bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of the Anatomical Region Used for Insulin Injections on Glycemia in Type I Diabetes Subjects
Authors: Bantle John P , Neal Lonzetta , Frankamp Lisa M 
Published: March 2007

OBJECTIVE
Subcutaneous insulin is absorbed at different rates from different anatomical regions, but it is not clear how much the varying rates of absorption affect plasma glucose concentrations in diabetic subjects. To address this issue, subcutaneous injections of insulin in the abdomen were compared with subcutaneous injections of insulin in the thigh.

RESEARCH DESIGN AND METHODS
In a crossover trial, 22 type I diabetic subjects received, in random order, a test dose of regular insulin injected subcutaneously in the abdomen on one morning and in a thigh on another morning. The subjects also received, in random order, usual morning doses of NPH and regular insulins injected subcutaneously in the abdomen on one morning and in a thigh on another morning. The study was performed in the University of Minnesota General Clinical Research Center. Main outcome measures were plasma glucose and serum free insulin.

RESULTS
After injections of regular insulin in the abdomen, the peak postprandial increment in plasma glucose was 3.1 mM or 29% lower (P &lt; 0.001), the peak increment in serum free insulin was 54 pM or 38% higher (P = 0.017), and the length of time required to achieve peak serum free insulin was significantly shorter than after injections of regular insulin in the thigh. After injections of NPH and regular insulins in the abdomen, the morning peak increment in plasma glucose was 2.5 mM or 18% lower (P = 0.008) than after injections of NPH and regular insulins in a thigh. However, no significant difference was observed in the afternoon peak increment in plasma glucose.

CONCLUSIONS
A subcutaneous injection of regular insulin in the abdomen produced a substantially greater reduction in plasma glucose than an injection of regular insulin in the thigh. Changing the injection site of regular insulin from the abdomen to the thigh had an effect equivalent to reducing the dose administered. With injections of NPH and regular insulin in combination, the influence of the region used for injection was less but still potentially important.
Lipoprotein Abnormalities in Well-Treated Type II Diabetic Patients
Authors: Manzato Enzo , Zambon Alberto , Lapolla Annunziata , Zambon Sabina , Braghetto Lorenzo , Crepaldi Gaetano , Fedele Domenico 
Published: March 2007

OBJECTIVE
To investigate lipoprotein levels and composition in well-treated type II diabetic patients.

RESEARCH DESIGN AND METHODS
Cholesterol and triglyceride levels were measured in plasma, VLDL, LDL, and HDL in 120 type II diabetic patients in good to fair metabolic control (HbA1c, 7.2 ± 1.6%) and in 30 normal control subjects. ApoAI, AII, B, CII, CIII, and E levels in plasma were also determined.

RESULTS
The diabetic patients have significantly higher levels of mean plasma cholesterol (5.85 vs. 5.43 mM, P = 0.03), LDL triglycerides (0.41 vs. 0.31 mM, P = 0.003), and HDL triglycerides (0.24 vs. 0.19 mM, P = 0.02), whereas total triglycerides, VLDL cholesterol and triglycerides, LDL cholesterol, and HDL cholesterol are not significantly different from normal control subjects. ApoB (150 vs. 135 mg/dl, P = 0.02) and apoCIII (10.6 vs. 8.4 mg/dl, P = 0.01) are significantly higher in diabetic patients compared with control subjects. No significant differences are observed in all the parameters among diabetic patients treated with diet only, sulphonylurea, sulphonylurea plus biguanides, or insulin. Body weight is significantly related to VLDL lipids. The VLDL triglycerides are inversely related to the HDL cholesterol in both diabetic patients and control subjects. The VLDL triglycerides are directly related to the HDL triglycerides only in diabetic patients. No other lipid or lipoprotein parameters are significantly related to body weight or metabolic control.

CONCLUSIONS
Type II diabetic patients in good to fair metabolic control are characterized by minor alterations of the plasma lipids, but LDL and HDL triglycerides, apoB, and apoCIII are increased, thus indicating that the lipoprotein composition is altered, possibly because of an abnormal triglyceride metabolism and/or lipid transfer activity.
Oral Health in Patients With Type II Diabetes and Impaired Glucose Tolerance
Authors: Cherry-Peppers Gail , Ship Jonathan A 
Published: March 2007

OBJECTIVE
To assess the influence of type II diabetes and impaired glucose tolerance on dental, periodontal, and oral mucosal tissues.

RESEARCH DESIGN AND METHODS
We examined 11 subjects with type II diabetes, 32 with impaired glucose tolerance, and 43 control subjects from the oral physiology component of the Baltimore Longitudinal Study of Aging. At the time of the study, none of the participants was taking medication nor being treated for any medical problems other than diabetes.

RESULTS
Only a few statistically significant dental and periodontal changes were apparent in the group with type II diabetes, and no oral mucosal differences existed between the diabetes and control groups. Dental, periodontal, and oral mucosal parameters in patients with impaired glucose tolerance were essentially indistinguishable from the other two groups.

CONCLUSIONS
These findings suggest that among well-controlled individuals with type II diabetes and impaired glucose tolerance, few appreciable differences are evident in oral health.
Lipoprotein(a) Concentration Shows Little Relationship to IDDM Complications in the Pittsburgh Epidemiology of Diabetes Complications Study Cohort
Authors: Maser Raelene E , Usher David , Becker Dorothy J , Drash Allan L , Kuller Lewis H , Orchard Trevor J 
Published: March 2007

OBJECTIVE
To examine the potential associations of lipoprotein(a) and the complications of IDDM and their risk factors.

RESEARCH DESIGN AND METHODS
This report focuses on 186 individuals with IDDM (mean age = 34 yr) participating in a 10-yr prospective study examining various complications. Lp(a) concentrations were evaluated for those with and without complications.

RESULTS
A weak correlation was seen between Lp(a) and HbAj (r = 0.16, P &lt; 0.05). Lp(a) concentrations were not significantly different for those with or without proliferative retinopathy, overt nephropathy, peripheral vascular disease, or definite myocardial infarction or angina. However, an inverse association (P &lt; 0.05) was seen with distal symmetric polyneuropathy. These results were also confirmed by categorical analyses (i.e., Lp(a) levels &lt;30 vs. &gt;30 mg/dl).

CONCLUSIONS
These results suggest that any association of Lp(a) concentration with IDDM complications is likely to be weak or nonexistent. However, prospective studies are needed before its full role can be determined.
Attitudes and Behaviors of Primary Care Physicians Regarding Tight Control of Blood Glucose in IDDM Patients
Authors: Tuttleman Marilyn , Lipsett Lois , Harris Maureen I 
Published: March 2007

OBJECTIVE
To evaluate attitudes and practices of primary-care physicians toward tight blood glucose control in IDDM.

RESEARCH DESIGN AND METHODS
A mail and telephone questionnaire survey was conducted on a systematic, stratified sample of 1429 family-practice physicians, general practitioners, internists, and pediatricians in active practice in the United States who treated patients with IDDM. Physicians were asked about methods they used for clinical and laboratory assessment of blood glucose control and about their attitudes and beliefs in treating IDDM. They were asked also what they consider to be acceptable ranges for blood glucose and HbA1 in IDDM patients. A score was developed reflecting three criteria for tight blood glucose control: fasting glucose 70–120 mg/dl (3.9–6.7 mM), 2-h postprandial glucose &lt;180 mg/dl (&lt;10 mM), and HbA1 &lt;8% (the nondiabetic value was specified as 5–7%). Physicians were accorded one point when their acceptable range agreed with an intensive treatment criterion (range for score 0–3).

RESULTS
Only 31% of physicians agreed with all three criteria for tight control of blood glucose; 37% agreed with none or only one of the standards. Pediatricians were particularly low in their agreement with the HbA1 standard. Physicians who agreed with one of the three criteria often did not agree with the other two. With increasing value for the score, there was a greater proportion of physicians whose management practices (e.g., frequent measurement of HbA1 multiple insulin injections, patient SMBG, use of dietitian/educator in care of patients) are conducive toward tight control of blood glucose. However, even among physicians with a score of 3, HbA1 was ordered infrequently, three or more insulin injections/day was prescribed rarely, patient SMBG was less than fully endorsed, and both a dietitian and diabetes educator were used by a minority of physicians.

CONCLUSIONS
It appears that primary-care physicians are not fully aware of recommended criteria for intensive treatment of blood glucose in IDDM patients or of the importance of multiple insulin injections, use of HbA1; and patient SMBG. Physician practice behaviors are less than optimal for intensive management of IDDM patients, even among physicians who agree with all three standards for intensive treatment of blood glucose in IDDM.
Vascular Dysfunction Detected by a Simplified Venous Occlusion Test in NIDDM Patients
Authors: Mizuno Akira , Isobe Junichi , Shima Kenji 
Published: March 2007

Objective— To elucidate the relationship between angiopathies and vascular function evaluated by a simplified venous occlusion test in patients with NIDDM.
Research Design and Methods— The serum concentration of FDP was measured before and 5 min after venous occlusion in 23 NIDDM patients, 11 patients with cerebrovascular accident, and 10 age-matched healthy control subjects.
Results— The increment of serum FDP level after venous occlusion was significantly less in patients with NIDDM (60.6 ± 33.5 to 81.5 ± 49.6 ng/ml) and in those with cerebrovascular accident (101.4 ± 51.5 to 116.2 ± 47.2 ng/ml) than in control subjects (79.9 ± 41.0 to 148.8 ± 65.4 ng/ml). The increment of serum FDP after venous occlusion in NIDDM patients with macroangiopathy was significantly lower than that in those without macroangiopathy.
CONCLUSION— The responsiveness of fibrinolytic activity to venous occlusion was significantly less in NIDDM patients with macroangiopathy, as in patients with cerebrovascular accident, compared with that in healthy control subjects.
Increased Levels of Cow's Milk and β-Lactoglobulin Antibodies in Young Children With Newly Diagnosed IDDM
Authors: Savilahti Erkki , Saukkonen Tero T , Virtala Esa T , Tuomilehto Jaakko , Åkerblom Hans K ,   The Childhood Diabetes in Finland Study Group
Published: March 2007

Objective— To investigate the humoral immune response to cow's milk in pediatric patients with newly diagnosed IDDM.
Research Design and Methods— We measured IgA, IgG, and IgM antibodies to the proteins of cow's milk and to β-lactoglobulin by an enzyme-linked immunosorbent assay. Samples from 706 pediatric patients with newly diagnosed IDDM were available. We used two comparison groups: 105 patients &lt; 7 yr old had an unrelated age-matched control subject, and samples from 456 3- to 14-yr-old nondiabetic siblings also were available.
Results— Patients &lt; 3 yr of age had a markedly higher median level of IgG and IgA antibodies to cow's milk compared with the control subjects (P = 0.03 and 0.002, respectively), IgG antibodies to β-lactoglobulin also were higher (P = 0.03). Older groups of diabetic patients, 3.0–6.9 and 7.0–14.9 yr of age, had significantly higher levels of IgA antibodies to cow's milk and β-lactoglobulin than the age-matched comparison groups of both unrelated control subjects and nondiabetic siblings, although the median values of the diabetic patients were closer to those of the comparison groups than in the youngest groups. Nondiabetic siblings had higher levels of IgA cow's milk antibodies than unrelated control subjects of similar ages (3–6.9 yr of age) (P = 0.03). The 14 siblings contracting IDDM during the follow-up showed no change in the levels of cow's milk or β-lactoglobulin antibodies in relation to the clinical diagnosis.
Conclusions— The results indicate an abnormally strong humoral response to the proteins of cow's milk, particularly in young IDDM patients and, to a lesser extent, in their siblings. We infer that the proteins of cow's milk may trigger the autoimmune process of IDDM.
HLA-DQβ Typing and Non-Asp57 Alleles in IDDM and Nondiabetic Subjects in New Zealand
Authors: Forbes Louisa V , Brown Laurie J , Scott Russell S 
Published: March 2007

OBJECTIVE
To determine the frequency of IDDM risk-associated HLA-DQβ alleles in New Zealanders with IDDM and nondiabetic control subjects, and to examine these as susceptibility markers in relation to IDDM incidence.

RESEARCH DESIGN AND METHODS
HLA-DQβ typing was conducted in 55 juvenile-onset IDDM subjects diagnosed between 1990 and 1992, and 53 nondiabetic control subjects. Allele typing was conducted by a polymerase chain reaction-restriction fragment-length polymorphism technique. All subjects were residents of Canterbury, New Zealand. IDDM incidence data were obtained from the Canterbury, New Zealand, Diabetes Registry.

RESULTS
The frequency of the susceptibility genotype DQβ*0201/0302 was 43.6 and 5.7% in the IDDM and control groups, respectively, reflecting the increased prevalence of allele 0302 in the IDDM group. Alleles 0301, 0501, and 0602.3 were more prevalent in the control group than the IDDM group. The frequency of non-Asp57 alleles was 90.9 and 61.3% in the IDDM and control groups, respectively. Overall, the HLA-DQβ allele distribution was similar to reports from other Caucasian populations. The 0- to 19-yr age-specific IDDM incidence rate over the period in which the diabetic subjects were diagnosed was 19.5/100,000 person-yr, the highest levels observed in Canterbury over the last decade. Our relatively high background prevalence of non-Asp57 alleles and high IDDM incidence rates were similar to results from some Scandinavian and other hotspot populations.

CONCLUSIONS
HLA-DQβ alleles are genetic susceptibility markers in New Zealand, and other Caucasian populations. Peak IDDM incidence levels observed in 1990–1992 in our population are in accordance with a high background population prevalence of non-Asp57 alleles. These results suggest that the high Canterbury incidence rates may be due to a large HLA-DQβ non-Asp57 at-risk population.
Alterations in Glucose Metabolism in the Elderly Patient with Diabetes
Authors: Meneilly Graydon S , Dawson Keith , Tessier Daniel 
Published: March 2007

Objective— To determine the alterations in glucose metabolism in elderly patients with NIDDM.
Research Design and Methods— We studied 9 healthy elderly control subjects (73 ± 1 yr of age; body mass index 25.7 ± 0.4 kg/m2) and 9 untreated elderly NIDDM patients (72 ± 2 yr of age; BMI 25.9 ± 0.5 kg/m2). Each subject underwent a 3-h oral glucose tolerance test (40 g/m2); a 2-h hyperglycemic glucose clamp study (glucose 5.4 mM above basal); and a 4-h euglycemic insulin clamp (40 mM · m2 · min−1). Tritiated glucose methodology was used to measure glucose production and disposal rates during the euglycemic clamp.
Results— Patients with NIDDM had a higher fasting glucose (9.3 ± 0.3 vs. 5.1 ± 0.1 mM in control subjects vs. NIDDM patients, respectively, P &lt; 0.001) and a greater area under the curve for glucose during the OGTT (16.0 ± 0.6 vs. 6.7 ± 0.3 mM in control subjects vs. NIDDM patients, respectively, P &lt; 0.01) than the healthy control subjects. During the hyperglycemic clamp, patients with NIDDM had an absent first-phase insulin response (112 ± 6 vs. 250 ± 31 pM in control subjects vs. NIDDM patients, respectively, P &lt; 0.01), and a blunted second-phase insulin response (159 ± 11 vs. 337 ± 46 pM in control subjects vs. NIDDM patients, respectively, P &lt; 0.01). Before the euglycemic clamp, fasting insulin (99 ± 5 vs. 111 ± 10 pM in control subjects vs. NIDDM patients, respectively) and hepatic glucose production (11.8 ± 0.7 vs. 11.5 ± 0.5 μmol · kg−1 μ min−1 in control subjects vs. NIDDM patients, respectively) were similar. Steady-state (180–240 min) glucose disposal rates during the euglycemic clamp were slightly, but not significantly, higher in the normal control subjects (36.5 ± 1.1 vs. 33.1 ± 1.9 μmol · kg−1 · min−1 in control subjects vs. NIDDM patients, respectively, NS).
Conclusions— We conclude that NIDDM in nonobese elderly subjects is characterized by a marked impairment in insulin release. This may be attributable to the toxic effects of chronic hyperglycemia on the β-cell. When compared with age-matched control subjects, the NIDDM patients showed no increase in fasting insulin or hepatic glucose production, and insulin resistance was mild.
Long-Term Randomized Placebo-Controlled Double-Blind Therapeutic Comparison of Glipizide and Glyburide: Glycemic control and insulin secretion during 15 months
Authors: Birkeland Kåre I , Furuseth Kristian , Melander Arne , Mowinckel Petter , Vaaler Stein 
Published: March 2007

OBJECTIVE
To examine the long-term (15 months) effects on glycemic control and insulin secretion of glipizide and glyburide treatment in patients with noninsulin- dependent diabetes mellitus (N1DDM).

RESEARCH DESIGN AND METHODS
Prospective, randomized, doubleblind, placebo-controlled study on 46 NIDDM patients comparing fasting levels and test-meal responses of glucose and insulin during 15 months of follow-up.

RESULTS
A comparable reduction in HbA1c levels by both agents versus placebo was observed throughout the study period, but after a marked initial reduction in both sulfonylurea groups, all three groups showed gradually increasing HbA1c levels. However, both glipizide and glyburide achieved and maintained lowered postprandial glucose levels and increased fasting and postprandial insulin levels compared with placebo.

CONCLUSIONS
Both glipizide and glyburide may achieve and maintain glycemic reduction and stimulation of insulin secretion during long-term treatment. However, these agents do not prevent the gradual increase in overall glycemia that develops over time in NIDDM patients.
Establishment of Time-Action Profiles for Regular and NPH Insulin Using Pharmacodynamic Modeling
Authors: Woodworth James R , Howey Daniel C , Bowsher Ronald R 
Published: March 2007

OBJECTIVE
To provide distinct definitions and quantify the establishment of onset, peak, and duration of action for insulins.

RESEARCH DESIGN AND METHODS
We administered single subcutaneous doses of 10 U regular insulin to 10 volunteer subjects and 25 U NPH insulin to 6 healthy male volunteer subjects on separate occasions. Each dose was given after an overnight fast during a glucose clamp to maintain an euglycemic state. We measured serum insulin concentrations and glucose infusion rates (GIR) from frequent blood sampling after each treatment. Serum insulin concentrations were related to GIR values at each collection time and a counter-clockwise hysteresis resulted. An effect compartment model was used to simultaneously describe the pharmacokinetics and pharmacodynamics of each insulin and to resolve the hysteresis.

RESULTS
From the resulting relationship, GIR could then be predicted, with onset and duration of action reflecting the time when effect compartment concentrations initially exceeded then declined below a 10% maximum possible effect (Emax) level. Ninety-five percent confidence intervals were constructed allowing a predictive range of values. For regular insulin, a mean onset of 0.75 h, peak of 2 h, and duration of 6 h was estimated. Mean values were also produced with NPH, with an onset of 3 h, peak of 6–7 h, and a duration of 13 h estimated.

CONCLUSIONS
This method estimates the onset, peak, and duration of insulin action. Although these estimates were from single doses, we believe they can provide good estimations of insulin activity.
Glycemic Control in a Sample of Black and White Clinic Patients with NIDDM
Authors: Weatherspoon Lorraine J , Kumanyika Shiriki K , Ludlow Robert , Schatz Desmond 
Published: March 2007

OBJECTIVE
To compare glycemic control of black and white patients under treatment for non-insulin-dependent diabetes mellitus (NIDDM).

RESEARCH DESIGN AND METHODS
Medical records of patients with NIDDM were reviewed at 19 of 24 clinics or health centers in a specified area of north central Florida. Data were abstracted from the charts of all non-Hispanic black (n = 248) or white (n = 280) patients who met preset eligibility criteria.

RESULTS
The mean ± SD age was 58 ± 14 years; the mean ± SD duration of diabetes was 9 ± 7.5 years. Of 528 patients, 220 were treated with oral hypoglycemic agents, 269 were treated with insulin, 28 were treated with diet alone, and 11 were treated with a combination of oral agents, diet, and insulin. Glycosylated hemoglobin was ≥8% for 47% of black women, 41% of black men, 38% of white men, and 29% of white women. The less favorable control status of the black women persisted within categories of age (40–59 years or ≥60 years), treatment (insulin or oral hypoglycemic agents), time since diagnosis (less than versus greater than or equal to the median of 7 years), and obesity (noted versus not noted in chart). In multiple logistic regression analyses controlling simultaneously for these variables, the odds (95% confidence interval [CI]), compared with white women, of having glycosylated hemoglobin ≥8% were 2.2 (1.4, 3.4) for black women and 1.5 (0.8, 2.9) and 1.4 (0.8, 2.5) for black and white men, respectively.

CONCLUSIONS
Black women were more likely than white women or men to have glycosylated hemoglobin ≥8%. This difference was not readily explained by age, type of treatment, time since diagnosis, or a notation of obesity in the medical record, although an effect of obesity cannot be excluded on this basis.
Greater Effect of Diabetes on LDL size in Women Than in Men
Authors: Haffner Steven M , Mykkänen Leena , Stern Michael P , Paidi Michael , Howard Barbara V 
Published: March 2007

OBJECTIVE
Coronary heart disease (CHD) is increased two- to fourfold in subjects with NIDDM compared with normoglycemic subjects. This excess risk is only partially explained by conventional risk factors. We studied the effect of non-insulin-dependent diabetes mellitus (NIDDM) on the size of low-density lipoproteins (LDL).

RESEARCH DESIGN AND METHODS
We examined the effect of NIDDM on LDL size and subclass pattern B (LDL size &lt; 253.5 Å) in 95 diabetic subjects and 371 nondiabetic subjects from the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease.

RESULTS
LDL size (Å) was significantly lower in diabetic subjects (men: 252.2 ± 1.8; women: 254.7 ± 1.3) than in nondiabetic subjects (men: 256.1 ± 0.8; women: 259.7 ± 0.7) (P = 0.007). After the use of analysis of covariance to adjust for triglyceride and high-density lipoprotein cholesterol, LDL size was still significantly lower in diabetic women than in nondiabetic women. In men, however, diabetes was no longer significantly associated with LDL size after similar adjustments. Fasting glucose was more strongly correlated with LDL size in women (r = −0.30) than in men (r = −0.18).

CONCLUSIONS
We conclude that LDL size is significantly lower in diabetic subjects of both sexes than in nondiabetic subjects, but that diabetic dyslipidemia accounts for the association in diabetic men. The stronger association between LDL size and diabetes in women than in men may partially explain the greater relative risk of CHD observed in women with NIDDM in some studies.