bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Randomized Trial of Two Irremovable Off-Loading Devices in the Management of Plantar Neuropathic Diabetic Foot Ulcers
Authors: Katz Ira A. , Harlan Anthony , Miranda-Palma Bresta , Prieto-Sanchez Luz , Armstrong David G. , Bowker John H. , Mizel Mark S. , Boulton Andrew J.M. 
Published: March 2007

OBJECTIVE—The purpose of this study was to compare the effectiveness of a removable cast walker (RCW) rendered irremovable (iTCC) with the total contact cast (TCC) in the treatment of diabetic neuropathic plantar foot ulcers.
RESEARCH DESIGN AND METHODS—In a prospective, randomized, controlled trial, 41 consecutive diabetic patients with chronic, nonischemic, neuropathic plantar foot ulcers were randomly assigned to one of two groups: a RCW rendered irremovable by wrapping it with a single layer of fiberglass casting material (i.e., an iTCC) or a standard TCC. Primary outcome measures were the proportion of patients with ulcers that healed at ≤12 weeks, healing rates, complication rates, cast placement/removal times, and costs.
RESULTS—The proportions of patients with ulcers that healed within 12 weeks in the iTCC and TCC groups were 80 and 74%, respectively (94 and 93%, respectively, when patients who were lost to follow-up were excluded). Survival analysis (healing rates) was statistically equivalent in the two groups, as were complication rates, but with a trend toward benefit in the iTCC group. The iTCC took significantly less time to place and remove than the TCC with 39% and 36% reductions, respectively. There was also an overall lower cost associated with the use of the iTCC compared with the TCC.
CONCLUSIONS—The iTCC may be equally efficacious, faster to place, easier to use, and less expensive than the TCC in the treatment of diabetic plantar neuropathic foot ulcers.
Blood Glucose and Heart Failure in Nondiabetic Patients
Authors: Nielson Christopher , Lange Theodore 
Published: March 2007

OBJECTIVE—Nondiabetic patients were studied to determine whether increasing blood glucose is associated with subsequent incidence of heart failure.
RESEARCH DESIGN AND METHODS—Baseline morning blood glucose determinations were evaluated with respect to subsequent heart failure using records from 20,810 nondiabetic patients. The onset of heart failure &gt;1 year after initial glucose determinations was evaluated for patients who had 2–12 years of care. Patients were excluded if they had ever had the diagnosis of diabetes, had a diagnosis of heart failure &lt;1 year after initial blood glucose determinations, had a blood glucose determination &gt;125 mg/dl, or used corticosteroids, loop diuretics, insulin, or oral hypoglycemics.
RESULTS—Of the 20,810 patients studied, 916 patients developed heart failure over a total analysis time of 71,890 years at risk. Higher baseline morning glucose levels were associated with increased heart failure from 3.5% (glucose &lt;90 mg/dl) to 3.8% (90–99 mg/dl) to 4.8% (100–109 mg/dl) to 6% (110–125 mg/dl) over a mean 4- to 5-year evaluation period. The incidence rate increased from 7.5 cases per 1,000 person-years (glucose &lt;90 mg/dl) to 8.4 (90–99 mg/dl, NS) to 11.1 (100–109 mg/dl, P &lt; 0.001) to 13.7 (110–125 mg/dl, P &lt; 0.0001), an 83% increase in heart failure if baseline glucose was &gt;109 mg/dl compared with &lt;90 mg/dl. A Cox proportionate hazards model including age, sex, BMI, creatinine, hypertension, lipids, smoking, medications, and coronary disease showed a progressive increase in hazard ratio from 1.25 (glucose 90–99 mg/dl, P &lt; 0.05) to 1.46 (100–109 mg/dl, P &lt; 0.001) to 1.55 (110–125 mg/dl, P &lt; 0.001) compared with glucose &lt;90 mg/dl. Kaplan-Meier analysis showed increased glucose- associated risk with time.
CONCLUSIONS—Patients with higher baseline blood glucose levels in the absence of diabetes and after adjustment for covariants have a significantly increased risk of heart failure.
Identification of Amadori-Modified Plasma Proteins in Type 2 Diabetes and the Effect of Short-Term Intensive Insulin Treatment
Authors: Jaleel Abdul , Halvatsiotis Panagiotis , Williamson Brian , Juhasz Peter , Martin Stephen , Nair K. Sreekumaran 
Published: March 2007

OBJECTIVE—Growing evidence supports that nonenzymatic glycation products may cause hyperglycemia-induced diabetes complications. Amadori-modified proteins are the intermediate products of nonenzymatic glycation and constitute the forms of glycated proteins in diabetes. The objective of the current study was to utilize two-dimensional gel electrophoresis, Western blot, and mass spectrometry to identify Amadori-modified plasma proteins in type 2 diabetic patients with poor glycemic control and assess the impact of short-term insulin treatment on the glycation of these proteins.
RESEARCH DESIGN AND METHODS—We compared eight type 2 diabetic subjects (aged 56 ± 3 years and BMI 29.7 ± 0.9 kg/m2) with an average diabetes duration of 8.5 years (range 3–19) with equal numbers of weight-matched (aged 56 ± 2 years and BMI 30.1 ± 10.0 kg/m2) and lean (aged 58 ± 2 years and BMI 25 ± 00.5 kg/m2) nondiabetic subjects who have no first-degree relatives with diabetes. Two separate blood samples were collected from the type 2 diabetic subjects, one following 2 weeks of withdrawal of all antidiabetic medications (T2D−; plasma glucose 12.6 ± 1.0 mmol/l) and another following 10 days of intensive insulin treatment (T2D+; plasma glucose 5.5 ± 0.2 mmol/l). Plasma proteins were separated using single and two-dimensional gel electrophoresis. Western blot analysis was performed, and several proteins, which reacted with the Amadori-antibody (1-deoxyfructosyl lysine), were identified by tandem mass spectrometry.
RESULTS—No significant differences in the glycation of proteins between the obese and lean groups were noted, but type 2 diabetic patients had several proteins with higher glycation than the control groups. We identified 12 plasma proteins with reduced reaction to the anti-Amadori antibody upon intensive insulin treatment. A significant (P &lt; 0.03) difference in Amadori modification was observed between the T2D− and control subjects for all these proteins except the Ig light chain. Insulin treatment reduced Amadori modification of albumin (23.2%, P &lt; 0.02), fibrin (34.6%, P &lt; 0.001), Ig heavy chain constant region (20.7%, P &lt; 0.05), transferrin (25.4%, P &lt; 0.04), and Ig light chain (13%, P &lt; 0.02). In addition, Western blot analysis of two-dimensional gel electrophoresis identified α-fibrinogen precursor, β-fibrinogen precursor, fibrinogen γ-B chain precursor, hemopexin, vitamin D binding protein, and serine protease inhibitor as proteins with a reduced reaction to anti-Amadori antibody upon intensive insulin treatment.
CONCLUSIONS—The current approach offers the opportunity to identify Amadori modification of many proteins that may cause functional alterations and offers the potential for monitoring short-term glycemic control in diabetic patients.
Moderate Alcohol Consumption Lowers the Risk of Type 2 Diabetes
Authors: Koppes Lando L.J. , Dekker Jacqueline M. , Hendriks Henk F.J. , Bouter Lex M. , Heine Robert J. 
Published: March 2007

OBJECTIVE—This meta-analysis was undertaken to obtain insight regarding the shape and strength of the relationship between alcohol consumption and the risk of type 2 diabetes, the effects of adjustment for confounders, and the effect of modification by type 2 diabetes definition, sex, and BMI.
RESEARCH DESIGN AND METHODS—The 15 original prospective cohort studies that were included comprise 11,959 incident cases of type 2 diabetes in 369,862 individuals who, on average, were followed for 12 years.
RESULTS—After pooling the data, a U-shaped relationship was found. Compared with nonconsumers, the relative risk (RR) for type 2 diabetes in those who consumed ≤6 g/day alcohol was 0.87 (95% CI 0.79–0.95). For the moderate consumption ranges of 6–12, 12–24, and 24–48 g/day, RRs of 0.70 (0.61–0.79), 0.69 (0.58–0.81), and 0.72 (0.62–0.84) were found, respectively. The risk of type 2 diabetes in heavy drinkers (≥48 g/day) was equal to that in nonconsumers (1.04 [0.84–1.29]). In general, nonsignificant trends for larger RR reduction associated with moderate alcohol consumption were observed for women compared with men, for crude compared with multivariate-adjusted analyses, and for studies that used self-reports instead of testing for type 2 diabetes definition. No differences in RR reductions were found between individuals with low or high BMI.
CONCLUSIONS—The present evidence from observational studies suggests an ∼30% reduced risk of type 2 diabetes in moderate alcohol consumers, whereas no risk reduction is observed in consumers of ≥48 g/day.
The Effects of Type 1 Diabetes on Cognitive Performance
Authors: Brands Augustina M.A. , Biessels Geert Jan , de Haan Edward H.F. , Kappelle L. Jaap , Kessels Roy P.C. 
Published: March 2007

OBJECTIVE—To investigate the exact nature and magnitude of cognitive impairments in patients with type 1 diabetes and the possible association with other disease variables, such as recurrent episodes of hypoglycemia and metabolic control.
RESEARCH DESIGN AND METHODS—MedLine and PsycLit search engines were used to identify studies on cognitive performance in patients with type 1 diabetes. Effect sizes (Cohen’s d), which are the standardized differences between the experimental and the control group, were calculated. In the meta-analysis, a combined d value was calculated, expressing the magnitude of associations across studies.
RESULTS—A total of 33 studies were identified that met the inclusion criteria. Compared with nondiabetic control subjects, the type 1 diabetic group demonstrated a significantly lowered performance on the following cognitive domains: intelligence (d = −0.7), speed of information processing (d = −0.3), psychomotor efficiency (d = −0.6), visual (d = −0.4) and sustained attention (d = −0.3), cognitive flexibility (d = −0.5), and visual perception (d = −0.4). Lowered cognitive performance in diabetic patients appeared to be associated with the presence of microvascular complications but not with the occurrence of severe hypoglycemic episodes or with poor metabolic control.
CONCLUSIONS—In patients with type 1 diabetes, cognitive dysfunction is characterized by a slowing of mental speed and a diminished mental flexibility, whereas learning and memory are spared.The magnitude of the cognitive deficits is mild to moderate, but even mild forms of cognitive dysfunction might hamper everyday activities since they can be expected to present problems in more demanding situations.
Impact of Fasting Plasma Glucose Levels on Gastric Cancer Incidence in a General Japanese Population
Authors: Yamagata Hajime , Kiyohara Yutaka , Nakamura Shotaro , Kubo Michiaki , Tanizaki Yumihiro , Matsumoto Takayuki , Tanaka Keiichi , Kato Isao , Shirota Tomoko , Iida Mitsuo 
Published: March 2007

OBJECTIVE—Several studies have shown associations between diabetes and various types of cancer other than gastric cancer. The aim of this cohort study was to evaluate the impact of fasting plasma glucose (FPG) levels on gastric cancer occurrence.
RESEARCH DESIGN AND METHODS—A total of 2,466 Japanese subjects aged ≥40 years were stratified into three groups according to FPG tertiles (&lt;5.3 mmol/l, low FPG; 5.3–5.8 mmol/l, modest FPG; &gt;5.8 mmol/l, high FPG) and followed up prospectively for 9 years.
RESULTS—During the follow-up, 66 subjects experienced gastric cancer. In men, the age-adjusted incidences were significantly higher in the modest-FPG (7.0 per 1,000 person-years, P &lt; 0.05) and high-FPG (7.2, P &lt; 0.05) groups than in the low-FPG group (2.2). In women, the high-FPG group also had a significantly higher age-adjusted incidence of gastric cancer compared with the low-FPG group (2.5 vs. 0.8, P &lt; 0.05). The multivariate analysis with Cox’s proportional hazards model revealed that the risks of gastric cancer in the modest-FPG (relative risk [RR] 2.3 [95% CI 1.1–5.0]) and high-FPG (3.1 [1.5–6.4]) groups were significantly higher than that in the low-FPG group, even after adjusting for other comprehensive risk factors, including Helicobacter pylori status, smoking, and dietary factors. However, this FPG-cancer association was observed only among H. pylori–seropositive subjects.
CONCLUSIONS—Our findings suggest that a modest increase in FPG is a risk factor for gastric cancer and that hyperglycemia is a possible cofactor increasing the risk posed by Helicobacter pylori infection.
The Prevalence of Diabetes and Impaired Glucose Tolerance in Sivas, Central Anatolia, Turkey
Authors: Özdemir Levent , Topçu Saniye , Nadir Işılay , Nur Naim , Arslan Seher , Sümer Haldun 
Published: March 2007

OBJECTIVE—The aim of this study was to determine type 2 diabetes, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) prevalence in Sivas, Turkey.
RESEARCH DESIGN AND METHODS—This cross-sectional study was conducted in the city center of Sivas. The study population of 771 subjects was selected by the cluster sampling method from 115,998 individuals aged ≥30 years. Participants with fasting venous plasma glucose concentrations &lt;100 mg/dl were classified as “normal.” Diabetes was diagnosed in participants if they had fasting blood glucose levels ≥126 mg/dl. An oral glucose tolerance test (OGTT) was performed in subjects with fasting blood glucose levels ≥100 mg/dl and &lt;126 mg/dl.
RESULTS—According to the fasting blood glucose levels of the 771 subjects, 44 (5.7%) had diabetes. OGTTs were performed in 80 (10.4%) subjects. According to OGTT results, there were 5 subjects with diabetes, 20 subjects with IGT (2.6%), and 55 subjects with IFG (7.1%). The combined prevalence of IFG and IGT was 9.7%. After OGTT, the total number of diabetic subjects was determined to be 49 (6.4%). Twenty-four (3.1%) of the subjects had a previous diagnosis of diabetes. Multivariate analyses showed that age, sex, hypertension, cigarette smoking, obesity, and family history of diabetes were risk factors for type 2 diabetes (P &lt; 0.05).
CONCLUSIONS—Diabetes incidence increases with changes in dietary habits and lifestyle. Education is particularly important for public health, as the community may then have required knowledge about the disease and its risk factors.
The Relation Between Hyperglycemia and Outcomes in 2,471 Patients Admitted to the Hospital With Community-Acquired Pneumonia
Authors: McAlister Finlay A. , Majumdar Sumit R. , Blitz Sandra , Rowe Brian H. , Romney Jacques , Marrie Thomas J. 
Published: March 2007

OBJECTIVE— To examine whether hyperglycemia at the time of presentation was associated with outcomes in patients admitted to non–intensive care settings with community-acquired pneumonia (CAP).
RESEARCH DESIGN AND METHODS— Prospective cohort study of consecutive patients admitted to six hospitals between 15 November 2000 and 14 November 2002.
RESULTS— Of the 2,471 patients in this study (median age 75 years), 279 (11%) had serum glucose at presentation &gt;11 mmol/l: 178 of the 401 patients (44%) with a prior diagnosis of diabetes and 101 of the 2,070 patients (5%) without a history of diabetes. Of patients hospitalized with CAP, 9% died and 23% suffered an in-hospital complication. Compared with those with values ≤11 mmol/l, patients with an admission glucose &gt;11 mmol/l had an increased risk of death (13 vs. 9%, P = 0.03) and in-hospital complications (29 vs. 22%, P = 0.01). Compared with those patients with admission glucose ≤6.1 mmol/l, the mortality risk was 73% higher (95% CI 12–168%) and the in-hospital complication risk was 52% higher (12–108%) in patients with admission glucose &gt;11 mmol/l. Even after adjustment for factors in the Pneumonia Severity Index, hyperglycemia on admission remained significantly associated with subsequent adverse outcomes: for each 1-mmol/l increase, risk of in-hospital complications increased 3% (0.2–6%).
CONCLUSIONS— Hyperglycemia on admission is independently associated with adverse outcomes in patients with CAP, with the increased risks evident at lower glucose levels than previously reported.
The Metabolic Syndrome and Concentrations of C-Reactive Protein Among U.S. Youth
Authors: Ford Earl S. , Ajani Umed A. , Mokdad Ali H. 
Published: March 2007

OBJECTIVE—Adults with the metabolic syndrome show biochemical evidence of low-grade inflammation. We sought to examine whether this is true among U.S. youth with the metabolic syndrome.
RESEARCH DESIGN AND METHODS—We used data from 1,366 participants aged 12–17 years from the National Health and Nutrition Examination Survey 1999–2000. A modification of the definition of the metabolic syndrome proposed by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults was used. C-reactive protein (CRP) was measured by latex-enhanced nephelometry.
RESULTS—Mean and median concentrations of CRP were higher among participants who had the metabolic syndrome (mean 3.8 mg/l, geometric mean 1.8 mg/l) than among those who did not (mean 1.4 mg/l, geometric mean 0.4 mg/l). The percentage of participants with a concentration of CRP &gt;3.0 mg/l was 38.4% among those with the metabolic syndrome and 10.3% among those without the syndrome (P = 0.007). Of the five components of the syndrome, only abdominal obesity was significantly and independently associated with log-transformed concentrations of CRP in multiple linear regression analysis.
CONCLUSIONS—Our results show that a large percentage of children and adolescents with the metabolic syndrome have elevated concentrations of CRP. Whether the elevated concentrations of CRP among children and adolescents who have the metabolic syndrome predict future adverse health events remains to be determined.
Cardiorespiratory Fitness Attenuates Metabolic Risk Independent of Abdominal Subcutaneous and Visceral Fat in Men
Authors: Lee SoJung , Kuk Jennifer L. , Katzmarzyk Peter T. , Blair Steven N. , Church Timothy S. , Ross Robert 
Published: March 2007

OBJECTIVE—Moderate to high levels of cardiorespiratory fitness (CRF) are associated with a lower risk of the metabolic syndrome and all-cause mortality. Unknown is whether CRF attenuates health risk for a given level of abdominal visceral fat, subcutaneous fat, and/or waist circumference.
RESEARCH DESIGN AND METHODS—The sample studied comprised 297 apparently healthy men with available computed tomography or magnetic resonance imaging scans of the abdomen, metabolic data, and maximal treadmill exercise test results. Men were categorized into low-CRF (20%, n = 56), moderate-CRF (40%, n = 94), and high-CRF (40%, n = 147) groups based on age and exercise test results. All analyses were adjusted for age.
RESULTS—For a given level of waist circumference, visceral fat, or subcutaneous fat, the high-CRF group had lower triglyceride levels (P &lt; 0.05) and higher HDL cholesterol levels than the low- or moderate-CRF groups. There was a significant group interaction (P &lt; 0.01) for blood pressure, indicating that the increase in blood pressure per unit increase in visceral fat or waist circumference was greater in men in the low-CRF group compared with the high-CRF group. The relative risks of having the metabolic syndrome were 1.8 (95% CI 1.0–3.1) and 1.6 (0.9–2.7) times higher in the low- and moderate-CRF groups, respectively, compared with the high-CRF group after adjusting for age, visceral fat, and subcutaneous fat (P for trend = 0.06).
CONCLUSIONS—High levels of CRF are associated with a substantial reduction in health risk for a given level of visceral and subcutaneous fat.
Pregnancy Experience Among Women With and Without Gestational Diabetes in the U.S., 1995 National Survey of Family Growth
Authors: Saydah Sharon H. , Chandra Anjani , Eberhardt Mark S. 
Published: March 2007

OBJECTIVE—To compare the pregnancy experience among women with and without gestational diabetes mellitus (GDM) using a nationally representative survey.
RESEARCH DESIGN AND METHODS—We analyzed data from the 1995 National Survey of Family Growth conducted by National Center for Health Statistics on 3,088 women age 15–44 years with at least one pregnancy between 1991 and 1995 to compare demographics, fecundity, and pregnancy experience by GDM (n = 116) or nondiabetes (n = 2,969) status.
RESULTS—Among women with a pregnancy during 1991–1995, 3.6% reported GDM history. Women with GDM were older at age of delivery (31.8 years) than women without diabetes (29.0 years, P &lt; 0.001). There was no significant difference between the groups by race/ethnicity. Compared with women without diabetes, women with gestational diabetes were more likely to report being currently surgically sterile (20.4 vs. 32.6%) or having impaired fecundity (12.6 vs. 19.7%, P &lt; 0.001). GDM patients were more likely to have had a caesarean section than those without diabetes (31.7 vs. 20.9%, P = 0.02) and were more likely to report at least one of six additional nonroutine medical complications during pregnancy than nondiabetic patients (48.8 vs. 17.1%, P &lt; 0.001). The odds ratio of a maternal medical complication during pregnancy for women with GDM compared with nondiabetic women, after adjusting for age at pregnancy and nongestational hypertension, was 4.3 (95% CI 2.7–6.8).
CONCLUSIONS—These findings suggest that pregnancies in women with GDM are more likely to be associated with maternal medical complications compared with pregnancies in women without diabetes.
The Influence of Adiponectin Gene Polymorphism on the Rosiglitazone Response in Patients With Type 2 Diabetes
Authors: Kang Eun Seok , Park So Young , Kim Hyeong Jin , Ahn Chul Woo , Nam Moonsuk , Cha Bong Soo , Lim Sung Kil , Kim Kyung Rae , Lee Hyun Chul 
Published: March 2007

OBJECTIVE —The aim of this study was to examine the effects of rosiglitazone on adiponectin and plasma glucose levels in relation with common adiponectin gene (ACDC) polymorphisms.
RESEARCH DESIGN AND METHODS —A total of 166 patients with type 2 diabetes were treated with rosiglitazone (4 mg/day) for 12 weeks without changing any of their previous medications. In all, single nucleotide polymorphism (SNP)45 and SNP276 of ACDC were examined.
RESULTS —Regarding SNP45, there was a smaller reduction in the fasting plasma glucose (FPG) level and the HbA1c value in the carriers of the GG genotype than in the carriers of the other genotypes (P = 0.031 and 0.013, respectively). There was a smaller increase in the serum adiponectin concentration for the GG genotype than for the other genotypes (P = 0.003). Regarding SNP276, there was less reduction in the FPG level for the GG genotype than for the other genotypes (P = 0.001). In the haplotype analysis, the reductions in the FPG and HbA1c levels were smaller for the GG homozygote haplotype than for the other haplotypes (P = 0.001 and 0.001, respectively). The increase in the plasma adiponectin concentration for the GG homozygote haplotype was smaller than that of the other haplotypes (P = 0.003).
CONCLUSIONS —These data suggest that genetic variations in the adiponectin gene can affect the rosiglitazone treatment response of the circulating adiponectin level and blood glucose control in type 2 diabetic patients.