bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chicken and Fish Diet Reduces Glomerular Hyperfiltration in IDDM Patients
Authors: Pecis Miriam , Azevedo Mirela J De , Gross Jorge L 
Published: March 2007

OBJECTIVE
To compare the effect of a normal protein diet (test diet) in which chicken and fish were substituted for red meat with a low-protein diet (LPD) on glomerular nitration rate (GFR) in normoalbuminuric insulin-dependent-diabetes mellitus (IDDM) patients.

RESEARCH DESIGN AND METHODS
A crossover randomized clinical trial was performed in 15 normoalbuminuric IDDM patients, 9 normofiltering, and 6 hyperfiltering patients. They followed three diets for a 3-week period each: a usual diet (UD), an LPD (0.5 g · kg–1 · day–1 of proteins, 7% calories as protein, 33% as fat, and 60% as carbohydrates), and a normoproteic isocaloric test diet in which white meat (chicken and fish) was substituted for red meat of the UD. At the end of each diet, a clinical evaluation and measurements of GFR (51Cr-ethylenediaminetetraacetate (EDTA) single injection technique), urinary albumin excretion (UAE), and plasma amino acids were performed. Dietary compliance was assessed by a 24-h urinary urea and weekly interviews with the dietitian.

RESULTS
In all diabetic patients, GFR after the LPD (114.9 ± 16.5ml · min–1 · 1.73 m∼2) and after the test diet (122.7 ± 16.7 ml · min–1 · 1.73 m∼2) was significantly lower than after the UD (132.0 ± 27.7 ml · min–1 · 1.73 m∼2) (P = 0.001). Similar results were found in the hyperfiltering group: after UD = 161.1 ± 15.4 ml · min–1 · 1.73 m–2, after LPD = 129.8 ± 9.0 ml-min–1 · 1.73 m–2, and after the test diet = 136.5 ± 3.1 ml · min–1 · 1.73 m–2, (P &lt; 0.001). In the normofiltering group, no significant changes in GFR were observed after the three diets. Metabolic control, nutritional indexes, blood pressure (BP), and UAE did not change after the three diets in all patients.

CONCLUSIONS
A normoproteic diet with chicken and fish as the only meat protein source decreases the GFR in the hyperfiltering normoalbuminuric IDDM patients. The GFR reduction after this diet is similar to that observed after an LPD.
Evaluation of a Subcutaneous Glucose Sensor out to 3 Months in a Dog Model
Authors: Gilligan Barbara J , Shults Mark C , Rhodes Rathbun K , Updike Stuart J 
Published: March 2007

OBJECTIVE
To advance the feasibility of an impiantatile long-term glucose sensor with bioprotective sensor membranes and test protocols using a somatostatin analog (octreotide).

RESEARCH DESIGN AND METHODS
Implantable sensors were constructed with one of eight bioprotective membranes and screened in vitro for stable response to glucose. Sensors were implanted subcutaneously into nondiabetic mongrel dogs and monitored at 4-min intervals via radiotelemetry. When implanted sensor responses showed evidence of tracking blood glucose after glucagon challenge (8–21 days postimplant), a glucose infusion protocolwas used to assess performance. Sensor data were collected every 4 s after octreotide inhibition of endogenous insulin release. Reference plasma glucose samples were taken every 4–10 min.

RESULTS
Preimplant in vitro testing of sensors verified linearity to 33.3 mM glucose and response times to 90% of equilibrium in 2–7 min. Ten implanted sensors tracked glucose for 20–114 days, during which 25 separate glucose infusion studies were conducted. The resulting regression data yielded a mean slope of 0.99 ± 0.06, an intercept of 0.24 ± 0.53 mM glucose, and a correlation coefficient 0.98 ± 0.01. Long-term sensor stability was not judged adequate for clinical application, although two sensors tracked within ±15% for 33 and 42 days. In vivo oxygen delivery was shown toaffect sensor performance. On expiant, two of eight tested bioprotective membranes were found to be biostable and to fully protect the sensor's enzyme membrane. The foreign body capsule was adequately vascularized adjacent to the sensor up to 91 days postimplant. Sensor units eventually failed because of electronic problems (package leakage) or because of biodegradation or biofouling of test bioprotective membranes.

CONCLUSION
Further development of this type of sensor may provide diabetic patients with a better means of monitoring blood glucose.
Type II Diabetes and Cognitive Function: A population-based study of Native Americans
Authors: Lowe Lynn P , Tranel Daniel , Wallace Robert B , Welty Thomas K 
Published: March 2007

OBJECTIVE
To explore the relationship between type II diabetes and cognitive function in older Native Americans and to assess the effects of other selected risk factors for cognitive dysfunction on this relationship.

RESEARCH DESIGN AND METHODS
Cognitive function was assessed in 80 diabetic and 81 nondiabetic Native Americans who were 45–76 years of age in a cross-sectional population-based sub-study of the Strong Heart Study. Thirteen cognitive function tests were administered during a personal interview. Information about six other risk factors for cognitive dysfunction, including depressive symptoms, physical function, alcoholism, current alcohol use, hypertension, and myocardial infarction, was ascertained from interviews andfrom abstraction of medical records.

RESULTS
Diabetes was associated with impairment on only two tests of cognitive function: verbal fluency (P = 0.004) and similarities (P = 0.010). Depressive symptoms were related to verbal fluency (P = 0.004), but did not explain thediabetes-related difference in performance. The effects of hypertension, depressive symptoms, and current alcohol use explained the diabetes-related performance difference on similarities. Cognitive function was not related to metabolic control (HbA1c level).

CONCLUSIONS
We found little evidence that type II diabetes in this population of Native Americans is associated with decrement in cognitive function. Some of the cognitive impairment previously attributed to diabetes may be related, at least in part, to the influence of other risk factors. This should be considered in the design of future studies in other populations.
Remission of Proteinuria Following Correction of Hyperlipidemia in NIDDM Patients With Nondiabetic Glomerulopathy
Authors: Dubois Daniéle , Chanson Philippe , Timsit José , Chauveau Dominique , Nochy Dominique , Guillausseau Pierre-Jean , Lubetzki Jean 
Published: March 2007

OBJECTIVE
Animal studies suggest that hyperlipidemia may play a direct role in glomerular damage. In patients with non-insulin-dependent diabetes mellitus (NIDDM), dyslipidemia occurs early in the course of nephropathy and may be involved in the progression of renal disease.

CASES
We report on two young NIDDM patients with marked hyperlipidemia and proteinu ria, in whom renal biopsy demonstrated nondiabetic glomerulopathy. In both cases, the decrease in blood lipid levels was associated with a major decrease in proteinuria. Episodes of hyperlipidemia were associated with a resumption of heavy protcinuria in one patient with serum triglyceride levels and proteinuria being closely correlated.

CONCLUSIONS
These two cases suggest that hyperlipidemia has an important rolein the pathogenesis of glomerular disease.
In-Shoe Foot Pressure Measurements in Diabetic Patients With At-Risk Feet and in Healthy Subjects
Authors: Sarnow Marc R , Veves Aristidis , Giurini John M , Rosenblum Barry I , Chrzan James S , Habershaw Geoffrey M 
Published: March 2007

OBJECTIVE
To measure in-shoe foot pressures in diabetic patients and healthy subjects and compare them with the foot pressures when they walked without their shoes.

RESEARCH DESIGN AND METHODS
Forty-four diabetic patients at risk of foot ulceration and 65 healthy subjects were matched for age, sex, race, and weight. Neuropathy was evaluated clinically, and the F-Scan program was used to measure the foot pressures. Foot pressures were measured with the sensors placed in the shoes (S measurements), between the foot and the sock with shoes (H measurements) or with their socks alone (B measurements).

RESULTS
In the control group, significant differences were found between S (4.77 ± 1.87 kg/cm2) and H measurements (5.12 ± 1.87 kg/cm2, P &lt; 0.001), between S and B (7.23 ± 2.95 kg/cm2, P &lt; 0.0001), and between H and B (P &lt; 0.0001). In the diabetic group, no difference was found between S and H measurements (5.28 ± 2.22 vs. 5.27 ± 2.39 kg/cm2, NS). In contrast, the B pressure was significantly higher when compared with both (8.77 ± 4.67 kg/cm2, P &lt; 0.02). When compared with the control group, the S and H pressures did not differ significantly, but the B pressure in the diabetic group was significantly higher (P &lt; 0.02). The peak S pressure was above the normal limit in 24 (27%) diabetic and 21 (16%) control feet (P &lt; 0.05), the H pressure in 17 (19%) diabetic feet and 22 (17%) control feet (NS), and the B pressure in 24 (27%) diabetic and 21 (16%) control feet (P &lt; 0.05).

CONCLUSIONS
In-shoe foot pressure measurements are significantly lower than the ones measured when walking with the socks only in both diabetic patients and healthy subjects. The shoes of diabetic patients provided a higher pressure reduction than did those of the control group, but the number of feet with abnormally high pressures did not change. The F-Scan system may be particularly helpful in designing footwear suitable for diabetic patients with at-risk feet.
How Does Provider and Patient Awareness of High-Risk Status for Lower-Extremity Amputation Influence Foot-Care Practice?
Authors: Del Aguila Michael A , Reiber Gayle E , Koepsell Thomas D 
Published: March 2007

OBJECTIVE
To assess whether patients with diabetes at high risk for lower extremity amputation received more intensive medical care or self-care instruction and to determine the association between foot care and risk of lower-extremity amputation.

RESEARCH DESIGN AND METHODS
Patients with diabetes were seen at the Seattle Veterans Affairs Medical Center (VAMC) between October 1984 and April 1987; 67 patients were seen for initial non-traumatic amputation, and 236 consecutive control subjects were seen for non-traumatic but medically necessary surgery unrelated to diabetes. Data collection included patient interview and medical record review. High-risk status, defined as presence of peripheral neuropathy, peripheral vascular disease, or prior foot ulcer, was temporally fixed at 2 years before study enrollment.

RESULTS
Peripheral neuropathy, peripheral vascular disease, and prior foot ulcer were independently associated with risk of lower-extremity amputation: peripheral neuropathy odds ratio (OR) = 1.4 (95% confidence interval (CI) 0.7-2.7), peripheral vascular disease OR = 2.6 (95% CI 1.5-4.5), and prior foot ulcer OR = 10.9 (95% CI 4.6-25.5). Patients with a prior foot ulcer were significantly more likely to have seen a podiatrist and to have received outpatient diabetes education at the Seattle VAMC; their providers were more likely to prescribe clipping toenails, regular foot washing, and elevating feet during the day (X12 for proportions P &lt; 0.05). However, for patients with a history of peripheral neuropathy or peripheral vascular disease, there was no statistically significant increase in medical care (podiatry visits, outpatient diabetes education) or self-care instruction (clip nails, elevate feet, or self-monitor blood glucose) compared with patients without either of these two conditions (x12 for proportions P &gt; 0.20).

CONCLUSIONS
When clinicians were aware of a patient's very elevated risk for lower-extremity amputation (evidenced by prior history of foot ulcer), they were more likely to prescribe preventive foot-care behaviors, but awareness of other risk factors (peripheral neuropathy or peripheral vascular disease) did not necessarily increase preventive care. Physicians and patients should receive periodic education and reinforcement of diabetes management skills to modify care delivered to individuals at highest risk for lower-extremity amputation.
Erythrocyte Sodium-Lithium Countertransport Activity as a Marker of Predisposition to Hypertension and Diabetic Nephropathy in NIDDM
Authors: Fujita Jun , Tsuda Kinsuke , Seno Michiyo , Obayashi Hiroshi , Fukui Iwao , Seino Yutaka 
Published: March 2007

OBJECTIVE
To evaluate the potentiality of erythrocyte sodium-lithium countertransport activity (SLC) as a marker of predisposition to hypertension and diabetic nephropathy in non-insulin-dependent diabetes mellitus (NIDDM).

RESEARCH DESIGN AND METHODS
We examined 96 patients with NIDDM and 26 healthy control subjects. SLC and other data were compared among subgroups of the patients classified on the basis of hypertension, family history of hypertension, and stages of nephropathy. Data were also analyzed by stepwise multiple regression analyses.

RESULTS
SLC was significantly higher in patients with hypertension than in those with normotension and significantly higher in patients with a positive family history of hypertension than in the negative group. Further analysis revealed that a family history of hypertension has independent influence on SLC, but hypertension itself does not. SLC was significantly higher in patients with macroalbuminuria than with microalbuminuria and higher in patients with microalbuminuria than with nor-moalbuminuria. In stepwise multiple regression analyses, a family history of hypertension was the most important determinant of SLC, and SLC was the most important determinant of nephropathy.

CONCLUSIONS
These data suggest that SLC strongly reflects a predisposition to hypertension and that it can be a useful marker of diabetic nephropathy in NIDDM.
Intraperitoneal Insulin Absorption After Lona-Term Intraperitoneal Insulin Therapy
Authors: Scavini Marina , Pincelli Angela , Petrella Giovanna , Galimberti Gabriella , Zager Philip G , Torri Michiela , Pozza Guido 
Published: March 2007

OBJECTIVE
To evaluate insulin absorption through the peritoneal membrane after long-term intraperitoneal insulin therapy using an implanted programmable device.

RESEARCH DESIGN AND METHODS
Seven insulin-dependent diabetes mellitus (IDDM) patients implanted with a programmable pump were studied after 3 and 30 months of intraperitoneal insulin therapy. A 20-min square wave infusion of 15 IU of insulin was administered in the peritoneal space, and plasma glucose and plasma free insulin levels were monitored for 180 min. Hypoglycernia was prevented by intravenous glucose infusion.

RESULTS
After 30 months of intraperitoneal insulin therapy, plasma free insulin profiles following the administration of insulin in the peritoneal space were similar to those observed at the beginning of this mode of therapy.

CONCLUSIONS
In IDDM patients, intraperitoneal insulin absorption does not change after long-term intraperitoneal insulin therapy using an implanted device.
Probucol Normalizes Cholesteryl Ester Transfer in IDDM
Authors: Bagdade J D , Stein E , Ritter M C 
Published: March 2007

OBJECTIVE
Cholesteryl ester transfer (CET) is pathologically increased in insulin-dependent diabetes mellitus (IDDM), and the resulting enrichment of the apolipoprotein B-containing lipoproteins with cholesteryl ester (CE) is believed to increase their atherogenicity. Because we have shown previously that treatment with the lipid-modifying antioxidant probucol normalizes CET in nondiabetic patients with hypercholesterolemia, we sought to determine whether the same beneficial effects could be achieved in IDDM.

RESEARCH DESIGN AND METHODS
CET was measured by both mass and isotopic assay in eight normolipidemic (triglyceride, 102; cholesterol, 192; high-density lipoprotein [HDL] cholesterol, 45 mg/dl) IDDM patients (fructosamine 495 ± 146 μmol/l; normal 174–286) before and after 2 months of treatment with probucol (1.0 g/day).

RESULTS
Before treatment, CET was accelerated abnormally (P &lt; 0.001). As expected, probucol decreased plasma (−13%; P &lt; 0.025) and HDL2 cholesterol levels (−52%; P &lt; 0.025) and the concentration of lipoprotein A-I particles (P &lt; 0.025). In conjunction with these changes, CET fell dramatically in all subjects (mass assay: −94%; isotopic assay: −22%, P &lt; 0.001) with no change in the mass of cholesteryl ester transfer protein (CETP) (pretreatment 2.91 ± 0.97 vs. posttreatment 3.21 ± 1.03 μg/ml). Glycemic control, however, improved significantly (fructosamine 409 ± 85 μmol/l, P &lt; 0.025).

CONCLUSIONS
Because it is believed that accelerated CET promotes the formation of apolipoprotein B-containing lipoproteins enriched with atherogenic CE, the capacity of probucol to reverse this functional abnormality without adversely affecting glycemic control suggests that it has a place in the therapy of IDDM.
Immunogenetic, Clinical, and Demographic Characterization of Childhood Type I Diabetes in New Zealand
Authors: Forbes Louisa V , Scott Russell S , Brown Laurie J , Darlow Brian A 
Published: March 2007

OBJECTIVE
To examine the relationship between genetic susceptibility alleles and islet cell antibodies (ICAs) in type I diabetes.

RESEARCH DESIGN AND METHODS
The human leukocyte antigen (HLA)-DQB1 alleles and ICA levels of all incident type I diabetic cases in patients &lt; 20 years of age diagnosed in 1990 and 1991 in Canterbury, New Zealand, were determined.

RESULTS
The mean annual incidence rate for type I diabetes over the 24 months was 19.0/100,000 patient-years (95% confidence interval [CI] 13.5−26.0/100,000), which was considerably higher than rates observed between 1982 and 1989 (11.7/100,000; 95% CI 9.6−14.3/100,000). ICAs ≥ 10 Juvenile Diabetes Foundation units (JDF U) were present in 84.6% of the subjects, but there was a higher prevalence of ICA-negative (ICA−) subjects among those diagnosed during the winter months. The frequencies of the susceptibility allele DQB1*0302 and susceptibility genotype 0302/0201 were 71.8% and 43.5%, respectively. Subjects with 0302 tended to be younger (mean age 8.3 ± 5.1 years) than those with nonsusceptibility types (mean age 11.8 ± 4.7 years, P = 0.056). The probability of being ICA positive (ICA+) was not significantly different between subjects with allele 0302 (85.7%) and those without it (81.8%). All seven patients negative for ICA were homozygous for DQB1 nonaspartate-57. There was no clustering of the immunogenetic markers with demographic and clinical characteristics apart from age at diagnosis.

CONCLUSIONS
No direct relationship was observed between DQB1-defined genetic susceptibility and ICA at diagnosis, suggesting that variations at the DQB1 locus are not linked to the expression of this autoimmune marker of β-cell destruction.
Impaired Retinal Artery Blood Flow in IDDM Patients Before Clinical Manifestations of Diabetic Retinopathy
Authors: Kawagishi Takahiko , Nishizawa Yoshiki , Emoto Masanori , Konishi Toshiaki , Maekawa Kiyoshi , Hagiwara Satoshi , Okuno Yasuhisa , Inada Hiroshi , Isshiki Gen , Morii Hirotoshi 
Published: March 2007

OBJECTIVE
To determine whether hemodynamic changes in retinal arteries precede clinical manifestations of diabetic retinopathy and to examine the effects of control of hyperglycemia on retinal artery blood flow.

RESEARCH DESIGN AND METHODS
We assessed blood flow in bilateral central retinal arteries in 50 insulin-dependent diabetes mellitus (IDDM) patients without retinopathy and 20 sex- and age-matched control subjects using duplex Doppler sonography. We determined the peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged velocity (TAV), resistance index (RI), and pulsatility index (PI).

RESULTS
PSV, EDV, and TAV were significantly lower in IDDM patients than in control subjects (P &lt; 0.05, P &lt; 0.01, and P &lt; 0.01, respectively). The RI was significantly higher in IDDM patients than in control subjects (P &lt; 0.01) and was significantly correlated with plasma levels of glucose in IDDM patients (r = 0.0.310, P = 0.0248). Multiple regression analysis identified the plasma levels of glucose as a significant determination of RI in IDDM patients. After 14 days of intensive insulin therapy in 7 IDDM patients, the RI and plasma levels of glucose showed significant decreases (P = 0.018, P = 0.001, respectively).

CONCLUSIONS
Our results showed that changes in retinal hemodynamics were present before the clinical detection of overt diabetic retinopathy and suggest that the presence of short-term hyperglycemia partly contributes to impaired retinal circulation.
Muscle Sympathetic Nerve Activity Is Higher in Intensively versus Conventionally Treated IDDM Subjects
Authors: Hoffman Robert P , Sinkey Christine A , Anderson Erling A 
Published: March 2007

OBJECTIVE
To determine whether poor long–term glycemie control may play a role in the lower muscle sympathetic nerve activity (MSNA) levels in insulindependent diabetes mellitus (IDDM).

RESEARCH DESIGN AND METHODS
Intraneural electrodes were used to record MSNA from the peroneal nerve at baseline and during euglycemic insulin infusion (120 mU · m−2 · min−1) in 16 IDDM subjects enrolled in the Diabetes Control and Complications Trial (DCCT), 8 intensively treated (HbAlc 7.1 ± 1.2%) and 8 conventionally treated (HbA1c 9.0 ± 1.5%; P &lt; 0.05).

RESULTS
Fasting plasma glucose levels tended to be higher at baseline in the conventionally treated group (11.3 ± 1.7 mmol/l) than in the intensively treated group (7.4 ±1.1 mmol/l, P &lt; 0.1), but did not differ during insulin infusion (conventional, 5.0 ± 0.3 mmol/l; intensive, 5.1 ± 0.4 mmol/l). Plasma free insulin levels did not differ between groups either before or during insulin infusion. The intensively treated group had significantly higher MSNA levels than the conventionally treated group both in the fasting state (16.2 ± 2.7 vs. 10.5 ± 4.4 bursts/min, P &lt; 0.05) and during insulin infusion with euglycemia (27.8 ± 2.1 vs. 17.5 ± 5.2 bursts/min).

CONCLUSIONS
MSNA levels in intensively treated IDDM subjects are higher than in conventionally treated subjects. These results suggest that improved long-term glycemie control is associated with increased sympathetic neural outflow to muscle. The mechanism for this effect remains unclear.
Trial of Pentoxifylline for Diabetic Impotence
Authors: Georgitis William J , Merenich John A 
Published: March 2007

OBJECTIVE
To test the effectiveness of pentoxifylline as a therapy for diabetic impotence.

RESEARCH DESIGN AND METHODS
A 3-month placebo-controlled double-blind treatment study was conducted at a single center. Therapeutic response was assessed subjectively by serial self-appraisals of erectile function and objectively by nocturnal penile tumescence (NPT) monitoring.

RESULTS
This cohort of impotent diabetic men displayed substantial neurological and penile vascular dysfunction. Age, body mass index, duration of diabetes, duration of impotence, glycemie control, mode of therapy for non-insulin-dependent diabetes, mean testosterone, mean prolactin, and penile brachial indexes were similar in the treatment (n = 34) and placebo groups (n = 26). NPT monitoring revealed infrequent erectile events, diminished average rigidity, and decreased tumescence. Pentoxifylline did not alter overall glycemie control and did not improve neurological, vascular, or erectile function. In fact, a slight decrease in average percent rigidity from 22 ± 3 to 17 ± 2% (mean ± SE, P &lt; 0.05) was observed in the pentoxifylline-treated group. Although eight (24%) pentoxifylline-treated and five (19%) placebo-treated men reported benefit, no objective improvement was observed in nocturnal tumescence.

CONCLUSIONS
Pentoxifylline is not an effective treatment for diabetic erectile dysfunction.