bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association Between Impaired Glucose Tolerance and Birth Weight Among Black and White Women in Central North Carolina
Authors: Saldana Tina M. , Siega-Riz Anna Maria , Adair Linda S. , Savitz David A. , Thorp John M. 
Published: March 2007

OBJECTIVE—This study examines the relationship of glucose intolerance during pregnancy to birth weight among black and white participants of the Pregnancy, Infection, and Nutrition Study.
RESEARCH DESIGN AND METHODS—This prospective cohort study recruited women from prenatal clinics in central North Carolina at 24–29 weeks’ gestation. A 1-h 50-g glucose challenge test (GCT) and 100-g oral glucose tolerance test (OGTT) were conducted. Impaired glucose tolerance (IGT) was defined as one high value on the OGTT, gestational diabetes mellitus (GDM) as two or more high values, and normal glucose tolerance (NGT) was defined as a low or high value on the GCT screen but no high values on the OGTT. Women with known glucose status and birth outcome information were included in this analysis (n = 2055).
RESULTS—Black women with IGT had higher rates of both macrosomia (38.5%) and large for gestational age (LGA) (53.9%) compared with white women (10.0% and 13.2%). Black infants’ birth weights (3,800 g) and prevalence of macrosomia and LGA were significantly higher among mothers with IGT compared with NGT women (birth weight, 3,184 g; macrosomia, 7.0%; LGA, 11.6%). In contrast, among white infants, there was no significant increase in birth weight, macrosomia, or LGA associated with the mother’s glucose tolerance status. In addition, there was no effect of GDM on birth weight in either group.
CONCLUSIONS—This study suggests that, independent of maternal prepregnant weight, there may be significant increased risk of macrosomia among black IGT women but not among white IGT women. Further investigations into factors that may contribute to the observed results are needed.
Hypoglycemia Prevalence in Prepubertal Children With Type 1 Diabetes on Standard Insulin Regimen: Use of Continuous Glucose Monitoring System
Authors: Amin Rakesh , Ross Karen , Acerini Carlo L. , Edge Julie A. , Warner Justin , Dunger David B. 
Published: March 2007

OBJECTIVE—To determine hypoglycemia prevalence in prepubertal children on thrice (TID) and twice (BID) daily insulin regimens, using the Medtronic Minimed Continuous Glucose Monitoring System.
RESEARCH DESIGN AND METHODS—Twenty-eight children aged &lt;12 years (median 9.8, range 6.9–11.8) wore the sensor for three consecutive days and nights. Hypoglycemia was defined as glucose &lt;60 mg/dl for &gt;15 min. Data are expressed as the percentage of time period spent hypoglycemic.
RESULTS—Hypoglycemia prevalence was 10.1% (mean 2.6 h · subject−1 · day−1). Hypoglycemia was more common at night compared with daytime (18.81 vs. 4.4%, P &lt; 0.001); 78 and 43% of subjects showed hypoglycemia on at least one night and two or more nights, respectively. Nocturnal episodes were prolonged (median 3.3 h) and asymptomatic (91% of episodes). Prevalence was greater between 0400 and 0730 h than between 2200 and 0400 h (25.5 vs. 15.4%, P &lt; 0.001). On a TID compared with a BID regimen, nocturnal hypoglycemia prevalence was reduced, particularly between 0400–0730 h (22.9 vs. 27.4%, P = 0.005), whereas hypoglycemia the following morning (0730–1200 h) was greater (7.8 vs. 2.8%, P &lt; 0.001). Nocturnal hypoglycemia risk was associated with decreasing age (by a factor of 0.6 for a year less in age), increased insulin dose (by 1.6 for an increase of 0.1 units · kg−1 · day−1), insulin regimen (by 0.2 on a BID compared with a TID regimen), and increased weight standard deviation score (SDS) (by 2.7 for a one SDS rise).
CONCLUSIONS—Use of standard insulin regimens results in high prevalence and large intraindividual variation in hypoglycemia, particularly at night. Independent risk factors for nocturnal hypoglycemia were younger age, greater daily insulin dose, insulin regimen, and increasing weight.
The Impact of Smoking on Inhaled Insulin
Authors: Himmelmann Anders , Jendle Johan , Mellén Anders , Petersen Astrid H. , Dahl Ulf L. , Wollmer Per 
Published: March 2007

OBJECTIVE—This study, one of the first to address issues of pulmonary insulin delivery in smokers, compared pharmacokinetics of inhaled insulin delivered via the AERx insulin Diabetes Management System (iDMS) in nondiabetic cigarette smokers and nonsmokers.
RESEARCH DESIGN AND METHODS—In this randomized two-period crossover efficacy and safety trial in 27 nondiabetic smokers and 16 nonsmokers (18 men/25 women, mean age 28 years, mean BMI 23.0 kg/m2), subjects received single doses of inhaled insulin (33.8 IU) following overnight fasting on consecutive dosing days. On one dosing day, smokers smoked three cigarettes immediately before insulin administration (“acute smoking”); on the other dosing day, smokers had not smoked since midnight (“nonacute smoking”). After inhalation, 6-h serum insulin and serum glucose profiles were determined.
RESULTS—Pharmacokinetic results for evaluable subjects were derived from serum insulin profiles. The amount of insulin absorbed during the first 6 h after dosing (area under the exogenous serum insulin curve from 0 to 6 h [AUC(0–6 h)]) was significantly greater in smokers (63.2 vs. 40.0 mU · l−1 · h−1, P = 0.0017); peak concentration was both higher and earlier in the smokers (maximal serum concentration of insulin [Cmax] 42.0 vs. 13.9 mU/l, P &lt; 0.0001; time to maximal serum concentration of insulin [tmax] 31.5 vs. 53.9 min, P = 0.0003). The estimated intrasubject variability of AUC(0–6 h) was 13.7 and 16.5% for nonsmokers and smokers, respectively. No safety issues arose.
CONCLUSIONS—Absorption of inhaled insulin via the AERx iDMS was significantly greater in smokers, with a higher AUC(0–6 h) and Cmax and a shorter tmax. Intrasubject variability of AUC(0–6 h) was low and similar in nonsmokers and smokers. These data prompt more extensive investigation of inhaled insulin in diabetic smokers.
Are Spouses of Patients With Type 2 Diabetes at Increased Risk of Developing Diabetes?
Authors: Khan Asya , Lasker Shawarna S. , Chowdhury Tahseen A. 
Published: March 2007

OBJECTIVE—To determine whether spouses of patients with type 2 diabetes have an increased risk of diabetes compared with spouses of subjects with normal glucose tolerance.
RESEARCH DESIGN AND METHODS—A random sample of spouses of patients with type 2 diabetes (group 1S) attending a general practice diabetes clinic was compared with spouses of nondiabetic subjects (as determined by oral glucose tolerance test [OGTT]) (group 2S). Spouses in both groups underwent OGTT, fasting lipid profile, and blood pressure (BP) measurements.
RESULTS—A total of 245 subjects in group 1S and 234 subjects in group 2S underwent OGTT. Group 1S had a significantly higher incidence of fasting glucose, impaired glucose tolerance, or type 2 diabetes (19.1 vs. 9.4%). Group 1S also had higher fasting glucose and triglyceride levels, higher BMI, and a trend toward higher BP. Multivariate logistic regression analysis, adjusted for BMI and age, showed the risk of diabetes in the spouse of a patient with diabetes was 2.11 (95% CI 1.74–5.1), as compared with the spouse of a subject with normal glucose tolerance. Similarly, the risk of any degree of glucose intolerance in a spouse of a patient with type 2 diabetes was 2.32 (1.87–3.98), as compared with a spouse of a subject with normal glucose tolerance.
CONCLUSIONS—Spouses of patients with type 2 diabetes have a significantly increased risk of glucose intolerance and type 2 diabetes, and they should be classified as high risk for diabetes. This finding has implications for screening programs, which should include spouses of subjects with diabetes.
Unadjusted and Adjusted Prevalence of Diagnosed Depression in Type 2 Diabetes
Authors: Nichols Gregory A. , Brown Jonathan B. 
Published: March 2007

OBJECTIVE—To estimate the prevalence of diagnosed depression in a large population of individuals with type 2 diabetes, compared to a matched control group, and to estimate the extent of depression that is independently associated with diabetes.
RESEARCH DESIGN AND METHODS—We compared the prevalence of diagnosed depression in all 16,180 full-year health maintenance organization members in 1999 who had been diagnosed with type 2 diabetes and in 16,180 comparison members without diabetes matched for age and sex. We ascertained diagnoses from the Kaiser Permanente Northwest Region’s electronic medical record. Using multiple logistic regression, we adjusted the prevalence estimates for the presence of cardiovascular disease, age, sex, and body weight.
RESULTS—Depression was more common in individuals with type 2 diabetes than among matched control subjects (17.9 vs. 11.2%; P &lt; 0.001). Women in both groups were nearly twice as likely to be depressed as men; however, the relative difference in depression prevalence between subjects with and without diabetes was greater in men. In the multivariate model for women, body weight was a much stronger predictor of depression than diabetes status.
CONCLUSIONS—This study further documents the association between depression and diabetes, providing unadjusted population-based estimates in a large sample. Depression remained associated with diabetes after adjustment for several other possible causes. The association among diabetes, cardiovascular disease, depression, and obesity are multifaceted and differ for men and women.
Inhaled Insulin Using the AERx Insulin Diabetes Management System in Healthy and Asthmatic Subjects
Authors: Henry Robert R. , Mudaliar Sunder R.D. , Howland III William C. , Chu Neelima , Kim Dennis , An Bob , Reinhardt Rickey R. 
Published: March 2007

OBJECTIVE—The AERx insulin Diabetes Management System (AERx iDMS) (Aradigm, Hayward, CA) delivers an aerosol of liquid human insulin to the deep lung for systemic absorption. This study examined the effects on pulmonary function, pharmacokinetics, and pharmacodynamics of inhaled insulin in asthmatic and nonasthmatic subjects without diabetes.RESEARCH DESIGN AND METHODS—A total of 28 healthy and 17 asthmatic (forced expiratory volume during the first second [ FEV1] 50–80% of predicted value) subjects were enrolled in a two-part, open-label trial. To assess insulin pharmacokinetics and pharmacodynamics, a single inhalation dose of 1.57 mg (45 IU) was given on each of the 2 dosing days in part 1. A dose of 4.7 mg (135 IU) of insulin was inhaled in part 2 to assess effects on pulmonary function.RESULTS—Inhaled insulin showed area under the curve (AUC)(0–360 min) values that were significantly greater for healthy subjects than for asthmatic subjects (P = 0.013), whereas no difference was observed for maximum concentration (Cmax) in the two groups. A greater reduction of serum glucose as indicated by area over the curve (AOC)(0–360 min) was observed in healthy subjects (P = 0.007). Asthmatic subjects had greater intrasubject variations in insulin AUC(0–360 min) and Cmax values than healthy subjects, but similar variations in glucose AOC(0–360 min). No significant changes in FEV1, forced vital capacity (FVC), and FEV1/FVC were observed from pre- to postdose times, and there were no observed safety issues.CONCLUSIONS—After inhaling insulin using the AERx iDMS, asthmatic subjects absorbed less insulin than healthy subjects, resulting in less reduction of serum glucose. No effects on airway reactivity were observed. Diabetic patients with asthma may need to inhale more insulin than patients with normal respiratory function in order to achieve similar glycemic control.
Differential Effects of Acute and Extended Infusions of Glucagon-Like Peptide-1 on First- and Second-Phase Insulin Secretion in Diabetic and Nondiabetic Humans
Authors: Quddusi Shaista , Vahl Torsten P. , Hanson Kevin , Prigeon Ronald L. , D’Alessio David A. 
Published: March 2007

OBJECTIVE—The purpose of this study was to determine whether an extended infusion of the incretin hormone glucagon-like peptide 1 (GLP-1) has a greater effect to promote insulin secretion in type 2 diabetic subjects than acute administration of the peptide.
RESEARCH DESIGN AND METHODS—Nine diabetic subjects and nine nondiabetic volunteers of similar age and weight were studied in identical protocols. First-phase insulin release (FPIR; the incremental insulin response in the first 10 min after the intravenous glucose bolus) and second-phase insulin release (SPIR; the incremental insulin response from 10–60 min after intravenous glucose) were measured during three separate intravenous glucose tolerance tests (IVGTTs): 1) without GLP-1 (control); 2) with acute administration of GLP-1 as a square wave starting just before glucose administration; and 3) with an extended infusion of GLP-1 for 3 h before and during the IVGTT.
RESULTS—In the subjects with diabetes, FPIR was severely impaired—a defect that was only modestly improved by acute administration of GLP-1 (197 ± 97 vs. 539 ± 218 pmol/l · min, P &lt; 0.05), while SPIR was substantially increased (1,952 ± 512 vs. 8,072 ± 1,664 pmol/l · min, P &lt; 0.05). In contrast, the 3-h preinfusion of GLP-1 normalized fasting hyperglycemia (7.9 ± 0.5 vs. 5.2 ± 0.6, P &lt; 0.05), increased FPIR by 5- to 6-fold (197 ± 97 vs. 1,141 ± 409 pmol/l · min, P &lt; 0.05), and augmented SPIR significantly (1,952 ± 512 vs. 4,026 ± 851 pmol/l · min, P &lt; 0.05), but to a lesser degree than the acute administration of GLP-1. In addition, only the 3-h GLP-1 preinfusion significantly improved intravenous glucose tolerance (Kg control 0.61 ± 0.04, acute infusion 0.71 ± 0.04, P = NS; 3-h infusion 0.92 ± 0.08%/min, P &lt; 0.05). These findings were also noted in the nondiabetic subjects in whom acute administration of GLP-1 significantly increased SPIR relative to the control IVGTT (9,439 ± 2,885 vs. 31,553 ± 11660 pmol/l · min, P &lt; 0.001) with less effect on FPIR (3,221 ± 918 vs. 4,917 ± 1,614 pmol/l · min, P = 0.075), while the 3-h preinfusion of GLP-1 significantly increased both FPIR (3,221 ± 918 vs. 7,948 ± 2,647 pmol/l · min, P &lt; 0.01) and SPIR (9,439 ± 2,885 vs. 21,997 ± 9,849 pmol/l · min, P &lt; 0.03).
CONCLUSIONS—Extended administration of GLP-1 not only augments glucose-stimulated insulin secretion, but also shifts the dynamics of the insulin response to earlier release in both diabetic and nondiabetic humans. The restitution of some FPIR in subjects with type 2 diabetes is associated with significantly improved glucose tolerance. These findings demonstrate the benefits of a 3-h infusion of GLP-1 on β-cell function beyond those of an acute insulin secretagogue, and support the development of strategies using continuous or prolonged GLP-1 receptor agonism for treating diabetic patients.
Randomized Cross-Over Trial of Insulin Glargine Plus Lispro or NPH Insulin Plus Regular Human Insulin in Adolescents With Type 1 Diabetes on Intensive Insulin Regimens
Authors: Murphy Nuala P. , Keane Suzanne M. , Ong Ken K. , Ford-Adams Martha , Edge Julie A. , Acerini Carlo L. , Dunger David B. 
Published: March 2007

OBJECTIVE—To compare blood glucose control and incidence of nocturnal hypoglycemia in adolescents with type 1 diabetes on multiple injection regimens managed with either an insulin analog combination or NPH insulin plus regular human insulin.
RESEARCH DESIGN AND METHODS—In a randomized cross-over study, 28 adolescents with type 1 diabetes on multiple injection therapy received either insulin glargine prebedtime plus lispro preprandially (LIS/GLAR) or NPH insulin prebedtime plus regular human insulin preprandially (R/NPH). During each 16-week treatment arm, subjects completed home blood glucose profiles, and at the end of each treatment arm, they were admitted for an overnight metabolic profile. A total of 25 subjects completed the study.
RESULTS—Compared with R/NPH therapy, LIS/GLAR was associated with lower mean blood glucose levels (LIS/GLAR versus R/NPH): fasting (8.0 vs. 9.2 mmol/l, P &lt; 0.0001), 2 h postbreakfast (8.1 vs. 10.7 mmol/l, P &lt; 0.0005), prelunch (8.9 vs. 10.1 mmol/l, P &lt; 0.01), and 2 h postlunch (8.0 vs. 9.5 mmol/l, P &lt; 0.002). However, there was no difference in mean blood glucose levels before or after the evening meal. Incidence of nocturnal hypoglycemia on overnight profiles was 43% lower on LIS/GLAR compared with R/NPH therapy; however, there was no difference in rates of self-reported symptomatic hypoglycemia. Total insulin dose required to achieve target blood glucose control was lower on LIS/GLAR (1.16 IU/kg) compared with R/NPH therapy (1.26 IU/kg, P &lt; 0.005), but there was no significant difference in HbA1c levels (LIS/GLAR versus R/NPH: 8.7 vs. 9.1%, P = 0.13).
CONCLUSIONS—Combination therapy with insulin glargine plus lispro reduced the incidence of nocturnal hypoglycemia and was at least as effective as R/NPH insulin therapy in maintaining glycemic control in adolescents on multiple injection regimens.
A Comparison of Diabetes Education Administered Through Telemedicine Versus in Person
Authors: Izquierdo Roberto E. , Knudson Paul E. , Meyer Suzanne , Kearns Joann , Ploutz-Snyder Robert , Weinstock Ruth S. 
Published: March 2007

OBJECTIVE—To determine whether diabetes education can be provided as effectively through telemedicine technology as through in-person encounters with diabetes nurse and nutrition educators.
RESEARCH DESIGN AND METHODS—A total of 56 adults with diabetes were randomized to receive diabetes education in person (control group) or via telemedicine (telemedicine group) and were followed prospectively. The education consisted of three consultative visits with diabetes nurse and nutrition educators. The in-person and telemedicine groups were compared using measures of glycemic control (HbA1c) and questionnaires to assess patient satisfaction and psychosocial functioning as related to diabetes. Outcome measures were obtained at baseline, immediately after the completion of diabetes education, and 3 months after the third educational visit.
RESULTS—Patient satisfaction was high in the telemedicine group. Problem Areas in Diabetes scale scores improved significantly with diabetes education (adjusted P &lt; 0.05, before vs. immediately after education and 3 months after education), and the attainment of behavior-change goals did not differ between groups. With diabetes education, HbA1c improved from 8.6 ± 1.8% at baseline to 7.8 ± 1.5% immediately after education and 7.8 ± 1.8% 3 months after the third educational visit (unadjusted P &lt; 0.001, P = 0.089 adjusted for BMI and age), with similar changes observed in the telemedicine and in-person groups.
CONCLUSIONS—Diabetes education via telemedicine and in person was equally effective in improving glycemic control, and both methods were well accepted by patients. Reduced diabetes-related stress was observed in both groups. These data suggest that telemedicine can be successfully used to provide diabetes education to patients.
Menstrual Cycle Differences Between Women With Type 1 Diabetes and Women Without Diabetes
Authors: Strotmeyer Elsa S. , Steenkiste Ann R. , Foley Thomas P. , Berga Sarah L. , Dorman Janice S. 
Published: March 2007

OBJECTIVE—To evaluate menstrual cycle histories among women with type 1 diabetes, their sisters, and unrelated control subjects without diabetes across all reproductive ages.
RESEARCH DESIGN AND METHODS—Menstrual and reproductive histories were obtained by questionnaire from 143 women with type 1 diabetes, 186 sisters without diabetes, and 158 unrelated control subjects without diabetes participating in the Familial Autoimmune and Diabetes study.
RESULTS—Women with type 1 diabetes had more menstrual problems (long cycles, long menstruation, and heavy menstruation) before age 30 years than sisters and control subjects. These differences were all statistically significant, except for heavy menstruation at age &lt;20 years. No differences were observed after age 30 years. Women with type 1 diabetes experienced later menarche, earlier natural menopause, fewer pregnancies, and more stillbirths than women without diabetes. Multiple regression analyses revealed that type 1 diabetes caused an approximate twofold increased risk of any menstrual problem before age 30 years. These were primarily related to long cycles and long menstruation in women aged &lt;20 and 20–29 years, as well as with heavy menstruation from 20 to 29 years. Oral contraceptives were protective for any menstrual problem and heavy menstruation from 30 to 39 years of age. With history of pregnancy from 20 to 40 years of age, any menstrual problem and long menstruation were more likely.
CONCLUSIONS—The results suggest that type 1 diabetes is an independent risk factor for menstrual disturbances in young adults. Future studies may determine whether addressing menstrual disturbances improves quality of life and health for these women.
Type 2 Diabetes in Asian-Indian Urban Children
Authors: Ramachandran Ambady , Snehalatha Chamukuttan , Satyavani Kumpatla , Sivasankari Selvaraj , Vijay Viswanathan 
Published: March 2007

OBJECTIVE—Due to a background of high prevalence of type 2 diabetes and the increasing rate of obesity occurring in relatively young urban children, we felt the need to look for type 2 diabetes in children.
RESEARCH DESIGN AND METHODS—A study of cases of type 2 diabetes with age at diagnosis of ≤15 years seen at a diabetes speciality center in Chennai, India, is reported. A total of 18 children (5 boys and 13 girls) aged 9–15 years with insidious onset of diabetes responding to oral antidiabetic agents (ODAs) for periods from 2 months to 12 years were studied. Clinical details, anthropometry, and details of family history of diabetes were elicited. All of them were tested for the presence of anti-GAD65 antibodies and for pancreatic β-cell reserve by measuring serum C-peptide response (radioimmunoassay procedures).
RESULTS—All children showed a response to ODAs, had good β-cell reserve (≥0.6 pmol/ml on stimulation), and negligible GAD65 antibodies indicating the presence of type 2 diabetes. The children were nonketotic; nine were obese, four had acanthosis nigricans, and one had polycystic ovary syndrome. Positive family history of diabetes was present in all cases.
CONCLUSIONS—The clinical, immunological, and biochemical profile showed that the children had type 2 diabetes. The profile of type 2 diabetes was similar to that described in children in many other countries. Although less common than type 1 diabetes, type 2 diabetes in children is a condition that needs to be recognized and looked for in Asian-Indians.