bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can Postmenopausal Hormone Replacement Improve Plasma Lipids in Women With Diabetes?
Authors: Robinson Jennifer G , Folsom Aaron R , Nabulsi Azmi A , Watson Robert , Brancati Frederick L , Cai Jianwen ,   For the Atherosclerosis Risk in Communities Study Investigators
Published: March 2007

OBJECTIVE
To evaluate the association of postmenopausal hormone replacement with plasma lipids in diabetic women.

RESEARCH DESIGN AND METHODS
Cross-sectional data from a multiracial population study were used to evaluate the relationship of hormone replacement status with plasma lipids in diabetic (n = 694) versus nondiabetic (n = 5,321) postmenopausal women.

RESULTS
Although diabetic women who currently used hormone replacement had higher adjusted mean HDL cholesterol levels than those who did not (56.9 vs. 53.6 mg/dl), they had proportionately lower hormone-related increases in HDL, HDL2, and HDL3 cholesterol than did nondiabetic women (HDL cholesterol 64.9 [current users] vs. 55.7 mg/dl [those who never used hormones]). There was a trend toward greater triglyceride values with hormone replacement in diabetic women (156.6 [current users] vs. 125.4 mg/dl [those who never used hormones]) than in nondiabetic women (143.3 [current users] vs. 123.7 mg/dl [those who never used hormones]). LDL cholesterol and apolipoprotein B levels were lower and apolipoprotein A-I levels were higher with hormone replacement, to a similar degree in diabetic and nondiabetic women.

CONCLUSIONS
Diabetic women appear to have a blunted response to the HDL-raising effects of estrogen and an exaggerated hypertriglyceridemic response. This may result in attenuated cardioprotection from postmenopausal hormone replacement therapy and potentially an increased risk of acute pancreatitis from hypertriglyceridemia. The risks and benefits of postmenopausal hormone replacement need to be carefully weighed in diabetic women.
Evolution, Risk Factors, and Prognostic Implications of Albuminuria in NIDDM
Authors: Niskanen Leo K , Penttilã Ilkka , Parviainen Markku , Uusitupa Matti I J 
Published: March 2007

OBJECTIVE
To study the cumulative incidence of albuminuria and its determinants in NIDDM patients and nondiabetic subjects from the diagnosis and impact of albuminuria on cardiovascular mortality.

RESEARCH DESIGN AND METHODS
We performed a 10-year prospective observational study of 133 well-characterized middle-aged patients with newly diagnosed NIDDM and 144 control subjects. Both groups were examined at baseline and after 5 and 10 years. Urinary albumin excretion was determined from timed 24-h (baseline and 5-year examinations) or overnight samples (10-year examination). Microalbuminuria was defined as urinary albumin excretion of 30–300 mg/24 hr or 20–200 μg/min, with the higher values considered as macroalbuminuria.

RESULTS
The cumulative incidence of micro- and macroalbuminuria increased sharply after 5 years in NIDDM patients (baseline: 18.2 and 3.0%; 5 years: 18.9 and 1.8%; and 10 years: 33.0 and 10.2%) but markedly less in control subjects (baseline: 1.4 and 0%, P &lt; 0.001 for diabetic patients vs. control subjects for any albuminuria; 5 years: 6.0 and 0.8%, P &lt; 0.01; 10 years: 11.9 and 0.8%, P &lt; 0.001). The most important determinant of the development of albuminuria was the metabolic control of diabetes in NIDDM patients during the follow-up, whereas in nondiabetic subjects, the development of albuminuria was related to elevated blood pressure and fasting insulin levels. Baseline and 5-year albuminuria predicted subsequent cardiovascular mortality in diabetic patients, even when adjusted for multiple risk factors. The risk of cardiovascular death in NIDDM patients increased by simultaneous occurrence of hyperinsulinemia and albuminuria.

CONCLUSIONS
The frequency of microalbuminuria in patients with NIDDM increases sharply with the duration of diabetes. Chronic hyperglycemia is the main risk factor for microalbuminuria in diabetic patients. Microalbuminuria accompanied by hyperinsulinemia is a powerful predictor of cardiovascular death in NIDDM patients.
Structure and Costs of Health Care of Diabetic Patients in Finland
Authors: Kangas Tero , Aro Seppo , Koivisto Veikko A , Salinto Marjo , Laakso Markku , Reunanen Antti 
Published: March 2007

OBJECTIVE
The aim of the present study was to examine both the structure, including modes of drug treatment, ambulatory care, and hospital inpatient care, and the costs of health care for drug-treated diabetic patients in Finland.

RESEARCH DESIGN AND METHODS
The modes of drug treatment and ambulatory care were studied with the help of a questionnaire given to all diabetic patients obtaining their medication through pharmacies in Finland during a 7-week period in 1989. The questionnaire sought information on drug treatment, site of health care, and frequency of visits to physicians. Hospital inpatient care was evaluated by linking the patient data from the Hospital Discharge Register and the Central Drug Register. The direct costs of health care were calculated by using relevant average costs.

RESULTS
A total of 30,266 questionnaires were returned, representing &gt; 70% of all drug-treated diabetic patients receiving medication in the period studied. Of the diabetic patients, 63% were treated by oral medication only, 31% by insulin only, and 6% by a combination of insulin and oral agents. Of the patients in whom diabetes was diagnosed at ≥ 30 years of age, 75% were treated at health centers, whereas &gt; 60% of those in whom diabetes was diagnosed at &lt; 30 years of age were treated at outpatient clinics. The mean annual frequency of visits was 4.0 for patients receiving insulin treatment and 3.3 for patients receiving treatment with oral medications. The diabetic patients used 1.5 million hospital inpatient days per year, which was 13% of the total inpatient days in Finland. Of the inpatient days, 20% were for diabetes as the principal cause, 52% for diabetes-related diseases, and 28% for causes unrelated to diabetes. The direct costs of the health care of drug-treated diabetic patients in 1989 were 5.8% of the total costs of health care in Finland and were three times higher than the average costs of care for nondiabetic individuals. The direct costs were divided into inpatient care (81%), medication (9%), ambulatory care (8%), and self-care equipment (2%).

CONCLUSIONS
Hospital inpatient care is the major contributor to the excess of health care expenditures for diabetic patients.
Endogenous Insulin Modulates Circulating Endothelin-1 Concentrations in Humans
Authors: Ferri Claudio , Bellini Cesare , Desideri Giovambattista , De Mattia Giancarlo , Santucci Anna 
Published: March 2007

OBJECTIVE
To assess the effect of oral glucose loading on plasma endothelin-1 (ET-1) levels in humans.

RESEARCH DESIGN AND METHODS
A total of 75 g D-glucose was given orally to 14 nonobese nondiabetic essential hypertensive subjects (eight men and six women, mean age 43.1 ± 3.0 years) and eight normotensive subjects (four men and four women, mean age 45.2 ± 4.1 years). Blood samples for plasma ET-1 measurement were drawn every 30 min for 2 h and then at 180 and 240 min.

RESULTS
After glucose load, insulin increased more significantly in hypertensive subjects than in normotensive subjects at times 60 (P = 0.004) and 90 (P = 0.001) min. Glucose loading was followed by a mild but significant increase in circulating ET-1 levels in both groups (hypertensive subjects, from 0.87 ± 0.25 pg/ml at time 0 to 1.64 ± 0.33 pg/ml at 120 min and 1.74 ± 0.38 pg/ml at 180 min, P &lt; 0.05; normotensive subjects, from 0.82 ± 0.38 pg/ml at time 0 to 1.42 ± 0.18 pg/ml at 180 min, P &lt; 0.05). Whereas baseline ET-1 levels were similar between the two groups, postload ET-1 levels were higher in hypertensive subjects than in normotensive subjects (P = 0.003 at 120 min; P = 0.04 at 180 min).

CONCLUSIONS
This study indicates that significant changes in circulating ET-1 levels occur after oral glucose loading, probably due to a glucose-induced increment in endogenous insulin concentration.
Quality of Outpatient Care Provided to Diabetic Patients: A health maintenance organization experience
Authors: Peters Anne L , Legorreta Antonio P , Ossorio R Clifford , Davidson Mayer B 
Published: March 2007

OBJECTIVE
To document the quality of diabetes care provided to patients in a large health maintenance organization (HMO) from 1 January 1993 to 1 January 1994 and compare it to the standards of the American Diabetes Association (ADA).

RESEARCH DESIGN AND METHODS
To meet a Health Plan and Employer Data Information Set (HEDIS) requirement, a major HMO in California identified 14,539 members with diabetes and randomly selected 384 individuals for review. Charts were available on 353 of these patients, and after obtaining the information for the HEDIS review, additional information was extracted from the charts by an outside chart reviewer. This data set was used for an analysis of the quality of diabetic care provided by the participating medical groups to these HMO members during 1 year. Documentation of follow-up and measures of glycemic and lipid control was examined both for absolute values and for the frequency of measurement over the year. These results were compared to the ADA standards of care.

RESULTS
Although patients averaged 4.5 visits to their primary care physicians (PCPs) over the year, 21% had one or fewer visits per year. Glycated hemoglobin levels were not documented in 56% of patients (ADA recommends two to four measurements per year), and of those with a glycated hemoglobin level measured. 39% had at least one value ≥ 10%. Fasting plasma glucose concentrations were not documented in 65% of patients (four to six per year recommended). Foot exams (which should be performed at each regular visit) were not documented for 94% of patients. Urine protein measurements were not performed in 52% of patients. Additionally, many patients had elevated and untreated lipid abnormalities.

CONCLUSIONS
In spite of the frequency of PCP visits during the year for many of these patients, diabetes management was inadequate. This lack of adequate preventive care will lead to an increased risk of the development of the acute and chronic complications of diabetes, creating an even greater future burden on the health care system and negative consequences for patients.
Interlaboratory Variation of GHb Assays in Victoria, Australia
Authors: Gilbert Richard E , Goodall Ian , Young Val , Jerums George 
Published: March 2007

OBJECTIVE
To determine the extent of interlaboratory variation and accuracy in the measurement of glycated hemoglobin (GHb).

RESEARCH DESIGN AND METHODS
All laboratories that measure glycated hemoglobin in the State of Victoria, Australia, were invited to participate, and positive responses were received from 27 to 30 laboratories. An aliquot of blood drawn from three patients with diabetes and varied glycemia and from one nondiabetic subject was sent to each participating laboratory. Distribution of results was analyzed according to the reported results and their variance from an assigned reference value and were expressed as differing from this latter value as percentage bias and in absolute terms. A bias ≥ 10% or an absolute difference of ≥ 1% HbA1c from the reference value was considered significant.

RESULTS
Reported results for the same blood sample ranged from 4.1 to 5.8%, 5.1 to 8.2%, 6.7 to 9.3%, and 10.1 to 14.7% for the specimens from the nondiabetic subject and the diabetic patients with good, moderate, and poor glycemic control, respectively. The proportion of laboratories with results that differed by ≥ 10% bias from the reference value were 39% (12 of 30), 29% (9 of 30), 16% (5 of 30), and 32% (10 of 30), and the proportion reporting results that differed by ≥ 1% HbA1c in absolute terms from the reference values were 3% (1 of 30), 6% (2 of 30), 16% (5 of 30), and 23% (7 of 30) for the specimens from the nondiabetic subject and the diabetic patients with good, moderate, and poor glycemic control, respectively.

CONCLUSIONS
A substantial degree of interlaboratory variation for GHb measurement exists in Victoria, Australia. This may lead to difficulties in interpretation when GHb is assayed by different laboratories in the same patient over time. Interlaboratory standardization may be achievable by calibration to a standard assigned by a reference laboratory and distributed to all laboratories measuring GHb.
Altered Taste Sensation in Newly-Diagnosed NIDDM
Authors: Perros Petros , MacFarlane T Wallace , Counsell Carl , Frier Brian M 
Published: March 2007

OBJECTIVE
To assess gustatory appreciation in newly diagnosed NIDDM patients and to determine whether it altered with the improvement of glycemic control after treatment with diet and oral hypoglycemic drugs.

RESEARCH DESIGN AND METHODS
Assessments of taste, peripheral and autonomic neural function, diet, and oral microbiological flora were performed in 20 patients before and after treatment of hyperglycemia, 20 matched nondiabetic control subjects, and 11 patients with long duration of diabetes and advanced peripheral neuropathy.

RESULTS
Median total HbA1 fell from 12.6 to 8.8% in new diabetic patients after 3–5 months of treatment. Electrical taste thresholds, detection threshold for glucose, and recognition threshold for glucose and salt were increased in newly-diagnosed NIDDM patients compared with the control subjects. The dose-response curve to glucose (using a visual analogue scale [VAS]) of newly-diagnosed NIDDM patients was significantly impaired and improved after treatment. By contrast, newly-diagnosed NIDDM patients had normal VAS taste responses to fructose, salt, and urea. Measurements of somatic and autonomic nerve function did not correlate with electrical or chemical taste function.

CONCLUSIONS
Newly-diagnosed NIDDM patients have a blunted taste response, which displays a degree of specificity to glucose, is partially reversed after correction of hyperglycemia, and is independent of somatic or autonomic nerve function. This taste abnormality may influence the premorbid choice of nutrients, with a preference for sweet-tasting foods, thereby exacerbating hyperglycemia.
Incidence and Prevalence of Diabetes in Manitoba, 1986–1991
Authors: Blanchard James F , Ludwig Sora , Wajda Andre , Dean Heather , Anderson Kristin , Kendall Ora , Depew Noella 
Published: March 2007

OBJECTIVE
To estimate the incidence and prevalence of diabetes among adults in Manitoba, Canada, from 1986 to 1991.

RESEARCH DESIGN AND METHODS
A population-based database of individuals diagnosed with diabetes (Manitoba Diabetes Database) was created using data from Manitoba Health's comprehensive insurance system. Using this database, estimates of the annual incidence and prevalence of diabetes among Manitoba adults aged ≥25 years were made for the years 1986–1991. Age-specific and age-adjusted rates were calculated separately for men and women.

RESULTS
The prevalence of diabetes in 1991 was 66.9/1,000 among adults ≥25 years. Between 1986 and 1991 the age-adjusted prevalence rose steadily among both men and women. In 1991, the incidence of diabetes was 5.6/1,000. After an observed decline prior to 1989, the annual incidence of diabetes appears to be relatively stable.

CONCLUSIONS
The prevalence of diabetes is increasing steadily despite relatively stable incidence rates. Population-based data are required for projecting future trends and are an important tool for planning the required health resources.
Effect of Maternal Diabetes on the Pattern of Selected Insulin Resistance Syndrome Parameters in Normal Glucose Tolerant Subjects of Two Algonquin Indian Communities in Quebec
Authors: Ekoé Jean-Marie , Thomas Frederique , Balkau Beverley , Eschwege Eveline , Delisle Helene 
Published: March 2007

OBJECTIVE
To determine whether a maternal antecedent with diabetes has an effect on insulin resistance syndrome parameters.

RESEARCH DESIGN AND METHODS
We studied 352 Algonquin Indians from Quebec aged at least 15 years who had no personal antecedents with diabetes. Data concerned clinical and biological parameters and the parental antecedents with diabetes.

RESULTS
For subjects over &gt; 30 years, fasting insulin and cholesterol levels were significantly higher in the group with a maternal history of diabetes than in the group with a paternal history. Significant differences were observed for serum triglyceride, BMI, and subscapular skinfold thickness when comparing subjects with a maternal history and those with no parental history of diabetes. Blood pressure and fasting glucose did not differ according to parental history.

CONCLUSIONS
Subjects of maternal antecedents with diabetes have known risk factors for NIDDM. This study does not identify whether there is a genetic or maternal environmental reason for this association.
Effects of a Brief Office-Based Intervention to Facilitate Diabetes Dietary Self-Management
Authors: Glasgow RE , Toobert DJ , Hampson SE 
Published: March 2007

OBJECTIVE
There is a pressing need for brief practical interventions that address diabetes management. Using a randomized design, we evaluated a medical office-based intervention focused on behavioral issues relevant to dietary self-management.

RESEARCH DESIGN AND METHODS
There were 206 adult diabetes patients randomized to usual care or brief intervention, which consisted of touchscreen computer-assisted assessment to provide immediate feedback on key barriers to dietary self-management, and goal setting and problem-solving counseling for patients. Follow-up components to the single session intervention included phone calls and interactive video or videotape instruction as needed.

RESULTS
Multivariate analyses of covariance revealed that the brief intervention produced greater improvements than usual care on a number of measures of dietary behavior (e.g., fewer calories from saturated fat, fewer high-fat eating habits and behaviors) at the 3-month follow-up. There were also significant differences favoring intervention on changes in serum cholesterol levels and patient satisfaction but not on glycosylated hemoglobin. The intervention effects were relatively robust across a variety of patient characteristics, the two participating physicians, and intervention staff members.

CONCLUSIONS
If the long-term results are equally positive and generalize to other setting, this intervention could provide a prototype for a feasible cost-effective way to integrate patient views and behavioral management into office-based care for diabetes.
A Dose-Response Study of Glimepiride in Patients With NIDDM Who Have Previously Received Sulfonylurea Agents
Authors: Goldberg Ronald B , Holvey Sherman M , Schneider Jill ,   The Glimepiride Protocol #201 Study Group
Published: March 2007

OBJECTIVE
To assess the efficacy, safety, and dose-response relationship of glimepiride in patients with NIDDM.

RESEARCH DESIGN AND METHODS
After a 21-day placebo washout period, 304 patients were randomized to receive either placebo or glimepiride, 1, 4, or 8 mg once daily. Fasting plasma glucose (FPG), 2-h postprandial glucose (PPG), and HbA1c were measured at predetermined intervals during the washout period and the 14-week study. Adverse events were tabulated.

RESULTS
At each patient visit, reduction from baseline FPG was greater in each glimepiride group than in the placebo group (P &lt; 0.001). Changes from baseline to endpoint after 1, 4, and 8 mg glimepiride exceeded those after placebo (P &lt; 0.001) by 2.4, 3.9, and 4.1 mmol/l, respectively, for FPG; by 1.2, 1.8, and 1.9 percentage points, respectively, for HbA1c; and by 3.5, 5.1, and 5.2 mmol/l, respectively, for 2-h PPG. Greater reductions in these parameters were observed with 8 and 4 mg than with 1 mg (P &lt; 0.05), indicating a dose-response relationship. When patients with baseline HbA1c levels ≥ 8% were assessed, more patients who received 8 mg glimepiride had HbA1c values &lt; 8% at endpoint compared with patients receiving 4 mg. Glimepiride had a favorable safety profile.

CONCLUSIONS
Glimepiride in 1-, 4-, or 8-mg doses was effective and well tolerated. Although the 4- and 8-mg once-daily doses were significantly more potent than the 1-mg dose, all three doses yielded clinical improvement. Because the 8-mg dose controlled HbA1c values in a greater number of patients with high baseline HbA1c levels than did the 4-mg dose, this higher dose might be beneficial for patients who are difficult to treat.
Hyperglycemia affects cardiovascular autonomic nerve function in normal subjects
Authors: Yeap Bu B , Russo Antonietta , Fraser Robert J , Wittert Gary A , Horowitz Michael 
Published: March 2007

OBJECTIVE
To evaluate the effect of acute hyperglycemia on autonomic nerve function in normal subjects.

RESEARCH DESIGN AND METHODS
Six healthy volunteers ages 19-32 years underwent paired studies during euglycemia (blood glucose 5.1 ± 0.04 mmol/l) and hyperglycemia (blood glucose 15.7 ± 0.48 mmol/l) induced by intravenous infusion of glucose and maintained for 150 min. The order of the two studies was randomized. In each experiment, supine heart rate, heart rate variation with respiration, ratio of the maximum to minimum R-R interval after standing (“30:15” ratio), systolic blood pressure response to standing, and diastolic blood pressure response to sustained handgrip were measured. Data were analyzed using repeated measures analysis of variance.

RESULTS
The supine heart rate was greater (P = 0.04) and the “30:15” ratio less (P = 0.03) during hyperglycemia than during euglycemia. Hyperglycemia had no significant effect on any of the other cardiovascular reflex tests.

CONCLUSIONS
These observations indicate that acute hyperglycemia affects autonomic nerve function in healthy humans.
Effects of the Short-Acting Insulin Analog [Lys(B28),Pro(B29)] on Postprandial Blood Glucose Control in IDDM
Authors: Torlone Elisabetta , Pampanelli Simone , Lalli Carlo , Sindaco Paola Del , Vincenzo Antonio Di , Rambotti Anna Maria , Modarelli Francesco , Epifano Lucilla , Kassi Giorgia , Perriello Gabriele , Brunetti Paolo , Bolli Geremia 
Published: March 2007

OBJECTIVE
To establish the effects of the short-acting insulin analog Lispro versus human regular insulin (Hum-R) on postprandial metabolic control in IDDM.

RESEARCH DESIGN AND METHODS
Four studies were performed in 10 C-peptide-negative IDDM patients. Lispro or Hum-R (0.15 U/kg) or Lispro + NPH (0.07 U/kg) or Hum-R + NPH were injected subcutaneously 30 min (Hum-R) or 5 min (Lispro) before lunch. Preprandial plasma glucose (PG) was maintained on all four occasions at ∼ 7.3 mmol/l by intravenous insulin.

RESULTS
After subcutaneous Lispro injection, plasma free insulin (FIRI) was greater between 0 and 2 h (233 ± 22 pmol/l) than after Hum-R (197 ± 25 pmol/l) but lower between 2.25 and 7 h (81 ± 10 vs. 104 ± 13 pmol/l, P &lt; 0.05). After Lispro, PG was lower versus Hum-R for 3 h (7.4 ± 0.6 vs. 8.3 ± 0.9 mmol/l) but subsequently increased more than after Hum-R (3.25-7h, 11.3 ± 1 vs. 9.6 ± 1.2 mmol/l), resulting in a 7-h postprandial PG greater than Hum-R (9.4 ± 0.5 vs. 8.8 ± 0.6 mmol/l) (all P &lt; 0.05). Addition of NPH to Lispro increased the 2.5-to 7-h FIRI to 110 ± 11 pmol/l and decreased the 3.25- to 7-h PG to 7.7 ± 0.8 pmol/l, resulting in 0- to 7-h PG (7.3 ± 0.3 mmol/l) lower than after Hum-R + NPH (7.9 ± 0.5 pmol/l) (P &lt; 0.05).

CONCLUSIONS
At meals, in order for Lispro to improve postprandial blood glucose not only at 2-h, but also over a 7-h period in C-peptide–negative IDDM, basal insulin must be optimally replaced.