bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Achilles Tendon Lengthening on Functional Limitations and Perceived Disability in People With a Neuropathic Plantar Ulcer
Authors: Mueller Michael J. , Sinacore David R. , Hastings Mary Kent , Lott Donovan J. , Strube Michael J , Johnson Jeffrey E. 
Published: March 2007

OBJECTIVE—An Achilles tendon-lengthening (ATL) procedure is effective at reducing ulcer recurrence in patients with diabetes, peripheral neuropathy, and a plantar ulcer, but its effects on functional limitations and perceived disability are unknown. The purpose of this study is to report the effects of an ATL and total contact casting (TCC) on the functional limitations and perceived disability of patients with neuropathic plantar ulcers.
RESEARCH DESIGN AND METHODS—Twenty-eight subjects with a mean age of 55 ± 10 years and a BMI of 33 ± 6 kg/m2 participated. All subjects had a history of diabetes, loss of protective sensation, limited ankle motion, and a recurrent forefoot ulcer. Subjects were randomized into two groups: an ATL group (n = 14), who received treatment of ATL, and TCC and a TCC group (n = 14), who received TCC only. Subjects completed a modified physical performance test (PPT) and the SF-36 Health Survey before treatment, after primary treatment and healing of the plantar forefoot ulcer, and 8 months after initial ulcer healing.
RESULTS—There were no significant changes in functional limitations as measured by the PPT between groups or over time. The physical summary score of the SF-36 decreased slightly from before treatment to 8 months after initial ulcer healing in the ATL group (35 ± 7 to 31 ± 6), whereas the TCC group score increased during this time (34 ± 8 to 39 ± 11; P &lt; 0.05).
CONCLUSIONS—The ATL resulted in no measurable change in functional limitations, but patients receiving an ATL and TCC reported lower physical functioning at 8 months after initial ulcer healing than subjects receiving TCC alone and may require additional physical therapy to address this perceived disability.
Nationwide, Prospective Registration of Type 1 Diabetes in Children Aged &lt;15 Years in Norway 1989–1998
Authors: Joner Geir , Stene Lars C. , Søvik Oddmund ,   the Norwegian Childhood Diabetes Study Group
Published: March 2007

OBJECTIVE—An increasing incidence rate of childhood-onset type 1 diabetes has been described in several countries, particularly among the youngest children, and the Nordic countries have consistently been shown to have the highest incidence rates. An increasing incidence had previously been reported in Norway for 1973–1982, together with regional variation within the country. The aim of this study was to test whether there has been an increasing incidence of type 1 diabetes and a continued regional variation among children aged &lt;15 years in Norway during 1989–1998.
RESEARCH DESIGN AND METHODS—As a part of the activities of the National Childhood Diabetes Registry of Norway and the EURODIAB study, a 10-year prospective, nationwide case registration of type 1 diabetes was done among children aged &lt;15 years.
RESULTS—A total of 1,867 new case subjects (1,009 boys and 858 girls) were identified. The total incidence rate was 22.4 per 100,000 person-years (95% CI 21.5–23.5). The incidence was 13.1, 26.3, and 28.8 per 100,000 in the age-groups 0–4.9, 5–9.9, and 10–14.9 years, respectively. No increase or decrease over time was detected in any of the age-groups during the 10-year period. We found significant variation between the 19 counties, which only partly reflected the pattern previously described for 1973–1982.
CONCLUSIONS—We found a significant regional variation within Norway. After a previous period of increase, the incidence has been stable in all age-groups &lt;15 years during 1989–1998.
The Effect of Pioglitazone on Peroxisome Proliferator-Activated Receptor-γ Target Genes Related to Lipid Storage In Vivo
Authors: Bogacka Iwona , Xie Hui , Bray George A. , Smith Steven R. 
Published: March 2007

OBJECTIVE—Pioglitazone is a member of the thiazolidinediones (TZDs), insulin-sensitizing agents used to treat type 2 diabetes. The aim of this study was to define the effect of pioglitazone on the expression of genes related to carbohydrate and lipid metabolism in subcutaneous fat obtained from type 2 diabetic patients.
RESEARCH DESIGN AND METHODS—Forty-eight volunteers with type 2 diabetes were divided into two groups treated for 12 weeks with placebo or pioglitazone (30 mg/day). The expression of several genes was quantified by real-time RT-PCR.
RESULTS—Pioglitazone treatment increased the expression of genes involved in glycerol-3-phosphate synthesis. The mRNA expression of PEPCK-C and glycerol-3-phosphate dehydrogenase (GPDH) increased (P &lt; 0.01) in patients treated with pioglitazone. There was no difference in glycerol kinase (GyK) mRNA levels. The expression of genes that regulate fatty acid availability in adipocytes, including lipoprotein lipase (LPL) and acetyl-CoA synthetase (ACS), was higher (P &lt; 0.01) in pioglitazone-treated patients. Pioglitazone stimulated (P &lt; 0.0001) expression of c-Cbl-associated protein (CAP), whereas tumor necrosis factor-α, leptin, resistin, angiopoietin like-4, and 11-β-hydroxysteroid dehydrogenase type 1 (11β HSD 1) were not affected by pioglitazone. The baseline peroxisome proliferator-activated receptor (PPAR)-γ1 mRNA was significantly correlated with mRNA for LPL, CAP, ACS, 11β HSD 1, GyK, fatty acid synthase, leptin, and GPDH, whereas PPAR-γ2 mRNA was correlated with CAP, PEPCK-C, leptin, and GPDH.
CONCLUSIONS—Treatment with pioglitazone increased body weight, and this is associated with upregulation of some, but not all, genes previously demonstrated as “TZD responsive” in subcutaneous fat. The results suggest that TZDs might increase body weight through the upregulation of genes facilitating adipocyte lipid storage in vivo.
Non-HDL Cholesterol and Apolipoprotein B Predict Cardiovascular Disease Events Among Men With Type 2 Diabetes
Authors: Jiang Rui , Schulze Matthias B. , Li Tricia , Rifai Nader , Stampfer Meir J. , Rimm Eric B. , Hu Frank B. 
Published: March 2007

OBJECTIVE—To evaluate the role of non-HDL cholesterol and apolipoprotein (apo)B, markers of all potentially atherogenic lipoproteins, as predictors of cardiovascular disease (CVD) in comparison with LDL cholesterol in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—We prospectively followed 746 diabetic men in the Health Professionals’ Follow-up Study who were aged 46–81 years and free of CVD or cancer at the time of blood draw in 1993–1994. During 6 years of follow-up, we ascertained 103 incident CVD cases.
RESULTS—We used Cox proportional hazard modeling to estimate the relative risk (RR) of CVD. After adjustment for age, BMI, and other lifestyle risk factors, the multivariate RR of CVD (the highest versus the lowest quartile) was 2.34 (95% CI 1.26–4.32) for non-HDL cholesterol, 2.31 (1.23–4.35) for apoB, and 1.74 (0.99–3.06) for LDL cholesterol. Comparisons of nested models indicate that non-HDL cholesterol, but not apoB, adds significantly to the prediction of CVD risk beyond LDL cholesterol. The area under the receiver operating characteristic curve was 0.685, 0.691, 0.695, and 0.722 for the CVD risk-prediction model with LDL cholesterol, apoB, non-HDL cholesterol, and total cholesterol–to–HDL cholesterol ratio (or the non-HDL–to–HDL cholesterol ratio), respectively.
CONCLUSIONS—Non-HDL cholesterol and apoB are more potent predictors of CVD incidence among diabetic men than LDL cholesterol. Statistically, the ratio of total to HDL cholesterol is the best predictor of CVD in this cohort of diabetic men.
Phenotype-Genotype Correlations in a Series of Wolfram Syndrome Families
Authors: Smith Casey J.A. , Crock Patricia A. , King Bruce R. , Meldrum Cliff J. , Scott Rodney J. 
Published: March 2007

OBJECTIVE—Wolfram syndrome is an extremely rare autosomal-recessive disorder that predisposes the development of type 1 diabetes in association with progressive optic atrophy. The genetic basis of this disease has been shown to be due to mutations in the WFS1 gene. The WFS1 gene encodes a novel transmembrane protein called wolframin, which recent evidence suggests may serve as a novel endoplasmic reticulum calcium channel in pancreatic β-cells and neurons. Genotype-phenotype correlations in this syndrome are becoming apparent and may help in explaining some of the variable characteristics observed in this disease.
RESEARCH DESIGN AND METHODS—In this report, we have studied 13 patients with Wolfram syndrome from nine families to further define the relationship between mutation site and type with specific disease characteristics.
RESULTS—A severe phenotype was seen in patients with mutations in exon 4 and with a large deletion encompassing most of exon 8. In total, nine novel mutations were identified as well as three new silent polymorphisms.
CONCLUSIONS—Similar to all other mutation reports, most causative changes identified in the WFS1 gene occurred in exon 8, and only one was identified outside this region in exon 4.
Increased Utilization of Primary Care 5 Years Before Diagnosis of Type 2 Diabetes
Authors: Gulliford Martin C. , Charlton Judith , Latinovic Radoslav 
Published: March 2007

OBJECTIVE—To determine whether case subjects who were later diagnosed with type 2 diabetes utilized primary care differently from control subjects who remained free from diabetes.
RESEARCH DESIGN AND METHODS—We conducted a matched cohort study using the U.K. General Practice Research Database. Case subjects were aged 30–89 years, diagnosed with diabetes, and later prescribed oral hypoglycemic drugs between 1997 and 2000. Control subjects, who were matched for age, sex, and general practice, were not diagnosed with diabetes and not treated with oral hypoglycemic drugs or insulin.
RESULTS—Data were analyzed for 5,158 case subjects (2,492 women and 2,666 men) and their matched control subjects with a mean age of 63 years. Five years before the date of diagnosis, case subjects consulted more frequently than control subjects (rate ratio [RR] 1.26 [95% CI 1.20–1.33]) and received more prescription items (1.44 [1.36–1.53]). Consultations were increased for a wide range of conditions. The cumulative 5-year prevalence of diagnoses of hypertension or treatment, hyperlipidemia or treatment, obesity, or coronary heart disease or stroke was 66.1% in case subjects and 45.9% in control subjects (1.44 [1.40–1.49]). A medical diagnosis of hyperglycemia or impaired glucose tolerance was highly (&gt;99%) specific for later diagnosis of diabetes.
CONCLUSIONS—Primary care consultations and drug utilization are increased from 5 years before diagnosis of diabetes. Diagnoses of hypertension, hyperlipidemia, obesity, or coronary heart disease or stroke have moderate sensitivity for subsequent diabetes but are nonspecific. A diagnosis of hyperglycemia has a high specificity for later detection of diabetes.
Elevated C-Reactive Protein Is a Predictor of the Development of Diabetes in a General Japanese Population
Authors: Doi Yasufumi , Kiyohara Yutaka , Kubo Michiaki , Ninomiya Toshiharu , Wakugawa Yoshiyuki , Yonemoto Koji , Iwase Masanori , Iida Mitsuo 
Published: March 2007

OBJECTIVE—We examined the association between high-sensitivity C-reactive protein (CRP) levels and the development of diabetes in a general Japanese population.
RESEARCH DESIGN AND METHODS—A total of 1,759 Japanese subjects, aged 40–79 years and without diabetes (according to American Diabetes Association fasting criteria), were stratified into three groups according to CRP tertiles by sex and followed up prospectively for a mean of 9.0 years.
RESULTS—During the follow-up, 131 subjects (67 men and 64 women) developed diabetes. In both sexes, the age-adjusted cumulative incidence of diabetes increased significantly as the tertiles of CRP levels increased. In multivariate analyses, the risk of developing diabetes was significantly higher in the highest CRP tertile than in the lowest after adjustment for a number of confounding factors (odds ratio 2.63 [95% CI 1.23–5.65] for men and 2.25 [1.01–5.01] for women). In stratified analyses, this CRP-diabetes association was stronger in subjects without obesity or other risk factors related to insulin resistance and in nondrinking subjects.
CONCLUSIONS—Our findings suggest that elevated CRP concentration is a significant predictor of diabetes in the general Japanese population, independent of obesity and insulin resistance.
Sleep Disturbances in Midlife Unrelated to 32-Year Diabetes Incidence
Authors: Björkelund Cecilia , Bondyr-Carlsson Dorota , Lapidus Leif , Lissner Lauren , Månsson Jörgen , Skoog Ingmar , Bengtsson Calle 
Published: March 2007

OBJECTIVE—To study the relation between diabetes incidence and sleep problems in a population-based sample of women followed for 32 years.RESEARCH DESIGN AND METHODS—The researchers conducted a prospective population study initiated in 1968–1969, with follow-ups in 1974–1975, 1980–1981, 1992–1993, and 2000–2001 in Gothenburg, Sweden. A total of 1,462 women born in 1908, 1914, 1918, 1922, and 1930, representative of women of the same ages in the general population, initially participated (90% participation rate). Reported sleep duration, sleep problems, and use of sleeping medication were related to incident diabetes from 1968 to 2000. Associations between sleep problems and diabetes were corrected for waist-to-hip ratio (WHR), BMI, subscapular skinfold, fasting blood glucose and serum lipid concentrations, blood pressure, heart rate, smoking, physical activity, education, and socioeconomic status. Additionally, associations between BMI, WHR, and sleep problems were examined.RESULTS—Over 32 years, 126 women (8.7%) developed diabetes. Associations between diabetes and initial sleep problems were tested in a Cox regression analysis, taking into consideration factors associated (P &lt; 0.1) with diabetes. Sleep problems in 1968 did not increase risk of developing diabetes during the following 32 years. Obesity, particularly centralized, was associated with sleep problems.CONCLUSIONS—No association between sleep problems and developing diabetes was seen in this 32-year follow-up of middle-aged women. Obesity, on the other hand, known to cause increased risk of diabetes, was associated with current sleep problems.
Decreasing the Risk of Diabetic Retinopathy in a Study of Case Management
Authors: Pettitt David J. , Okada Wollitzer Alison , Jovanovic Lois , He Guozhong , Ipp Eli ,   the California Medi-Cal Type 2 Diabetes Study Group
Published: March 2007

OBJECTIVE—Diabetic retinopathy affects &gt;60% of people with type 2 diabetes during the first 2 decades of the disease and is ameliorated by good glycemic control. This study tested whether intensive diabetes case management could prevent or delay diabetic retinopathy in patients with established type 2 diabetes.
RESEARCH DESIGN AND METHODS—This study was part of a randomized, controlled clinical trial of diabetes case management in type 2 diabetes in southern California counties serving low income ethnic minority populations. Subjects were randomized to intervention (diabetes case management) or control (traditional treatment) groups. Subjects with at least two retinal photographs (n = 149) were included in this analysis to assess the effect of intervention on development or progression of diabetic retinopathy.
RESULTS—Progression of retinopathy in the intervention group was not significantly less than in the control group (P = 0.226). However, those in the intervention group with no evidence of retinopathy at baseline were less likely to develop diabetic retinal changes (5/48) during a mean follow-up of 23.1 months than those in the control group (10/34, χ2 = 4.805, P = 0.028). This difference remained significant in a logistic regression model that controlled for potential confounders (odds ratio 5.35 [95% CI 1.14–25.12]).
CONCLUSIONS—This study shows that a relatively short duration of case management instituted before the onset of clinically identifiable retinopathy significantly diminished the risk of developing retinopathy in patients with type 2 diabetes. The findings also emphasized the retinal disease burden in this population, with development and progression of retinopathy occurring in &lt;2 years.
Epidemiology of Ischemic Stroke in Patients With Diabetes
Authors: Kissela Brett M. , Khoury Jane , Kleindorfer Dawn , Woo Daniel , Schneider Alexander , Alwell Kathleen , Miller Rosemary , Ewing Irene , Moomaw Charles J. , Szaflarski Jerzy P. , Gebel James , Shukla Rakesh , Broderick Joseph P. 
Published: March 2007

OBJECTIVE— Diabetes is a well known risk factor for stroke, but the impact of diabetes on stroke incidence rates is not known. This study uses a population-based study to describe the epidemiology of ischemic stroke in diabetic patients.
RESEARCH DESIGN AND METHODS— Hospitalized cases were ascertained by ICD-9 discharge codes, prospective screening of emergency department admission logs, and review of coroner’s cases. A sampling scheme was used to ascertain cases in the out-of-hospital setting. All potential cases underwent detailed chart abstraction by study nurses followed by physician review. Diabetes-specific incidence rates, case fatality rates, and population-attributable risks were estimated.
RESULTS— Ischemic stroke patients with diabetes are younger, more likely to be African American, and more likely to have hypertension, myocardial infarction, and high cholesterol than nondiabetic patients. Age-specific incidence rates and rate ratios show that diabetes increases ischemic stroke incidence at all ages, but this risk is most prominent before age 55 in African Americans and before age 65 in whites. One-year case fatality rates after ischemic stroke are not different between those patients with and without diabetes.
CONCLUSIONS— Given the “epidemic” of diabetes, with substantially increasing diabetes prevalence each year across all age- and race/ethnicity groups, the significance of diabetes as a risk factor for stroke is becoming more evident. Diabetes is clearly one of the most important risk factors for ischemic stroke, especially in those patients less than 65 years of age. We estimate that 37–42% of all ischemic strokes in both African Americans and whites are attributable to the effects of diabetes alone or in combination with hypertension.
Reduced Prevalence of Limited Joint Mobility in Type 1 Diabetes in a U.K. Clinic Population Over a 20-Year Period
Authors: Lindsay John R. , Kennedy Laurence , Atkinson A. Brew , Bell Patrick M. , Carson Dennis J. , McCance David R. , Hunter Steven J. 
Published: March 2007

OBJECTIVE—Limited joint mobility (LJM), one of the earliest clinically apparent long-term complications of type 1 diabetes, is a risk marker for subsequent microvascular complications. We hypothesize that the prevalence of LJM may have decreased during the past two decades due to improved standards of glycemic control.
RESEARCH DESIGN AND METHODS—A single observer performed a survey in 204 consecutive patients with type 1 diabetes (106 men and 98 women, age 27 ± 1 years, HbA1c 8.3 ± 0.1%, duration of diabetes 14.5 ± 0.8 years, insulin dose 63 ± 2 units/day). We used the same examination method and criteria for assessment of LJM as used by us in an earlier study in 1981–1982.
RESULTS—The prevalence of LJM has fallen from 43 to 23% between the 1980s and 2002 (P &lt; 0.0001). The relative risk for LJM in 2002 compared with the 1981–1982 cohort was 0.53 (0.40 &lt; RR &lt; 0.72, P &lt; 0.0001). The prevalence of LJM was increased with longer duration of diabetes (&lt;10 years, 13%; 10–20 years, 19%; 20–29 years, 30%; &gt;30 years, 65%; P &lt; 0.001). The relative risk for those with a mean HbA1c &lt;7% in 2002 was 0.3 (0.1 &lt; RR &lt; 1.2, P = 0.05) when compared with those with mean HbA1c &gt;7%.
CONCLUSIONS—The present study confirms the hypothesis that the prevalence of LJM is lower than 20 years ago and that improved standards of glycemic control and diabetes care may have contributed to this occurrence. Joint limitation in type 1 diabetes is strongly associated with duration of diabetes. The presence of LJM remains a common and important clinical marker for subsequent microvascular disease and can be a useful clinical tool for identification of patients at increased risk.
Twice-Weekly Progressive Resistance Training Decreases Abdominal Fat and Improves Insulin Sensitivity in Older Men With Type 2 Diabetes
Authors: Ibañez Javier , Izquierdo Mikel , Argüelles Iñaki , Forga Luis , Larrión José L. , García-Unciti Marisol , Idoate Fernando , Gorostiaga Esteban M. 
Published: March 2007

OBJECTIVE—To evaluate the influence of a twice-weekly progressive resistance training (PRT) program, without a concomitant weight loss diet, on abdominal fat and insulin sensitivity in older men with type 2 diabetes.
RESEARCH DESIGN AND METHODS—Nine older men (aged 66.6 ± 3.1) with type 2 diabetes participated in a 16-week PRT supervised program (50–80% of the one repetition maximum), for all main muscle groups. Basal glycemia, HbA1c, diet, habitual physical activity, body composition, and upper/lower maximal strength were measured. Insulin sensitivity was determined according to Bergman’s minimal model procedure and abdominal fat was obtained by computed tomography. The measurements were taken 4 weeks before training (−4), immediately before training (0), and at 8-week intervals (i.e., weeks 8 and 16) during the 16-week training period.
RESULTS—No significant variation was observed in any of the above selected parameters during the 4-week control period. After PRT, both leg and arm maximal strength increased significantly by 17.1 and 18.2%, respectively. Visceral and subcutaneous abdominal fat decreased significantly by 10.3% (from 249.5 ± 97.9 to 225.6 ± 96.6 cm3, P &lt; 0.01) and by 11.2% (from 356.0 ± 127.5 to 308.6 ± 118.8 cm3, P &lt; 0.01), respectively, while no changes were observed in body mass. PRT significantly increased insulin sensitivity by 46.3% (from 2.0 ± 1.2 to 2.8 ± 1.6 · 104 · min−1 · μU−1 · ml−1, P &lt; 0.01), whereas it significantly decreased (−7.1%, P &lt; 0.05) fasting blood glucose (from 146.6 ± 28.3 to 135.0 ± 29.3 mg/dl). Finally, a 15.5% increase in energy intake (from 2,287.1 ± 354.7 to 2,619.0 ± 472.1 kcal/day, P &lt; 0.05) was observed.
CONCLUSIONS—Two sessions per week of PRT, without a concomitant weight loss diet, significantly improves insulin sensitivity and fasting glycemia and decreases abdominal fat in older men with type 2 diabetes.