bluuebunny/crossref_metadata_2025_split huggingface dataset:
Troglitazone Use in Insulin-Treated Type 2 Diabetic Patients
Authors: Buse John B , Gumbiner Barry , Mathias Nancy P , Nelson Debra M , Faja Barbara W , Whitcomb Randall W ,   The Troglitazone Insulin Study Group
Published: March 2007

OBJECTIVE
To determine the ability of troglitazone to reduce requirements for injected insulin while maintaining blood glucose levels in insulin-treated patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS
This 26-week double-blind study with open-label extension included patients who had failed previous oral antidiabetic medication and took ≥30 but &lt;150 U of insulin daily The 222 patients in the double-blind study received 200 or 400 mg troglitazone once daily or matching placebo. The primary end point was the proportion of patients meeting the target of ≥50% reduction in injected insulin and either a 15% reduction in fasting blood glucose or a blood glucose &lt;7.8 mmol/l. Insulin dose was reduced 25% based on a study-specific algorithm whenever fasting blood glucose was reduced 5% from baseline. Also of interest were changes in insulin dose and HbA1c. The open-label extension included 173 patients. They received 200 mg of troglitazone with optional titration to 400 mg, and insulin dose was adjusted based on investigators' standards of care. Open-label measures were change in insulin dose, HbA1c, and fasting serum glucose (FSG).

RESULTS
In the double-blind phase, 22 and 27% of the 200- and 400-mg troglitazone groups, respectively, reached target, compared with placebo (7%) (P &lt; 0.01). Insulin dose reductions of 13 ± 3, 30 ± 3, and 41 ± 3 U were observed for placebo, 200-, and 400-mg troglitazone groups, respectively HbA1c decreased 0.09 ± 0.14% for placebo, 0.13 ± 0.14% for 200 mg, and 0.41 ± 0.14% for 400 mg (P &lt; 0.05) troglitazone. In the open-label extension, troglitazone treatment resulted in &gt;50% reduction from baseline in daily insulin dose and decreases in HbA1c of 1% and in FSG of &gt;17%.

CONCLUSIONS
Troglitazone decreases daily injected insulin dose requirements and improves glycemic control in insulin-treated patients with type 2 diabetes.
The Starr County Diabetes Education Study
Authors: Garcia Alexandra A. , Villagomez Evangelina T. , Brown Sharon A. , Kouzekanani Kamiar , Hanis Craig L. 
Published: March 2007

OBJECTIVE— This study reports the psychometric properties of the 24-item version of the Diabetes Knowledge Questionnaire (DKQ).
RESEARCH DESIGN AND METHODS— The original 60-item DKQ was administered to 502 adult Mexican-Americans with type 2 diabetes who are part of the Starr County Diabetes Education Study. The sample was composed of 252 participants and 250 support partners. The subjects were randomly assigned to the educational and social support intervention (n = 250) or to the wait-listed control group (n = 252). A shortened 24-item version of the DKQ was derived from the original instrument after data collection was completed. Reliability was assessed by means of Cronbach's coefficientα. To determine validity, differentiation between the experimental and control groups was conducted at baseline and after the educational portion of the intervention.
RESULTS— The 24-item version of the DKQ (DKQ-24) attained a reliability coefficient of 0.78, indicating internal consistency, and showed sensitivity to the intervention, suggesting construct validation.
CONCLUSIONS— The DKQ-24 is a reliable and valid measure of diabetes-related knowledge that is relatively easy to administer to either English or Spanish speakers.
Comparative Analysis of Organ-Specific Autoantibodies and Celiac Disease—Associated Antibodies in Type 1 Diabetic Patients, Their First-Degree Relatives, and Healthy Control Subjects
Authors: Jaeger Clemens , Hatziagelaki Erifili , Petzoldt Rüdiger , Bretzel Reinhard G. 
Published: March 2007

OBJECTIVE— In type 1 diabetes the coexistence with other endocrine diseases and organ-specific autoantibodies has been frequently reported leading to the concept of autoimmune polyendocrine syndrome (APS). In addition, an association of type 1 diabetes with celiac disease has been described. These disorders share a similar genetic background, and first-degree relatives of type 1 diabetic patients may also be affected significantly. Screening for specific antibodies allows early diagnosis of these disorders.RESEARCH DESIGN AND METHODS— In the present cross-sectional study, we analyzed sera from 197 recent-onset type 1 diabetic patients at the time of diagnosis, 882 first-degree relatives, and sera of 150 healthy control subjects for prevalence and co-occurence of the following antibodies (method):insulin autoantibodies (radioimmunoassay); GAD and IA-2 antibodies(radioligand assay); islet cell antibody, anti-adrenal cortex antibodies, and anti-gastric parietal cell antibodies (indirect immunofluorescence);anti-thyroglobulin and anti-thyroid peroxidase antibodies; and gliadin IgG/A and tissue-transglutaminase IgA (enzyme-linked immunosorbent assay).RESULTS— The overall frequency of gastric patietal cell antibodies and adrenal antibodies did not differ significantly among groups. In contrast, type 1 diabetes—associated antibodies and thyroid antibodies were significantly more frequent both in recent-onset type 1 diabetic patients and in the group of first-degree relatives (P &lt;0.05). The prevalence of gliadin IgG/IgA and transglutaminase IgA was significantly higher in the group of recent-onset type 1 diabetic patients(P &lt; 0.05), but the difference between first-degree relatives and control subjects did not reach statistical significance. Focusing on the coexistence of antibodies, the group of recent-onset type 1 diabetic patients presented with 27.4% of the subjects testing antibody-positive—specific for two or more of the envisaged disorders (i.e., type 1 diabetes, autoimmune thyroiditis, and celiac disease) compared with 3.1% in the group of first-degree relatives and 0 of 150 in the control population (P &lt;0.05).CONCLUSIONS— We conclude that, in an active case-finding strategy, recent-onset type 1 diabetic patients should be routinely screened at least for concomitant autoimmune thyroid disease and additionally for celiac disease. Screening in their first-degree relatives should include at a minimum the search for thyroid autoimmunity in addition to screening for pre—type 1 diabetes.
New Ulceration, New Major Amputation, and Survival Rates in Diabetic Subjects Hospitalized for Foot Ulceration From 1990 to 1993
Authors: Faglia Ezio , Favales Fabrizio , Morabito Alberto 
Published: March 2007

OBJECTIVE— To evaluate 1) the new ulceration, the new major amputation, and the survival rates of 115 diabetic subjects hospitalized for foot ulceration from 1990 to 1993, with an average follow-up of 6.5 years,and 2) the demographic and clinical characteristics associated with these events.
RESEARCH DESIGN AND METHODS— A total of 115 subjects, 31 women and 84 men, were monitored until 31 December 1998. All subjects were provided with therapeutic shoes and received intense education. Data concerning new ulceration, new major amputation, and reamputation events and the date and cause of death were recorded for each patient. The prognostic factors for these events were then evaluated.
RESULTS— The average follow-up was 78.3 ± 15.3 months(range 60-106). During this time, 13 homolateral and 12 contralateral episodes of new ulceration occurred. At univariate analysis, none of the variables considered were significantly associated with the new ulceration. There were three major amputations: two of the limb previously healed and one of the contralateral limb. Of the 115 subjects, 51 (44.3%) died: 24 of the 31 women(77.4%) and 27 of the 84 men (32.1%). Ischemic cardiopathy was the most frequent cause of death (60.8%). Mortality concerned 20 of the 27 subjects(74.1%) undergoing major amputation from 1990 to 1993 and 31 of the 88 healed subjects (35.2%), with a significant difference (P &lt; 0.0001). Multivariate analysis showed the independent role of the ankle-brachial index≤0.5 (P = 0.005), age (P = 0.003), and female sex(P = 0.027).
CONCLUSIONS— We believe that the use of therapeutic shoes and intense educational training, including the education of the family, have contributed to the low incidence of new ulceration and major amputation in our study population. The high frequency of ischemic cardiopathy as a cause of death should, perhaps, lead to a more aggressive diagnostic and therapeutic attitude toward this pathology in diabetic subjects admitted to hospitals for foot ulceration.
Risk Factors for Frequent and Severe Hypoglycemia in Type 1 Diabetes
Authors: Allen Catherine , LeCaire Tamara , Palta Mari , Daniels Kathleen , Meredith Melissa , D’Alessio Donn J. ,   for the Wisconsin Diabetes Registry Project
Published: March 2007

OBJECTIVE—To determine the risk of frequent and severe hypoglycemia and the associated demographic and clinical risk factors.
RESEARCH DESIGN AND METHODS—Demographic and diabetes self-management factors were measured in 415 subjects followed prospectively for 4–6.5 years of type 1 diabetes duration as participants in a population-based incident cohort. Blood samples were collected up to three times yearly to test glycosylated hemoglobin (GHb) levels. Reports of frequent (2–4 times/week) and severe (lost consciousness) hypoglycemia as well as other diabetes self-management data were collected by questionnaires.
RESULTS—Frequent hypoglycemia was common (33 and 35% of participants reported this on the 4- and 6.5-year questionnaires, respectively), whereas severe hypoglycemia occurred much less often. Better glycemic control (odds ratio [OR] 1.3 per 2% decrease in GHb, 95% CI 1.1–1.5) and more frequent self-monitored blood glucose (1.5 per blood glucose check, 1.3–1.7) were independently related to frequent hypoglycemia. The association of frequent hypoglycemia with intensive insulin therapy increased with age. Better glycemic control (1.5 per 2% decrease in GHb, 1.2–2.0) and older age were related to severe hypoglycemic reactions. No sociodemographic factors other than age increased the risk of hypoglycemia.
CONCLUSIONS—Frequent hypoglycemia was common in a population representing the full range of glycemic control in the community. Intensive insulin management and blood glucose monitoring independently predicted frequent but not severe hypoglycemia. This information may be useful for updating patients such that minor changes in diabetes management might decrease the daily burden of this condition while maintaining intensive insulin therapy.
Weighing in on Type 2 Diabetes in the Military
Authors: Paris Robert M. , Bedno Sheryl A. , Krauss Margot R. , Keep Lisa W. , Rubertone Mark V. 
Published: March 2007

OBJECTIVES—Current incidence trends in type 2 diabetes portend a significant public health burden and have largely been attributed to similar trends in overweight and physical inactivity. Medical surveillance of the U.S. military indicates that the incidence of all types of diabetes is similar to that in the civilian population (1.9 vs. 1.6 cases per 1,000 person-years) despite weight and fitness standards. Differences in the common determinants of diabetes have not been studied in the military population, which may provide novel clues to the increasing incidence of diabetes in the U.S.
RESEARCH DESIGN AND METHODS—A case-control study, 4-to-1 matched for age, sex, entry date, time in service, and service component (e.g., Army, Navy), was used to describe the association of race/ethnicity, socioeconomic status, and BMI and blood pressure at entry into military service with the subsequent development of type 2 diabetes.
RESULTS—Increased BMI (adjusted odds ratio, 3.0 for the ≥30 kg/m2 vs. ≤20 kg/m2 categories and 2.0 for the 25.0–29.9 kg/m2 category, compared with the reference category), African-American (adjusted odds ratio, 2.0) and Hispanic origin (adjusted odds ratio, 1.6) compared with white race and rank (adjusted odds ratio for junior enlisted versus officers, 4.1) were all associated with type 2 diabetes.
CONCLUSIONS—Individuals with type 2 diabetes in the U.S. military have risk factors similar to the general U.S. population. Because diabetes is a preventable disease, it is of concern that it is occurring in this population of younger and presumably more fit individuals. This has significant implications for the prevention of diabetes in both military and civilian populations.
Fat Consumption and HbA1c Levels
Authors: Harding Anne-Helen , Sargeant Lincoln A. , Welch Ailsa , Oakes Suzy , Luben Robert N. , Bingham Sheila , Day Nicholas E. , Khaw Kay-Tee , Wareham Nicholas J. 
Published: March 2007

OBJECTIVE—To describe the relationship between total dietary fat and the pattern of fat intake and HbA1c.
RESEARCH DESIGN AND METHODS—In this cross-sectional study, 2,759 men and 3,464 women (40–78 years of age) without a previous diagnosis of type 2 diabetes were recruited from a population-based sampling frame. Diet was assessed using a self-reported semiquantitative food frequency questionnaire.
RESULTS—The HbA1c level was negatively associated with the polyunsaturated fat–to–saturated fat ratio (P:S ratio) of the diet (β = −0.0338 HbA1c% per SD change in P:S ratio; P &lt; 0.001) and positively associated with the total level of fat intake (β = 0.0620 HbA1c% per SD change in total fat intake; P &lt; 0.001), adjusted for age and total energy intake. The associations remained significant when adjusted for each other and for total energy, protein, age, sex, family history of diabetes, BMI, waist-to-hip ratio, physical activity, and smoking (for P:S ratio, β = −0.0200 HbA1c% per SD change in P:S ratio, P = 0.013; for total fat, β = 0.420% HbA1c% per SD change in total fat intake, P &lt; 0.001). The benefits from a high P:S ratio were attributed to a lower saturated fat intake.
CONCLUSIONS—These findings demonstrate independent associations between HbA1c concentration across the normal range of HbA1c and both total fat intake and the pattern of dietary fat intake. They provide further support to efforts promoting modifications in the intake of dietary fat.
Obese Premenopausal African-American Women With Normal and Impaired Glucose Tolerance Have a Similar Degree of Insulin Resistance but Differ in β-Cell Function
Authors: Sumner Anne E. , Farmer Nicole M. , Cochran Craig S. , Sebring Nancy G. , Vanevski Konstantina , Reynolds James C. , Premkumar Ahalya , Boston Raymond C. 
Published: March 2007

OBJECTIVE—To determine whether insulin resistance and secretion differ in obese premenopausal African-American women with and without glucose intolerance.
RESEARCH DESIGN AND METHODS—A total of 63 women underwent oral glucose tolerance tests (OGTTs). A total of 48 women underwent frequently sampled intravenous glucose tolerance tests (FSIGTs). Insulin resistance was determined from the insulin sensitivity index (SI) from the FSIGT. Insulin secretion during the OGTT was determined by (I30 min − I0 min)/(G30 min − G0 min) and during the FSIGT by the acute insulin response to glucose (AIRg). The disposition index, the product of AIRg and SI, was used to determine whether AIRg was adequate to compensate for insulin resistance. Statistical analyses included one-way analysis of variance with Bonferroni corrections for multiple comparisons and regression analyses.
RESULTS—The women were divided into three groups: nonobese glucose tolerant (n = 32), obese glucose tolerant (n = 17), and obese glucose intolerant (n = 14). The BMI of the three groups were 24.8 ± 2.3, 37.8 ± 5.5, and 42.0 ± 7.6 kg/m2 (mean ± SD), respectively (P &lt; 0.0001). The ages of the three groups were 34.9 ± 8.4, 32.1 ± 5.0, and 41.1 ± 6.3 years (P = 0.011). SI was higher in the nonobese women than in the obese glucose-tolerant women (3.99 ± 1.44 vs. 2.66 ± 2.14 l · mU−1 · min−1, P = 0.03). SI was similar in the obese glucose-intolerant and obese glucose-tolerant women (2.12 ± 1.27 vs. 2.66 ± 2.14 l · mU−1 · min−1, P = 0.9). OGTT showed that insulin secretion was lower in the glucose-intolerant than the obese glucose-tolerant women (1.73 ± 1.38 vs. 3.62 ± 2.11, P = 0.005). FSIGT showed that AIRg was not significantly lower in glucose-intolerant than in obese glucose-tolerant women (807 ± 665 vs. 1,253 ± 655 mU · l−1 · min, P = 0.078). The disposition index was lower in glucose-intolerant than in obese glucose-tolerant women (1,324 ± 1,061 vs. 2,656 ± 1,415, P = 0.014).
CONCLUSIONS—Obese premenopausal African-American women with and without glucose intolerance have a similar degree of insulin resistance but differ in insulin secretion.
ACE Gene Polymorphism as a Prognostic Indicator in Patients With Type 2 Diabetes and Established Renal Disease
Authors: Fava Stephen , Azzopardi Joseph , Ellard Sian , Hattersley Andrew T. 
Published: March 2007

OBJECTIVE—To investigate whether the DD genotype is a predictor of mortality and of the decline in renal function in patients with type 2 diabetes and established nephropathy.
RESEARCH DESIGN AND METHODS—A total of 56 such patients of Maltese Caucasian descent were recruited, and their ACE genotype was determined. Serum creatinine was estimated approximately every 4 months. The glomerular filtration rate (GFR) was calculated according to the Cockroft-Gault formula, and rate of change was determined by regression analysis.
RESULTS—The rate of change in calculated GFR was −7.76 ml · min–1 · year–1 in those with the DD genotype (n = 31) and −1.17 ml · min–1 · h–1 in those with the ID or II genotype (n = 25) (P &lt; 0.01). The 3-year mortality was 45.2% in the DD group compared with 20.0% in the ID/II group (P &lt; 0.05).
CONCLUSIONS—The DD genotype of the ACE gene polymorphism is associated with a more rapid decline in renal function and higher mortality in type 2 diabetic patients with established nephropathy.
Visceral Fat Is a Major Contributor for Multiple Risk Factor Clustering in Japanese Men With Impaired Glucose Tolerance
Authors: Nagaretani Hiroyuki , Nakamura Tadashi , Funahashi Tohru , Kotani Kazuaki , Miyanaga Minoru , Tokunaga Katsuto , Takahashi Masahiko , Nishizawa Hitoshi , Kishida Ken , Kuriyama Hiroshi , Hotta Kikuko , Yamashita Shizuya , Matsuzawa Yuji 
Published: March 2007

OBJECTIVE—The significance of abdominal visceral fat accumulation was evaluated in Japanese men with impaired glucose tolerance (IGT).
RESEARCH DESIGN AND METHODS—The IGT subjects (n = 123) were aged 55 ± 9 years with a BMI of 24 ± 3 kg/m2. The 148 control subjects with normal glucose tolerance (NGT) were matched for age and BMI. IGT and NGT were classified according to the 1985 World Health Organization criteria. Abdominal fat distribution was analyzed by computed tomography at umbilical level. Plasma lipid, glucose, and insulin concentrations and blood pressure (BP) were measured.
RESULTS—In subjects with IGT, the average visceral fat area (VFA) was significantly greater than in subjects with NGT. Fasting insulin, the sum of insulin concentrations during an oral glucose tolerance test, insulin resistance according to a homeostasis model assessment for insulin resistance (HOMA-IR), systolic BP, and serum triglyceride were significantly higher, whereas the ΔI30–0/ΔG30–0 was significantly lower, in subjects with IGT. Subjects with IGT and NGT were then divided into three subgroups according to the number of risk factors they possessed (dyslipidemia, hypertension, neither, or both). In both IGT and NGT subjects, BMI, VFA, subcutaneous fat area, fasting insulin, HOMA-IR, and insulin secretion of the homeostasis model assessment were significantly higher in the double–risk factor subgroup than in the no–risk factor subgroup, and VFA was a potent and independent variable in association with the presence of a double risk factor.
CONCLUSIONS—Visceral fat accumulation is a major contributor for multiple risk factor clustering in Japanese men with IGT and NGT.
Once- and Twice-Daily Dosing With Rosiglitazone Improves Glycemic Control in Patients With Type 2 Diabetes
Authors: Phillips Lawrence S. , Grunberger George , Miller Elizabeth , Patwardhan Rita , Rappaport Elizabeth B. , Salzman Alan ,   the Rosiglitazone Clinical Trials Study Group
Published: March 2007

OBJECTIVE— To determine the efficacy of rosiglitazone compared with placebo in reducing hyperglycemia.RESEARCH DESIGN AND METHODS— After a 4-week placebo run-in period, 959 patients were randomized to placebo or rosiglitazone (total daily dose 4 or 8 mg) for 26 weeks. The primary measure of efficacy was change in the HbAlc concentration.RESULTS— Rosiglitazone produced dosage-dependent reductions in HbAlc of 0.8, 0.9, 1.1, and 1.5% in the 4 mg o.d., 2 mg b.i.d., 8 mg o.d., and 4 mg b.i.d. groups, respectively, compared with placebo. Clinically significant decreases from baseline in HbAlc were observed in drug-naive patients at all rosiglitazone doses and in patients previously treated with oral monotherapy at rosiglitazone 8 mg o.d. and 4 mg b.i.d. Clinically significant decreases from baseline in HbAlc were also observed with rosiglitazone 4 mg b.i.d. in patients previously treated with combination oral therapy. Approximately 33% of drug-naive patients treated with rosiglitazone achieved HbAlc ≤7% at study end. The proportions of patients with at least one adverse event were comparable among the rosiglitazone and placebo groups. There was no evidence of hepatotoxicity in any treatment group. There were statistically significant increases in weight and serum lipids in all rosiglitazone treatment groups compared with placebo. For LDL and HDL cholesterol, the observed increase appeared to be dose related.CONCLUSIONS— Rosiglitazone at total daily doses of 4 and 8 mg significantly improved glycemic control in patients with type 2 diabetes and was well tolerated.
Effect of Metformin on Glucagon-Like Peptide 1 (GLP-1) and Leptin Levels in Obese Nondiabetic Subjects
Authors: Mannucci Edoardo , Ognibene Agostino , Cremasco Francesco , Bardini Gianluca , Mencucci Antonella , Pierazzuoli Enrica , Ciani Silvia , Messeri Gianni , Rotella Carlo M. 
Published: March 2007

OBJECTIVE—To evaluate the effects of metformin on glucagon-like peptide 1 (GLP-1) and leptin levels.
RESEARCH DESIGN AND METHODS—A total of 10 obese nondiabetic male patients were studied before and after a 14-day treatment with 2,550 mg/day metformin and were compared with 10 untreated obese control subjects. On days 0 and 15, leptin and GLP-1(7–36)amide/(7–37) levels were assessed before and after an oral glucose load during a euglycemic hyperinsulinemic clamp to avoid the interference of variations of insulinemia and glycemia on GLP-1 and leptin secretion. The effects of metformin on GLP-1(7–36)amide degradation in human plasma and in a buffer solution containing dipeptidyl peptidase IV (DPP-IV) were also studied.
RESULTS—Leptin levels were not affected by the oral glucose load, and they were not modified after metformin treatment. Metformin induced a significant (P &lt; 0.05) increase of GLP-1(7–36)amide/(7–37) at 30 and 60 min after the oral glucose load (63.8 ± 29.0 vs. 50.3 ± 15.6 pmol/l and 75.8 ± 35.4 vs. 46.9 ± 20.0 pmol/l, respectively), without affecting baseline GLP-1 levels. No variations of GLP-1 levels were observed in the control group. In pooled human plasma, metformin (0.1–0.5 μg/ml) significantly inhibited degradation of GLP-1(7–36)amide after a 30-min incubation at 37°C; similar results were obtained in a buffer solution containing DPP-IV.
CONCLUSIONS—Metformin significantly increases GLP-1 levels after an oral glucose load in obese nondiabetic subjects; this effect could be due to an inhibition of GLP-1 degradation.