bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Between Serum Levels of Methylguanidine and Glycemic Control in IDDM Children
Authors: Nagashima Kanji , Yagi Hideki , Yutani Shigenori , Miyake Hiroshi , Onigata Kazumichi , Kuroume Takayoshi 
Published: March 2007

OBJECTIVE
To examine the serum levels of methylguanidine in IDDM children and compare them with markers for glycemic control. Reports have indicated that active oxygen, which damages various tissues, increases in diabetes mellitus. The increase of active oxygen is one of the risk factors for diabetic complications. The synthesis of methylguanidine, a metabolic product of guanidine, is mainly regulated by active oxygen.

RESEARCH DESIGN AND METHODS
Forty-eight children with IDDM (mean age 13.3 yr) and 17 age-matched nondiabetic control subjects were studied. Diabetic children were divided into a well-controlled group (HbA1c &lt; 8%, n = 24) and a poorly controlled group (HbA1c &gt; 8%, n = 24). Serum concentrations of methylguanidine were measured by enzymatic assay.

RESULTS
Levels of methylguanidine in the poorly controlled group (1.31 ± 0.08 μM) were significantly higher than those in both the well-controlled group (0.85 ± 0.08 μM) and the control group (0.59 ± 0.11 μM), respectively (P &lt; 0.01). Methylguanidine levels showed a positive correlation with the levels of HbA1c (P &lt; 0.01) or fructosamine (P &lt; 0.01). No significant correlations were noted between methylguanidine levels and age, sex, duration of diabetes, or insulin dose.

CONCLUSIONS
Our data indicate that the levels of methylguanidine in IDDM children might be affected by glycemic control and that the determination of serum methylguanidine levels could be a useful test for evaluating the state of diabetic control.
Long-Term Glycemic Control and Neurological Function in IDDM Patients
Authors: McCance David R , Atkinson A Brew , Hadden David R , Kennedy Laurence 
Published: March 2007

Objective— To examine the relationship between sensory modalities of neurological function and antecedent glycemic control in IDDM patients.
Research Design and Methods— Examinations were conducted on 220 IDDM patients (age at onset &lt;25 yr, duration &lt;18 yr) for the presence or absence of the right or left ankle reflex and determination of vibration perception threshold at each medial malleolus and great toe using biothesiometry. These parameters were related to the concurrent HbA1 and to a mean of serial measurements (mean HbA1) over the previous 6 yr.
Results— Ankle reflexes were absent in 39 (right ankle) and 41 (left ankle) patients, respectively. Mean (right + left) ankle and toe VPTs were 8.7 ± 3.6 and 6.3 ± 4.2 (mean ± SD) (arbitrary units), respectively. Both the mean and concurrent HbA1 were significantly different in patients with absent ankle reflexes (11.6 ± 1.9 and 12.2 ± 2.8%, respectively) compared with present ankle reflexes (10.3 ± 1.7, 10.3 ± 2.1%) (P &lt;0.0001). Similarly, a present ankle reflex was related to mean HbA1 arbitrarily divided into groups &lt;10, 10−12, &gt; 12% (P = 0.0009). In contrast, mean ankle VPT (8.0 ± 2.2, 8.8 ± 3.1, and 10.3 ± 6.2) and toe VPT (5.5 ± 2.2, 6.1 ± 2.9, and 8.5 ± 8.2) did not increase significantly with poor glycemic control (P &gt; 0.05). Age, right ankle reflex, retinopathy, 24-h urinary albumin excretion rate, and erect systolic blood pressure were the only independent variables predicting the toe VPT using linear regression analysis.
Conclusions— These findings support a role for glycemic control in neurological dysfunction in IDDM patients, but also suggest that other unknown factors may be involved.
Long-Term Follow-Up Evaluation of Blood Glucose Awareness Training
Authors: Cox Daniel J , Gonder-Frederick Linda , Julian Diana M , Clarke William 
Published: March 2007

OBJECTIVE
Blood glucose awareness training (BGAT) has been found effective in teaching individuals with insulin-requiring diabetes to improve their ability to better recognize blood glucose (BG) fluctuations. This study investigated whether subjects who underwent BGAT a mean of 4.9 years previously were superior to past control subjects in terms of their ability to recognize BG fluctuations, and whether past BGAT subjects had fewer automobile crashes and lost work days and better glycosylated hemoglobin than control subjects. Additionally, the beneficial effects of providing booster training to past BGAT subjects also was evaluated.

RESEARCH DESIGN AND METHODS
This study followed up 28 past BGAT subjects. Half of these subjects (n = 14) received a simple booster-training program. Twelve previous control subjects also were evaluated. Booster subjects were given a BGAT diary to complete for 2 weeks before evaluation. Evaluation for all subjects included completion of a retrospective questionnaire on work and driving history, blood drawing for a glycosylated hemoglobin analysis, and having subjects estimate and measure their BG levels 50–80 times during a 3- to 4-week period during their daily routine.

RESULTS
At long-term follow-up, BGAT subjects had significantly fewer automobile crashes than control subjects. BGAT subjects receiving booster training were significantly more accurate at estimating their BG levels and were more aware of hypoglycemia. Post hoc analyses indicated that the ability to accurately estimate BG fluctuations correlated positively with follow-up glycosylated hemoglobin and the number of hypoglycemic and hyperglycemic symptoms participants demonstrated.Both BGAT and control subjects demonstrated significantly improved glycosylated hemoglobin relative to baseline measures.

CONCLUSIONS
These data suggest that BGAT has long-term benefits, which can be enhanced with booster training. Specifically, BGAT and simple booster training may result in reduction of severe hypoglycemic episodes and automobile crashes in the long term.
Effects of a Small Quantity of ω-3 Fatty Acids on Cardiovascular Risk Factors in NIDDM: A randomized, prospective, double-blind, controlled study
Authors: Axelrod Lloyd , Camuso Janice , Williams Ellen , Kleinman Kenneth , Briones Esperanza , Schoenfeld David 
Published: March 2007

OBJECTIVE
To study the effects of a low dose of ω-3 fatty acids on platelet function and other cardiovascular risk factors in patients with non-insulin-dependent diabetes mellus (NIDDM).

RESEARCH DESIGN AND METHODS
We performed a randomized, prospective, double-blind, controlled study of a low dose of ω-3 fatty acids (2.5 g/day) in 20 ambulatory subjects with NIDDM. Subjects ingested five 1-g fish oil capsules each containing 0.5 g ω-3 fatty acids or five 1-g safflower oil capsules per day for 6 weeks followed by a 6-week washout period.

RESULTS
Nine subjects completed the study in each group. Both groups exhibited moderate control of glucose levels; modest elevations in baseline total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride (TG) levels; and normal blood pressure values. In the fish oil group, plasma ω-3 fatty acid levels increased significantly. Fish oil significantly reduced the slope of the dose-response curves for collagen-induced platelet aggregation to one-third the value observed with safflower oil. No difference was observed in collageninduced production of thromboxane A2 (TXA2, measured as the stable derivative TXB2), or in adenosine-5'-diphosphate- (ADP) induced platelet aggregation or TXA2 generation. Patients with high initial collagen-induced platelet TXA2 production showed a significantly larger drop after fish oil than safflower oil. Fish oil significantly reduced TG levels by 44 mg/dl and decreased upright systolic blood pressure (sBP) by 8 mmHg compared with safflower oil. Fish oil caused a significant but small increase in HbA1c (0.56%) and total cholesterol (20 mg/dl) but had no effect on fasting glucose, high-density lipoprotein cholesterol, or LDL-cholesterol levels.

CONCLUSIONS
Small doses of fish oil inhibit platelet aggregation and TXA2 production, reduce upright sBP and TG levels, and have only a small effect on glucose and cholesterol levels in patients with moderately controlled NIDDM. Small quantities of ω-3 fatty acids or dietary fish are safe and potentially beneficial in NIDDM patients.
Comparison of Excess Costs of Care and Production Losses Because of Morbidity in Diabetic Patients
Authors: Olsson Jonny , Persson Ulf , Tollin Claes , Nilsson Sven , Melander Arne 
Published: March 2007

OBJECTIVE
To assess and compare excess costs of care and production losses because of morbidity in diabetic patients and the general population of a Swedish community.

RESEARCH DESIGN AND METHODS
Costs of production losses were calculated from medical and social insurance records on sickness benefit days (short-term illness) and premature retirement (permanent disability) in people with diabetes and in the entire population of the community (a municipality comprising a town and rural surroundings, with 28,000 inhabitants). Care costs included those of consultations and inpatient care, as well as costs of insulin, oral antidiabetic medications, other drugs, test material, and treatment devices, and they were obtained from patient records, the health care administration, and the statistics of community pharmacy sales.

RESULTS
Of the diabetic patients &lt; 65 years of age, above which both diabetic and nondiabetic people get retirement pension, and sickness benefits cease, 62% of those on insulin treatment in each gender had insulin-dependent diabetes mellitus (IDDM). All insulin-treated non-insulin-dependent diabetes mellitus (NIDDM) patients were &gt; 40 years of age. Both the insulin-treated and the non-insulin-treated diabetic patients were prematurely retired twice as often as the average population and had twice as many inpatient days. The insulin-treated subjects also had twice as many sickness benefit days. The excess costs of production losses as a result of morbidity in people with diabetes were about $7,000 per individual and year. The corresponding excess costs of inpatient care were $800. The therapeutic expenditures for control of diabetes were about $600 per individual and year. If converted to U.S. conditions, the costs of lost production as a result of excess morbidity (&lt; 65 years of age) would be $12 billion and $9 billion for people with insulin-treated and non-insulin-treated diabetes, respectively.

CONCLUSIONS
If improved metabolic control by intensified treatment would reduce excess morbidity in both IDDM and NIDDM, the predominant costs of production losses imply that intensified antidiabetic treatment might save costs.
Diabetic Nephropathy and Microalbuminuria in the Community: The South Auckland Diabetes Survey
Authors: Simmons David , Shaw Lois M , Scott David J , Kenealy Tim , Scragg Robert K 
Published: March 2007

OBJECTIVE
To compare the clinical, anthropometric, and metabolic characteristics of New Zealand Europeans, Maori, and Pacific Islanders with non-insulin-dependent diabetes mellitus (NIDDM) with emphasis on risk factors for the development of diabetic nephropathy.

RESEARCH DESIGN AND METHODS
A cross-sectional survey of 555 (74% of 750 available) diabetic patients attending diabetes clinics and randomly selected primary care centers was conducted in Auckland, New Zealand.

RESULTS
Among those with NIDDM, Maori and Pacific Islanders were younger at diagnosis, more obese, and had poorer glucose control when compared with the Europeans (fructosamine in μmol/l: Maori 335 ± 78, Pacific Islanders 367 ± 90, Europeans 318 ± 55; overall P &lt; 0.001). Systolic blood pressure (sBP) was higher in Maori (145 ± 31 mmHg) and lower in Pacific Islanders (135 ± 25 mmHg) when compared with Europeans (141 ± 25 mmHg; overall P &lt; 0.005). Mean estimated daily urinary albumin excretion (UAE) was 18.2 (15.5–1.3) mg/day in Europeans, 94.8 (60.5–148.7) mg/day in Maori, and 44.2 (32.3–60.3) mg/day in Pacific Islanders. The prevalence of proteinuria and end-stage renal failure were also higher in Maori and Pacific Islanders. The excess prevalence of microalbuminuria and proteinuria in Maori was present within 5 years of diagnosis. Europeans with impaired renal function were least likely to have associated proteinuria or microalbuminuria. Microalbuminuria and nephropathy were not consistently associated with either higher blood pressure or worse glucose control.

CONCLUSIONS
NIDDM in Maori and Pacific Islanders is associated with a greater degree of proteinuria and end-stage renal failure than that in Europeans. This observation is not explained by conventional risk factors.
Reliability and Validity of Cardiovascular and Vasomotor Autonomic Function Tests
Authors: Hartwig Mary S , Cardoso Sergio S , Hathaway Donna K , Gaber A Osama 
Published: March 2007

OBJECTIVE
To determine the reliability and validity of autonomic function tests (AFTs) as clinical tools for diagnosing diabetic autonomic dysfunction.

RESEARCH DESIGN AND METHODS
Twenty-one healthy control subjects and 21 insulin-dependent diabetes mellitus (IDDM) patients (11 with no symptomatology and 10 with symptomatic diabetic autonomic neuropathy [DAN]) were matched for age, and administered three standard cardiovascular tests and two new vasomotor tests of autonomic function. Each of the cardiovascular tests (change in heart rate [Δbpm], Valsalva ratio [VR], change in systolic blood pressure [ΔsBP]) and vasomotor tests (total pulse amplitude [TPA] and percent vasoconstriction [%VC]) were repeated within 1 week. Infrared photoplethysmography measured sympathetic-mediated vasomotor function. Reliability was determined by intraclass correlation coefficients. Validity was determined by analysis of variance procedures to test for differences between known groups and by computing sensitivity, specificity, and positive and negative predictive values.

RESULTS
All AFTs were reliable, with %VC having highest reproducibility (r = 0.90). AFT scores were not different from time 1 to time 2. After controlling for age, two cardiovascular tests had significantly different values for control subjects and asymptomatic diabetic patients. AFTs, except ΔsBP, were significantly different between symptomatic diabetic patients and asymptomatic diabetic patients after controlling for age and duration of disease simultaneously. Sensitivity, specificity, and predictive values for %VC were comparable to the values for Δbpm and VR. TPA indexes were lower but clinically acceptable.

CONCLUSIONS
AFTs were found to be reliable and valid tests for detecting DAN. TPA and %VC are important because they measure an aspect of sympathetic function not assessed by standard cardiovascular AFTs, and they do not depend on the patient's cooperation or ability to exert effort.
Alrial Natriuretic Factor in Hypertensive and Normotensive Diabetic Patients
Authors: Ferri Claudio , Piccoli Alfonso , Laurenti Oriana , Bellini Cesare , De Mattia Giancarlo , Santucci Anna , Balsano Francesco 
Published: March 2007

OBJECTIVE
To evaluate plasma amai natriuretic factor (ANF) behavior in hypertensive patients with either insulin-dependent (type I) or non-insulin-dependent (type II) diabetes.

RESEARCH DESIGN AND METHODS
Plasma ANF levels were measured in euglycemic normotensive patients (n = 18) and hypertensive patients (n = 18), in diabetic normotensive patients (type I diabetes, n = 12; type II diabetes, n = 12), and in diabetic hypertensive patients (type I diabetes, n = 12; type II diabetes, n = 22). In all groups, plasma ANF levels were determined at the end of a normal NaCl diet period (120 mmol NaCl per day for 10 days) in both the supine and the upright positions.

RESULTS
Plasma ANF levels were significantly higher (P &lt; 0.05) in hypertensive euglycemic patients (supine vs. upright: 13.4 ± 6.7 vs. 8.5 ± 4.3 fmol/ml) than in normotensive type I diabetic patients (supine vs. upright: 8.6 ± 2.2 vs. 5.9 ± 2.9 fmol/ml) but not in euglycemic normotensive subjects (supine vs. upright: 11.4 ± 5.1 vs. 7.6 ± 5.8 fmol/ml) and normotensive type II diabetic patients (supine vs. upright: 10.1 ±4.1 vs. 7.9 ±4.1 fmol/ml). Moreover, in the normotensive groups plasma ANF levels did not significantly differ among euglycemic type I and type II diabetic patients. However, the highest levels of plasma ANF were observed in hypertensive type II diabetic patients (supine vs. upright: 16.9 ± 7.4 fmol/ml [P &lt; 0.01 vs. euglycemic normotensive subjects, P &lt; 0.0001 vs. normotensive type I diabetic patients, P &lt; 0.01 vs. hypertensive type I diabetic patients and normotensive type II diabetic patients] vs. 11.6 ± 2.9 fmol/ml [P &lt; 0.005 vs. normotensive type I diabetic patients, P &lt; 0.01 vs. hypertensive type I diabetic patients]). On the contrary, plasma ANF levels were higher (P &lt; 0.05) in hypertensive type I diabetic patients (supine vs. upright: 10.8 ±1.9 vs. 6.4 ± 2.2 fmol/ml) compared with normotensive type I diabetic patients, but not with any other patient group. A significant correlation between supine ANF and insulin levels was found in both type II diabetic (r = 0.457; P &lt; 0.05) and nondiabetic hypertensive patients (r = 0.716; P &lt; 0.0001).

CONCLUSIONS
These findings indicate that circulating ANF levels are markedly elevated in type II diabetic patients affected by essential hypertension. On the contrary, plasma ANF levels are in the range of normality in normotensive type I and type II diabetic patients.
Increased Urinary Endothelin-1 -Like Immunoreactivity Excretion in NIDDM Patients With Albuminuria
Authors: Lee Yau-Jiunn , Shin Shyi-Jang , Tsai Juei-Hsiung 
Published: March 2007

OBJECTIVE
To determine the urinary endothelin-1-like immunoreactivity (ET- 1-LI) in non-insulin-dependent diabetes mellitus (NIDDM) patients and toinvestigate whether urinary ET-l-LI excretion is elevated in patients with albuminuria.

RESEARCH DESIGN AND METHODS
Urinary ET-l-LI substance was determined byradioimmunoassay in 45 normoalbuminuric and 28 albuminuric NIDDM patients.

RESULTS
The mean amounts of 24-h ET-1 -LI excretion in NIDDM patients with normoalbuminuria and albuminuria were 154.9 ± 13.5 and 174.4 ± 12.9 ng/day, respectively. The latter was significantly higher thanthat of the 40 normal control subjects (111.8 ± 7.9 ng/day, P &lt; 0.01).

CONCLUSIONS
The increase in urinary ET-l-LI substance excretion in patients with albuminuria suggests that ET-1 may be a pathogenetic factor in diabetic nephropathy.
The Evaluation of Two Measures of Quality of Life in Patients With Type I and Type II Diabetes
Authors: Jacobson Alan M , Groot Mary De , Samson Jacqueline A 
Published: March 2007

OBJECTIVE
To examine the effects of type I and type II diabetes on patient perceptions of their quality of life and compare the psychometric properties of a generic versus a diabetes-specific quality of life measure.

RESEARCH DESIGN AND METHODS
Consecutive outpatients (n = 240) from a large multispecialty diabetes clinic were studied on a single occasion using two measures of quality of life—Diabetes Quality of Life Measure (DQOL) and the Medical Outcome Study Health Survey 36-Item Short Form (SF-36). No interventions were performed. This study examines three issues: 1) the reliability(internal consistency) of the two measures; 2) the relationship between the DQOL and SF-36 scales; and 3) the influence of clinical patient characteristics, such as number and severity of diabetes complications, on quality of life. Examination of this issue provides information about the construct validity of the two quality of life measures.

RESULTS
The estimates of internal consistency (Cronbach's alpha) for the DQOL and SF-36 subscales ranged from 0.47 to 0.97. These values werevery similar to the published findings from previous studies. The subscales of the two measures were variably correlated with one another (range of correlations: —0.003 to 0.60), indicating that the areas of functioning addressed by the DQOL and SF-36 overlapped only to a modest degree. Examination of the relationship of demographic factors to the DQOL measures suggests that they are not generally confounded by factors such as education, sex, or duration of diabetes. Health-related quality of life is affected by the marital status of both type I and type II diabetic patients, with separated and divorced individuals generally experiencing lower levels of quality of life. The quality of life measures were sensitive to clinical characteristics, such as frequency and severity of complications. Even after factors such as marital status and, among type II diabetic patients, type of treatment, patients' severity of diabetes complications was a significant predictor of both the diabetes-related and the more broad-based measure of quality of life. For type II diabetic patients, insulin treatment was associated with lower levels of satisfaction with diabetes and greater impact of diabetes on quality of life.

CONCLUSIONS
This study provides evidence for the reliability and validity of two measures of quality of life. The two measures examine quality of life from different but complimentary perspectives. The DQOL seems more sensitive to lifestyle issues and contains special questions and worry scales oriented toward younger patients, whereas the SF-36 provides more information about functional health status. Thus, the measures may be used usefully in combination in studies of both type I and type II diabetic patients.
Efficacy of 24-Week Monotnerapy With Acarbose, Glibenclamide, or Placebo in NIDDM Patients: The Essen Study
Authors: Hoffmann Juergen , Spengler Manfred 
Published: March 2007

OBJECTIVE
To compare the different therapeutic principles of α-glucosidase inhibitors and sulphonylureas as first-line treatment in non-insulin-dependent diabetes mellitus (NIDDM) patients with dietary failure.

RESEARCH DESIGN AND METHODS
Ninety-six NIDDM patients (35–70 years of age, body mass index [BMI] ≤ 35), insufficiently treated with diet alone (HbA1c 7–9%) were randomized into three groups and treated for 24 weeks with acarbose, glibenclamide, or placebo. Efficacy, based on fasting blood glucose (BG), BG 1 h after ingestion of standard breakfast (postprandial), serum insulin, postprandial insulin increase, and HbA1c; and tolerability, based on subjective symptoms and laboratory values, were investigated every 6 weeks. Efficacy evaluation was valid for 85 patients.

RESULTS
The test drugs were dosed as follows: 100 mg acarbose (A) three times a day, 1 placebo tablet three times a day, 3.5 mg glibenclamide tablets dosed 1–0-0 or 1–0-1, mean dose 4.3 mg/day. Compared with the placebo, both drugs showed the same mean efficacy on fasting BG (–1.4 raM with acarbose, –1.6 mM with glibenclamide), 1-h postprandial BG (–2.2 mM with acarbose, –1.9 mM with glibenclamide), and HbA1c (–1.1% with acarbose, –0.9% with glibenclamide); but they showed a marked difference in 1-h postprandial insulin values (–80.7 pM with acarbose, 96.7 pM with glibenclamide). The mean relative insulin increase (1-h postprandial) was 1.5 in the placebo group, 1.1 in the acarbose group, and 2.5 in the glibenclamide group. No changes in body weight could be observed. No adverse events were seen under placebo. Acarbose led to mild or moderate intestinal symptoms in 38% of patients. Glibenclamide led to hypoglycemia, which could be solved by dose reduction, in 6% of patients. No dropouts occurred in any of the treatment groups.

CONCLUSIONS
Acarbose and glibenclamide are effective drugs for the monotherapy of NIDDM patients when diet alone fails. Because postprandial insulin increase has been shown to be associated with increased risk for cardiovascular disease, acarbose, which lowers pp increase, may be superior to glibenclamide, which elevates postprandial insulin increase.