bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medial Artery Calcification Predicts Cardiovascular Mortality in Patients With NIDDM
Authors: Niskanen Leo , Siitonen Onni , Suhonen Matti , Uusitupa Matti I 
Published: March 2007

OBJECTIVE
To study the predictive value of medial artery calcification (Mönckeberg's sclerosis) in relation to 10-year cardiovascular mortality in patients with non-insulin-dependent diabetes mellitus (NIDDM).

RESEARCH DESIGN AND METHODS
We studied the predictive value of thigh medial and intimal artery calcifications to 10-year cardiovascular mortality in a well-characterized group of 133 middle-aged, newly diagnosed patients with NIDDM (70 men and 63 women).

RESULTS
At baseline, medial artery calcifications were found in 17% of the patients and intimal-type calcifications were found in 23%. During the follow-up, 21% of the diabetic patients died from cardiovascular causes. The age-adjusted odds ratio for cardiovascular mortality was 4.2 (95% confidence intervals: 1.5−11.3) for medial-type and 1.6 (0.6−4.3) for intimal-type calcifications. In multiple logistic regression analysis, including age, sex, systolic blood pressure, low-density- and high-density-lipoprotein cholesterol, very-low-density lipoprotein triglycerides, smoking, body mass index, fasting serum insulin, blood glucose, urinary albumin, and ischemic ECG changes, as well as the intimal artery calcification, the medial artery calcification was the dominant factor predicting cardiovascular mortality.

CONCLUSIONS
In this study medial artery calcification was a strong independent predictor of cardiovascular mortality in patients with newly diagnosed NIDDM. Whether these subjects had a longer duration of hyperglycemia before the diagnosis than those without medial artery calcifications remains unknown.
The ROC Curve in the Evaluation of Fasting Capillary Blood Glucose as a Screening Test for Diabetes and IGT
Authors: Bortheiry Aida L. , Malerbi Domingos A. , Franco Laercio J. 
Published: March 2007

OBJECTIVE
To assess the performance of different cutoff points of fasting capillary glycemia (FCG) in the diagnosis of diabetes and impaired glucose tolerance (IGT) using the receiver operating characteristics (ROC) curve approach.

RESEARCH DESIGN AND METHODS
This study included a sample of 4,019 subjects without a previous history of diabetes who were recruited for a confirmatory 2-h post-glucose challenge capillary glycemia from a larger sample of 21,847 individuals screened with FCG. The sensitivity and the specificity of FCG as a screening test were analyzed in the cutoff range 3.9–8.9 mmol/l, and the corresponding ROC curves were plotted to assess the performance of the test.

RESULTS
The screening test performance was better for diabetes than for IGT in the full range of cutoff points studied. Sensitivities ranged between 37.9 and 97.1% for diabetes and 1.8 and 94.4% for IGT; the areas under the ROC curves were 0.91 ± 0.01 and 0.75 ± 0.01, respectively. The cutoffs showing the best equilibrium between sensitivity and specificity approached 5.6 and 5.0 mmol/l for diabetes and IGT, respectively. Factors such as age, color, and family history of diabetes can affect the screening test performance.

CONCLUSIONS
ROC curves can provide useful information toward improving the usefulness of FCG as a screening test for abnormalities of glucose tolerance.
Hospital Use Among Diabetic Patients and the General Population
Authors: Aro Seppo , Kangas Tero , Reunanen Antti , Salinto Marjo , Koivisto Veikko 
Published: March 2007

OBJECTIVE
This register-based linkage study compared hospital use among diabetic and nondiabetic populations. The study focused on overall use, use by disease categories, and inpatient care caused by complications.

RESEARCH DESIGN AND METHODS
The patient data were derived from the Hospital Discharge Register and the Central Drug Register in Finland. All drug-treated diabetic patients and discharges of patients in a 3-year period were included in the study. Hospital use was measured by inpatient days, mean length of stay, and discharge rate.

RESULTS
Among diabetic patients were eligible for drug reimbursement, 14.2% had at least one hospital stay because of diabetes in a year, while 50.7% had at least one hospital stay for any cause. Only 12.4% of the nondiabetic population was hospitalized annually. Patients with diabetes as the principal diagnosis consumed about 3% of all inpatient days; patients who had diabetes either as the principal or as a subsidiary diagnosis used 8.3%; and people who were eligible for antidiabetic drug reimbursement used 13.3% of total inpatient days. Among diabetic children, the risk for hospitalization was 6.5 times higher than among nondiabetic children. With advancing age, causes other than diabetes increasingly dominated hospitalization among diabetic patients. Inpatient days because of cardiovascular diseases were 1.6−18 times more common among diabetic patients than among nondiabetic patients, depending on gender and age-group. Diabetic patients used many more hospital inpatient days than did the nondiabetic population for a number of other disease categories that are usually not related to diabetes.

CONCLUSIONS
Hospital use among diabetic patients is substantially &gt; that among the nondiabetic population, mainly because of cardiovascular and microvascular complications, but also because of diseases unrelated to diabetes.
Cholesterol Absorption and Cholesterol and Bile Acid Synthesis in Two Brothers With IDDM and Diarrhea
Authors: Gylling Helena , Miettinen Tatu A 
Published: March 2007

OBJECTIVE
To determine the best possible treatment for two brothers who had IDDM and bile acid malabsorption-associated disabling diarrhea that was resistant to cholestyramine, antibiotics, clonidine, loperamide, or anticholinergic drugs.

RESEARCH DESIGN AND METHODS
Our study paired these two brothers with control subjects. Serum noncholesterol sterols and fecal elimination of cholesterol and plant sterols were quantitated by gas-liquid chromatography.

RESULTS
Fecal losses of bile acids exceeded four to six times the control values, and cholesterol synthesis was increased two to three times. Cholesterol absorption efficiency and serum cholesterol concentrations were, respectively, within the high and low control range.

CONCLUSIONS
Bile acid malabsorption might have resulted from deranged intestinal motility, possibly contributed by gastrointestinal neuropathy, and some genetic factor.
Diet and Exercise in the Treatment of NIDDM: The need for early emphasis
Authors: Barnard R James , Jung Tiffany , Inkeles Stephen B 
Published: March 2007

OBJECTIVE
To investigate the effectiveness of an intensive diet and exercise program for controlling non-insulin-dependent diabetes mellitus (NIDDM) and reducing risk factors associated with macrovascular complications.

RESEARCH DESIGN AND METHODS
Medical charts obtained from 4,587 participants in a lifestyle modification program were screened for patients with NIDDM. A total of 652 patients was identified, and their responses to the 3-week program were analyzed.

RESULTS
Fasting glucose level was reduced from 10.0 to 8.45 mmol/l, and 71% of 197 subjects taking oral hypoglycemic agents and 39% of 212 taking insulin were able to discontinue their medication. Of the 243 not taking medication, 76% reduced their fasting glucose levels to ≤ 7.84 mmol/l. Blood pressure was significantly reduced, and of the 319 initially taking antihypertension drugs, 34% had their medication discontinued. Serum total and low-density lipoprotein cholesterol were reduced by 22% and triglycerides by 33%. The ratio of total to high-density lipoprotein cholesterol was reduced by 13%.

CONCLUSIONS
Lifestyle modification consisting of diet combined with aerobic exercise can be effective for controlling NIDDM and reducing risk factors associated with macrovascular complications in both men and women. The program was far more effective in controlling the disease in patients taking no medication or oral agents compared with patients taking insulin. These results stress the need for early emphasis on lifestyle modification in the treatment of NIDDM.
Relationship Between Dairy Product Consumption and Incidence of IDDM in Childhood in Italy
Authors: Fava Danila , Leslie R David G , Pozzilli Paolo 
Published: March 2007

OBJECTIVE
To test the hypothesis that the consumption of dairy products, including fluid cows' milk and cheese, is related to the incidence of insulin-dependent diabetes mellitus (IDDM), we correlated incidence rates in children 0–14 years of age with cows' milk and cheese consumption in nine regions of a single country, Italy.

RESEARCH DESIGN AND METHODS
Data on the incidence of IDDM were derived from the only nine Italian regions where primary and secondary sources of ascertainment were available for 1991. Data on fluid cows' milk and cheese consumption in the corresponding year in each region were obtained from the National Institute of Statistics.

RESULTS
The correlation between fluid milk consumption and incidence of IDDM in Italy was 0.84 (P &lt; 0.004, Poisson regression analysis). Cheese consumption was not related to IDDM incidence.

CONCLUSIONS
The results indicate that there is a relationship, even in a single country, between dairy product consumption and the incidence of IDDM that is confined to fluid milk consumption. Cows' milk may contain a triggering factor for the development of diabetes, but the high incidence of IDDM in Sardinia and in other countries worldwide cannot be explained simply by the quantity of fluid cows' milk consumed.
Physicians' Practices in Screening for the Development of Diabetic Nephropathy and the Use of Glycosylated Hemoglobin Levels
Authors: Miller Karen L , Hirsch Irl B 
Published: March 2007

OBJECTIVE
To compare outpatient screening of diabetic patients for nephropathy and measurement of glycosylated hemoglobin (GHb) levels to published American Diabetes Association (ADA) guidelines.

RESEARCH DESIGN AND METHODS
We reviewed charts from 157 diabetic patients followed for 27 months at the University of Washington's primary care clinics. The number of screening urinalyses, 24-h urine measurements, and GHb measurements were obtained. From these values, the frequency of screening tests, normalized by patient-year, could be compared with the ADA guidelines.

RESULTS
Forty-two percent of the patients received at least one urinalysis, and 5% had 24-h urine measurements. There were 0.48 urinalyses and 0.05 24-h urine measurements per patient-year. Of 14 type I diabetes patients, 5 had a urinalysis and 1 received a 24-h urine measurement. At least one GHb was measured for 85% of patients, and there were 1.66 GHb measurements per patient-year. Only 29% of patients received GHb concentrations as recommended by ADA guidelines.

CONCLUSIONS
Diabetic patients at this institution are not screened for nephropathy and do not receive GHb measurements according to the ADA guidelines. Because of recent advancements in the treatment of diabetic nephropathy and the results of the Diabetes Control and Complications Trial (DCCT), further efforts are needed for educating primary care physicians about standards of care of patients with diabetes.
Increased Risk Factors for Coronary Artery Disease in Japanese Subjects With Hyperinsulinemia or Glucose Intolerance
Authors: Yamada Nobuhiro , Yoshinaga Hideyo , Sakurai Noboru , Shimano Hitoshi , Gotoda Takanari , Ohashi Yasuo , Yazaki Yoshio , Kosaka Kinori 
Published: March 2007

OBJECTIVE
To understand the interrelationship of coronary artery disease (CAD) risk factors including hyperlipidemia, hypertension, and glucose intolerance to prevent and better manage this disease.

RESEARCH DESIGN AND METHODS
We performed a 100-g oral glucose tolerance test in 2,113 subjects, and we evaluated their plasma lipid levels, blood pressure (BP), and plasma glucose and plasma insulin responses.

RESULTS
Multiple regression analysis demonstrated a significant relationship of either BP, plasma triglyceride (TG), or high-density lipoprotein (HDL) cholesterol levels to plasma insulin and glucose response after the glucose load. Plasma cholesterol levels were related only to the plasma glucose response. In subjects matched for age, sex, and body mass index (BMI) with hyperinsulinemia or normoinsulinemia, the hyperinsulinemic subjects had a significantly higher mean BP and plasma TG level than the normoinsulinemic subjects (128.8/82.3 vs. 122.9/79.3 mmHg and 172.1 vs. 119.4 mg/dl), and the HDL-cholesterol level was significantly lower (43.9 vs. 47.8 mg/dl). Furthermore, subjects matched for age, sex, and BMI with glucose intolerance had a higher mean BP (128.4/81.8 vs. 123.5/78.7 mmHg) and higher plasma TG level (154.2 vs. 123.0 mg/dl) than those without glucose intolerance.

CONCLUSIONS
Based on these findings, subjects with hyperinsulinemia or glucose intolerance should be carefully managed to prevent CAD, because they have more numerous and more severe risk factors than subjects with normal plasma insulin levels or subjects without glucose intolerance.
The Predictive Value of Microalbuminuriq in IPPM: A five-year follow-up study
Authors: Almdal Thomas , Nörgaard Kjrsten , Feldt-Rasmussen Bo , Deckert Torsten 
Published: March 2007

OBJECTIVE
To investigate the predictive value of microalbuminuria and the annual increase of albumin excretion as risk factors for diabetic nephropathy.

RESEARCH DESIGN AND METHODS
A 5-year follow-up of patients with microalbuminuria (urinary albumin excretion [UAE\ = 30-299 mg/24 h) and matched patients with normoalbuminuria (UAE &lt; 30 mg/24 h). The initial classification was based on one single 24-h urine collection. The annual increase in UAE was calculated by linear regression analysis of log-transformed UAE on time. This study was conducted at the outpatient clinic of the Steno Diabetes Center. The study subjects included 118 insulin-dependent diabetes mellitus (IDDM) patients between 18 and 50 years of age with microalbuminuria and 112 matched control patients with normal UAE with an age at diabetes onset of &lt;31 years. The main outcome measures were UAE, annual change in UAE rate (percentage per year), and the prevalence of retinopathy.

RESULTS
After 5 years, 39 (33%, 24-42 CI [95% confidence interval]) patients with microalbuminuria had normoalbuminuria, 57 (48%, 38-57 CI) still had microalbuminuria, and 22 (19%, 12-27 CI) had developed diabetic nephropathy. Among the 112 patients with normoalbuminuria in 1985, 9 (8%, 4-15 CI) had developed microalbuminuria, and 2 (2%, 0-6 CI) had developed diabetic nephropathy. Of the 79 patients with persistent albuminuria, only 36 (46%, 34-57 CI) were progressors with a rate of progression of &gt;5%/year. Progressors had significantly higher HbA1c, higher mean blood pressure, and a higher incidence of proliferative retinopathy compared with nonprogressors. Multiple regression analysis only identified mean HbA1c as an independent predictor of the rate of progression. Smoking was significantly more prevalent in patients with persistent albuminuria.

CONCLUSIONS
Microalbuminuria is a predictor of progression to diabetic nephropathy; however, not as strong as suggested previously. Calculation of the annual increase in UAE seems to be a more specific method of identifying patients who will develop diabetic nephropathy.
Smoking Is Associated With Progression of Diabetic Nephropathy
Authors: Sawicki Peter T , Didjurgeit Ulrike , Mühlhauser Ingrid , Bender Ralf , Heinemann Lutz , Berger Michael 
Published: March 2007

OBJECTIVE
To investigate the association between cigarette smoking and the progression of diabetic nephropathy.

RESEARCH DESIGN AND METHODS
A prospective, follow-up study over one year was conducted in a sequential sample of 34 smokers, 35 nonsmokers, and 24 ex-smokers with type I diabetes, hypertension, and diabetic nephropathy. Progression of renal disease was defined according to the stage of nephropathy as an increase in proteinuria or serum creatinine or a decrease in the glomerular filtration rate.

RESULTS
Progression of nephropathy was less common in nonsmokers (11%) than in smokers (53%) and patients who had quit smoking (33%), P &gt; 0.001. In a stepwise logistic regression analysis, cigarette pack years, 24-h sodium excretion, and GHb were independent predictive factors for the progression of diabetic nephropathy. Because blood pressure (BP) was well controlled in these patients and most values were within a normotensive range, neither standing, sitting, nor supine BP values were associated with progression of nephropathy.

CONCLUSIONS
Cigarette smoking represents an important factor associated with progression of nephropathy in treated hypertensive type I diabetic patients.
Ethnic Differences in Human Leukocyte Antigen Markers of Susceptibility to IDDM
Authors: Cruickshanks Karen J , Jobim Luiz F , Lawler-Heavner Janet , Neville Terri G , Gay Elizabeth C , Chase H Peter , Klingensmith Georgeanna , Todd John A , Hamman Richard F 
Published: March 2007

OBJECTIVE
To determine whether genetic differences explain the lower risk of developing insulin-dependent diabetes mellitus (IDDM) for Hispanic versus non- Hispanic white children in Colorado.

RESEARCH DESIGN AND METHODS
Hispanic (n = 62) and non-Hispanic white (n = 82) subjects with IDDM identified from the Colorado IDDM Registry and healthy, nondiabetic control subjects were recruited. Human leukocyte antigen (HLA) serologic typing and sequence-specific oligonucleotide typing of DQA1 and DQB1 alleles were performed.

RESULTS
HLA and allele associations with IDDM were similar in both ethnic groups. HLA-DR3 and HLA-DR4 were more common in IDDM subjects in both ethnic groups. Subjects with DQB1 alleles encoding aspartic acid (Asp) in position 57 were less likely to have IDDM, irrespective of ethnic background. HL A-DR3 was less common among Hispanic subjects than non-Hispanic white control subjects (4.4 vs. 17.5%, Hispanics vs. non-Hispanic whites, P = 0.04).

CONCLUSIONS
These data suggest that the lower prevalence of HLA-DR3 in the Hispanic population, a pattern consistent with the presence of Amerindian admixture, may explain the lower rate of IDDM in the Hispanic population.
Linear Loss of Insulin Secretory Capacity During the Last Six Months Preceding IDDM: No effect of antiedematous therapy with ketotifen
Authors: Böhmer Kirsten P , Kolb Hubert , Kuglin Bernd , Zielasek Jürgen , Hübinger Achim , Lampeter Eberhard F , Weber Bruno , Kolb-Bachofen Victoria , Jastram H U , Bertrams Jörg , Arnold Gries F 
Published: March 2007

OBJECTIVE
To investigate the effect of an antiedematous therapy with the histamine antagonist ketotifen on β-cell function in late prediabetes.

RESEARCH DESIGN AND METHODS
In a randomized double-blind placebo-controlled study, ketotifen was administered for 3 months to 9 islet cell antibody positive (ICA+) prediabetic patients with a first-phase insulin response (FPIR) below the 2.5th percentile to preserve residual β-cell function. Patients were followed by intravenous glucose tolerance tests (IVGTTs) every 4—6 weeks for determination of FPIR, HbA1, ICAs, and insulin autoantibodies. In 5 patients, the immune activation state was followed by determination of serum levels of tumor necrosis factor-α (TNF-α), (β2-microglobulin, and C-reactive protein (CRP).

RESULTS
Seven of nine patients developed diabetes within one year of followup. Irrespective of treatment with ketotifen, a slow and linear decline (P &lt; 0.05) of 1 + 3-min insulin values was observed in sequential IVGTTs in those 7 patients who developed insulin-dependent diabetes mellitus (IDDM) during follow-up. The 2 other patients showed wide fluctuations of the insulin response with a threefold increase of initial insulin levels. HbAi did not correlate with FPIR. Fasting blood glucose increased significantly during the study (P &lt; 0.05). Individual levels of serum TNF-α, CRP, and β2-microglobulin did not change during the study.

CONCLUSIONS
The study could not demonstrate preservation of β-cell function by ketotifen in the late stage before manifestation of clinical diabetes. Manifestation is preceded in the last 6 months by a steady loss of the FPIR without rapid deterioration immediately before diagnosis and without signs of increased immune activity.
Use Of Runs Test to Assess Cardiovascular Autonomic Function in Diabetic Subjects
Authors: Chau Nguyen Phong , Mestivier Denis , Chanudet Xavier , Bauduceau Bernard , Gautier Daniel , Larroque Pierre 
Published: March 2007

OBJECTIVE
We suggest a simple, noninvasive method to assess the autonomie function in diabetic subjects. The method requires only a monitoring of heart rate (HR) with subjects in the sitting position.

RESEARCH DESIGN AND METHODS
Sixty diabetic subjects, 44 men and 16 women, between 20-80 years of age, were recruited, chronologically, for this study. Subjects treated for high blood pressure were not included. Their autonomic function was assessed by the total score of five classical cardiovascular function tests. In the same subjects and in 44 healthy subjects, blood pressure and HR were determined from beat to beat by the Finapres system with subjects in the sitting position. We examined the randomness of the HR changes by calculating the z statistic of the runs test on 1,000 successive HR readings (the z value is low if the HR changes are random). When the HR changes are random, we consider that the autonomic control of HR is impaired.

RESULTS
The z values of HR changes were significantly lower in diabetic subjects compared with normal subjects (2.98 ± 0.97 vs. 3.54 ± 0.97, ,P &lt; 0.004). In diabetic subjects, the z value was closely correlated to the total score of disautonomy (r = –0.66, P &lt; 0.0001, after correction for age effect) and to the office systolic blood pressure (r = –0.43, P &lt; 0.001).

CONCLUSIONS
The z value of HR changes might be a marker of the autonomic function in diabetic subjects.
A Mathematical Model for the Determination of Total Area Under Glucose Tolerance and Other Metabolic Curves
Authors: Tai Mary M 
Published: March 2007

OBJECTIVE
To develop a mathematical model for the determination of total areas under curves from various metabolic studies.

RESEARCH DESIGN AND METHODS
In Tai's Model, the total area under a curve is computed by dividing the area under the curve between two designated values on the X-axis (abscissas) into small segments (rectangles and triangles) whose areas can be accurately calculated from their respective geometrical formulas. The total sum of these individual areas thus represents the total area under the curve. Validity of the model is established by comparing total areas obtained from this model to these same areas obtained from graphic method Gess than ±0.4%). Other formulas widely applied by researchers under- or overestimated total area under a metabolic curve by a great margin.

RESULTS
Tai's model proves to be able to 1) determine total area under a curve with precision; 2) calculate area with varied shapes that may or may not intercept on one or both X/Y axes; 3) estimate total area under a curve plotted against varied time intervals (abscissas), whereas other formulas only allow the same time interval; and 4) compare total areas of metabolic curves produced by different studies.

CONCLUSIONS
The Tai model allows flexibility in experimental conditions, which means, in the case of the glucose-response curve, samples can be taken with differing time intervals and total area under the curve can still be determined with precision.