bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduced Skeletal Muscle Oxygen Uptake and Reduced β-Cell Function
Authors: Thamer Claus , Stumvoll Michael , Niess Andreas , Tschritter Otto , Haap Michael , Becker Regine , Shirkavand Fatemeh , Bachmann Oliver , Rett Kristian , Volk Annette , Häring Hans , Fritsche Andreas 
Published: March 2007

OBJECTIVE—Studies on insulin sensitivity and insulin secretion in subjects with a familial predisposition for type 2 diabetes mellitus (T2DM) traditionally produce inconsistent results. This may be due to small sample size, subject selection, matching procedures, and perhaps lack of a measure of physical fitness.
RESEARCH DESIGN AND METHODS—In the present study, we specifically tested the hypothesis that a family history of T2DM is associated with reduced Vo2max, measured by incremental bicycle ergometry, independent of insulin sensitivity estimated from an oral glucose tolerance test (OGTT; n = 424) and measured by a euglycemic-hyperinsulinemic clamp (n = 185). Subjects included in the study were young (34 ± 10 years), healthy, and normal glucose tolerant with either a first-degree relative (FDR) with T2DM (n = 183), a second-degree relative with T2DM (n = 94), or no family history of T2DM (control subjects, n = 147). BMI, percent body fat, waist-to-hip ratio (WHR), and habitual physical activity (HPA; standard questionnaire) were comparable among groups. FDRs had significantly lower Vo2max than control subjects: 40.5 ± 0.6 vs. 45.2 ± 0.9 ml O2/kg lean body mass, P = 0.01 after adjusting for sex, age, BMI, HPA, and insulin sensitivity (euglycemic-hyperinsulinemic clamp).
RESULTS—BMI, percent body fat, waist-to-hip ratio (WHR), and habitual physical activity (HPA; standard questionnaire) were comparable among groups. FDRs had significantly lower Vo2max than control subjects: 40.5 ± 0.6 vs. 45.2 ± 0.9 ml O2/kg lean body mass, P = 0.01 after adjusting for sex, age, BMI, HPA, and insulin sensitivity (euglycemic-hyperinsulinemic clamp). Insulin sensitivity per se was not affected by family history of T2DM after adjusting for age, sex, BMI, and percent body fat (P = 0.76). The appropriateness of β-cell function for the individual insulin sensitivity (disposition index: product of a validated secretion parameter [OGTT] and sensitivity [clamp]) was significantly lower in FDRs (87 ± 4 units) versus control subjects (104 ± 6 units, P = 0.02 after adjusting for sex, age, and BMI). Analyses of the larger OGTT group produced essentially the same results.
CONCLUSIONS—In conclusion, these data are compatible with the hypothesis that familial predisposition for T2DM impairs maximal oxygen consumption in skeletal muscle. Because habitual physical activity was not different, genetic factors may be involved. Conceivably, reduced Vo2max precedes skeletal muscle insulin resistance, providing a partial explanation for discrepancies in the literature.
Impaired Fasting Glucose and Impaired Glucose Tolerance in Women With Prior Gestational Diabetes Are Associated With a Different Cardiovascular Profile
Authors: Pallardo Luis Felipe , Herranz Lucrecia , Martin-Vaquero Pilar , Garcia-Ingelmo Teresa , Grande Cristina , Jañez Mercedes 
Published: March 2007

OBJECTIVE—The purpose of this study was to investigate the association of cardiovascular risk factors to impaired glucose tolerance (IGT) and to impaired fasting glucose (IFG) in women with prior gestational diabetes mellitus (GDM).
RESEARCH DESIGN AND METHODS—We studied 838 women with prior GDM. Postpartum glucose tolerance status was classified as normal, IFG, IGT, IFG plus IGT, and diabetes according to the World Health Organization criteria. Postpartum BMI, waist circumference, blood pressure, triglyceride, cholesterol, and HDL cholesterol were assessed.
RESULTS—BMI and blood pressure were significantly higher in women with IFG than in women with normal glucose status. BMI and waist circumference were significantly higher in women with IFG plus IGT than in women with normal glucose status. No differences were observed between women with IGT and normal glucose status. The prevalence of hypertension and obesity was significantly increased in IFG compared with normal glucose status. The prevalence of obesity and abnormal lipids was significantly increased in IFG plus IGT compared with normal glucose status. IGT showed no increased prevalence of cardiovascular risk factors.
CONCLUSIONS—Traditional cardiovascular risk factors have a stronger association with isolated IFG than with isolated IGT in women with prior GDM.
Quantitative Insulin Sensitivity Check Index and the Reciprocal Index of Homeostasis Model Assessment in Normal Range Weight and Moderately Obese Type 2 Diabetic Patients
Authors: Yokoyama Hisayo , Emoto Masanori , Fujiwara Shigehiko , Motoyama Koka , Morioka Tomoaki , Komatsu Miyoko , Tahara Hideki , Shoji Tetsuo , Okuno Yasuhisa , Nishizawa Yoshiki 
Published: March 2007

OBJECTIVE—To investigate whether the quantitative insulin sensitivity check index (QUICKI) and the reciprocal index of homeostasis model assessment (1/HOMA-IR) derived from fasting plasma glucose and insulin level are excellent surrogate indices of insulin resistance in both normal range-weight and moderately obese type 2 diabetic and healthy subjects.
RESEARCH DESIGN AND METHODS—The association between QUICKI or 1/HOMA-IR and insulin resistance index assessed by euglycemic-hyperinsulinemic clamp (clamp-IR) was investigated in 121 type 2 diabetic and 29 healthy subjects recruited from among 120 (age 55 ± 11, 48 ± 15, and 52 ± 15 years [means ± SD], respectively). Type 2 diabetic subjects were divided into groups of 76 normal range-weight and 45 moderately obese subjects (BMI 21.4 ± 2.3 vs. 27.2 ± 2.2 kg/m2, P &lt; 0.0001).
RESULTS—QUICKI and 1/HOMA-IR were significantly lower in the moderately obese group than in the normal range-weight type 2 diabetic and healthy groups (n = 120) (QUICKI, 0.338 ± 0.030, 0.371 ± 0.037, and 0.389 ± 0.041, respectively, P &lt; 0.0001; 1/HOMA-IR, 0.50 ± 0.33, 0.92 ± 0.55, and 1.24 ± 0.82, P &lt; 0.0001). QUICKI was strongly correlated with clamp-IR in normal range-weight, moderately obese type 2 diabetic, and healthy subjects (r = 0.641, 0.570, and 0.502, respectively; all subjects, r = 0.608, P &lt; 0.01) and 1/HOMA-IR exhibited correlations comparable to those of QUICKI with clamp-IR (r = 0.637, 0.530, and 0.461, respectively; all subjects, r = 0.589, P &lt; 0.001). In multiple regression models including QUICKI or 1/HOMA-IR as an independent variable, the estimation formula accounted for 55% of the variability of clamp-IR for the group of all type 2 diabetic subjects (R2 = 0.547 and 0.551, respectively, P ≤ 0.0001).
CONCLUSIONS—QUICKI and 1/HOMA-IR were highly correlated with clamp-IR, with comparable coefficients in both normal range-weight and moderately obese type 2 diabetic patients and nondiabetic subjects. The latter can probably be applied clinically in view of its convenience.
One-Year Outcome of a Combination of Weight Loss Therapies for Subjects With Type 2 Diabetes
Authors: Redmon J. Bruce , Raatz Susan K. , Reck Kristell P. , Swanson Joyce E. , Kwong Christine A. , Fan Qiao , Thomas William , Bantle John P. 
Published: March 2007

OBJECTIVE—The purpose of this study was to evaluate the effects of a combination weight loss program using intermittent low-calorie diets, energy-controlled meal replacement products, and sibutramine on weight loss, diabetes control, and cardiovascular risk factors in overweight or obese subjects with type 2 diabetes.
RESEARCH DESIGN AND METHODS—Overweight or obese individuals with type 2 diabetes treated with diet or oral medication were randomly assigned to either a standard therapy or combination therapy group. Both groups received a standardized program to facilitate weight loss. The combination therapy group also received 10–15 mg sibutramine daily, low-calorie diets using meal replacement products for 1 week every 2 months, and between low-calorie diet weeks, once daily use of meal replacement product and snack bars to replace one usual meal and snack. Primary outcome measures were changes in body weight, glycemic control, plasma lipids, blood pressure, pulse, and body composition at 1 year.
RESULTS—At 1 year, combination therapy, compared with standard therapy, resulted in significantly more weight loss (−7.3 ± 1.3 kg vs. −0.8 ± 0.9 kg, P &lt; 0.001) and reduction in HbA1c (−0.6 ± 0.3 vs. 0.0 ± 0.2%, P = 0.05). Combination therapy resulted in reduced requirement for diabetes medications and decreased fat mass and lean body mass. A 5-kg decrease in weight at 1 year was associated with a decrease of 0.4% in HbA1c (P = 0.006). Changes in fasting glucose, lipids, pulse, and blood pressure did not differ between groups.
CONCLUSIONS—This combination weight loss program resulted in greater weight loss and improved diabetes control compared with a standard weight loss program in overweight or obese subjects with type 2 diabetes.
The Development and Validation of a Neuropathy- and Foot Ulcer-Specific Quality of Life Instrument
Authors: Vileikyte Loretta , Peyrot Mark , Bundy Christine , Rubin Richard R. , Leventhal Howard , Mora Pablo , Shaw Jonathan E. , Baker Paul , Boulton Andrew J.M. 
Published: March 2007

OBJECTIVE—The purpose of this study was to develop a questionnaire that measures patients’ perceptions of the impact of diabetic peripheral neuropathy and foot ulcers on their quality of life and to assess the psychometric properties of this instrument in a sample of patients with varying severity and symptomatology of diabetic peripheral neuropathy.
RESEARCH DESIGN AND METHODS—The neuropathy- and foot ulcer-specific quality of life instrument (NeuroQoL), generated from interviews with patients with (n = 47) and without (n = 15) diabetic peripheral neuropathy, was administered to 418 consecutive patients with diabetic peripheral neuropathy (35% with foot ulcer history) attending either U.K. (n = 290) or U.S. (n = 128) diabetes centers. Psychometric tests of NeuroQoL included factor analyses and internal consistency of scales; a series of multivariate analyses were performed to establish its criterion, construct, and incremental validity. Results were compared with those obtained using the Short Form (SF)-12 measure of health-related functioning.
RESULTS—Factor analyses of NeuroQoL revealed three physical symptom measures and two psychosocial functioning measures with good reliability (α = 0.86–0.95). NeuroQoL was more strongly associated with measures of neuropathic severity than SF-12, more fully mediated the relationship of diabetic peripheral neuropathy with overall quality of life, and significantly increased explained variance in overall quality of life over SF-12.
CONCLUSIONS—NeuroQoL reliably captures the key dimensions of the patients’ experience of diabetic peripheral neuropathy and is a valid tool for studying the impact of neuropathy and foot ulceration on quality of life.
Haptoglobin Genotype Is Predictive of Major Adverse Cardiac Events in the 1-Year Period After Percutaneous Transluminal Coronary Angioplasty in Individuals With Diabetes
Authors: Roguin Ariel , Koch Werner , Kastrati Adnan , Aronson Doron , Schomig Albert , Levy Andrew P. 
Published: March 2007

OBJECTIVE—The goal of this study was to determine whether the haptoglobin (Hp) genotype was predictive of restenosis and major adverse cardiac events (MACEs) after percutaneous transluminal coronary angioplasty (PTCA) in individuals with diabetes.
RESEARCH DESIGN AND METHODS—A consecutive series of 935 diabetic patients treated with oral agents and/or insulin were followed for 1 year after PTCA. The primary study end point was angiographic restenosis, MACEs and secondary study end points were defined as target vessel revascularization, myocardial infarction, and death. Two alleles exist at the Hp gene locus, denoted 1 and 2. The Hp genotype (Hp 1–1, Hp 2–1, or Hp 2–2) was determined by PCR.
RESULTS—In multivariate analysis controlling for all known determinants of outcome after PTCA, we found that the Hp genotype was a highly significant independent predictor of MACEs in the 1-year period after PTCA in individuals with diabetes. This was predominantly due to differences in the risk of myocardial infarction during that period: Hp 1–1, 0 of 129 (0%); Hp 2–1, 20 of 424 (4.7%); and Hp 2–2, 32 of 382 (8.4%); P &lt; 0.0001.
CONCLUSIONS—The Hp genotype seems to be highly predictive of adverse cardiac events, particularly myocardial infarction, in the 1-year period after PTCA. Determination of the Hp genotype may be useful in the evaluation of new therapies to reduce cardiovascular risk after PTCA.
Restoration of Sensation, Reduced Pain, and Improved Balance in Subjects With Diabetic Peripheral Neuropathy
Authors: Leonard David R. , Farooqi M. Hamed , Myers Sara 
Published: March 2007

OBJECTIVE—Diabetic peripheral neuropathy (DPN) has been thought to be progressive and irreversible. Recently, symptomatic reversal of DPN was reported after treatments with a near-infrared medical device, the Anodyne Therapy System (ATS). However, the study was not controlled nor was the investigator blinded. We initiated this study to determine whether treatments with the ATS would decrease pain and/or improve sensation diminished due to DPN under a sham-controlled, double-blind protocol.
RESEARCH DESIGN AND METHODS—Tests involved the use of the 5.07 and 6.65 Semmes Weinstein monofilament (SWM) and a modified Michigan Neuropathy Screening Instrument (MNSI). Twenty-seven patients, nine of whom were insensitive to the 6.65 SWM and 18 who were sensitive to this filament but insensitive to the 5.07 SWM, were studied. Each lower extremity was treated for 2 weeks with sham or active ATS, and then both received active treatments for an additional 2 weeks.
RESULTS—The group of 18 patients who could sense the 6.65 SWM but were insensitive to the 5.07 SWM at baseline obtained a significant decrease in the number of sites insensate after both 6 and 12 active treatments (P &lt; 0.02 and 0.001). Sham treatments did not improve sensitivity to the SWM, but subsequent active treatments did (P &lt; 0.002). The MNSI measures of neuropathic symptoms decreased significantly (from 4.7 to 3.1; P &lt; 0.001). Pain reported on the 10-point visual analog scale decreased progressively from 4.2 at entry to 3.2 after 6 treatments and to 2.3 after 12 treatments (both P &lt; 0.03). At entry, 90% of subjects reported substantial balance impairment; after treatment, this decreased to 17%. However, among the group of nine patients with greater sensory impairment measured by insensitivity to the 6.65 SWM at baseline, improvements in sensation, neuropathic symptoms, and pain reduction were not significant.
CONCLUSIONS—ATS treatments improve sensation in the feet of subjects with DPN, improve balance, and reduce pain.
Nonalbuminuric Renal Insufficiency in Type 2 Diabetes
Authors: MacIsaac Richard J. , Tsalamandris Con , Panagiotopoulos Sianna , Smith Trudy J. , McNeil Karen J. , Jerums George 
Published: March 2007

OBJECTIVE—To determine the prevalence and characteristics of patients with type 2 diabetes who have impaired renal function, defined as a glomerular filtration rate (GFR) &lt;60 ml · min−1 · 1.73 m−2, and normoalbuminuria.
RESEARCH DESIGN AND METHODS—A cross-sectional survey of 301 outpatients attending a single tertiary referral center using the plasma disappearance of isotopic 99mTc-diethylene-triamine-penta-acetic acid to measure GFR and at least two measurements of urinary albumin excretion rate (AER) over 24 h to determine albuminuria.
RESULTS—A total of 109 patients (36%) had a GFR &lt;60 ml · min−1 · 1.73 m−2. The overall prevalence of normo-, micro-, and macroalbuminuria was 43 of 109 (39%), 38 of 109 (35%), and 28 of 109 (26%), respectively. Compared with patients with macroalbuminuria, those with normoalbuminuria were more likely to be older and female. After excluding patients whose normoalbuminuric status was possibly related to the initiation of a renin-angiotensin system (RAS) inhibitor before the start of the study, the prevalence of a GFR &lt;60 ml · min−1 · 1.73 m−2 and normoalbuminuria was 23%. Temporal changes in GFR in a subset of 34 of 109 (32%) unselected patients with impaired renal function were available for comparison over a 3- to 10-year period. The rates of decline in GFR (ml · min−1 · 1.73 m−2 · year−1) of −4.6 ± 1.0, −2.8 ± 1.0, and −3.0 ± 07 were not significantly different for normo- (n = 12), micro- (n = 12), and macroalbuminuric (n = 10) patients, respectively.
CONCLUSIONS—These results suggest that patients with type 2 diabetes can commonly progress to a significant degree of renal impairment while remaining normoalbuminuric.
Prognostic Value of Epicardial Coronary Artery Constriction to the Cold Pressor Test in Type 2 Diabetic Patients With Angiographically Normal Coronary Arteries and No Other Major Coronary Risk Factors
Authors: Nitenberg Alain , Valensi Paul , Sachs Régis , Cosson Emmanuel , Attali Jean-Raymond , Antony Isabelle 
Published: March 2007

OBJECTIVE—Endothelium-dependent coronary dilation is impaired in diabetic patients and has been found to independently predict cardiovascular events (CVEs) in patients with multiple coronary risk factors. The aim of this study was to evaluate the outcome of type 2 diabetic patients on the basis of epicardial coronary dysfunction.
RESEARCH DESIGN AND METHODS— We examined 56 control subjects (aged 51.7 ± 6.4 years) using coronary artery response to the cold pressor test (quantitative coronary angiography) and compared them with 72 type 2 diabetic patients (aged 50.3 ± 8.5 years) without other major coronary risk factors.
RESULTS—Average diameter change was 17.2 ± 10.4% in the control subjects, dilation occurred in 91.1% of subjects, no change occurred in 8.9%, and there was no constriction. Average diameter change was −14.4 ± 12.1% in diabetic patients (P &lt; 0.001 vs. control subjects), constriction occurred in 73.6%, no change occurred in 26.4%, and there was no dilation. CVEs were recorded with a mean follow-up of 45 ± 19 months. There was 1 CVE in the control group and 26 CVEs in 18 of 72 diabetic patients (P &lt; 0.001 vs. control subjects), with 23 events in 16 of 53 diabetic patients with coronary artery constriction (P &lt; 0.001 vs. control subjects), and 3 events in 2 of 19 diabetic patients with no diameter change (NS vs. control subjects).
CONCLUSIONS—In type 2 diabetic patients without other major coronary risk factors, constriction of angiographically normal coronary arteries to the cold pressor test is predictive of long-term CVEs.
Is Patient Readiness to Change a Predictor of Improved Glycemic Control?
Authors: O’Connor Patrick J. , Asche Stephen E. , Crain A. Lauren , Rush William A. , Whitebird Robin R. , Solberg Leif I. , Sperl-Hillen JoAnn M. 
Published: March 2007

OBJECTIVE—To test the hypothesis that patient readiness to change (RTC) predicts future changes in glycemic control in adults with diabetes.
RESEARCH DESIGN AND METHODS—We linked survey data with HbA1c data for a stratified random sample of consenting adults with diabetes. Change in HbA1c from baseline to the 1-year follow-up was computed and used as a dependent variable. Linear regression models assessed RTC and other patient variables as predictors of HbA1c change.
RESULTS—Among 617 patients with baseline HbA1c ≥7% and complete data for analysis, RTC predicted subsequent improvement in HbA1c for those with higher physical functioning (interaction t = −2.45, P &lt; 0.05). Other factors that predicted HbA1c improvement in multivariate linear regression models included higher self-reported medication adherence (t = −4.41, P &lt; 0.01), higher baseline HbA1c (t = −15.08, P &lt; 0.01), and older age (t = −2.61, P &lt; 0.01).
CONCLUSIONS— Diabetes RTC independently predicts change in HbA1c for patients with high but not for patients with low functional health status. Customized use of RTC assessment may have potential to improve care.
Increased Diabetes Incidence in Greek and Italian Migrants to Australia
Authors: Hodge Allison M. , English Dallas R. , O’Dea Kerin , Giles Graham G. 
Published: March 2007

OBJECTIVE—The aims of the study were to determine whether Greek or Italian migrants to Australia have an elevated incidence of type 2 diabetes compared with Australian-born individuals and to what extent any differences can be explained by known risk factors.
RESEARCH DESIGN AND METHODS—This was a prospective study of 34,097 men and women aged 40–69 years born in Greece, Italy, Australia, or New Zealand who were free from diabetes at baseline. For all self-reported cases of diabetes at the 4-year follow-up, a confirmation of diagnosis was sought from medical practitioners. Of these, anyone for whom there was no evidence against a diagnosis of type 2 diabetes was considered a case subject.
RESULTS—Follow-up was completed by 29,331 (86%) participants, and 334 case subjects were identified. The cumulative incidence of type 2 diabetes among Greek (2.6%) and Italian (2.4%) migrants was more than three times that in Australian-born (0.7%) individuals. After adjusting for age only, the odds ratios (ORs) for being of Greek and Italian origin compared with Australian origin were 3.8 (95% CI 2.9–5.0) and 3.3 (2.6–4.3), respectively. The only known risk factor for type 2 diabetes that materially affected these ORs was BMI. After adjusting for BMI and age, the ORs for being of Greek and Italian origin, respectively, were 2.4 (1.8–3.2) and 2.0 (1.5–2.6).
CONCLUSIONS—Greek and Italian migrants to Australia have a more than three times greater incidence of type 2 diabetes than Australian-born individuals, and this is only partly explained by BMI. Although weight control will remain important for these high-risk groups, identification of other risk factors is required.
Thermal Thresholds Predict Painfulness of Diabetic Neuropathies
Authors: Krämer Heidrun H. , Rolke Roman , Bickel Andreas , Birklein Frank 
Published: March 2007

OBJECTIVE—Pathophysiology explaining pain in diabetic neuropathy (DN) is still unknown.RESEARCH DESIGN AND METHODS—Thirty patients with peripheral DN (17 men and 13 women; mean age 52.4 ± 2.5 years) were investigated. Fifteen patients had neuropathic pain, and 15 patients were free of pain. Patients were followed over 2 years and examined at the beginning and thereafter every 6 months. Clinical severity and painfulness of the DN were assessed by the neuropathy impairment score and visual analog scales (VASs). Cold and warm perception thresholds as well as heat pain thresholds were obtained for evaluation of Aδ- and C-fibers. Nerve conduction velocities (NCVs) and vibratory thresholds were recorded for analysis of thickly myelinated fibers. Moreover, for assessment of cardiac vagal function, heart rate variability (HRV) was evaluated. In order to reduce day-to-day variability of pain, mean values of the five time points over 2 years were calculated and used for further analysis. Data were compared with an age- and sex-matched control group of healthy volunteers.RESULTS—There were significant differences regarding electrophysiological studies, HRV and quantitative sensory testing (QST) between patients and healthy control subjects (P &lt; 0.001). Generally, patients with neuropathic pain were indistinguishable from pain-free patients. In the pain group, however, VAS pain ratings were correlated to the impairment of small-fiber function (cold detection thresholds, P = 0.02; warm detection thresholds, P = 0.056).CONCLUSIONS—Intensity of pain in painful DN seems to depend on small nerve fiber damage and deafferentation.