bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Assessment of the Association Between Functional Edentulism, Obesity, and NIDDM
Authors: Cleary Thomas J , Hutton John E 
Published: March 2007

OBJECTIVE
To assess the association between a measure of extensive tooth loss (functional edentulism) and obesity with non-insulin-dependent diabetes mellitus (NIDDM) in a racially heterogeneous sample.

RESEARCH DESIGN AND METHODS
A cross-sectional survey (370 subjects) was performed by reviewing the medical and dental records of dependently or independently living individuals who were treated as inpatients and/or outpatients at a Department of Veterans Affairs facility. Frequencies and descriptive measures were derived; univariate and multiple logistic regression analyses were conducted to test for associations, confounding, effect modification, and interaction using functional edentulism and obesity as the independent variables and NIDDM as the dependent measure.

RESULTS
Functionally edentulous individuals were at significantly greater risk for NIDDM (estimated odds ratio [] = 4.06), than the obese ( = 3.29). These relationships were not confounded by age or race in this sample. Obesity did confound functional edentulism in the multivariable model, suggesting that they act independently on the outcome variable (NIDDM).

CONCLUSIONS
Dentist-assessed functional edentulism and physician-diagnosed obesity were significantly associated with NIDDM in this sample of predominantly older men. This finding ought to be considered by primary care providers in formulating dietary strategies in order to facilitate the realization of their therapeutic goals.
Abnormal Albuminuria as a Predictor of Mortality and Renal Impairment in Chinese Patients With NIDDM
Authors: Chan Juliana C N , Cheung Chi-Keung , Cheung Margaret Y F , Swaminathan Ramasmyiyer , Critchley Julian A J H , Cockram Clive S 
Published: March 2007

OBJECTIVE
Microalbuminuria predicts mortality in non-insulin-dependent diabetes mellitus (NIDDM), but its association with deterioration of renal function remains more controversial than in insulin-dependent diabetes mellitus (IDDM). Using albumin-to-creatinine ratios (ACRs) in random spot urine samples is a convenient method for evaluating albuminuria. We studied prospectively the predictive values of albuminuria in NIDDM when assessed by this urine measurement.

RESEARCH DESIGN AND METHODS
Between 1991 and 1992, we restudied the clinical and biochemical status of 403 Chinese NIDDM patients recruited in 1989 after a follow-up period of 26.6 ± 3.2 months (mean ± SD). Spot urine ACR was measured on two occasions and microalbuminuria was defined as a mean ACR between 5.6 and 38 mg/mmol.

RESULTS
From the original cohort, 29 patients had died mostly because of cardiovascular events with or without renal failure. The overall relative risk of death in patients with abnormal albuminuria was 7.1 (P &lt; 0.001) (microalbuminuria: 3.7, P = 0.04; macroalbuminuria: 11, P &lt; 0.001). On multivariate analysis, the independent predictive factors for mortality were plasma creatinine (wald = 12.1, P &lt; 0.001) and glucose concentrations (wald = 10.4, P &lt; 0.001) in the normo- and microalbuminuric patients (n = 11) and age (wald = 4.4, P = 0.03) and plasma creatinine (wald = 8.2, P &lt; 0.01) in the macroalbuminuric group (n = 18). In the survivors (n = 374), baseline spot urine ACR was independently associated with 2-year spot urine ACR in the normo- (P &lt; 0.001), micro- (P &lt; 0.01), and macroalbuminuric groups (P = 0.01). In addition, baseline spot urine ACR was independently related to 2-year plasma creatinine (P = 0.01) in the macroalbuminuric group. The rates of change of the reciprocal of plasma creatinine (Δ [Cr]−1) were −27.3 ± 62.5, −43.4 ± 68.6, and −108.8 ± 98.81·μmol−1·months−1 in the normo-, micro-, and macroalbuminuric groups, respectively (P &lt; 0.001). The Δ [Cr]−1 was independently and inversely related to the baseline spot urine ACR (P &lt; 0.001) and 2-year systolic blood pressure (P &lt; 0.001).

CONCLUSIONS
Abnormal albuminuria as indicated by a random spot urine ACR &gt; 5.6 mg/mmol predicts increased mortality and is associated with the progression of albuminuria and deterioration of renal function in Chinese NIDDM patients.
Features of Syndrome X in First-Degree Relatives of NIDDM Patients
Authors: Stewart Murray W , Humphriss David B , Berrish Taher S , Barriocanal Luis A , Trajano Laura R , Alberti K George M M , Walker Mark 
Published: March 2007

OBJECTIVE
To determine whether the features of syndrome × are more common in first-degree relatives of non-insulin-dependent diabetes mellitus (NIDDM) patients than in control subjects with no family history of diabetes.

RESEARCH DESIGN AND METHODS
A total of 154 first-degree relatives from 60 families with two or more NIDDM patients and 154 age- and sex-matched control subjects were studied. All subjects underwent a 75-g oral glucose tolerance test and baseline lipid blood and anthropometric measures. The features of syndrome × that were studied were obesity, hypertension, dyslipidemia (high triglyceride levels and low high-density lipoprotein [HDL] cholesterol concentrations), impaired glucose tolerance (World Health Organization criteria), and insulin resistance (as assessed by the homeostasis model assessment).

RESULTS
Relatives were heavier than control subjects (body mass index 27.5 ± 5.2 vs. 25.2 ± 4.6 kg/m2, respectively [mean ± SD], P &lt; 0.0002), had lower HDL cholesterol concentrations (1.2 ± 0.3 vs. 1.4 ± 0.4 mmol/l, P &lt; 0.001), were more insulin-resistant (2.3 [0.7−7.6] vs. 1.6 [0.5−5.1], geometric mean [95% confidence intervals], P &lt; 0.0001), and had more individuals classified as having impaired glucose tolerance (28 of 154 [18%] vs. 7 of 154 [7%], χ 2, P &lt; 0.001). The differences in insulin resistance and HDL cholesterol concentrations between the groups were independent of obesity.

CONCLUSIONS
Features of syndrome X occur more frequently in relatives of NIDDM patients than in control subjects with no family history of diabetes.
Dietary Factors Determining Diabetes and Impaired Glucose Tolerance: A 20-year follow-up of the Finnish and Dutch cohorts of the Seven Countries Study
Authors: Feskens Edith J , Virtanen Suvi M , Räsänen Leena , Tuomilehto Jaakko , Stengård Jari , Pekkanen Juha , Nissinen Aulikki , Kromhout Daan 
Published: March 2007

OBJECTIVE
To investigate the role of diet as a predictor of glucose intolerance and non-insulin-dependent diabetes mellitus (NIDDM).

RESEARCH DESIGN AND METHODS
At the 30-year follow-up survey of the Dutch and Finnish cohorts of the Seven Countries Study, in 1989/1990, men were examined according to a standardized protocol including a 2-h oral glucose tolerance test. Information on habitual food consumption was obtained using the cross-check dietary history method. Those 338 men in whom information on habitual diet was also available 20 years earlier were included in this study. Subjects known as having diabetes in 1989/1990 were excluded from the analyses.

RESULTS
Adjusting for age and cohort, the intake of total, saturated, and monounsaturated fatty acids and dietary cholesterol 20 years before diagnosis was higher in men with newly diagnosed diabetes in the survey than in men with normal or impaired glucose tolerance. After adjustment for cohort, age, past body mass index, and past energy intake, the past intake of total fat was positively associated with 2-h postload glucose level (P &lt; 0.05). An independent inverse association with the past intake of vitamin C was observed (P &lt; 0.05). These associations were independent of changes in the intake of fat and vitamin C during the 20-year follow-up. An increase in the consumption of vegetables and legumes, potatoes, and fish during the 20-year follow-up was inversely related with 2-h glucose level (P &lt; 0.05).

CONCLUSIONS
Although the regression coefficients were in general not very large, these results indicate that a high intake of fat, especially that of saturated fatty acids, contributes to the risk of glucose intolerance and NIDDM. Foods such as fish, potatoes, vegetables, and legumes may have a protective effect. In addition, the observed inverse association between vitamin C and glucose intolerance suggests that antioxidants may also play a role in the development of derangements in glucose metabolism.
Effect of Chronic Intermittent Intravenous Insulin Therapy on Antihypertensive Medication Requirements in IDDM Subjects With Hypertension and Nephropathy
Authors: Aoki Thomas T , Grecu Eugen O , Prendergast Joseph J , Arcangeli Michael A , Meisenheimer Ronald 
Published: March 2007

OBJECTIVE
The prevalence of systemic hypertension is increased in patients with diabetes. In this prospective, randomized, crossover clinical trial, we assessed antihypertensive effects of chronic intermittent intravenous insulin therapy (CIIIT) on insulin-dependent diabetes mellitus (IDDM) subjects with hypertension and nephropathy by monitoring the amount of antihypertensive medication (AHM) required to maintain blood pressure (BP) ≤ 140/90 mmHg.

RESEARCH DESIGN AND METHODS
After a stabilization period, 26 hypertensive IDDM subjects were randomly assigned to a control or treatment phase for 3 months and then crossed over into the opposite phase for another 3 months. Addition of CIIIT during the treatment phase was the only procedural difference between the control and treatment phases.

RESULTS
The AHM dosage requirements for maintenance of the baseline BP levels decreased significantly (46% P &lt; 0.0001) and linearly over time (P &lt; 0.0058) during the treatment phase, while remaining essentially unchanged during the control phase.

CONCLUSIONS
Our data suggest that CIIIT markedly improves BP control, as evidenced by the significantly reduced AHM dosage requirements in subjects with IDDM and hypertension, possibly through an improvement in vascular reactivity.
The Jamaican Diabetes Survey: A protocol for the Caribbean
Authors: Ragoobirsingh Dalip , Lewis-Fuller Eva , Morrison Errol Y St A 
Published: March 2007

OBJECTIVE
This study was designed to investigate the point prevalence of diabetes in Jamaica.

RESEARCH DESIGN AND METHODS
A two-stage stratified random sampling design was used, and individuals aged 15 years and over were interviewed. Nonresponse was documented and factored into the final analysis of the survey data. The overall response rate obtained was 57.9%. All subjects with fasting blood glucose (FBG) &gt; 6.1 mmol/1 (110 mg/dl) were brought back for an abbreviated glucose tolerance test. The data was analyzed using Epi 5, an advanced statistical program designed specifically for use with epidemiological data.

RESULTS
The 2,109 subjects who participated were the basis for estimates of diabetes and IGT prevalence. Among those with previously diagnosed diabetes, diet therapy alone, oral hypoglycemic agents plus diet therapy, insulin therapy, and lack of treatment were reported.

CONCLUSIONS
By the World Health Organization (WHO) criteria, Jamaica has a point prevalence of diabetes of 17.9% in the 15-and-over age-group.
Increasing Incidence of IDDM in Austrian Children: A nationwide study 1979–1993
Authors: Schober Edith , Schneider Ursula , Waldhör Thomas , Tuomilehto Jaako ,   Austrian Diabetes Incidence Study Group
Published: March 2007

OBJECTIVE
A nationwide population-based study was conducted to assess the insulin-dependent diabetes mellitus (IDDM) incidence in childhood over a 15-year period (1979–1993).

RESEARCH DESIGN AND METHODS
A questionnaire was sent to all Austrian pediatric departments and diabetologists. The secondary data source was based on patient organization lists and hospital administration data. The data from 1979-1987 were collected retrospectively, while from 1988 to 1993 the registration of cases was performed prospectively in the same network. Estimates of probability of ascertainment were calculated according to the capture-recapture method.

RESULTS
The achieved ascertainment was 94%. The overall annual incidence was 7.9/100,000 person-years in children 0–14 years old. During the observation period, the incidence rose by 2.4% annually.

CONCLUSIONS
The incidence of childhood IDDM in Austria, a European country with an intermediate risk for IDDM, showed a proportionally similar increase to that of Northern European countries over the past decade. The increase seems to be continuous, following mainly a linear trend with superimposed sudden outbreaks indicating environmental causative factors.
Hyperinsulinemia in Nondiabetic Asian Subjects Using Specific Assays for Insulin, Intact Proinsulin, and Des-31, 32-Proinsulin
Authors: Nagi Dinesh K , Ali Vidya Mohamed , Walji Shahenaz , Jain Sachin K , Yudkin John S 
Published: March 2007

OBJECTIVE
To investigate the contributions of intact proinsulin and of des-31,32-proinsulin to fasting concentrations of insulin-like molecules in nondiabetic subjects from two ethnic groups (Asian and white) and to see whether Asian subjects are hyperinsulinemic compared with white subjects using highly specific assays for insulin.

RESEARCH DESIGN AND METHODS
We investigated subjects with normal glucose tolerance (NGT) (82 Asian and 67 white) and impaired glucose tolerance (IGT) (16 Asian and 13 white), diagnosed by using standard World Health Organization criteria. Highly specific monoclonal antibody-based assays were used to measure insulin, intact proinsulin, and des-31, 32-proinsulin. An index of insulin secretion was derived as a ratio of incremental insulin to incremental glucose concentrations from 0 to 30 min during an oral glucose tolerance test.

RESULTS
Asian subjects with NGT, despite being significantly thinner than whites (BMI 24.4 ± 3.5 vs. 25.7 ± 3.7 kg/m2, P = 0.04), had a more central distribution of obesity (subscapsular-to-triceps skinfold ratios 1.36 ± 0.69 vs. 1.17 ± 0.41, P = 0.047). Asian subjects with NGT showed significant hyperinsulinemia 2 h after oral glucose load (plasma insulin median 274 pmol/l [range 26–1,505] vs. 186 pmol/l [27–720], P &lt; 0.005) compared with whites. Asian subjects with NGT also had significantly higher insulin increments (P &lt; 0.02) compared with white subjects and significantly higher fasting concentrations of intact proinsulin (median 2.7 pmol/l [range 0.9–14.1] vs. 2.1 [0.8-7.9], P &lt; 0.02) but not of des-31, 32-proinsulin. The ratio of proinsulin-like molecules to the total sum of three insulin-like molecules, however, was similar between Asian and white subjects with NGT and IGT.

CONCLUSIONS
These results indicate that when specific assays for insulin are used, Asian subjects show postglucose load hyperinsulinemia and fasting hyperproinsulinemia compared with white subjects, suggesting increased insulin secretion and/or the presence of underlying insulin resistance in this ethnic group. The contribution of proinsulin-like molecules to total insulin-like molecules was similar between Asian and white subjects with NGT and IGT, and there was no contribution to hyperinsulinemia in Asian subjects.
Islet Cell Antibodies at Diagnosis, But Not Leanness, Relate to a Better Cardiovascular Risk Factor Profile 5 Years After Diagnosis of NIDDM
Authors: Gottsäter Anders , Ahmed Mubarik , Lilja Bo , Fernlund Per , Sundkvist Göran 
Published: March 2007

OBJECTIVE
To evaluate the relationship between islet cell antibodies (ICAs) and the cardiovascular risk profile 5 years after clinical diagnosis of NIDDM.

RESEARCH DESIGN AND METHODS
Five years after clinical diagnosis, we evaluated blood pressure (BP) and lipids in 17 NIDDM patients with ICA at diagnosis (age 60 ± 4 years) and 133 NIDDM patients without ICA at diagnosis (age 61 ± 1 year). Urinary albumin excretion was evaluated in a subset of 12 NIDDM patients with ICA at diagnosis (age 60 ± 4 years) and 82 NIDDM patients without ICA at diagnosis (age 61 ± 1 year).

RESULTS
NIDDM patients without ICA showed higher BP (140/86 ± 2/1 mmHg vs. 128/79 ± 3/2 mmHg; P &lt; 0.05), total cholesterol (6.10 ± 0.11 vs. 5.09 ± 0.29 mmol/l; P &lt; 0.01), LDL-to-HDL ratio (3.85 ± 0.14 vs. 2.49 ± 0.18; P &lt; 0.001), and triglycerides (2.58 ± 0.24 vs. 0.90 ± 0.06 mmol/l; P &lt; 0.001), lower HDL cholesterol (1.08 ± 0.03 vs. 1.40 ± 0.08 mmol/l; P &lt; 0.001), and higher urinary albumin excretion (0.16 ± 0.06 vs. 0.01 ± 0.01 g/24 h; P &lt; 0.05) than NIDDM patients with ICA. Among NIDDM patients without ICA, no differences concerning BP or lipids were found between obese and nonobese patients.

CONCLUSIONS
ICA at diagnosis of NIDDM is a marker of more favorable cardiovascular risk profile 5 years after clinical diagnosis.
A 5-year (1989–1993) Prospective Study of the Incidence of IDDM in Rome and the Lazio Region in the Age-Group 0–14 years
Authors: Sebastiani L , Visalli N , Adorisio E , Suppa M A , Buzzetti R , De Cicco A L , Giovannini C , Comerci M D , Negri M , Pozzilli P 
Published: March 2007

OBJECTIVE
To provide data on the incidence of IDDM in Rome and the Lazio region evaluated prospectively from 1989 to 1993 for a total of &gt; 5 million subjects younger than 15 years.

RESEARCH DESIGN AND METHODS
All patients with newly discovered IDDM diagnosed between 1 January 1989 and 31 December 1993 among residents in Rome and its region were recorded. Primary ascertainment was based in diabetes clinics and specialized hospitals in the region, whereas the secondary independent source was taken from the archives of the region where patients are registered to obtain exemption from paying for medications.

RESULTS
We identified 330 new patients with a degree of ascertainment of 85%. Overall the incidence rate of the disease was 7.9 per 100,000 per year (95% CI 7.1–8.8). The incidence was higher in the 5- to 9-year-old age-group (10.4 per 100,000) and in winter (36.2%). The cumulative risk for the disease is on the order of 1.18 per 1,000 subjects &lt; 15 years of age. No significant differences in incidence were observed between boys and girls. There were 14 instances of coma at diagnosis (4.3%), but hyperglycemia without ketonuria was diagnosed in 35% of patients, suggesting an early diagnosis.

DISCUSSION
Compared with the other continental Italian regions for which data are available for a single year, the IDDM incidence rate in Rome is similar. We conclude that the IDDM incidence rate in Rome and its region is comparable to that in other Southern European countries and remained stable over the 5-year observation period.
An Economic Analysis of Captopril in the Treatment of Diabetic Nephropathy
Authors: Rodby Roger A , Firth Louise M , Lewis Edmund J ,   The Collaborative Study Group
Published: March 2007

OBJECTIVE
The results of a recent clinical trial. The Effect of ACE inhibition on Diabetic Nephropathy, demonstrated that captopril reduced the rate of renal failure, end-stage renal disease (ESRD), and death in patients with IDDM and nephropathy. The purpose of this study was to determine the cost-benefitand cost-effectiveness of captopril as a therapy in patients with IDDM as well as the potential savings for all patients with diabetes and nephropathy.

RESEARCH DESIGN AND METHODS
We used the results from a randomized, placebo-controlled trial comparing captopril (207 patients) with placebo (202 patients), whose purpose was to determine whether captopril has kidney-protecting properties independent of its effect on blood pressure in diabetic nephropathy to develop a model of medical treatment for patients before progression to ESRD. To model the course of illness after progression to ESRD and to extend the model to patients with NIDDM, we used data from the U.S. Renal Data System and published literature. Medical resource cost data were based predominantly upon Medicare reimbursement levels, published wholesale drug prices, and surveying health care providers. The economic model uses a payer perspective to estimate direct cost. The cost to society (indirect cost) associated with lost patient productivity due to ESRD was also estimated. Using this information, we predicted the costs incurred annually and over a lifetime if patients with IDDM and NIDDM and overt nephropathy were treated with either placebo or captopril. We also constructed a model of the overall prevalence of diabetic nephropathy to estimate the aggregate savings in total U.S. health care expenditures.

RESULTS
Treatment with captopril resulted in an absolute direct cost savings or benefit of $32,550 per patient with IDDM over the course of a lifetime compared to treatment with placebo. For patients with NIDDM, the direct cost savings totaled $9,900 per patient. Absolute savings were found for indirect costs as well: $84,390 per patient with IDDM and $45,730 per patient with NIDDM. If captopril therapy were initiated in 1995 for patients with either IDDM or NIDDM and nephropathy, the aggregate health care cost savings (i.e. direct cost savings alone) would be $189 million a year for the year 1999 and $475 million a year in 2004, the present value of cumulative health care cost savings for these 10 years would be $2.4 billion.

CONCLUSIONS
The use of captopril in diabetic nephropathy will provide significant savings in health care costs; in addition, it will result in savings in indirect cost, which reflects the broader societal benefit.
Deranged platelet calcium homeostasis in diabetic patients with end-stage renal failure: A possible link to increased cardiovascular mortality?
Authors: Vicari Aurelio M , Taglietti Maria V , Pellegatta Fabio , Spotti Donatella , Melandri Marco , Galli Laura , Ronchi Paola , Folli Franco 
Published: March 2007

OBJECTIVE
Platelet hyperfunction is a typical feature of the prothrombotic state that frequently complicates the natural history of diabetes. In uremia, a bleeding diathesis is present, which principally involves the primary phase of hemostasis. Thus, in patients with uremia of diabetic origin, the infrequent coexistence of two opposite alterations of hemostasis takes place. In patients with uremia, an increased incidence of cardiovascular events and related mortality is observed. This phenomenon is greatly amplified in uremia of diabetic origin. Calcium homeostasis is a critical aspect of platelet function, which has recently become available in human diseases. The aim of this study was to evaluate calcium homeostasis in platelets from patients with uremia of diabetic and nondiabetic origin.

RESEARCH DESIGN AND METHODS
We evaluated, by means of Fura 2, the intracellular concentration of ionized calcium ([Ca2+]i) in platelets from 18 patients with uremia of diabetic origin, 12 patients with uremia of nondiabetic origin and 16 healthy control subjects [Ca2+]i was evaluated in resting conditions and after stimulation with 0.05, 0.1, 0.5 U/ml thrombin.

RESULTS
Platelets from uremic patients with diabetes had higher resting [Ca2+]i than both control subjects (P = 0.01) and uremic patients without diabetes (P = 0.001). Similarly, after stimulation with thrombin, the absolute increase of [Ca2+]i was higher (P &lt; 0.05) in platelets from uremic patients with diabetes compared with both control subjects and uremic patients without diabetes. The relative increase of [Ca2+]i was higher (P &lt; 0.05) than normal in platelets from uremic patients after weak or intermediate strength thrombin. No correlation were present between [Ca2+]i values and other clinical and laboratory variables potentially associated with platelet hyperfunction.

CONCLUSIONS
Diabetes and uremia in combination further deteriorate the abnormal platelet calcium homeostasis observed in uremia.