bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contraception in Women With IDDM: An epidemiological study
Authors: Kjær Karen , Hagen Claus , Sandø Steen H , Eshøj Ole 
Published: March 2007

OBJECTIVE
To study whether suitable contraceptive methods to women with diabetes mellitus in fact are applied.

RESEARCH DESIGN AND METHODS
A questionnaire survey on the use of contraceptives in all 18-to-49-yr-old women (n = 261) with IDDM in Funen County, Denmark, and an age-comparable control group, (n = 287) was performed. Data were collected from 1987 to 1990. Response was achieved from 94% diabetic women and 88% control subjects.

RESULTS
The overall use of contraception in diabetic women (77.1%) was almost identical to that of control subjects (73.6%). Compared with control subjects, significantly fewer diabetic women were using the OCP (P &lt; 0.005) and partner sterilization (P &lt; 0.05), whereas more diabetic women were sterilized (P &lt; 0.0005). Among diabetic contraceptive users, the IUD, female sterilization, condoms, and the OCP each accounted for roughly 20%. Diabetic women using the OCP were predominantly young, and most had never been pregnant; ∼ 20% of them used high-dose formulations. Sterilization was frequently used by older diabetic women, and most of these women had 2 or more children; 27% of the diabetic women using an IUD were nulligravidae. Further, 18% used a method with an unsuitable high failure rate.

CONCLUSIONS
Our study demonstrates that diabetic women are not sufficiently advised concerning use of contraception.
Telematic expert system Diabeto: New Tool for Diet Self-Monitoring for Diabetic Patients
Authors: Turnin Marie-Christine G , Beddok René H , Clottes Jacqueline P , Martini Pascale F , Abadie Robert G , Buisson Jean-Christophe , Dupuy Chantal-Soulé , Bonneu Michel , Camaré Rita , Anton Jean-Paul , Chrisment Claude Y , Farreny Henri , Bayard Francis , Tauber Jean-Pierre J 
Published: March 2007

Objective
— To evaluate Diabeto, a computer-assisted diet education system.

Research Design And Methods
— One hundred five patients with insulin-dependent diabetes mellitus (IDDM) or non-insulin-dependent diabetes mellitus (NIDDM) were divided into two randomized groups to participate in the evaluation of Diabeto. With free access through Minitel, the French public videotex network, Diabeto helps diabetic patients self-monitor their diets and balance their meals with personalized counseling.

Results
— During the first 6-mo study, group A (54 patients) used Diabeto, whereas group B (51 patients) were control subjects. For the second 6-mo study, group B used the system. Evaluation was based on patients' dietetic knowledge, dietary habits, and metabolic balance.

Conclusions
–Diabeto led to a significant improvement of dietetic, knowledge in group A (P &lt; 0.0005) and also to improved dietary habits; decreased caloric intake in patients initially overeating (P &lt; 0.05), increase of dietary carbohydrate from 39.7 ± 0.7 to 42.9 ± 0.9% in patients with an initial intake &lt;45% carbohydrate, and decrease of fat intake from 41.9 ± 0.9 to 37.4 ± 1.1% in patients with an initial intake of &gt;35% fat (P &lt; 0.0005). In the second study, in addition to similar improvements to those observed in the first study, HbA1 decreased from 11.0 ± 0.4 to 9.9 ± 0.4% (P &lt; 0.005) and fructosamine from 5.00 ± 0.17 to 4.57 ± 0.17% (P &lt; 0.001). Diabeto appears to be an effective therapeutic tool in the control of metabolic diseases.
Assessment of Experts' Approach to Insulin Therapy and Development of a Simulator for Diabetes Insulin Adjustment
Authors: Hauser Thomas , Kraegen Edward W , Campbell Lesley V , Compton Paul J , Sammut Claude , Chisholm Donald J 
Published: March 2007

Objective
— To develop a computer program (Macintosh) to predict changes in blood glucose after changes in insulin dose, timing, and regimen.

Research Design and Methods
— We established program parameters (apparent insulin action profiles; different for insulin-dependent and non-insulin-dependent diabetes mellitus) to match predictions by five diabetes specialists at our hospital of blood glucose changes after insulin-dose adjustment in 22 hypothetical patient cases. We compared the action profiles, which represent the blood glucose changes predicted by the experts with glucose-clamp studies of insulin action. We tested the program's performance in 22 different hypothetical cases against the responses of 15 specialists from outside our hospital.

Results
— The specialists, when predicting effects of insulin dose adjustment, integrate numerous processes (insulin action, diet, sequential blood glucose interactions). They could not specify algorithms for determining these individual factors, but they could easily predict the overall effect in the context of patient cases. The computer program's insulin-action profiles simulate this “composite” approach. The developed program incorporates multiple insulin regimens, which may be changed during the stimulation, and adjusts predicted responses according to the patient's estimated sensitivity to insulin. Its predicted change in 172 blood glucose levels (22 cases) correlated well with the corresponding means of the outside specialists (r = 0.83, P = 0.0001). Comparing this correlation with that of individual specialists ranked the program third.

Conclusions
—A computer program can simulate specialists' “composite” approach (not based purely on conscious application of physiological data) to insulin adjustment.
Measurement of Health Status in Diabetic Patients: Diabetes Impact Measurement Scales
Authors: Hammond G Steven , Aoki Thomas T 
Published: March 2007

Objective
To develop an instrument to measure health status in adult insulin-dependent (type I) and non-insulin-dependent (type II) diabetic patients.

Research Design and Methods
Correlative study to examine psychometric properties of the questionnaire. Test-retest reliability, item-scale correlations, principal-components analysis, correlations with global clinical ratings, and correlations with clinical data extracted from medical records were examined at the diabetes clinics at the University of California, Davis, Medical Center. Patients were volunteer clinic patients able to complete the questionnaire. One hundred thirty patients completed a first administration of the questionnaire, and 52 completed a second administration.

Results
Test-retest reliability was satisfactory. Item-scale correlations showed that 40 of 44 questionnaire items were highly correlated with subscale and total scale scores. Principal-components analysis identified one major factor measured by the questionnaire. Cronbach's α, a measure of the scales' internal consistency, was of satisfactory magnitude. Global ratings of clinical status by patients and clinicians were highly correlated with scale scores. Correlations of scale scores with clinical data were generally of low magnitude but, where significant, were consistently in the direction hypothesized if the scale truly measures health status or disease impact.

Conclusions
The Diabetes Impact Management Scales (DIMS) is an easily administered questionnaire with internal consistency and test-retest reliability. Preliminary correlative analyses support the validity of the instrument as a measure of health status in adult type I and type II diabetic patients. Further work will be necessary to firmly establish the validity of the DIMS and its usefulness in clinical outcomes research.
Microalbuminuria in Type I Diabetic Patients: Prevalence and Clinical Characteristics
Authors:   Microalbuminuria Collaborative Study Group
Published: March 2007

Objective
To estimate the prevalence of microalbuminuria, overnight urinary albumin excretion rate (AER) ≥30 and ≤250 μg/min, in a large sequential sample of nonhypertensive insulin-dependent (type I) diabetic patients attending hospital diabetic clinics, to identify micro- and normoalbuminuric patients in this sample for subsequent intervention and natural history follow-up studies, and to compare the clinical characteristics of the micro- and normoalbuminuric patients identified.

Research Design and methods
Screening was conducted in two phases. In phase 1, all eligible patients were asked to provide an early morning urine specimen for measurement of albumin concentration and albumin-creatinine ratio. In phase 2, all patients with an albumin concn ≥15 mg/L and/or an albumin-creatinine ratio ≥3.5 mg/mmol and a random sample of those with an albumin concn &lt;15 mg/L and albumin-creatinine ratio &lt;3.5 mg/mmol were asked to collect a timed overnight urine specimen for determination of AER.

Results
Among 1888 patients (16–60 yr old, diabetes onset &lt;40 yr, and duration of diabetes &lt;35 yr) who were screened, the prevalence of microalbuminuria was ∼3.7% (95% confidence interval (CI) 2.7–7.6%). Duration of diabetes was significantly longer in micro- than normoalbuminuric patients (20 vs. 15 yr, respectively; P &lt;0.001), and in no patient with microalbuminuria was the duration of diabetes &lt;5 yr. Systolic and diastolic blood pressures, higher in micro- than normoalbuminuric patients (132 vs. 122 mmHg, P &lt;0.01; 77 vs. 72 mmHg, P &lt;0.01), were strongly associated with AER.

Conclusions
Microalbuminuria in type I diabetes, which appears to represent an earlier phase in the development of clinical nephropathy, is associated with elevated blood pressure and a longer duration of diabetes.
Early Sonographic Evaluation for Fetal Growth Delay and Congenital Malformations in Pregnancies Complicated by Insulin-Requiring Diabetes
Authors: Brown Zane A , Mills James L , Metzger Boyd E , Knopp Robert H , Simpson Joe Leigh , Jovanovic-Peterson Lois , Scheer Kenneth , Van Allen Margot I , Aarons Jerome H , Reed George F ,   National Institute of Child Health and Human Development Diabetes in Early Pregnancy Study
Published: March 2007

Objective
It has been reported that early fetal growth retardation may be a useful marker for congenital malformations in diabetic pregnancies. To test this hypothesis, diabetic and nondiabetic women were sonographically evaluated during the first trimester.

Research Desihn and Methods
Fetal crown-rump lengths were measured sonographically at least once during the first 15 wk of pregnancy in 329 nondiabetic and 312 diabetic women. Of these, 289 nondiabetic and 269 diabetic women had sonograms before 10 wk of gestation and 283 nondiabetic and 269 diabetic women had sonograms between 10 and 15 wk of gestation. Early fetal growth delay was defined as a sonographic gestational age of ≥6 days less than menstrual gestational age.

Results
The mean crown-rump lengths at 8 wk were 17.9 ± 4.6 mm in the diabetic and 18.7 ± 4.9 mm in the nondiabetic groups (P = 0.13). At 12 wk, the mean fetal crown-rump length was 58.5 ± 8.8 mm for diabetic subjects and 60.6 ± 8.7 mm for nondiabetic subjects (P = 0.04). Between 5 and 9 wk, 28 of 289 (9.7%) fetuses of nondiabetic subjects, 34 of 259 (13.1%) normal fetuses of diabetic subjects, and 2 of 10 (20%) malformed fetuses of diabetic subjects demonstrated growth delay (P = 0.31, normal vs. malformed diabetic). Between 10 and 15 wk of gestation, 28 of 283 (9.9%) fetuses of nondiabetic subjects, 32 of 256 (12.5%) normal fetuses of diabetic subjects, and 4 of 13 (30.8%) malformed fetuses of diabetic subjects demonstrated growth delay (P = 0.06, normal vs. malformed diabetic). Early fetal growth delay did not predict a reduced birth weight at term.

Conclusions
Among insulin-dependent diabetic subjects who were moderately well controlled at conception, statistically significant but mild early fetal growth delay was present but did not appear to be useful clinically in predicting congenital malformations. Recommendations that growth delay demonstrated on early ultrasound be used as a predictor of congenital malformation require careful reexamination.
Hypertriglyceridemia in Different Degrees of Glucose Intolerance in a Finnish Population-Based Study
Authors: Salomaa Veikko V , Tuomilehto Jaakko , Jauhiainen Matti , Korhonen Heikki J , Stengård Jari , Uusitupa Matti , Pitkanen Matti , Penttila Ilkka 
Published: March 2007

Objective
To determine the prevalence of hypertriglyceridemia and the mean serum triglyceride concentrations in different degrees of glucose tolerance—non-insulin-dependent diabetes mellitus (NIDDM), impaired glucose tolerance (IGT), and normal glucose tolerance (NGT). In addition, we analyzed the correlates of serum triglyceride concentration to explain why it is more prevalent in diabetic subjects.

Resarch Design and Methods
This study was a cross-sectional survey of 4000 people aged 45-64 yr randomly drawn from the population register of the Finnish population of the provinces of North Karelia and Kuopio in eastern Finland and Turku/Loimaa area in southwestern Finland and stratified by four 10-yr age- and sex groups. The final material comprised 96 subjects with NIDDM, 102 subjects with IGT, and 323 subjects with normal glucose tolerance classified on the basis of two 2-h oral glucose tolerance tests. The prevalence of hypertriglyceridemia by the glucose tolerance status and the variation in serum triglycerides associated with selected life-style and biochemical factors were executed as the main outcome measures.

Results
The prevalence of hypertriglyceridemia (≥ 2.3 mM) was 47.6% (95% confidence interval [CI] 32.5–62.7%) in NIDDM men, 21.9% (95% CI 7.6–36.2%) in IGT men, and 15.4% (95% CI 9.3–21.5%) in NGT. In women, hypertriglyceridemia was found in 51.9% (95% CI 38.6–65.2%) among those with NIDDM, 25.7% (95% CI 15.5–35.9%) among those with IGT, and 10.7% (95% CI 6.3–15.1%) in women with NGT. After adjusting for body mass index (BMI) and age, the difference in the prevalence of hypertriglyceridemia between the glucose tolerance groups remained significant in both men (P = 0.008) and women (P = 0.0001). High serum total cholesterol, high BMI, high waist-hip ratio, and low high-density lipoprotein (HDL) cholesterol were significantly associated with high serum triglycerides in all glucose tolerance groups. No synergistic effect between these parameters and glucose tolerance status was found. In multiple linear regression analyses, fasting plasma insulin, diabetes status, and serum uric acid were significant predictors of serum triglyceride concentration after taking into account age, BMI, and HDL and total cholesterol. The association between BMI and serum triglycerides in the regression analysis was significant only when plasma insulin was not included in the model.

Conclsions
Hypertriglyceridemia is common in subjects with NIDDM and IGT and is often associated with low HDL cholesterol, high total cholesterol, hyperinsulinemia, and elevated serum uric acid concentration.
Onset of NIDDM occurs at Least 4–7 yr Before Clinical Diagnosis
Authors: Harris Maureen I , Klein Ronald , Welborn Tim A , Knuiman Matthew W 
Published: March 2007

Objective
To investigate duration of the period between diabetes onset and its clinical diagnosis.

Research Design and Methods
Two population-based groups of white patients with non-insulin-dependent diabetes (NIDDM) in the United States and Australia were studied. Prevalence of retinopathy and duration of diabetes subsequent to clinical diagnosis were determined for all subjects. Weighted linear regression was used to examine the relationship between diabetes duration and prevalence of retinopathy.

Results
Prevalence of retinopathy at clinical diagnosis of diabetes was estimated to be 20.8% in the U.S. and 9.9% in Australia and increased linearly with longer duration of diabetes. By extrapolating this linear relationship to the time when retinopathy prevalence was estimated to be zero, onset of detectable retinopathy was calculated to have occurred ∼ 4–7 yr before diagnosis of NIDDM. Because other data indicate that diabetes may be present for 5 yr before retinopathy becomes evident, onset of NIDDM may occur 9–12 yr before its clinical diagnosis.

Conclusions
These findings suggest that undiagnosed NIDDM is not a benign condition. Clinically significant morbidity is present at diagnosis and for years before diagnosis. During this preclinical period, treatment is not being offered for diabetes or its specific complications, despite the fact that reduction in hyperglycemia, hypertension, and cardiovascular risk factors is believed to benefit patients. Imprecise dating of diabetes onset also obscures investigations of the etiology of NIDDM and studies of the nature and importance of risk factors for diabetes complications.
Immediate HbA1c Results: Performance of new HbA1c system in pediatric outpatient population
Authors: Marrero David G , Vandagriff Julie L , Gibson Reid , Fineberg S Edwin , Fineberg Naomi S , Hiar Charles E , Crowley Lawrence E 
Published: March 2007

OBJECTIVE
This study compared the performance of a new device that uses an IA to measure HbA1c in 9 min with a 1-μl capillary blood sample with AC and CE methods in both nondiabetic and diabetic pediatric patients.

RESEARCH DESIGN AND METHODS
Two hundred seven pediatric subjects (103 nondiabetic, 104 with insulin-dependent diabetes mellitus) had HbA1c measured with the IA method and compared with total GHb values determined by AC and HbA1 by the CE method with the same whole-blood capillary aliquot. Glucose values were also obtained from the same blood samples.

RESULTS
Correlations and regression analyses show excellent correspondence between the three assays. The correlation between the AC and CE methods is 0.98 (P &lt; 0.001) with a slope of 1.615 ± 0.0125 and intercept of 4.00 ± 0.20. The correlation between the IA and AC methods is 0.99 (P &lt; 0.001) with a slope of 0.608 ± 0.007 and intercept of 1.326 ± 0.066. The correlation between the IA and CE methods is 0.97 (P &lt; 0.001), with a slope of 0.983 ± 0.018 and intercept of 1.122 ± 0.153. The average difference and average percentage difference between methods were also significant (P &lt; 0.001), reflecting the differences in GHb components measured. There was a significant correlation (P &lt; 0.001) between each method and glucose values (IA r = 0.72, AC r = 0.70, CE r = 0.73). Within-run precision for IA ranged from 1.7 to 3.5% and between-run precision 2.7 to 4.1%.

CONCLUSIONS
Study results suggest that the IA method gives extremely accurate and reliable values over the clinical range of interest. The instrument is small, portable, easy to use, and provides information within 9 min for both physicians and patients.
Smokers with IDDM Experience Excess Morbidity: The Colorado IDDM Registry
Authors: Gay Elizabeth C , Cai Yong , Gale Susan M , Baron Anna , Cruickshanks Karen J , Kostraba Jill N , Hamman Richard F 
Published: March 2007

OBJECTIVE
To determine whether there is an association between smoking and the self-reported morbidity of people with IDDM and to evaluate the nature of a possible interaction between smoking and IDDM in increasing the risk of morbidity among smokers with IDDM.

RESEARCH DESIGN AND METHODS
Subjects were non-Hispanic whites aged 18–28 yr who participated in the Colorado IDDM Registry Follow-up Survey (case subjects, n = 24) or the 1985 NHIS (control subjects, n = 5876). Assessments of self-reported morbidity included any hospitalization in the past year; bed days, sick days, and limited-activity days in the past 2 wk; and ratings of poor health. The criteria outlined by Saracci were used to determine whether smoking was associated with greater morbidity among IDDM case compared to control subjects (smoking by IDDM interaction).

RESULTS
Age- and sex-adjusted ORs, estimated from logistic regression, showed that people with IDDM reported excess morbidity compared with control subjects, regardless of smoking status. Smokers with IDDM reported morbidity 3–10 times as often as nonsmoking control subjects and were 2–3 times more likely to report morbidity than nonsmokers with IDDM. The smoking by IDDM interaction was more than multiplicative for all morbidity measures. Fifty to 75% of excess morbidity in young smokers with IDDM over simple additive effects was related to the interaction between smoking and IDDM.

CONCLUSIONS
There was excess reported morbidity among people with IDDM who smoked, &gt; that expected from the combined effects of smoking and IDDM. Smoking cessation in young people with IDDM may alleviate some of this excess, but more study is needed to determine whether smoking serves as an indicator of poor IDDM care practices or has a physiological impact that compounds the morbidity experienced by people with IDDM.
Factors Predicting Course of β-cell Function in IDDM
Authors: Schiffrin Alicia , Suissa Samy , Weitzner Gabriel , Poussier Philippe , Lalla Daniel 
Published: March 2007

OBJECTIVE
The purpose of this study was to determine whether the severity o clinical presentation, sex, age, HLA type, and the presence of IAs and ICAs could predict the variation of residual insulin secretion as measured by the serum C-peptide response to a Sustacal meal.

RESEARCH DESIGN AND METHODS
A cohort of 151 newly diagnosed IDDM children (mean age 10.2 ± 4.6 yr) was followed prospectively for 3 yr. Thirty-five patients (12 males, 23 females) were still secreting C-peptide after 36 mo.

RESULTS
We found that age (P = 0.0001), sex (P = 0.003), presence of ICA (P = 0.006), severity of clinical presentation (P = 0.001), and symptom duration (P = 0.002) significantly predicted the rate of loss of C-peptide secretion. The risks of accelerated C-peptide disappearance decreased with increasing age, the risk ratios being 0.25 for the older group (&gt; 12 yr) compared with the younger group (&lt; 6 yr) and 0.50 for the intermediate group (6–12 yr) compared with the younger group. The risk for the presence of ICA was 1.7, and the risk for males was 1.7 also. There was a significant negative correlation between ICA titers and C-peptide at 18 and 24 mo after diagnosis (P = 0.04). There were no significant differences in HbA1 values between patients who secreted C-peptide and those who did not.

CONCLUSIONS
We conclude that younger age of onset, male sex, high titers of ICA, severe clinical presentation, and shorter symptom duration significantly predict accelerated rates of loss of C-peptide secretion.