bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex Disparities in Treatment of Cardiac Risk Factors in Patients With Type 2 Diabetes
Authors: Wexler Deborah J. , Grant Richard W. , Meigs James B. , Nathan David M. , Cagliero Enrico 
Published: March 2007

OBJECTIVE—Diabetes eliminates the protective effect of female sex on the risk of coronary heart disease (CHD). We assessed sex differences in the treatment of CHD risk factors among patients with diabetes.
RESEARCH DESIGN AND METHODS—A cross-sectional analysis included 3,849 patients with diabetes treated in five academic internal medicine practices from 2000 to 2003. Outcomes were stratified by the presence of CHD and included adjusted odds ratios (AORs) that women (relative to men) were treated with hypoglycemic, antihypertensive, lipid-lowering medications or aspirin (if indicated) and AORs of reaching target HbA1c, blood pressure, or lipid levels.
RESULTS—Women were less likely than men to have HbA1c &lt;7% (without CHD: AOR 0.84 [95% CI 0.75–0.95], P = 0.005; with CHD: 0.63 [0.53–0.75], P &lt; 0.0001). Women without CHD were less likely than men to be treated with lipid-lowering medication (0.82 [0.71–0.96], P = 0.01) or, when treated, to have LDL cholesterol levels &lt;100 mg/dl (0.75 [0.62–0.93], P = 0.004) and were less likely than men to be prescribed aspirin (0.63 [0.55–0.72], P &lt; 0.0001). Women with diabetes and CHD were less likely than men to be prescribed aspirin (0.70 [0.60–0.83], P &lt; 0.0001) or, when treated for hypertension or hyperlipidemia, were less likely to have blood pressure levels &lt;130/80 mmHg (0.75 [0.69–0.82], P &lt; 0.0001) or LDL cholesterol levels &lt;100 mg/dl (0.80 [0.68–0.94], P = 0.006).
CONCLUSIONS—Women with diabetes received less treatment for many modifiable CHD risk factors than diabetic men. More aggressive treatment of CHD risk factors in this population offers a specific target for improvement in diabetes care.
Impact of Early Neonatal Breast-Feeding on Psychomotor and Neuropsychological Development in Children of Diabetic Mothers
Authors: Plagemann Andreas , Harder Thomas , Kohlhoff Rainer , Fahrenkrog Sonja , Rodekamp Elke , Franke Kerstin , Dudenhausen Joachim W. 
Published: March 2007

OBJECTIVE—In general, breast-feeding positively influences development of psychomotor function and cognition in children. Offspring of diabetic mothers (ODM) have delayed psychomotor and cognitive development. Recently, we observed a dose-dependent negative effect of early neonatal ingestion of breast milk from diabetic mothers (diabetic breast milk [DBM]) on the risk of overweight during early childhood. Here, we investigated the influence of early neonatal intake of DBM on neurodevelopment in ODM.
RESEARCH DESIGN AND METHODS—A total of 242 ODM were evaluated for age of achieving major developmental milestones (Denver Developmental Scale) according to the volume of DBM ingested during the first week of life, using Kruskal-Wallis and Kaplan-Meier analysis.
RESULTS—Children in the upper tertile of early neonatal ingestion of DBM achieved early psychomotor developmental milestones (“lifting head while prone,” “following with eyes”) earlier than those in lower tertiles (P = 0.002). In contrast, a delay in the onset of speaking was observed in children who had ingested larger volumes of DBM compared with those with lower DBM intake (P = 0.002). This negative impact of DBM ingestion was not confounded by birth characteristics, total milk intake, or socioeconomic/educational status.
CONCLUSIONS—Our data indicate differential effects of early neonatal DBM ingestion on psychomotor and cognitive development. Ingesting larger compared with smaller volumes of DBM may normalize early psychomotor development in ODM but delays onset of speaking as a parameter indicative of cognitive development. This effect may result from qualitative alterations in the composition of DBM. Further studies are urgently recommended on the benefits and harms of breast-feeding in ODM.
Increasing Prevalence of Gestational Diabetes Mellitus (GDM) Over Time and by Birth Cohort
Authors: Dabelea Dana , Snell-Bergeon Janet K. , Hartsfield Cynthia L. , Bischoff Kimberly J. , Hamman Richard F. , McDuffie Robert S. 
Published: March 2007

OBJECTIVE—The prevalence of gestational diabetes mellitus (GDM) varies in direct proportion with the prevalence of type 2 diabetes in a given population or ethnic group. Given that the number of people with diabetes worldwide is expected to increase at record levels through 2030, we examined temporal trends in GDM among diverse ethnic groups.
RESEARCH DESIGN AND METHODS—Kaiser Permanente of Colorado (KPCO) has used a standard protocol to universally screen for GDM since 1994. This report is based on 36,403 KPCO singleton pregnancies occurring between 1994 and 2002 and examines trends in GDM prevalence among women with diverse ethnic backgrounds.
RESULTS—The prevalence of GDM among KPCO members doubled from 1994 to 2002 (2.1–4.1%, P &lt; 0.001), with significant increases in all racial/ethnic groups. In logistic regression, year of diagnosis (odds ratio [OR] and 95% CI per 1 year = 1.12 [1.09–1.14]), mother’s age (OR per 5 years = 1.7 [1.6–1.8]) and ethnicity other than non-Hispanic white (OR = 2.1 [1.9–2.4]) were all significantly associated with GDM. Birth year remained significant (OR = 1.06, P = 0.006), even after adjusting for prior GDM history.
CONCLUSIONS—This study shows that the prevalence of GDM is increasing in a universally screened multiethnic population. The increasing GDM prevalence suggests that the vicious cycle of diabetes in pregnancy initially described among Pima Indians may also be occurring among other U.S. ethnic groups.
Effects of Pramlintide on Postprandial Glucose Excursions and Measures of Oxidative Stress in Patients With Type 1 Diabetes
Authors: Ceriello Antonio , Piconi Ludovica , Quagliaro Lisa , Wang Yan , Schnabel Catherine A. , Ruggles James A. , Gloster Maurice A. , Maggs David G. , Weyer Christian 
Published: March 2007

OBJECTIVE—Oxidative stress has been shown to be increased in the postprandial period in patients with diabetes and has been implicated in the pathogenesis of micro- and macrovascular complications. The aim of this post hoc analysis was to assess the effects of pramlintide, an amylin analog shown to reduce postprandial glucose excursions in patients with diabetes, on markers of oxidative stress in the postprandial period.
RESEARCH DESIGN AND METHODS—In a randomized, single-blind, placebo-controlled, crossover study, 18 evaluable subjects with type 1 diabetes underwent two standardized breakfast meal tests and received pramlintide or placebo in addition to their preprandial insulin. The plasma concentrations of glucose and markers of oxidative stress (nitrotyrosine, oxidized LDL [ox-LDL], and total radical-trapping antioxidant parameter [TRAP]) were measured at baseline and during the 4-h postprandial period.
RESULTS—Compared with placebo, pramlintide treatment significantly reduced postprandial excursions of glucose, nitrotyrosine, and ox-LDL and prevented a decline in TRAP (P &lt; 0.03 for all comparisons). Correlation analyses adjusted for treatment revealed a significant association between postprandial mean incremental area under the curve from 0 to 4 h (AUC0–4 h) for glucose and postprandial mean incremental AUC0–4 h for each measure of oxidative stress (r = 0.75, 0.54, and −0.63 for nitrotyrosine, ox-LDL, and TRAP, respectively; P &lt; 0.001 for all correlations).
CONCLUSIONS—These findings indicate that the postprandial glucose-lowering effect of pramlintide in type 1 diabetes is associated with a significant reduction in postprandial oxidative stress.
Diabetes, Glucose, Insulin, and Heart Rate Variability
Authors: Schroeder Emily B. , Chambless Lloyd E. , Liao Duanping , Prineas Ronald J. , Evans Gregory W. , Rosamond Wayne D. , Heiss Gerardo 
Published: March 2007

OBJECTIVE—To describe the progression of autonomic impairment among individuals with diabetes and pre-diabetic metabolic impairments.
RESEARCH DESIGN AND METHODS—We investigated the consequence of diabetes and pre-diabetic metabolic impairments on the 9-year change in heart rate variability (HRV) in a population-based cohort of 6,245 individuals aged 45–64 years at baseline and cross-sectional associations among 9,940 individuals.
RESULTS—Diabetic subjects had a more rapid temporal decrease in HRV conditional on baseline HRV than nondiabetic subjects. Adjusted mean annual changes (95% CI) (ms/year) in the SD of all normal-to-normal R-R intervals were −0.65 (−0.69 to −0.61) for those with normal fasting glucose vs. −0.95 (−1.09 to −0.81) for diabetic subjects, in root mean square of successive differences in normal-to-normal R-R intervals −0.35 (−0.39 to −0.30) vs. −0.66 (−0.82 to −0.51), and in R-R interval 6.70 (6.37–7.04) vs. 3.89 (2.72–5.05). While we found cross-sectional associations between decreased HRV and diabetes and nondiabetic hyperinsulinemia and a weak inverse association with fasting glucose, neither impaired fasting glucose nor nondiabetic hyperinsulimenia was associated with a measurably more rapid decline in HRV than normal.
CONCLUSIONS—Cardiac autonomic impairment appears to be present at early stages of diabetic metabolic impairment, and progressive worsening of autonomic cardiac function over 9 years was observed in diabetic subjects. The degree to which pre-diabetic metabolic impairments in insulin and glucose metabolism contribute to decreases in cardiac autonomic function remains to be determined.
Presence of the Metabolic Syndrome Does Not Impair Coronary Collateral Vessel Formation in Patients With Documented Coronary Artery Disease
Authors: Olijhoek Jobien K. , Koerselman Jeroen , de Jaegere Peter P.Th. , Verhaar Marianne C. , Grobbee Diederick E. , van der Graaf Yolanda , Visseren Frank L.J. ,   for the SMART Study Group
Published: March 2007

OBJECTIVE—The metabolic syndrome confers an increased risk for cardiovascular morbidity and mortality. The presence of coronary collaterals may have beneficial effects during myocardial ischemia and may improve cardiovascular outcome in patients with coronary artery disease. Impaired collateral formation could be one of the reasons for the increased cardiovascular risk in patients with the metabolic syndrome. The aim of the present study was to determine the influence of the metabolic syndrome and insulin resistance on the presence of coronary collaterals.
RESEARCH DESIGNS AND METHODS—We conducted a cross-sectional study in 227 patients referred for elective percutaneous transluminal coronary angioplasty to the University Medical Centre Utrecht. The metabolic syndrome was diagnosed according to Adult Treatment Panel III, and homeostasis model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) were used to quantify insulin resistance. Coronary collaterals were graded with Rentrop’s classification. Rentrop grade ≥1 indicated the presence of collaterals. Results were adjusted for age, sex, and severity of coronary artery disease.
RESULTS—A total of 103 patients (45%) were diagnosed with the metabolic syndrome. There was no association between the metabolic syndrome and the presence of coronary collateral formation (odds ratio [OR] 1.2 [95% CI 0.7–2.0]). Also, the degree of insulin resistance was not related to the presence of coronary collaterals. The OR for HOMA-IR (highest versus lowest tertile) was 0.7 (0.3–1.5) and for QUICKI (lowest versus highest tertile) 0.8 (0.4–1.6).
CONCLUSIONS—The metabolic syndrome and insulin resistance are not related to the presence of coronary collaterals in patients with documented coronary artery disease.
Endothelial-Dependent Vasodilation and Incidence of Type 2 Diabetes in a Population of Healthy Postmenopausal Women
Authors: Rossi Rosario , Cioni Elena , Nuzzo Annachiara , Origliani Giorgia , Modena Maria Grazia 
Published: March 2007

OBJECTIVE—Both postmenopausal state and diabetes are associated with endothelial dysfunction and are well-known risk factors for atherosclerosis. However, the relationship of endothelium-dependent vasodilation and diabetes has never been prospectively evaluated. This study provided the opportunity to assess the association between endothelial vasodilation function and the incidence of diabetes in a cohort of apparently healthy postmenopausal women.RESEARCH DESIGN AND METHODS—We conducted a prospective cohort study that began in 1997 with 840 apparently healthy, nonobese, postmenopausal women, aged 53 ± 6 years, initially with normal glucose tolerance at the oral glucose tolerance test. All participants were followed up for a mean period of 3.9 ± 0.7 years (range 0.5–6.9). Endothelial function was measured as flow-mediated dilation (FMD) of the brachial artery, using high-resolution ultrasound.RESULTS—There were no significant differences in demographic, blood pressure, and biochemical profiles among each tertile group at baseline or at follow-up review. During follow-up, 102 women developed type 2 diabetes. The adjusted relative risk (RR) for women with FMD ≤4.3 (lowest tertile) was 5.87 (95% CI 4.34–8.10) versus women with FMD ≥5.6 (highest tertile reference). Each 1-unit decrease of FMD was associated with a significant 32% (22–48%) increase in the multiple-adjusted RR of incident diabetes.CONCLUSIONS—These prospective data indicate a significant increase in the RR of diabetes with each unit decrease of FMD. This could suggest that an impaired endothelial function may play a fundamental role in diabetogenesis in postmenopausal women.
Effect of a Pharmaceutical Care Program on Vascular Risk Factors in Type 2 Diabetes
Authors: Clifford Rhonda M. , Davis Wendy A. , Batty Kevin T. , Davis Timothy M.E. 
Published: March 2007

OBJECTIVE—To examine the effect of a 12-month pharmaceutical care (PC) program on vascular risk in type 2 diabetes.
RESEARCH DESIGN AND METHODS—We recruited 198 community-based patients randomized to PC or usual care. PC patients had face-to-face goal-directed medication and lifestyle counseling at baseline and at 6 and 12 months plus 6-weekly telephone assessments and provision of other educational material. Clinical, biochemical, and medication-related data were sent regularly to each patient’s physician(s). The main outcome measure was change in HbA1c. A diabetes-specific risk engine was used to estimate changes in 10-year coronary heart disease (CHD) and stroke risk in patients without a history of cardiovascular disease.
RESULTS—At total of 180 patients (91%) completed the study. Mean (95% CI) reductions were greater in PC case subjects (n = 92) than control subjects (n = 88) for HbA1c (−0.5% [95% CI −0.7 to −0.3] vs. 0 [−0.2 to 0.2]) and systolic (−14 mmHg [−19 to −9] vs. −7 [−11 to −2]) and diastolic (−5 mmHg [−8 to −3] vs. −2 [−4 to 1]) blood pressure (P ≤ 0.043). The improvement in HbA1c persisted after adjustment for baseline value and demographic and treatment-specific variables. The median (interquartile range) 10-year estimated risk of a first CHD event decreased in the PC case subjects (25.1% [15.6–36.2] to 20.3 [14.6–30.2]; n = 42, P = 0.002) but not in the control subjects (26.1% [17.2–39.4] vs. 26.4 [16.7–38.0]; n = 52, P = 0.17).
CONCLUSIONS—A 12-month PC program in type 2 diabetes reduced glycemia and blood pressure. Pharmacist involvement contributed to improvement in HbA1c independently of pharmacotherapeutic changes. PC could prove a valuable component of community-based multidisciplinary diabetes care.
Physical Activity, Cardiovascular Risk Factors, and Mortality Among Finnish Adults With Diabetes
Authors: Hu Gang , Jousilahti Pekka , Barengo Noël C. , Qiao Qing , Lakka Timo A. , Tuomilehto Jaakko 
Published: March 2007

OBJECTIVE—The aim of this study was to examine both single and joint associations of physical activity and conventional cardiovascular risk factors with total and cardiovascular mortality among patients with diabetes.
RESEARCH DESIGN AND METHODS—We prospectively followed 3,708 Finnish patients with type 2 diabetes aged 25–74 years. Physical activity, smoking status, blood pressure, height, weight, and serum cholesterol level were determined at baseline. Cox proportional hazard models were used to estimate single and joint effects of physical activity and other cardiovascular risk factors on the risk of mortality.
RESULTS—During a mean follow-up of 18.7 years, 1,423 deaths were recorded, 906 of which were due to cardiovascular disease. Moderate or high levels of physical activity were associated with decreased total and cardiovascular mortality, whereas higher levels of BMI and blood pressure and current smoking were associated with increased total and cardiovascular mortality. High serum cholesterol levels also increased cardiovascular mortality. The protective effect of physical activity was consistent in diabetic patients with any levels of BMI, blood pressure, total cholesterol, and smoking.
CONCLUSIONS—A moderate or high level of physical activity was associated with a reduced risk of total and cardiovascular mortality among patients with type 2 diabetes. The favorable association of physical activity with longevity was observed regardless of the levels of BMI, blood pressure, total cholesterol, and smoking.
Estimation of Glomerular Filtration Rate in Diabetic Subjects
Authors: Rigalleau Vincent , Lasseur Catherine , Perlemoine Caroline , Barthe Nicole , Raffaitin C. , Liu Chung , Chauveau Phillipe , Baillet-Blanco Laurence , Beauvieux Marie-Christine , Combe C. , Gin Henri 
Published: March 2007

OBJECTIVE—The Cockcroft-Gault formula is recommended for the evaluation of renal function in diabetic patients. The more recent Modification of Diet in Renal Disease (MDRD) study equation seems more accurate, but it has not been validated in diabetic patients. This study compares the two methods.
RESEARCH DESIGN AND METHODS—In 160 diabetic patients, we compared the Cockcroft-Gault formula and MDRD equation estimations to glomerular filtration rates (GFRs) measured by an isotopic method (51Cr-EDTA) by correlation studies and a Bland-Altman procedure. Their accuracy for the diagnosis of moderately (GFR &lt;60 ml · min−1 · 1.73 m−2) or severely (GFR &lt;30 ml · min−1 · 1.73 m−2) impaired renal function were compared with receiver operating characteristic (ROC) curves.
RESULTS—Both the Cockcroft-Gault formula (r = 0.74; P &lt; 0.0001) and MDRD equation (r = 0.81; P &lt; 0.0001) were well correlated with isotopic GFR. The Bland-Altman procedure revealed a bias for the MDRD equation, which was not the case for the Cockcroft-Gault formula. Analysis of ROC curves showed that the MDRD equation had a better maximal accuracy for the diagnosis of moderate (areas under the curve [AUCs] 0.868 for the Cockcroft-Gault formula and 0.927 for the MDRD equation; P = 0.012) and severe renal failure (AUC 0.883 for the Cockcroft-Gault formula and 0.962 for the MDRD equation; P = 0.0001). In the 87 patients with renal insufficiency, the MDRD equation estimation was better correlated with isotopic GFR (Cockcroft-Gault formula r = 0.57; the MDRD equation r = 0.78; P &lt; 0.01), and it was not biased as evaluated by the Bland-Altman procedure.
CONCLUSIONS—Although both equations have imperfections, the MDRD equation is more accurate for the diagnosis and stratification of renal failure in diabetic patients.
Autoantibody “Subspecificity” in Type 1 Diabetes
Authors: Barker Jennifer M. , Yu Jeesuk , Yu Liping , Wang Jian , Miao Dongmei , Bao Fei , Hoffenberg Edward , Nelson Jerald C. , Gottlieb Peter A. , Rewers Marian , Eisenbarth George S. 
Published: March 2007

OBJECTIVE—Autoimmune thyroid disease (AIT), celiac disease, and Addison’s disease are characterized by the presence of autoantibodies: thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) in AIT, tissue transglutaminase antibody (TTGAb) in celiac disease, and 21-hydroxylase antibody (21-OHAb) in Addison’s disease. The objective of this study was to define the prevalence of these autoantibodies and clinical disease in a population with type 1 diabetes.
RESEARCH DESIGN AND METHODS—We screened 814 individuals with type 1 diabetes for TPOAb, TGAb, TTGAb, and 21-OHAb. Clinical disease was defined by chart review. Factors related to the presence of autoimmunity and clinical disease including age at onset of type 1 diabetes, duration of diabetes, age at screening, sex, and the presence of autoantibodies were reviewed.
RESULTS—The most common autoantibodies expressed were TPOAb and/or TGAb (29%), followed by TTGAb (10.1%) and 21-OHAb (1.6%). Specific HLA DR/DQ genotypes were associated with the highest risk for expression of 21-OHAb (DRB1*0404-DQ8, DR3-DQ2) and TTGAb (DR3-DQ2- DR3-DQ2). The expression of thyroid autoantibodies was related to 21-OHAb but not to TTGAb. The presence of autoantibodies was associated with and predictive of disease.
CONCLUSIONS—In this large cohort of individuals with type 1 diabetes, the expression of organ-specific autoantibodies was very high. The grouping of autoantibody expression suggests common factors contributing to the clustering.
Effect of Maternal Use of Antiretroviral Agents on Serum Insulin Levels of the Newborn Infant
Authors: El Beitune Patrícia , Duarte Geraldo , Foss Milton C. , Montenegro Renan M. , Quintana Silvana M. , Figueiró-Filho Ernesto A. , Nogueira Antonio A. 
Published: March 2007

OBJECTIVE—The aim of this study was to investigate the effect of antiretroviral drugs on neonatal serum insulin levels.
RESEARCH DESIGN AND METHODS—A prospective study was conducted on 57 pregnant women divided into three groups: the zidovudine (ZDV) group, HIV-infected women taking ZDV (n = 20); the triple treatment group, HIV-infected women taking triple antiretroviral agents ZDV + lamivudine + nelfinavir (n = 25); and the control group, pregnant women considered normal from a clinical and laboratory standpoint (n = 12). Blood was collected from the umbilical cord of newborn infants upon delivery for measurement of insulin level. The insulin measurements were performed in duplicate by radioimmunoassay.
RESULTS—Demographic and anthropometric data were homogeneous, and pregnant women with a personal and family history of diabetes were excluded. There was no difference between groups regarding glycemia in the newborn. Median newborn insulin doses were 2.9, 4.8, and 6.5 μU/ml for the triple treatment, ZDV, and control groups, respectively (P &lt; 0.05).
CONCLUSIONS—Use of triple therapy during pregnancy induced a significant decrease in serum levels of neonatal insulin compared with the control group. Active surveillance of short- and long-term adverse events is imperative to issue a definitive statement regarding the impact that use of protease inhibitors during pregnancy will have on infant metabolism.