bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intensive Replacement of Basal Insulin in Patients With Type 1 Diabetes Given Rapid-Acting Insulin Analog at Mealtime
Authors: Rossetti Paolo , Pampanelli Simone , Fanelli Carmine , Porcellati Francesca , Costa Emanuela , Torlone Elisabetta , Scionti Luciano , Bolli Geremia B. 
Published: March 2007

OBJECTIVE—To establish differences in blood glucose between different regimens of optimized basal insulin substitution in type 1 diabetic patients given lispro insulin at meals, i.e., NPH injected four times a day versus glargine insulin once daily at dinner or at bedtime.
RESEARCH DESIGN AND METHODS—A total of 51 patients with type 1 diabetes on intensive therapy (NPH four times/day and lispro insulin at each meal) were randomized to three different regimens of basal insulin substitution while continuing lispro insulin at meals: continuation of NPH four times/day (n = 17), once daily glargine at dinnertime (n = 17), and once daily glargine at bedtime (n = 17) for 3 months. Blood glucose targets were fasting, preprandial, and bedtime concentrations at 6.4–7.2 mmol/l and 2 h after meals at 8.0–9.2 mmol/l. The primary end point was HbA1c.
RESULTS—Mean daily blood glucose was lower with dinnertime glargine (7.5 ± 0.2 mmol/l) or bedtime glargine (7.4 ± 0.2 mmol/l) versus NPH (8.3 ± 0.2 mmol/l) (P &lt; 0.05). A greater percentage of blood glucose values were at the target value with glargine at dinner and bedtime versus those with NPH (P &lt; 0.05). HbA1c at 3 months did not change with NPH but decreased with glargine at dinnertime (from 6.8 ± 0.2 to 6.4 ± 0.1%) and glargine at bedtime (from 7.0 ± 0.2 to 6.6 ± 0.1%) (P &lt; 0.04 vs. NPH). Total daily insulin doses were similar with the three treatments, but with glargine there was an increase in basal and a decrease in mealtime insulin requirements (P &lt; 0.05). Frequency of mild hypoglycemia (self-assisted episodes, blood glucose ≤4.0 mmol/l) was lower with glargine (dinnertime 8.1 ± 0.8 mmol/l, bedtime 7.7 ± 0.9 mmol/l) than with NPH (12.2 ± 1.3 mmol/l) (episodes/patient-month, P &lt; 0.04). In-hospital profiles confirmed outpatient blood glucose data and indicated more steady plasma insulin concentrations at night and before meals with glargine versus NPH (P &lt; 0.05). There were no differences between glargine given at dinnertime and at bedtime.
CONCLUSIONS—Regimens of basal insulin with either NPH four times/day or glargine once/day in type 1 diabetic patients both result in good glycemic control. However, the simpler glargine regimen decreases the HbA1c level and frequency of hypoglycemia versus NPH. In contrast to NPH, which should be given at bedtime, insulin glargine can be administered at dinnertime without deteriorating blood glucose control.
Cell Surface Expression of LDL Receptor Is Decreased in Type 2 Diabetic Patients and Is Normalized by Insulin Therapy
Authors: Duvillard Laurence , Florentin Emmanuel , Lizard Gérard , Petit Jean-Michel , Galland Françoise , Monier Serge , Gambert Philippe , Vergès Bruno 
Published: March 2007

OBJECTIVE—In type 2 diabetic patients with poor metabolic control, kinetic studies have demonstrated that LDL fractional catabolic rate (FCR) is slowed down, whereas it is normalized on insulin therapy. This study was designed to analyze whether variations in the expression of LDL receptors at the cell surface could explain the results observed in kinetic studies.
RESEARCH DESIGN AND METHODS—LDL receptors were quantified at the surface of mononuclear cells in fresh fasting blood samples by a flow cytometry method in 21 control subjects and 21 type 2 diabetic patients before and 3 months after the introduction of insulin therapy and concomitant removal of oral antidiabetic drugs.
RESULTS—Before insulin treatment, monocyte LDL receptor expression was reduced by 41% (6,439 ± 2,310 vs. 10,846 ± 2,764 receptors per monocyte, P &lt; 0.001) in type 2 diabetic patients compared with control subjects. It increased by 57% after 3 months of insulin therapy (10,096 ± 5,657 vs. 6,439 ± 2,310, P &lt; 0.01) and was similar to that observed in control subjects.
CONCLUSIONS—Our results suggest that insulin plays an important role in the in vivo expression of LDL receptors. Moreover, modulations in the expression of LDL receptors in type 2 diabetic patients either with poor metabolic control or on insulin therapy are likely to contribute to the variations of LDL FCR demonstrated by kinetic studies under those circumstances.
Lowering of LDL Cholesterol Rather Than Moderate Weight Loss Improves Endothelium-Dependent Vasodilatation in Obese Women With Previous Gestational Diabetes
Authors: Bergholm Robert , Tiikkainen Mirja , Vehkavaara Satu , Tamminen Marjo , Teramo Kari , Rissanen Aila , Yki-Järvinen Hannele 
Published: March 2007

OBJECTIVE—Effects of weight loss on vascular function are unknown. We compared, in the face of similar weight loss over 3–6 months, effects of orlistat (120 mg t.i.d., n = 23) and placebo (n = 24) on in vivo endothelial function in a high-risk group of obese (BMI 32.1 ± 0.4 kg/m2) premenopausal nondiabetic women with a history of gestational diabetes.
RESEARCH DESIGN AND METHODS—Forearm blood flow responses to intra-arterial infusions of acetylcholine (ACh) and sodium nitroprusside (SNP), body composition, and serum lipids were determined before and after weight loss.
RESULTS—Weight loss averaged 7.3 ± 0.2 kg (8.3 ± 0.1%) and 7.4 ± 0.2 kg (8.2 ± 0.1%) of initial body weight in the orlistat and placebo groups, respectively. Forearm and body compositions changed similarly in both groups. Responses to ACh increased by 41% to the low dose (5.9 ± 0.6 vs. 8.3 ± 0.3 for flow in the experimental/control arm, P &lt; 0.01) and by 33% to the high dose (7.6 ± 0.8 vs. 10.1 ± 0.6, P &lt; 0.001) in the orlistat group, but they remained unchanged in the placebo group. The blood flow responses to SNP did not differ significantly between the groups. LDL cholesterol decreased significantly in the orlistat group from 3.5 ± 0.2 to 3.0 ± 0.1 mmol/l (P &lt; 0.01) but remained unchanged in the placebo group. Within the orlistat group, the decrease in LDL cholesterol correlated significantly with the improvement in the blood flow response to ACh (r = −0.44, P &lt; 0.05).
CONCLUSIONS—Orlistat but not moderate (8%) weight loss per se improves endothelial function in women with previous gestational diabetes. This improvement is associated with a lowering of LDL cholesterol by orlistat.
Addition of Nateglinide to Rosiglitazone Monotherapy Suppresses Mealtime Hyperglycemia and Improves Overall Glycemic Control
Authors: Fonseca Vivian , Grunberger George , Gupta Shamita , Shen Sharon , Foley James E. 
Published: March 2007

OBJECTIVE—To determine the effects of nateglinide added to rosiglitazone monotherapy on glycemic control and on postprandial glucose and insulin levels in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—This 24-week, multicenter, double-blind, randomized study compared the efficacy of nateglinide (120 mg a.c.) and placebo added to rosiglitazone monotherapy (8 mg q.d.) in 402 patients with type 2 diabetes with HbA1c between 7 and 11% (inclusive). Efficacy parameters tested included HbA1c and plasma glucose and insulin levels in the fasting state and after a standardized meal challenge. Safety data were also collected.
RESULTS—In placebo-treated patients, HbA1c did not change (Δ = 0.0 ± 0.1%). In patients randomized to nateglinide, HbA1c decreased from 8.3 to 7.5% (Δ = −0.8 ± 0.1%, P &lt; 0.0001 vs. placebo). Target HbA1c (&lt;7.0%) was achieved by 38% of patients treated with combination therapy and by 9% of patients remaining on rosiglitazone monotherapy. In nateglinide-treated patients, fasting plasma glucose levels decreased by 0.7 mmol/l, 2-h postprandial glucose levels decreased by 2.7 mmol/l, and 30-min insulin levels increased by 165 pmol/l compared with no changes from baseline of these parameters with placebo added to rosiglitazone (P &lt; 0.001).
CONCLUSIONS—By selectively augmenting early insulin release and decreasing prandial glucose excursions, nateglinide produced a clinically meaningful improvement in overall glycemic exposure in patients with type 2 diabetes inadequately controlled with rosiglitazone. Therefore, nateglinide substantially improves the likelihood of achieving a therapeutic target of HbA1c &lt;7.0%.
The Efficacy and Safety of Dermagraft in Improving the Healing of Chronic Diabetic Foot Ulcers
Authors: Marston William A. , Hanft Jason , Norwood Paul , Pollak Richard ,   for the Dermagraft Diabetic Foot Ulcer Study Group
Published: March 2007

OBJECTIVE—To determine if a human fibroblast–derived dermal substitute could promote the healing of diabetic foot ulcers.
RESEARCH DESIGN AND METHODS—A randomized, controlled, multicenter study was undertaken at 35 centers throughout the U.S. and enrolled 314 patients to evaluate complete wound closure by 12 weeks. Patients were randomized to either the Dermagraft treatment group or control (conventional therapy). Except for the application of Dermagraft, treatment of study ulcers was identical for patients in both groups. All patients received pressure-reducing footwear and were allowed to be ambulatory during the study.
RESULTS—The results demonstrated that patients with chronic diabetic foot ulcers of &gt;6 weeks duration experienced a significant clinical benefit when treated with Dermagraft versus patients treated with conventional therapy alone. With regard to complete wound closure by week 12, 30.0% (39 of 130) of Dermagraft patients healed compared with 18.3% (21 of 115) of control patients (P = 0.023). The overall incidence of adverse events was similar for both the Dermagraft and control groups, but the Dermagraft group experienced significantly fewer ulcer-related adverse events.
CONCLUSIONS—The data from this study show that Dermagraft is a safe and effective treatment for chronic diabetic foot ulcers.
Inflammatory Markers, Adiponectin, and Risk of Type 2 Diabetes in the Pima Indian
Authors: Krakoff Jonathan , Funahashi Tohru , Stehouwer Coen D.A. , Schalkwijk Casper G. , Tanaka Sachiyo , Matsuzawa Yuji , Kobes Sayuko , Tataranni P. Antonio , Hanson Robert L. , Knowler William C. , Lindsay Robert S. 
Published: March 2007

OBJECTIVE—To examine the association between adiponectin, a known predictor of diabetes in Pima Indians, and markers of inflammation and endothelial function in nondiabetic subjects and to assess whether these markers predict later diabetes in a case-control study within a longitudinal health study in Pima Indians.
RESEARCH DESIGN AND METHODS—Participants with normal glucose tolerance at baseline were selected. Case subjects (who later developed type 2 diabetes), and control subjects (n = 71 pairs) were matched for BMI, age, and sex. Adiponectin, C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor-α, phospholipase A2 (sPLA2), soluble E-selectin (SE-selectin), soluble intracellular adhesion molecule-1, soluble vascular adhesion molecule-1, and von Willebrand factor (vWF) were measured in baseline samples.
RESULTS—Adiponectin was negatively correlated with CRP (r = −0.25, P &lt; 0.05), IL-6 (r = −0.20, P &lt; 0.05), sPLA2 (r = −0.22, P &lt; 0.05), and SE-selectin (r = −0.20, P &lt; 0.05). CRP and IL-6 did not predict diabetes. Only vWF predicted the development of diabetes (incidence rate ratio 0.67 for a 1-SD difference, 95% CI 0.41–1.00, P = 0.05), but this was not significant after adjustment for age, glucose, HbA1c, waist circumference, and fasting insulin (hazard rate ratio 0.73, 95% CI 0.46–1.16, P = 0.18).
CONCLUSIONS—Adiponectin is negatively correlated with markers of inflammation in vivo. In case and control subjects matched for BMI, with the exception of vWF, none of the inflammatory markers predicted diabetes. Adiponectin may be the link between adiposity, inflammation, and type 2 diabetes.
Intensified Blood Glucose Monitoring Improves Glycemic Control in Stable, Insulin-Treated Veterans With Type 2 Diabetes
Authors: Murata Glen H. , Shah Jayendra H. , Hoffman Richard M. , Wendel Christopher S. , Adam Karen D. , Solvas Patricia A. , Bokhari Syed U. , Duckworth William C. 
Published: March 2007

OBJECTIVE—To examine the effect of intensified self-monitored blood glucose (SMBG) testing on glycemic control.
RESEARCH DESIGN AND METHODS—Subjects with stable, insulin-treated type 2 diabetes performed SMBG using an electronic blood glucose meter before all meals and at bedtime for 8 weeks. Baseline data were collected on demographics, clinical characteristics, diet, and exercise. HbA1c was measured at baseline, at 4 weeks, and at 8 weeks. After the intensified monitoring period, subjects resumed their usual monitoring. HbA1c was then measured at 24, 37, and 52 weeks. Multivariate linear regression was used to determine the effect of monitoring on glycemic control.
RESULTS—A total of 201 subjects completed the monitoring period. The baseline HbA1c (8.10 ± 1.67%) decreased during the monitoring period by 0.30 ± 0.68% (P &lt; 0.001) at 4 weeks and by 0.36 ± 0.88% (P &lt; 0.001) at 8 weeks. Although entry HbA1c and compliance independently predicted the week 8 HbA1c (r = 0.862, P &lt; 0.001), standardized regression analysis found that compliance with the SMBG protocol influenced the week 8 HbA1c more than age, sex, BMI, exercise level, carbohydrate consumption, or treatment intensity at baseline. However, SMBG benefited only subjects whose testing compliance exceeded 75% or with an entry HbA1c &gt;8.0%. Decreases in HbA1c (−0.31 ± 1.17%, P = 0.001) persisted in the 159 subjects followed for 52 weeks.
CONCLUSIONS—Intensified blood glucose monitoring improved glycemic control in a large cohort of stable, insulin-treated veterans with type 2 diabetes. SMBG provided a strong stimulus for improved self-care resulting in clinically important and sustained reductions in HbA1c.
High Incidence of Childhood Type 1 Diabetes in Liguria, Italy, From 1989 to 1998
Authors: Cotellessa Mario , Barbieri Paola , Mazzella Massimo , Bonassi Stefano , Minicucci Laura , Lorini Renata 
Published: March 2007

OBJECTIVE—Assessing updated incidence of type 1 diabetes in 0- to 14-year-old children in Liguria, a Northwest region of Italy.
RESEARCH DESIGN AND METHODS—Incident cases were recorded prospectively from 1989 to 1998. Incidence rates (IRs) were standardized to the 1999 world population using the direct method. The independent effect of sex, age, residence, and calendar year was estimated with Poisson regression model. The degree of ascertainment was calculated in accordance to capture/recapture method.
RESULTS—During 10 full calendar years, 219 new cases of type 1 diabetes in children were diagnosed in Liguria. The standardized IR over the 10-year period was 12.56 cases per 100,000 per year (95% CI 11.0–14.3). The sex-specific IR among men and women was 14.15 and 10.88, respectively. The age-specific IR was higher in the 10- to 14-year-old age-group (15.01/100,000) than in 0- to 4-year-old age-group (9.01/100,000) and in the 5- to 9-year-old age-group (13.03/100,000).
CONCLUSIONS—The IR of type 1 diabetes in Liguria is among the highest in Southern Europe and approaches IRs of Northern European countries. In particular it is much higher than those reported in the surrounding Italian regions except for Sardinia. Therefore, the geographical distribution of type 1 diabetes does not seem to reflect the simple North-South gradient reported in several previous works.
Treating Hypertension in Diabetic Nephropathy
Authors: Tomlinson Jeremy W. , Owen Katharine R. , Close Colin F. 
Published: March 2007

OBJECTIVE—Control of hypertension in patients with diabetic nephropathy improves mortality and slows progression to end-stage renal disease. However, blood pressure is difficult to treat; multiple drug combination therapy is required and treatment algorithms to establish this are lacking. We used a stepped-care algorithm, centered on maximum doses of an ACE inhibitor or angiotensin II receptor blocker, to treat hypertension according to American Diabetes Association recommended blood pressure target goals (&lt;130/80 mmHg) in patients with diabetic nephropathy.
RESEARCH DESIGN AND METHODS—We treated 49 consecutive patients with diabetes (13 with type 1 and 36 with type 2), diabetic nephropathy, and proteinuria ≥500 mg/24 h with a stepped-care blood pressure treatment algorithm. The level of blood pressure control achieved at most recent follow-up was assessed.
RESULTS—Patients were followed for a median of 18 months (range 9–48). Mean blood pressure achieved was 140/75 ± 23/14 mmHg in patients with type 1 diabetes and 146/76 ± 22/14 mmHg in patients with type 2 diabetes. Target blood pressure was reached in 16 (33%) patients, 6 of 13 patients with type 1 diabetes and 10 of 36 patients with type 2 diabetes, whereas systolic blood pressure remained above the target level in the remaining patients. There was no difference in baseline blood pressure, proteinuria, or serum creatinine level between patients who were treated to target and those who were not.
CONCLUSIONS—Levels of blood pressure control similar to those achieved in clinical trials in diabetic nephropathy were obtained with a stepped-care algorithm. However, in most patients, systolic blood pressure was difficult to control to target despite the use of multiple drug combination therapy.
Steroids in Adult Men With Type 1 Diabetes
Authors: van Dam Eveline W.C.M. , Dekker Jacqueline M. , Lentjes Eef G.W.M. , Romijn Fred P.T.H.M. , Smulders Yvo M. , Post Wendy J. , Romijn Johannes A. , Krans H. Michiel J. 
Published: March 2007

OBJECTIVE—To compare steroids and their associations in men with type 1 diabetes and healthy control subjects.
RESEARCH DESIGN AND METHODS—We studied 52 adult men with type 1 diabetes without microvascular complications, compared with 53 control subjects matched for age and BMI. Steroids and their binding globulins were assessed in a single venous blood sample and a 24-h urine sample.
RESULTS—In adult men with type 1 diabetes, total testosterone did not differ from healthy control subjects, but sex hormone–binding globulin (SHBG) (42 [14–83] vs. 26 [9–117] nmol/l, P &lt; 0.001), cortisol-binding globulin (CBG; 0.87 ± 0.17 vs. 0.73 ± 0.10 nmol/l, P &lt; 0.001), and cortisol levels (0.46 ± 0.16 vs. 0.39 ± 0.14 nmol/l, P &lt; 0.01) were higher. The free testosterone index was lower (60 [17–139] vs. 82 [24–200], P &lt; 0.001), and the calculated free testosterone was slightly lower (497 [115] vs. 542 [130], P &lt; 0.064), but the pituitary-gonadal axis was not obviously affected in type 1 diabetes. The calculated free serum cortisol was not different, and 24-h urinary free cortisol excretion was lower in type 1 diabetes (121 [42–365] vs. 161 [55–284] nmol/24 h, P &lt; 0.009). Testosterone was mainly associated with SHBG. Estimated portal insulin was a contributer to SHBG in control subjects but not in type 1 diabetes. Cortisol was associated with CBG. HbA1c contributed to CBG in men with diabetes but not in control subjects, whereas estimated portal insulin did not contribute.
CONCLUSIONS—Adult men with fairly controlled type 1 diabetes without complications who are treated with subcutaneous insulin have a tendency to hypogonadism, as reflected by lower free testosterone levels in the presence of similar total testosterone levels and higher SHBG levels.
A Cross-Sectional Study of Alcohol Consumption Patterns and Biologic Markers of Glycemic Control Among 459 Women
Authors: Kroenke Candyce H. , Chu Nain-Feng , Rifai Nader , Spiegelman Donna , Hankinson Susan E. , Manson JoAnn E. , Rimm Eric B. 
Published: March 2007

OBJECTIVE—Little research has explored associations of drinking patterns with glycemic control, especially among women. Our objective was to determine the relationship of patterns of alcohol consumption—including average daily consumption, weekly frequency of consumption, drinking with meals, and beverage type—with biologic markers of insulin resistance in young women.
RESEARCH DESIGN AND METHODS—This study was cross-sectional in design. The subjects consisted of a stratified random subpopulation of 459 U.S. normal-weight and overweight female nurses, 33–50 years of age, drawn from the Nurses’ Health Study II and sampled for distinct drinking patterns. Women provided blood samples and detailed information on dietary and lifestyle factors between 1995 and 1999. The main outcome measures were fasting insulin, C-peptide, and HbA1c.
RESULTS—Adjusting for age, smoking, physical activity, television watching, BMI, and several dietary factors, average alcohol intake was inversely associated with HbA1c (units in percentage of HbA1c): 0 g/day (reference = 5.36%), 0.1 to &lt;5.0 g/day (−0.04%), 5.0 to &lt;15.0 g/day (−0.09%), 15.0 to &lt;25.0 g/day (−0.10%), and ≥25.0 g/day (−0.17%) (P value, test for trend &lt;0.001). We found an inverse association of alcohol intake and insulin, but only for women with a BMI ≥25 kg/m2. Specifically, insulin levels were lowest for episodic drinkers consuming ≥2 drinks per day on 0–3 days per week. Consumption with meals and type of alcoholic beverage did not further influence these results.
CONCLUSIONS—Moderate alcohol consumption of 1–2 drinks per day on a few to several days of the week may have a beneficial glycemic effect, particularly among overweight women.
Association Between Insulin Sensitivity and Post-Glucose Challenge Plasma Insulin Values in Overweight Latino Youth
Authors: Weigensberg Marc J. , Cruz Martha L. , Goran Michael I. 
Published: March 2007

OBJECTIVE—To determine associations between directly measured insulin sensitivity (SI) and oral glucose tolerance test (OGTT)-derived plasma insulin values, or calculated SI indices, in overweight peripubertal Latino children at risk for type 2 diabetes.
RESEARCH DESIGN AND METHODS—Thirty overweight Latino children with a family history of type 2 diabetes, aged 8–13 years, Tanner stages 1–2, underwent an OGTT. Fasting and 2-h plasma insulin values and OGTT-derived SI indices were compared with SI derived from a frequently sampled intravenous glucose tolerance test (FSIGTT) with minimal model analysis, before and after adjustment for total body fat and lean tissue mass, or BMI.
RESULTS—FSIGTT-derived SI for all subjects was 1.62 ± 0.78 × 10−4 min −1 · (μU/ml), with no sex differences. SI correlated (all P values &lt; 0.001) with fasting (r = −0.57) and 2-h (r = −0.58) plasma insulin and all SI indices (r = −0.57 to 0.67). After adjusting for total body fat and lean tissue mass, or BMI, the associations between SI and either fasting insulin or fasting SI indices were no longer significant. However, the 2-h insulin and post-glucose challenge SI indices maintained significant independent associations with SI, even after adjustment for body composition.
CONCLUSIONS—In overweight, peripubertal Latino children at risk for type 2 diabetes, the 2-h plasma insulin value and postchallenge SI indices are better independent correlates of SI than fasting values, after accounting for body composition. The 2-h insulin may therefore be superior to fasting insulin as a single blood sample value for clinical or epidemiological estimates of SI, especially when combined with assessment of body composition.