bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recent Developments in Metabolism That Impinge on Research into the Nature and Treatment of Diabetes Mellitus
Authors: Newsholme Eric A 
Published: March 2007

It has been established that adenosine, its agonists, or antagonists can cause dramatic changes in insulin sensitivity in isolated soleus muscle and, moreover, can modify changes in sensitivity caused by pathophysiological conditions. Addition of adenosine deaminase to the incubation medium, which is known to lower the concentration of adenosine, increases the sensitivity of glycolysis to insulin. Addition of an adenosine-receptor agonist decreases sensitivity by about 10-fold, whereas addition of an adenosine-receptor antagonist increases sensitivity by about 10-fold. The latter totally removes the resistance of glucose utilization to insulin in the isolated soleus muscle obtained from either the genetically obese rat or from the rat fed a high sucrose diet. These findings strongly support the view that changes in insulin sensitivity in muscle can be brought about either by acute changes in the local concentration of adenosine or in the affinity or number of receptors for adenosine in muscle. However, in many of the conditions investigated, in which insulin sensitivity in muscle is changed, there was no correlation between the change in the adenosine content of the muscle and altered insulin sensitivity.
It has also been shown that prostaglandin E1 can increase dramatically the sensitivity of glycolysis to insulin and that this is a specific effect of prostaglandins of the E series. It is not produced by prostacyclins, thromboxanes, or leukotrienes. It is unclear if there is a relationship between the effects of adenosine and prostaglandins.
Chronic elevation of catecholamines may increase the sensitivity of glucose utilization to insulin and also increase the rate of thermogenesis by substrate cycling. Thus, resistance to catecholamines in muscle could result in both insulin resistance and impaired thermogenesis. Recent work has emphasized the important role of glutamine in the immune system, yet little or no work has been done on glutamine metabolism in diabetes mellitus.
Fuel and Fluid Homeostasis During Long-Term Exercise in Healthy Subjects and Type I Diabetic Patients
Authors: Koivisto Veikko A , Sane Timo , Fyhrquist Frej , Pelkonen Risto 
Published: March 2007

OBJECTIVE
This study was designed to examine metabolic and hormonal effects of long-term exercise in healthy subjects and insulin-dependent (type I) diabetic patients.

RESEARCH DESIGN AND METHODS
Two studies were performed. First, 16 healthy males (32 ± 3 yr) were studied during a semitriathlon competition (2 km swimming, 90 km biking, and 21 km running). Second, 9 type I diabetic males (41 ± 2 yr) and 17 healthy matched control subjects were studied during a 75 km cross-country skiing race. Blood samples were taken before and immediately after exercise, and also during the ski race.

RESULTS
During the semitriathlon race, serum insulin, C-peptide, glucagon cortisol, growth hormone ACTH, prolactin, and plasma renin activity increased two- to ninefold, whereas serum testosterone fell. Apart from a fall in magnesium, serum electrolyte concentrations remained unchanged. Before long-term skiing, patients reduced their insulin dose by 30–40%. They were hyperglycemic during the initial part of the race, but near normoglycemic thereafter. There were large interindividual variations in the increments of counterregulatory hormones, whereas serum testosterone and luteinizing hormone fell quite uniformly. Plasma renin activity and aldosterone concentrations rose similarly in diabetic and healthy subjects, whereas the rise in antidiuretic hormone was slightly greater in diabetic patients. During the initial part of the race, serum atrial natriuretic peptide fell in both groups.

CONCLUSIONS
Severalfold increments in hormone concentrations contribute to the maintenance of fuel and fluid homeostasis during long-term exercise. With an appropriate adjustment of insulin dose and diet, also type I diabetic patients can participate in competitive long-term exercise.
Prevention of Early-Morning Hyperglycemia in IDDM Patients With Long-Acting Zinc Insulin
Authors: Parillo Mario , Mura Antonio , Iovine Ciro , Rivellese Angela A , Lavicoli Mario , Riccardi Gabriele 
Published: March 2007

Objective
— To evaluate whether an insulin regimen with a long-acting zinc insulin (Ultratard HM) could help control fasting hyperglycemia in insulin-dependent diabetes mellitus (IDDM) patients.

Research Design And Methods
— A randomized sequential crossover trial with 6-wk treatment periods was used. Ten IDDM patients from the diabetes clinic at the Medical School who had persistent fasting hyperglycemia (&gt; 10 mmol/L) were studied. Patients with nocturnal hypoglycemia were excluded. All patients completed the study. Insulin regimens consisted of three daily injections of a short-acting insulin (Actrapid HM) before meals and either a long-acting zinc insulin (Ultratard HM) or an intermediate isophane insulin (Protaphane HM) before the evening meal. Each regimen was followed for 6 wk.

Results
— Fasting blood glucose levels (at 06:00 and 08:00) were significantly lower after the long-acting insulin regimen (6.26 ± 0.88 vs. 10.82 ± 4.27 mM, P &lt; 0.05 and 9.26 ± 1.02 vs. 14.03 ± 1.08 mM, &lt; 0.05, respectively). Plasma-free insulin levels mirrored blood glucose concentrations because they were significantly higher at 06:00 and 08:00 after the long-acting insulin regimen (49.5 ± 10.1 vs. 20.1 ± 4.3 pM, P &lt; 0.05 and 31.6 ± 5.0 vs. 16.5 ± 3.4 pM, P &lt; 0.05, respectively). At any other time of the day, blood glucose and plasma insulin levels were not significantly different with either one of the two insulin regimens.

Conclusions
— A long-acting zinc human insulin injected before the evening meal can help to control persistent fasting hyperglycemia in IDDM patients.
Cardiorespiratory Fitness, Glycemic Status, and Mortality Risk in Men
Authors: Kohl Harold W , Gordon Neil F , Villegas Jesús A , Blair Steven N 
Published: March 2007

Objective
— To determine the association of baseline cardiorespiratory fitness to all-cause mortality across the range of blood glucose levels.

Research Design And Methods
— Data from a prospective study of 8715 men (average age 42 yr), followed for an average of 8.2 yr (range 1-15 yr), were analyzed. Cardiorespiratory fitness was assessed by maximal-exercise treadmill testing. Men with evidence of clinical vascular disease or who did not achieve 85% of their age-predicted maximum heart rate during exercise testing were excluded from analyses.

Results
— Age-adjusted death rates increased with higher levels, of fasting blood glucose. Regardless of glycemic status, fit men had lower age-adjusted all-cause death rates than their less fit counterparts. For men with fasting blood glucose ≥ 7.8 mM or physician-diagnosed non-insulin-dependent diabetes mellitus (NIDDM), the age-adjusted death rates per 10,000 person-yr of follow-up in unfit and fit subjects were 82.5 and 45.9, respectively. The age-adjusted relative risk of death due to all causes was significantly elevated in the lower-fitness group within each of three glycemic status levels: fasting blood glucose &lt;6.4 mM; relative risk (RR) = 1.93 (95% confidence interval [95% CI] 1.15-3.26); fasting blood glucose 6.4-7.8 mM; RR = 3.42 (95% CI 2.27-5.15); and fasting blood glucose ≥ 7.8 mM or with NIDDM, RR = 1.80 (95% CI = 1.25-2.58). Multivariate analyses, controlling for risk factors of mortality (age, resting systolic blood pressure, serum cholesterol, body mass index, family history of heart disease, follow-up interval, and smoking habit) showed a higher risk of death due to all causes for unfit compared with fit men. Multivariate risks of death associated with low fitness, compared with higher fitness (RR), in the three glycemic status groups were: fasting blood glucose &lt;6.4 mM, RR = 1.38 (95% CI 1.09-1.74); fasting blood glucose 6.4-7.8 mM, RR = 1.61 (95% CI 0.91-2.86); and fasting blood glucose ≥7.8 mM or with NIDDM, RR = 1.92 (95% CI 0.75-4.90).

Conclusions
— These data suggest that risk of death increases with lessfavorable glycemic status, and that cardiorespiratory fitness may attenuate the forces of impaired carbohydrate metabolism on mortality from any cause.
Serum Cholesterol in Wisconsin Epidemiologic Study of Diabetic Retinopathy
Authors: Klein Barbara E K , Moss Scot E , Klein Ronald , Surawicz Tanya S 
Published: March 2007

Objective
To describe serum total and high-density lipoprotein (HDL) cholesterol in a sample of people with diabetes.

Research Design and Methods
Subjects were those who participated in the 1984-1986 Wisconsin Epidemiologic Study of Diabetic Retinopathy. Data were from three groups of subjects: 304 younger-onset and 185 older-onset people taking insulin and 162 older-onset individuals not taking insulin. Serum lipids, duration of diabetes, glycosylated hemoglobin, diastolic blood pressure, sex, age, serum creatinine, units of insulin per kiliogram per day, smoking status, serum C-peptide level, and alcohol use were analyzed statistically.

Results
In subjects taking insulin, glycosylated hemoglobin was correlated most strongly with total cholesterol. In those not taking insulin, C-peptide was correlated most strongly. In subjects taking insulin, the units used per day (fewer)and sex (female) were significantly associated with higher HDL cholesterol, and in both older-onset groups, serum C-peptide was significantly associated with lower HDL cholesterol. Mean total cholesterol levels were generally higher and mean HDL cholesterol levels were generally lower than those found in a nondiabetic comparison group.

Conclusions
By the National Cholesterol Education Program guidelines, 17% of younger-onset and 30% of older-onset insulin users and 32% of olderonset subjects not taking insulin were in the high-risk range for total cholesterol. Lower levels of glycosylated hemoglobin might result in lower cholesterol levels.
α-Glucosidase Inhibition by Miglitol in NIDDM Patients
Authors: Kingma Paulus J , Menheere Paulus PCA , Sels Jean P , Kruseman Arie C Nieuwenhuijzen 
Published: March 2007

Objective
To determine the efficacy of the α-glucosidase inhibitor miglitol (BAYm 1099) regarding the starch content of food.

Research Design and Methods
Thirty-six non-insulin-dependent diabetes mellitus (NIDDM) subjects were studied in a double-blind randomized study comparing treatment with a single dosage of 100 mg miglitol or placebo and a single-blind crossover comparison of three test meals in which the carbohydrate contained either 30, 50, or 70% starch, and quantities of fat and protein were kept constant.

Results
Postprandial blood glucose excursions were reduced by ∼ 50% with miglitol after all test meals. In contrast, after miglitol treatment, maximum postprandial serum C-peptide and insulin values reached the same levels as after placebo treatment, although the time to reach these maximum levels was delayed. Free fatty acid values decreased after both miglitol and placebo similarly. Twenty-eight untoward events in 15 patients were reported in the miglitol treatment group and 11 events in 7 patients in the placebo treatment group.

Conclusions
Miglitol reduces postprandial blood glucose excursions independent of the starch content of the meal. Because no effects were found on incremental postprandial maximal levels of serum insulin and C-peptide, it may be that miglitol exerts, in addition to a delay of intestinal carbohydrate absorption, extraintestinal effects as well, particularly effects on disposition of glucose or anti-insulin counterregulatory factors.
Psychosocial Slate of Patients With IDDM Prone to Recurrent Episodes of Severe Hypoglycemia
Authors: Wredling Regina AM , Theorell PG Töres , Roll H Martin , Lins Per Eric S , Adamson Ulf KC 
Published: March 2007

Objective
The aim of this study was to investigate the psychosocial situation in patients with insulin-dependent diabetes mellitus (IDDM) with recurrent attacks of severe hypoglycemia (SH).

Research Design and Methods
The study group consisted of 17 adult patients with SH and 17 patients matched to the study group with regard to sex, age, and duration of diabetes without severe attacks. The psychosocial situation was measured by means of self-rated questionnaires and an observer's rating scale.

Results
Parameters such as social support, life events, type A behavior, neuroticism, and vital exhaustion were not different, although a higher anxiety rating (P &lt;0.05) and a lower rating of happiness (P &lt;0.01) were found in the SH group.

Conclusions
We conclude that the anxiety level is increased and that experienced happiness is decreased in patients prone to recurrent severe hypoglycemia.
Accuracy of Home Blood Glucose Monitors
Authors: Tate Phyllis F , Clements Carol A , Walters J Edward 
Published: March 2007

Objective
To determine the accuracy of five home blood glucose monitors (HBGM) in reference to a standard laboratory reference method.

Research Design and Methods
The study took place in the laboratory of a 350-bed private acute-care hospital. Subjects were a sample of convenience of 207 diabetic and nondiabetic adult and pediatric patients scheduled for fasting blood work that included a blood glucose test. Venous blood samples were collected for laboratory determination of blood glucose level. A separate sample was collected for testing on two each of five HBGMs: AccuChek II M, Tracer II, ExacTech, Glucometer II with Memory, and One Touch.

Results
Multiple regression analysis showed that all 10 monitors could be used to predict laboratory blood glucose values. The monitors with the highest predictabilities were One Touch, Tracer II, and AccuChek II M. Consistency between monitors of the same brand was lowest with One Touch. AccuChek II M had the smallest SD between the 2 monitors used in the study.

Conclusions
HBGM can be used to predict actual laboratory values of blood glucose. However, the controlled environment of the study should be considered and patient education made a high priority when recommending monitors.
Beneficial Effect of Low-Glycemic Index Diet in Overweight NIDDM Subjects
Authors: Wolever Thomas M S , Jenkins David JA , Vuksan Vladimir , Jenkins Alexandra L , Wong Gerald S , Josse Robert G 
Published: March 2007

Objectives
To determine whether low-glycemic index (GI) diets have clinical utility in overweight patients with non-insulin-dependent diabetes mellitus (NIDDM).

Research Design and Methods
Six patients with NIDDM were studied on both high- and low-GI diets of 6-wk duration with metabolic diets with a randomized crossover design. Both diets were of similar composition (57% carbohydrate, 23% fat, and 34 g/day dietary fiber), but the low-GI diet had a GI of 58 compared with 86 for the high-GI diet.

Results
Small and similar amounts of weight were lost on both diets: 2.5 kg on high-GI diet and 1.8 kg on low-GI diet. On the low-GI diet, the mean level of serum fructosamine, as an index of overall blood glucose control, was lower than on the high-GI diet by 8% (P &lt;0.05), and total serum cholesterol was lower by 7% (P &lt;0.01).

Conclusions
In overweight patients with NIDDM, reducing diet GI improves overall blood glucose and lipid control.
Muscle Blood Flow in Diabetes Mellitus: Evidence of Abnormality After Exercise
Authors: Menon Ram K , Grace Andrew A , Burgoyne William , Fonseca Vivian A , James Ian M , Dandona Paresh 
Published: March 2007

Objective
To determine whether muscle blood flow before and after exercise is abnormal in patients with diabetes mellitus.

Research Design and Methods
Muscle blood flow (MBF) was measured with the 133Xe clearance technique in 15 nondiabetic subjects, 10 patients with insulin-dependent diabetes mellitus (IDDM), and 11 patients with non-insulin-dependent diabetes (NIDDM) at rest and after exercise. None of the patients had neuropathy.

Results
The median resting MBF was similar in all three groups. The median postexercise MBF was significantly greater in nondiabetic subjects (40.1 ml· min−1·100 g−1 of tissue) than in patients with IDDM (25.7 ml· min−1·100 g−1 of tissue; P &lt;0.01) or NIDDM (14 ml· min−1·100 g−1 of tissue; P &lt;0.01). The difference between IDDM and NIDDM was not significant.

Conclusions
Diabetic patients have abnormalities of MBF in response to exercise. This abnormality occurs in the absence of clinical diabetic neuropathy.
Metabolic Impact of Education in NIDDM
Authors: D'Eramo-Melkus Gail A , Wylie-Rosett Judith , Hagan Julie A 
Published: March 2007

Objective
To evaluate the impact of a model program of diabetes education and weight reduction on diabetes control and weight loss in obese individuals with non-insulin-dependent diabetes mellitus (NIDDM).

Research Design and Methods
Eighty-two obese diabetic subjects were randomized to three levels of educational intensity: 1) a single individual session, 2) a 12-wk behavior-oriented diabetes education and weight control group intervention, or 3) group intervention plus six individual follow-up sessions. Repeated measures of weight, fasting blood glucose, and HbA1c were collected. Measures of diabetes knowledge, skills, and attitudes were also obtained.

Results
By 6 mo, all three intervention groups had a significant weight loss (P &lt; 0.01). The mean weight loss of ∼ 10 lb was independent of treatment group and was maintained over the duration of the study. However, significant improvement in metabolic control was associated with participation in the diabetes education-weight reduction intervention.

Conclusions
The findings of this study indicate that a cognitive behavioral group intervention of diabetes knowledge and weight reduction training can produce weight loss and improvements in diabetes control. The addition of individual counseling as a follow-up maintenance strategy does not appear to have any advantage.
Foot Pressure Measurements in Diabetic and Nondiabetic Amputees
Authors: Veves Aristidis , Van Ross Ernest RE , Boulton Andrew JM 
Published: March 2007

Objective
Foot problems are common in the remaining foot of diabetic amputees. Because high foot pressures are associated with foot ulceration, we studied foot pressures of the remaining foot of diabetic and nondiabetic unilateral amputees.

Research Design and Methods
Four age-matched groups of 11 subjects were studied. The groups were comprised of diabetic subjects with previous major amputation, nondiabetic nonneuropathic amputees, diabetic nonamputee patients with similar peripheral nerve involvement as the diabetic amputees, and nondiabetic control subjects. Vibration perception threshold (VPT) was assessed by biothesiometry and foot pressures with an optical pedobarograph.

Results
Mean ± SE VPT in the diabetic amputees was significantly higher than the nondiabetic amputees (40.2 ± 3.7 vs. 17.7 ± 2.8 V, P &lt; 0.002) and similar to diabetic nonamputees (43.4 ± 3.3 V, NS). VPT was abnormal in 9 (82%) diabetic amputees, 2 (18%) nondiabetic amputees, and 10 (91%) nonamputee diabetic patients. The mean peak foot pressure in the diabetic amputees was higher compared with nondiabetic amputees (18.3 ± 2.2 vs. 11.3 ± 1.4 kg/cm2, P &lt; 0.05) and control subjects (10.0 ± 1.5 kg/m2, P &lt; 0.01), but no difference existed with diabetic nonamputees. Abnormally high foot pressures (&gt; 12.3 kg/cm2) were present in 8 (73%) diabetic amputees, 3 (27%) nondiabetic amputees, 8 (73%) diabetic nonamputees, and 4 (36%) healthy subjects.

Conclusions
We conclude that high pressures are present under the remaining foot in diabetic amputees, and that these pressures are associated with diabetic neuropathy. Prosthetic usage does not increase the pressures under the remaining foot in nondiabetic amputees.
High Systolic Blood Pressure Increases Prevalence and Severity Of Retinopathy in NIDDM Patients
Authors: Cignarelli Mauro , Cicco Maria Luigia De , Damato Aurelio , Paternostro Adriano , Pagliarini Sergio , Santoro Salvatore , Cardia Luigi , Pergola Giovanni De , Giorgino Riccardo 
Published: March 2007

OBJECTIVE
To determine whether the severity of retinopathy is higher in a group of NIDDM patients with sBP ≥ 140 mmHg compared with NIDDM patients with sBP &lt; 140 mmHg.

RESEARCH DESIGN AND METHODS
Ophthalmoscopy and FAG were conducted among a group of NIDDM patients with either a sBP above (n = 54) or below (n = 55) 140 mmHg. The groups were matched according to diabetes duration, metabolic control (HbA1c), and AER.

RESULTS
Patients with sBP &gt; 140 mmHg had a higher prevalence of retinopathy, as established according to a rating scale (4.9 ± 3.8 vs. 3.2 ± 3.3, P &lt; 0.02); furthermore, their BMI values were higher (28.1 ± 4.5 vs. 24.9 ± 4.1 kg/m2, P &lt; 0.001). The group of normotensive subjects showed the highest rate of low grading (0–2) values. However, the highest prevalence rates of 8–10 grading values (proliferative retinopathy) were found in the hypertensive group.

CONCLUSIONS
These data suggest that sBP values ≥ 140 mmHg favor the onset of retinopathy in NIDDM patients during their 1st 10 yr of disease.
Severe Hypoglycemia Incidence and Predisposing Factors in 85 Pregnancies of Type I Diabetic Women
Authors: Kimmerle Renate , Heinemann Lutz , Delecki Alexander , Berger Michael 
Published: March 2007

OBJECTIVE
To evaluate the incidence and predisposing factors of severe hypoglycemia (SH) in pregnant women with insulin-dependent (type I) diabetes mellitus.

RESEARCH DESIGN AND METHODS
SH (impairment of consciousness due to hypoglycemia subsequently treated with glucagon or i.v. glucose) was recorded in all pregnant type I diabetic women (n = 77) who attended our pregnancy clinic during 85 pregnancies from 1986 to 1990.

RESULTS
Ninety-four SHs were reported during 35 pregnancies. Of 94 SHs, 84% occurred before the 20th gestational wk (median 12th wk) and 77% during sleep. In the group with SH, there was no permanent maternal sequelae, and there was a favorable fetal outcome (no perinatal death and no congenital malformation). Mean HbA1c values were not different between the group with and without SH for the first half (6.4 ± 1.1 vs. 6.3 ± 0.9%) and 2nd half (5.4 ± 0.6 vs. 5.5 ± 0.7%) of pregnancy. The percentage of women with SH before pregnancy (51 vs. 28%, P &lt; 0.05) and the incidence of SH patients before pregnancy (0.49 vs. 0.08 SH/patient/yr) was different between the group with and without SH.

CONCLUSIONS
SH is frequent during pregnancies of type I diabetic women with near normoglycemia. The risk for SH is particularly pronounced during the first half of pregnancy and in women with a history of SH.