bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Acculturation Modes and Type 2 Diabetes Among Native Hawaiians
Authors: Kaholokula Joseph Keawe‘aimoku , Nacapoy Andrea H. , Grandinetti Andrew , Chang Healani K. 
Published: March 2008

OBJECTIVE—To examine the association between acculturation modes (integrated, assimilated, traditional, and marginalized) and type 2 diabetes prevalence in Native Hawaiians.
RESEARCH DESIGN AND METHODS—Cross-sectional data were analyzed from 495 Native Hawaiians, including acculturation modes, diabetes status, triglycerides, fasting insulin, BMI, age, and education level. Acculturation modes were assessed using an eight-item cultural affiliation questionnaire.
RESULTS—Native Hawaiians in a traditional mode of acculturation were more likely to have type 2 diabetes (27.9%) than those in integrated (15.4%), assimilated (12.5%), or marginalized (10.5%) modes.
CONCLUSIONS—The higher prevalence of type 2 diabetes among Native Hawaiians in a traditional mode of acculturation could not be attributed to any of the sociodemographic or biological factors included in this study. We discuss the role of psychosocial factors as possible mediators in the relationship between acculturation modes and type 2 diabetes.
Physician Recommendations About Maternal Involvement in Adolescent Diabetes Management
Authors: Wiebe Deborah J. , Berg Cynthia A. , Fortenberry Katherine T. , Sirstins Janet , Lindsay Rob , Donaldson David , Murray Mary 
Published: March 2008

OBJECTIVE—The purpose of this study was to examine whether perceptions of physician recommendations about maternal involvement in adolescent diabetes management are associated with children's reports of mothers’ involvement during the subsequent week.
RESEARCH DESIGN AND METHODS—Youth with type 1 diabetes (aged 10–15 years) and mothers completed scales measuring perceptions of physician recommendations about maternal involvement. At their appointment, and again 1 week later, children reported mothers’ involvement in diabetes over the preceding week.
RESULTS—A total of 53 dyads provided usable data at both time points. Perceived recommendations to increase involvement were associated with children's reports of increased maternal collaboration during the subsequent week (B = 0.81, P &lt; 0.05), an effect that was stronger among boys (B = −1.21, P &lt; 0.005). Increased maternal collaboration correlated with better A1C (r = −0.39, P &lt; 0.005).
CONCLUSIONS—Physicians may facilitate adaptive forms of maternal involvement during adolescence by conveying messages about involvement to patients and families.
Alternative Methods of Insulin Sensitivity Assessment in Obese Children and Adolescents
Authors: Rössner Sophia M. , Neovius Martin , Montgomery Scott M. , Marcus Claude , Norgren Svante 
Published: March 2008

OBJECTIVE—To validate fasting indexes against minimal model analysis (MMOD) of the frequently sampled intravenous glucose tolerance test (FSIVGTT) in an obese pediatric population.
RESEARCH DESIGN AND METHODS—FSIVGTT-MMOD results were compared with homeostasis model assessment of insulin resistance (HOMA-IR) and fasting insulin with the sample stratified by sex, puberty, and sensitivity index (Si) median in 191 children (82 males and 109 females, 13.9 ± 2.9 years of age, BMI 36.9 ± 6.2 kg/m2, BMI SD score 6.1 ± 1.6).
RESULTS—Across pubertal groups, correlation coefficients between Si and HOMA-IR ranged from −0.43 to −0.78 in males and from −0.53 to −0.57 in females (age and BMI adjusted, P &lt; 0.05 in all instances). Similar results were seen for fasting insulin. In females, the relationship was significantly weaker in more-insulin-resistant subjects.
CONCLUSIONS—The validity of fasting indexes in explaining Si was sex dependent, varied with pubertal stage, and in females was influenced by degree of insulin sensitivity. In obese pediatric populations, we generally discourage the use of fasting indexes, although the validity varies within subgroups.
Retinal Vascular Lesions in Patients of Caucasian and Asian Origin With Type 2 Diabetes
Authors: Stolk Ronald P. , van Schooneveld Mary J. , Cruickshank J. Kennedy , Hughes Alun D. , Stanton Alice , Lu Juming , Patel Anushka , Thom Simon A. McG. , Grobbee Diederick E. , Vingerling Johannes R. ,   on behalf of the AdRem Project Team and ADVANCE Management Committee
Published: March 2008

OBJECTIVE—The objective of this study was to describe prevalent vascular retinal lesions among patients with type 2 diabetes enrolled in the ADVANCE Retinal Measurements (AdRem) study, a substudy of the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial.
RESEARCH DESIGN AND METHODS—Seven-field stereoscopic photographs of both eyes were obtained at the baseline assessment of the ADVANCE trial. All photographs were graded in a central reading center. Gradable retinal images were received from 1,605 patients.
RESULTS—The number of patients with any retinopathy (Early Treatment of Diabetic Retinopathy Study [ETDRS] score ≥20) was 645 (40.2% [95% CI 37.8–42.6]); of these, 35 (2.2% [1.6–3.0]) had severe diabetic retinopathy (ETDRS score ≥50). Focal arterial narrowing, venous beading, and arteriovenous nicking were present in 3.8, 5.1, and 9.8% of participants, respectively. Among participants included in this study, Chinese and South-Asian patients had more retinopathy than Caucasians, as defined both by ETDRS score (49.4, 46.0, and 31.3%, respectively; P &lt; 0.001, adjusted for age, sex, A1C, systolic blood pressure, and duration of diabetes) and specific vascular lesions (e.g., arteriovenous nicking 12.3, 8.5, and 7.5%, respectively; adjusted P &lt; 0.005). A1C, duration of diabetes, and systolic blood pressure were similarly associated with increased retinal lesions in Chinese, South-Asian, and Caucasian patients.
CONCLUSIONS—Using a sensitive diagnostic procedure, more than one-third of patients with type 2 diabetes enrolled in the AdRem study had retinal lesions at baseline. Despite differences in prevalence and severity of retinopathy among Chinese, South-Asian, and Caucasian patients included in this study, the cross-sectional associations among established risk factors for retinopathy and retinal lesions were similar across ethnic groups.
Can Serum β-Hydroxybutyrate Be Used to Diagnose Diabetic Ketoacidosis?
Authors: Sheikh-Ali Mae , Karon Brad S. , Basu Ananda , Kudva Yogish C. , Muller Lisa A. , Xu Jia , Schwenk W. Frederick , Miles John M. 
Published: March 2008

OBJECTIVE—Current criteria for the diagnosis of diabetic ketoacidosis (DKA) are limited by their nonspecificity (serum bicarbonate [HCO3] and pH) and qualitative nature (the presence of ketonemia/ketonuria). The present study was undertaken to determine whether quantitative measurement of a ketone body anion could be used to diagnose DKA.
RESEARCH DESIGN AND METHODS—A retrospective review of records from hospitalized diabetic patients was undertaken to determine the concentration of serum β-hydroxybutyrate (βOHB) that corresponds to a HCO3 level of 18 mEq/l, the threshold value for diagnosis in recently published consensus criteria. Simultaneous admission βOHB and HCO3 values were recorded from 466 encounters, 129 in children and 337 in adults.
RESULTS—A HCO3 level of 18 mEq/l corresponded with βOHB levels of 3.0 and 3.8 mmol/l in children and adults, respectively. With the use of these threshold βOHB values to define DKA, there was substantial discordance (∼≥20%) between βOHB and conventional diagnostic criteria using HCO3, pH, and glucose. In patients with DKA, there was no correlation between HCO3 and glucose levels on admission and a significant but weak correlation between βOHB and glucose levels (P &lt; 0.001).
CONCLUSIONS—Where available, serum βOHB levels ≥3.0 and ≥3.8 mmol/l in children and adults, respectively, in the presence of uncontrolled diabetes can be used to diagnose DKA and may be superior to the serum HCO3 level for that purpose. The marked variability in the relationship between βOHB and HCO3 is probably due to the presence of other acid-base disturbances, especially hyperchloremic, nonanion gap acidosis.
Outcome of Diabetic Foot Osteomyelitis Treated Nonsurgically
Authors: Senneville Eric , Lombart Audrey , Beltrand Eric , Valette Michel , Legout Laurence , Cazaubiel Marie , Yazdanpanah Yazdan , Fontaine Pierre 
Published: March 2008

OBJECTIVE—The purpose of this article was to identify criteria predictive of remission in nonsurgical treatment of diabetic foot osteomyelitis.RESEARCH DESIGN AND METHODS—Diabetic patients who were initially treated without orthopedic surgery for osteomyelitis of the toe or metatarsal head of a nonischemic foot between June 2002 and June 2003 in nine French diabetic foot centers were identified, and their medical records were reviewed. Remission was defined as the absence of any sign of infection at the initial or contiguous site assessed at least 1 year after the end of treatment. A total of 24 demographic, clinical, and therapeutic variables including bone versus swab culture–based antibiotic therapy were analyzed.RESULTS—Fifty consecutive patients aged 62.2 ± 11.1 years (mean ± SD) with diabetes duration of 16 ± 10.9 years were included. The mean duration of antibiotic treatment was 11.5 ± 4.21 weeks. Bone biopsy was routinely available in four of the nine centers. Overall patient management was similar in the different centers except for the use of rifampin, which was recorded more frequently in patients from centers in which a bone biopsy was available. At the end of a 12.8-month posttreatment mean follow-up, 32 patients (64%) were in remission. Bone culture–based antibiotic therapy was the only variable associated with remission, as determined by both univariate (18 of 32 [56.3%] vs. 4 of 18 [22.2%], P = 0.02) and multivariate analyses (odds ratio 4.78 [95% CI 1.0–22.7], P = 0.04).CONCLUSIONS—Bone culture–based antibiotic therapy is a factor predictive of success in diabetic patients treated nonsurgically for osteomyelitis of the foot.
Ethnic Differences in the Relationship Between Adiponectin and Insulin Sensitivity in South Asian and Caucasian Women
Authors: Martin Marlene , Palaniappan Latha P. , Kwan Andrea C. , Reaven Gerald M. , Reaven Peter D. 
Published: March 2008

OBJECTIVE—To assess whether lower adiponectin concentrations in South Asian Indians may be responsible for their greater degree of insulin resistance.
RESEARCH DESIGN AND METHODS—Insulin-mediated glucose uptake and plasma total and high molecular weight (HMW) adiponectin concentrations were quantified in 52 women of South Asian (SA) and Caucasian (CAU) ancestry and compared.
RESULTS—Mean ± SD total (2,965 ± 1,278 vs. 4,235 ± 160 ng/ml) and HMW (1,001 ± 352 vs. 1,591 ± 854 ng/ml) adiponectin were lower in SAs than CAUs (P &lt; 0.005). Insulin-resistant CAUs (CAU-IR) had lower total (2,665 ± 1,040 vs. 5,133 ± 1,086 ng/ml) and HMW (987 ± 479 vs. 1,935 ± 838 ng/ml) adiponectin than insulin-sensitive CAUs (CAU-IS) (P &lt; 0.01), but there were no significant differences between insulin-resistant (SA-IR) and insulin-sensitive (SA-IS) SAs. HMW adiponectin did not differ between SA-IR and CAU-IR, but SA-IS had significantly lower adiponectin concentrations than CAU-IS.
CONCLUSIONS—Insulin resistance status is not associated with significantly lower levels of adiponectin in these SA women, in contrast to the CAU women.
Influence of the ACE Gene Insertion/Deletion Polymorphism on Insulin Sensitivity and Impaired Glucose Tolerance in Healthy Subjects
Authors: Bonnet Fabrice , Patel Sheila , Laville Martine , Balkau Beverley , Favuzzi Angela , Monti Lucilla D. , Lalic Nebojsa , Walker Mark ,   on behalf of the European Group for the Study of Insulin Resistance Relationship Between Insulin Sensitivity and Cardiovascular Disease Risk Study Group
Published: March 2008

OBJECTIVE—Recent studies suggested that the blockade of the renin-angiotensin system (RAS) may be associated with metabolic benefits. However, data about the potential influence of the ACE insertion/deletion (I/D) genotype on insulin resistance have been contradictory with studies of limited sample sizes. The purpose of this study was to investigate the relationship between the ACE gene I/D polymorphism and both insulin sensitivity and glucose intolerance in a large cohort of healthy subjects.
RESEARCH DESIGN AND METHODS—A total of 1,286 participants in the Relationship Between Insulin Sensitivity and Cardiovascular Disease Risk Study had a 75-g oral glucose tolerance test and a hyperinsulinemic-euglycemic clamp to assess whole-body insulin sensitivity.
RESULTS—Age, BMI, waist, fat-free mass (ffm), and physical activity did not differ by ACE genotype. Fasting glucose and insulin were similar among genotypes, but 2-h glucose levels were higher in DD than in ID and II subjects (DD: 5.9 ± 1.7; ID: 5.7 ± 1.5; II: 5.6 ± 1.5 mmol/l) (P = 0.004). Participants with the DD genotype were more likely to have impaired glucose tolerance than those with the ID and II genotypes (13.1 vs. 8.7%; P = 0.02). Insulin sensitivity was lower in participants with the DD genotype than in those with the II genotype (136 ± 63 vs. 147 ± 65 μmol · min−1· kg ffm−1 · mmol−1 · l−1; P = 0.02). The presence of the D allele was associated with a trend, albeit not significant, for reduced insulin secretion during the oral glucose tolerance test (P = 0.07).
CONCLUSIONS—The ACE I/D polymorphism is associated with whole-body insulin sensitivity and with impaired glucose tolerance in our healthy population. These findings confirm potential interactions between the RAS and glucose metabolism.
Calcium Plus Vitamin D Supplementation and the Risk of Incident Diabetes in the Women's Health Initiative
Authors: de Boer Ian H. , Tinker Lesley F. , Connelly Stephanie , Curb J. David , Howard Barbara V. , Kestenbaum Bryan , Larson Joseph C. , Manson JoAnn E. , Margolis Karen L. , Siscovick David S. , Weiss Noel S. ,   For the Women's Health Initiative Investigators
Published: March 2008

OBJECTIVE—Experimental and epidemiologic studies suggest that calcium and vitamin D may reduce the risk of developing diabetes. We examined the effect of calcium plus vitamin D supplementation on the incidence of drug-treated diabetes in postmenopausal women.
RESEARCH DESIGN AND METHODS—The Women's Health Initiative Calcium/Vitamin D Trial randomly assigned postmenopausal women to receive 1,000 mg elemental calcium plus 400 IU of vitamin D3 daily, or placebo, in a double-blind fashion. Among 33,951 participants without self-reported diabetes at baseline, we ascertained by treatment assignment new diagnoses of diabetes treated with oral hypoglycemic agents or insulin. Effects of the intervention on fasting measurements of glucose, insulin, and insulin resistance were examined among a subset of participants.
RESULTS—Over a median follow-up time of 7 years, 2,291 women were newly diagnosed with diabetes. The hazard ratio for incident diabetes associated with calcium/vitamin D treatment was 1.01 (95% CI 0.94–1.10) based on intention to treat. This null result was robust in subgroup analyses, efficacy analyses accounting for nonadherence, and analyses examining change in laboratory measurements.
CONCLUSIONS—Calcium plus vitamin D3 supplementation did not reduce the risk of developing diabetes over 7 years of follow-up in this randomized placebo-controlled trial. Higher doses of vitamin D may be required to affect diabetes risk, and/or associations of calcium and vitamin D intake with improved glucose metabolism observed in nonrandomized studies may be the result of confounding or of other components of foods containing these nutrients.
Effect of Varying Glycemic Index Meals on Blood Glucose Control Assessed With Continuous Glucose Monitoring in Youth With Type 1 Diabetes on Basal-Bolus Insulin Regimens
Authors: Nansel Tonja R. , Gellar Lauren , McGill Adrienne 
Published: March 2008

OBJECTIVE—The purpose of this study was to test the effect of high glycemic index (HGI) and low glycemic index (LGI) meals on blood glucose levels using continuous blood glucose monitoring in youths with type 1 diabetes.
RESEARCH DESIGN AND METHODS—A total of 20 youths on basal-bolus regimens consumed macronutrient-matched HGI and LGI meals 1 day each in a controlled setting in varying order following consumption of a standardized evening meal. Medtronic MiniMed Continuous Glucose Monitoring Systems were used to assess blood glucose (BG) profiles.
RESULTS—Participants demonstrated significantly lower daytime mean BG, BG area &gt;180 mg/dl, and high BG index when consuming LGI meals but no differences for daytime BG area &lt;70 mg/dl, daytime low BG index, or any nighttime values. Significantly more BG values &lt;80 mg/dl were treated on LGI days.
CONCLUSIONS—Findings indicate that consumption of an LGI diet may reduce glucose excursions, improving glycemic control.
Soy Protein Intake, Cardiorenal Indices, and C-Reactive Protein in Type 2 Diabetes With Nephropathy
Authors: Azadbakht Leila , Atabak Shahnaz , Esmaillzadeh Ahmad 
Published: March 2008

OBJECTIVE—Several short-term trials on the effect of soy consumption on cardiovascular risks are available, but little evidence exists regarding the impact of long-term soy protein consumption among type 2 diabetic patients with nephropathy. To determine the effects of long-term soy consumption on cardiovascular risks, we measured C-reactive protein (CRP) and kidney function indexes among type 2 diabetic patients with nephropathy.
RESEARCH DESIGN AND METHODS—This longitudinal randomized clinical trial was conducted among 41 type 2 diabetic patients with nephropathy (18 men and 23 women). Twenty patients in the soy protein group consumed a diet containing 0.8 g protein/kg body weight (35% animal proteins, 35% textured soy protein, and 30% vegetable proteins) and 21 patients in the control group consumed a similar diet containing 70% animal proteins and 30% vegetable proteins for 4 years.
RESULTS—Soy protein consumption significantly affected cardiovascular risks such as fasting plasma glucose (mean change in the soy protein versus control groups: −18 ± 3 vs. 11 ± 2 mg/dl; P = 0.03), total cholesterol (−23 ± 5 vs. 10 ± 3 mg/dl; P = 0.01), LDL cholesterol (−20 ± 5 vs. 6 ± 2 mg/dl; P = 0.01), and serum triglyceride (−24 ± 6 vs. −5 ± 2 mg/dl; P = 0.01) concentrations. Serum CRP levels were significantly decreased by soy protein intake compared with those in the control group (1.31 ± 0.6 vs. 0.33 ± 0.1 mg/l; P = 0.02). Significant improvements were also seen in proteinuria (−0.15 ± 0.03 vs. 0.02 ± 0.01 g/day; P = 0.001) and urinary creatinine (−1.5 ± 0.9 vs. 0.6 ± 0.3 mg/dl, P = 0.01) by consumption of soy protein.
CONCLUSIONS—Longitudinal soy protein consumption significantly affected cardiovascular risk factors and kidney-related biomarkers among type 2 diabetic patients with nephropathy.
Similarity of the Impact of Type 1 and Type 2 Diabetes on Cardiovascular Mortality in Middle-Aged Subjects
Authors: Juutilainen Auni , Lehto Seppo , Rönnemaa Tapani , Pyörälä Kalevi , Laakso Markku 
Published: March 2008

OBJECTIVE—To compare the risk of cardiovascular disease (CVD) death and the impact of hyperglycemia on the risk of CVD mortality associated with type 1 diabetes to that associated with type 2 diabetes.
RESEARCH DESIGN AND METHODS—The study comprised 173 participants with type 1 diabetes, 834 participants with type 2 diabetes, and 1,294 nondiabetic participants, aged 45–64 years at baseline and free of CVD. The age of onset of diabetes was &gt;30 years in both diabetic groups.
RESULTS—During an 18-year follow-up, 86 participants with type 1 diabetes, 567 participants with type 2 diabetes, and 252 nondiabetic participants died. CVD mortality rates per 1,000 person-years were 23.1 (95% CI 16.9–31.9) in type 1 diabetic, 35.3 (30.8–40.4) in type 2 diabetic, and 4.6 (3.8–5.7) in nondiabetic participants. Adjusted hazard ratios for CVD mortality in participants with type 1 diabetes versus no diabetes was 3.6 (95% CI 2.2–5.7) in men and 13.3 (6.9–22.5) in women and in participants with type 2 diabetes versus no diabetes 3.3 (2.5–4.5) in men and 10.1 (6.7–17.4) in women. An increment of 1 unit (%) of GHb increased CVD mortality by 52.5% (95% CI 28.4–81.3) in type 1 diabetic subjects and by 7.5% (4.3–10.8) in type 2 diabetic participants.
CONCLUSIONS—The impact of type 1 and type 2 diabetes on CVD mortality was similar. The effect of increasing hyperglycemia on the risk of CVD mortality was more profound in type 1 than in type 2 diabetic subjects.
Comparison of Negative Pressure Wound Therapy Using Vacuum-Assisted Closure With Advanced Moist Wound Therapy in the Treatment of Diabetic Foot Ulcers
Authors: Blume Peter A. , Walters Jodi , Payne Wyatt , Ayala Jose , Lantis John 
Published: March 2008

OBJECTIVE—The purpose of this study was to evaluate safety and clinical efficacy of negative pressure wound therapy (NPWT) compared with advanced moist wound therapy (AMWT) to treat foot ulcers in diabetic patients.
RESEARCH DESIGN AND METHODS—This multicenter randomized controlled trial enrolled 342 patients with a mean age of 58 years; 79% were male. Complete ulcer closure was defined as skin closure (100% reepithelization) without drainage or dressing requirements. Patients were randomly assigned to either NPWT (vacuum-assisted closure) or AMWT (predominately hydrogels and alginates) and received standard off-loading therapy as needed. The trial evaluated treatment until day 112 or ulcer closure by any means. Patients whose wounds achieved ulcer closure were followed at 3 and 9 months. Each study visit included closure assessment by wound examination and tracings.
RESULTS—A greater proportion of foot ulcers achieved complete ulcer closure with NPWT (73 of 169, 43.2%) than with AMWT (48 of 166, 28.9%) within the 112-day active treatment phase (P = 0.007). The Kaplan-Meier median estimate for 100% ulcer closure was 96 days (95% CI 75.0–114.0) for NPWT and not determinable for AMWT (P = 0.001). NPWT patients experienced significantly (P = 0.035) fewer secondary amputations. The proportion of home care therapy days to total therapy days for NPWT was 9,471 of 10,579 (89.5%) and 12,210 of 12,810 (95.3%) for AMWT. In assessing safety, no significant difference between the groups was observed in treatment-related complications such as infection, cellulitis, and osteomyelitis at 6 months.
CONCLUSIONS—NPWT appears to be as safe as and more efficacious than AMWT for the treatment of diabetic foot ulcers.