bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glucagonostatic Actions and Reduction of Fasting Hyperglycemia by Exogenous Glucagon-Like Peptide I(7–36) amide in type I diabetic patients
Authors: Creutzfeldt Werner O C , Kleine Nicola , Willms Berend , Ørskov Cathrine , Holst Jens J , Nauck Michael A 
Published: March 2007

OBJECTIVE
Glucagon-like peptide I(7–36) amide (GLP-1) is a physiological incretin hormone that, in slightly supraphysiological doses, stimulates insulin secretion, lowers glucagon concentrations, and thereby normalizes elevated fasting plasma glucose concentrations in type II diabetic patients. It is not known whether GLP-1 has effects also in fasting type I diabetic patients.

RESEARCH DESIGN AND METHODS
In 11 type I diabetic patients (HbA1c 9.1 ± 2.1%; normal, 4.2–6.3%), fasting hyperglycemia was provoked by halving their usual evening NPH insulin dose. In random order on two occasions, 1.2 pmol · kg−1 · min−1 GLP-1 or placebo was infused intravenously in the morning (plasma glucose 13.7 ± 0.9 mmol/l; plasma insulin 26 ± 4 pmol/l). Glucose (glucose oxidase method), insulin, C-peptide, glucagon, GLP-1, cortisol, growth hormone (immunoassays), triglycerides, cholesterol, and nonesterified fatty acids (enzymatic tests) were measured.

RESULTS
Glucagon was reduced from ∼8 to 4 pmol/l, and plasma glucose was lowered from 13.4 ± 1.0 to 10.0 ± 1.2 mmol/l with GLP-1 administration (plasma concentrations ∼100 pmol, P &lt; 0.0001), but not with placebo (14.2 ± 0.7 to 13.2 ± 1.0). Transiently, C-peptide was stimulated from basal 0.09 ± 0.02 to 0.19 ± 0.06 nmol/l by GLP-1 (P &lt; 0.0001), but not by placebo (0.07 ± 0.02 to 0.07 ± 0.02). There was no significant effect on nonesterified fatty acids (P = 0.34), triglycerides (P = 0.57), cholesterol (P = 0.64), cortisol (P = 0.40), or growth hormone (P = 0.53).

CONCLUSIONS
Therefore, exogenous GLP-1 is able to lower fasting glycemia also in type I diabetic patients, mainly by reducing glucagon concentrations. However, this alone is not sufficient to normalize fasting plasma glucose concentrations, as was previously observed in type II diabetic patients, in whom insulin secretion (C-peptide response) was stimulated 20-fold.
Impaired Glucose Tolerance, Diabetes, and Cardiovascular Disease Risk Factor Profiles in the Elderly: The Honolulu Heart Program
Authors: Rodriguez Beatriz L , Curb Jess David , Burchfiel Cecil M , Huang Boji , Sharp Dan S , Ye Lu Guiqing , Fujimoto Wilfred , Yano Katsuhiko 
Published: March 2007

OBJECTIVE
The relationship between glucose tolerance status and other cardiovascular disease (CVD) risk factors was evaluated in a cohort of Japanese-American men (n = 3,741) ages 71–93 years who participated in the fourth examination of the Honolulu Heart Program in 1991–1993.

RESEARCH DESIGN AND METHODS
In this cross-sectional study, subjects were classified by reported diabetes and glucose tolerance status using questionnaires and the World Health Organization (WHO) criteria, respectively.

RESULTS
The prevalence of reported diabetes was 17%. Among the men who completed an oral glucose tolerance test and had no history of diabetes (n = 1,900), 23% were diagnosed as diabetic and 39% had impaired glucose tolerance (IGT) by WHO criteria. The CVD risk factor profiles of men with IGT and diabetes were significantly more adverse compared with men with normal glucose tolerance after adjustment for age. The rates of hypertension, mean levels of BMI, waist-to-hip ratio, triglycerides, and fasting insulin were higher in men with IGT and diabetes compared with normal subjects. Opposite trends were observed for HDL cholesterol. Two-hour insulin was significantly higher among men with IGT and previously undiagnosed diabetes. Men with known diabetes had a lower physical activity index and higher fibrinogen levels than normal subjects. No significant differences were observed for current smoking and alcohol intake. Differences in risk factor levels by glucose tolerance status remained after adjustment for age, physical activity, BMI, and waist-to-hip ratio.

CONCLUSIONS
These findings show that among elderly men of Japanese ancestry, impaired glucose tolerance and undiagnosed and known diabetes are highly prevalent, and these conditions are associated with adverse CVD factor profiles.
Low Risk of Post-Cesarean Section Infection in Insulin-Requiring Diabetic Women
Authors: Riley Laura E , Tuomala Ruth E , Heeren Tim , Greene Michael F 
Published: March 2007

OBJECTIVE
The purpose of this study was to determine if insulin-requiring diabetic women undergoing nonelective cesarean section are at higher risk for postoperative infection than nondiabetic women.

RESEARCH DESIGN AND METHODS
Medical records of a cohort of insulin-requiring diabetic women who underwent cesarean section after labor or rupture of membranes and nondiabetic control subjects matched for age and insurance status were retrospectively reviewed. Data abstracted included maternal characteristics, antepartum, intrapartum, and postpartum events.

RESULTS
Post-cesarean section infection including endometritis, wound infection, and septic pelvic thrombophlebitis occurred in 10.2% of 205 diabetic women and 12.1% of control subjects, in whom antibiotic prophylaxis was used in 79% of diabetic women and 84% of control subjects. Duration of rupture of membranes was a significant risk factor for post-cesarean section infection in both groups.

CONCLUSIONS
Insulin-requiring diabetic women undergoing nonelective cesarean section with antimicrobial prophylaxis have a rate of postoperative infection similar to that for nondiabetic women.
Diabetic Foot Infections: Bacteriology and activity of 10 oral antimicrobial agents against bacteria isolated from consecutive cases
Authors: Goldstein Ellie J C , Citron Diane M , Nesbit Catherine A 
Published: March 2007

OBJECTIVE
To study the relative frequency of bacterial isolates cultured from community-acquired foot infections and assess their comparative in vitro susceptibility to sparfloxacin, levofloxacin, and eight other commonly used oral antimicrobial agents.

RESEARCH DESIGN AND METHODS
This is a prospective study in which the infected wounds of 25 consecutive diabetic patients seen by one of the authors were cultured as they entered the hospital. Isolates were stored and tested for susceptibility to 10 oral antimicrobial agents using the agar dilution method.

RESULTS
Staphylococcus aurcus was the most common isolate (76% of patients), including methicillin-resistant S. aurcus (MRSA) in 5 of 25 (20%) patient wounds. Streptococci, enterococci, Enterobacteriaceae, and anaerobes were also present in ≥40% of patient wounds. Sparfloxacin and levofloxacin were the most active agents tested with activity against ≥88% of isolates. Isolates resistant to sparfloxacin and levofloxacin included MRSA, enterococci, and some anaerobes. When analyzed by prior exposure to antibiotics, patients who had previously received oral antibiotics were more likely to have MRSA, enterococci, and Pseudomonas aeruginosa isolated and less likely to have Enterobacteriaceae and anaerobes isolated from their wounds.

CONCLUSIONS
MRSA and enterococci are now a common cause of diabetic foot infections, and the increased prevalence may be due to antimicrobial use. These wounds may require use of combined antimicrobial therapy for initial outpatient management. The new fluoroquinolones, sparfloxacin and levofloxacin, were the most active oral agents tested.
Proinsulin Secretion During the First 3 Years After Diagnosis in Diabetic Patients With and Without Islet Cell Antibodies
Authors: Gottsäter A , Owens D R , Luzio S , Sundkvist G 
Published: March 2007

OBJECTIVE
To evaluate proinsulin secretion in different types of NIDDM.

RESEARCH DESIGN AND METHODS
Proinsulin and insulin were evaluated at diagnosis of diabetes and 3 years later (fasting and after stimulation with intravenous glucose and glucagon) in 10 NIDDM patients without islet cell antibodies (ICAs) at diagnosis (age 52 ± 4 years), 11 NIDDM patients with ICAs at diagnosis (age 50 ± 5 years), and 21 healthy control subjects (age 53 ± 4 years).

RESULTS
At diagnosis, fasting proinsulin was higher in NIDDM patients without ICAs than in control subjects (39.6 ± 10.0 vs. 12.8 ± 1.6 pmol/l, P &lt; 0.01). Proinsulin response to intravenous glucose decreased in NIDDM patients with ICAs (from 35.6 ± 6.2 to 13.5 ± 5.4 pmol/l, P &lt; 0.05), but remained unchanged in those without ICAs. At 3 years after diagnosis, fasting proinsulin (10.0 ± 3.7 vs. 59.1 ± 17.0 pmol/l) and proinsulin responses to intravenous glucose (13.5 ± 5.4 vs. 103.9 ± 35.1 pmol/l) and to intravenous glucagon (7.4 ± 3.9 vs. 36.0 ± 7.7 pmol/l) were much lower (P &lt; 0.01) in NIDDM patients with ICAs than in those without ICAs.

CONCLUSIONS
After diagnosis of diabetes, proinsulin secretion decreases significantly in NIDDM patients with ICAs and remains constant in those without.
Cardiovascular Disease and Its Risk Factors in IDDM in Europe
Authors: Koivisto V A , Stevens I K , Mattock M , Ebeling P , Muggeo M , Stephenson J , Idzior-Walus B ,   The EURODIAB IDDM Complications Study Group
Published: March 2007

OBJECTIVE
To study the prevalence of cardiovascular disease (CVD), its risk factors, and their associations in IDDM patients in different European countries.

RESEARCH DESIGN AND METHODS
The prevalence of CVD (a past history or electrocardiogram abnormalities) and its risk factors were examined in a cross-sectional study in 3,250 IDDM patients from 16 European countries (EURODIAB IDDM Complications Study). The patients were examined in 31 centers and were stratified between centers for age, sex, and duration of diabetes. The mean ± SD duration of diabetes was 14.7 ± 9.3 years.

RESULTS
The prevalence of CVD was 9% in men and 10% in women. The prevalence increased with age (from 6% in patients 15–29 years old to 25% in patients 45–59 years old) and with duration of diabetes. The between-center variation for the whole population was from 3 to 19%. In both sexes, fasting triglyceride concentration was higher and HDL cholesterol lower in those patients with CVD than in those without. In men, duration of diabetes was longer, waist-to-hip ratio greater, and hypertension more common in patients with CVD. In women, a greater BMI was associated with increased prevalence of CVD. There was no association between insulin dose, HbA1c level, age-adjusted rate of albumin excretion, or smoking status and CVD. Waist-to-hip ratio, particularly in men, was positively associated with age, age-adjusted HbA1c, prevalence of smoking, daily insulin dose, albumin excretion rate, and fasting triglyceride concentrations.

CONCLUSIONS
The overall prevalence of CVD in these IDDM patients was ∼ 10%, increasing with age and duration of diabetes and with a sixfold variation between different European centers. CVD prevalence was most strongly associated with elevated triglyceride and decreased HDL cholesterol concentrations. CVD was also associated with albuminuria, but when adjusted by age, this association vanished. Increasing waist-to-hip ratio was associated with a number of adverse characteristics, particularly in IDDM men, reflecting the metabolic syndrome previously described in other populations.
Mortality and Morbidity in Diabetic and Nondiabetic Patients During a 2-Year Period After Coronary Artery Bypass Grafting
Authors: Herlitz Johan , Wognsen Gunnar Brandrup , Emanuelsson Håkan , Haglid Maria , Karlson Björn W , Karlsson Thomas , Albertsson Per , Westberg Staffan 
Published: March 2007

OBJECTIVE
To describe mortality and morbidity during a 2-year period after coronary artery bypass grafting (CABG) among diabetic and nondiabetic patients.

RESEARCH DESIGN AND METHODS
All the patients in western Sweden in whom CABG was undertaken between June 1988 and June 1991 and in whom concomitant procedures were not performed were registered prospectively. The study was a prospective follow-up.

RESULTS
Diabetic patients (n = 268) differed from nondiabetic patients (n = 1,859) in that more women were included, and the patients more frequently had a previous history of myocardial infarction (MI), hypertension, congestive heart failure, intermittent claudication, and obesity. Diabetic patients more frequently required reoperation and had a higher incidence of peri- and postoperative neurological complications. Mortality during the 30 days after CABG was 6.7% in diabetic patients versus 3.0% in nondiabetic patients (P &lt; 0.01). Mortality between day 30 and 2 years was 7.8 and 3.6%, respectively (P &lt; 0.01). During 2 years of follow-up, a history of diabetes appeared to be a significant independent predictor of death. Whereas the development of MI after discharge from the hospital did not significantly differ between the two groups; 6.3% of diabetic patients developed stroke versus 2.5% in nondiabetic patients (P &lt; 0.001).

CONCLUSIONS
Diabetic patients have a mortality rate during the 2-year period after CABG that is about twice that of nondiabetic patients during both the early and late phase after the operation.
A Foot Risk Classification System to Predict Diabetic Amputation in Pima Indians
Authors: Mayfield Jennifer A , Reiber Gayle E , Nelson Robert G , Greene Tom 
Published: March 2007

OBJECTIVE
To quantify the contribution of various risk factors to the risk of amputation in diabetic patients and to develop a foot risk scoring system based on clinical data.

RESEARCH DESIGN AND METHODS
A population case-control study was undertaken. Eligible subjects were 1) 25-85 years of age, 2) diabetic, 3) 50% or more Pima or Tohono O'odham Indian, 4) lived in the Gila River Indian Community, and 5) had had at least one National Institutes of Health research examination. Case patients had had an incident lower extremity amputation between 1983 and 1992; control subjects had no amputation by 1992. Medical records were reviewed to determine risk conditions and health status before the pivotal event that led to the amputation.

RESULTS
Sixty-one people with amputations were identified and compared with 183 control subjects. Men were more likely to suffer amputation than women (odds ratio [OR] 6.5, 95% CI 2.6–15), and people with diabetic eye, renal, or cardiovascular disease were more likely to undergo amputation than those without (OR 4.6, 95% CI 1.7–12). The risk of amputation was almost equally associated with these foot risk factors: peripheral neuropathy, peripheral vascular disease, bony deformities, and a history of foot ulcers. After controlling for demographic differences and diabetes severity, the ORs for amputation with one foot risk factor was 2.1 (95% CI 1.4–3.3), with two risk factors, 4.5 (95% CI 2.9–6.9), and with three or four risk factors, 9.7 (95% CI 6.3–14.8).

CONCLUSIONS
Male Sex, end-organ complications of eye, heart, and kidney, and poor glucose control were associated with a higher amputation rate. Peripheral neuropathy, peripheral vascular disease, deformity, and a prior ulcer were similarly equally associated with an increased risk of lower extremity amputation.
Impaired Peripheral Vasomotion in Diabetes
Authors: Stansberry Kevin B , Shapiro Shane A , Hill Michael A , McNitt Patricia M , Meyer Martin D , Vinik Aaron I 
Published: March 2007

OBJECTIVE
To test the hypothesis that vasomotion, the rhythmic contraction exhibited by small arteries and arterioles, is impaired in diabetic subjects compared with healthy control subjects.

RESEARCH DESIGN AND METHODS
We mathematically modeled the oscillations in laser Doppler microvascular measurements taken from the pulpar surface of the index finger in 20 healthy control subjects and 20 age-matched diabetic subjects (8 with type I and 12 with type II diabetes). The mean duration of diabetes was 17.1 ± 2.3 years, and mean HbA1c was 9.1 ± 0.4%. Blood flow was measured for 5 min as subjects rested quietly in a closed room. Fast Fourier transformation was performed to provide the frequency power spectrum of each recording. Amplitude of vasomotion was correlated with six quantitative measurements of neuropathy.

RESULTS
Diabetic subjects had impaired low-frequency oscillation vasomotion in 75% of age-matched patients (15 of 20 patients), with mean amplitudes of 24.9 ± 6.4 vs. 129.0 ± 33.2 (P &lt; 0.0039). Of six somatic and autonomic neuropathy variables, only the warm thermal sensory threshold correlated significantly with the mean amplitude of vasomotion (r = −0.75, P &lt; 0.0009).

CONCLUSIONS
Patterns of peripheral vasomotion are clearly disordered in diabetes. The loss of low-frequency oscillations observed here suggests a peripheral vascular abnormality that extends past the capillary network to arterial vessels. It is uncertain whether the accompanying small unmyelinated nerve C-fiber dysfunction is a cause or consequence of the impaired microvascular function. Measurement of vasomotion may prove useful as a novel test for peripheral neurovascular function.
Pain Intensity and Blood Pressure Reactions During a Cold Pressor Test in IDDM Patients
Authors: Luft Dieter , Lay Andreas , Benda Norbert , Kort Christine , Hofmann Valerie , Hardin Hedwig , Renn Walter 
Published: March 2007

OBJECTIVE
To determine the contribution of altered pain perception to the impaired blood pressure reactions during a cold pressor test in diabetic patients. Reduced blood pressure increases have been observed in diabetic patients during a cold pressor test and have been attributed to an impaired efferent sympathetic function.

RESEARCH DESIGN AND METHODS
We investigated pain intensities and blood pressure reactions simultaneously during a cold pressor test in 30 IDDM patients (diabetes duration 12 ± 6 years, HbA1c 7.5 ± 1.4%) and in 30 normal control subjects with comparable sex distribution, age, height, BMI, physical fitness, and smoking habits.

RESULTS
Initial pain intensities and respective time courses did not differ between the two groups. The initial blood pressure response was significantly smaller in diabetic patients (P &lt; 0.002). Correlations of diastolic blood pressure increases in diabetic patients with initial pain intensity, standard cardiovascular reflex tests, age, clock time, smoking habits, disease duration, and actual blood glucose concentrations did not reach statistical significance. Pain intensity and diastolic blood pressure increases, however, were correlated to HbA1c concentrations in diabetic patients.

CONCLUSIONS
Impaired pain perception is not the cause of the impaired reactions of blood pressure in diabetic patients during the cold pressor test, leaving very early deterioration of either cerebral processing of pain stimuli, cardiac function, efferent sympathetic nerves, or decreased vascular reactivity as possible explanations.
Diet After Pancreas Transplantation
Authors: Markowski Dawn M , Larsen Jennifer L , McElligott Maxine C , Walter Georgia A , Miller Suzanne A , Frisbie Kecia , Stratta Robert J 
Published: March 2007

OBJECTIVE
To determine whether discontinuation of insulin therapy and glucose monitoring and instructions to increase dietary salt and water intake after pancreas transplantation (PTX) resulted in changes in food choices.

RESEARCH DESIGN AND METHODS
All PTX recipients who had completed a preoperative diet record, had received their PTX &gt; 6 months before, had stable pancreas and kidney function, and were on a stable diet were invited to submit a 3-day post-PTX diet record. Of the 14 eligible, 11 agreed to participate and completed the study (2 women and 9 men). Their pre- and post-PTX diet records were analyzed by computer program. Weight, glycohemoglobin, blood pressure, medications, and fasting lipids both before and after PTX were also analyzed.

RESULTS
The recipients were studied 576 ± 60 days post-PTX, on average. Total calories and BMI were unchanged after PTX. Before PTX, 34% of calories were in fats, 49% in carbohydrate, and 17% in protein with no change in distribution of calories after PTX, although there was a trend toward greater saturated fat intake. Total salt intake was increased after PTX (P &lt; 0.01) because of sodium bicarbonate administration, although dietary salt intake did not change. The HDL cholesterol concentration increased and cholesterol-to-HDL ratio decreased after PTX (P &lt; 0.05), while the remaining lipids were unchanged.

CONCLUSION
Weight, total calories and distribution of calories, and dietary salt were unchanged after PTX, and diet did not explain the changes in HDL cholesterol or cholesterol-to-HDL ratio. These preliminary diet results suggest that greater emphasis on dietary instruction may be needed after PTX.
Diabetes With the 3243 Mitochondrial tRNALeu(UUR) Mutation: Characteristic neuroimaging findings
Authors: Suzuki Yoshihiko , Hata Takashi , Miyaoka Hitoshi , Atsumi Yoshito , Kadowaki Hiroko , Taniyama Matsuo , Kadowaki Takasi , Odawara Masato , Tanaka Yasushi , Asahina Takayuki , Matsuoka Kempei 
Published: March 2007

OBJECTIVE
To investigate the basis of central nervous system dysfunction in diabetes associated with the 3243 mitochondrial tRNA mutation, we studied neuroimaging findings in patients with this disease.

RESEARCH DESIGN AND METHODS
We screened 205 diabetic patients. Those patients who had the 3243 mutation in leukocytes or muscle were enrolled. All the subjects underwent computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), and N-isopropyl-p-[123I]iodoamphetamine ([123I]IMP) single-photon emission computed tomography (SPECT) of the brain.

RESULTS
None of the nine subjects with the 3243 mutation had the typical clinical picture of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes, and none had neurological focal signs. CT or MRI revealed diffuse brain atrophy in three patients (33%) and cerebellar atrophy in one (11%). Abnormal high intensity areas were observed on MRI in five patients (56%). The overall prevalence of brain abnormalities was 56% (5 of 9) on CT and 78% (7 of 9) on MRI scans. MRA revealed no stenotic lesions. SPECT showed reduced accumulation of [123I]IMP in the right or left parieto-occipital region in eight patients (89%).

CONCLUSIONS
Reduced accumulation of [123I]IMP in the parieto-occipital cortex was found in a high proportion of our subjects on SPECT. This imaging finding might be characteristic of diabetes associated with the 3243 mitochondrial tRNA mutation and may be a sign of latent central nervous system dysfunction.
A Major Improvement in the Prognosis of Individuals With IDDM in the Past 30 Years in Japan
Authors: Nishimura Rimei , Matsushima Masato , Tajima Naoko , Agata Toshihiko , Shimizu Hidesuke , LaPorte Ronald E ,   The Diabetes Epidemiology Research International Study Group
Published: March 2007

OBJECTIVE
To evaluate the time trends of mortality among individuals with IDDM in Japan.

RESEARCH DESIGN AND METHODS
A historical prospective study of two independent population-based cohorts composed of individuals who were diagnosed between 1965 and 1969 (1960s cohort) and between 1975 and 1979 (1970s cohort), which included 286 IDDM patients (onset age &lt; 18 years) for the 1960s cohort and 779 patients for the 1970s cohort, was performed. After 10 years of observation, mortality status and causes of deaths between the two cohorts were compared.

RESULTS
The age-adjusted mortality rate per 100,000 person-years of the 1960s cohort was 754 (95% CI, 471–1,141); in contrast, that of the 1970s cohort was only 196 (95% CI, 107–329) (P &lt; 0.001). The standardized mortality ratio of the 1960s cohort was 1,432 (95% CI, 898–2,161), and that of the 1970s cohort was 489 (95% CI, 267—821). Analyses of the causes of deaths revealed a marked decline in recent years in the number of deaths by acute complications and renal disease.

CONCLUSIONS
A major decline in the mortality of diabetic children in Japan may be attributed to the dramatic changes in the quality of care and medical infrastructure that occurred after the mid-1970s.