bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short-Term Insulin Therapy and Normoglycemia: Effects on erythrocyte lipid peroxidation in NIDDM patients
Authors: Peuchant Evelyne , Delmas-Beauvieux Marie Christine , Couchouron Anne , Dubourg Liliane , Thomas Marie José , Perromat Annie , Clerc Michel , Gin Henri 
Published: March 2007

OBJECTIVE
To evaluate erythrocyte lipid peroxidation (LPO) before and after an adaptive short-term insulin therapy in NIDDM patients who were chronically hyperglycemic.

RESEARCH DESIGN AND METHODS
Twenty-six patients with NIDDM (mean HbA1c, 11.28%) aged 53.04 ± 2.03 years were submitted for 3 days to constant intravenous glucose and continuous insulin perfusion at an adaptable rate to maintain glycemia within the normal range. An evaluation of LPO at baseline and after euglycemic insulin therapy was determined by erythrocyte free and total malondialdehyde (MDA) levels, polyunsaturated fatty acid (PUFA) percentage, vitamin E and glutathione content, and the following antioxidant enzymatic activity determinations: glutathione peroxidase (GPX), superoxide dismutase (SOD) and catalase (CAT). Fasting serum glucose, HbA1c, triglycerides, cholesterol, and HDL cholesterol levels were also determined at these time points.

RESULTS
At baseline, erythrocyte free and total MDA were significantly higher in NIDDM patients than in control subjects (11.14 ± 0.80 vs. 1.74 ± 0.11 nmol/g Hb [P &lt; 0.0001] for free MDA; 18.04 ± 1.79 vs. 7.85 ± 0.55 nmol/g Hb [P &lt; 0.0001] for total MDA). PUFAs, particularly C20:4 and C22:5, were increased (14.69 ± 0.34 vs. 12.03 ± 0.31 and 2.31 ± 0.04 vs. 1.71 ± 0.03% of total fatty acids, respectively). Vitamin E and glutathione were reduced significantly (6.16 ± 0.61 vs. 14.84 ± 0.64 nmol/g Hb and 0.42 ± 0.04 vs. 0.97 ± 0.06 mmol/l, respectively). No difference was observed for the enzymatic activities. After euglycemic insulin therapy, triglycerides significantly decreased compared with baseline concentrations (1.55 ± 0.13 vs. 2.42 ± 0.22 mmol/l; P &lt; 0.001), whereas other lipidic parameters were unchanged. Free MDA significantly decreased (8.60 ± 0.76 vs. 11.14 ± 0.80 nmol/g Hb [P &lt; 0.01]), while vitamin E increased (7.93 ± 0.73 vs. 6.16 ± 0.61 nmol/g Hb [P &lt; 0.05]). No difference was observed for PUFAs, glutathione, or total MDA.

CONCLUSIONS
The observed erythrocyte LPO in NIDDM decreased after a short-term adaptive insulin therapy. This decrease could be principally attributed to the normalized glycemia that reduces reactive oxygen species (ROS) production, which in turn may explain the increase in erythrocyte membrane vitamin E and the decrease in MDA. This study shows the value of a euglycemic environment in NIDDM to reduce LPO and, at long range, to minimize clinical diabetes complications.
Predictors of Renal Morphological Changes in the Early Stage of Microalbuminuria in Adolescents With IDDM
Authors: Rudberg Susanne , Østerby Ruth , Dahlquist Gisela , Nyberg Gudrun , Persson Bengt 
Published: March 2007

OBJECTIVE
To evaluate the impact of glycemic control, blood pressure, lipid levels, glomerular filtration rate (GFR), age, and duration of IDDM on the degree of structural glomerular changes in the transitional stage of microalbuminuria.

RESEARCH DESIGN AND METHODS
Fifteen adolescents (seven boys and eight girls) with &gt; 5 years of duration of IDDM and with low-grade microalbuminuria (15–30 micrograms/min) participated. Seventeen living kidney donors served as healthy control subjects. Five-year mean HbA1c; 5-year mean systolic and diastolic blood pressure; GFR, cholesterol, and triglycerides 2–5 years before renal biopsy; age; and duration of IDDM were investigated and related to basement membrane thickness (BMT), mesangial and matrix volume fractions, and the overall glomerulopathy index [(BMT/10 + mat/glom, %) + matrix star volume].

RESULTS
BMT and the overall diabetic glomerulopathy were increased in diabetic patients as compared with control subjects (P &lt; 0.001), whereas matrix volume fraction, but not mesangial volume fraction, tended to be increased (P = 0.11). In multivariate analysis, BMT was predicted by 5-year mean HbA1c, diabetes duration, and previous GFR (R2 = 0.71, P = 0.003). With matrix volume fraction as the dependent variable, BMT and diabetes duration were the only significant determinants (R2 = 0.63, P = 0.003). Diabetes duration, 5-year mean HbA1c, and GFR were the variables with an independent influence on the overall diabetic glomerulopathy index (R2 = 0.72, P = 0.003). Preceding blood pressure and lipid levels or age had no significant independent influence on these morphometric measures.

CONCLUSIONS
In the very early stage of microalbuminuria in IDDM adolescents, a high percentage of the variation in BMT and overall severity of glomerulopathy is explained by prolonged hyperglycemia and diabetes duration. Previous glomerular hyperfiltration may also add to the prediction of these morphological changes.
Incidence of Childhood-Onset IDDM in Black African-Heritage Populations in the Caribbean
Authors: Tull Eugene S , Jordan Oscar W , Simon Lester , Laws Mervyn , Smith D Orlando , Vanterpool Heskitt , Butler Cleve ,   The Caribbean African Heritage IDDM Study (CAHIS) Group
Published: March 2007

OBJECTIVE
To compare incidence rates of childhood-onset IDDM among black African-heritage populations age 0–19 years in the Caribbean region.

RESEARCH DESIGN AND METHODS
Population-based registries for IDDM were established on the eastern Caribbean islands of Antigua, Barbados, Dominica, St. Croix, St. Kitts, St. Thomas, and Tortola using standardized criteria from the World Health Organization (WHO) Multinational Project for Childhood Diabetes (DiaMond). Average annual incidence rates (IR) with 95% CI for 0–19 years olds were computed using the DiaMond Registry program for the 5-year period from 1989 to 1993. Poisson regression analysis was used to determine differences in incidence rates.

RESULTS
The highest incidence rate for 0–19 year olds was for the black African-heritage population of St. Croix (IR 10.09 per 100,000; 95% CI 4.35–19.89), one of the U.S. Caribbean islands. A significant (P &lt; 0.05) 3.9 variation in IDDM incidence across the registries was found when the IR for St. Croix was compared to the IR for Barbados (IR 2.57 per 100,000; 95% CI 0.90–4.64).

CONCLUSIONS
The variation in childhood-onset IDDM incidence rates among the black populations of the eastern Caribbean islands is consistent with the geographic variation in IDDM incidence seen among African Americans in the U.S. Variation in incidence rates of childhood diabetes in black populations may reflect differences in level of white genetic admixture or exposure to environmental diabetogenic agents.
Prevalence of Latex-Specific IgE Antibodies in Atopic and Nonatopic Children With Type I Diabetes
Authors: Danne Thomas , Niggemann Bodo , Weber Bruno , Wahn Ulrich 
Published: March 2007

OBJECTIVE
The potential induction of allergic sensitization to latex from insulin vial tops stimulated an investigation of the prevalence of specific IgE antibodies to latex in serum and the relationship to atopic disease in children with diabetes.

RESEARCH DESIGN AND METHODS
In a cross-sectional study, serum samples of 112 children with type I diabetes (age: 15 [5–18] years; diabetes duration: 6 [1–14] years; median [range]) were investigated for total IgE, IgE screening for inhalational and nutritional allergens, and specific IgE antibodies to latex.

RESULTS
Specific IgE antibodies for inhalational and/or nutritional allergens was found in 42 (38%) children (atopic group). Seven children (6%) exhibited specific IgE antibodies (0.61 [0.40–3.84] kU/I) to latex in serum although none reported clinical symptoms of latex allergy. All latex-sensitized children were found in the atopic group. This prevalence of latex sensitization of 17% (7/42) in atopic children with diabetes is comparable with the frequency described in atopic children without diabetes. These seven patients had higher serum total IgE antibody levels (328 [113–1,000] kU/I) than atopic patients without latex sensitization (n = 35; 124 [24–857] kU/I; P &lt; 0.05) or patients without atopy (n = 70; 33 [2–339] kU/I; P &lt; 0.001). No differences in age or diabetes duration were observed between either group.

CONCLUSIONS
Sensitization to latex is found exclusively in children with atopic sensitization and appears to be related to atopic disease and not to frequent contact to latex through insulin injections. However, atopic patients may be at risk for reactions secondary to latex from insulin vials and syringes.
Comparative Effects of Glibenclamide and Metformin on Ambulatory Blood Pressure and Cardiovascular Reactivity in NIDDM
Authors: Sundaresan Purnima , Lykos Denise , Daher Ali , Diamond Terence , Morris Richard , Howes Laurence G 
Published: March 2007

OBJECTIVE
To compare the effects of chronic glibenclamide and metformin therapy on blood pressure (BP) and cardiovascular responsiveness in patients with NIDDM.

RESEARCH DESIGN AND METHODS
Fourteen patients with NIDDM received metformin or glibenclamide for 1 month in a double-blind, randomized crossover study. At the end of each treatment period, patients were tested for forearm vascular responsiveness to intrabrachial arterial infusion of diazoxide (an ATP-sensitive potassium channel opener), acetylcholine, sodium nitroprusside, and norepinephrine, BP responses to intravenous infusions of NE and angiotensin II, BP responses to cold pressor testing and isometric exercise, and 24-h ambulatory BP monitoring.

RESULTS
Metformin and glibenclamide produced similar glycemic control. Mean 24-h BPs did not differ between the two groups, but mean 24-h heart rates were significantly lower (75 ± 6 bpm vs. 80 ± 6 bpm) on glibenclamide therapy than on metformin. Plasma norepinephrine levels were significantly higher on glibenclamide (6.41 ± 1.77 vs. 4.26 ± 1.54 mmol/l, P &lt; 0.01), and systolic BP responses to intravenous norepinephrine and angiotensin II were significantly higher on glibenclamide than on metformin (P &lt; 0.02 and P &lt; 0.05, respectively). Systolic BP responses to cold pressor testing appeared higher on glibenclamide than on metformin, but the difference did not quite achieve statistical significance (P = 0.052). Baseline forearm vascular resistance did not differ between the two drugs, nor did forearm vascular resistance responses to diazoxide, acetylcholine, sodium nitroprusside, and norepinephrine differ.

CONCLUSIONS
Glibenclamide therapy is accompanied by greater systolic BP responses to norepinephrine and angiotensin II and higher plasma norepinephrine levels than those that occur on metformin therapy. Lower heart rates on glibenclamide therapy despite evidence of greater sympathetic activity suggests that glibenclamide may have negative chronotropic effects.
Comparison of Metabolic Control in a Cross-Sectional Study of 2,873 Children and Adolescents With IDDM from 18 Countries
Authors: Mortensen Henrik B , Hougaard Philip ,   For the Hvidøre Study Group on Childhood Diabetes
Published: March 2007

OBJECTIVE
To obtain an estimate of the current level of metabolic control in children and adolescents with IDDM, the Hvidøre Study Group on Childhood Diabetes decided to establish a formal collaboration among countries to gather and exchange data for comparative purposes.

RESEARCH DESIGN AND METHODS
This cross-sectional non-population-based survey involved 22 pediatric departments from 18 countries in Europe, Japan, and North America. Blood samples and information were collected from March through August 1995 on 2,873 children who were born in 1977 or later and seen in the outpatient clinics. HbA1c levels were determined once and analyzed centrally (normal range, 4.4–6.3%; mean, 5.4%). Year of birth, sex, duration of diabetes, height, body weight, insulin regimen, and number of episodes of severe hypoglycemia during the past 3 months were recorded.

RESULTS
Average HbA1c was 8.6 ± 1.7%, but varied significantly (P &lt; 0.0001) between centers. Hypoglycemia resulting in unconsciousness and/or seizures was related to younger age (0–8 years) and lower HbA1c level. The incidence, based on the 3-month period, was 22 per 100 patient-years. Sixty percent of the children (n = 1,707) had two injections daily, while 37% (n = 1,071) were on three or more. HbA1c increased during maturation for both sexes. No difference in glycemic control was found among adolescents treated with two, three, and four or more daily injections. Adolescents on four or more injections received significantly (P &lt; 0.001) more insulin. Girls on four or more injections had significantly (P &lt; 0.01) higher BMI than girls on twice-daily insulin.

CONCLUSIONS
In the participating centers with a multidisciplinary team, only one third of the patients had an HbA1c level of &lt; 8%.
Pubertal Growth, Sexual Maturation, and Final Height in Children With IDDM: Effects of age at onset and metabolic control
Authors: Salerno Mariacarolina , Argenziano Alessandro , Di Maio Salvatore , Gasparini Nicoletta , Formicola Stefania , De Filippo Glanpaolo , Tenore Alfred 
Published: March 2007

OBJECTIVE
To evaluate growth and pubertal development in children with IDDM and the influence of the age at onset of IDDM and the degree of metabolic control on final height.

RESEARCH DESIGN AND METHODS
We conducted a retrospective evaluation of 62 subjects followed longitudinally both clinically and metabolically from the onset of IDDM until final height was reached.

RESULTS
Height at diagnosis was within the normal percentiles in boys (0.5 ± 1.0 standard deviation score [SDS]) and girls (0.4 ± 1.0 SDS), but above the genetic target height (−1.0 ± 0.9 SDS in boys and −1.1 ± 0.6 SDS in girls; P = 0.0001 for both comparisons). Although a lesser height gain was observed during the ensuing years, the final height reached by boys (−0.4 ± 1.1 SDS) and girls (−0.4 ± 0.9 SDS) was higher than the genetic target height. Blunted total pubertal growth was observed both in boys (24.5 ± 3.6 cm) and girls (20.1 ± 4.2 cm). The decrease in height gain was independent of the duration of IDDM, the degree of metabolic control, or the insulin requirement. The greater the height at diagnosis, with respect to the genetic target height, the lesser was the subsequent height gain to reach final adult height (r = 0.34, p &lt; 0.01). BMI increased with age as normally occurs in healthy children, independent of the duration of disease and the degree of metabolic control. Pubertal development began and progressed normally both in boys and girls. In boys, a testicular volume of 4 ml was reached at a mean age of 12.1 ± 0.9 years. In girls, breast enlargement occurred at a mean age of 10.4 ± 1.2 years and the mean age of menarche was 12.8 ± 1.4 years. Pubertal development and progression occurred independent of the age at onset of IDDM, the glycemic control, or the insulin requirement during the pubertal period.

CONCLUSIONS
Children with IDDM have normal onset of puberty and normal sexual maturation. Even though final height falls within the normal percentiles, the diminished height gain after diagnosis requires further investigation.
Effects of Aspirin or Basic Amino Acids on Collagen Cross-Links and Complications in NIDDM
Authors: Contreras Ivan , Reiser Karen M , Martinez Nahir , Giansante Elda , Lopez Tulio , Suarez Nancy , Postalian Sarkis , Molina Miguel , Gonzalez Freddy , Sanchez Maria R , Camejo Manuel , Blanco Maria C 
Published: March 2007

OBJECTIVE
To determine if long-term therapy with aspirin or basic amino acids for subjects with NIDDM reduces the severity of clinical complications and/or reduces tissue levels of markers of glycooxidative damage.

RESEARCH DESIGN AND METHODS
Subjects with NIDDM were administered either aspirin (100 mg/day) or a combination of basic amino acids consisting of L-arginine (2 g/day) plus L-lysine (0.5 g/day) for 1 year. The study was double-blind and placebo-controlled. The presence and severity of retinopathy, nephropathy, and neuropathy were assessed in all subjects at 4-month intervals, as were serum blood glucose, glycohemoglobin levels, and presence of albuminuria. Collagen cross-linking and collagen glycation were measured in skin collagen obtained by biopsy at the beginning and the end of the study. Skin biopsies were also obtained from age-matched control subjects.

RESULTS
Skin samples obtained from NIDDM subjects at the beginning of the study had significantly increased levels of glucitolyllysine, pentosidine, and hydroxypyridinium, as compared with age-matched control subjects. Pentosidine levels were significantly correlated with severity of retinopathy and neuropathy, but not nephropathy. Subjects receiving aspirin, but not amino acids or placebo, had significantly decreased levels of skin pentosidine after 1 year of therapy.

CONCLUSIONS
It is concluded that 1) low-dose aspirin may reduce glycooxidative damage in people with NIDDM, and 2) treatment may need to continue for more than 1 year before clinical status improves.
The Role of Dynamic Plantar Pressures in Diabetic Foot Ulcers
Authors: Stess Richard M , Jensen Shayne R , Mirmiran Roya 
Published: March 2007

OBJECTIVE
The significance of plantar pressure studies in detecting sites of plantar ulceration in diabetic patients was investigated.

RESEARCH DESIGN AND METHODS
A total of 97 diabetic patients participated in this study. History and physical data, such as history of smoking, type of diabetes, ankle/brachial indexes, and the presence of protective sensory threshold, were collected. Using the EMED-SF plantar pressure analyzer, dynamic pressure variables, such as normalized peak pressure of maximum pressure picture (MPP), pressure-time integral (PTI), and force-time integral (FTI), were measured in each foot. Statistical analysis included descriptive statistics and analyses of variance.

RESULTS
Out of 97 patients, 34 patients had no history of neuropathy and plantar ulceration (the diabetic control [DC] group). Another 14 patients had neuropathy with no previous history of plantar ulcers (the DN group), whereas the remainder of the patients had a history of peripheral neuropathy with plantar ulceration (the DU group). There were significant increases in MPP (P &lt; 0.004) and PTI (P &lt; 0.0004) levels in the DU group when compared with the DC group with the highest pressure present under the 4th and 5th metatarsal heads. No statistical significance existed among groups when comparing FTI levels.

CONCLUSIONS
Neuropathic patients have an increase in dynamic plantar foot pressures placing them at risk for plantar ulceration. Instruments such as the EMED-SF system can be helpful in detecting possible sites of plantar ulcerations by locating the areas of maximum pressure.
Open-Flow Microperfusion of Subcutaneous Adipose Tissue for On-Line Continuous Ex Vivo Measurement of Glucose Concentration
Authors: Trajanoski Zlatko , Brunner Gernot A , Schaupp Lukas , Ellmerer Martin , Wach Paul , Pieber Thomas R , Kotanko Peter , Skrabal Falko 
Published: March 2007

OBJECTIVE
To evaluate a novel technique for on-line continuous glucose measurement in subcutaneous adipose tissue, and to investigate its accuracy for detection of hypoglycemia.

RESEARCH DESIGN AND METHODS
The method combined an open-flow microperfusion of subcutaneous adipose tissue using a double lumen catheter and an extracorporeal sensor cell. An isotonic ion-free solution was perfused through the inner lumen of the catheter, equilibrated with the subcutaneous tissue fluid, and sampled through the outer lumen. The recovery was continuously monitored as the ratio between the measured sampled fluid conductivity and the subcutaneous tissue fluid conductivity (assumed to have a constant value of 1.28 S/m at 25°C). Glucose concentration was calculated on-line from the measured glucose in the sampled fluid and the measured recovery in healthy volunteers during hyperglycemic glucose loads (n = 8), hypoglycemic hyperinsulinemic clamp (n = 6), and a 24-h monitoring period (n = 7).

RESULTS
Subcutaneous glucose concentrations in the fasting state were 94% of the plasma glucose concentrations in arterialized venous samples. According to the error grid analysis, 96.9% of the on-line measured subcutaneous glucose concentrations during hyperglycemia and 96.3% during hypoglycemia were in accurate or acceptable zones. The mean differences between the measured subcutaneous glucose and the actual plasma glucose concentration were −0.06–3.3 mmol/l (hyperglycemia), and −0.6–1.1 mmol/l (hypoglycemia).

CONCLUSIONS
By combining open-flow microperfusion, glucose sensor, and conductivity measurement, glucose concentration in the subcutaneous adipose tissue can be monitored on-line, extracorporeally, and continuously without any in vivo calibration, and gives accurate measurements during hyper- and hypoglycemia.
ACE Inhibitor Use Is Associated With Hospitalization for Severe Hypoglycemia in Patients With Diabetes
Authors: Morris Andrew D , Boyle Douglas I , McMahon Alexander D , Pearce Hilary , Evans Josie M.M , Newton Ray W , Jung Roland T , MacDonald Thomas M ,   The Darts/Memo Collaboration
Published: March 2007

OBJECTIVE
To evaluate the association between the use of ACE inhibitors and hospital admission for severe hypoglycemia and to explore the effects of potential confounding variables on this relationship.

RESEARCH DESIGN AND METHODS
The association between the use of ACE inhibitors and the incidence of hypoglycemia is controversial. A recent study reported that 14% of all hospital admissions for hypoglycemia might be attributable to ACE inhibitors. We performed a nested case-control study, using a cohort of 6,649 diabetic patients taking insulin or oral antidiabetic drugs, on the Diabetes Audit and Research in Tayside, Scotland (DARTS) database. From 1 January 1993 to 30 April 1994, we identified 64 patients who had been admitted to Tayside hospitals with hypoglycemia and selected 440 control patients from the same cohort.

RESULTS
Hypoglycemia was associated with the use of ACE inhibitors (odds ratio [OR] 3.2, 95% CI 1.2–8.3, P = 0.023), whereas use of β-blockers and calcium antagonists was not associated with an increased risk of hospitalization for hypoglycemia with ORs of 0.9 (95% CI 0.3–3.3) and 1.7 (95% CI 0.2–2.1), respectively. There were significant differences between case and control patients in type of diabetes treatment, diabetes duration, place of routine diabetes care, and congestive cardiac failure. These differences did not confound the relationship between ACE inhibitors and hypoglycemia (adjusted OR 4.3, 95% CI 1.2–16.0).

CONCLUSIONS
The results show that the association between ACE inhibitor therapy and hospital admission for severe hypoglycemia is not explained by these confounding factors. Although ACE inhibitors have distinct advantages over other antihypertensive drugs in diabetes, the risk of hypoglycemia should be considered.