bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes Complications in NIDDM Kindreds Linked to the MODY3 Locus on Chromosome 12q
Authors: Velho Gilberto , Vaxillaire Martine , Boccio Valérie , Charpentier Guillaume , Froguel Philippe 
Published: March 2007

OBJECTIVE
To assess the prevalence of diabetes complications and the severity of diabetes in kindreds with NIDDM linked to the MODY3 locus (chromosome 12q) and to compare these parameters with data obtained in glucokinase (GCK)-deficient and other-MODY (unlinked to any of the three known loci) families, as well as with data from families with a late age of onset of NIDDM.

RESEARCH DESIGN AND METHODS
Clinical and biological data were obtained from 667 affected members of 7 MODY3, 25 GCK-deficient, 6 other-MODY, and 81 NIDDM families. Severity of diabetes (glucose tolerance status and insulin secretion) was assessed by an oral glucose tolerance test. Neurological examination and eye fundus examination were performed in 349 and 251 subjects, respectively, and proteinuria was tested with strips in 282 family members.

RESULTS
A higher prevalence of proliferative retinopathy was observed in MODY3 (21%) and NIDDM subjects (23%) than in GCK-deficient (3%) and other-MODY subjects (8%; P = 0.004). Proteinuria was detected in 19, 7, 5, and 0% (P = 0.07) of subjects, respectively. Prevalence of neuropathy was higher in NIDDM (17%; P = 0.005) than in MODY3 (4%), GCK-deficient (5%) and other-MODY (0%) subjects. MODY3 and NIDDM subjects had significantly higher fasting glucose levels than subjects in the other groups. Glucose levels after 2 h were significantly higher, and the ratios of insulin to glucose levels were significantly lower in MODY3 subjects than in the other three groups.

CONCLUSIONS
The MODY3 subtype of NIDDM is characterized by a severe insulin secretory defect and by major hyperglycemia that progresses rapidly to overt diabetes. Microvascular complications of diabetes were frequently observed in the MODY3 subjects and the subjects with a late age of onset of NIDDM in this cohort. Both the duration and the severity of diabetes were independently associated with these complications.
Metformin Improves Hemodynamic and Rheological Responses to L-Arginine in NIDDM Patients
Authors: Marfella Raffaele , Acampora Rita , Verrazzo Giovanni , Ziccardi Patrizia , Rosa Nicoletta De , Giunta Riccardo , Giugliano Dario 
Published: March 2007

OBJECTIVE
The endothelium plays a pivotal role in the regulation of vascular tone by releasing nitric oxide (NO). Increased availability of L-arginine, the natural precursor of NO, induces vasodilatation and inhibits platelet activity. We studied the effect of metformin on hemodynamic and rheological responses to L-arginine in patients with NIDDM.

RESEARCH DESIGN AND METHODS
Ten newly diagnosed NIDDM patients with mild fasting hyperglycemia (7.5 ± 0.3 mmol/l) and without evidence of both micro- and macrovascular complications were investigated. They received an intravenous infusion of L-arginine (1 g/min for 30 min) with evaluation of plasma glucose and insulin, systolic (sBP) and diastolic (dBP) blood pressure, heart rate and plasma catecholamines, platelet aggregation, and blood viscosity and filterability. The L-arginine test was repeated after an 8-week treatment with metformin (850 mg b.i.d.).

RESULTS
Metformin treatment significantly reduced basal fasting plasma glucose, HbA1c, and platelet aggregation to ADP (P &lt; 0.05); the other parameters did not change. During pretreatment test, L-arginine infusion decreased sBP (from 137 ± 4.1 to 129 ± 4.5 mmHg, P &lt; 0.01) and dBP (from 79 ± 1.9 to 75 ± 1.2 mmHg, P &lt; 0.01) without affecting heart rate or plasma catecholamines. Both platelet aggregation and blood viscosity showed significant decrements after L-arginine, while blood filterability did not change. After metformin treatment, the decrease in blood pressure after L-arginine infusion was significantly enhanced, with a maximal decrease of sBP of 12 ± 3.4 mmHg (8 ± 2.5 mmHg pretreatment, P &lt; 0.05) and dBP of 9.5 ± 2.4 mmHg (4.5 ± 1.9 mmHg pretreatment, P &lt; 0.01). Heart rate, plasma norepinephrine levels, and blood filterability also rose significantly (P &lt; 0.05–0.01). The decrease in both platelet aggregation and blood viscosity after L-arginine was significantly amplified after metformin.

CONCLUSIONS
We conclude that L-arginine infusion in newly diagnosed NIDDM patients without vascular complications produces relevant hemodynamic and theological changes, which are amplified by an 8-week treatment with metformin. Whether these vascular effects of metformin will improve the poor cardiovascular outlook of the diabetic patient is still unknown.
Seven-Year Changes in Body Fat and Visceral Adipose Tissue in Women. Association with indexes of plasma glucose-insulin homeostasis
Authors: Lemieux Simone , Prud'homme Denis , Nadeau André , Tremblay Angelo , Bouchard Claude , Després Jean Pierre 
Published: March 2007

OBJECTIVE
To study the associations between changes in body fatness, visceral adipose tissue (AT), and indexes of plasma glucose-insulin homeostasis over a 7-year follow-up period.

RESEARCH DESIGN AND METHODS
A sample of 30 nondiabetic women aged 35.2 ± 5.6 (SD) years at baseline was studied.

RESULTS
Changes in visceral AT and in subcutaneous AT (measured by computed tomography) as well as changes in body fat mass (obtained by hydrostatic weighting) were significantly related to changes in fasting plasma insulin levels and in plasma insulin area measured after a 75-g oral glucose load (0.47 ≤ r ≤ 0.62; P &lt; 0.01). Changes in visceral AT but not in body fat mass or in subcutaneous AT area were significantly associated with changes in plasma glucose area (r = 0.37; P &lt; 0.05). When two subgroups of women with similar mean increases in body fat mass but with either small or large increases in visceral AT were compared, the subgroup with the largest gain in visceral AT showed the greatest deterioration in indexes of plasma glucose-insulin homeostasis. On the other hand, when two subgroups with similar mean increases in visceral AT but with different changes in body fat mass were compared, both subgroups showed similar changes in plasma glucose and insulin concentrations.

CONCLUSIONS
Results of this 7-year follow-up study in women suggest that changes in indexes of plasma glucose-insulin homeostasis are significantly associated with changes in visceral AT, even after control for changes in body fat mass.
Drug Use in Patients With Diabetes
Authors: Wändell Per E , Brorsson Bengt , Åberg Hans 
Published: March 2007

OBJECTIVE
To describe the use of pharmaceutical medications by patients with diabetes in Sweden.

RESEARCH DESIGN AND METHODS
We analyzed the computerized Surveys of Living Conditions (SLC), performed regularly in Sweden, for the years 1988 and 1989, among individuals aged 16–84 years. Drug use (during a 2-week period) and the use of health services (during a 3-month period) were registered for subjects with diabetes (n = 361) and compared with age- and gender-standardized figures (using the diabetes group as the standard) in subjects with hypertension but without diabetes (n = 980), in subjects with a musculoskeletal condition but without diabetes (n = 2,187), in healthy subjects free from any medical condition (n = 6,664), and in the general population sample (n = 12,717).

RESULTS
The reported use of medication was higher for subjects with diabetes compared with the general population regarding overall use (92.5 vs. 71.9%; P &lt; 0.001), the use of cardiovascular drugs (52.2 vs. 36.3%; P &lt; 0.001), all use of analgesics (43.8 vs. 36.5%; P &lt; 0.05), and use of psychoactive drugs (23.5 vs. 15.3%; P &lt; 0.01). Compared with the hypertension group, the use was lower regarding cardiovascular drugs (52.2 vs. 93.3%; P &lt; 0.001), and compared with the musculoskeletal group, the use was lower regarding all use of analgesics (43.8 vs. 56.5%; P &lt; 0.01) and the use of herbal products (6.8 vs. 11.8%; P &lt; 0.05), but was higher regarding cardiovascular drugs (52.2 vs. 37.8%; P &lt; 0.001). The use was higher compared with the healthy individuals, regarding all groups of drugs with the exception of vitamins and herbal products.

CONCLUSIONS
Diabetic subjects have a higher overall use of drugs compared with the general population. Compared with other chronic illnesses, the differences are small except for disease-specific drugs (cardiovascular drugs in the hypertension group and analgesics in the musculoskeletal group). The main difference concerns the comparison with healthy subjects who had a markedly higher drug rate among diabetic subjects, thus signifying a greater impact on health.
Glycated Hemoglobin and Related Factors in Diabetic Children and Adolescents Under 18 Years of Age: a Belgian Experience
Authors: Dorchy Harry , Roggemans Marie-Paule , Willems Dominique 
Published: March 2007

OBJECTIVE
To determine, in an unselected population of diabetic children and adolescents &lt; 18 years of age, which HbA1c levels can be achieved, and to examine the relationships with insulin regimen, insulin dose, sex, diabetes duration, BM1, and frequency of home blood glucose monitoring (HBGM) and outpatient clinic attendance.

RESEARCH DESIGN AND METHODS
A total of 144 unselected subjects (73 boys and 71 girls) aged 11.8 ± 3.7 years (mean ± SD) were included in the study over a 6-month period. They had diabetes durations ranging from 5 months to 15 years (4.0 ± 3.0). They were followed by the same pediatric diabetologist and the same nurse. The yearly frequency of visits was 8.9 ± 2.0, and the monthly frequency of HBGM was 111 ± 27. Of the patients, 129 were treated with two daily insulin injections of an individualized mixture of rapid- and intermediate-acting insulins, and 15 adolescents were treated with four injections using the basal-bolus regimen. The patients were divided into two subgroups according to diabetes duration: ≤ 2 years (n = 53) and &gt; 2 years (n = 91), i.e., outside the honeymoon period. HbA1c was measured by a high-pressure liquid chromatography method (normal values 3.9–5.5%).

RESULTS
The mean ± SD HbA1c level in the 144 children and adolescents was 6.6 ± 1.2% using our method. In 62% of the patients, it was possible to obtain an HbA1c level under the normal mean value plus 5 SD. HbA1c was not related to sex, number of insulin injections, or age, i.e., it was not poorer at adolescence. The mean daily insulin dose was 0.9 U/kg body wt, being lower during the first 2 years of diabetes and reaching 1 U at adolescence. HbA1c levels were lower during the first 2 years of diabetes (6.2 ± 1.0%) than afterwards (6.9 ± 1.2%), but the frequencies of outpatient visits and HBGM were higher. After 2 years, HbA1c was negatively correlated with the frequency of HBGM. The yearly incidence rate of severe hypoglycemic episodes was 0.2. After the age of 13 years, BM1 was significantly higher in girls and in adolescents on four daily injections.

CONCLUSIONS
In nearly two-thirds of diabetic children and adolescents, it is possible to obtain HbA1c levels under the normal mean plus 5 SD, which is considered satisfactory and close to that of the adult cohort of the Diabetes Control and Complications Trial (DCCT) with intensive treatment. There is no difference between the children on only two daily insulin injections and the adolescents on four injections. After 2 years of diabetes, increased frequency of HBGM helps reduce HbA1c levels, taking into account the “intensive” education of the patients and their families. Adolescent girls on four injections must pay attention to the risk of becoming overweight.
Severe Antibody-Mediated Human Insulin Resistance: Successful Treatment With the Insulin Analog Lispro: A case report
Authors: Lahtela Jorma T , Knip Mikael , Paul Robert , Antonen Jaakko , Salmi Jorma 
Published: March 2007

OBJECTIVE
To evaluate the efficacy of the insulin analog lispro (Lys B28, Pro B29) in severe insulin resistance caused by human insulin antibodies.

CASE:
A 27-year-old man with a history of diabetes treated with human insulin for 3 years developed severe immunological insulin resistance caused by human insulin antibodies. Throughout follow-up (12 months) the insulin analog lispro was administered with an infusion pump as the only insulin therapy. The insulin dose decreased from an average of 300 U/day to 58 U/day, HbA1c decreased from 12.6 to 7.4%, and human insulin antibodies decreased from 8,057 to 1,860 nU/ml. Hypoglycemic episodes during early morning disappeared.

CONCLUSIONS
The insulin analog lispro might be suitable for the treatment of diabetic patients with substantially increased insulin antibody levels Apparently, the structural difference between the lispro and human insulin molecules prevented lispro from binding to the human insulin antibodies in this patient and consequently was nonimmunogenic.
A Randomized Controlled Trial of Weight Reduction and Exercise for Diabetes Management in Older African-American Subjects
Authors: Agurs-Collins Tanya D , Kumanyika Shiriki K , Have Thomas R Ten , Adams-Campbell Lucile L 
Published: March 2007

OBJECTIVE
To evaluate a weight loss and exercise program designed to improve diabetes management in older African-Americans.

RESEARCH DESIGN AND METHODS
Overweight African-Americans (n = 64) ages 55–79 years with NIDDM were randomized to either an intervention (12 weekly group sessions, 1 individual session, and 6 biweekly group sessions) or usual care (1 class and 2 informational mailings). Clinical and behavioral variables were assessed at 0, 3, and 6 months of treatment.

RESULTS
Significant net differences in the intervention versus usual care were observed for weight (−2.0 kg, P = 0.006), physical activity, and dietary intake of fat, saturated fat, cholesterol, and nutrition knowledge at 3 months (all P &lt; 0.05) and for weight at 6 months (−2.4 kg; P = 0.006) and mean HbA1c values at 3 and 6 months (respectively, −1.6 and −2.4%, both P &lt; 0.01). After the adjustment for changes in weight and activity, the intervention participants were ∼ twice as likely to have a one unit decrease in HbA1c value as those in usual care. Blood pressure increase sin usual care participants resulted in net differences (intervention minus control) at 3 and 6 months of −3.3 (P = 0.09) and −4.0 (P = 0.05) mmHg diastolic, respectively, and −8.4 (P = 0.06) and −5.9 (P &gt; 0.10) mmHg systolic, respectively. Blood lipid profiles improved more in intervention than usual care participants, but not significantly.

CONCLUSIONS
The intervention program was effective in improving glycemic and blood pressure control. The decrease in HbA1c values was generally independent of the relatively modest changes in dietary intake, weight, and activity and may reflect indirect program effects on other aspects of self-care.
Thyroid Peroxidase Autoantibodies Predict Poor Metabolic Control and Need for Thyroid Treatment in Pregnant IDDM Women
Authors: Fernandez-Soto Luisa , Gonzalez Amalia , Lobón Jose Antonio , Lopez Jose Antonio , Peterson Charles M , Escobar-Jiménez Fernando 
Published: March 2007

OBJECTIVE
To study whether the presence of antithyroid peroxidase antibodies (TPO-Abs) before gestation in IDDM affects thyroid function and metabolic control during pregnancy and early postpartum as well as neonatal outcome.

RESEARCH DESIGN AND METHODS
A prospective study at an outpatient endocrine-obstetric unit was carried out in 20 pregnant IDDM women. Free T4 (thyroxine), thyroid-stimulating hormone (TSH), TPO-Abs, and HbA1c were assayed before gestation; during the first, second, and third trimester of pregnancy; and 3 months postpartum.

RESULTS
HbA1c was significantly higher in TPO-Ab+ women than in those who were TPO-Ab− during the second (P &lt; 0.01) and third (P &lt; 0.05) trimesters. HbA1c levels significantly decreased in TPO-Ab− patients when the second (P &lt; 0.01) and third (P &lt; 0.05) trimesters were compared with before the pregnancy and the first trimester. There was a significant increase in the dosage of insulin for TPO-Ab+ versus TPO-Ab− patients during the second (P &lt; 0.05) and third (P &lt; 0.01) trimesters and 3 months postpartum (P &lt; 0.05). TSH was significantly increased in the second (P &lt; 0.001) and third (P &lt; 0.05) trimesters and 3 months postpartum (P &lt; 0.01) when compared with TPO-Ab− patients; 7.6% of the TPO-Ab− group and 29% in the TPO-Ab+ group presented postpartum thyroid dysfunction, and 42% of the TPO-Ab+ women required thyroid treatment.

CONCLUSIONS
Pregnant women with IDDM who have a positive test for TPO-Abs before gestation have poorer glucose control and a high prevalence of hypothyroidism. Therefore we recommend that prepregnant IDDM patients be screened for anti-TPO-Abs. Those with a positive result should be followed with serial monitoring of free T4 and TSH levels during each trimester as well as the postpartum period.
Increased Macrosomia and Perinatal Morbidity Independent of Maternal Obesity and Advanced Age in Korean Women With GDM
Authors: Jang Hak C , Cho Nam H , Min Yong-Ki , Han In K , Jung Kyu B , Metzger Boyd E 
Published: March 2007

OBJECTIVE
To examine the impact of gestational diabetes mellitus(GDM) on perinatal outcome in a setting where influences of maternal age and obesity would be minimal.

RESEARCH DESIGN AND METHODS
A case-control study was done to compare the outcome of pregnancy in 65 women with GDM and 153 women with normal carbohydrate metabolism matched for age, height, and prepregnancy weight.

RESULTS
The frequencies of preeclampsia and primary cesarean sections were higher and delivery was earlier in pregnancies complicated by GDM. Birth weight, symmetry index, and chest circumference were greater, and macrosomia and need for phototherapy were more common in offspring of mothers with GDM. Cord-serum C-peptide and insulin concentrations were higher in the infants of mothers with GDM and were strongly correlated with birth weight and symmetry index. However, maternal age, prepregnancy weight, and prepregnancy BMI were not correlated with birth weight. Postprandial glucose levels during the first 2 weeks after diagnosis of GDM had associations with the infants' birth weight, symmetry index, and cord insulin concentration in the diet-treated patients with GDM.

CONCLUSIONS
Antepartum maternal glucose metabolism was significantly associated with fetal hyperinsulinemia and excessive fetal growth in relatively nonobese Korean women. These findings support a direct role for metabolic factors in the adverse outcomes in pregnancies complicated by GDM.
Metformin Enhances Clearance of Chylomicrons and Chylomicron Remnants in Nondiabetic Mildly Overweight Glucose-Intolerant Subjects
Authors: Grosskopf Itamar , Ringel Yehuda , Charach Gideon , Maharshak Nitsan , Mor Ronit , Iaina Adrian , Weintraub Moshe 
Published: March 2007

OBJECTIVE
To assess the effect of metformin on the metabolism of intestinally derived lipoproteins in nondiabetic individuals who were mildly overweight and glucose intolerant.

RESEARCH DESIGN AND METHODS
A total of nine subjects with a BMI ≥ 25 kg/m2 and fasting serum glucose ≤ 6.1 mmol/l and who were glucose intolerant were studied. The subjects underwent a vitamin A fat-loading test before and after a 3-month treatment with 850 mg metformin twice a day. The metabolic behavior of the postprandial lipoproteins was compared with that found in a group of 19 healthy normolipidemic individuals who participated in a previous study.

RESULTS
Mean total plasma, chylomicron fraction, and nonchylomicron fraction retinyl palmitate (RP) pretreatment levels were 3.4-fold, 3.59-fold, and 3-fold higher, respectively, in the study group than in the normolipidemic group and were reduced by 50, 56, and 32%, respectively, after 3 months of metformin treatment. The decrease of chylomicron levels after treatment was positively correlated to the fasting triglyceride values before treatment (r = 0.73, P = 0.039) and to the serum insulin level at 120 min of standard glucose loading before treatment (r = 0.91, P = 0.002).

CONCLUSIONS
Metformin was shown to be beneficial in the clearance of postprandial lipoproteins in nondiabetic individuals who were mildly overweight and glucose intolerant.
Gender Differences in Hospitalizations for IDDM Among Adolescents in California, 1991: Implications for prevention
Authors: Cohn Barbara A , Cirillo Piera M , Wingard Deborah L , Austin Donald F , Roffers Steven D 
Published: March 2007

OBJECTIVE
Describe gender differences in hospitalizations for IDDM to investigate the need for gender-specific interventions to reduce diabetes-related morbidity.

RESEARCH DESIGN AND METHODS
Analyses were based on hospital discharges with any mention of IDDM (n = 2,889) and the subset of these for IDDM as a principal diagnosis (n = 2,270) in California children, ages 0–18 years during 1991. Pregnancy-related hospitalizations were excluded.

RESULTS
Females had more diabetes hospitalizations among discharges with any mention of diabetes, among discharges with diabetes as a principal diagnosis, and among discharges with diabetic ketoacidosis as a principal diagnosis. For diabetes as a principal diagnosis, females had 40% more hospitalizations, 44% more repeated hospitalizations, 23% more individuals hospitalized, and significantly higher rates of hospitalizations for ages 10–14 years (50 vs. 38 per 100,000) and for ages 15–18 years (68 vs. 29 per 100,000). Gender differences occurred primarily in adolescents, were independent of complicating conditions at the time of hospitalization, and were observed for diabetic ketoacidosis alone.

CONCLUSIONS
Adolescent females had more diabetes hospitalizations than did males. The underlying cause may be biological or behavioral. Management protocols tailored for young women may be required to reduce hospitalizations for IDDM among females.
Nonfasting Plasma Glucose is a Better Marker of Diabetic Control Than Fasting Plasma Glucose in Type 2 Diabetes
Authors: Avignon A , Radauceanu A , Monnier L 
Published: March 2007

OBJECTIVE
To evaluate the relative value of plasma glucose (PG) at different time points in assessing glucose control of type 2 diabetic patients.

RESEARCH DESIGN AND METHODS
Glycemic profiles, i.e., PG at prebreakfast (8:00 A.M.), prelunch (11:00 A.M.), postlunch (2:00 P.M.), and extended postlunch (5:00 P.M.) times over the same day, were obtained in 66 type 2 diabetic patients on an ambulatory basis. The different time points of PG were compared with a measurement of HbA1c made in a reference laboratory.

RESULTS
Extended postlunch PG was lower than prebreakfast PG (104 ± 21 vs. 133 ± 35 mg/dl, P &lt; 0.02) in patients demonstrating good diabetic control (HbA1c ≤ 7.0%), was not different from prebreakfast PG (149 ± 47 vs. 166 ± 26 mg/dl, NS) in patients demonstrating fair diabetic control (7.0% &lt; HbA1c ≤ 8.5%), and was higher than prebreakfast PG (221 ± 62 vs. 199 ± 49 mg/dl, P ≤ 0.01) in those demonstrating poor diabetic control (HbA1c ≤ 8.5%). Prebreakfast, prelunch, postlunch, and extended postlunch PG values were all significantly correlated with HbA1c. Multiple linear regression analysis demonstrated that postlunch PG and extended postlunch PG correlated significantly and independently with HbA1c, but that prebreakfast PG and prelunch PG did not. Moreover, postlunch PG and extended postlunch PG demonstrated better sensitivity, specificity, and positive predictive value in predicting poor glycemic control than did prebreakfast PG or prelunch PG.

CONCLUSIONS
In type 2 diabetes, postlunch PG and extended postlunch PG are better predictors of glycemic control than fasting plasma glucose (FPG). We therefore suggest that they be more widely used to supplement, or substitute for, FPG in evaluating the metabolic control of type 2 diabetic patients.