the epidemic of diabetes among the various Indian tribes are urgently needed.
Diabetes in Mississippi Choctaw Indians
Authors: Johnson Lynda G , Strauss Karen 
Published: March 2007

Objective— To establish a registry of patients with diabetes and determine the point prevalence of diabetes in the Mississippi Choctaw Indians at the end of September 1989.
Research Design and Methods— A survey of diabetes cases was conducted, using the NDDG criteria for diagnosis with comparison to U.S. rates determined from the 1979–1981 NHIS. IHS-supported hospital and outpatient clinics serving the Choctaw Indians of Mississippi were the setting. Medical charts of patients on the computer record of outpatient visits seen for diabetes and laboratory lists of patients who had elevated blood glucose levels in 1988 were reviewed.
Results— The age-adjusted prevalence of 163.2/1000 population was 6.5 times (95% CI 4.3–9.8) the U.S. rate. The prevalence of diabetes in the Choctaw Indians was significantly higher than the U.S. rates for all age-groups except for those &lt;15 yr of age.
Conclusions— Intervention programs are urgently needed to prevent or delay the onset of diabetes and its complications in this southeastern tribe. The registry system is being used to gather information on the prevalence and incidence of diabetic complications and associated risk factors to guide programs.
A Follow-Up Study of Diabetic Oklahoma Indians: Mortality and causes of death
Authors: Lee Elisa T , Russell Dana , Jorge Nisa , Kenny Susan , Yu Mei-Lin 
Published: March 2007

OBJECTIVE— To determine the mortality rates and causes of death for diabetic Oklahoma Indian adults by sex and age.
RESEARCH DESIGN AND METHODS— This was a cohort follow-up study with baseline examination between 1972–1980 and the mortality follow-up between 1986 and 1989. Mean follow-up time was 10 ± 4 yr. A quasi-random sample of 1012 (379 men and 633 women) NIDDM American Indians in Oklahoma was performed. Mean age was 52 yr and duration was 7 yr at baseline. Mean degree of Indian blood was 92% (77% full blood). At follow-up, 548 (54%) were alive, 452 (45%) were decreased, and 12 (1%) could not be traced.
RESULTS— Death certificates were obtained and coded (ICD-9) for 439 (97%) of the deceased. Mean annual mortality rates were 4.99% for men and 4.17% for women, with an increasing trend with age for both sexes. Compared with the general population of Oklahoma, the observed/expected ratios for number of deaths were 2.92 for men and 4.09 for women (P &lt; 0.0001). The three leading causes of death were circulatory disease (38%), diabetes (24%), and malignant neoplasms (12%).
CONCLUSIONS— There is an excessively high mortality among diabetic Oklahoma Indians compared with the general population in the state and with diabetic patients in other populations.
Factors Associated With Failure to Complete Treatment for Diabetic Retinopathy Among Navajo Indians
Authors: Sugarman Jonathan R , Bauer Mark C , Barber Elouise L , Hayes Janet L , Hughes James W 
Published: March 2007

OBJECTIVE— To determine the proportion of patients with suspected proliferative diabetic retinopathy who did not receive the recommended follow-up ophthalmological evaluation and care, and to examine associations between various patient characteristics and the failure to obtain care.
RESEARCH DESIGN AND METHODS— The study cohort included all Navajo Indians identified by a retrospective review of records who had proliferative diabetic retinopathy diagnosed at an Indian Health Service Optometry Clinic between 1 October 1985 and 30 September 1988. Follow-up data were obtained by medical record reviews and by interviews with subjects.
RESULTS— Of 69 patients identified, 57 of 61 living patients were interviewed. Twenty-three (40.4%) had failed to obtain recommended follow-up. The RR for incomplete treatment among those without a vehicle in the household compared with those with a vehicle was 1.91 (95% CI 1.32–2.76). Other factors associated with incomplete treatment were female sex and marital status other than currently married. Twelve (21%) patients answered “no” to the question, “Have you been told that diabetes was affecting your eyes?” Eight of 38 (21%) who confirmed that they had been told that diabetes was affecting their eyes responded “no” to the question, “Do you think that diabetes is affecting your eyes?” However, the answers to these questions did not distinguish between patients who obtained or did not obtain recommended care.
CONCLUSIONS— Interventions to increase the proportion of Navajo Indians with diabetic retinopathy who receive appropriate ophthalmologic care must address the issue of transportation.