bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripheral Autonomic Impairment in Patients Newly Diagnosed With Type II Diabetes
Authors: McDaid Elizabeth A , Monaghan Bronagh , Parker Ann I , Hayes John R , Allen Judith A 
Published: March 2007

OBJECTIVE
To measure both peripheral and central autonomic function in patients newly diagnosed with type II diabetes.

RESEARCH DESIGN AND METHODS
Measurements were made on 49 diabetic patients (8 with long-standing diabetes and neuropathic complications, 41 with newly diagnosed type II diabetes) and on 49 healthy, age- and sex-matched, control subjects. Five of the 41 newly diagnosed type II diabetic patients had retinopathy, and 4 had clinical evidence of neuropathy. No patient or control subject had significant vascular disease. Cardiac autonomic function was investigated by using standard cardiovascular reflex tests. The digital vasoconstrictor responses to deep breathing and body cooling were measured using venous occlusion plethysmography.

RESULTS
The vasoconstrictor responses to a deep breath and body cooling were significantly reduced (P &lt; 0.001) in the fingers and toes of the neuropathic patients compared with their matched control subjects, as were the heart rate responses (P &lt; 0.02). The vasoconstrictor responses were significantly reduced in the toes (P &lt; 0.001) and fingers (P &lt; 0.05, P &lt; 0.01) of the newly diagnosed patients compared with the corresponding responses in the control subjects. There was no significant difference in the heart rate or blood pressure responses of these patients and control subjects during standard tests of cardiac autonomic function.

CONCLUSIONS
Patients with type II diabetes may have impaired peripheral autonomic function at diagnosis.
Diabetes With Mitochondrial Gene tRNALYS Mutation
Authors: Suzuki Susumu , Hinokio Yoshinori , Hirai Satoshi , Onoda Masatoshi , Matsumoto Masahiro , Ohtomo Masataka , Kawasaki Hiromasa , Satoh Yoshinori , Akai Hiroaki , Abe Kohji , Toyota Takayoshi 
Published: March 2007

OBJECTIVE
To solve a possible relationship between mtDNA mutation of tRNALYS(8344) and diabetes, we have surveyed the tRNALYS mutation, glucose intolerance, and insulin secretory capacity in a Japanese family with diabetes and myoclonic epilepsy with ragged-red fiber disease. Several lines of evidence suggested possible linkage between mtDNA mutation and diabetes (1–4).

RESEARCH DESIGN AND METHODS
DNA was isolated from peripheral lymphocytes. The polymerase chain reaction analysis for the tRNALYS(8344) mutation of the mtDNA was conducted as described by Larsson (5). Insulin secretory capacity was assessed by 24-h urinary C-peptide immunoreactivity response (CPR) excretion and plasma CPR to glucagon administration.

RESULTS
We identified seven subjects with the tRNALYS mutation as well as seven non-mutated members in the pedigrees. Oral glucose tolerance tests in the pedigree indicated that five of the mutated subjects were diabetic, one had impaired glucose tolerance, and one had normal glucose tolerance (NGT), whereas all nonmutated family members had NGT. The pedigree shows maternal transmission of diabetes and the tRNALYS mutation over three generations. Twenty-four-hour urinary excretion of CPR was significantly reduced in the mutant subjects (mean ± SD, 67.8 ± 79.2 nmol/day, n = 6, P &lt; 0.001) compared with the nonmutant members (276.6 ± 41.8 nmol/day, n = 5) and the age-matched normal control subjects (263 ± 64.3 nmol/day, n = 12). Plasma CPR 6 min after glucagon injection demonstrated a marked reduction in the mutant subjects (3.68 ± 3.45 nmol/l, n = 5, P &lt; 0.001) compared with the nonmutant members (19.4 ± 1.17 nmol/l, n = 5) and the normal control subjects (15.8 ± 3.81 nmol/l, n = 12). Bilateral neurosensory deafness was demonstrated in five of seven (71.4%) mutant subjects (five of five [100%] mutated diabetic patients), but not detected in six nonmutant members.

CONCLUSIONS
This observation is the first report of association of diabetes with the mitochondrial tRNALYS mutation. Insulin secretory capacity was significantly lower in the mutant members than in the nonmutated members. These findings suggest that the pancreatic β-cell secretory defect of insulin might be one of the phenotypes of the mitochondrial tRNALYS mutation.
Urinary chiro-Inositol Excretion is an Index Marker of Insulin Sensitivity in Japanese Type II Diabetes
Authors: Suzuki Susumu , Kawasaki Hiromasa , Satoh Yoshinori , Ohtomo Masataka , Hirai Masashi , Hirai Aki , Hirai Satoshi , Onoda Masatoshi , Matsumoto Masahiro , Hinokio Yoshinori , Akai Hiroaki , Craig James , Larner Joseph , Toyota Takayoshi 
Published: March 2007

OBJECTIVE
To determine the relationship between urinary chiro-inositol excretion and insulin sensitivity in Japanese type II diabetic patients.

RESEARCH DESIGN AND METHODS
Eighteen subjects were age-matched, nonobese, type II diabetic patients. Eight subjects had impaired glucose tolerance (IGT), and 10 had normal glucose tolerance (NGT). We quantified urinary chiro-inositol excretion using gas chromatography-mass spectrometry and the insulin sensitivity index (SI), and glucose effectiveness (SG) using Bergman's modified minimal model method.

RESULTS
The urinary excretion of chiro-inositol was much lower in the diabetic patients (32.3 ± 16.0 μmol/day, means ± SD) than in the NGT subjects (96.0 ± 17.6; P &lt; 0.0001) and IGT subjects (58.9 ± 11.6; P &lt; 0.0001). SI was much lower in the diabetic patients (3.81 ± 1.49) than in the NGT subjects 6.30 ± 1.59, P &lt; 0.0005). SG was much lower in the diabetic patients (2.14 ± 0.56) than in the NGT subjects (3.07 ± 0.38, P &lt; 0.0001). There was a significant correlation between urinary chiro-inositol excretion and SI (r = 0.766), as well as a significant correlation between urinary chiro-inositol excretion and SG (r = 0.747).

CONCLUSIONS
There is a direct relationship of urinary chiro-inositol excretion to insulin sensitivity and SG in humans. Urinary chiro-inositol excretion might be useful as a metabolic index of insulin sensitivity in type II diabetes.
Glucokinase Gene Variations in Japanese-Americans With a Family History of NIDDM
Authors: Stone Lisa M , Kahn Steven E , Deeb Samir S , Fujimoto Wilfred Y , Porte Daniel 
Published: March 2007

OBJECTIVE
To determine if sequence variants in the glucokinase (GCK) gene contribute to the high risk of impaired glucose metabolism in Japanese-Americans and whether the gene sequence differs between Japanese-Americans and Caucasians.

RESEARCH DESIGN AND METHODS
Forty-seven unrelated Japanese-Americans with one or more first-degree relatives with non-insulin-dependent diabetes mellitus (NIDDM) were selected, irrespective of glucose tolerance status. By World Health Organization criteria, 13 had normal glucose tolerance, 11 had impaired glucose tolerance, and 23 had NIDDM. Variations in the GCK gene were identified by single-strand conformation polymorphism analysis and sequenced using standard techniques.

RESULTS
Six variants of the GCK gene were identified in a total of 21 subjects: 1) a G→A substitution at nucleotide −30 in the β-cell-specific promoter; 2) an A→G substitution at nucleotide 244 in the 5'-untranslated region (5'-UTR) of exon 1a; 3) a C→G substitution at nucleotide 403 in the 5'-UTR of exon 1a; 4) a G→A variant 13 base pair (bp) 5' to the intron 3 exon 4 junction; 5) a silent substitution in the third base of codon 145 in exon 4; and 6) a C→T substitution 8 bp 3' to the exon 9 intron 9 junction. None of these variations would be expected to affect the structure of the GCK enzyme. While none of these variants were significantly associated with IGT or NIDDM, a nonsignificant increase in the β-cell promoter variant was observed in subjects with abnormal glucose tolerance. No uniform sequence differences in the GCK gene were identified between Japanese-American and Caucasian-American subjects.

CONCLUSIONS
Mutations affecting the amino acid sequence of GCK do not account for the increased incidence of impaired glucose metabolism in Japanese-Americans, and the gene sequence does not uniformly differ from that in Caucasians.
Slow Elimination of Glyburide in NIDDM Subjects
Authors: Jönsson Anders , Rydberg Tony , Ekberg Goran , Hallengren Bengt , Melander Arne 
Published: March 2007

OBJECTIVE
To determine the terminal elimination half-life of glyburide in non-insulin-dependent diabetes mellitus (NIDDM) subjects after cessation of long-term treatment.

RESEARCH DESIGN AND METHODS
Ten NIDDM patients (5 of each sex, 36-72 years old, without hepatic or renal disease) taking a median glyburide dose of 14 mg/day, who were to start insulin therapy because of sulfonylurea failure, were studied. Serum glyburide concentrations, measured by a newly developed selective and sensitive liquid chromatographic method, were followed from 10 to 48 h after the last glyburide dose.

RESULTS
Serum glyburide levels declined in three different phases, with a terminal 7-phase between 18 and 48 h having a mean ± SD half-life of 15.0 ± 6.7 h. Two patients had half-lives over 20 h. The half-life values did not correlate with fasting blood glucose, age, body weight, body mass index, or creatinine levels. The latter agrees with the assumption that glyburide is completely eliminated by metabolic transformation. Although longer than previously observed, the current half-life values are in accordance with clinical experience that glyburide is a long-acting sulfonylurea.

CONCLUSIONS
The elimination of glyburide in NIDDM subjects is slower than previously reported. The long half-life adds support to the use of a once-daily dosage of glyburide. It also justifies increased caution when using this sulfonylurea.
Effect of Antecedent Hypoglycemia on Cognitive Function and on Glycemie Thresholds for Counterregulatory Hormone Secretion in Healthy Humans
Authors: Mellman Michael J , Davis Maris R , Brisman Michelle , Shamoon Harry 
Published: March 2007

OBJECTIVE
To determine whether reduced hormonal, symtomatic, and/or cognitive responses to hypoglycemia are caused by an increase in the plasma glucose concentration required to stimulate these counterregulatory parameters after antecedent hypoglycemia.

RESEARCH DESIGN AND METHODS
We studied nine healthy volunteers during stepped hypoglycemia clamps (plasma glucose targets from 80 to 50 mg/dl in 10 mg/dl steps) on two separate days. The study was preceded either by a 2-h period of hypoglycemia (plasma glucose 58 ± 2 mg/dl) or a 2-h period of euglycemia (plasma glucose 94 ± 2 mg/dl) for 90 min.

RESULTS
The plasma glucose that triggered secretion of-plasma norepinephrine (NE) was lower after antecedent hypoglycemia (control = 74 ± 2 and experimental = 67 ± 2 mg/dl, respectively, P &lt; 0.005). In contrast, a relatively higher plasma glucose stimulated secretion of other counterregulatory hormones after anteceden hypoglycemia: growth hormone (GH) (65 ± 2 to 72 ± 2 mg/dl, P &lt; 0.01); glucagon (63 ± 2 to 70 ± 2 mg/dl, P &lt; 0.01); and epinephrine (EPI) (68 ± 2 to 76 ± 2 mg/dl, P &lt; 0.01) when comparing control days with experimental days. Hypoglycemic symptoms were first observed at a plasma glucose plateau of 59 ± 2 mg/dl. Motor function reflected by Digit Symbol Substitution deteriorated equally whether there had been antecedent hypoglycemia or euglycemia. Logical (immediate) memory deteriorated in the control study at a plasma glucose of 54 ± 2 mg/dl but remained unchanged at equivalent hypoglycemia in the experimental study (P / 0.03).

CONCLUSIONS
Our conclusions are as follows: 1) symptoms of moderate hypoglycemia occur at plasma glucose levels averaging ∼5-15 mg/dl lower than the plasma glucose concentrations required to trigger counterregulatory hormone release; 2) after acute antecedent hypoglycemia, glucagon, EPI, and GH secretion occur at higher plasma glucose concentrations and NE is released at lower plasma glucose concentrations; and 3) there may be CNS adaptation to prior hypoglycemia reflected in preservation of logical memory function at plasma glucose levels of ∼50 mg/dl. These findings suggest that thresholds for hormone secretion and for changes in cognitive function can be altered very acutely by foregoing hypoglycemia in healthy humans.
Suicides in Men With IPPM
Authors: Kyvik Kirsten O , Stenager Elsebeth N , Green Anders , Svendsen Anders 
Published: March 2007

OBJECTIVE
To investigate the occurrence of suicide in men with insulin-dependent diabetes mellitus (IDDM).

RESEARCH DESIGN AND METHODS
A cohort of all Danish men born between 1949 and 1964 (including 1964) who were diagnosed with IDDM before age 20 (n = 1,682) was ascertained earlier. Follow-up from diagnosis to death or 1 January 1991 was based on record linkage with the Danish Civil Registration System and was supplemented with information from death certificates obtained from the Danish National Registry of Deaths. From published vital statistics, cause-specific standardized mortality ratios (SMRs), adjusted for age and calendar time, were calculated.

RESULTS
Among the 168 deaths recorded during follow-up, 15 took place in connection with the onset of IDDM and have been excluded. Of the remaining 153 deaths, 12 were officially classified as suicides (SMR 12/7.48 = 1.6, 0.05 &lt; P &lt; 0.1); as for the age-group of 20-24 years, SMR was 2.98, P &lt; 0.05. Furthermore, all deaths officially classified as attributable to unknown causes (n = 28) and accidents (n = 22) were reviewed with respect to unrecognized suicides; as for deaths of unknown causes, three could be reclassified as probable suicides and two as possible suicides, whereas one of the deaths caused by accident could be reclassified as possible suicide.

CONCLUSIONS
Young men with IDDM may confer a higher risk of suicide than expected. Furthermore, suicide may represent an underestimated cause of death among patients with IDDM.
Clinical Evaluation of a Semipermeable Polymeric Membrane Dressing for the Treatment of Chronic Diabetic Foot Ulcers
Authors: Blackman John D , Senseng Daniel , Quinn Lauretta , Mazzone Theodore 
Published: March 2007

OBJECTIVE
To evaluate the utility of a semipermeable polymeric membrane dressing for the treatment of chronic diabetic foot ulcers.

RESEARCH DESIGN AND METHODS
Nineteen subjects with either insulin- dependent diabetes mellitus (IDDM) or non-insulin-dependent diabetes mellitus (NIDDM) and foot ulcers were randomly assigned to the polymeric dressing or conventional wet-to-dry saline dressings. Subjects had foot ulcer site measurements performed every 3 weeks. The subjects using conventional therapy were allowed to cross over to polymeric dressing after 2 months.

RESULTS
At the end of 2 months, in the patients using the polymeric dressing, ulcer size was reduced to 35 ± 16% of baseline. The patients on conventional therapy had an ulcer size of 105 ± 28% of baseline (P &lt; 0.03, polymeric vs. conventional). Patients initially treated with wet-to-dry saline were crossed over into the polymeric membrane treatment and demonstrated a decrease to 35 ± 11% of baseline size (P &lt; 0.02) after an additional 2 months.

CONCLUSIONS
The semipermeable polymeric membrane dressing is a useful therapeutic option for treating uncomplicated chronic diabetic foot ulcers.
Community Screening for Diabetes: Low detection rate in a low-risk population
Authors: Newman William P , Nelson Rik , Scheer Kurt 
Published: March 2007

OBJECTIVE
To evaluate glucose-based community screening for diabetes with regard to detection rate.

RESEARCH DESIGN AND METHODS
A retrospective analysis of a community-screening questionnaire data base that included a screening for blood glucose. Referred subjects had fasting glucose levels &gt;6.4 mM (115 mg/dl) or postprandial levels &gt;8.9 mM (160 mg/dl). An attempt was made to contact referred subjects and to ascertain whether follow-up was undertaken and current status. A random sample of subjects not meeting the glucose criteria (nonreferred) also was contacted in an analogous fashion to referred subjects.

RESULTS
In 2,016 questionnaires, glucose-based referral criteria were exhibited by 148 (7.3%) individuals, and subsequent evaluation data were available for 111. Of those 111 individuals, 37 (33%) knew they had diabetes before the screening, and 39 (36%) did not seek further evaluation. Of the remaining 35 subjects, 6 (13%) were told of their new diagnosis of diabetes, and 29 were told they did not have diabetes. Three of 50 nonreferred subjects knew of their diabetes before screening. Thirty percent (14 out of 47) of nonreferred subjects underwent subsequent evaluation, although they were not told to do so. A single new case of diabetes occurred in the nonreferred group.

CONCLUSIONS
Community screening for diabetes that is based on measured glucose is of low yield. The known problems of glucose-based screening, coupled with its low yield, make a glucose-based approach difficult to justify. These results indicate that glucose-based community screening should be done only under the careful supervision of a health professional who is trained both in glucose measurement instrumentation and in screening.
Development of a Miniaturized Glucose Monitoring System by Combining a Needle-Type Glucose Sensor With Microdialysis Sampling Method: Long-term subcutaneous tissue glucose monitoring in ambulatory diabetic patients
Authors: Hashiguchi Yasuhiro , Sakakida Michiharu , Nishida Kenro , Uemura Takero , Kajiwara Ken-Ichiro , Shichiri Motoaki 
Published: March 2007

OBJECTIVE
To develop a reliable and practical glucose monitoring system by combining a needle-type glucose sensor with a microdialysis sampling technique for long-term subcutaneous tissue glucose measurements.

RESEARCH DESIGN AND METHODS
A microdialysis Cuprophan hollowfiber probe (inner diameter, 0.20 mm; length, 15 mm) was perfused with isotonic saline solution (120 μl/h) and glucose concentrations in the dialysate were measured by a needle-type glucose sensor extracorporeally. This system was tested both in vitro and in vivo. Subcutaneous tissue glucose concentrations were then monitored continuously in 5 healthy and 8 diabetic volunteers for 7 to 8 days. A hollow-fiber probe was inserted into the abdominal subcutaneous tissue.

RESULTS
This monitoring system achieved excellent results in vitro. Subcutaneous tissue glucose concentrations were measured in a wide range from 1.7 to &gt;027.8 mM glucose, with a time delay of 6.9 ±1.2 min associated with a rise in glucose and 8.8 ±1.6 min with a fall in the glucose level (means ± SE). The overall correlation between subcutaneous tissue (Y) and blood (X) glucose concentration was Y = 1.08X ± 0.19 (r = 0.99). The subcutaneous tissue glucose concentration could be monitored precisely for 4 days without any in vivo calibrations and for 7 days by introducing in vivo calibrations.

CONCLUSIONS
Glycemic excursions could be monitored precisely in the subcutaneous tissue by this microdialysis sampling method with a needle-type glucose sensor in ambulatory diabetic patients.
Plasma Cholesteryl Ester Transfer Protein and Its Relationship to Plasma Lipoproteins and Apolipoprotein A-I-Containing Lipoproteins in IDDM Patients With Microalbuminuria and Clinical Nephropathy
Authors: Kahri Juhani , Groop Per-Henrik , Elliott Tom , Viberti Giancarlo , Taskinen Marja-Riitta 
Published: March 2007

OBJECTIVE
To study the distribution of high-density lipoprotein (HDL) subclasses in insulindependent diabetes mellitus (IDDM) patients with nephropathy and factors involved in the regulation of HDL, including plasma cholesteryl ester transfer protein (CETP) and postheparin plasma lipoprotein lipase (LPL) and hepatic lipase (HL) activities.

RESEARCH DESIGN AND METHODS
Participants included 52 microalbuminuric IDDM patients (with a urinary albumin excretion rate [UAER] of 20–200 μg/min), 37 macroalbuminuric IDDM patients (UAER &gt;200 μg/min), and 64 normoalbuminuric IDDM patients (UAER &lt;20 μg/min). Groups were matched for age, body mass index, duration of diabetes, and glycemic control (HbA1).

RESULTS
Median concentrations of HDL and HDL2 cholesterol were 11.6 (P = 0.01) and 22.7% (P = 0.01) less in microalbuminuric patients and 5.1 and 15.5% less in macroalbuminuric patients compared with normoalbuminuric patients. No significant differences were observed in the concentrations of apoA-I, apoA-II (apolipoprotein) or LpA-I or LpA-I:A-II (lipoprotein) particles between the groups. HDL cholesterol: apoA-I + apoA-II ratio was significantly lower in micro- (19.7 ± 4.2 (± SD); P &lt; 0.01) and macroalbuminuric patients (20.0 ± 3.7, P &lt; 0.05) than in normoalbuminuric patients (22.1 ± 4.4). Postheparin plasma LPL:IIL ratio was lower in microalbuminuric patients compared with normoalbuminuric patients (1.65 vs. 1.05 [median], P &lt; 0.01). Plasma CETP activity was higher in the macroalbuminuric patients than in micro- (P &lt; 0.05) and normoalbuminuric patients (P &lt; 0.05) but did not correlate with HDL, HDL2, or HDL, cholesterol. LPLHL ratio correlated positively with HDL cholesterol (r = 0.372, P &lt; 0.001), HDL2 cholesterol (r = 0.413, P &lt; 0.001) and with LpA-I particles (r = 0.355, P &lt; 0.001) but not with LpA-I:A-II particles (r = –0.065, NS).

CONCLUSIONS
IDDM patients with micro- and macroalbuminuria show only trivial changes in concentrations of different HDL parameters, which cannot explain the excess risk of coronary heart disease in these patients. Data also indicate that elevation of CETP activity in IDDM patients with nephropathy is probably not responsible for the lowering of HDL cholesterol.
Fasting Plasma Glucose in Screening for NIDDM in the U. S. and Israel
Authors: Modan Michaela , Harris Maureen I 
Published: March 2007

OBJECTIVE
To demonstrate the inadequacy of fasting plasma glucose for screening for NIDDM, even among groups at high risk for diabetes.

RESEARCH PESIGN AND METHODS
Representative samples of adults 40–69 years of age in the U. S. (n = 2,035) and Israel (n = 2,316) were selected. Fasting plasma glucose (FPG) was measured and a 2-h oral glucose tolerance test (OGTT) was administered. Subjects with undiagnosed NIDDM were identified using internationally accepted diagnostic criteria (FPG ≥7.8 mM or 2-h plasma glucose ≥11.1 mM).

RESULTS
Only 31–38% of subjects with undiagnosed NIDDM had fasting hyperglycemia (2:7.8 mM), and 36% in the U. S. and 19% in Israel had normoglycemia (&lt;6.1 mM). Postchallenge glucose, diagnostic of diabetes, was associated with all fasting values, including values &lt;5.0 mM. Based on sensitivity, specificity, and positive predictive value, no FPG level provided a satisfactory cutoff point to use in screening for undiagnosed NIDDM. Sensitivity at each FPG cutoff point varied little among groups classified by age, sex, race, blood pressure status, or body mass index (BMI) levels &gt;23, but sensitivity was lower among those with BMI levels &lt;23.

CONCLUSIONS
In the clinical setting, FPG is commonly used in screening for NIDDM. However, fasting values ≥7.8 mM are highly insensitive for detecting NIDDM. Lower FPG cutoff points that achieve acceptable sensitivity are accompanied by inadequately low specificity, require a high percentage of patients to be retested, and result in a low yield of diabetes among those screened. Clinicians and researchers who seek detection of undiagnosed NIDDM should use the OGTT, because FPG lacks adequate sensitivity and specificity for this purpose.