bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pittsburgh Epidemiology of Diabetes Complications Study: Measuring Diabetic Neuropathy Follow-up Study Results
Authors: Maser Raelene E , Becker Dorothy J , Drash Allan L , Ellis Demetrius , Kuller Lewis H , Greene Douglas A , Orchard Trevor J 
Published: March 2007

Objective
This project evaluated the utility of quantitative sensory techniques in predicting the development of neuropathy for subjects participating in a prospective study.

Research Design and Methods
Distal symmetric polyneuropathy was evaluated in 77 insulin-dependent diabetes mellitus individuals via quantitative sensory testing, nerve conduction studies, and clinical examination.

Results
Although the specificity and positive predictive value were low for the quantitative sensory techniques as predictors of neuropathy diagnosed on clinical exam ∼2 yr later, the sensitivity for vibratory thresholds was high (100%). Variability over the 2-yr interval was shown on follow-up testing for each of the objective assessment modalities and it was not explained by differences for potential risk factors measured at baseline.

Conclusion
Despite a cross-sectional relationship between the assessment modalities and clinically overt neuropathy at baseline, these follow-up data suggest that the potential for the objective modalities as predictors of clinically diagnosed neuropathy may be limited.
Sex Differences in Secondary Attack Rate of IDDM to Siblings of Probands Through Older Ages: Pittsburgh Etiology of IDDM Study
Authors: Gavard Jeffrey A , Dorman Janics S , LaPorte Ronald E , Orchard Trevor J , Drash Allan L , Trucco Massimo M , Kelsey Sheryl F , Kostraba Jill N , Becker Dorothy J 
Published: March 2007

Objectives
To determine the descriptive epidemiological patterns of the secondary attack rate of insulin-dependent diabetes mellitus (IDDM) among siblings of probands through older ages.

Research Design and Methods
A family history analysis was performed on 1774 IDDM probands who were diagnosed or seen within 1 yr of diagnosis at Children's Hospital of Pittsburgh from 1 January 1950 through 31 December 1981. The probands were discharged on insulin and were diagnosed at &lt;17 yr of age. The time frame permitted the risk of IDDM for siblings of probands to be calculated over a broad spectrum of age.

Results
Risk estimates for the 3966 full natural siblings through 10, 20, and 30 yr of age were 1.6, 4.1, and 6.3%, respectively. Secondary attack rates were equivalent for male and female siblings through 15 yr of age (3%); however, the risk to males increased an additional 4% between 16 and 30 yr of age compared with 2.5% for females (P = 0.01). There was no evidence of an excess sex concordance among affected sibling pairs.

Conclusions
Males have a greater secondary attack rate of IDDM at older ages than females. This may be due to an increased exposure to environmental agents among males or protective influences operating among females.
Coronary Heart Disease Risk Factors in Morbidly Obese Women With Normal Glucose Tolerance
Authors: Barakat Hisham A , Mooney Nitin , O'Brien Kevin , Long Stuart , Khazani Prabhaker G , Pories Walter , Caro Jose F 
Published: March 2007

Objective— To examine if the risk for CHD increases progressively with increases in the BMI of normoglycemic, hyperinsulinemic, morbidly obese women (BMI ≥ 35 kg/m2).
Research Design and Methods— Insulin sensitivity was evaluated by calculating an ISI following an OGTT. There was a significant linear relationship between ISI and BMI fitted by two straight lines intersecting at a point corresponding to a BMI of 29.7 ± 1.5 kg/m2. Significant linear relationships between insulin sensitivity and BMI were obtained below and above this breakpoint. Similarly, a breakpoint for the relation between dBP and BMI corresponding to a BMI ≥ 33.7 ± 3.4 kg/m2 was obtained. Significant linear relationships between BMI and plasma fasting glucose, triglyceride, cholesterol, HDL cholesterol, sBP, or dBP were not observed in the women with a BMI &gt; 35 kg/m2.
Results— Compared with lean (BMI &lt;27) women of similar age, the morbidly obese patients appear to be at a higher risk for CHD. This is suggested by statistically significant increases in fasting insulin (mean ± SD; 187 ± 137 vs. 64.2 ± 16.2 pM) and triglyceride levels (128 ± 78.1 vs. 73 ± 25 mg/dl), sBP (132 ± 114 vs. 104 ± 15.8) and dBP (84 ± 72 vs. 67 ± 2.1 mmHg), and decreases in HDL cholesterol (1.03 ± 0.44 vs. 1.29 ± 0.82 mM) and apo A-I (91 ± 55 vs. 122 ± 35 mg/dl) concentrations.
Conclusions— It appears that there may be a threshold of body mass up to which insulin sensitivity is associated with CHD risk. Above this threshold, there does not appear to be a progressive increase in the risk factors for CHD with increases in BMI.
Clinical Hypertension and Its Interaction With Diabetes Among American Indians and Alaska Natives: Estimated rates from ambulatory care data
Authors: Broussard Brenda A , Valway Sarah E , Kaufman Stephen , Beaver Shelli , Gohdes Dorothy 
Published: March 2007

OBJECTIVE— To estimate the prevalence of clinical hypertension and describe the coexistence with diabetes in American Indian and Alaska Native communities.
RESEARCH DESIGN AND METHODS— A cross-sectional study of outpatient visits for hypertension and diabetes over a 1-yr period (1 October 1986 to 30 September 1987) in IHS facilities was conducted.
RESULTS— The 1987 estimated age-adjusted prevalence of diagnosed hypertension for this group was 10.9/100 for people ≥15 yr of age. Thirty-seven percent of diabetic patients were diagnosed with hypertension. The relative risk of hypertension in the diabetic populations compared with the nondiabetic population varied from 4.7 to 7.7 among the different IHS areas.
CONCLUSIONS— Despite high rates of diabetes and obesity, hypertension rates were relatively low among American Indians and Alaska Natives when compared with other ethnic groups in the U.S.
Diabetes and Obesity in the Offspring of Pima Indian Women With Diabetes During Pregnancy
Authors: Pettitt David J , Nelson Robert G , Saad Mohammed F , Bennett Peter H , Knowler William C 
Published: March 2007

OBJECTIVE— To review the long-term effects of the diabetic pregnancy on the offspring among the Pima Indians of Arizona.
RESEARCH DESIGN AND METHODS— Studies published by the Phoenix Epidemiology and Clinical Research branch of the National Institute of Diabetes and Digestive and Kidney Diseases, since the inception of the longitudinal diabetes studies in 1965 were reviewed. In addition, pertinent studies from other centers, mentioned as references in these publications, were reviewed. As far as possible, all original articles and abstracts on this aspect of the Pima Indian studies were discussed.
RESULTS— The offspring of women who had diabetes during pregnancy, on average, were more obese and had higher glucose concentrations and more diabetes than the offspring of women who developed diabetes after pregnancy or who remained nondiabetic. Although no new analyses were attempted, several of the older publications were updated by repeating the analyses on later, expanded data sets.
CONCLUSIONS— The diabetic pregnancy, in addition to its effects on the newborn, has effects on the subsequent growth and glucose metabolism of the offspring. These effects are in addition to genetically determined traits.
Diabetes Mellitus in Tohon O'odham Pregnancies
Authors: Livingston Robert C , Bachman-Carter Karen , Frank Christine , Mason William B 
Published: March 2007

OBJECTIVE— To determine the prevalence of diabetes in Tohono O'odham pregnancies, and to assess the efficacy of early prenatal diabetes screening in populations with high rates of diabetes.
RESEARCH DESIGN AND METHODS— All Tohono O'odham women receiving prenatal care at the Sells Service Unit who delivered a viable baby in the 5-yr study period were reviewed.
RESULTS— Diabetes was confirmed in 97 of 1854 (5.2%) Tohono O'odham pregnancies delivered during the study period. NIDDM antedated pregnancy in 38 (39%) of the diabetic pregnancies. Diabetes was diagnosed for the first time in 59 (61%) of these diabetic pregnancies. The diagnosis was made at or before the 20th gestational wk in 25 of 59 (42%) gestational diabetic women. These 25 women represented 61% of 41 gestational diabetic women who received prenatal care at or before the 20th gestational week.
CONCLUSIONS— Our findings indicate that first trimester diabetes screening is justified in this population and may be appropriate in other populations with high rates of diabetes.
Disruptive Effects of Acute Hypoglycemia on Speed of Cognitive and Motor Performance
Authors: Cox Daniel J , Gonder-Frederick Linda A , Schroeder Deborah B , Cryer Philip E , Clarke William L 
Published: March 2007

OBJECTIVE
To directly examine whether hypoglycemia differentially slows cognitive versus motor function, to evaluate the reliability of hypoglycemic-related slowing, and to examine factors contributing to individual differences.

RESEARCH DESIGN AND METHODS
IDDM subjects (n = 10) were administered a pure cognitive and a pure motor neuropsychological test at euglycemia (5.4 mmol), blood glucose nadir (2.6 mmol), postnadir (3.6 mmol), and again at euglycemia (6.7 mmol). To assess the practice effect, matched control subjects were tested at similar time intervals.

RESULTS
Concurrent and test-retest reliability for all tests was robust (r = 0.68–0.94). Only cognitive tasks demonstrated impairment at nadir (P &lt; 0.04). Individual differences, in terms of cognitive impairment, were significantly correlated with levels of blood glucose at nadir and baseline performance.

CONCLUSIONS
Cognitive tasks appear to be more sensitive to neuroglycopenia than motor tasks. Cognitive impairment caused by hypoglycemia is reliable and differs across subjects. Individuals who show reliable sensitivity to cognitive impairments of hypoglycemia should avoid moderately low blood glucose levels.
Regional Cerebral Blood Flow and Cerebrovascular Reactivity in IDDM
Authors: Rodriguez Guido , Nobili Fiavio , Celestino Maria Assunta , Francione Stefano , Gulli Giovanni , Hassan Khalil , Marenco Stefano , Rosadini Guido , Cordera Renzo 
Published: March 2007

OBJECTIVE
To investigate both rCBF and cerebrovascular reactivity, evaluated as pre- and post-ACZ rCBF differences in a group of IDDM patients with differences in duration of disease and severity of complications.

RESEARCH DESIGN AND METHODS
rCBF was measured by the 133Xenon inhalation method in 20 IDDM patients and in 15 healthy control subjects before and after an intravenous injection of ACZ, a carbonic anhydrase inhibitor commonly used to assess cerebrovascular reactivity.

RESULTS
Basal global CBF (the mean of 32 regional values) was within the normal range in all patients but 1, who showed slight hyperperfusion; moreover, in 3 patients with long-lasting disease, some hypoperfused regions were found. ANOVA showed an inverse correlation between basal global CBF (P &lt; 0.01) and duration of diabetes, but no correlation with Hb, MABP, serum glucose concentration, or GHb. Compared with control subjects, the percentage of global CBF increment after ACZ administration was significantly impaired in 4 patients and gave a borderline response in 2 patients; 4 of these poor ACZ responders had retinopathy, and 1 had suffered from a TIA. Duration of diabetes, Hb, MABP, serum glucose concentration, and GHb did not correlate with the percentage of post-ACZ global CBF changes, and did not differ among the 6 poor ACZ responders and the other diabetic patients or control subjects.

CONCLUSIONS
These results confirm that global CBF is within the normal range in most IDDM patients, although it is significantly influenced by the duration of diabetes; pathophysiological correlates of the altered cerebrovascular reactivity need to be further investigated. rCBF measurements, before and after ACZ administration, seem to represent a safe and reliable tool for assessing cerebrovascular function in IDDM.
Low-Dose Acarbose Improves Glycemic Control in NIDDM Patients Without Changes in Insulin Sensitivity
Authors: Jenney Adam , Proietto Joe , O'Dea Kerin , Nankervis Alison , Traianedes Kathy , D'Embden Helen 
Published: March 2007

OBJECTIVE
To examine the impact on metabolic control in NIDDM patients of the alpha-glucosidase inhibitor, acarbose, when administered at a low dose in powdered form.

RESEARCH DESIGN AND METHODS
Six subjects were recruited for a double-blind cross-over trial using 25 mg powdered acarbose and a placebo 3 times a day with meals for 3 mo. In addition to parameters of diabetes control and body weight, glucose turnover and insulin sensitivity were measured with the hyperinsulinemic/euglycemic clamp technique combined with tracer kinetics.

RESULTS
None of the subjects showed significant changes in FPG levels or body weight either on the 3-mo course of acarbose or placebo. HbA1c fell significantly from 10.6 ± 1.0 to 9.4 ± 1.3% (P = 0.05) during treatment with acarbose but failed to change on placebo (10.1 ± 1.0 to 11.1 ± 2.0%; P = 0.36). Basal HGP and glucose utilization were unchanged during either of the treatment periods, and hyperinsulinemia produced a similar degree of suppression of HGP before and after each treatment. At a physiological concentration, insulin failed to stimulate glucose clearance in these diabetic patients, and no improvement was seen with acarbose treatment. No changes in plasma lipids or lipoprotein profiles were demonstrated after 3 mo on acarbose. In acute studies, it was shown that administration of acarbose at a dose of 25 mg powder per meal significantly decreased the postprandial glycemic excursion.

CONCLUSIONS
When administered in the powdered form at the low dose of 25 mg 3 times/day with meals over 3 mo, acarbose was well tolerated by the NIDDM patients and was without side effects. It improved glycemic control by reducing postprandial hyperglycemia, but had no effect on glucose turnover, insulin sensitivity, or lipid profile.
Effect of Aldose Reductase Inhibitor (Tolrestat) on Urinary Albumin Excretion Rate and Glomerular Filtration Rate in IDDM Subjects With Nephropathy
Authors: Passariello N , Sepe J , Marrazzo G , De Cicco A , Peluso A , Plsano MCA , Sgambato S , Tesauro P , D'Onofrio F 
Published: March 2007

OBJECTIVE
To explore the possible link between diabetic nephropathy and the enhanced activity of the polyol pathway, known to occur in IDDM subjects.

RESEARCH DESIGN AND METHODS
We studied the effects of the aldose reductase inhibitor tolrestat (200 mg/day) on urinary albumin excretion rate and glomerular filtration rate in 20 IDDM patients with diabetic nephropathy.

RESULTS
Six months of placebo treatment produced no significant changes in glomerular filtration rate, urinary albumin excretion rate, and renal plasma flow. Consequently, filtration fraction remained unchanged. During tolrestat treatment, glomerular filtration rate decreased from the basal value of 156 ± 14 ml·min−1.73 m2 to 142 ± 13.7 ml·min−1·1.73 m2 (P &lt; 0.001) at 2 mo; 128 ± 12.4 ml·min−1·1.73 m2 (P &lt; 0.001) at 4 mo; and 123.7 ± 13.0 ml·min−1·1.73 m2 at 6 mo. A significant decrease of urinary albumin excretion rate was observed during the trial (basal values 219 ± 32.5 vs. 196.9 ± 28.5 μg/min at 2 mo [P &lt; 0.05] 171.6 ± 25.5 μg/min at 4 mo [P &lt; 0.001] and 58.6 ± 19.3 μg/min at 6 mo [P &lt; 0.001]). No significant change in renal plasma flow was seen during tolrestat treatment. Filtration fraction significantly decreased in the tolrestat group from the basal value of 0.23 ± 0.02 to 0.21 ± 0.01 at 2 mo (P &lt; 0.005); 0.18 ± 0.02 at 4 mo (P &lt; 0.001); and 0.17 ± 0.02 at 6 mo (P &lt; 0.001).

CONCLUSIONS
The polyol pathway is implicated in hemodynamic changes associated with early diabetic nephropathy, and aldose reductase treatment can positively influence these parameters.
Serum Creatinine, Height, and Weight Do Not Predict Glomerular Filtration Rate in Children with IDDM
Authors: Waz Wayne R , Quattrin Teresa , Feld Leonard G 
Published: March 2007

OBJECTIVE
To assess the validity of two equations: K × height/serum creatinine (KL/Cr; K = 0.55 for females 1–18 yr of age and 0.7 for males 12–18 yr of age) and (140 – age) × weight/72 × creatinine (×0.85 for women; Cockroft-Gault) in estimating glomerular filtration rate in children and adolescents with IDDM.

RESEARCH DESIGN AND METHODS
From the records of the Children's Hospital Diabetes Clinic, we selected 70 patients with GFR determined by 99mTc-labeled DTPA plasma clearance, stable renal function, and simultaneous measurements of height, weight, blood pressure, HbA1c, and plasma creatinine. We compared DTPA-GFR with estimated GFR from KL/Cr and Cockroft-Gault equations for three groups: all patients, patients with DTPA-GFR ≤ 140 ml·min−1 · 1.73 m−2, and patients with DTPA-GFR &gt; 140 ml·min−1 · 1.73 m−2.

RESULTS
For all patients, mean values for DTPA-GFR = 147 (95% confidence interval, 139–155), for KL/Cr = 118 (110–125), and for Cockroft-Gault = 84 ml–·min−1 · 1.73 m−2 (78–90). For patients with DTPA-GFR ≤ 140, DTPA-GFR = 123 (117–128), KL/Cr = 110 (100–119), and Cockroft-Gault = 92 (82–102). For patients with DTPA-GFR &gt; 140, DTPA-GFR = 167 (158–177), KL/Cr = 125 (114–136), and Cockroft-Gault = 77 (71–84). Linear regression analysis showed significant (P &lt; 0.05) relationships for KL/Cr only in patients with DTPA-GFR ≤ 140 (r = 0.29), for Cockroft-Gault in all patients (r = −0.46), and for patients with DTPA-GFR ≤ 140 (r = −0.31). Determination of a revised K for use in KL/Cr from individual calculations of K (DTPA-GFR × Cr/L) yielded an average value of 0.70 (SD = 0.11). With the use of K = 0.7, the mean KL/Cr value for patients with DTPA-GFR ≤ 140 ml·min−1 · 1.73 m−2 was 125 ± 27 (95% confidence interval, 115–135), compared with a DTPA-GFR value of 123 ± 14 (95% confidence interval, 117–128).

CONCLUSIONS
KL/Cr and Cockroft-Gault do not accurately estimate DTPA plasma clearance. We recommend the use of K equal to 0.70 when estimating GFR in children and adolescents with IDDM and DTPA-GFR ≤ 140 using KL/Cr and do not recommend the use of the KL/Cr (for patients with DTPA-GFR &gt; 140) or the Cockroft-Gault equation in this population.
Evaluation of a Structured Treatment and Teaching Program for Non-Insulin-Treated Type II Diabetic Outpatients in Germany After the Nationwide Introduction of Reimbursement Policy for Physicians
Authors: Gruesser Monika , Bott Uwe , Ellermann Petra , Kronsbein Petra , Joergens Viktor 
Published: March 2007

Objective— To evaluate the practicability and efficacy of a structured treatment and teaching program for non-insulin-treated type II diabetic patients in routine primary health care.
Research Design and Methods— All physicians (n = 139) and their office staffs in Hamburg, Germany, who had participated in a special training course from 1 April 1991 to 31 December 1991 were contacted for a standardized interview. A random sample of 17 of these offices was selected for office visits during which the documented data of all patients who had received the standardized treatment and teaching in the same period were collected and evaluated.
Results— The program was well received by the physicians, and the data collected on 179 patients (5.1 mo median after the intervention) demonstrated the efficacy of the program at the treatment level: reduction of body weight (mean 2.8 kg, P &lt; 0.0001) and HbA1c levels (from 8.11 ± 1.68 to 7.47 ± 1.64%, P &lt; 0.0001) was substantial. The individual prescribed volume of oral antidiabetic agents was ∼50% lower after patient attendance of the program (significant decrease from 1.41 ± 1.42 to 0.76 ± 1.11 tablets/patient/day, P &lt; 0.0001). The proportion of patients treated with oral antidiabetic drugs decreased from 63 to 42% (P &lt; 0.0001).
Conclusions— Subsequent to the introduction of nationwide remuneration of outpatient education for type II diabetic patients by office-based physicians, a relevant improvement was observed in the quality of care, comparable with the effects of the program in a previous prospective controlled trial.
Postural Instability in Patients with Diabetic Sensory Neuropathy
Authors: Simoneau Guy G , Ulbrecht Jan S , Derr Janice A , Becker Mary B , Cavanagh Peter R 
Published: March 2007

OBJECTIVE
Recent survey evidence suggests that sensory ataxia due to diabetic neuropathy may be a more frequent and serious problem than is commonly recognized. This view is further supported by research that confirms the major contribution of the somatosensory system to the control of posture. We therefore sought to determine the effects of significant diabetic distal symmetrical polyneuropathy on the control of posture.

RESEARCH DESIGN AND METHODS
Fifty-one subjects, divided into three groups, participated in this study. Seventeen had diabetes and significant sensory neuropathy, 17 had diabetes and no neuropathy, and 17 had neither diabetes nor neuropathy. The subjects were matched across groups, and stringent exclusion criteria were applied. Postural stability during quiet standing was measured using a force platform. In addition to electrophysiological and quantitative sensory tests of neuropathy, a number of physical and functional characteristics were measured for all subjects.

RESULTS
Postural instability was found to be significantly associated with sensory neuropathy, but not with diabetes per se. Patients with sensory neuropathy demonstrated between 66 and 117% more instability than did control subjects (depending on the testing condition). Based on multiple linear regression analyses, the most significant correlates of instability were the quantitative sensory measures of neuropathy and age.

CONCLUSIONS
The loss of sensory perception secondary to diabetic distal symmetrical sensory neuropathy has a markedly detrimental effect on postural stability. The deficit is greatest when visual or vestibular cues are absent or degraded. Patients with neuropathy need to be informed of the postural consequences of this condition to limit the potential morbidity caused by falls.
The Incidence of IDDM in Seoul From 1985 to 1988
Authors: Ko Kwang W , Yang Sei W , Cho Nam H 
Published: March 2007

OBJECTIVE
To determine insulin-dependent diabetes mellitus (IDDM) incidence rates for the first time in Seoul, Korea, from 1985 to 1988.

RESEARCH DESIGN AND METHODS
A mail survey was conducted among all hospitals, a total of 136, with &gt; 80 beds in the Seoul area. Of these, (15.4%) hospitals reported patients with newly diagnosed IDDM.

RESULTS
The average incidence rate of IDDM from 1985 to 1988 was 0.70/100,000 (95% confidence interval [CI]: 0.55–0.89). When stratified by gender, the average incidence rate in boys was 0.58/100,000 (95% CI: 0.42–0.9), and in girls it was 0.78/100,000 (95% CI: 0.56–1.07). The age at onset was similar to that reported in other countries, i.e., more than 50% of the cases were diagnosed between the ages of 10 and 14. The incidence of IDDM increased in parallel with the age-group (0–4 &lt; 5–9 &lt; 10–14 years). Onset seasonality was also similar to that in other reported countries with the most cases occurring during the winter months and the least number of cases during the summer months.

CONCLUSIONS
The incidence rate of IDDM in Seoul is the lowest reported in the world. This might be effectively considered a baseline incidence rate before exposure to environment or other risk factors. The similar pattern of onset characteristics in Korea to those in other countries suggests that the same etiological factors are operative.