bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Neuropathy in IDDM Patients in Piemonte, Italy
Authors: Veglio Massimo , Sivieri Roberto ,   The Neuropathy Study Group of the Italian Society for the Study of Diabetes, Piemonte Affiliate
Published: March 2007

OBJECTIVE
In view of the scarce data available in Italy, to assess the prevalence of neuropathy in various subgroups of IDDM patients living in the Piemonte region of Italy and to develop, based on existing guidelines, and test the practicality of a standardized assessment of diabetic neuropathy.

RESEARCH DESIGN AND METHODS
All IDDM patients (766) attending 23 outpatient clinics, evenly distributed in the region, were stratified into 3 age-groups (15–29, 30–44, and 45–59 yr) and into 3 groups of diabetes duration (1–7, 8–14, and ≥ 15 yr). A random sample of 467 patients was selected; 81% of whom participated in the studies (196 men and 183 women). The following data were collected: personal and clinical data, structured questionnaire (SQ), neurological examination (NE), vibration sensation (tuning fork) (VS), and two cardiovascular tests (CTs). Patients were classified as follows: stage 0, (no neuropathy) &lt;2 abnormalities among SQ, NE, VS, and CT; stage 1, (asymptomatic neuropathy) &gt; 1 abnormality among NE, VS, and CT; stage 2, (symptomatic neuropathy) abnormalities in SQ and in NE, and/or VS, and/or CT.

RESULTS
The prevalence rates were as follows: stage 0 = 71.5%, stage 1 = 7.2%, and stage 2 = 21.3% and all had a 95% CI. No difference was found between men and women. The prevalence of neuropathy (stages 1 and 2) was higher (P &lt; 0.01) in groups of longer diabetes duration or older age.

CONCLUSIONS
Polyneuropathy is a frequent complication in a north Italian IDDM population. Our results suggest that IDDM patients &gt; 30 yr of age, with diabetes of &gt; 15 yr duration, and who complain of symptoms suggestive of neuropathy, should be promptly assessed for the presence of diabetic polyneuropathy.
Glucose Tolerance During and After Pregnancy in Nondiabetic Women in an Urban Population in Tanzania
Authors: Lutale Janet K , Justesen Aafke , Swai Andrew B M , Alberti K George M M , McLarty Donald F 
Published: March 2007

OBJECTIVE
It is generally accepted that glucose tolerance deteriorates during pregnancy in the developed world. Several small studies have suggested that this may not be the case in sub-Saharan Africa. This study was designed to investigate changes in glucose tolerance in nondiabetic African women during pregnancy in Dar es Salaam, Tanzania.

RESEARCH DESIGN AND METHODS
Women (n = 89) seen before the 14th wk of pregnancy without known diabetes were recruited: 58 had a 75-g OGTT in the 1st, 2nd, and 3rd trimesters and postpartum.

RESULTS
Mean FBG levels were 3.9, 3.5, 3.6, and 3.7 mM in the 1st, 2nd, and 3rd trimesters and postpartum period, respectively. Values were significantly lower in the 2nd and 3rd trimesters than in the 1st and 2nd trimesters compared with postpartum. Mean 2-h blood glucoses were 4.7, 4.4, 4.3, and 4.2 mM, respectively. The 1st trimester value was significantly higher than in the 3rd trimester and postpartum. Fifteen (26%) of the 58 women showed a decreased or unchanged 2-h blood glucose during the course of pregnancy, 5 (9%) showed an increase, and no clear pattern was seen in 38 (67%). Values for fasting glucose showed similar trends.

CONCLUSIONS
We conclude that women during pregnancy in an urban African setting show little change in glucose tolerance. This contrasts with women in both the developed world, where glucose tolerance worsens, and in a rural African environment, where glucose tends to improve.
Comparison of Six Commercial Techniques in the Measurement of Microalbuminuria in Diabetic Patients
Authors: Tiu Sau Cheung , Lee Shui Shan , Cheng Mei Wan 
Published: March 2007

OBJECTIVE
To evaluate the advantages and drawbacks of six commercially available techniques in the measurement of microalbuminuria in diabetic patients.

RESEARCH DESIGN AND METHODS
Timed overnight urine samples from 75 patients in our diabetic clinic were tested with 2 qualitative tests (Micral-Test and Microbumintest) and assayed with 4 quantitative tests, which used different methodologies: double-antibody RIA, RID, IT, and NEPH. All tests were commercially available. The double-antibody RIA was taken as the golden standard. All urine samples were either negative or trace by Albustix (Ames, Elkhart, IN). Interobserver variation for the 2 qualitative tests was assessed by asking 12 experienced nurses to read the color changes on the dipsticks and the tablets simultaneously, using test solutions with albumin concentrations of 16, 32, and 64 mg/L.

RESULTS
The 75 urine samples contained 0–154.2 mg/L of albumin. Correlation coefficients of RID, NEPH, and IT with RIA were 0.970, 0.975, and 0.974, respectively. Intra-assay and interassay CVs ranged from 1.36–11.5%. Microbumintest had a higher sensitivity (100 vs. 75%), but lower specificity (82.5 vs. 87.3%) than Micral-Test. Considerable interobserver variation existed in the matching of colors for both tests. Discrepancies were especially significant with Microbumintest, with 8 of 12 nurses misreading the 32 mg/L level.

CONCLUSIONS
Correlations of the 3 quantitative methods with RIA were all &gt;0.970. Choice of test may depend more on considerations such as time, space, number of specimens to be handled, and availability of instruments. Both qualitative tests showed a relatively low specificity. Positive tests must be confirmed with quantitative assays before microalbuminuria is diagnosed. Microbumintest had a higher sensitivity, but its unacceptably high interobserver variation and lower specificity were serious drawbacks.
Maternal Age and Birth Order of Young IDDM Patients: A study from southern India
Authors: Ramachandran Ambady , Snehalatha Chamukuttan , Joseph Annie , Viswanathan Vijay , Viswanathan Moopil 
Published: March 2007

OBJECTIVE
To assess the effects of maternal age and birth order on the risk of IDDM in Asian Indians.

RESEARCH DESIGN AND METHODS
Data from a diabetes registry in Madras, India, was used to find IDDM patients diagnosed before 20 yr of age. A questionnaire was used to elicit clinical details of subjects.

RESULTS
Children with mothers ≤24 yr of age had a higher percentage of IDDM. Children with lower birth orders had a higher prevalence of IDDM.

CONCLUSIONS
The risk of IDDM in children is increased in children with lower birth orders, born of younger mothers.
Cardiovascular Reflex Abnormalities in Children and Adolescents With Diabetes Mellitus
Authors: Ringel Richard E , Chalew Stuart A , Armour Karen A , McLughun Judith , McCarter Robert J , Kramer Wendy E 
Published: March 2007

OBJECTIVE
To assess the usefulness of specific cardiovascular reflex tests in childhood and to estimate the prevalence of cardiovascular reflex abnormalities among children with IDDM. In adults, abnormal cardiovascular reflexes are a frequent complication of diabetes, associated with increased morbidity and mortality.

RESEARCH DESIGN AND METHODS
We measured heart-rate responses to deep breathing and standing in ambulatory children with and without IDDM between 6–19 yr of age. A subgroup of the IDDM patients was retested after 1 yr.

RESULTS
We found the best techniques for detecting cardiovascular reflex abnormality in children were as follows: to record heart-rate responses to deep breathing either as the change inheart rate corrected for inspiratory heart rate or as the ratio of R-R intervals during expiration and inspiration; and to use the Maximum-minimum ratio for heart-rate responses to standing. HR-DBC was lower in diabetic than nondiabetic children (28.6 ± 9.2% [n = 248] vs. 33.6 ± 6.8% [n = 60]; P &lt; 0.0005). Similarly, E:I was lower in children with IDDM than control subjects (1.42 ± 0.19 [n = 248] vs. 1.52 ± 0.15 [n = 60]; P &lt; 0.0005). In the IDDM group, 21% of the children had abnormal HR-DBc or E:I responses. HR-STND M/m was lower in children with IDDM than control subjects (1.28 ± 0.20 [n = 167] vs. 1.38 ± 0.22 [n = 45]; P &lt; 0.014). Among children with IDDM, 11.4% had abnormal HR-STND M/m responses. Overall, 29% of IDDM children tested abnormal in either HR-DBC or HR-STND M/m; 3% were abnormal in both tests. We found no correlation of HbA1c levels (n = 74) or duration of diabetes with either HR-DB, expiration to inspiration (n = 248), or HR-STND M/m (n = 167). In patients who were reevaluated after 1 yr we found a high correlation of the first and repeat HR-DBC tests (r = 0.47, n = 75, P &lt; 0.0001), E:I (r = 0.53, n = 75, P &lt; 0.0001), and HR-STND M/m (r = .49, n = 37, P &lt; 0.002), but no evidence of an increased number of children with cardiovascular reflex abnormality.

CONCLUSIONS
With easily performed HR-DB and HR-STND tests, we detected cardiovascular reflex abnormality in 29% of children with IDDM. We found no correlation of changes in HR-DB and HR-STND with HbA1c or duration of diabetes. These tests provide an objective clinical measurement to monitor autonomic neuropathy in children with diabetes.
Serum Lipoprotein(a) in Patients With Diabetes Mellitus
Authors: Heller Francis R , Jamart Jacques , Honore Patrick , Derue Geneviève , Novik Vicky , Galanti Laurence , Parfonry Alex , Hondekijn Jean-Claude , Buysschaert Martin 
Published: March 2007

OBJECTIVE
To investigate subjects with different types of diabetes mellitus regarding their serum levels of lipoprotein(a). High serum Lp(a) concentration is associated with a high risk of coronary heart disease. Diabetic patients are prone to developing coronary heart disease.

RESEARCH DESIGN AND METHODS
The subjects were 66 type I diabetic patients, 100 type II diabetic patients treated with diet alone or diet combined with oral hypoglycemic agents, and 46 insulin-requiring type II diabetic patients. Subjects were compared with 142 nondiabetic outpatients.

RESULTS
Subjects with insulin-requiring type II diabetes mellitus were found to have an increase both in serum Lp(a) concentration and in prevalence of serum Lp(a) concentration &gt;30 mg/dl compared with the other groups of diabetic patients and nondiabetic control subjects. A nonsignificant increase in the prevalence of coronary heart disease was also found in insulin-requiring type II diabetic patients. The levels of serum concentrations of Lp(a) were not significantly related to the degree of glycemic control, duration of diabetes, presence of macrovascular disease, or intake of female hormone therapy. High levels of Lp(a) in this group of diabetic patients could not be explained by the presence of albuminuria.

CONCLUSIONS
Insulin-requiring type II diabetic patients have high levels of Lp(a). Chronic hyperinsulinemia might be an eventual causal factor.
Association of Lipoprotein(a) With Puberty in IDDM
Authors: Couper Jennifer J , Bates David J , Cocciolone Robert , Magarey Anthea M , Boulton T John C , Penfold James L , Ryall Richard G 
Published: March 2007

OBJECTIVE— To determine serum lipoprotein(a) in a large sample of IDDM and control children and to examine a possible association with puberty.
RESEARCH DESIGN AND METHODS—Serum lipoprotein(a), apoB-100, and apoA-I were measured under identical conditions in 170 Caucasian children with IDDM aged 12.3 ± 3.59 yr and 233 Caucasian control children aged 13.6 ± 1.12 yr. Patients with persistent microalbuminuria were excluded. Lipoprotein(a), apoB-100, and apoA-I were measured by nephelometry using a specific monoclonal antibody. Pubertal assessment was performed using Tanner staging and testicular volume measurement.
RESULTS— Lipoprotein(a) was higher in the IDDM than control group (geometric mean 237 mg/L, 25–75th percentile 134–465 vs. 172 [99–316] mg/L, P = 0.0008). When analyzed according to pubertal stage, only pubertal and postpubertal patients had higher levels than control subjects (265 [148–560] vs. 174 [101–320] mg/L, P = 0.0001), with prepubertal patients showing no difference. Pubertal and postpubertal patients showed both higher lipoprotein(a) (P = 0.01) levels and higher albumin excretion rates (P = 0.02) than prepubertal patients, correcting for the other variable. Lipoprotein(a) was not related to HbA1c, albumin excretion rate, duration, age, sex, mean arterial pressure, or a family history of premature coronary artery disease in the IDDM group. Lipoprotein(a) was not higher in patients with overnight albumin excretion rate above the 95th percentile but below the microalbuminuric range. ApoB-100 did not differ between IDDM and control children. ApoA-I was significantly lower in the IDDM group (1.04 [0.94–1.17] vs. 1.21 [1.10–1.31] g/L; P &lt; 0.0001).
CONCLUSIONS— Pubertal and postpubertal IDDM patients have higher serum lipoprotein(a) than Caucasian control subjects. Our findings suggest a rise in lipoprotein(a) may occur during puberty in IDDM. Longitudinal studies are required to clarify the relationship between lipoprotein(a), albumin excretion rate, and puberty.
Obesity, Diabetes, and Hyperlipidemia in a Central Australian Aboriginal Community With a Long History of Acculturation
Authors: O'Dea Kerin , Patel Mahomed , Kubisch Doris , Hopper John , Traianedes Kathy 
Published: March 2007

Objective— To determine the age- and sex-specific prevalence of diabetes and to examine associations between related anthropometric and metabolic abnormalities in an Aboriginal community in central Australia with a long history of acculturation.
Research Design and Methods— We used a cross-sectional survey of 353 adults &gt; 15 yr of age (87% response rate) and measured the following parameters: weight, height, circumferences of waist and hips; glucose, insulin, cholesterol, triglyceride, and high-density lipoprotein cholesterol in fasting plasma; and plasma glucose and insulin 2 h after 75 g oral glucose.
Results— The prevalence of diabetes was 29.6% in survey participants &gt; 35 yr of age and 5.3% in those &lt; 35 yr of age. Impaired glucose tolerance also occurred with higher frequency in those &gt; 35 yr of age (14.8 vs. 4.7%). Of those &gt; 35 yr of age, 75% of the women and 51% of the men were overweight or obese, with a body mass index ≥ 25 kg/m2. A large insulin response to oral glucose was evident, with the upper tertile of the 2-h insulin response six times higher than the lower tertile (113 ± 43 vs. 19 ± 8 mU/L). Hyperinsulinemia showed a strong, positive association with impaired glucose tolerance, body mass index, waist-to-hip ratio, cholesterol, and triglyceride levels and a negative association with high-density lipoprotein cholesterol levels. Cholesterol levels were on average 0.5 mM higher in men than in women. Deteriorations in carbohydrate and lipid metabolism occurred before 40 yr of age: diabetes, body mass index, waist-to-hip ratio, and fasting triglycerides and cholesterol concentrations peaked and high-density lipoprotein cholesterol concentrations reached their nadir at the end of the fourth decade.
Conclusions— These data suggest that any intervention programs developed to prevent or reduce diabetes prevalence in this population should be targeted at adolescents and young adults.
Effective Treatment of Insulin-Induced Edema Using Ephedrine
Authors: Hopkins David F C , Cotton Stephen J , Williams Gareth 
Published: March 2007

Objective— To control insulin-induced edema in a patient with poorly controlled IDDM.
Research Design and Methods— A 31-yr-old woman with a 14-yr history of poorly controlled IDDM first developed peripheral edema 3 yr after diagnosis of IDDM; the edema worsened whenever insulin dosage was increased. In August 1991, severe edema developed after treatment of ketoacidosis, with body weight increasing from 46 to 61 kg. No evidence of cardiac dysfunction or autonomic neuropathy existed, and serum albumin was consistently normal.
Results— Treatment with 15 mg of ephedrine every 8 h produced a prompt diuresis, with body weight falling by 4 kg in 48 h and by 12 kg within 1 wk.
Conclusions— Ephedrine may be an effective treatment for insulin-induced edema and may be preferable to the use of diuretics in such patients.
Renal Effects of Different Types of Protein in Healthy Volunteer Subjects and Diabetic Patients
Authors: Nakamura Hiroshi , Ito Seiki , Ebe Naoko , Shibata Akira 
Published: March 2007

OBJECTIVE
To evaluate the effects of acute loading of protein from different sources on the glomerular filtration rate.

RESEARCH DESIGN AND METHODS
A total of 6 healthy volunteer subjects and 6 diabetic patients with normoalbuminuria were studied before and after ingestion on separate days of tuna fish containing 0.7 g/kg body wt of protein, boiled egg white containing the same amount of protein as the tuna fish, or boiled egg white containing 1.4 g/kg body wt of protein. Furthermore, to study the possible role of prostaglandins and amino acids in the response of GFR to protein loading, urinary excretion of prostaglandins, and plasma levels of amino acids were measured during these tests.

RESULTS
In normal subjects, the GFR rose significantly (P &lt; 0.01) after ingestion of tuna fish. No significant differences were found between GFR before and after ingestion of the different amounts of egg white. The GFRs of the diabetic patients after ingestion of each of the meals were similar to the responses in healthy volunteers. Plasma levels of Gly and Ala (amino acids known to induce glomerular hyperfiltration) were higher after ingestion of tuna fish than after administration of egg white in all subjects. No differences were found in the plasma concentrations of any amino acids except Gly and Ala after loads of tuna fish and egg white containing 1.4 g/kg of protein. Urinary 6-keto-PGF1a excretion increased significantly (P &lt; 0.01) after tuna fish loading, but did not change after egg white challenge.

CONCLUSIONS
These findings could be explained either by differences in renal vasodilatory prostaglandin secretion or by increased plasma levels of Gly and Ala, which were increased only after ingestion of tuna fish. Thus, egg white has renal effects on GFR different from those of tuna fish, independent of the quantity of protein ingested.
Self-Monitoring of Blood Glucose by Adults With Diabetes in the United States Population
Authors: Harris Maureen I , Cowie Catherine C , Howie L Jean 
Published: March 2007

OBJECTIVE
To evaluate self-monitoring of blood glucose, which is considered an important practice for patients with diabetes. However, little is known about the frequency or determinants of this technique.

RESEARCH DESIGN AND METHODS
A detailed questionnaire on diabetes was administered to a representative sample of 2405 diabetic subjects ≥ 18 yr of age in the U.S. population in the 1989 National Health Interview Survey.

RESULTS
Among subjects with IDDM, 40% monitored their blood glucose at least 1 time/day. Among subjects with NIDDM treated with insulin, 26% monitored at least 1 time/day and among NIDDM subjects not treated with insulin, the percentage was 5%. When stratified by age, little difference was observed between IDDM subjects and insulin-treated NIDDM subjects in the percentage testing at least 1 time/day. By multivariate analysis, age and insulin use were the major determinants of whether diabetic subjects tested their blood glucose. Race and education were also independently related to self-monitoring of blood glucose. Blacks were 60% less likely to test their blood glucose at least 1 time/day compared with non-Hispanic whites and Mexican Americans. Those with college education were 80% more likely to test their blood glucose compared with those with lower education levels. Having had a patient education class in diabetes management and frequent physician visits for diabetes care were positively related to self-testing. Self-monitoring was not related to higher income or having health insurance.

CONCLUSIONS
A large proportion of patients with diabetes do not test their blood glucose. Financial barriers associated with income and health insurance do not appear to impede the practice of self-monitoring. Because of the importance of blood glucose control in the prevention of diabetes complications and the role of self-monitoring in achieving blood glucose control, it may be prudent for physicians and their patients to make greater use of this technique. Special attention should be directed to the subgroups of patients (blacks, patients not treated with insulin, those with less education, and those with no education in diabetes) in which the frequency of self-monitoring is particularly low.
Alanine and Terbutaline in Treatment of Hypoglycemia in IDDM
Authors: Wiethop Brian V , Cryer Philip E 
Published: March 2007

OBJECTIVE
To test the hypothesis that, in contrast to administration of glucose or glucagon, administration of the amino acid Ala or of the beta 2-adrenergic agonist terbutaline produces sustained glucose recovery from hypoglycemia.

RESEARCH DESIGN AND METHODS
We developed a model of clinical hypoglycemia using subcutaneous injection of insulin (0.15 U/kg) in patients with IDDM. In comparison with nondiabetic subjects, patients with IDDM exhibited reduced glucagon (P = 0.0001), epinephrine (P = 0.0060), and pancreatic polypeptide (P = 0.0001) responses to hypoglycemia. In addition to placebos, the following were administered during hypoglycemia (2 h after insulin injection) in IDDM patients: oral glucose, 10 and 20 g; subcutaneous glucagon, 1.0 mg; oral Ala, 40 g; oral terbutaline, 5.0 mg; and subcutaneous terbutaline, 0.25 mg.

RESULTS
Glucose (10 and 20 g) and glucagon raised plasma glucose (P = 0.0163, 0.0060, and 0.0001, respectively) from 3.0–3.3 mM to peaks of 5.4 ± 0.4, 6.8 ± 0.7, and 11.8 ± 0.8 mM within 30, 45, and 60 min, respectively, but the responses were transient. Oral Ala raised glucose levels (P = 0.0401) to 4.0 ± 0.4 mM within 30 min; glucose levels then rose gradually to a 6-h value of only 7.1 ± 0.9 mM. Oral terbutaline raised glucose levels (P = 0.0294) to 4.3 ± 0.3 mM within 30 min; glucose levels then rose substantially. In contrast, subcutaneous terbutaline raised glucose levels (P = 0.0249) to 3.7 ± 0.1 mM within 15 min; the levels plateaued at 5.0 mM from ∼60–150 min and then paralleled the placebo curve.

CONCLUSIONS
Ala and terbutaline produce sustained glucose recovery from hypoglycemia in IDDM and are therefore potentially useful agents for the treatment of mild or moderate iatrogenic hypoglycemia, or the prevention of iatrogenic hypoglycemia, when food intake is not anticipated over the following several hours.
Diabetes in Pregnancy in Zuni Indian Women: Prevalence and subsequent development of clinical diabetes after gestational diabetes
Authors: Benjamin Evan , Winters Diane , Mayfield Jennifer , Gohdes Dorothy 
Published: March 2007

Objective— To determine the prevalence of gestational diabetes mellitus in Zuni Indian women and the subsequent rate of diabetes among Zuni women with GDM.
Research Design and Methods— A retrospective analysis of 809 deliveries over a 4-yr period among Zuni Indian women was conducted to determine the prevalence of GDM and diabetes antedating pregnancy. A prospective case-control study of 47 full-blooded Zuni Indian women with GDM and 47 control subjects was performed to determine the progression to clinical diabetes in women with a first-time diagnosis of GDM. Cases with GDM delivered during a defined 8-yr period. The control group of Zuni women delivered during the same time period but had plasma glucose values &lt;7.8 mM on the 1-h glucose screening test. Cases with GDM and control subjects were matched for age, body mass index, gravidity, and length of follow-up. All women were re-evaluated for diabetes up to 9 yr after the index pregnancy.
Results— Between 1987–1990, 116 cases of GDM and 8 cases of pre-existing diabetes were identified, giving a prevalence of maternal diabetes in pregnancy of 15.3%. At the time of follow-up, 14 of 47 (30%) women with GDM had developed diabetes after a mean of 4.8 yr compared with only 3 of 47 (6%) from the control group with an average of 5.5 yr follow-up.
Conclusions— GDM is prevalent among Zuni Indians and is associated with an increased risk of diabetes. Glucose tolerance after GDM may deteriorate at a greater rate in Native Americans than in other populations.