bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening Mammogram Utilization in Women With Diabetes
Authors: Beckman Thomas J. , Cuddihy Robert M. , Scheitel Sidna M. , Naessens James M. , Killian Jill M. , Pankratz V. Shane 
Published: March 2007

OBJECTIVE—To determine whether women with diabetes undergo fewer screening mammograms than matched control subjects.RESEARCH DESIGN AND METHODS—A total of 424 women with diabetes aged 50–75 years who received their primary care from general internists at a large Midwestern multispecialty group practice were retrospectively studied for frequency of mammography from August 1997 to January 2000. Two control subjects without diabetes (n = 845) were matched to each case by age, sex, provider, and date of visit. The main outcome measure was the percentage of subjects undergoing mammography 1 year before and 30 days after an index date, defined as the most recent health care visit after August 1997 and before January 2000.RESULTS—Analysis by conditional logistic regression demonstrated that women with diabetes had significantly lower rates of mammograms than control subjects (78.1 vs. 84.9%, respectively; odds ratio 0.63, P = 0.002). After adjusting for insurance status and race, women with diabetes continued to have significantly lower rates of mammography (odds ratio 0.70, P = 0.027).CONCLUSIONS—Women with diabetes were significantly less likely to undergo screening mammography than control subjects. Considering the increasing incidence of diabetes and the equal incidence of malignancy in women with and without diabetes, it would be beneficial to improve breast cancer screening in this population.
Is One 60° Fundus Photograph Sufficient for Screening of Proliferative Diabetic Retinopathy?
Authors: Møller Flemming , Hansen Merete , Sjølie Anne Katrin 
Published: March 2007

OBJECTIVE—To compare one 60° fundus photograph to seven field stereo fundus photographs in identifying proliferative diabetic retinopathy.
RESEARCH DESIGN AND METHODS—A total of 44 eyes in 23 patients with moderate/severe nonproliferative diabetic retinopathy were included. Evaluation of each eye was based on one 60° fundus photograph. Eyes were re-examined using seven field 30° stereo fundus photographs according to the protocol of the Early Treatment Diabetic Retinopathy Study, and the photographs were examined independently by three ophthalmologists to identify retinal neovascular lesions. In addition, fluorescein angiography was performed in all patients to verify the presence of the lesions.
RESULTS—In four eyes of three patients (11.1% of eyes) evaluated based on seven field stereo photographs, retinal neovascularization was found. This condition was not found on examination of 60° fundus photographs.
CONCLUSIONS—Examination of one 60° fundus photograph was found to be insufficient as a screening procedure in patients with moderate/severe nonproliferative diabetic retinopathy.
Beneficial Effects of a Soy-Based Dietary Supplement on Lipid Levels and Cardiovascular Risk Markers in Type 2 Diabetic Subjects
Authors: Hermansen Kjeld , Søndergaard Mette , Høie Lars , Carstensen Marius , Brock Birgitte 
Published: March 2007

OBJECTIVE— Consumption of soy protein has recently been shown to improve the blood lipid levels in nondiabetic subjects. The purpose of this study was to evaluate if a dietary supplement of soy protein, isoflavones, and cotyledon fiber (Abalon) affects cardiovascular risk markers, blood glucose,and insulin levels in type 2 diabetic subjects.
RESEARCH DESIGN AND METHODS— Twenty type 2 diabetic subjects participated in a crossover trial. They were randomized to double-blind supplementation for 6 weeks with Abalon (soy protein [50 g/day] with high levels of isoflavones [minimum 165 mg/day] and cotyledon fiber [20 g/day]) or placebo (casein [50 g/day] and cellulose [20 g/day]), separated by a 3-week wash-out period.
RESULTS— The results are expressed as means ± SD. The percentage mean treatment difference between Abalon and placebo demonstrated significantly lower mean values after Abalon for LDL cholesterol (10 ±15%, P &lt; 0.05), LDL/HDL ratio (12 ± 18%, P &lt;0.05), apolipoprotein (apo) B100 (30 ± 38%, P &lt; 0.01),triglycerides (22 ± 10%, P &lt; 0.05), and homocysteine (14± 21%, P &lt; 0.01), whereas the total cholesterol value tended to be less significant but still lower (8 ± 15%, P &lt;0.08). No change occurred in HDL cholesterol, apo B100/apo A1 ratio,plasminogen activator inhibitor 1, factor VIIc, von Willebrand factor,fibrinogen, lipoprotein(a), glucose, HbAlc, or 24-h blood pressure.
CONCLUSIONS— These results indicate beneficial effects of dietary supplementation with Abalon on cardiovascular risk markers in type 2 diabetic subjects. This improvement is seen even in individuals with near-normal lipid values.
Differential Influence of LDL Cholesterol and Triglycerides on Lipoprotein(a) Concentrations in Diabetic Patients
Authors: Hernández Cristina , Chacón Pilar , García-Pascual Luis , Simó Rafael 
Published: March 2007

OBJECTIVE— To evaluate the relationship between plasma lipid profiles and lipoprotein(a) [Lp(a)] concentrations in diabetic patients,taking into account the Lp(a) phenotype.
RESEARCH DESIGN AND METHODS— We included 191 consecutive diabetic outpatients (69 type 1 and 122 type 2 diabetic patients) in a cross-sectional study. Serum Lp(a) was determined by enzyme-linked immunosorbent assay, and Lp(a) phenotypes were assessed by SDS-PAGE followed by immunoblotting. The statistical methods included a stepwise multiple regression analysis using the Lp(a) serum concentration as the dependent variable. The lipid profile consisted of total cholesterol, HDL cholesterol,LDL cholesterol, corrected LDL cholesterol, triglycerides, and apolipoproteins AI and B.
RESULTS— In the multiple regression analysis, LDL cholesterol(positively) and triglycerides (negatively) were independently related to the Lp(a) concentration, and they explained the 6.6 and 7.8% of the Lp(a)variation, respectively. After correcting LDL cholesterol, the two variables explained 3.8 and 6.4% of the Lp(a) variation, respectively. In addition, we observed that serum Lp(a) concentrations were significantly lower in patients with type IV hyperlipidemia (mean 1.0 mg/dl [range 0.5-17], n = 16)than in normolipidemic patients (6.5 mg/dl [0.5-33.5], n = 117) and in type II hyperlipidemic patients (IIa 15.5 mg/dl [3.5-75], n = 13;IIb 9 mg/dl [1-80], n = 45); P &lt; 0.001 by analysis of variance.
CONCLUSIONS— Lp(a) concentrations were directly correlated with LDL cholesterol and negatively correlated with triglyceride levels in diabetic patients. Therefore, our results suggest that the treatment of diabetic dyslipemia may indirectly affect Lp(a) concentrations.
The Relationship Between Physicians’ Self-Reported Target Fasting Blood Glucose Levels and Metabolic Control in Type 2 Diabetes
Authors:   The QuED Study Group Writing Committee Coordinating Center:, Belfiglio Maurizio , De Berardis Giorgia , Franciosi Monica , Cavaliere Donatella , Di Nardo Barbara , Greenfield Sheldon , Kaplan Sherrie H. , Pellegrini Fabio , Sacco Michele , Tognoni Gianni , Valentini Miriam , Nicolucci Antonio ,   Scientific Committee:, Caimi Vittorio , Capani Fabio , Corsi Andrea , Della Vedova Roberto , Massi Benedetti Massimo , Nicolucci Antonio , Taboga Claudio , Tombesi Massimo , Vespasiani Giacomo 
Published: March 2007

OBJECTIVE—To investigate the relationship between beliefs of physicians relative to intensive metabolic control in type 2 diabetes and levels of HbA1c obtained in a sample of their patients.
RESEARCH DESIGN AND METHODS—Physicians’ beliefs were investigated through a questionnaire sent to a sample of self-selected clinicians participating in a nationwide initiative aimed at assessing the relationship between the quality of care delivered to patients with type 2 diabetes and their outcomes. At the same time, physicians were asked to collect clinical data on a random sample of their patients, stratified by age (&lt;65 vs. ≥65 years). Mean HbA1c levels in the study population were thus evaluated according to target fasting blood glucose (FBG) used by their physicians.
RESULTS—Of 456 physicians, 342 (75%) returned the questionnaire. Among the responders, 200 diabetologists and 99 general practitioners (GPs) recruited 3,297 patients; 2,003 of whom were always followed by the same physician and 1,294 of whom were seen by different physicians in the same structure on different occasions. Only 14% of the respondents used target FBG levels ≤6.1 mmol/l, whereas 38% pursued values &gt;7.8 mmol/l, with no statistically significant difference between diabetologists and GPs. The analysis of the relationship between FBG targets and metabolic control, restricted to those patients always seen by the same physician, showed a strong linear association, with mean HbA1c values of 7.0 ± 1.6 for patients in the charge of physicians pursuing FBG levels ≤6.1 mmol/l and 7.8 ± 1.8 for those followed by physicians who used target values &gt;7.8 mmol/l. After adjusting for patients’ and physicians’ characteristics, the risk of having HbA1c values &gt;7.0% was highly correlated with physicians’ beliefs. Patients followed by different physicians in the same unit showed a risk of inadequate metabolic control similar to that of patients followed by physicians adopting a nonaggressive policy.
CONCLUSIONS—Doctors adopt extremely heterogeneous target FBG levels in patients with type 2 diabetes, which in turn represent an important independent predictor of metabolic control. To improve patient outcomes, physicians-centered educational activities aimed at increasing the awareness of the potential benefits of a tight metabolic control in patients with type 2 diabetes are urgently needed.
Hospitalization Among Diabetic Children and Adolescents and the General Population in Germany
Authors: Icks Andrea , Rosenbauer Joachim , Holl Reinhard W. , Grabert Matthias , Rathmann Wolfgang , Giani Guido ,   On behalf of the German Working Group for Pediatric Diabetology
Published: March 2007

OBJECTIVE—To compare hospitalization in a multicenter-based cohort of diabetic children and adolescents (aged 1–19 years) in Germany with that of the general population.
RESEARCH DESIGN AND METHODS—Based on standardized documentation, hospital stays after manifestation were ascertained in diabetic subjects 1–19 years of age in 1997. Hospitalization data in the general German population were derived from official statistics. Incidence rates and numbers of hospital days were estimated. Ratios of hospitalization incidences and numbers of hospital days between the diabetic and the general population were calculated. Costs for hospital care in the German diabetic population in 1997 were determined.
RESULTS—A total of 5,874 patients came from 61 pediatric centers (52% male, age [mean ± SD] 12.2 ± 4.3 years, diabetes duration 4.6 ± 4.4 years). Hospitalization incidence rates and hospital days per person-year (95% CI) were 0.27 (0.25–0.29) and 1.80 (1.75–1.84) in the diabetic population and 0.0948 (0.0946–0.0949) and 0.6416 (0.6412–0.6420) in the general population. The standardized ratio of hospital incidences was 3.1 (2.9–3.2), and the ratio of numbers of hospital days was 2.8 (2.7–2.9). Costs for hospital care after manifestation were estimated to be $506 (U.S. dollars) per person-year and $12.4 million in the whole German diabetic population aged 1–19 years in 1997; including hospital stays at diabetes onset, total annual costs were $24 million ($970 per person-year).
CONCLUSIONS—Diabetic children and adolescents in Germany had an approximately three times higher hospitalization risk and three times more hospital days than the age-matched general population. Including hospitalization at diabetes onset, the annual costs of hospital care for the German diabetic population aged 1–19 years amounted to ∼1% of all costs for hospital care in this age-group. Thus, costs were largely overproportional (diabetes prevalence 0.1%).
Effectiveness of Platelet Releasate for the Treatment of Diabetic Neuropathic Foot Ulcers
Authors: Margolis David J. , Kantor Jonathan , Santanna Jill , Strom Brian L. , Berlin Jesse A. 
Published: March 2007

OBJECTIVE—The goal of this study was to specifically estimate the effectiveness of platelet releasate, a widely available treatment administered by a proprietary group of wound care centers (WCCs) for the treatment of diabetic neuropathic foot ulceration.RESEARCH DESIGN AND METHODS—Treatment effectiveness was estimated in a retrospective cohort study controlling for treatment selection bias using logistic regression–derived propensity scores.RESULTS—Platelet releasate was more effective than standard care. The relative risk for a wound to heal after treatment with platelet releasate compared with standard care at a WCC varied from 1.14 (95% CI 1.03–1.27) to 1.59 (1.49–1.70). The effect was greatest in those with the most severe wounds, i.e., large wounds that affect deeper anatomical structures.CONCLUSIONS—Within the limitations of the ability of propensity score analysis to control for selection bias, platelet releasate is more effective than standard therapy. This effect is more pronounced in more severe wounds. Unfortunately, severe wounds have not been evaluated in randomized clinical trials of new interventions. We encourage the inclusion of these patients in future trials.
Familial Early-Onset Type 2 Diabetes in Chinese Patients
Authors: Ng Maggie C.Y. , Lee Shao-Chin , Ko Gary T.C. , Li June K.Y. , So Wing-Yee , Hashim Yasmeen , Barnett Anthony H. , Mackay Ian R. , Critchley Julian A.J.H. , Cockram Clive S. , Chan Juliana C.N. 
Published: March 2007

OBJECTIVE—We examined the prevalence of different forms of diabetes in Hong Kong Chinese patients with familial early-onset type 2 diabetes and compared their clinical features with patients with familial late-onset type 2 diabetes.
RESEARCH DESIGN AND METHODS—A total of 145 young patients with early-onset diabetes (age and age at diagnosis ≤40 years) and a family history of diabetes were studied. They were screened for mutations in the genes encoding glucokinase, hepatocyte nuclear factor (HNF)-4α, and HNF-1α. The mitochondrial DNA A→G at nucleotide 3243 (mt3243) and amylin S20G mutations were studied, and antibodies to GAD (anti-GADs) were also examined.
RESULTS—The prevalence of putative diabetogenic gene mutations and autoimmune markers were 4% for glucokinase, 0% for HNF-4α, 5% for HNF-1α, 3% for mt3243, 2% for amylin S20G, and 4% for anti-GAD. Compared with late-onset patients, the patients with early-onset diabetes had a higher prevalence of a parental history of diabetes and were generally more obese. When classified by obesity indexes (BMI and waist circumference), the obese patients, especially those with early-onset diabetes, had a clustering of cardiovascular risk factors and increased rates of retinopathy and albuminuria.
CONCLUSIONS—Genetic factors (up to 14%) and obesity (55%) play more significant roles than autoimmunity (4%) in familial type 2 diabetes in young Chinese patients. The significance of obesity-related genes and other gene-gene and gene-environment interactions in these young patients remains to be determined.
Glycemic Control Is Related to the Morphological Severity of Diabetic Sensorimotor Polyneuropathy
Authors: Perkins Bruce A. , Greene Douglas A. , Bril Vera 
Published: March 2007

OBJECTIVE—The aim of the current study was to determine the independent clinical risk factors for predicting morphological severity of distal diabetic sensorimotor polyneuropathy (DSP) as determined by fiber density (FD) on sural nerve biopsy.RESEARCH DESIGN AND METHODS—A total of 89 patients with both type 1 and type 2 diabetes, ascertained from a large therapeutic randomized clinical trial, were included in this observational cohort study. Morphological severity of DSP was expressed as the myelinated FD in the sural nerve biopsy. General linear models were used to assess the relationship between the morphological severity of DSP and various clinical risk factors.RESULTS—Glycated hemoglobin (GHb) was significantly related to FD in univariate and multivariate regression analyses. This relationship was present in models in which GHb was handled either as a continuous variable or as a categorical variable with the highest significance level, with a GHb cutoff level of 9%. After dividing patients into groups with optimal to moderate (GHb ≤9%) and suboptimal (GHb &gt;9%) glycemic control, the difference in FD between the two groups ranged between 3,461 and 2,334 per mm2. FD was also significantly related to duration of diabetes and age of the patient.CONCLUSIONS—The severity of peripheral DSP expressed by morphological criteria was significantly related to glycemic control in type 1 and type 2 diabetic patients. Inconsistent with previously published electrophysiological data demonstrating a correlation between height and conduction velocity, increasing height is not associated with morphological severity. Based on the results of the present study, it might be hypothesized that improving glycemic control will lessen severity of DSP in terms of FD loss in subjects with diabetes.
Peripheral Blood Mitochondrial DNA Content Is Related to Insulin Sensitivity in Offspring of Type 2 Diabetic Patients
Authors: Song Jihyun , Oh Jee Young , Sung Yeon-Ah , Pak Youngmi Kim , Park Kyong Soo , Lee Hong Kyu 
Published: March 2007

OBJECTIVE—To investigate whether the peripheral blood mtDNA (pb-mtDNA) content is decreased and linked to insulin resistance in the offspring of type 2 diabetic patients.
RESEARCH DESIGN AND METHODS—A total of 82 offspring of type 2 diabetic patients and 52 age-, sex-, and BMI-matched normal subjects from the Mokdong, Korea, population were selected for this study by stratified, randomized sampling. Of the offspring of diabetic patients, 52 had normal glucose tolerance (NGT), 21 had impaired glucose tolerance (IGT), and 9 had newly diagnosed type 2 diabetes. The pb-mtDNA content was measured by real-time polymerase chain reaction with a mitochondria-specific fluorescent probe, normalized by a nuclear DNA, 28S rRNA gene. The associations between pb-mtDNA content and several parameters of insulin resistance were studied.
RESULTS—The pb-mtDNA contents tended to be lower in the 82 offspring of type 2 diabetic patients (1,084.7 ± 62.6 vs. 1,304.0 ± 99.2 in the offspring and control subjects, respectively, P = 0.051) and was significantly lower in the combined NGT and IGT offspring group (NGT+IGT, 1,068.0 ± 67.8, P &lt; 0.05) than in the control subjects. In NGT+IGT offspring, the pb-mtDNA content was significantly correlated with logarithmically transformed insulin sensitivity (r = 0.253, P &lt; 0.05) and was the main predictor of insulin sensitivity.
CONCLUSIONS—Quantitative mtDNA status might be a hereditary factor associated with type 2 diabetes and could serve as an indicator for insulin sensitivity.
A Model Educational Program for People With Type 2 Diabetes
Authors: Gagliardino Juan José , Etchegoyen Graciela ,   for the PEDNID-LA Research Group
Published: March 2007

OBJECTIVE—To implement an educational program in 10 Latin American countries and to evaluate its effect on the clinical, biochemical, and therapeutic aspects as well as the economic cost of diabetes.RESEARCH DESIGN AND METHODS—Educators from each participating country were previously trained to implement the educational model. The patient population included 446 individuals with type 2 diabetes; all patients were &lt;65 years of age, did not require insulin for metabolic control, did not have severe complications of diabetes or life-limiting illnesses, and had not previously participated in diabetes education courses. Clinical and therapeutic data and the cost of their pharmacological treatment were collected 6 months before participation in the educational program (−6 months), on entry into the program (time 0), and at 4, 8, and 12 months after initiation of the program.RESULTS—All parameters measured had improved significantly (P &lt; 0.001) by 1 year: fasting blood glucose (mean ± SD) 10.6 ± 3.5 vs. 8.7 ± 3.0 mmol/l; HbA1c 9.0 ± 2.0 vs. 7.8 ± 1.6%; body weight 84.6 ± 14.7 vs. 81.2 ± 15.2 kg; systolic blood pressure 149.6 ± 33.6 vs. 142.9 ± 18.8 mmHg; total cholesterol 6.1 ± 1.1 vs. 5.4 ± 1.0 mmol/l; and triglycerides 2.7 ± 1.8 vs. 2.1 ± 1.2 mmol/l. At 12 months, the decrease in pharmacotherapy required for control of diabetes, hypertension, and hyperlipidemia represented a 62% decrease in the annual cost of treatment ($107,939.99 vs. $41,106.30 [U.S.]). After deducting the additional cost of glucosuria monitoring ($30,604), there was still a 34% annual savings.CONCLUSIONS—The beneficial results of this educational model, implemented in 10 Latin American countries, reinforce the value of patient education as an essential part of diabetes care. They also suggest that an educational approach promoting healthy lifestyle habits and patient empowerment is an effective strategy with the potential to decrease the development of complications related to diabetes as well as the socioeconomic costs of the disease.
Off-Loading the Diabetic Foot Wound
Authors: Armstrong David G. , Nguyen Hienvu C. , Lavery Lawrence A. , van Schie Carine H.M. , Boulton Andrew J.M. , Harkless Lawrence B. 
Published: March 2007

OBJECTIVE—To compare the effectiveness of total-contact casts (TCCs), removable cast walkers (RCWs), and half-shoes to heal neuropathic foot ulcerations in individuals with diabetes.RESEARCH DESIGN AND METHODS—In this prospective clinical trial, 63 patients with superficial noninfected, nonischemic diabetic plantar foot ulcers were randomized to one of three off-loading modalities: TCC, half-shoe, or RCW. Outcomes were assessed at wound healing or at 12 weeks, whichever came first. Primary outcome measures included proportion of complete wound healing at 12 weeks and activity (defined as steps per day).RESULTS—The proportions of healing for patients treated with TCC, RCW, and half-shoe were 89.5, 65.0, and 58.3%, respectively. A significantly higher proportion of patients were healed by 12 weeks in the TCC group when compared with the two other modalities (89.5 vs. 61.4%, P = 0.026, odds ratio 5.4, 95% CI 1.1–26.1). There was also a significant difference in survival distribution (time to healing) between patients treated with a TCC and both an RCW (P = 0.033) and half-shoe (P = 0.012). Patients were significantly less active in the TCC (600.1 ± 320.0 daily steps) compared with the half-shoe (1,461.8 ± 1,452.3 daily steps, P = 0.04). There was no significant difference in the average number of steps between the TCC and the RCW (767.6 ± 563.3 daily steps, P = 0.67) or the RCW and the half-shoe (P = 0.15).CONCLUSIONS—The TCC seems to heal a higher proportion of wounds in a shorter amount of time than two other widely used off-loading modalities, the RCW and the half-shoe.