bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute Fructose Administration Improves Oral Glucose Tolerance in Adults With Type 2 Diabetes
Authors: Moore Mary Courtney , Davis Stephen N. , Mann Stephnie L. , Cherrington Alan D. 
Published: March 2007

OBJECTIVE—In normal adults, a small (catalytic) dose of fructose administered with glucose decreases the glycemic response to a glucose load, especially in those with the poorest glucose tolerance. We hypothesized that an acute catalytic dose of fructose would also improve glucose tolerance in individuals with type 2 diabetes.
RESEARCH DESIGN AND METHODS—Five adults with type 2 diabetes underwent an oral glucose tolerance test (OGTT) on two separate occasions, at least 1 week apart. Each OGTT consisted of 75 g glucose with or without the addition of 7.5 g fructose (OGTT + F or OGTT – F), in random order. Arterialized blood samples were collected from a heated dorsal hand vein twice before ingestion of the carbohydrate and every 15 min for 3 h afterward.
RESULTS—The area under the curve (AUC) of the plasma glucose response was reduced by fructose administration in all subjects; the mean AUC during the OGTT + F was 14% less than that during the OGTT – F (P &lt; 0.05). The insulin AUC was decreased 21% with fructose administration (P = 0.2). Plasma glucagon concentrations declined similarly during OGTT – F and OGTT + F. The incremental AUC of the blood lactate response during the OGTT – F was ∼50% of that observed during the OGTT + F (P &lt; 0.05). Neither nonesterified fatty acid nor triglyceride concentrations differed between the two OGTTs.
CONCLUSIONS—Low-dose fructose improves the glycemic response to an oral glucose load in adults with type 2 diabetes, and this effect is not a result of stimulation of insulin secretion.
A Randomized Controlled Trial Using Glycemic Plus Fetal Ultrasound Parameters Versus Glycemic Parameters to Determine Insulin Therapy in Gestational Diabetes With Fasting Hyperglycemia
Authors: Kjos Siri L. , Schaefer-Graf Ute , Sardesi Smeeta , Peters Ruth K. , Buley Ann , Xiang Anny H. , Bryne James D. , Sutherland Cher , Montoro Martin N. , Buchanan Thomas A. 
Published: March 2007

OBJECTIVE—To compare management based on maternal glycemic criteria with management based on relaxed glycemic criteria and fetal abdominal circumference (AC) measurements in order to select patients for insulin treatment of gestational diabetes mellitus (GDM) with fasting hyperglycemia.
RESEARCH DESIGN AND METHODS—In a pilot study, 98 women with fasting plasma glucose (FPG) concentrations of 105–120 mg/dl were randomized. The standard group received insulin treatment. The experimental group received insulin if the AC, measured monthly, was ≥70th percentile and/or if any venous FPG measurement was &gt;120 mg/dl. Power was projected to detect a 250-g difference in birth weights.
RESULTS—Gestational ages, maternal glycemia, and AC percentiles were similar at randomization. After initiation of protocol, venous FPG (P = 0.003) and capillary blood glucose levels (P = 0.049) were significantly lower in the standard group. Birth weights (3,271 ± 458 vs. 3,369 ± 461 g), frequencies of birth weights &gt;90th percentile (6.3 vs 8.3%), and neonatal morbidity (25 vs. 25%) did not differ significantly between the standard and experimental groups, respectively. The cesarean delivery rate was significantly lower (14.6 vs. 33.3%, P = 0.03) in the standard group; this difference was not explained by birth weights. In the experimental group, infants of women who did not receive insulin had lower birth weights than infants of mothers treated with insulin (3,180 ± 425 vs. 3,482 ± 451 g, P = 0.03).
CONCLUSIONS—In women with GDM and fasting hyperglycemia, glucose plus fetal AC measurements identified pregnancies at low risk for macrosomia and resulted in the avoidance of insulin therapy in 38% of patients without increasing rates of neonatal morbidity.
A Pilot Study of the Continuous Glucose Monitoring System
Authors: Kaufman Francine R. , Gibson Leena C. , Halvorson Mary , Carpenter Sue , Fisher Lynda K. , Pitukcheewanont Pisit 
Published: March 2007

OBJECTIVE—To determine whether the continuous glucose monitoring system (CGMS) (MiniMed, Sylmar, CA) could be used to make clinical decisions and whether it has an impact on glycemia in pediatric type 1 diabetic subjects.
RESEARCH DESIGN AND METHODS—Pediatric subjects were recruited if they had HbA1c &gt;8.0% with management problems (n = 35) or episodes of severe or nocturnal hypoglycemia or hypoglycemia unawareness associated with HbA1c ≤8.0% (n = 12). A total of 47 patients with a mean HbA1c value of 8.6 ± 1.6% (mean age 11.8 ± 4.6 years, youngest 2.7 years, and diabetes duration 5.5 ± 3.5 years) on three to four insulin injections/day (n = 24) or insulin pump therapy (n = 23) were followed with the CGMS for a mean of 69.5 ± 28 h. Comparisons were made between the number of high (&gt;150 mg/dl) and low (&lt;70 mg/dl) glucose patterns discerned with the sensor or the logbook, and HbA1c levels were evaluated.
RESULTS—In patients on injection therapy, 30 high or low glucose patterns were discerned with the logbook records and 120 patterns with the CGMS. Specific alterations of the diabetes regimen were made. An overall significant change in HbA1c, from 3 months before wearing the sensor to 6 months after (analysis of variance 0.04), was found in the subjects. Post hoc analysis showed a significant change in HbA1c from 8.6 ± 1.5% at baseline to 8.4 ± 1.3% at 3 months (paired Student’s t test 0.03).
CONCLUSIONS—The CGMS can be used by pediatric patients to detect abnormal patterns of glycemia. The information that was obtained could be used to alter the diabetes regimen and impact glycemic outcome.
Prevalence and Determinants of Type 2 Diabetes Among Filipino-Americans in the Houston, Texas Metropolitan Statistical Area
Authors: Cuasay Luceli C. , Lee Eun Sul , Orlander Philip P. , Steffen-Batey Lyn , Hanis Craig L. 
Published: March 2007

OBJECTIVE—The few available studies suggest that Filipino-Americans have an increased risk for developing type 2 diabetes. The purpose of this study was to determine the prevalence of previously diagnosed type 2 diabetes and its major risk factors among Filipino-Americans.
RESEARCH DESIGN AND METHODS—A cross-sectional survey was conducted in the Houston, Texas, metropolitan statistical area between September 1998 and March 2000. The convenience sample included 831 Filipino-American participants aged 20–74 years. The major risk factors assessed were age, sex, family history of diabetes, socioeconomic status, obesity (BMI &gt;30), physical inactivity, acculturation, region of birth and, in women, history of gestational diabetes and delivery of a baby weighing &gt;9 lb.
RESULTS—Overall prevalence was estimated to be 16.1% (95% CI 13.5–18.7). Multivariate logistic regression analyses identified independent risk factors: increasing age from ages 35–44 years (odds ratio [OR] 5.6, 95% CI 1.5–20.5) to 65–74 years (34.2, 7.2–163.0); male sex (1.8, 1.1–32.1); family history of diabetes (4.7, 2.6–8.5); obesity (3.6, 1.4–9.0); region of birth, Mindanao (3.2, 1.3–7.7); and, among women, gestational diabetes (21.7, 6.7–69.7) and low income (5.3, 1.4–20.2).
CONCLUSIONS—The study observed a high prevalence of type 2 diabetes and supports earlier studies suggesting that Filipinos are at higher risk for type 2 diabetes than the U.S. non-Hispanic white population.
Type 2 Diabetes in Older Well-Functioning People: Who Is Undiagnosed?
Authors: Franse Lonneke V. , Di Bari Mauro , Shorr Ron I. , Resnick Helaine E. , van Eijk Jacques T. M. , Bauer Doug C. , Newman Anne B. , Pahor Marco ,   for the Health, Aging, and Body Composition Study Group
Published: March 2007

OBJECTIVE—To assess, in an older population, the prevalence of diagnosed and undiagnosed diabetes, the number needed to screen (NNTS) to identify one individual with undiagnosed diabetes, and factors associated with undiagnosed diabetes.
RESEARCH DESIGN AND METHODS—Socioeconomic and health-related factors were assessed at the baseline examination of the Health, Aging, and Body Composition (Health ABC) Study, a cohort of 3,075 well-functioning people aged 70–79 years living in Memphis, Tennessee and Pittsburgh, Pennsylvania (42% blacks and 48% men). Diabetes was defined according to the 1985 World Health Organization criteria (fasting glucose ≥7.8 mmol/l or 2-h glucose ≥11.1 mmol/l) and the 1997 American Diabetes Association criteria (fasting glucose ≥7.0 mmol/l).
RESULTS—The prevalence of diagnosed and undiagnosed diabetes was 15.6 and 8.0%, respectively, among all participants (NNTS 10.6), 13.9 and 9.1% among white men (NNTS 9.5), 7.8 and 7.4% among white women (NNTS 12.4), 22.7 and 9.1% among black men (NNTS 8.5), and 21.6 and 6.2% among black women (NNTS 12.6). In multivariate analyses, compared with individuals without diabetes, individuals with undiagnosed diabetes were more likely to be men and were more likely to have a history of hypertension, higher BMI, and larger waist circumference. NNTS was lowest in men (9.1), individuals with hypertension (8.7), individuals in the highest BMI quartile (6.9), and individuals in the largest waist circumference quartile (6.8).
CONCLUSIONS—In approximately one-third of all older people with diabetes, the condition remains undiagnosed. Screening for diabetes may be more efficient among men and individuals with hypertension, high BMI, and large waist circumference.
Teaching Subjects With Type 2 Diabetes How to Incorporate Sugar Choices Into Their Daily Meal Plan Promotes Dietary Compliance and Does Not Deteriorate Metabolic Profile
Authors: Nadeau Julie , Koski Kristine G. , Strychar Irene , Yale Jean-François 
Published: March 2007

OBJECTIVE— To determine whether teaching free-living subjects with type 2 diabetes how to incorporate added sugars or sweets into their daily meal plan results in a greater consumption of calories (fat or sugar)and deteriorates their glycemic or lipid profiles but improves their perceived quality of life.
RESEARCH DESIGN AND METHODS— In an 8-month randomized controlled trial, 48 free-living subjects with type 2 diabetes were taught either a conventional (C) meal plan (no concentrated sweets) or one permitting as much as 10% of total energy as added sugars or sweets (S). Mean individual nutrient intake was determined using the average of six 24-h telephone recalls per 4 months. Metabolic control and quality of life were evaluated every 2 months. Quality of life was assessed using the Medical Outcome Survey and the Diabetes Quality of Life questionnaire.
RESULTS— The S group did not consume more calories (fat or sugar) and in fact ate significantly less carbohydrate (- 15 vs. 10 g) and less starch (- 7 vs. 8 g) and had a tendency to eat fewer calories (- 77 vs. 81 kcal) than the C group. Weight remained stable, and there was no evidence that consuming more sugar worsened metabolic profile or improved their perceived quality of life.
CONCLUSIONS— Giving individuals with type 2 diabetes the freedom to include sugar in their daily meal plan had no negative impact on dietary habits or metabolic control. Health professionals can be reassured and encouraged to teach the new “sugar guidelines,” because doing so may result in a more conscientious carbohydrate consumption.
Renin-Angiotensin System Gene Polymorphisms, Blood Pressure,Dyslipidemia, and Diabetes in Hong Kong Chinese
Authors: Thomas G. Neil , Tomlinson Brian , Chan Juliana C.N. , Sanderson John E. , Cockram Clive S. , Critchley Julian A.J.H. 
Published: March 2007

OBJECTIVE— In Chinese populations, hypertension is common and is a major risk factor for cerebrovascular and coronary heart disease,particularly when associated with diabetes. The clustering of these disorders and dyslipidemia and obesity is termed the metabolic syndrome and is increasing in prevalence in the populations of modernizing Asian nations. The renin-angiotensin system (RAS) helps maintain blood pressure and salt homeostasis and may play a role in the pathogenesis of aspects of the metabolic syndrome. We investigated three RAS gene polymorphisms—the ACE insertion/deletion (I/D), angiotensinogen (AGT) M235T, and angiotensin II type 1 receptor (AT1R) A1166C polymorphisms—for a possible role in modulating these disorders in 853 Chinese subjects with varying components of the metabolic syndrome.
RESEARCH DESIGN AND METHODS— The three gene polymorphisms of this crosssectional study were detected using polymerase chain reaction—based protocols. The genotype frequencies were compared between the controls (n = 119) and both overlapping and nonoverlapping groups of patients with type 2 diabetes, hypertension, and dyslipidemia usingχ2 test. Differences in levels of the biochemical parameters between the genotypes were determined using analysis of variance.
RESULTS— No significant relationship was identified between these polymorphisms and blood pressure in this population. Although the AT1RA1166C polymorphism was not associated with any aspect of the metabolic syndrome examined, there was limited evidence to suggest that the AGT M235T polymorphism may be associated with cholesterol levels. The ACE I allele was significantly more frequent in each group comprising subjects with type 2 diabetes/glucose intolerance (GIT), and the I allele was associated with higher fasting plasma glucose levels.
CONCLUSIONS— These findings suggest that these polymorphisms are unlikely to be involved in the pathogenesis of hypertension. The ACE I/D polymorphism was associated with the metabolic syndrome, having a higher frequency of I allele—containing genotypes in those groups, but this appeared to result predominantly from the relationship with type 2 diabetes/GIT in this population of Chinese subjects.
Changes in Cognitive Abilities Over a 4-Year Period Are Unfavorably Affected in Elderly Diabetic Subjects
Authors: Fontbonne Annick , Berr Claudine , Ducimetière Pierre , Alpérovitch Annick 
Published: March 2007

OBJECTIVE— To compare 4-year changes in cognitive performance among elderly subjects according to category of fasting blood glucose (FBG)using American Diabetes Association criteria.
RESEARCH DESIGN AND METHODS— Subjects without any detectable cognitive dysfunction were selected from the Epidemiology of Vascular Aging(EVA) Study, a cohort of community-dwelling people aged 59-71 years at baseline. They were classified into glucose categories (normal, impaired fasting glucose [IFG], or diabetic) based on FBG values or known diabetes. Their cognitive abilities were assessed by a global test (Mini Mental Status Examination [MMSE]) and eight domain-specific tests, and they were reassessed 4 years later. Serious cognitive worsening was defined as a score evolution into the worst 15% of the sample's distribution of score differences (4-year score minus baseline score) for each test.
RESULTS— At baseline, age-, sex-, and education-adjusted scores for all cognitive tests except one were similar across glucose categories. After 4 years, diabetic subjects had a lower performance on all tests except the MMSE, with differences reaching statistical significance on four tests. Adjusted odds ratios for serious worsening over 4 years in diabetic subjects, with reference to normal subjects, were &gt;2 for four tests (P &lt; 0.05) and bordering this value for two others(P &lt; 0.09). Further adjustment for blood pressure or potential cognition-affecting substances (alcohol, tobacco, and medications) did not modify these results.
CONCLUSIONS— Despite similar high initial cognitive function,diabetic subjects tended to have an unfavorable evolution of cognitive performance over 4 years compared with subjects who had normal glucose or IFG.
Behavior Therapy for Families of Adolescents With Diabetes
Authors: Wysocki Tim , Greco Peggy , Harris Michael A. , Bubb Jeannie , White Neil H. 
Published: March 2007

OBJECTIVE—This study reports 6- and 12-month follow-up for the families of adolescents with diabetes who participated in a trial of Behavioral–Family Systems Therapy (BFST).
RESEARCH DESIGN AND METHODS—A total of 119 families of adolescents with type 1 diabetes were randomized to 3 months of treatment with either BFST, an education and support (ES) group, or current therapy (CT). Family relationships, adjustment to diabetes, treatment adherence, and diabetic control were assessed at baseline, after 3 months of treatment, and 6 and 12 months later. This report focuses on the latter two evaluations.
RESULTS—Compared with CT and ES, BFST yielded lasting improvements in parent-adolescent relationships and diabetes-specific conflict. Delayed effects on treatment adherence emerged at 6- and 12-month follow-ups. There were no immediate or delayed effects on adolescents’ adjustment to diabetes or diabetic control.
CONCLUSIONS—BFST yielded lasting improvement in parent-adolescent relationships and delayed improvement in treatment adherence, but it had no effect on adjustment to diabetes or diabetic control. A variety of adaptations to BFST could enhance its impact on diabetes outcomes.
HbA1c Measurement Improves the Detection of Type 2 Diabetes in High-Risk Individuals With Nondiagnostic Levels of Fasting Plasma Glucose
Authors: Perry R. Clark , Shankar R. Ravi , Fineberg Naomi , McGill Janet , Baron Alain D. 
Published: March 2007

OBJECTIVE—Whereas new diagnostic criteria based on a fasting plasma glucose (FPG) of &gt;126 mg/dl (7.8 mmol/l) have improved the detection of diabetes, multiple reports indicate that many people with diabetes diagnosed by 2-h oral glucose tolerance test (OGTT) glucose measurements of ≥11.1 mmol/l (200 mg/dl) would remain undiagnosed based on this FPG criteria. Thus, improved methods to detect diabetes are particularly needed for high-risk individuals. We evaluated whether the combination of FPG and HbA1c measurements enhanced detection of diabetes in those individuals at risk for diabetes with nondiagnostic or minimally elevated FPG.
RESEARCH DESIGN AND METHODS—We analyzed FPG, OGTT, and HbA1c data from 244 subjects screened for participation in the Early Diabetes Intervention Program (EDIP).
RESULTS—Of 244 high-risk subjects studied by FPG measurements and OGTT, 24% of the individuals with FPG levels of 5.5–6.0 mmol/l (100–109 mg/dl) had OGTT-diagnosed diabetes, and nearly 50% of the individuals with FPG levels of 6.1–6.9 mmol/l (110–125 mg/dl) had OGTT-diagnosed diabetes. In the subjects with OGTT-diagnosed diabetes and FPG levels between 5.5 and 8.0 mmol/l, detection of an elevated HbA1c (&gt;6.1% or mean + 2 SDs) led to a substantial improvement in diagnostic sensitivity over the FPG threshold of 7.0 mmol/l (61 vs. 45%, respectively, P = 0.002). Concordant FPG levels ≥7.0 mmol/l (currently recommended for diagnosis) occurred in only 19% of our cohort with type 2 diabetes.
CONCLUSIONS—Diagnostic criteria based on FPG criteria are relatively insensitive in the detection of early type 2 diabetes in at-risk subjects. HbA1c measurement improves the sensitivity of screening in high-risk individuals.
Improvement of Glycemic Control by 1 Year of Insulin Therapy Leads to a Sustained Decrease in sE-Selectin Concentrations in Type 2 Diabetes
Authors: Ryysy Leena , Yki-Järvinen Hannele 
Published: March 2007

OBJECTIVE—To examine whether and how improvement of glycemic control by long-term insulin therapy decreases endothelial activation as measured by serum levels of the soluble adhesion molecules sE-selectin and vascular cell adhesion molecule (VCAM-1) and whether the drug used to lower blood glucose in addition to insulin influences such a response.RESEARCH DESIGN AND METHODS—Circulating adhesion molecules were measured before and after 3 and 12 months of therapy in 81 patients with type 2 diabetes and 41 subjects without diabetes. The patients were treated with bedtime administration of NPH insulin combined with either glibenclamide (n = 19), metformin (n = 17), glibenclamide and metformin (n = 17), or morning administration of NPH insulin (n = 23).RESULTS—Before insulin therapy, serum sE-selectin level was 71% higher in the patients with type 2 diabetes (77 ± 4 ng/ml) than in the normal subjects (45 ± 3 ng/ml, P &lt; 0.001), whereas levels of sVCAM-1 were comparable (420 ± 25 vs. 400 ± 11 ng/ml, respectively). Glycemic control in all patients improved as judged from a decrease in HbA1c from 9.7 ± 0.2 to 7.6 ± 0.1% (P &lt; 0.001). sE-selectin decreased to 67 ± 4 ng/ml by 3 months (P &lt; 0.001 vs. 0 months) and then remained unchanged until 12 months (70 ± 4 ng/ml, P &lt; 0.001 vs. 0 months). sVCAM-1 levels at 12 months was similar to those at 0 months (416 ± 25 ng/ml). The change in glycemic control, measured by HbA1c, but not in other parameters, was correlated with the change of sE-selectin (r = 0.41, P &lt; 0.001) within the patients with type 2 diabetes. The decreases in sE-selectin were not different between the various treatment groups.CONCLUSIONS—We conclude that improvement in glycemic control by administration of insulin alone or insulin combined with either glibenclamide, metformin, or both agents induces a sustained decrease in sE-selectin, the magnitude of which seems to be dependent on the degree of improvement in glycemia. These data suggest that sE-selectin might provide a marker of effects of treatment of chronic hyperglycemia on endothelial activation.
Factors Predicting the Age When Type 2 Diabetes Is Diagnosed in Hong Kong Chinese Subjects
Authors: Lee Shao C. , Ko Gary T.C. , Li June K.Y. , Chow Chun C. , Yeung Vincent T.F. , Critchley Julian A.J.H. , Cockram Clive S. , Chan Juliana C.N. 
Published: March 2007

OBJECTIVE—To examine the factors predicting age at diagnosis of type 2 diabetes in Hong Kong Chinese.
RESEARCH DESIGN AND METHODS—The relationships between age at diagnosis and parental history of diabetes as well as an array of clinical and metabolic factors were examined using a hospital clinic-based diabetes registry involving 3,414 index patients with type 2 diabetes. Patterns of age at diagnosis in successive generations were also examined using 21 affected child-parent pairs and 7 affected child-parent-grandparent trios.
RESULTS—Approximately 29% of the index patients were diagnosed with type 2 diabetes at ≤35 years of age (hereby defined as early-onset). Compared with the patients diagnosed at &gt;35 years of age (hereby defined as late-onset), the early-onset patients had higher rates of positive paternal (16 vs. 5%) and maternal (22 vs. 12%) history of diabetes (both at P &lt; 0.01) and had poorer metabolic profiles. In the overall index patients, male sex, higher HbA1c, waist-to-hip ratio (WHR), and systolic blood pressure (sBP); lower HDL cholesterol level; and a positive paternal as well as maternal history of diabetes predicted younger age at diagnosis. More senior age and higher BMI and diastolic blood pressure predicted older age at diagnosis. Predictors for younger age at diagnosis in the male patients were higher HbA1c and sBP and a positive paternal history of diabetes. Predictors for younger age at diagnosis in the female patients were higher HbA1c, WHR, and sBP and a paternal as well as maternal history of diabetes. In the affected child-parent pairs and child-parent-grandparent trios, there was a decrease in age at diagnosis in successive generations.
CONCLUSIONS—Our data indicate that both familial (possibly genetic) and metabolic factors affect the age of onset of type 2 diabetes in the Chinese population. The results also suggest an onset and progression pattern of the disease that is compatible with the phenomenon of anticipation.