bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for the Development of Type II Diabetes Among Men Enrolled in the Usual Care Group of the Multiple Risk Factor Intervention Trial
Authors: Shaten B Jessica , Smith George Davey , Kuller Lewis H , Neaton James D 
Published: March 2007

OBJECTIVE
To study the association between selected risk factors and the subsequent incidence of type II diabetes over a 5-yr period.

RESEACH DESIGN AND METHODS
Between 1973 and 1976, a cohort of men from 22 clinical centers throughout the U.S. enrolled in the Usual Care group of the Multiple Risk Factor Intervention Trial. The men (5420 white, 428 black, 56 Asian, 70 Hispanic, and 26 other) were nondiabetic at baseline, were in the upper 15% of risk for coronary heart disease, and had at least two annual follow-up visits for fasting glucose measurements. The average age was 46 yr and average body mass index was 27.6 kg/m . Incidence of diabetes was defined as use of insulin or hypoglycemic agents, fasting glucose ≥140 mg/dl on two consecutive annual visits, or fasting glucose ≥ 140 mg/dl followed the next year by insulin or hypoglycemic use. Observations were taken annually over a 5-yr period.

RESULTS
Cumulative incidence of diabetes over 5 yr was 4.1%, with 247 incident cases. Development of diabetes was directly associated with race (blacks higher than non-blacks), reported parental history of diabetes, and with baseline levels of body mass index, fasting glucose, and glucose 1 h after a 75-g oral glucose load. These associations were statistically significant in both univariate and multivariate models. A significant interaction was observed between race and reported parental history of diabetes in development of diabetes, particularly within black men who reported a parental history. These individuals had higher than expected rates of diabetes development.

CONCLUSIONS
The data from men in the Usual Care group enrolled in the Multiple Risk Factor Intervention Trial confirm previous findings regarding the associations between the development of diabetes and baseline glucose levels, obesity, race, and parental history of diabetes. The identification of these risk factors provides very powerful tools to identify individuals at high risk of diabetes mellitus who may be amenable to intervention, thereby reducing their risk of developing the disease and its complications.
Comparison of Diets of Diabetic and Nondiabetic Women
Authors: Shimakawa Tomoko , Herrera-Acena MG , Colditz Graham A , Manson JoAnn E , Stamper Meir J , Willett Walter C 
Published: March 2007

OBJECTIVE
To assess the dietary habits of diabetic women.

RESEARCH DESIGN AND METHODS
Participants in the Nurses Health Study, a cohort of 121,700 registered female nurses, were followed since 1976. We compared the usual dietary intakes of women who had been diagnosed with diabetes mellitus by 1980 and age-matched nondiabetic control women; diets of these women were assessed in 1980 and 1984 by a semiquantitative food frequency questionnaire. The study examined 162 IDDM women and 738 NIDDM women. Similar comparisons were made for 429 women who developed NIDDM between 1980 and 1984.

RESULTS
Although differences were small, women with IDDM in 1984 and women with NIDDM in 1980 and 1984 consumed less energy from carbohydrates, especially from sucrose, and more energy from protein and fat than did control women. Similar results were also found in 1984 for the 429 women who developed NIDDM between 1980 and 1984. In 1980, energy from nonsucrose carbohydrate was slightly higher in both IDDM and NIDDM women than in the control women. However, in 1984, using a dietary questionnaire designed to assess more complete dietary intake, less consistent results were obtained. Diabetic women tended to avoid desserts and sweets, sugar-containing beverages, and alcoholic beverages but consumed more meat and meat products. Intakes of foods high in complex carbohydrates (e.g., bread, rice, pasta, and potatoes) were similar between diabetic and control women.

CONCLUSIONS
The results suggest that these diabetic women did not consume the high-carbohydrate, low-fat diets that the American Diabetes Association has been recommending over the past decade.
Relationship Between Glycemic Control and Collagen-Linked Advanced Glycosylation End Products in Type I Diabetes
Authors: Beisswenger Paul J , Moore Lynn L , Curphey Thomas J 
Published: March 2007

OBJECTIVE
To evaluate the relationship between glycemic control over a 3-yr period and tissue levels of advanced glycosylation end products. The development of renal failure, blindness, and generalized vascular occlusion continue to be the most serious ravages of diabetes. Tissue glycosylation and AGEs are felt to play an important role in the development of these sequelae, but no data are available on the relationship between AGEs and long-term glycemic control.

RESEARCH DESIGN AND METHODS
We studied 48 subjects with type I diabetes. Glycemic control was determined by mean levels of HbA1 and AGEs were determined on collagenase digests of skin collagen by fluorescence at excitation/ emission readings of 335/385 and 370/440 nm.

RESULTS
To evaluate the relationship between glycemic control and AGE levels, control was classified as good (&lt;8.5%), fair (&gt;8.5% but ≤ 10%), or poor (&gt; 10%) on the basis of mean HbA: levels during 1- and 3-yr periods. Analysis of the mean AGE levels for each level of glycemic control over 1–3 yr showed that AGEs differed significantly across categories of glycemic control (P = 0.04 and 0.003), with thelowest AGE levels associated with good and the highest with poor glycemic control. The relationship also was highly significant when adjusted for age, sex, and duration of diabetes, and when examined by Pearson's correlation coefficients (P = 0.02 and 0.008).

CONCLUSIONS
Finding a relationship between glycemic control over 1–3 yr and tissue levels of AGEs suggests that AGEs can be modified and possibly reversed by improved glucose levels.
Comparison of Bolus and Infusion Protocols for Determining Acute Insulin Response to Intravenous Glucose in Normal Humans
Authors: McCulloch David K , Bingley Polly J , Colman Peters G , Jackson Richard A , Gale Edwin A M ,   The ICARUS Group
Published: March 2007

OBJECTIVE— To help standardize methodology for intravenous glucose tolerance testing in preclinical IDDM by comparing a 30-s bolus and a 3-min infusion of glucose.
RESEARCH DESIGN AND METHODS— We tested 20 healthy nondiabetic adults at four centers (in Seattle, Boston, Melbourne, and London). Each subject had four intravenous glucose tolerance tests (two bolus and two infusion). The acute insulin response to glucose was calculated as the mean of the 1′ + 3′, the mean of 1′ to 10′, or as the integrated area from 0 to 10′. Glucose and insulin profiles and intrasubject coefficient of variation were compared.
RESULTS— With the infusion protocol, the 1′ insulin was significantly higher, resulting in a higher acute insulin response to glucose when calculated as 1′ + 3′ (525 ± 66 vs. 376 ± 35 pM, P &lt; 0.004). When calculated over 10 min, however, the acute insulin response to glucose was not different between protocols. In addition, the intrasubject coefficient of variation was significantly better when calculated over 10 min in both protocols, but no significant differences were noted between the bolus and infusion (infusion: AIRg [area from 0 to 10′] 10.4 ± 2.1% vs. AIRg [1′ + 3′] 14.9 ± 2.8%, P &lt; 0.007; bolus: AIRg [area from 0 to 10′] 14.6 ± 2.8% vs. AIRg [1′ + 3′] 19.8 ± 3.5%, P &lt; 0.007). Comparison of the insulin assays between the four centers showed close correlation and gave indistinguishable results in terms of within-subject coefficient of variation. Glucose profiles were similar in both protocols. Although the glucose values were lower with the bolus protocol from 4′ to 40′, the rate of fall from 10 to 30′ (and thus the rate of glucose disposal) was indistinguishable between the two.
CONCLUSIONS— These data suggest that neither protocol gives significant advantage over the other. However, to allow comparison of the acute insulin response to glucose between different protocols used in centers around the world, the ICARUS 3-min infusion protocol is recommended, with acute insulin response to glucose calculated over 10 min after the end of glucose administration; this reduces the within-subject coefficient of variation and provides similar acute insulin response to glucose with both protocols.
The Epidemiology of Type I Diabetes in Children 0–14 Yr of Age in Philadelphia
Authors: Lipman Terri H 
Published: March 2007

OBJECTIVE— To determine the epidemiology of type I diabetes in children in Philadelphia, particularly with respect to racial differences.
RESEARCH DESIGN AND METHODS— This is a descriptive epidemiological study using a retrospective population-based registry in Philadelphia, Pennsylvania, a city with large white, black, and Hispanic populations. All hospitals in Philadelphia that admit children were identified. All charts meeting the following criteria were reviewed: 1) newly diagnosed IDDM, 2) 0–14 yr of age, 3) residing in Philadelphia at the time of diagnosis, and 4) diagnosed from 1 January 1985 to 31 December 1989. Standard IDDM registry data were abstracted from the charts. Ascertainment of the completeness of the hospital registry was validated by two secondary sources: 1) diabetes camp records, 2) Philadelphia School District data.
RESULTS— A total of 215 cases were identified, and the combined hospital, camp, and school registry was determined to be 93% complete. The overall age-adjusted incidence rate in Philadelphia was 13.4/100,000/yr. The highest incidence rate was in Hispanics (15.16), followed by whites (13.31), and blacks (10.95).
CONCLUSIONS— The incidence of IDDM in Philadelphia is similar to what has been found in other U.S. registries. The unexpected finding was that the incidence in the Puerto Rican Hispanic population was the highest in the city. This is the first data reported on this population, and more studies are needed to elucidate the genetic and environmental causes of this high incidence of IDDM.
Role of Experimental Socks in the Care of the High-Risk Diabetic Foot: A multicenter patient evaluation study
Authors: Murray Heather J , Veves Aristids , Young Matthew J , Richie Douglas H , Boulton Andrew J M ,   American Group for the Study of Experimental Hosiery in the Diabetic Foot
Published: March 2007

OBJECTIVE
To assess the acceptability of specially designed socks to provide satisfactory pressure relief in the insensitive, high-risk, diabetic foot. We have conducted a longitudinal multicenter patient evaluation study to assess the acceptability of such hosiery in neuropathic diabetic patients.

RESEARCH DESIGN AND METHODS
A group of 86 neuropathic diabetic patients (69 males, 14 with type I diabetes) with a mean age of 63 yr (range 34–85 yr), and a diabetes duration of 16 yr (range 1–45 yr) participated in the study. Peripheral vascular disease was present in 28 (33%) patients, previous foot ulceration in 39 (44%) patients, and active ulceration was present in 11 (13%) patients. All patients were provided with three pairs of specially designed socks and 80 patients with extra-depth shoes. Evaluation and foot examination were performed at 3 and 6 mo.

RESULTS
Socks were worn for a mean of 6 days/wk (range 1–7 days/wk). Patient satisfaction evaluated at both visits was good or very good in 85%, average in 12%, and poor in 3% of patients. Ten ulcers healed during this period, and seven new ulcers occurred. Intention to continue wearing the socks, most or all of the time, was expressed by 84% of patients.

CONCLUSIONS
We conclude that the experimental socks have a high level of patient satisfaction when worn with suitable shoes, and may be an acceptable and inexpensive addition to existing methods of protecting the high-risk insensitive diabetic foot.
Structural Equation Modeling of Symptoms, Awareness and Fear of Hypoglycemia, and Personality in Patients With Insulin-Treated Diabetes
Authors: Hepburn David A. , Deary Ian J. , MacLeod Kenneth M. , Frier Brian M. 
Published: March 2007

OBJECTIVE
To assess the possible influence of personality on self-reported awareness, symptoms, and fear of hypoglycemia and also to identify the relationship among these self-reported measures using formal structural equation modeling.

RESEARCH DESIGN AND METHODS
A structured questionnaire, which included questions about sociodemographic details, awareness of the onset of hypoglycemia, and a list of symptoms of hypoglycemia, was completed by 305 consecutive insulin-treated diabetic patients attending the diabetic clinic at the Royal Infirmary of Edinburgh. They also completed the Hypoglycemia Fear Survey (HFS), and personality was assessed using the short form of the shortened Eysenck Personality Questionnaire-Revised (EPQ-R). Formal structural equation modeling was performed using the following variables: awareness, autonomic symptoms, neuroglycopenic symptoms, severe hypoglycemic episodes in the last year, worry and behavior (from the HFS), and extroversion and neuroticism (from the short EPQ-R). This allowed a model to be constructed that expressed the putative causal associations among the variables that could be tested statistically.

RESULTS
Of the 302 patients who had experienced hypoglycemia, 111 (37%) reported reduced awareness, and these patients scored higher on the worry subscale of the HFS (reduced awareness: 41 ± 12 vs. normal awareness: 34 ± 12, P &lt; 0.001). The patients with reduced awareness scored higher for neuroticism than did the patients with normal awareness (reduced awareness: 6.1 ± 3.4 vs. normal awareness: 4.9 ± 3.3, P &lt; 0.01) and scored lower for extroversion (reduced awareness: 5.8 ± 3.7 vs. normal awareness: 7.1 ± 3.7, P &lt; 0.01). In the structural equation modeling exercise, neuroticism was a significant putative determinant of many of the other variables.

CONCLUSIONS
Personality was the major determinant of the variance that could be accounted for in this study and influenced self-reported symptoms, awareness, and fear of hypoglycemia. Personality factors may, therefore, influence self-reports from patients, particularly when soft measures, such as symptoms, are assessed and even when using validated clinical questionnaires. This finding stresses the importance of using additional evidence, such as reports from relatives, to substantiate reports from patients of loss of hypoglycemia awareness.
Long-Term Glycemic Control Has a Nonlinear Association to the Frequency of Background Retinopathy in Adolescents With Diabetes: Follow-up of the Berlin Retinopathy Study
Authors: Danne Thomas , Weber Bruno , Hartmann Reinhard , Enders Ingo , Burger Walter , Hovener Gerd 
Published: March 2007

OBJECTIVE
To assess the influence of long-term glycemic control on the development of background retinopathy in adolescents followed longitudinally from the onset of insulin-dependent diabetes mellitus (IDDM).

RESEARCH DESIGN AND METHODS
Repeated retinal fluorescein angiographies, in intervals of 1–2 years, were evaluated prospectively in 346 patients (190 males, 156 females; 19.8 [8.8–35.4] years of age; diabetes duration of 10.4 [1.1–27.4] years at their latest eye examination, median [range]). The influences of long-term HbA1c (mean of 18 [1–95] determinations per person) and microalbuminuria (≥2 of ≥3 measurements ≥ 15 μg/min × 1.73 m2) were studied by multiple linear regression, life-table analysis, and trend analyses.

RESULTS
The rate of background retinopathy per 100 patient-years increased with poorer glycemic control from 0.7 (long-term HbA1c &lt; 7% to 7.3 (HbA1c &gt; 11%) following an exponential function. Life-table analysis after subdivision in HbA1c quartiles of equal sizes (HbA1c &lt; 8, 8–9, 9–10, and &gt; 10%) revealed an individual median expectation of background retinopathy after more than 25, 16.2, 12.7, or 12.0 years of diabetes, respectively. However, significant differences were found only between 8–9% and 9–10%, calculated either as prevalence, life-table analysis, or relative incidence, thus suggesting that a threshold model may also fit the data. After 12 years of diabetes, &lt; 25% of those patients exhibiting microalbuminuria (n = 18) were expected to be free from retinopathy compared with 81% of those with normoalbuminuria (n = 86).

CONCLUSIONS
Two statistical models are appropriate to explain the relationship between glycemic control and risk for background retinopathy: 1) a continuous exponential relationship as described by the DCCT or 2) the presence of a threshold HbA1c level at 9%. Thus, diabetes treatment in children should aim at long-term HbA1c levels &lt; 9.0%, but every progress closer to normal may further reduce the risk.
Genes Within the Major Histocompatibility Complex Predict NIDDM in African-American Women in Alabama
Authors: Acton Ronald T , Roseman Jeffrey M , Bell David S H , Goldenberg Robert L , Tseng Mei-Ling , Vanichanan Chotip , Harman Leigh A , Go Rodney C P 
Published: March 2007

OBJECTIVE
To test the hypothesis that genes within the major histocompatibility complex (MHC) are associated with gestational diabetes mellitus (GDM) and, subsequently, non-insulin-dependent diabetes mellitus (NIDDM) in African-American women.

RESEARCH DESIGN AND METHODS
African-American women who presented with GDM were compared with pregnant African-American control subjects. Following pregnancy, GDM patients were assessed at various intervals of time (median = 6 years) to determine whether they had developed diabetes.

RESULTS
GDM patients who required insulin during pregnancy possessed a significantly higher frequency of A33, DR2, DR9, and BF-S phenotypes than control subjects. GDM patients who subsequently developed NIDDM had a significantly higher frequency of B41, DR2, and BF-S and a lower frequency of DR1 and DR6 phenotypes than control subjects. Even after controlling for age and body mass index, B41 and DR2 were independent predictors of developing insulin-requiring GDM and NIDDM in GDM subjects.

CONCLUSIONS
These results suggest that either one or more genes within the MHC are involved in the etiology of NIDDM.
Radiographic Abnormalities in the Feet of Patients With Diabetic Neuropathy
Authors: Cavanagh Peter R , Young Matthew J , Adams Judith E , Vickers Karen L , Boulton Andrew J M 
Published: March 2007

OBJECTIVE
To investigate the prevalence of radiographie bone and joint abnormalities in the feet of diabetic patients.

RESEARCH DESIGN AND METHODS
In a blinded randomized study, 94 diabetic patients with peripheral neuropathy (54 with a history of foot ulcers) and 43 non-neuropathic patients were drawn at random from the data base of a large university diabetes clinic in the United Kingdom. Fifty nondiabetic age-matched control subjects also were studied. Lateral and dorsi-plantar weight-bearing plain radiographs of the foot and ankle were taken by a single radiographer. Abnormalities in the bones and joints were determined according to a structured reading of the radiographs by a single radiologist.

RESULTS
Diabetes per se resulted in no excess of bony abnormality. Diabetic patients with neuropathy had significantly more radiographic abnormalities of the bones and joints than non-neuropathic and age-matched nondiabetic control subjects. However, except for periosteal reaction, this was predominantly caused by an excess of abnormalities in diabetic patients with a history of foot ulceration. Traumatic fractures (most previously unrecognized) were found in 12 (22%) of the 54 neuropathic patients with previous foot ulceration, and 9 (16%) patients who had experienced foot ulcers exhibited characteristic Charcot changes.

CONCLUSIONS
These results suggest that bony abnormalities, particularly Charcot changes and traumatic fractures, are more frequent than previously recognized in neuropathic diabetic patients, especially in those with a history of foot ulceration. Early recognition of bony abnormality and appropriate treatment may prevent progression of foot deformity and thereby reduce the morbidity caused by ulceration or reulceration.
Insulin Availability Among International Diabetes Federation Member Associations: Report of the Task Force on Insulin Distribution
Authors: Deeb Larry C , Tan Meng H , Alberti K G M M 
Published: March 2007

OBJECTIVE
To assess the availability of insulin and diabetes supplies among International Diabetes Federation (IDF) member associations.

RESEARCH DESIGN AND METHODS
A mail survey of IDF member associations asked about the following issues: 1) diabetes prevalence and insulin use, 2) availability and cost of insulin and supplies, 3) availability of glycemic monitoring supplies, 4) cost of insulin and supplies to patients, and 5) availability of oral hypoglycemic agents.

RESULTS
Of 85 member associations, 60 responded. The mean prevalence of diabetes was 3.7%. Of the 39 with a population-based survey data, the prevalence was 3.9%. Insulin use was reported for 19.2% of diabetes patients and, for the 15 with population-based data, the proportion using insulin was 16.1%. Of the respondents, 47 (78%) reported insulin was always available, 11 (18%) reported insulin was available from 25 to 99% of the time, and 2 (Uganda and Tanzania) reported insulin was available &lt;25% of the time. Insulin is free to patients in 39 (65%) of the countries. The average cost of the least expensive insulin was U. S. $9.62 per vial. Fifteen countries imposed a mean 13% customs charge. Disposable syringes were available in 42 (72%) of countries all of the time. Glucose meters were in use in 49 countries: The most common oral agent was glyburide, which was available in 57 countries.

CONCLUSIONS
Insulin is in reasonable supply in IDF member countries. Cost and customs charges are an impediment to universal access. IDF now can recommend programs based on this data.