bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of Distal Symmetric (Sensory) Neuropathy in NIDDM: The San Luis Valley Diabetes Study
Authors: Sands M L , Shetterly S M , Franklin G M , Hamman R F 
Published: March 2007

OBJECTIVE
To determine the incidence and risk factors for distal symmetric sensory neuropathy (DSN) in people with NIDDM.

RESEARCH DESIGN AND METHODS
Prospective follow-up was conducted from 1988 to 1992 on 231 people free of DSN during the baseline period 1984–1988 (mean follow-up, 4.7 years). Subjects with incident DSN (n = 66) were defined by any two of three criteria: 1) bilateral paresthesia in legs or feet; 2) bilateral decreased or absent ankle reflexes; and/or 3) bilateral decreased or absent cold temperature discrimination in feet. Of all 66 cases, 42 had one positive follow-up visit; 14 cases had 2 positive follow-up visits.

RESULTS
The overall incidence rate of DSN was 6.1 per 100 person-years (95% CI, 4.7–7.8). The rate for Hispanics (n = 164) and non-Hispanic whites (n = 67), adjusted for age, sex, and NIDDM duration, was 5.3 per 100 person-years (95% CI, 3.9–7.0) and 5.0 per 100 person-years (95% CI, 2.8–8.1), respectively. Adjusting for age and sex, higher glycohemoglobin level and lower C-peptide secretion were associated with increased DSN but were no longer predictive after accounting for duration of diabetes. Logistic regression models found significantly increased risk of DSN for insulin treatment, current smoking, and history of myocardial infarction. Duration was related to DSN incidence until insulin treatment was included. Other risk factors, including height, weight, family history of diabetes, peripheral vascular disease, hypertension, urinary albumin, protein:creatinine ratio, retinopathy, and alcohol use, were not significantly related to incident DSN.

CONCLUSIONS
Hispanic and non-Hispanic whites with NIDDM have similar risks of DSN. Current cigarette smoking and a history of myocardial infarction may represent independent risk factors for DSN in addition to glycemic control.
Solitary Pancreas Transplantation: Experience with 62 consecutive cases
Authors: Stratta Robert J , Weide Lamont G , Sindhi Rakesh , Sudan Debra , Jerius John T , Larsen Jennifer L , Cushing Kathleen , Grune Martin T , Radio Stanley J 
Published: March 2007

OBJECTIVE
To determine the safety and efficacy of solitary pancreas transplantation in the treatment of IDDM.

RESEARCH DESIGN AND METHODS
A single-center retrospective case series of 62 consecutive solitary pancreas transplants (20 sequential pancreas after kidney, 42 pancreas transplants alone) performed in 57 adult IDDM patients was studied. Indications for solitary pancreas transplantation were 1) the presence of two or more overt diabetic complications and/or 2) glucose hyperlability with hypoglycemic unawareness and impaired quality of life. The recipient group consisted of 31 men and 26 women with a mean age of 38 years (range 25–62) and a mean duration of diabetes of 26 years (range 14–52). Mean pretransplant glycohemoglobin level was 9.9 ± 2.6%. Organ acceptance was restricted to ideal donors and man-dated a minimum of a two-antigen match (mean human leukocyte antigen ABDR match 2.7). The mean cold ischemia time was 16.6 h. Whole-organ pancreas transplantation was performed with bladder drainage by the duodenal segment technique. All patients were managed with either triple or quadruple immunosuppression. Monitoring included prospective urine cytology as well as cystoscopic transduodenal needle biopsies.

RESULTS
The mean length of initial hospital stay was 18 days, and mean hospital charges were $106,341. The incidences of rejection, infection, and surgical complications were 70, 55, and 47%, respectively. Overall patient and graft survival rates were 86 and 52%, respectively, with a mean follow-up of 28 months. All patients with functioning grafts had excellent metabolic control (mean glycohemoglobin level 5.1%) and achieved good rehabilitation.

CONCLUSIONS
Despite morbidity, solitary pancreas transplantation can be performed with improving success, can enhance quality of life, and can offer an opportunity to arrest secondary diabetic complications.
Dual Hormonal Replacement With Insulin and Recombinant Human Insulin-Like Growth Factor I in IDDM: Effects on glycemic control, IGF-I levels, and safety profile
Authors: Quattrin Teresa , Thrailkill Kathryn , Baker Lester , Litton Jean , Dwigun Karen , Rearson Melissa , Poppenheimer Mary , Giltinan David , Gesundheit Neil , Martha Paul , Jr  
Published: March 2007

OBJECTIVE
To examine if dual replacement with insulin and rhIGF-I, recombinant human insulin-like growth factor I (rhIGF-I) may be safe and result in improved metabolic control and reduced insulin usage.

RESEARCH DESIGN AND METHODS
Forty-three patients with IDDM were randomized to receive a daily injection of rhIGF-I (80 mcg/kg s.c.) or placebo while on conventional insulin therapy for 4 weeks. Insulin was adjusted in the attempt to achieve predetermined goal glycemic values. Free and total IGF-I, four daily blood glucoses, and HbA1c were measured.

RESULTS
Before randomization, placebo and rhIGF-I groups exhibited low plasma levels of free and total IGF-I, which increased toward normal levels during the treatment period only in the rhIGF group. The regression curve obtained from the average of daily blood glucose measurements indicated that the glycemic profile, overlapping in the lead-in period, exhibited a downward trend in the rhIGF-I group during the treatment period. Mean blood glucose level during the last 10 days of treatment was lower in the rhIGF-I groups (174 ± 37 vs. 194 ± 32 mg/dl). HbA1c level was reduced by more than one-half percent more in the rhIGF-I group (−1.85%) than in the control group (−1.3%). The dose of regular insulin was significantly lower in the rhIGF-I group (0.2 ± 0.1 vs. 0.28 ± 0.1 U · kg−1 · 10 days−1 in the placebo group; P &lt; 0.05).

CONCLUSIONS
rhIGF-I in combination with conventional insulin treatment ameliorated the low plasma total and free IGF-I levels and was well tolerated in IDDM. There was a trend toward improved glycemic control, while the regular insulin dose was significantly decreased.
Diabetic Ketoacidosis Among Obese African-American Adolescents With NIDDM
Authors: Pinhas-Hamiel Orit , Dolan Lawrence M , Zeitler Philip S 
Published: March 2007

OBJECTIVE
To determine whether ketosis at the time of presentation occurs among African-American adolescents with NIDDM.

RESEARCH DESIGN AND METHODS
We reviewed the charts of all islet cell antibody (ICA) negative patients diagnosed with NIDDM at Children's Hospital Medical Center (CHMC) between 1982 and 1995.

RESULTS
Between 1982 and 1985, 70 adolescents were diagnosed with NIDDM. Of these, ICA determinations were available and negative on 42 subjects (28 African-American, 12 white). Twelve of 28 (42%) African-American patients presented with ketonuria, and seven of 28 (25%) presented with DKA. In comparison, none of the 12 white adolescents with NIDDM had ketonuria at presentation or during their subsequent course. Mean follow-up time for patients with ketosis at presentation was 24 months. There was no difference between the age, BMI, or sex distribution of patients with and without ketosis. Previously diagnosed hypertension was present in 42% of patients presenting with ketosis, compared with 17% of the general NIDDM population at CHMC.

CONCLUSIONS
We conclude that ketosis may occur among African-American adolescents with NIDDM, as has been previously reported among African-American adults with NIDDM. Therefore, ketosis in obese young African-American patients with new-onset diabetes does not necessarily imply the presence of IDDM and insulin dependence.
Ethnic Differences in the Incidence of Childhood IDDM in Israel (1965–1993): Marked increase since 1985, especially in Yemenite Jews
Authors: Shamis Igor , Gordon Orit , Albag Yael , Goldsand George , Laron Zvi 
Published: March 2007

OBJECTIVE
To establish the changes in the incidence of childhood IDDM during the years 1965–1993 in the different ethnic groups in Israel.

RESEARCH DESIGN AND METHODS
A whole-country register of childhood IDDM (0–17 years) was started in Israel in 1965. Onset of IDDM was considered to be the date of first insulin injection. The data were collected from all outpatient clinics and hospitals. Ascertainment is estimated to be over 95%.

RESULTS
A total of 1,868 patients were registered for a period of 28 years. Marked differences were found between ethnic groups. The highest incidence was among the Yemenite Jews, who reached an incidence of 18.5/105, followed by Ashkenazi Jews (10.0/105), non-Ashkenazi Jews, except Yemenites (7.3/105), and Arabs (2.9/105). In addition, it was found that in all Jewish subgroups, in contrast with the Arabs, there was a marked increase in incidence after 1985.

CONCLUSIONS
Israel is a country with low, intermediate, and high incidence of childhood IDDM. The interethnic differences in incidence are probably due to genetic factors. However, the significant increase in incidence since 1985 in the Jewish population is ascribed to thus far unidentified environmental factors. It is hypothesized that the marked increase in IDDM is due to environmental factors linked to changes in affluence and lifestyle. These may also explain the difference in incidence between the Jewish and Arab populations, the latter living more in rural areas and leading a more traditional lifestyle.
Waist Circumference and Waist-to-Hip Ratio Are Related to Gestational Glucose Tolerance
Authors: Branchtein Leandro , Schmidt Maria Inês , Mengue Sotero S , Reichelt Ângela J , Matos Maria Cristina G , Duncan Bruce B 
Published: March 2007

OBJECTIVE
To evaluate the relationship of central fat distribution with gestational glucose tolerance during the usual time for screening gestational diabetes.

RESEARCH DESIGN AND METHODS
This cross-sectional study investigated 1,113 consecutive women, ≥ 20 years old, pregnant for ∼ 21 to 28 weeks, without history of previous diabetes outside pregnancy, who attended two general prenatal care units in Porto Alegre, Brazil, from 1991 to 1993. Weight, height, waist and hip circumferences, and skinfolds were measured, and a 2-h, 75-g glucose tolerance test was performed. Data were analyzed using multiple linear regression models.

RESULTS
Waist-to-hip ratio (WHR) and waist circumference were independently associated with higher 2-h glycemia. Glycemic level was 0.11 and 0.13 mmol/l greater for each standard deviation increase in WHR (0.06) and waist circumference (8.0 cm), respectively (P &lt; 0.02). Restricting analyses to the subset of women with uterine height ≤ 26 cm improved the association (0.13 and 0.19 mmol/l, respectively, P &lt; 0.02); differences of 0.22 and 0.19 mmol/l were observed for 1 SD changes in the sum of skinfold thicknesses (24.7 mm) and in age (5.5 years), respectively.

CONCLUSIONS
Central fat distribution measured in pregnancy is an independent predictor of gestational glucose intolerance. This finding supports the concept that NIDDM and gestational diabetes are parts of the same disease, differing basically in their moment of detection. The usefulness of these anthropometric measurements in identifying pregnant women at high risk of having gestational glucose intolerance merits further investigation.
Prevalence of Diabetes and Impaired Glucose Tolerance in Aragón, Spain
Authors: Tamayo-Marco Benito , Faure-Nogueras Eduardo , Roche-Asensio María José , Rubio-Calvo Emilio , Sánchez-Oriz Enrique , Salvador-Oliván José Antonio 
Published: March 2007

OBJECTIVE
To determine the prevalence of diabetes and impaired glucose tolerance (IGT) and to investigate their associated cardiovascular risk factors in Aragón, Spain.

RESEARCH DESIGN AND METHODS
We performed a population-based cross-sectional study with stratified and purposive sampling of residents aged 10–74 years. A sample of 935 subjects (427 men and 508 women) was selected. All except those with a previous history of diabetes underwent an oral glucose tolerance test (OGTT), and World Health Organization (WHO) criteria were used for diagnosis of undiagnosed diabetes and IGT. Plasma lipid levels, blood pressure, BMI, and waist-to-hip ratio were also measured.

RESULTS
The prevalence of diagnosed and undiagnosed diabetes and IGT was 3.1, 3.0, and 7.2%, respectively. In the age range of 30–64 years, the age-adjusted prevalence of diabetes (using the world population of Segi) was 7.1% in men and 5.6% in women. Both diabetes and IGT were associated with high blood pressure, high triglyceride levels, low HDL cholesterol levels, and overweight and upper-body fat distribution. Only upper-body fat distribution in women was significantly higher in subjects with diabetes than in subjects with IGT.

CONCLUSIONS
The prevalence of diabetes in Aragón was moderately high (6.1%) and comparable with that reported in other white populations around the world. The proportion of unknown cases of diabetes was nearly 50%. Cardiovascular risk factors associated with diabetes and IGT supported the existence of an insulin resistance or metabolic syndrome, but there were not sufficient differences between diabetes and IGT to suggest a possible pathogenetic relation of hyperinsulinemia and associated risk factors.
Effect of Socioeconomic Risk Factors on the Difference in Prevalence of Diabetes Between Rural and Urban Populations in Bangladesh
Authors: Sayeed M Abu , Ali Liaquat , Hussain M Zafirul , Rumi M A , Banu Akhtar , Azad Khan A K 
Published: March 2007

OBJECTIVE
To compare the prevalence of diabetes between the poor and rich of rural and urban populations in Bangladesh.

RESEARCH DESIGN AND METHODS
A total of 1,052 subjects from urban and 1,319 from rural communities (age ≥ 20 years) of different socioeconomic classes were investigated. Capillary blood glucose levels, fasting and 2 h after a 75-g glucose drink (2-h blood glucose [BG]), were measured. Height, weight, waist, hips, and blood pressure were also measured.

RESULTS
Age-adjusted (30–64 years) prevalence of NIDDM was higher in urban (7.97% with 95% CI 6.17–9.77) than in rural subjects (3.84%, CI 2.61–5.07), whereas impaired glucose tolerance (IGT) prevalence was higher in rural subjects. In either urban or rural areas, the highest prevalence of NIDDM was observed among the rich, and the lowest prevalence was observed among the poor socioeconomic classes. The rural rich had much higher prevalence of IGT than their urban counterpart (16.5 vs. 4.4%, CI 6.8–17.4). Increased age was an important risk factor for IGT and NIDDM in both rural and urban subjects, whereas the risk related to higher BMI and waist-to-hip ratio (WHR) was less significant in rural than urban subjects. Using logistic regression and adjusting for age, sex, and social class, the urban subjects had no excess risk for NIDDM. In contrast, an excess risk for glucose intolerance (2-h BG ≥ 7.8 mmol/l) was observed in the rural subjects.

CONCLUSIONS
Adjusting for age, sex, and social class, the prevalence of NIDDM among urban subjects did not differ significantly from that among rural subjects. Increased age, higher socioeconomic class, and higher WHR were proven to be independent risk factors for glucose intolerance in either area.
Glycemic Control and Prevention of Retinopathy in Japanese NIDDM Patients: A 10-year follow-up study
Authors: Nakagami Tomoko , Kawahara Reiko , Hori Sadao , Omori Yasue 
Published: March 2007

OBJECTIVE
To examine glycemic control for the prevention of retinopathy in early diagnosed Japanese NIDDM patients.

RESEARCH DESIGN AND METHODS
There were 137 patients with NIDDM but without retinopathy who first visited our facility from 1983–1985. Their age at diagnosis ranged from 30–65 years, with a disease duration of &lt; 3 years. The optic fundi were examined at least annually. The prevalence of retinopathy in the 10th year after registration in the study was compared in four groups stratified by mean HbA1c values for 10 years. Multiple logistic regression analysis was used to assess the relationship between retinopathy and covariates.

RESULTS
None of the patients with a mean HbA1c &lt;6% had retinopathy. The prevalence of retinopathy was 17.2% in the group with a mean HbA1c of 6–6.9%, 14.3% in the group with a mean HbA1c of 7–7.9%, 41.9% at a mean HbA1c of 8–8.9%, and 54.8% when the mean HbA1c exceeded 9%. The prevalence of retinopathy increased with the increase in the mean HbA1c values over 10 years (trend, P &lt; 0.005). Multiple logistic regression analysis revealed that mean HbA1c was the only significant risk factor for the development of retinopathy.

CONCLUSIONS
Our results support the concept that an early diagnosis and better control lessen the risk for the development of retinopathy in Japanese NIDDM patients.
Intimal-Medial Thickness of the Carotid Artery in Nondiabetic and NIDDM Patients: Relationship with insulin resistance
Authors: Bonora Enzo , Tessari Roberto , Micciolo Rocco , Zenere Marina , Targher Giovanni , Padovani Roberto , Falezza Giancarlo , Muggeo Michele 
Published: March 2007

OBJECTIVE
The aim of this study was 1) to compare intimal-medial thickness (IMT) of the carotid artery in nondiabetic and NIDDM patients and 2) to evaluate the association of this early marker of atherosclerosis with several cardiovascular risk factors, including plasma insulin and insulin resistance.

RESEARCH DESIGN AND METHODS
A total of 58 nondiabetic and 56 NIDDM patients, randomly selected among those attending the outpatient Diabetes Clinic or the Clinic for Internal Medicine were examined. BMI, waist-to-hip ratio (WHR), blood pressure, glycohemoglobin (HbA1c), and fasting concentrations of plasma glucose, serum lipids (total and HDL cholesterol, triglycerides), and serum insulin were measured. Insulin resistance was assessed by computing glucose disappearance rate from plasma after intravenous insulin injection (Kitt). IMT of the carotid artery was measured by ultrasonography.

RESULTS
IMT was significantly higher in diabetic patients, and the difference remained highly significant after adjusting for sex, age, BMI, WHR, presence of hypertension and dyslipidemia, and smoking status (1.39 vs. 1.24 mm, common SD 0.12, P &lt; 0.001). Univariate regression analyses showed that IMT was negatively correlated with Kitt in either nondiabetic (r = −0.348, P &lt; 0.01) or diabetic patients (r = −0.492, P &lt; 0.001). However, multiple regression analyses showed that IMT was independently associated with age and WHR in nondiabetic subjects, whereas in diabetic patients, IMT was independently predicted by Kitt and hypertension. These two variables explained ∼ 62% and ∼35% of the variability of IMT in nondiabetic and diabetic patients, respectively. Plasma insulin was not independently associated with IMT in either groups.

CONCLUSIONS
These results indicate that 1) diabetes is characterized by a greater thickness of the carotid artery independently of other established risk factor of atherosclerosis, 2) early atherosclerosis is independently associated with insulin resistance in diabetic but not in nondiabetic patients, 3) central adiposity is an independent predictor of IMT in nondiabetic individuals.
Therapeutic Footwear Can Reduce Plantar Pressures in Patients With Diabetes and Transmetatarsal Amputation
Authors: Mueller Michael J , Strube Michael J , Allen Brent T 
Published: March 2007

OBJECTIVE
To compare how footwear (full-length shoe or short shoe), a total contact insert, a rigid rocker-bottom (RRB) sole, and an ankle-foot orthosis (AFO) affect peak plantar pressure (PPP) on the distal residuum and contralateral extremity of patients with diabetes and transmetatarsal amputation (TMA).

RESEARCH DESIGN AND METHODS
Thirty patients with diabetes and TMA participated (mean age 62 ± 4 years). In-shoe plantar pressures during walking were measured in six types of footwear. Each measurement occurred after a 1-month adjustment period. Repeated measure analysis of variance (ANOVA) was used to compare treatments.

RESULTS
All five types of therapeutic footwear reduced plantar pressures compared with regular shoes with a toe-filler (P &lt; 0.05). A full-length shoe, total contact insert, and RRB sole resulted in lower pressures on the distal residuum (222 vs. 284 kPa) and forefoot of the contralateral extremity (197 vs. 239 kPa), compared with a regular shoe and toe-filler. Footwear with an AFO showed reduced PPP on the residuum, but most patients complained of reduced ankle motion during walking. A short shoe reduced pressures on the residuum, but not on the contralateral extremity, and many patients had complaints regarding cosmesis of the shoe.

CONCLUSIONS
The full-length shoe, total contact insert, and an RRB sole provided the best pressure reduction for the residuum and contralateral foot, with the optimal compromise for cosmetic acceptance and function.
The Efficacy and Safety of Miglitol Therapy Compared With Glibenclamide in Patients With NIDDM Inadequately Controlled by Diet Alone
Authors: Segal P , Feig PU , Schernthaner G , Ratzmann KP , Rybka J , Petzinna D , Berlin C 
Published: March 2007

OBJECTIVE
To compare the therapeutic effects of the α-glucosidase inhibitor miglitol (BAY m 1099), the sulfonylurea glibenclamide, and placebo on parameters of metabolic control and safety in patients with NIDDM that is inadequately controlled by diet alone.

RESEARCH DESIGN AND METHODS
After a 4-week placebo run-in period, 201 patients in 18 centers in 4 countries were randomized in a double-blind manner to miglitol (50 mg t.i.d., followed by 100 mg t.i.d.), glibenclamide (3.5 mg q.d/b.i.d.), or placebo for 24 weeks. Efficacy criteria were changes from baseline of HbA1c, fasting and postprandial blood glucose and insulin levels, body weight, and serum triglycerides.

RESULTS
Efficacy was assessed in 119 patients who completed the full protocol, and the results were similar to those obtained in 186 patients who fulfilled the validity criteria for analysis. Compared with placebo, mean baseline-adjusted HbA1c decreased by 0.75% (P = 0.0021) and 1.01% (P = 0.0001) in the miglitol and glibenclamide treatment groups, respectively. Blood glucose decreased slightly in the fasting state and considerably in the postprandial state in both treatment groups but not in the placebo group. Fasting insulin levels increased slightly (NS) in all treatment groups; however, postprandial insulin levels decreased with miglitol, while increasing markedly with glibenclamide (P = 0.0001 between all treatment groups). Gastrointestinal side effects (flatulence and diarrhea) occurred mostly in the miglitol-treated patients, while some glibenclamide-treated patients had symptoms suggestive of hypoglycemia.

CONCLUSIONS
Miglitol monotherapy is effective and safe in NIDDM patients. Compared with glibenclamide, it reduced HbA1c less effectively and caused more gastrointestinal side effects. On the other hand, glibenclamide, unlike miglitol, tended to cause hypoglycemia, hyperinsulinemia, and weight gain, which are not desirable in patients with NIDDM.