bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of Blood Glucose Estimation by Children With IDDM and Their Parents
Authors: Gonder-Frederick Linda A , Snyder Andrea L , Clarke William L 
Published: March 2007

Objective
To evaluate the accuracy of blood glucose symptom recognition and subjective blood glucose estimation in insulin-dependent diabetic (IDDM) children and their parents.

Research Design and Methods
Blood glucose estimation questionnaires were completed 4 times/day at home during routine activities. A sequential sample of 19 families, who attended a pediatric diabetes clinic, with IDDM children &lt;2265; 12 yr old and IDDM duration of &gt; or equal to 9 mo comprised the study.

Results
Error grid analysis showed that both children and parents demonstrated poor accuracy, making clinically significant errors as frequently as clinically accurate estimates. The most common error was the failure to detect extreme blood glucose levels, with a significant tendency to underestimate hyperglycemia. Children often reported hypoglycemia when blood glucose was hyperglycemic. Confidence in the ability to estimate blood glucose was unrelated to measured accuracy.

Conclusions
IDDM children and their parents demonstrated a higher rate of blood glucose estimation errors than IDDM adolescents and adults in previous studies. Even in families who use self-monitoring of blood glucose frequently, self-reported ability to recognize symptoms and estimate blood glucose should be viewed with caution. Families with IDDM children need more education about errors in symptom recognition and blood glucose estimation. They should also be encouraged to use self-monitoring of blood glucose before treating children's reported hypoglycemic symptoms whenever possible.
Therapeutic Potentials of Acarbose as First-Line Drug in NIDDM Insufficiently Treated With Diet Alone
Authors: Hanefeld Markolf , Fischer Sabine , Schulze Jan , Spengler Manfred , Wargenau Manfred , Schollberg Karl , Fücker Katja 
Published: March 2007

Objecative
Acarbose inhibits α-glucosidases of the small intestine and thus delays glucose release from complex carbohydrates. Therefore, its efficacy and acceptability as a first-line drug in non-insulin-dependent diabetes mellitus (NIDDM) insufficiently treated with diet alone was tested in a randomized double-blind placebo-controlled study.

Research Design And Methods
Ninety-four NIDDM subjects, aged 43–70 yr with average body mass index of 28 kg/m2 and undergoing a pretreatment period of at least 3 mo with diet alone, were treated with 100 mg acarbose three times daily or placebo for 24 wk. The patients were recruited after a 4-wk screening period of dietary reinforcement. The inclusion limits for patients termed diet not satisfactory were fasting blood glucose (FBG) ≥ 7.8 mM and/or postprandial blood glucose (BG) ≥ 10 mM.

Results
FBG was lowered in the acarbose group from 9.8 to 8.4 mM and in the placebo group from 10.2 to 9.6 mM after 24 wk (P = 0.007 vs. placebo). The most impressive therapeutic effect was a highly significant reduction of postprandial hyperglycemia for at least 5 h after the test meal (1-h postprandial BG with acarbose 10.4 mM and placebo 13.5 mM at 24 wk, P &lt; 0.001) accompanied by a significant decrease in HbA1 (acarbose 8.65%, placebo 9.32%, P = 0.003). Whereas C-peptide and fasting serum insulin were not significantly affected by acarbose, postprandial insulin increment was ∼ 30% lower after 24 wk compared with placebo. Furthermore, acarbose significantly reduced 1-h postprandial triglyceride levels. After an initial phase of &gt; 4 wk (when 76.6% in the acarbose group vs. 28% on placebo complained about flatulence, P &lt; 0.001), the drug was well accepted. At the end of the study, only 32% showed mild or moderate gastrointestinal sensations.

Conclusions
Extrapolation shows that acarbose is an efficient and acceptable drug for the treatment of NIDDM with poor metabolic control by diet alone. It has beneficial effects on postprandial hyperinsulinemia and postprandial hypertriglyceridemia.
Body Mass is a Poor Predictor of Peak Plantar Pressure in Diabetic Men
Authors: Cavanagh Peter R , Sims David S , Sanders Lee J 
Published: March 2007

Objective
To examine the relationship between peak plantar pressure during walking and body mass in diabetic patients and age-matched control subjects.

Research Design And Methods
A volunteer sample of 56 male diabetic veterans (12 insulin dependent, 44 non-insulin dependent) with a mean age of 58.9 yr, mean duration of diabetes of 16.9 yr, and mean vibration perception threshold of 30.8 and 27 age-matched nondiabetic control subjects comprised the study.

Results
Peak plantar pressure was measured with a 1000-element piezoelectric platform during the first step of gait. The correlation between body mass and peak pressure was found to be only 0.37 in the patients with diabetes and 0.36 in the control subjects, indicating that body mass accounts for &lt; 14% of the variance in peak plantar pressure. The body mass and peak plantar pressure of the 14 patients who experienced plantar ulcers was not significantly different from those who did not ulcerate, but vibration perception thresholds and monofilament perception thresholds of the ulcer patients were significantly higher.

Conclusions
Although the correlation between body mass and peak plantar pressure is statistically significant, the functional relationship between the two variables is weak. Elevated plantar pressures are as likely to occur in small individuals as they are in those with large body mass. Foot deformity, in the presence of neuropathy and other permissive factors, is itself likely to be an important risk factor for plantar ulceration in diabetes, and this hypothesis deserves further exploration.
Effect of Meal on Retinal Blood Flow in IDDM Patients
Authors: Sullivan Paul M , Parfitt Vernon J , Jagoe Roger , Newsom Richard , Kohner Eva M 
Published: March 2007

Objective
The effect of postprandial hyperglycemia on retinal blood flow was examined in 11 adults with insulin-dependent diabetes mellitus (IDDM) and 9 nondiabetic subjects.

Research Design And Methods
Retinal blood flow was measured with bidirectional laser Doppler velocimetry before and 60 and 120 min after a 50-g carbohydrate breakfast. Diabetic subjects were studied twice, being randomized to take their usual insulin (isoglycemic study) or to omit their morning short-acting insulin (hyperglycemic study). Nondiabetic subjects were studied once and received no insulin.

Results
Plasma glucose rose significantly (from 11.5 ± 5.2 to 22.1 ± 5.5 mM, P &lt; 0.001) during the hyperglycemic study but not during the isoglycemic or nondiabetic studies. There were no significant changes in blood pressure or retinal blood flow in any of the groups studied.

Conclusions
Short-term hyperglycemia does not increase retinal blood flow.
In-Hospital Prognosis of Ppatients With Fasting Hyperglycemia After First Myocardial Infarction
Authors: O'Sullivan John J , Conroy Ronan M , Robinson Killian , Hickey Noel , Mulcahy Risteard 
Published: March 2007

Objective
To investigate the incidence and prognostic significance of fasting hyperglycemia in a large group of patients with a first myocardial infarction.

Research Design and Methods
Blood glucose was measured after an 8-h overnight fast in 752 patients with a first myocardial infarction. Three groups of patients were identified: patients with normal fasting blood glucose (92.5%), patients with fasting hyperglycemia but no prior history of glucose intolerance (3%), and patients previously known to have diabetes mellitus (4.5%).

Results
The fasting hyperglycemic patients were significantly older and had significantly more in-hospital complications than the normal blood glucose group. Previously known diabetic subjects tended to be older and had more mechanical complications postinfarction than the group with normal blood glucose but the difference did not reach statistical significance. There was no significant difference between the diabetic subjects and patients with fasting hyperglycemia in mean age and in-hospital prognosis.

Conclusions
Fasting hyperglycemia detected after a first myocardial infarction is associated with a poor in-hospital prognosis that was not due to larger infarct size, as reflected in peak levels of cardiac enzymes. The measurement of a fasting blood glucose level provides additional information in identifying high-risk groups of patients postinfarction.
Glutathione Infusion Potentiates Glucose-Induced Insulin Secretion in Aged Patients With Impaired Glucose Tolerance
Authors: Paolisso Giuseppe , Giugliano Dario , Pizza Gennaro , Gambardella Antonio , Tesauro Paola , Varricchio Michele , D'Onofrio Felice 
Published: March 2007

Objective
–To evaluate the effect of glutathione infusion on β-cell response to glucose in elderly people with impaired glucose tolerance (IGT).

Research Desigh and Methods
–Ten patients with normal glucose tol-erance and 10 patients with IGT were matched for age (mean ± SE, 72.1 ± 2.8 vs. 71.0 ± 3.4 yr), body mass index (23.1 ± 1.1 vs. 22 ± 2.1 kg/m2), and sex (6/4 vs. 5/5, men/women) underwent glutathione infusion (10 mg/min) under basal conditions and during 75-g oral glucose tolerance tests and intravenous glucose tolerance tests (0.33 g.kg body wt−1.3 min−1). Patients with IGT were also submitted to euglycemic-hyperinsulemic and hyperglycemic glucose clamps.

Results
–In subjects with normal glucose tolerance, glutathione infusion failed to affect β-cell response to glucose. In contrast, glutathione significantly potentiated glucose-induced insulin secretion in patients with IGT. Furthermore, in the latter group studied by hyperglycemic clamps, glutathione infusion significantly potentiated the beta-cell response to glucose when plasma glucose levels varied between 10 and 15 mM. This effect disappeared at plasma glucose levels &lt;15 mM. No effect of glutathione on insulin clearance and action was observed.

Conclusios
–Glutathione infusion enhances insulin secretion in elderly people with IGT.
Prevalence of Diabetes and Impaired Glucose Tolerance Among Navajo Indians
Authors: Sugarman Jonathan R , Gilbert Timothy J , Weiss Noel S 
Published: March 2007

Objective
To estimate the prevalence of diabetes mellitus and impaired glucose tolerance and the incidence of clinically diagnosed diabetes in a community of Navajo Indians.

Research Design and Methods
We conducted a survey of a representative Navajo community screened for diabetes 3 yr previously. We used 75-g oral glucose tolerance tests to determine the prevalence of diabetes mellitus and impaired glucose tolerance and conducted medical record reviews to identify cases of diabetes that were diagnosed during routine medical care after the earlier study.

Results
By World Health Organization diagnostic criteria, the age-adjusted diabetes prevalence among 419 Navajo Indians 20–74 yr of age was 13.9% (95% confidence interval [CI] 9.2–18.5) for men and 18.4% (95% CI 14–22.8) for women. The ratio of the prevalence of diabetes among the Navajo population studied to that in the general United States population was 2.5. The prevalence of impaired glucose tolerance was 8% (95% CI 3.3–12.7) among men and 12.9% (95% CI 7.9–17.9) among women. Based on clinical diagnoses of diabetes made during routine medical care, mean ± SE age-adjusted incidence of diagnosed diabetes among men was 8.6 ± 4.3/1000 person-yr and 11.1 ± 4.4/1000 person-yr among women.

Conclusions
Although lower than that of some other tribes, the prevalence of diabetes among Navajo Indians is substantially higher than that in the general U.S. population. The high rate of clinical diagnoses suggests that the prevalence of the disease may continue to rise.
Randomized Comparison of Metabolic Control Achieved by Intraperitoneal Insulin Infusion With Implantable Pumps Versus Intensive Subcutaneous Insulin Therapy in Type I Diabetic Patients
Authors: Selam Jean-Louis , Raccah Denis , Jean-Didier Nathalie , Lozano Jim L , Waxman Ken , Charles M Arthur 
Published: March 2007

Objective
–To compare intraperitoneal implantable insulin infusion (IP) to subcutaneous (SC) intensive insulin therapy.

Research Design and Methods
–Twenty-one insulin-dependent (type I) diabetic patients aged 24–61 yr underwent a 3-mo treatment optimization using multiple SC daily injections or external pumps. Patients were then randomized (time 0 mo) to IP infusion using Infusaid-programmable pumps or continuation on SC intensive insulin for 6 mo.

Results
–No differences were noted between study and control group data. However, longitudinal within-group comparisons from baseline showed that glycosylated hemoglobin improved to near-normal in both groups: IP, 9.0 ± 0.5 vs. 7.8 ± 0.6% (P &lt; 0.05) and SC, 8.4 ± 0.5 vs. 7.5 ± 0.3% (P &lt; 0.5) at 0 and 4 mo, respectively (normal &lt; 6.9%). The percentage of blood glucose tests &gt; 11 mM at 0 and 6 mo was 28 ± 5 vs. 16 ± 4% in the IP group (P &lt; 0.05) and 22 ± 5 vs. 24 ± 7% in the SC group (NS). At 0 and 6 mo, the standard deviation of blood glucose values, an index of glycemic fluctuations, was 4.3 ± 0.4 vs. 3.2 ± 0.5 mM in the IP group (P &lt; 0.05) and 3.7 ± 0.3 vs. 4.0 ± 0.4 mM in the SC group (NS). Weight, insulin dosages, circulating lipid levels, and the frequency of severe hypoglycemic reactions and biochemical hypoglycemias were similar and did not change in the two groups.

Conclusions
–IP-implantable pumps compared with SC intensive insulin therapy have similar effects on most metabolic variables and are equally effective at achieving near-normal glycemic levels. Only longitudinal data suggest that IP treatment may be more effective at limiting glycemic fluctuations.
Benefits and Risks With Glyburide and Glipizide in Elderly NIDDM Patients
Authors: Brodows Robert G 
Published: March 2007

Objective
–To compare the efficacy, benefits, and risks of glyburide and glipizide in elderly patients with non-insulin-dependent diabetes mellitus (NIDDM).

Research Design and Methods
–Twenty-one elderly outpatients (mean age 70 yr) were treated for 8 wk, after being dose-titrated to achieve a fasting plasma glucose (FPG) concentration of &lt; 7.8 mM with glyburide or glipizide in a randomized crossover trial. FPG and postprandial plasma glucose, serum C-peptide, and HbA1c levels were measured. In 13 patients, self-monitoring of blood glucose (SMBG) with a memory meter was performed seven times per week.

Results
–Glipizide (11.9 mg) and glyburide (8.4 mg) produced similar fasting and postprandial plasma glucose and HbA1c concentrations. No significant differences in basal or stimulated C-peptide levels were detected. Despite a few patient reports of hypoglycemia, a high incidence of SMBG readings &lt; 4.5 mM was attributed to the use of both drugs.

Conclusions
–Both treatments proved effective for glycemic control; however, both second-generation sulfonylureas are associated with a significant risk of hypoglycemia in elderly NIDDM patients. The proper use of sulfonylureas in this population should include close surveillance of ambulatory glucose monitoring and intensive and repeated patient education about the risks of hypoglycemia.
Relationship of Fetal Macrosomia to Maternal Postprandial Glucose Control During Pregnancy
Authors: Combs C Andrew , Gunderson Erica , Kitzmiller John L , Gavin Laurence A , Main Elliot K 
Published: March 2007

OBJECTIVE
To determine the gestational ages at which maternal hyperglycemia is most closely related to fetal macrosomia; to determine whether macrosomia is related to elevations of fasting glucose, postprandial glucose, or both; and to assess the relationship of macrosomia to maternal insulin dose and caloric intake.

RESEARCH DESIGN AND METHODS
One hundred eleven consecutive pregnant women with Class B through RF diabetes were studied longitudinally from 13 to 36 wk gestation. Macrosomia was defined by birthweight &gt; 90th percentile for gestational age based on California norms. Women who delivered macrosomic infants were compared with those without macrosomic infants on pre- and postprandial blood glucose, GHb, insulin dose, macronutrient intake, and several other maternal variables.

RESULTS
Macrosomia occurred in 32 (29%) cases, although several measures indicated reasonable glycemic control throughout pregnancy. Women delivering macrosomic infants did not differ from those without macrosomic infants in maternal age, prepregnant weight, duration of diabetes, White class, macronutrient intake, GHb, or fasting glucose. Macrosomia was associated with higher postprandial glucose levels up to 32 wk gestation and lower insulin doses from 29 to 36 wk gestation. In multiple logistic regression, macrosomia was significantly associated with postprandial glucose only between 29 and 32 wk gestation. Postprandial glucose values &lt; 7.3 mM (&lt; 130 mg/dl) were associated with a higher risk of small-for-gestational-age infants (18%) compared with values above this level (1%).

CONCLUSIONS
Because macrosomia was related to postprandial glucose but not fasting glucose, we conclude that postprandial glucose measurement should be a part of routine care for diabetes in pregnancy. A target 1-h postprandial glucose value of 7.3 mM (130 mg/dl) may be the level that optimally reduces the incidence of macrosomia without increasing the incidence of small-for-gestational-age infants.
Effect of Insulin Therapy on Blood Pressure in NIDDM Patients With Secondary Failure
Authors: Randeree Hoosen A , Omar Mahomed A K , Motala Ayesha A , Seedat Mohomed A 
Published: March 2007

OBJECTIVE
To assess the effect of insulin therapy on blood pressure in NIDDM patients with secondary failure.

RESEARCH DESIGN AND METHODS
The influence of insulin treatment on blood pressure was assessed retrospectively in a group of 80 NIDDM patients with secondary failure to diet and maximum doses of oral hypoglycemic agents. Weight, blood glucose, and blood pressure were recorded over a 3-mo period before and after the initiation of insulin therapy.

RESULTS
There was a significant rise in systolic (131.8 ± 1.7 to 148 ± 1.9 mmHg, P &lt; 0.05) and diastolic (80.9 ± 0.9 to 89.2 ± 1.0 mmHg, P &lt; 0.02) blood pressures with insulin treatment. Insulin treatment was associated with a significant decrease in blood glucose (18.36 ± 0.28 to 10.4 ± 0.34 mM, P &lt; 0.01) and an increase in weight (72.1 ± 1.6 to 78 ± 1.7 kg, P = 0.01). A control group of 80 NIDDM patients matched for age, weight, BMI, and duration of diabetes demonstrated no significant change in blood pressure over a matched period of follow-up.

CONCLUSIONS
This study has shown that insulin therapy is associated with significant elevation of both systolic and diastolic blood pressures.
Prevalence of Carotid Atherosclerosis in Diabetic Patients Ultrasound high-resolution B-mode imaging on carotid arteries
Authors: Kawamori Ryuzo , Yamasaki Yamasaki , Matsushima Hiroyuki , Nishizawa Hideko , Nao Katsunori , Hougaku Hougaku , Maeda Hiroaki , Handa Nobuo , Matsumoto Masayasu , Kamada Takenobu 
Published: March 2007

OBJECTIVE
To quantitatively assess atherosclerosis of the carotid artery in subjects with and without diabetes.

RESEARCH DESIGN AND METHODS
Ultrasound high resolution B-mode imaging of carotid arteries was conducted on 71 nondiabetic subjects without hyperlipidemia or hypertension and 295 diabetic patients to determine IMT of the arterial wall.

RESULTS
IMT was linearly related with age in nondiabetic (IMT = [0.0087 × age] + 0.3318) and diabetic subjects (IMT = [0.0155 × age] + 0.32450). The regression coefficient for age was significantly greater in diabetic than nondiabetic subjects. IMT (mean ± SD) of diabetic subjects aged 20–29 was significantly &gt; that of nondiabetic subjects aged 20–29 (0.73 ± 0.27 vs. 0.52 ± 0.07 mm, P &lt; 0.01). Multivariate regression analysis of 275 NIDDM patients indicated smoking, hyperlipidemia, duration of diabetes, hypertension, and age were factors determining thickness of the carotid arterial wall.

CONCLUSIONS
Diabetes, along with age, hyperlipidemia, smoking, and hypertension, aggravates carotid atherosclerosis.
Diabetes Mellitus in Alaskan Yup'ik Eskimos and Athabascan Indians after 25 Yr
Authors: Murphy Neil J , Schraer Cynthia D , Bulkow Lisa R , Boyko Edward J , Lanier Anne P 
Published: March 2007

OBJECTIVE
To estimate the prevalence of diabetes mellitus and overweight in two populations of Alaska Natives and to compare the results with previous data.

RESEARCH DESIGN AND METHODS
Participants' heights, weights, and random plasma glucose levels were determined. Those with a glucose of ≥ 6.72 mM received a follow-up glucose-tolerance test, interpreted by WHO criteria. Overweight was defined by National Center for Health Statistics criteria and also by criteria used in previous studies. The subjects were Eskimo and Athabascan residents ≥ 40 yr of age in 15 villages in southwestern Alaska.

RESULTS
Diabetes prevalence was 4.7% for Eskimos and 10.0% for Indians. Among Eskimo men and women, the prevalence of overweight was 34 and 56%, respectively, among Indian men and women, it was 29 and 55%, respectively. Comparisons with past data indicate that the prevalence of diabetes has increased from 1.7% in 1962 for Eskimos and 1.8% in 1969 for Indians.

CONCLUSIONS
The prevalence of diabetes appears to have increased among Eskimos and Indians in Alaska. Overweight appears to be a significant problem in both groups.
Increased Plasma Endothelin in NIDDM Patients With Retinopathy
Authors: Kawamura Makiko , Ohgawara Hisako , Naruse Mitsuhide , Suzuki Nobuhiro , Iwasaki Naoko , Naruse Kiyoko , Hori Sadao , Demura Hiroshi , Omori Yasue 
Published: March 2007

OBJECTIVE
To elucidate the significance of ET in diabetic microvascular disease.

RESEARCH DESIGN AND METHODS
We determined plasma levels of ir-ET-1 in 25 NIDDM patients without hypertension and/or renal dysfunction.

RESULTS
The plasma levels of ir-ET-1 in NIDDM patients with simple (n = 8) and proliferative (n = 8) retinopathy were 0.58 ± 0.04 pM and 0.60 ± 0.04 pM, respectively, which were significantly higher than those in normal, nondiabetic subjects (0.24 ± 0.02 pM [n = 31]) and NIDDM patients without retinopathy (0.30 ± 0.05 pM [n = 9]).

CONCLUSIONS
These results suggest that plasma ET-1 is related to diabetic microvascular disease.
Family History of Diabetes in Relation to Different Types of Obesity and Change of Obesity During 12-yr Period: Results from prospective population study of women in Göteborg, Sweden
Authors: Lapidus Leif , Bengtsson Calle , Lissner Lauren , Smith Ulf 
Published: March 2007

OBJECTIVE
To assess the relationship between family history and different types of obesity and change in obesity in a longitudinal population study.

RESEARCH DESIGN AND METHODS
A longitudinal population study of 1462 randomly selected women (38–60 yr old) was conducted in Göteborg, Sweden, in 1968–69. The women were restudied after 12 yr.

RESULTS
A family history of diabetes in mothers but not fathers showed, in univariate analysis, a significant positive association with obesity expressed as BMI. A family history of diabetes in the mothers was inversely related to body fat distribution expressed as WHR. No other association was observed between family history of diabetes and WHR. The association with BMI was independent of age, WHR, smoking habits, blood glucose, systolic blood pressure, serum cholesterol, serum triglycerides, maternal obesity, and the incidence of diabetes during the 12-yr follow-up period. Twelve years later, in 1980–1981, an independent association still existed between family history for diabetes and BMI measured at that examination, whereas there was no relationship with WHR. Women who had a family history of diabetes increased their BMI significantly more during the 12-yr follow-up compared with the women without a family history of diabetes, whereas there was no difference for the change of WHR. Family history of coronary heart disease and family history of cancer did not correlate to any kind of obesity.

CONCLUSIONS
These findings indicate that family history of diabetes is related to overall obesity but not to abdominal adiposity per se.