bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased Prevalence of Impaired Glucose Tolerance in Patients With Painful Sensory Neuropathy
Authors: Singleton J. Robinson , Smith A. Gordon , Bromberg Mark B. 
Published: March 2007

OBJECTIVE—To characterize a cohort of patients with neuropathy and impaired glucose tolerance (IGT) but no other identifiable cause of neuropathy. Of patients with diabetes, 10% have peripheral neuropathy at the time of their diagnosis, suggesting that axonal injury may occur early in the course of glucose intolerance. The American Diabetes Association (ADA) revised diagnostic criteria to recognize IGT (a serum glucose between 140 and 200 mg/dl in a 2-h oral glucose tolerance test [OGTT]) as a risk factor for cardiovascular disease independent of development of diabetes.
RESEARCH DESIGN AND METHODS—Using revised ADA criteria for diabetes and IGT, we prospectively evaluated 107 sequential patients with idiopathic neuropathy.
RESULTS—A total of 13 of the 107 patients had diabetes, whereas 36 (34%) had IGT, nearly three times the prevalence in age-matched control subjects (P &lt; 0.01). OGTT was often elevated, whereas both fasting plasma glucose and HbA1c were normal. Comparing patients with diabetes, IGT, or normal OGTT, age and BMI were similar. However, painful sensory symptoms were more common in patients with IGT and diabetes, and family history of neuropathy was significantly more common in normoglycemic patients. Electrodiagnostic findings of axonal injury were less severe in patients with IGT and were more likely to be confined to sensory fibers than in patients with diabetes.
CONCLUSIONS—Our results suggest that IGT may cause or contribute to small-fiber neuropathy, which is similar in phenotype to the painful sensory neuropathy commonly encountered in diabetes. Two-hour OGTT is more sensitive than other measures of glucose handling in screening these patients.
Characteristics of an Adult Population With Newly Diagnosed Type 2 Diabetes
Authors: Hillier Teresa A. , Pedula Kathryn L. 
Published: March 2007

OBJECTIVE—To determine whether adults diagnosed with type 2 diabetes at 18–44 years of age (early type 2 diabetes) have different metabolic profiles at diagnosis than adults diagnosed at ≥45 years of age (usual type 2 diabetes).
RESEARCH DESIGN AND METHODS—Within a health maintenance organization, we studied characteristics among 2,437 adults newly diagnosed with type 2 diabetes between 1996 and 1998 who had measured weight, HbA1c, blood pressure, and cholesterol within 3 months of diagnosis. We abstracted clinical data from electronic medical records. We compared mean and proportional differences with parametric t tests and χ2 analyses, respectively. We used multiple logistic regression to identify the factors independently associated with the onset group (early vs. usual type 2 diabetes).
RESULTS—There was an inverse linear relationship between BMI and age at diagnosis of type 2 diabetes (P &lt; 0.001). On univariate analysis, adults with early type 2 diabetes were more obese (BMI 39 vs. 33 kg/m2, P &lt; 0.001), were more likely to be female (P = 0.04), had slightly worse glycemic control (HbA1c 7.7 vs. 7.5%, P = 0.03), had a higher prevalence of diastolic hypertension (37 vs. 26%, P &lt; 0.001), despite a lower prevalence of systolic hypertension (34 vs. 55%, P &lt; 0.001), and had an equally high rate of abnormal lipids (82 vs. 78%, P = 0.13) than adults with usual type 2 diabetes. BMI, female gender, cholesterol, and diastolic and systolic blood pressure remained independently associated with onset group at multivariate analysis.
CONCLUSIONS—Although both onset groups were on average obese, the inverse linear relationship of obesity and age of diabetes onset that we observed suggests that obesity is a continuous risk rather than a threshold risk for diabetes onset. Both onset groups had a high prevalence of cardiovascular disease risk factors.
A Biethnic Community Survey of Cognition in Participants With Type 2 Diabetes, Impaired Glucose Tolerance, and Normal Glucose Tolerance
Authors: Lindeman Robert D. , Romero Linda J. , LaRue Asenath , Yau C. Lillian , Schade David S. , Koehler Kathleen M. , Baumgartner Richard N. , Garry Phillip J. 
Published: March 2007

OBJECTIVE—To determine whether elderly individuals with type 2 diabetes or impaired glucose tolerance are at increased risk for cognitive impairment compared with individuals with normal glucose tolerance.
RESEARCH DESIGN AND METHODS—Elderly Hispanic individuals (n = 414) and non-Hispanic white individuals (n = 469) aged ≥65 years, randomly selected from the Medicare rolls of Bernalillo County (Albuquerque), NM, were recruited for an interview/examination that included an evaluation of glucose tolerance. Information on nine tests of cognitive function and two measures of depression allowed comparisons between diabetic status and these functions. Comparisons also were made between glycosolated hemoglobin concentrations and these cognitive tests in the 188 participants with diabetes.
RESULTS—None of the mean scores on the tests of cognitive function was significantly lower in the participants with diabetes compared with those participants with normal glucose tolerance after adjustments for ethnicity, sex, age, level of education, and presence of depression, with or without elimination of those with dementia (Mini-Mental State Exam &lt;18). Interestingly, participants with impaired glucose tolerance tended to score higher than those with normal glucose tolerance. No significant associations were found between glycosolated hemoglobin concentrations and cognitive test scores in participants with diabetes.
CONCLUSIONS—We could not show any increased risk for cognitive impairment in participants with diabetes compared with those with normal glucose tolerance after adjustments for ethnicity, sex, age, education, and presence of depression, before or after elimination of dementia in this random sample from a biethnic population of predominantly community-dwelling elders.
Total Antioxidant Status and Coronary Artery Calcification in Type 1 Diabetes
Authors: Valabhji Jonathan , McColl Avril J. , Richmond William , Schachter Michael , Rubens Michael B. , Elkeles Robert S. 
Published: March 2007

OBJECTIVE—Type 1 diabetes is associated with a high risk of coronary heart disease (CHD), despite the absence of dyslipidemia. Oxidative modification may render LDLs more atherogenic. We aimed to assess antioxidant status in type 1 diabetes and its association with coronary artery calcification (CAC).
RESEARCH DESIGN AND METHODS—Total antioxidant status (TAS) of serum was measured using the Trolox equivalent antioxidant capacity assay in 48 type 1 diabetic and 25 nondiabetic subjects. The presence of CAC was assessed in the diabetic subjects using electron beam computed tomography.
RESULTS—TAS was reduced in type 1 diabetic subjects compared with nondiabetic subjects (Mann-Whitney U test, P &lt; 0.0001). There were associations between TAS and HbA1c (r = −0.43; P = 0.0026) and duration of diabetes (r = −0.35; P = 0.0157). Significant CAC was considered present if the Agatston score was &gt;10. The diabetic subjects with significant CAC were older (P &lt; 0.0001); had longer duration of diabetes (P = 0.0002); were more likely to have high blood pressure (P = 0.040); had higher total cholesterol concentration (P = 0.039), serum creatinine concentration (P = 0.003), and urinary albumin–to–creatinine ratio (P = 0.022); and had lower serum TAS (P = 0.018) compared with those without significant calcification. In logistic regression with CAC as the dependent variable, TAS was entered as a predictor, and the effects on its predictive value of adding other explanatory variables in bivariate analyses were assessed. The power of TAS to predict CAC was independent of many of the traditional CHD risk factors. Whereas TAS as a predictor was no longer statistically significant when age or duration of diabetes were entered into the model, the odds ratio for a TAS concentration above the median value predicting significant CAC only increased from 0.19 to 0.26 and 0.32, respectively.
CONCLUSIONS—TAS is reduced in type 1 diabetes and is associated with the presence of CAC.
Impaired Incretin Response After a Mixed Meal Is Associated With Insulin Resistance in Nondiabetic Men
Authors: Rask Eva , Olsson Tommy , Söderberg Stefan , Johnson Owe , Seckl Jonathan , Holst Jens Juul , Ahrén Bo 
Published: March 2007

OBJECTIVE—To investigate whether features of the insulin resistance syndrome are associated with altered incretin responses to food intake.
RESEARCH DESIGN AND METHODS—From a population-based study, 35 men were recruited, representing a wide spectrum of insulin sensitivity and body weight. Each subject underwent a hyperinsulinemic-euglycemic clamp to determine insulin sensitivity. A mixed meal was given, and plasma levels of gastric inhibitory polypeptide (GIP) and glucagon-like peptide 1 (GLP-1), as well as insulin, glucagon, and glucose were measured.
RESULTS—Insulin resistance was associated with impaired GIP and GLP-1 responses to a mixed meal. The total area under the curve (AUC) of the GIP response after the mixed meal was associated with insulin sensitivity (r = 0.54, P &lt; 0.01). There was a significant difference between the highest and the lowest tertile of insulin sensitivity (P &lt; 0.05). GLP-1 levels 15 min after food intake were significantly lower in the most insulin-resistant tertile compared with the most insulin-sensitive tertile. During the first hour, the AUC of GLP-1 correlated significantly with insulin sensitivity (r = 0.47, P &lt; 0.01). Multiple linear regression analysis showed that insulin resistance, but not obesity, was an independent predictor of these decreased incretin responses.
CONCLUSIONS—In insulin resistance, the GIP and GLP-1 responses to a mixed meal are impaired and are related to the degree of insulin resistance. Decreased incretin responsiveness may be of importance for the development of impaired glucose tolerance.
Carriers of an Inactivating β-Cell ATP-Sensitive K+ Channel Mutation Have Normal Glucose Tolerance and Insulin Sensitivity and Appropriate Insulin Secretion
Authors: Huopio Hanna , Vauhkonen Ilkka , Komulainen Jorma , Niskanen Leo , Otonkoski Timo , Laakso Markku 
Published: March 2007

OBJECTIVE—Insulin release from the pancreatic β-cells is controlled by ATP-sensitive K+ (KATP) channels, which consist of a hetero-octameric complex of four sulfonylurea receptor 1 (SUR1) and four Kir6.2 proteins. Mutations in the SUR1 gene are the major cause of congenital hyperinsulinemia (CHI). Despite the hereditary nature of CHI, studies of glucose homeostasis in heterozygous relatives of CHI patients are lacking. Theoretically, in the heterozygous state of the SUR1 gene mutation, only 1 of 16 KATP channels consists of entirely normal subunits. The aim of our study was to investigate in vivo the glucose homeostasis of heterozygous SUR1 mutation carriers.
RESEARCH DESIGN AND METHODS—We studied 8 parents of CHI patients, all 8 of whom were heterozygous for the inactivating SUR1 mutation V187D, and 10 matched control subjects. We evaluated glucose tolerance and insulin secretory capacity with oral and intravenous glucose tests, rates of whole-body glucose uptake with hyperinsulinemic-euglycemic clamps, C-peptide response to hypoglycemia during hyperinsulinemic-hypoglycemic clamp, and function of the KATP channels with intravenous tolbutamide test.
RESULTS—Carriers of the V187D substitution had normal glucose tolerance, normal tissue sensitivity to insulin, and no signs of inappropriate insulin secretion. The normal insulin response to tolbutamide indicated that heterozygosity for the V187D mutation did not impair KATP channel function.
CONCLUSIONS—We conclude that the heterozygous carriers of the SUR1 mutation had normal glucose metabolism and insulin secretion, indicating that carriers of recessive KATP channel mutations are unlikely to be at an increased risk of hypoglycemia or other disturbances in glucose metabolism.
Long-Term Impact of Neonatal Breast-Feeding on Body Weight and Glucose Tolerance in Children of Diabetic Mothers
Authors: Plagemann Andreas , Harder Thomas , Franke Kerstin , Kohlhoff Rainer 
Published: March 2007

OBJECTIVE—Offspring born to women with pregnancies complicated by diabetes are at increased childhood risk of developing obesity and impaired glucose tolerance (IGT). In population-based studies, breast-feeding has been shown to be protective against obesity and diabetes later in life. To date, the role of breast-feeding on offspring of diabetic mothers (ODM) has not been investigated in this context.
RESEARCH DESIGN AND METHODS—A total of 112 ODM (type 1 diabetes, n = 83; gestational diabetes, n = 29) were evaluated prospectively for impact of ingestion of either diabetic breast milk (DBM) or nondiabetic banked donor breast milk (BBM) during the early neonatal period (day 1–7 of life) on relative body weight and glucose tolerance at a mean age of 2 years.
RESULTS—There was a positive correlation between the volume of DBM ingested and risk of overweight at 2 years of age (odds ratio [OR] 2.47, 95% CI 1.25–4.87). In contrast, the volume of BBM ingested was inversely correlated to body weight at follow-up (P = 0.001). Risk of childhood IGT decreased by increasing amounts of BBM ingested neonatally (OR 0.19, 95% CI 0.05–0.70). Stepwise regression analysis showed volume of DBM to be the only significant predictor of relative body weight at 2 years of age (P = 0.001).
CONCLUSIONS—Early neonatal ingestion of breast milk from diabetic mothers may increase risk of becoming overweight and, consequently, developing IGT during childhood. Additional studies are needed to assess long-term consequences that might result from the type of neonatal nutrition in ODM.
Impact of Computer-Generated Personalized Goals on HbA1c
Authors: Levetan Claresa S. , Dawn Karen R. , Robbins David C. , Ratner Robert E. 
Published: March 2007

OBJECTIVE—The public is increasingly aware of the importance of HbA1c testing, yet the vast majority of patients with diabetes do not know their HbA1c status or goal. We set forth to evaluate the impact of a system that provides uniquely formatted and personalized reports of diabetes status and goals on changes in HbA1c levels.
RESEARCH DESIGN AND METHODS—A total of 150 patients with diabetes were randomized to receive either standard care or intervention inclusive of a computer-generated 11” × 17” color poster depicting an individual’s HbA1c status and goals along with personalized steps to aid in goal achievement. All patients enrolled received diabetes education during the 3 months before enrollment. HbA1c was performed at baseline and 6 months.
RESULTS—At baseline, there were no significant differences between patient groups in terms of age, sex, education level, race, and HbA1c or lipid levels. Among patients with baseline HbA1c ≥7.0%, there was an 8.6% (0.77% absolute) reduction in HbA1c among control subjects compared with a 17.0% (1.69% absolute) decline in the intervention group (P = 0.032). There were no differences between the control and intervention groups with respect to the frequency of patients experiencing any decline in HbA1c (63 vs. 69%, P = 0.87); among these patients experiencing a decline, the most substantial reductions were seen with the control group, which had a 13.3% (1.15% absolute) decline compared with the intervention patients, who reduced their HbA1c by 24.2% (2.26% absolute reduction; P = 0.0048). At study close, 77% of the patients had their poster displayed on their refrigerator.
CONCLUSIONS—This unique and personalized computer-generated intervention resulted in HbA1c lowering comparable to that of hypoglycemic agents.
The Network of Psychological Variables  in Patients With Diabetes and Their Importance for Quality of Life and Metabolic Control
Authors: Rose Matthias , Fliege Herbert , Hildebrandt Martin , Schirop Thea , Klapp Burghard F. 
Published: March 2007

OBJECTIVE—The primary goals in treating patients with diabetes are maintaining blood glucose levels as close to normal as possible and making a relatively normal quality of life achievable. Both of these goals are influenced by a multitude of somatic and psychological factors that should be seen as building a complex network. We examined whether a mathematical model can be construed that can depict the relative significance of each factor for achieving these treatment goals.
RESEARCH DESIGN AND METHODS—A total of 625 patients from 32 different treatment facilities were examined (224 type 1 and 401 type 2 diabetic patients) using HbA1c values (high-performance liquid chromatography), number of secondary illnesses, and standardized questionnaires with respect to health-related quality of life (World Health Organization Quality of Life questionnaire), coping behavior (Freiburger Illness-Coping Strategies questionnaire), diabetes-specific knowledge (Test of Diabetes-Specific Knowledge), doctor-patient relationship (Medical Interview Satisfaction Scale), and personality characteristics (Giessen Test and Assessment of Beliefs in Self-Efficacy and Optimism). The analyses were carried out by means of a structural equation model.
RESULTS—The model proved to be valid (χ2 = 88.5, df = 76, P = 0.16), showing a sound fit (adjusted goodness of fit [AGFI] = 0.94). It explained 62% of the variance of the quality of life and 5% of the HbA1c values. Subjects characterized by strong beliefs in their self-efficacy and an optimistic outlook on life were more likely to be satisfied with their doctor-patient relationships. They demonstrated more active coping behavior and proved to have a higher quality of life. Active coping behavior was the only psychological variable significant for the HbA1c values.
CONCLUSIONS—It was possible to illustrate the various factors involved and their mutual dependency and significance for the treatment goals. Belief in self-efficacy and active coping behavior appear to have the greatest relevance for achieving the primary treatment goals.
Cause-Specific Mortality in a Population With Diabetes
Authors: Roper Nick A. , Bilous Rudy W. , Kelly William F. , Unwin Nigel C. , Connolly Vincent M. 
Published: March 2007

OBJECTIVE—To describe the mortality of a population with diabetes compared with the local nondiabetic population, using age-, sex-, and cause-specific death rates and relative and absolute differences in death rates.
RESEARCH DESIGN AND METHODS—A population-based cohort of 4,842 people with diabetes living within South Tees, U.K., was identified and followed from 1 January 1994 to 31 December 1999. Causes of death were obtained from death certificates, and mortality rates were compared with the nondiabetic population of the same area for the same time period.
RESULTS—There were 1,205 deaths (24.9%) in the study population during the 6 years of study. For type 2 diabetes, mortality from cardiovascular causes was significantly increased in both sexes and at all ages. Relative death rates for the age band 40–59 years were 5.47 (95% CI 4.18–7.15) for men and 5.60 (3.44–9.14) for women. The relative death rates declined with age for both sexes, but absolute excess mortality increased with age. There were no consistent differences in noncardiovascular death rates, other than for renal disease. Similar outcomes were found for type 1 diabetes, although these results were limited by a much smaller population size. People with diabetes and renal impairment had significantly higher mortality than people with diabetes alone, with a rate ratio of 7.27 for people with type 2 diabetes aged 40–59 years.
CONCLUSIONS—In an area of the U.K. with high cardiovascular death rates, people with diabetes had significantly higher cardiovascular death rates than people without diabetes. Interventions targeted at cardiovascular risk factors should be used to try and reduce this excess premature mortality, which is especially high in those with renal impairment.
Comparison of Antigenicity of Hoechst 21PH Insulin Using Either Implantable Intraperitoneal Pump or Subcutaneous External Pump Infusion in Type 1 Diabetic Patients
Authors: Jeandidier Nathalie , Boullu Sylvie , Busch-Brafin Marie-Sophie , Chabrier Gerard , Sapin Rémy , Gasser Françoise , Pinget Michel 
Published: March 2007

OBJECTIVE—To assess the antigenicity of the insulin Hoechst 21PH (Hoe21PH) using continuous subcutaneous insulin infusion (CSII) and to compare the antigenicity of this insulin when administered intraperitoneally or subcutaneously.
RESEARCH DESIGN AND METHODS—Peritoneal administration of Hoe21PH (Hoechst-Roussel, Somerville, NJ) insulin using implantable devices (continuous peritoneal insulin infusion [CPII]) increases anti-insulin antibody (AIA) levels in type 1 diabetic patients. Intraperitoneal administration, addition of a stabilizer (polyethylene polypropylene glycol), or insulin modifications due to storage in the pump may be involved in this antigenicity. In this nonrandomized study, 24 type 1 diabetic patients were treated with either CSII (n = 11, group 1) or CPII (n = 13, group 2). AIA levels were measured by radioimmunoassay (RIA) or enzyme-linked immunosorbent assay (ELISA) before starting patients on Hoe21PH and again after 3 and 6 months.
RESULTS—Patients were comparable in the two groups. AIA levels (RIA) remained stable (24.3 ± 8.5% [month 0] to 24.9 ± 8.5.5% [month 6]) in group 1 and increased (21.8 ± 6.7% [month 0] to 41.8 ± 6.9% [month 6]) in group 2 (P = 0.005, Wilcoxon’s rank-sum test). Using ELISA, AIA remained stable in the patients in group 1 (n = 9; 3.8 ± 0.8 units/ml [month 0] and 4.1 ± 1.0 units/ml [month 6]) and tended to increase in the patients in group 2 (n = 12; 4.1 ± 0.7 units/ml [month 0] to 17.5 ± 4.6 units/ml [month 6]) (P = 0.07). Comparison of the evolution of AIA formation between the two groups, using RIA at months 0, 3, and 6 showed a significant difference (analysis of variance, P = 0.009).
CONCLUSIONS—No increase in AIA levels was demonstrated when Hoe21PH insulin was administered subcutaneously as assessed by two different assays. CPII is proven to be more antigenic than CSII, and this is not related to a specific antigenicity of Hoe21PH insulin. The intraperitoneal route of administration or insulin modifications due to insulin storage in implantable devices might explain this antigenicity.