bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical Activity and NIDDM in African-Americans: The Pitt County Study
Authors: James Sherman A , Jamjoum Lama , Raghunathan T E , Strogatz David S , Furth Eugene D , Khazanie Prabhaker G 
Published: March 2007

OBJECTIVE
Studies directly examining the association between physical activity and NIDDM in African-Americans are rare. Consequently, the strength of this association in this ethnic minority group remains unclear. The current study broadly characterizes the types of physical activity engaged in by a community sample of working-class African-Americans and then quantifies the association between physical activity and NIDDM risk in this population.

RESEARCH DESIGN AND METHODS
During the 1993 reexamination of participants in the Pitt County Study in North Carolina, data on NIDDM history, current use of insulin or oral hypoglycemic drugs, and ∼12-h overnight fasting blood glucose (FBG) were obtained from 598 women and 318 men, ages 30-55 years. The presence of NIDDM was determined by current insulin or medication use and FBG ≥ 140 mg/dl. Study participants were assigned to one of four categories of physical activity: strenuous, moderate, low, or inactive.

RESULTS
The weighted prevalence of NIDDM in the sample was 7.1%. After adjustment was made for age, sex, education, BMI, and waist-to-hip ratio, NIDDM risk for moderately active subjects was one-third that for the physically inactive subjects (odds ratio [OR], 0.35; 95% CI, 0.12-0.98). The ORs for low (OR, 0.51; 95% CI, 0.20-1.29) and strenuous (OR, 0.65; 95% CI, 0.26-1.63) activity also tended to be lower. A summary OR that contrasted any activity versus no activity was 0.51 (95% CI, 0.23-1.13).

CONCLUSIONS
Moderate physical activity was strongly associated with reduced risk for NIDDM in this sample. While replication of these findings is needed, public health interventions designed to increase moderate (leisure-time) physical activity in black adults should be strongly encouraged.
Development of Proliferative Diabetic Retinopathy in African-Americans and Whites With Type 1 Diabetes
Authors: Arfken Cynthia L , Reno Philip L , Santiago Julio V , Klein Ronald 
Published: March 2007

OBJECTIVE
To investigate the comparable risk of developing proliferative diabetic retinopathy (PDR) in African-Americans and whites with type 1 diabetes.

RESEARCH DESIGN AND METHODS
Using a cohort design with the sample drawn from medical records, the sample consisted of 312 people with type 1 diabetes (97 African-Americans, 215 whites) having at least two visits to a Model Demonstration Unit with gradeable fundus photographs (stereo, color, 7 standard fields). Excluded were subjects with preexisting or treated PDR or hemoglobinopathy. Masked grading of the fundus photographs was conducted at the Wisconsin Reading Center.

RESULTS
At baseline, African-Americans had poorer glycemic control (mean HbA1 of 11.3 vs. 10.0%, P &lt; 0.0001), higher systolic blood pressure (mean of 117 vs. 110 mmHg, P &lt; 0.001), and were older (mean of 26.8 vs. 19.3 years, P &lt; 0.0001) than the white subjects. African-Americans also tended to have slightly longer duration of diabetes and length of follow- up. In the African-Americans, 17.5% developed PDR, compared with 10.2% in the 215 whites, for an odds ratio (OR) of 1.86 (95% CI 0.93–3.70). When adjusted for baseline glycemic control, retinopathy grade, and length of follow-up, race was not a significant risk factor (OR = 0.73, 95% CI 0.30–1.78).

CONCLUSIONS
African-Americans with type 1 diabetes may have a higher rate of developing PDR. The observed racial difference, however, is attributable to the presence of a worse risk factor profile, especially to poorer glycemic control. Efforts should be expanded to improve the care for all individuals with poor glycemic control.
Time-Action Profiles of Novel Premixed Preparations of Insulin Lispro and NPL Insulin
Authors: Heise Tim , Weyer Christian , Serwas Andreas , Heinrichs Sebastian , Osinga Johannes , Roach Paris , Woodworth Jim , Gudat Uwe , Heinemann Lutz 
Published: March 2007

OBJECTIVE
To study the pharmacodynamic properties of three premixed formulations of the rapid-acting insulin analog insulin lispro and its protamine-retarded preparation, neutral protamine lispro (NPL) insulin.

RESEARCH DESIGN AND METHODS
In this open, single-center, euglycemic glucose clamp study, 30 healthy volunteers (12 women, 18 men) aged 27 ± 2 years (mean ± SD), whose BM1 was 23.0 ± 2.3 kg/m2, received subcutaneous injections of 0.3 U/kg body wt of insulin mixture (high-mixture 75/25, mid-mixture 50/50, or low-mixture 25/75 insulin lispro/NPL insulin), insulin lispro, or NPL insulin on one of the five study days in randomized order. Glucose infusion rates were determined over a period of 24 h after administration.

RESULTS
Maximal metabolic activity decreased after subcutaneous injection of the mixtures with lower insulin lispro content; however, the time point of maximal and of early halfmaximal metabolic activity was comparable among the three mixtures. Higher proportions of insulin lispro resulted in higher values for area under the curve within the first 360 min after injection and a more rapid decline to late half-maximal activity. Serum insulin concentrations showed a similar pattern.

CONCLUSIONS
This study shows that the pharmacodynamic and pharmacokinetic properties of insulin lispro are preserved in stable mixtures with NPL insulin.
Beneficial Impact of Ramipril on Left Ventricular Hypertrophy in Normotensive Nonalbummuric NIDDM Patients
Authors: Nielsen Flemming S , Sato Asako , Ali Samir , Tarnow Lise , Smidt Ulla M , Kastrup Jens , Parving Hans-Henrik 
Published: March 2007

OBJECTIVE
To evaluate the effect of the ACE inhibitor ramipril as compared with placebo on left ventricular mass index (LVMl) in normotensive, nonalbuminuric NIDDM patients with left ventricular hypertrophy (LVH). Patients with NIDDM are characterized by excessive cardiovascular morbidity and mortality, and LVH, an independent risk factor for cardiac events, is often present in NIDDM patients.

RESEARCH DESIGN AND METHODS
A total of 38normotensive, nonalbuminuric (albuminuria &lt;100 mg/24 h) NIDDM patients with LVH (LVMl /131 g/m2in men and &gt;100 g/m2 in women) were enrolled in a 6-month randomized, double-blind parallel group study to compare the effects of ramipril (5 mg/day) with placebo on LVMl (echocardiography, Vingmed CFM725, Diasonics Sonotron), QTC dispersion determined as the interlead variation in QTC interval on standard electrocardiogram (ECG), and 24-h ambulatory blood pressure (A&D TM2420, Tokyo, Japan). A total of 16 ramipril (10 men, 60 ± 9 years [mean ± SD]) and 15 placebo-treated (8 men, 55 ± 10 years) patients completed the study, and their data are presented.

RESULTS
Ambulatory blood pressure was almost identical at baseline (132/76 ± 3/1 vs. 133/74 ± 5/2 mmHg [mean ± SEM]) and remained stable during follow-up (134/76 ± 3/1 vs. 136/74 ± 6/2 mmHg) in the ramipril and placebo group, respectively. LVMl was comparable at baseline (137.1 ± 7.0 vs. 129.6 ± 3.7 g/m2) in the ramipril and placebo group, respectively, and decreased significantly more in the ramipril group as compared with the placebo group (17.6 ± 3.0 vs. 5.7 ± 4.6 g/m2, respectively, 11.9 [0.7–23.1] g/m2, mean difference [95% CI]; P = 0.037). QTC dispersion was comparable at baseline (60.2 [5.5] vs. 64.1 [6.5] ms) and did not change significantly during follow-up: −2.5 [7.0] vs. −12.2 [9.5] ms; mean difference 9.8 (−14.2 to 33.8 ms) in the ramipril and placebo group, respectively.

CONCLUSIONS
Ramipril induces regression of LVH in normotensive, nonalbuminuric NIDDM patients, independent of reduction in systemic blood pressure.
Efficacy and Safely of a Topical Gel Formulation of Recombinant Human Platelet-Derived Growth Factor-BB (Becaplermin) in Patients With Chronic Neuropathic Diabetic Ulcers: A phase III randomized placebo-controlled double-blind study
Authors: Wieman T Jeffery , Smiell Janice M , Su Yachin 
Published: March 2007

OBJECTIVE
To compare the efficacy and safety of topically applied recombinant human platelet-derived growth factor-BB (rhPDGF-BB) (becaplermin) with placebo gel in patients with chronic diabetic neuropathic ulcers of the lower extremities.

RESEARCH DESIGN AND METHODS
This multicenter double-blind placebo-controlled phase 111 trial included 382 patients with type 1 or type 2 diabetes and chronic ulcers of at least 8 weeks' duration. After sharp debridement of the ulcer, patients were randomized to receive becaplermin gel 30 μg/g, becaplermin gel 100 μg/g, or placebo gel, in conjunction with a standardized regimen of good wound care until complete wound closure was achieved or for a maximum of 20 weeks. Moist saline-soaked gauze dressings were changed twice daily with study medication applied by patients or caregivers at the evening dressing change. Safety was assessed by monitoring adverse events (AEs) and by clinical laboratory evaluations.

RESULTS
Compared with placebo gel, becaplermin gel 100 μg/g significantly increased the incidence of complete wound closure by 43% (50 vs. 35%, P = 0.007) and decreased the time to achieve complete wound closure by 32% (86 vs. 127 days; estimated 35th percentile, P = 0.013). AEs reported during treatment or during a 3-month follow-up period were similar in nature and incidence across all treatment groups.

CONCLUSIONS
Becaplermin gel 100 μg/g, in conjunction with good wound care, significantly increased the incidence of complete wound closure and significantly reduced the time to complete closure of chronic diabetic neuropathic ulcers. The safety profile of becaplermin gel was similar to that of placebo gel.
Evaluation of the Insertion/Deletion ACE Gene Polymorphism as a Risk Factor for Carotid Artery Intima-Media Thickening and Hypertension in Young Type 1 Diabetic Patients
Authors: Frost Dietmar , Pfohl Martin , Clemens Pia , Haring Hans-Ulrich , Beischer Wolfgang 
Published: March 2007

OBJECTIVE
To study the distribution of the insertion/deletion polymorphism of the ACE gene in young type 1 diabetic patients and to evaluate possible associations between the ACE genotype, arterial hypertension, and intima-media thickness (IMT) of the common carotid artery.

RESEARCH DESIGN AND METHODS
Study participants were 148 type 1 diabetic patients (56 men and 92 women), aged 14–44 years, with a diabetes duration of ≥2 years. HbA1c, albuminuria, and lipid status were assessed by standard laboratory techniques; the ACE genotypes were assessed by polymerase chain reaction. The patients were categorized according to the presence or absence of hypertension, nephropathy, and retinopathy. The IMT, which can be used to estimate early stages of atherosclerosis, was measured by high-resolution ultrasonography.

RESULTS
The ACE genotypes were distributed as follows: 21% II, 37% ID, 42% DD. The IMT values did not differ among patients with various ACE genotypes (0.63 ± 0.15 mm), but the prevalence of hypertension was significantly higher in patients with DD (odds ratio, 4.26 versus II ± ID; 95% CI, 1.64–11.06). Multiple linear regression analysis showed that only age, hypertension, and sex were determinants for the IMT.

CONCLUSIONS
Our results suggest a relationship between the prevalence of hypertension and the deletion polymorphism of the ACE gene in young type 1 diabetic patients, but we could not find an association between carotid artery IMT and ACE genotype in this population.
Impact of a Diabetes Electronic Management System on the Care of Patients Seen in a Subspecialty Diabetes Clinic
Authors: Smith Steven A , Murphy Mary E , Huschka Todd R , Dinneen Sean F , Gorman Colum A , Zimmerman Bruce R , Rizza Robert A , Naessens James M 
Published: March 2007

OBJECTIVE
To compare the compliance with diabetes care performance indicators by diabetes specialists using a diabetes electronic management system (DEMS) and by those using the traditional paper medical record.

RESEARCH DESIGN AND METHODS
A DEMS has been gradually introduced into our subspecialty practice for diabetes care. To assess the value of this DEMS as a disease management tool, we completed a retrospective review of the medical records of 82 randomly selected patients attending a subspecialty diabetes clinic (DC) during the first quarter of 1996. Eligible patients were defined by the suggested criteria from the American Diabetes Association Provider Recognition Program. During the first quarter of 1996, ∼ one half of the providers began using the DEMS for some but not all of their patient encounters. Neither abstractors nor providers were aware of the intent to examine performance in relationship to use of the DEMS.

RESULTS
Several measures were positively influenced when providers used the DEMS. The number of foot examinations, the number of blood pressure readings, and a weighted criterion score were greater (P &lt; 0.01) for providers using the DEMS. There was evidence, although not statistically significant, for lower mean diastolic blood pressures (P = 0.043) in patients and for number of glycated hemoglobins documented (P = 0.018) by users of the DEMS.

CONCLUSIONS
Performance and documentation of the process of care for patients with diabetes in a subspecialty clinic are greater with the use of a DEMS than with the traditional paper record.
Comorbidity of Diabetes and Eating Disorders: Does diabetes control reflect disturbed eating behavior?
Authors: Herpertz Stephan , Albus Christian , Wagener Ruth , Kocnar Margit , Wagner Richard , Henning Andreas , Best Frank , Foerster Helmut , Schleppinghoff Bernd Schulze , Thomas Walter , Köhle Karl , Mann Klaus , Senf Wolfgang 
Published: March 2007

OBJECTIVE
This multicenter study was designed to explore the prevalence of clinical and subclinical eating disorders (EDs), the extent of intentional omission of insulin and oral antidiabetic agents, and its relationship to glycemic control in an inpatient and outpatient population of men and women with type 1 and type 2 diabetes.

RESEARCH DESIGN AND METHODS
Data have been collected from 12 diabetes medical centers in two German cities. In a questionnaire and interview-based study, a sample of male and female patients (n = 341 type 1, n = 322 type 2) was assessed for the following eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified. For lack of interview data of several patients meeting the screening criteria, prevalence ranges were calculated.

RESULTS
The overall prevalence range of current EDs was 5.9–8.0% (lifetime prevalence 10.3–14.0%). When patients were stratified according to type 1 and type 2 diabetes, there was no difference in prevalence of EDs. However, the distribution of the EDs was different in both types of diabetes, with a predominance of binge eating disorder in the type 2 diabetes sample. Type 1 (5.9%) and type 2 (2.2%) diabetic patients reported deliberate omission of hyperglycemic drugs (insulin or oral agents) in order to lose weight. Compared with control subjects, neither the presence of EDs nor insulin omission influenced diabetic control.

CONCLUSIONS
There seems to be no difference in prevalence rates of EDs in both types of diabetes; however, distribution of EDs is different. The findings suggest that neither EDs nor insulin omission are necessarily associated with poor control of glycemia. Binge eating disorder seems to precede type 2 diabetes in most patients and could be one of the causes of obesity that often precedes type 2 diabetes.
Power Spectral Analysis of Heart Rate Variation in Diabetic Patients With Neuropathic Foot Ulceration
Authors: Aso Yoshimasa , Fujiwara Yukio , Inukai Toshihiko , Takemura Yoshihiro 
Published: March 2007

OBJECTIVE
To evaluate the relationship between diabetic autonomic neuropathy and diabetic neuropathic foot ulceration, we used power spectral analysis (PSA) of heart rate variation, which provides the accurate simultaneous quantification of parasympathetic and sympathetic activities, to assess autonomic function in diabetic patients.

RESEARCH DESIGN AND METHODS
We studied 55 NIDDM patients including 10 diabetic patients without neuropathy, 23 diabetic patients with neuropathy and no history of foot ulceration, and 22 diabetic patients with neuropathic foot ulceration. We performed PSA of 100 R-R intervals at rest and analyzed the results by fast Fourier transformation.

RESULTS
The low frequency (LF) power, which reflects sympathetic activity, and the high frequency (HF) power, which reflects parasympathetic (vagal) activity, were inversely correlated with the duration of diabetes and the fasting plasma glucose (FPG) levels. By multiple regression analysis, the FPG remained with significant influence on both LF and HF powers. The LF and HF powers were positively correlated with motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) in the upper and lower limbs and the coefficient of variation of R-R intervals. The LF and HF powers were significantly reduced in patients with neuropathy and patients with foot ulceration compared with patients without neuropathy. Although the median MCV and SCV were similar between diabetic patients with neuropathy and patients with foot ulceration, both the LF and HF powers were significantly decreased in patients with foot ulceration compared with patients with neuropathy. There was no difference in the value of the LF:HF ratio, an index of sympathovagal balance, among three subgroups. We observed a positive correlation between LF and HF power in all subjects; however, the LF and HF powers were not correlated in the subgroups of patients with foot ulceration.

CONCLUSIONS
These results showed that diabetic patients with neuropathic foot ulceration have a greater impairment in spectral indexes of autonomic activity obtained by PSA than patients with neuropathy and no history of foot ulceration, whereas no difference was present in nerve conduction velocities.
Progression to Type 2 Diabetes Among Hign-Risk Groups in Kin-Chen, Kinmen: Exploring the natural history of type 2 diabetes
Authors: Chou Pesus , Li Chia-Lin , Wu Gin-Son , Tsai Shih-Tzer 
Published: March 2007

OBJECTIVE
To examine the natural history of 654 high-risk subjects (340 men and 314 women) with fasting hyperglycemia (first fasting plasma glucose [FPG] level 5.6–7.8 mmol/1) who also exhibited 2-h postload glucose concentrations &lt;11.1 mmol/1 and an FPG level &lt;7.8 mmol/1 in a 75-g oral glucose tolerance test (OGTT). We were particularly interested in comparing the likelihood of developing type 2 diabetes for those with persistent fasting hyperglycemia (PFH), impaired glucose tolerance (IGT), and normal glucose tolerance (NGT). PFH is a relatively new definition, and those with PFH used to be defined as NGT according to WHO criteria.

RESEARCH DESIGN AND METHODS
Subjects were located in a 1992–1994 community-based population survey and followed up and reexamined during 1995–1996. An OGTT was used to determine who had progressed to type 2 diabetes. Risk factors predictive of subsequent progression to type 2 diabetes were determined by comparing baseline variables from the 1992–1994 survey with data of those who had or had not progressed to type 2 diabetes in 1995–1996.

RESULTS
Of 654 high-risk subjects screened in the baseline survey 481 (73.5%, 255 men and 226 women) were followed up. Of these, 8.1% had progressed to diabetes (4.1% progression/year, 95% Cl 2.3–5.9). Of 131 baseline IGT subjects, 17.6% progressed to diabetes (8.8% progression/year, 6.3–11.3), but only 7.4% of 95 PFH subjects (3.7% progression/year, 2.0–5.4) and 3.5% of 255 NGT subjects (1.8% progression/year, 0.1–3.0) progressed to diabetes.

CONCLUSIONS
The rates of progression to type 2 diabetes were lowest from the NGT subgroup, highest from the IGT group, with the PFH group in the middle, suggesting that PFH might be a transitional condition that precedes IGT and diabetes. Other significant predictors of subsequent diabetes were baseline BMI, baseline hyperuricemia, baseline FPG, and 2-h plasma glucose concentration.
Troglitazone Reduces Plasma Leptin Concentration but Increases Hunger in NIDDM Patients
Authors: Shimizu Hiroyuki , Tsuchiya Takahumi , Sato Noriyuki , Shimomura Yohnosuke , Kobayashi Isao , Mori Masatomo 
Published: March 2007

OBJECTIVE
Troglitazone, which improves peripheral insulin resistance of experimental diabetic animals and diabetic patients, affects ob gene expression in the adipose tissue of rodents. The present study was undertaken to examine a hypothesis that clinical administration of troglitazone may reduce circulating leptin levels and affect eating behavior in NIDDM patients.

RESEARCH DESIGN AND METHODS
Troglitazone was administered at a dosage of 200 mg twice daily for 12 weeks in 20 poorly controlled NIDDM patients. Chronological changes in glycemic control, serum lipids, immunoreactive leptin (IRL) levels, and BMI were measured. Body fat weight was also assessed by bioelectric impedance.

RESULTS
Troglitazone significantly decreased fasting plasma glucose, serum immunoreactive insulin, and HbA1c levels. Serum levels of IRL and triglyceride were significantly reduced by troglitazone administered for 4, 8, and 12 weeks. Troglitazone administration significantly increased the BMI in NIDDM patients, and two-thirds of the patients complained of increased hunger after the start of troglitazone administration.

CONCLUSIONS
Troglitazone significantly reduces circulating leptin levels at clinical doses. It may affect the eating behavior of poorly controlled NIDDM patients through the improvement of glycemic control and/or the reduction of circulating leptin.
Comparison of Percent Total GHb With Percent HbA1c in People With and Without Known Diabetes
Authors: Nuttall Frank Q 
Published: March 2007

OBJECTIVE
To directly compare results obtained using an ion-exchange high-performance liquid chromatography (HPLC) HbA1c method used in the Diabetes Control and Complications Trial with two different affinity chromatography methods in which ”total GHb” is determined.

RESEARCH DESIGN AND METHODS
Blood was obtained from a large number of people with and without known diabetes. The specimens were divided and assayed for HbA1c and for total GHb. Total GHb was determined using a semi-automated gravity-elution boronate affinity chromatography method and an automated boronate affinity HPLC method. The results obtained with the two methods were also compared.

RESULTS
In subjects without known diabetes, the mean percentage HbA1c and the range of values were similar to the total GHb values in the same subjects when assayed using the semi-automated affinity gravity-elution method (mean 5.2 ± 0.4 and 5.1 ± 0.4% [SD], respectively). With the affinity HPLC method, results were 5.3 ± 0.4%. The similarity in results was surprising. However, analysis of the data suggests that a large proportion of the material in the HbA1c fraction measured using this ion-exchange HPLC method is not GHb, as pointed out by others. Although the results were similar in people without known diabetes, in the people with diabetes, the incremental increase was ∼25% greater for the total GHb when compared with the increase in HbA1c. When corrected for the non-GHb being measured by the HbA1c method, it can be calculated that ∼40% more GHb is measured using affinity chromatography over the entire range of GHb values.

CONCLUSIONS
The similarity in the mean and range of percent HbA1c and in percent total GHb using these different methods can be attributed to two factors: 1) the HbA1c ion-exchange method measures only ∼ 50–60% of the total GHb present, and 2) ∼ 40–50% of the material being measured in the HbA1c fraction is not GHb, i.e., offsetting factors fortuitously resulted in values similar to the more specific affinity methods. The greater incremental increase in percent total GHb compared with percent HbA1c in people with diabetes can be attributed to the greater amount of GHb being measured with the affinity methods.