bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maintenance of Sulfonylurea Responsiveness in NIDDM: Randomized Double-Blind Study of Intermittent Glyburide Therapy
Authors: Grunberger George 
Published: March 2007

Objective
To assess the effectiveness of intermittent administration of sulfonylurea (glyburide) to patients with non-insulin-dependent diabetes mellitus (NIDDM).

Research Design and Methods
A randomized, double-blind, prospective trial compared daily administration with intermittent administration of glyburide to patients who initially responded to the drug. Twenty-eight of 60 patients with NIDDM achieved the predetermined improvement in plasma glucose concentration on glyburide therapy. These 28 responders were enrolled into a 16-wk trial of daily versus intermittent (2 wk on, 2 wk off) glyburide treatment. Laboratory assessment of glycemic control and insulin secretion in fasting and 2-h postprandial states was done every 2 wk.

Results
Patients on continuous glyburide therapy maintained their glycemic control throughout the study. In contrast, patients on the intermittent schedule lost their glycemic control immediately after being placed on placebo. Despite a significant response to each sulfonylurea pulse, these subjects never regained their baseline glycemic levels. Their fructosamine and HbA1c concentrations deteriorated and remained significantly higher than those of the continuously treated subjects.

Conclusions
Results suggest that administration of glyburide on an intermittent basis after a 2-wk drug-free period to patients initially rendered responsive to sulfonylurea therapy is without clinical merit.
Low Incidence of Childhood IDDM in District of Novosibirsk (Russia)
Authors: Shubnikov Evgeni , Podar Toomas , Tuomilehto Jaakko , Nikitin Yuri 
Published: March 2007

Objectives
To study the incidence of insulin-dependent diabetes mellitus (IDDM) among 0- to 14-yr-old children of the district of Novosibirsk, in western Siberia, Russia, from 1983 to 1989.

Research Design and Methods
Data were collected with methods recommended by the Diabetes Epidemiology Research International Group.

Results
The average yearly incidence among males and females was 4.7 (95% confidence interval 3.9–5.8) and 4.4 (95% confidence interval 3.6–5.4) per 100,000 people, respectively. The incidence of IDDM among children living in the city of Novosibirsk was significantly higher than in children living in the surrounding counties of the district, 5.7/100,000 (95% confidence interval 4.8–6.8) versus 3.6/100,000 (95% confidence interval 2.9–4.5).

Conclusions
The incidence of childhood IDDM among Russians in Siberia is low. This is the first publication of internationally comparable data on the occurrence of childhood IDDM in the Russian population.
Asymptomatic Hyperglycemia and Atherosclerotic Vascular Disease in the Elderly
Authors: Mykkänen Leena , Laakso Markku , Pyörälä Kalevi 
Published: March 2007

OBJECTIVE
To investigate the relationship between asymptomatic hyperglycemia (IGT or newly diagnosed NIDDM) and atherosclerotic vascular disease.

RESEARCH DESIGN AND METHODS
A representative cross-sectional population sample of 1431 subjects (511 men, 920 women; 65–74 yr old). Altogether, 312 men and 515 women had NGT, 84 men and 158 women had IGT, 33 men and 59 women had newly diagnosed NIDDM, and 82 men and 188 women had previously diagnosed NIDDM. Participation rate was 71%. Main outcome measures were prevalence rates of CHD, stroke, and intermittent claudication.

RESULTS
There was no difference in the prevalence of definite or possible MI verified at hospital between subjects with asymptomatic hyperglycemia and NGT (15.5 vs. 13.3% in men, 6.3 vs. 5.3% in women). Men with asymptomatic hyperglycemia had 1.5 × higher prevalence of angina pectoris (29.4 vs. 19.3%, P &lt; 0.05), major Q-QS changes (21.1 vs. 12.0%, P &lt; 0.05), ischemic ECG changes (59 vs. 45%, P &lt; 0.05), and silent MI on ECG (14.8 vs. 7.9%, P &lt; 0.05) compared to men with NGT. Women with asymptomatic hyperglycemia had more often ischemic ECG changes compared to women with NGT (48.3 vs. 39.7%, P &lt; 0.05). There was no difference (NS) in the prevalence of verified stroke (3.5 vs. 4.6% in men, 2.7 vs. 2.5% in women) or claudication (7.0 vs. 7.7% in men, 4.6 vs. 4.3% in women) between subjects with asymptomatic hyperglycemia and NGT. In multiple logistic regression analyses, the association between risk factors and MI or ischemic ECG changes in subjects with asymptomatic hyperglycemia was not consistent.

CONCLUSION
Elderly subjects with asymptomatic hyperglycemia (particularly men) tended to have an increased prevalence of CHD. Thus, asymptomatic hyperglycemia in the elderly is not a benign phenomenon but is associated with cardiovascular morbidity.
Fibrinolytic System During Long-Distance Running in IDDM Patients and in Healthy Subjects
Authors: van Loon Bert-Jan Potter , Heere Leo P , Kluft Cornelius , Briët Ernest , Dooijewaard Gerard , Meinders Arend E 
Published: March 2007

OBJECTIVE
Endurance exercise has been advocated in diabetes mellitus to improve both metabolic control and prevent atherosclerotic complications. The response of the fibrinolytic system during prolonged exercise has not been studied in diabetes.

RESEARCH DESIGN AND METHODS
In seven male marathon runners with IDDM and eight healthy nondiabetic male control subjects, matched for age and degree of training, we studied fibrinolytic and coagulation parameters during a 3-h 32-km outdoor running session. Measurements included t-PA, u-PA, PAI-1, PAP (as a measure of in vivo activation of fibrinolysis), FbDPs, FGN, vWF, and VIII:C.

RESULTS
In both IDDM and control subjects, levels of t-PA, u-PA, PAP, vWF, and VIII:C continued to rise throughout the exercise, whereas PAI-1 showed a similar decline in both groups. FbDP rose slightly in both groups, and FGN remained unchanged. t-PA levels during exercise correlated closely with exercise intensity. These findings indicate that continued stimulation by exercise does not deplete endothelial PA stores. Differences between IDDM and control subjects were seen only for t-PA, vWF, and u-PA. The AUC during exercise (AUC0.5−3.0) of t-PA in IDDM was insignificantly lower than in control subjects (53 ± 19 vs. 67 ± 31 ng.ml−1.h), but the ratio of t-PA to exercise intensity was lower in IDDM (0.24 ± 0.11 vs. 0.31 ± 0.13, P &lt; 0.05). The AUC0.5−3.0 of vWF was lower in IDDM than in control subjects (569 ± 268 vs. 880 ± 265%·h, P &lt; 0.05). The AUC0.5−3.0 of u-PA was higher in IDDM than in control subjects (15.1 ± 3.5 vs. 11.2 ± 1.8 ng.ml−1.h, P &lt; 0.05).

CONCLUSIONS
Despite a defect in the exercise-induced endothelial release of vWF and t-PA, the overall potential to activate fibrinolysis is intact in IDDM, possibly by enhancement of u-PA after exercise. Our data suggest that in IDDM, as in nondiabetic subjects, long-distance running may slow the progression of atherosclerosis by stimulating fibrinolysis.
Sex Differences in Incidence of IDDM in Age-Group 15-29 yr: Higher risk in males in Province of Turin, Italy
Authors: Bruno Graziella , Merletti Franco , Vuolo Antonio , Pisu Elisabetta , Giorio Mauro , Pagano Gianfranco 
Published: March 2007

Objective— To report the incidence of IDDM in the age-group 0–29 yr in the Province of Turin, Italy (951, 445 inhabitants 0–29 yr of age), over a 5-yr period (1984–1988) according to age, sex, and geographical region within the area and to identify any temporal trend.
Research Design and Methods— The survey used as the primary data source the list of all patients attending diabetic clinics, and as secondary data source, used the list of hospital discharges for diabetes.
Results— We identified 298 incident cases of IDDM in people 0–29 yr of age. Estimated completeness of ascertainment of the registry was 97%. Age-adjusted (world-standard) incidence rates were 7.40/100,000 (95% CI 6.28–8.71), 5.83 (4.95–6.86), and 6.70 (5.97–7.51), respectively, in the age-groups 0–14, 15–29, and 0–29 yr. Incidence was significantly higher in males than in females in the age-group 15–29 yr (7.36, 6.02–8.98, vs. 4.21, 3.12–5.56). An increasing incidence from rural areas to the greater Turin area (city and its industrial belt) was evident. No significant temporal trend during the study period was found, although year-to-year variability was evident, with the highest incidence in 1984.
Conclusions— This study suggests a high male-to-female ratio of incidence of IDDM after 14 yr; either sex hormones or different exposure to environmental determinants could be involved.
Successful Treatment of Severe Refractory Sulfonylurea-Induced Hypoglycemia With Octreotide
Authors: Krentz Andrew J , Boyle Patrick J , Justice Keith M , Wright Alex D , Schade David S 
Published: March 2007

Objective— To test the clinical use of octreotide in the treatment of sulfonylurea-induced hypoglycemia.
Research Design and Methods— A case is reported of sulfonylurea-induced hypoglycemic coma in a nondiabetic subject, which was complicated by relapse of hypoglycemia after resuscitation with intravenous dextrose. Subcutaneous octreotide, 50 μg 12 hourly, suppressed stimulated endogenous insulin secretion, thereby preventing a further recurrence of hypoglycemia.
Results— No adverse effects of treatment were observed.
Conclusions— These results suggest a significant role for octreotide as an adjunct to intravenous dextrose in the management of severe and refractory cases of sulfonylurea-induced hypoglycemia.
Prevalence of Diabetes and Its Complications in the Eastern Band of Cherokee Indians
Authors: Farrell Mary A , Quiggins Patricia A , Eller James D , Owle Patricia A , Miner Kingsley M , Walkingstick Ernestine S 
Published: March 2007

Objective— To determine the prevalence of diabetes and selected complications among the Eastern Band of Cherokee Indians in North Carolina.
Research Design and Methods— Multiple IHS data systems were used to determine diabetes prevalence and complication rates. The RPMS was used to identify diabetes cases as of April 1989, degree of Indian inheritance, cardiovascular diseases (including hypertension), and retinopathy. Data on laser treatments and LEA were obtained from individual registries. Information on ESRD was obtained by a research assistant. The IHS Ambulatory Patient Care reporting system was used to calculate the number of diabetic patients for the years 1982–1987. The IHS user population was used as the denominator. Rates were age-adjusted to the 1980 U.S. population and diabetic population by the direct method.
Results— Using clinical records, the age-adjusted prevalence of diabetes in 1988 was 105.6/1000 people, four times the U.S. rate. Rates of diabetes were highest in the groups with the highest degree of Indian inheritance. LEAs occurred among diabetic patients at three times the rate for the U.S. Between 1985 and 1989, new cases of ESRD occurred at a crude annualized rate of 578/million, approximately six times the rate for U.S. whites.
Conclusions— Diabetes presents a major burden to the Eastern Band of Cherokees. The limitation inherent in this study probably result in underestimation of the prevalence of diabetes and its complications in the community. Future studies are needed to assess the impact of medical and preventive programs on diabetes prevalence and complications in this community.
Diabetes-Associated Mortality in Native Americans
Authors: Newman Jeffrey M , DeStefano Frank , Valway Sarah E , German Robert R , Muneta Ben 
Published: March 2007

OBJECTIVE— To describe diabetes-associated mortality among Native Americans.
RESEARCH DESIGN AND METHODS— In this population-based study, we analyzed diabetes-associated mortality data from the IHS and the NCHS. We also examined diabetes data from the 1986 NMFS.
RESULTS— IHS area-specific diabetes mortality rates for 1984–1986 ranged from 10 to 93/100,000, compared with 15/100,000 for the total U.S. population. NCHS data for the same period listed diabetes as the underlying cause of 708 deaths among Native Americans and the contributory cause of 1252 deaths; 63% of the latter deaths were attributable to circulatory diseases. The 1986 NMFS demonstrated that Native American heritage is underreported by 65% on death certificates. Using deaths identified as Native American by NMFS, the age-adjusted mortality rate for diabetes as the underlying cause for Native Americans (96/100,000) was 4.3 times that for whites and two times that for blacks. Where diabetes was a contributory cause of death, the mortality rate for Native Americans (264/100,000) was 3.7 times that for whites and 2.4 times that for blacks.
CONCLUSIONS— The excessive diabetes-associated mortality among Native Americans is consistent with other indicators of the magnitude of the diabetes problem in this population. Further epidemiological research and expanded diabetes control interventions are needed.
Prevalence and Risk Factors for Diabetes and Diabetes-Related Amputations in American Indians In Southern Arizona
Authors: Wirth Robert B , Marfin Anthony A , Grau David W , Helgerson Steven D 
Published: March 2007

OBJECTIVE— To describe the prevalence of NIDDM and LEA using data from a computer-based patient data base.
RESEARCH DESIGN AND METHODS— Diabetic patients with and without LEA, and nondiabetic patients were identified by computer search. Charts of diabetic patients were reviewed for confirmation of diagnosis of diabetes and diabetes-related amputation. The diabetic and nondiabetic populations were described, and certain risk factors were identified.
RESULTS— The overall prevalence of NIDDM in this tribe in 1985–1986 was 18.3/100 adults (≥ 18 yr of age), whereas the prevalence of LEA/100 adults with NIDDM was 10.3%. Females were 1.3 times as likely to have diagnosed diabetes as males (95% CI 1.2–1.4), and males with diabetes were 1.4 times more likely to have had LEA than females with diabetes (95% CI 1.1–1.9).
CONCLUSIONS— Automated health-care delivery data base used for this tribe can be used to maintain surveillance for diabetes and amputations in diabetic patients. Effective programs to prevent complications of diabetes, such as LEA, in this tribe are urgently needed.
The Diabetes Project at Fort Totten, North Dakota, 1984–1988
Authors: Newman William P , Hollevoet Jackie J , Frohlich Karen L 
Published: March 2007

OBJECTIVE— To characterize demographic, therapeutic, and complication features of patients in the Fort Totten Diabetes Project and to assess the longitudinal impact of intervention strategies.
RESEARCH DESIGN AND METHODS— Individuals (n = 215) of varying American Indian ethnic origin and a quantum of mean age 53 yr (range 14–86 yr), 62% women, with type II diabetes of 9 yr average duration were studied. Annual chart audits of the complete diabetic population were conducted from 1984 to 1988.
RESULTS— Obesity is a major problem complicating diabetes management (average BMI 32 ± 0.9), but BMI does not correlate with glucose control as assessed by total GHb (r = 0.014, NS). Individuals lost an average of 3.7 kg (P &lt; 0.001) during the audit years. Mean GHb declined for the population (11.3–9.7%, P &lt; 0.025) during the interval, but no significant decline was evident when values for individuals were considered. Complication rates for retinopathy, nephropathy, and neuropathy paralleled those rates published for urban populations.
CONCLUSIONS— Diabetes mellitus in American Indians living in a rural, economically deprived area can be identified and cared for with success similar to that published for urban populations.
The Traditional Pima Indian Diet: Composition and adaptation for use in a dietary intervention study
Authors: Boyce Vicky L , Swinburn Boyd A 
Published: March 2007

OBJECTIVE— To examine changes in the Pima Indian diet composition that may have played a role in the dramatic rise in the incidence of NIDDM among Pima Indians over the last century.
RESEARCH DESIGN AND METHODS— We investigated the composition of the foods comparable to those available to the Pima ∼ 100 yr ago, with the aim of reproducing this traditional diet as faithfully as possible for a dietary intervention study. An approximation of the traditional diet was ascertained from the ethnohistoric literature and traditional recipes.
RESULTS— We estimated that the traditional Pima diet, although seasonably variable, was ∼ 70–80% carbohydrate, 8–12% fat, and 12–18% protein. A diet analogous to the traditional Pima diet is largely reproducible with the foods available today. Many native foods are available locally and many commercial products can be substituted when native foods are unavailable.
CONCLUSIONS— The Pima Indian diet of the last century was much higher in carbohydrate and lower in fat compared with the modern-day Pima diet. Any changes that this diabetes-prone population can make toward their traditional diet may help to decrease their incidence of diabetes.
Can Islet Cell Antibodies Predict IDDM in the General Population?
Authors: Bingley Polly J , Bonifacio Ezio , Shattock Marion , Gillmor Hilary A , Sawtell Pamela A , Dunger David B , Scott Robin D M , Bottazzo Gian Franco , Gale Edwin A M 
Published: March 2007

Objective— To evaluate the likely prognostic significance of ICAs in children with no family history of IDDM.
Research Design and Methods— We examined the prevalence of ICAs in 2925 English schoolchildren aged 9–13 yr and in 274 age-matched siblings of children with diabetes from the same region, and we compared the estimated risk of progression to diabetes within 10 yr in the two groups.
Results— ICAs were present at levels ≥ 4 JDF U in 2.8% of schoolchildren and 6.6% of siblings and at ≥ 20 JDF U in 0.8% of schoolchildren and 2.2% of siblings. Although ICAs are only 2–3 times more prevalent in siblings than schoolchildren, the estimated cumulative risk that siblings will progress to diabetes by age 21 is 13 times greater (2.8 vs. 0.21%).
Conclusions— ICAs are unexpectedly prevalent in English schoolchildren, but only a small minority, with this evidence of immune activation directed against islet cells, will progress to diabetes. Although ICAs alone have limited predictive value in the general population, combining two or more predictive tests in series could achieve a level of prediction equivalent to that now obtained in first-degree relatives.
Symptoms of Sensory Neuropathy in Adults with NIDDM in the U.S. Population
Authors: Harris Maureen , Eastman Richard , Cowie Catherine 
Published: March 2007

OBJECTIVE
To ascertain the prevalence and determinants of sensory neuropathy symptoms through structured interview of a representative sample of people with diabetes in the U.S. population.

RESEARCH DESIGN AND METHODS
The 1989 National Health Interview Survey consisted of a representative sample of 84,572 persons in the U.S. ≥ 18 yr of age. A household respondent identified all people in the household believed to have diabetes (n = 2829). Subjects who could not be personally interviewed (n = 129) and individuals who stated they did not have diabetes (n = 295) were excluded. A detailed questionnaire was administered to 99.3% of the remaining 2405 subjects. Questions on symptoms of sensory neuropathy included whether during the past 3 mo the subjects had experienced numbness or loss of feeling, pain or tingling, or decreased ability to feel hot or cold. The neuropathy questions were also administered to a representative sample of 20,037 subjects who were not known to have diabetes.

RESULTS
Prevalence of symptoms of sensory neuropathy was 30.2% among people with IDDM. This prevalence was 36.0% for men with NIDDM and 39.8% for women with NIDDM, compared with 9.8 and 11.8% for nondiabetic men and women, respectively. In logistic regression, factors independently related to symptoms of sensory neuropathy in people with NIDDM included duration of diabetes, hypertension, hyperglycemia, and glycosuria. Long duration of NIDDM (&gt;20 yr) was associated with a twofold increased risk of symptoms of sensory neuropathy compared with those with 0-4 yr of diabetes. Hypertension was associated with a 60% higher likelihood of symptoms. Diabetic individuals whose blood glucose was high all or most of the time or whose urine tests showed glucose all of the time were &gt; 2 times as likely to have symptoms of sensory neuropathy than those who did not report hyperglycemia or glycosuria. Age, sex, ethnicity, cigarette smoking, and height were not determinants of sensory neuropathy.

CONCLUSIONS
Symptoms of sensory neuropathy affect 30–40% of diabetic patients in the U.S. Men and women are affected equally. Prevalence of these symptoms increases with longer duration of diabetes; hypertension and hyperglycemia predispose to symptoms of sensory neuropathy.
Comparison of Metoclopramide and Erythromycin in the Treatment of Diabetic Gastroparesis
Authors: Erbas Tomris , Varoglu Erhan , Erbas Belkis , Tastekin Gungor , Akalin Sema 
Published: March 2007

OBJECTIVE
To compare the effects of erythromycin and metoclopramide on gastric emptying and symptoms of gastroparesis in diabetic patients with delayed gastric emptying.

RESEARCH DESIGN AND METHODS
The study group consisted of 13 patients with symptoms of severe gastroparesis and delayed gastric emptying. Gastric emptying was evaluated using a radionuclide method, and gastrointestinal symptoms were scored. The patients were given either erythromycin (250 mg 3 times/day) or metoclopramide (10 mg 3 times/day) in random order for 3 wk, and after a washout period of 3 wk they were crossed-over to the other medication for another 3 wk. Parameters of gastric emptying were assessed before treatment and after both erythromycin and metoclopramide administration.

RESULTS
The half-time of gastric emptying in diabetic subjects was 110 (77–120) min before treatment. At 60 and 90 min, the median value of residual isotope activity was 66.5 (55–83.5) and 55% (43–74.3), respectively. The half-time decreased to 55 min (28.6–115) after 3 wk of treatment with erythromycin and percentages of meal retention in the stomach at 60 and 90 min were 49.9 (38.4–70) and 40.5% (29.7–60), respectively. After taking metoclopramide, the median value of half-time was 67 min (15–115) and percentages of meal retention at 60 and 90 min were 51 (34.5–93.9) and 42% (24–71.2), respectively. When compared with baseline values a significant difference in gastric emptying parameters was found after both erythromycin and metoclopramide. A significant improvement of the total score for gastrointestinal symptoms was observed with both drugs, but this improvement was more pronounced with erythromycin.

CONCLUSIONS
Erythromycin, a macrolide antibiotic and a motilin receptor agonist, appears to stimulate intestinal motility and seems to be an alternative agent for the treatment of gastroparesis caused by diabetic autonomic neuropathy.