bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Late-Onset Autoimmune Diabetes in White Familial NIDDM Pedigrees
Authors: Elbein Steven C , Wegner Kimberley , Miles Cindy , Yu Liping , Eisenbarth George 
Published: March 2007

OBJECTIVE
To determine whether autoimmunity is a prominent feature of NIDDM among diabetic members in families with a strong history of NIDDM or in families with a mixture of NIDDM and IDDM.

RESEARCH DESIGN AND METHODS
We determined GAD and islet cell (ICA512) autoantibodies from 215 NIDDM individuals and from 14 individuals with impaired glucose tolerance (IGT) of 68 families, including 1 family with maturity-onset diabetes of the young (MODY) and 3 families ascertained specifically for a mixture of NIDDM and IDDM. We tested 2 control populations: 50 unrelated spouses form Utah families, including 29 spouses with either IGT or NIDDM and 198 random nondiabetic white individuals from Colorado.

RESULTS
We detected either GAD or ICA512 autoantibodies in 11 members of seven families and in one spouse used as a control subject. In two families, two affected individuals showed evidence of autoimmunity, but NIDDM individuals in each of the seven families showed no evidence of autoimmunity. Among the five families with both IDDM and NIDDM individuals (three families ascertained for a mixture and two families ascertained with an incidental IDDM child), antibodies were detected in members of only one family. Antibody-positive individuals were significantly younger at diabetes onset and had low waist-to-hip ratios, but were not more likely to be insulin treated.

CONCLUSIONS
Autoimmunity is an important cause of apparent NIDDM, even among families with a strong history of NIDDM. However, autoimmunity among affected family members appeared to be a chance event and not the manifestation of a different genetic cause of diabetes.
Independent Physiological Predictors of Foot Lesions in Patients With NIDDM
Authors: Litzelman Debra K , Marriott Deanna J , Vinicor Frank 
Published: March 2007

OBJECTIVE
To identify and quantify independent physiological risk factors for foot lesions in diabetic patients.

RESEARCH DESIGN AND METHODS
There were 352 patients enrolled in a 1-year randomized controlled trial aimed at reducing risks for lower-extremity pathology through patient education and system interventions. Inclusion criteria were as follows: being age 40 years or over, being at or above ideal body weight, and having been diagnosed with NIDDM. Participants were predominantly African-American (76%), elderly (mean 60 years of age), indigent (77% with annual income &lt; $10,000), or women (81%) who had diabetes for 10 years. Prospective multivariate modeling used baseline clinical signs (e.g., blood pressure, dermatological characteristics, and neuropathic measures) and laboratory values (e.g., lipid profiles and measures of glycemic control) to predict foot lesions rated using the Seattle Wound Classification.

RESULTS
When controlling for intervention effects, only measures of neuropathy (monofilament testing [odds ratio {OR} 2.75, 95% CI 1.55–4.88] and thermal sensitivity testing [2.18, 1.13–4.21]) predicted wounds classified 1.2 (minor injury), but investigation of wounds rated at least 1.3 (nonulcerated lesions) indicated baseline wounds (13.41), 3.19–56.26), monofilament abnormalities (5.23, 2.26–12.13), and low HDL (1.63, 1.11–2.39) as predictors. Although fungal dermatitis, dry cracked skin, edema, ingrown nails, microalbuminuria, fasting blood glucose, and hemoglobin A1c were candidates for one or both of the multivariable models (P &lt; 0.3), they were not significant multivariate predictors.

CONCLUSIONS
Lesions may be preventable with aggressive screening for peripheral neuropathy and abnormal lipids. Also, these results provide empirical support for the commonly held belief that foot lesions prospectively predict future wounds.
Metabolic Efficacy of Preprandial Administration of Lys(B28), Pro(B29) Human Insulin Analog in IDDM Patients: A comparison with human regular insulin during a three-meal test period
Authors: Jacobs Maarten A J M , Keulen Erik T P , Kanc Karin , Casteleijn Sandrina , Scheffer Peter , Devillé Walter , Heine Robert J 
Published: March 2007

OBJECTIVE
The objective of this study was to compare the efficacy of the rapid-acting Lys(B28), Pro(B29) human insulin analog, insulin lispro, with currently available short-acting human insulin in a multiple injection therapy (MIT) regimen with respect to blood glucose and plasma insulin profiles and to serum metabolites (lactate, free fatty acids, glycerol, and β-hydroxybutyrate) in 12 well-controlled type 1 diabetic subjects (8 male, HbA1c 6.8 ± 0.9% [mean ± SD]).

RESEARCH DESIGN AND METHODS
After a run-in period of 4 weeks, patients were treated with either lispro at mealtime or human insulin 30 min before the meal for two periods of 4 weeks in a randomized open-label crossover study. Intermediate-acting insulin (NPH insulin) was given at bedtime. At the end of both study periods, metabolic profiles were assessed from 10:00 P.M. to 7:00 P.M. the next day.

RESUlTS
During the treatment periods, glycemic control was stable during lispro but improved during human insulin (ΔHbA1c lispro 0.1 ± 0.48, NS; human insulin −0.41 ± 0.34%, P &lt; 0.05). Glucose excursions, as measured by the incremental AUC, during the day and for the 2-h postprandial periods, were lower, although not significantly, for lispro. Insulin profiles demonstrated a faster rise after administration of lispro as compared with human insulin, peaking at 61 ± 11.9 and 111 ± 48.1 min (P &lt; 0.01). Glycerol levels showed a slight increase before lunch and dinner, suggestive of enhanced lipolytic activity and compatible with the lower insulin levels.

CONCLUSIONS
Lispro insulin applied in an MIT regimen creates more physiologic insulin profiles and tends to lower the glycemic excursions during the day compared with short-acting insulin. The analog can be applied safely in an MIT regimen, with mealtime intervals up to 5 h.
Evaluation of the Efficacy and Tolerability of Nitrendipine in Reducing Both Pressure and Left Ventricular Mass in Hypertensive Type 2 Diabetic Patients
Authors: Scognamiglio Roldano , Nosadini Romano , Marin Marco , Nisti Stefano , Fasoli Giuseppe , Palisi Monica , Frigato Francesco , Virgili Flavio , Carraro Andrea , Crepaldi Gaetano 
Published: March 2007

OBJECTIVE
To evaluate the efficacy and tolerability of nitrendipine in comparison with captopril in hypertensive diabetic patients with left ventricular hypertrophy (LVH).

RESEARCH DESIGN AND METHODS
A total of 75 patients enrolled in this study presented stable type 2 diabetes (not treated with insulin) and mild-to-moderate hypertension with a left ventricular mass ≥ 75 g/m2 by two-dimensional echocardiography. After a 4-week washout period, 38 patients were assigned to treatment with captopril, and 37 patients to nitrendipine (random allocation). The duration of follow-up was 36 weeks.

RESULTS
Patients of both groups were similar with regard to the duration of diabetes and hypertension, systolic and diastolic blood pressure at rest, degree of LVH, metabolic control, and albumin excretion rate (AER). Both drugs were equally effective in reducing systolic and diastolic blood pressure (captopril: from 165 ± 13/100 ± 4 to 147 ± 11/87 ± 4 mmHg; nitrendipine: from 167 ± 17/100 ± 5 to 143 ± 9/86 ± 4 mmHg; P &lt; 0.05) and in reversing LVH (nitrendipine: from 87 ± 2 to 81 ± 1 g/m2; captopril: from 89 ± 2 to 85 ± 2 g/m2; P = 0.0001). Neither the left ventricular end-diastolic volume index nor the left ventricular ejection fraction changed significantly during the treatment period.

CONCLUSION
Nitrendipine is as effective as captopril in reducing both systolic and diastolic blood pressure and in reversing LVH. Neither drug showed any negative side effects on fasting plasma glucose and glycated hemoglobin (HbA1c) levels, and both maintain constant AERs.
Susceptibility to Type 1 Diabetes in the Senegalese Population Is Linked to HLA-DQ and Not TAP and LMP Genes
Authors: Chauffert M , Cissé A , Chevenne D , You J F , Michel S , Trivin F 
Published: March 2007

OBJECTIVE
To investigate the frequency of the transporter associated with antigen processing (TAP) and large multifunctional protease (LMP) alleles and their role in the susceptibility to type 1 diabetes, in comparison with the well-known HLA-DQ alleles susceptibility, in Senegalese subjects.

RESEARCH DESIGN AND METHODS
Three loci in the TAP/LMP region were analyzed in 92 type 1 diabetic subjects and 117 nondiabetic control subjects by means of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).

RESULTS
No association was found between the studied polymorphisms of TAP1, TAP2, and LMP2 and type 1 diabetes in the Senegalese population, in contrast to the HLA-DQA1 and DQB1 genes, which were associated with type 1 diabetes.

CONCLUSIONS
Diabetogenic genes in the class II HLA region are located near the DQA1 and DQB1 loci rather than the TAP and LMP loci.
Determination of Amputation Level in Ischemic Limbs: Reappraisal of the measurement of TcPo2
Authors: Wütschert Robert , Bounameaux Henri 
Published: March 2007

OBJECTIVE
To study the accuracy of the measurement of TcPo2 for the determination of the optimal level of amputation in patients with end-stage vascular disease (i.e., the level at which the reamputation rate and the proportion of too-proximal amputations will be minimized).

RESEARCH DESIGN AND METHODS
We used a Medline literature search of all published studies of the past 12 years that fulfilled predefined quality criteria, and we analyzed the data by means of receiver operating characteristic (ROC) curve.

RESULTS
Ten studies could be identified with a total of 615 lower-limb amputations (51% of them being performed in diabetic patients) and a reamputation rate of 16.4%. The best performances of the TcPo2 measurement were obtained between 10 and 20 mmHg with an accuracy of ∼ 80%.

CONCLUSIONS
Preoperative TcPo2 measurement may be of considerable help to predict stump outcome and level of amputation. Our study provides objective prognostic values for the range 0–50 mmHg and suggests that TcP02 should usually be 20 mmHg at the site of amputation, which will predict healing with 80% accuracy and should, therefore, not be used as a sole criteron. Despite this aid in making his decision about the amputation level, the surgeon still has to balance between his goal of achieving primary wound healing and his hope of preserving the maximal limb length and has to consider patient preferences.
The Trp64Arg Polymorphism of the β3-Adrenergic Receptor Gene: Lack of association with NIDDM and features of insulin resistance syndrome
Authors: Rissanen Johanna , Kuopusjärvi Marja , Pihlajamäki Jussi , Sipiläinen Raisa , Heikkinen Sami , Vanhala Mauno , Kekäläinen Päivi , Kuusisto Johanna , Laakso Markku 
Published: March 2007

OBJECTIVE
To investigate the association of the Trp64Arg polymorphism of the β3-adrenergic receptor gene with NIDDM and the features of insulin resistance syndrome in subjects from eastern Finland.

RESEARCH DESIGN AND METHODS
We determined the prevalence of the Trp64Arg polymorphism of the β3-adrenergic receptor gene by restriction fragment length polymorphism analysis in 110 patients with NIDDM (54 men and 56 women, age 63 ± 1 years, BMI 30.4 ± 0.5 kg/m2), in 183 patients with features of insulin resistance syndrome (103 men and 80 women, age 44 ± 0 years, BMI 31.1 ± 0.4 kb/m2), and in 82 normoglycemic control men (age 54 ± 1 years, BMI 26.3 ± 0.4 kg/m2).

RESULTS
The allele frequency of the Trp64Arg polymorphism of the β3-adrenergic receptor gene was similar in patients with NIDDM, in patients with insulin resistance syndrome, and in control subjects (0.08, 0.07, and 0.07, respectively; NS). In addition, this polymorphism was not associated with low resting metabolic rate, abdominal obesity, increased lipid oxidation, hypertension, or earlier development of NIDDM as previously described. Furthermore, in 82 normoglycemic male control subjects the Trp64Arg polymorphism was not associated with insulin resistance evaluated by the euglycemic-hyperinsulinemic clamp.

CONCLUSIONS
The Trp64Arg polymorphism of the beta β3-adrenergic receptor gene is unlikely to be a major genetic predisposer to NIDDM or insulin resistance syndrome in subjects from eastern Finland.
Evaluation of Skin Vasomotor Reflexes in Response to Deep Inspiration in Diabetic Patients by Laser Doppler Flowmetry: A new approach to the diagnosis of diabetic peripheral autonomic neuropathy
Authors: Aso Yoshimasa , Inukai Toshihiko , Takemura Yoshihiro 
Published: March 2007

OBJECTIVE
To evaluate the peripheral sympathetic function in feet of NIDDM patients by means of laser Doppler flowmetry.

RESEARCH DESIGN AND METHODS
After deep inspiration, we measured the vasoconstrictor response in the feet of 51 patients with NIDDM, as compared with those of 20 healthy control subjects, using laser Doppler flowmetry. Subjects whose skin temperature was &lt; 32°C were excluded from our study because a skin temperature of ∼ 34°C is the optimal temperature for the evaluation of skin vasomotor reflexes in response to a deep inspiration by laser Doppler flowmetry.

RESULTS
The vasoconstrictor response to deep inspiration in the big toe was significantly decreased in NIDDM patients compared with healthy subjects (26.8 ± 2.0 vs. 48.3 ± 18.5%, P &lt; 0.0001). In NIDDM patients, the vasoconstrictor response was positively correlated with the duration of diabetes, the median motor and sensory nerve conduction velocities, the coefficient of variation of the R-R interval at rest, and the postural fall in systolic blood pressure. The vasoconstriction was inversely correlated with the vibratory perception threshold.

CONCLUSIONS
Vasomotor reflexes in the lower limbs were markedly impaired in NIDDM patients. The measurement of vasoconstrictor responses to deep inspiration by using laser Doppler flowmetry is a novel and useful method for detecting peripheral sympathetic failure in diabetic patients.
Glomerular Hyperfiltration Is Associated With Blood Pressure Abnormalities in Normotensive Normoalbuminuric IDDM Patients
Authors: Pecis Miriam , Azevedo Mirela J , Gross Jorge L 
Published: March 2007

OBJECTIVE
To analyze the blood pressure patterns in normoalbuminuric IDDM patients with glomerular hyperfiltration.

RESEARCH DESIGN AND METHODS
A controlled cross-sectional study of 38 normotensive normoalbuminuric (urinary albumin excretion rate &lt;20 μg/min) IDDM patients (18 hyperfiltering [glomerular filtration rate &gt;134 ml · min−1 · 1.73 m−2] and 20 normofiltering) and 20 normal individuals matched for age, sex, and BMI was performed. The 24-h ambulatory blood pressure was monitored using an auscultatory technique (Pressurometer IV, Del Mar Avionics), the glomerular filtration rate was measured by 51Cr-labeled EDTA method, extracellular volume by the distribution volume of 51Cr-labeled EDTA, and the 24-h urinary albumin excretion rate by radioimmunoassay.

RESULTS
Mean nocturnal diastolic blood pressure was higher in hyperfiltering IDDM patients (70.4 ± mmHg), when compared with the control group (65.1 ± 5.3 mmHg, P = 0.04). Diastolic blood pressure night:day ratio was higher in hyperfiltering IDDM patients (92.0 ± 8.6%), when compared with normofiltering IDDM patients (85.9 ± 4.8%) and control subjects (87.0 ± 6.8%, P = 0.02). In IDDM patients, the glomerular filtration rate significantly correlated with the diastolic blood pressure night:day ratio (r = 0.5, P = 0.002), extracellular volume (r = 0.04, P = 0.002), and HbA1 (r = 0.3, P = 0.03). In stepwise multiple regression analysis, factors associated with glomerular filtration rate were diastolic blood pressure night:day ratio, extracellular volume, and HbA1 (adjusted r2 = 0.27, P = 0.003).

CONCLUSIONS
Glomerular hyperfiltration is associated with higher nocturnal diastolic blood pressure and with a blunted nocturnal decrease in diastolic blood pressure levels in normotensive and normoalbuminuric IDDM patients.
Induction of Long-Term Glycemic Control in Newly Diagnosed Type 2 Diabetic Patients by Transient Intensive Insulin Treatment
Authors: Ilkova Hasan , Glaser Benjamin , Tunçkale Aydin , Bagriaçik Nazif , Cerasi Erol 
Published: March 2007

OBJECTIVE
Type 2 diabetes is a slowly progressive disease, in which the gradual deterioration of glucose tolerance is associated with the progressive decrease in β-cell function. Hyperglycemia per se has deleterious effects on both beta-cell function and insulin action, which are partially reversible by the short-term control of blood glucose levels. We hypothesized that the induction of euglycemia, using intensive insulin therapy at the time of clinical diagnosis, could lead to a significant improvement in insulin secretion and action and thus alter the clinical course of the disease.

RESEARCH DESIGN AND METHODS
Thirteen newly diagnosed diet-unresponsive type 2 diabetic patients were treated with continuous subcutaneous insulin infusion (CSII) for 2 weeks and followed longitudinally while being treated with diet alone.

RESULTS
Four patients were considered therapeutic failures since CSII failed to induce euglycemia (n = 1) or glucose control deteriorated within 6 months after CSII (n = 3). The remaining nine patients were maintained on diet alone with adequate control from 9 to &gt; 50 months (median ± SE, 26 ± 4.8 months). In five patients, glycemic control deteriorated after 9–36 months, but a repeat 2-week CSII treatment reestablished control in four patients. One of these patients underwent a third CSII treatment 13 months later. At the time this article was written, six patients of the initial group were still controlled without medication 16–59 months (median ± SE, 45.5 ± 6.6 months) after the initiation of treatment. Body weight remained unchanged in all patients.

CONCLUSIONS
These findings suggest that in a significant proportion of type 2 diabetic patients who fail to respond to dietary measures, short-term intensive insulin treatment can effectively establish responsiveness, allowing long-term glycemic control without medication. Further studies are required to establish whether simpler treatment regimens could be equally effective. If the hypothesis offered here finds support, present approaches to the management of newly diagnosed type 2 diabetes may need to be revised.
Coronary Artery Disease in Diabetic Patients With Lower-Extremity Arterial Disease: Disease Characteristics and Survival: A report from the Coronary Artery Surgery Study (CASS) registry
Authors: Barzilay Joshua I , Kronmal Richard A , Bittner Vera , Eaker Elaine , Evans Campbell , Foster Eric D 
Published: March 2007

OBJECTIVE
Patients who have diabetes and lower-extremity arterial disease (LEAD) are at an increased risk of dying from coronary artery disease (CAD). This study was undertaken to: 1) define the clinical and arteriographic factors associated with LEAD among diabetic patients; 2) determine the long-term survival and predictors of mortality of diabetic patients with LEAD, compared to those without LEAD; and 3) determine if the presence of LEAD is an independent risk factor for mortality among diabetic patients with CAD.

RESEARCH DESIGN AND METHODS
A total of 263 diabetic patients from the Coronary Artery Surgery Study (CASS) registry with LEAD, who were ≥ 50 years of age, and who had arteriographically proven CAD, were identified and followed for a mean of 12.8 years. A total of 1,349 comparably aged diabetic patients from the CASS registry with CAD and no evidence of LEAD were followed for an equivalent period of time.

RESULTS
Compared with diabetic patients without LEAD, diabetic patients with LEAD were characterized by the presence of cerebrovascular disease, a high rate of current smoking, elevated systolic blood pressure, high grades of angina pectoris, and digitalis use. Severity of epicardial CAD and extent of CAD were not independent predictors of the presence of LEAD. On follow-up, diabetic patients with LEAD had significantly higher mortality (mostly cardiovascular) than diabetic patients without LEAD, with a median survival of 8.1 and 10.9 years, respectively. On multivariate analysis, age, the number of significantly narrowed coronary arteries, and the presence of left ventricular dysfunction predicted mortality in both subsets of diabetic patients. Among all the diabetic patients with CAD, the presence of LEAD was an independent risk factor for mortality.

CONCLUSIONS
Diabetic patients with LEAD have a higher mortality rate (mostly cardiovascular) than diabetic patients without LEAD, despite no apparent anatomic differences in the severity and extent of CAD. This suggests that factors associated with the presence of LEAD, other than the anatomy of the coronary circulation, may play a role in determining survival among diabetic patients with LEAD and CAD.
Power Spectral Analysis of Heart Rate Variability in Children and Adolescents With IDDM
Authors: Wawryk Andrew M , Bates David J , Couper Jennifer J 
Published: March 2007

OBJECTIVE
To investigate power spectral analysis (PSA) of heart rate variability (HRV) in children and adolescents with IDDM, its relationship with other measures of HRV and standard cardiovascular responses, and factors associated with reduced HVR.

RESEARCH DESIGN AND METHODS
A total of 130 subjects with IDDM aged 12.8 ± 3.2 years and 108 healthy control subjects were studied. Power spectra were analyzed from supine electrocardiograph (ECG) recordings by processing into consecutive R-R intervals and analysis using fast Fourier transformation. Standard cardiovascular responses to deep breathing and standing were performed.

RESULTS
IDDM subjects had a reduction in total power including both low-frequency (0.05–0.14 Hz; P = 0.0001) and high-frequency (0.14–0.40 Hz; P = 0.0002) components. These changes were seen from diagnosis. Other measures of HRV, coefficient of variation (CV) and standard deviation (SD) of mean resting heart rate, were also significantly lower in IDDM. All 20 (15%) of the 130 IDDM subjects with total power &lt; the 5th percentile in control subjects also had reduced HRV when measured by CV of heart rate. There was an independent relationship between age and the high-frequency component in IDDM subjects and control subjects. Total power correlated with mean heart rate (r = −0.56; P &lt; 0.0001), CV of heart rate (r = 0.90; P &lt; 0.00001), SD of heart rate (r = 0.91; P &lt; 0.00001), heart rate response to deep breathing (r = 0.45; P &lt; 0.0001), and duration in IDDM subjects. There was no correlation with short-term or long-term metabolic control. Retesting of 27 subjects showed a variability in total power and its components comparable to other measures of HRV and standard heart rate responses.

CONCLUSIONS
Changes in HRV are a sensitive and reproducible measure of early autonomic dysfunction in childhood. In this age-group, PSA appears no more sensitive a measure of reduced HRV than other closely correlated measures of HRV.