bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Between Autonomic Neuropathy, 24-h Blood Pressure Profile, and Nephropathy in Normotensive IDDM Patients
Authors: Spallone Vincenza , Gambardella Sergio , Maiello Maria R , Barini Angela , Frontoni Slmona , Menzinger Guido 
Published: March 2007

OBJECTIVE
To evaluate the relationship between autonomic neuropathy, nephropathy, and 24-h blood pressure (BP) pattern in insulin-dependent diabetes mellitus (IDDM).

RESEARCH DESIGN AND METHODS
We studied 30 normotensive IDDM patients without overt nephropathy, divided into two groups and matched for age, duration of diabetes, and HbA1 according to the presence of cardiovascular autonomic neuropathy. We simultaneously measured 24-h BP and urinary albumin excretion rate (UAE) on urine collections timed overnight and at 2-h intervals during the day.

RESULTS
Mean day and night systolic and diastolic BP values did not significantly differ between the groups. Mean night albuminuria was significantly higher in patients with autonomic neuropathy than in those without (61.4 ± 104.6 [mean ± SD] vs. 16 ± 25.2 μg/min, P &lt; 0.04). The percentages day-night changes in systolic BP, diastolic BP, and UAE were significantly lower in neuropathic patients (systolic BP: 2.4 ± 7.7 vs. 9.6 ± 4.2%, P &lt; 0.001; diastolic BP: 8.4 ± 6.9 vs. 15.5 ± 5.4%, P &lt; 0.002; UAE: – 8 ± 99.4 vs. 49.3 ± 29.4%, P &lt; 0.02) and were inversely related to autonomic score, index of autonomic neuropathy degree (r = –0.54, P &lt; 0.002; r = –0.58, P &lt; 0.001; and r = –0.53, P &lt; 0.005, respectively). In patients with autonomic neuropathy, 2-h day periods and day and night UAE were more strongly related, respectively, to mean 2-h day periods (r = 0.58, P &lt; 0.0001), day systolic BP (r = 0.67, P &lt; 0.04), and night systolic BP (r = 0.69, P &lt; 0.04) than in patients without autonomic neuropathy (2-h day periods: r = 0.32, P &lt; 0.001; day: r = 0.37, NS; night: r = 0.35, NS).

CONCLUSIONS
Autonomic neuropathy in IDDM patients is associated with reduced nocturnal falls in BP and UAE and with a stronger relationship of UAE to systolic BP. We suggest a pathogenetic role of autonomic neuropathy in the development of diabetic nephropathy through changes in nocturnal glomerular function and by enhanced kidney vulnerability to hemodynamic effects of BP.
Comparison of Acute Daytime and Nocturnal Insulinization on Diurnal Glucose Homeostasis in NIDDM
Authors: Puhakainen Ilpo , Taskinen Marja-Riitta , Yki-Järvinen Hannele 
Published: March 2007

OBJECTIVE
The question of whether to use insulin in the evening or in the morning during combination therapy in patients with non-insulin-dependent diabetes mellitus (NIDDM) is controversial. We compared the acute effects of 12-h nocturnal or daytime insulin infusions on the 24-h glucose profile in 20 patients with NIDDM.

RESEARCH DESIGN AND METHODS
NIDDM patients were 56 ± 2 (mean ± SE) years of age and had a body mass index of 29.6 ±1.1 kg/m2; fasting plasma glucose concentration of 12.2 ± 0.5 mM; and fasting C-peptide concentration of 0.9 ± 0.2 nM. Each patient was studied twice. On one occasion, the patient received a 12-h intravenous infusion of insulin (mean 1.5 ± 0.1 1U/h) during the day, and on the other occasion an identical dose of insulin was infused during the night. Blood glucose, insulin, c-peptide, and free fatty acid concentrations were determined for 24 h.

RESULTS
The mean 24-h free insulin concentrations were similar in both studies (150 ± 12 vs. 162 ± 12 pM, daytime versus nocturnal insulin infusion). The mean 24-h free fatty acid concentration was 18% lower in the nocturnal than in the daytime (309 ± 30 vs. 376 ± 30 μM, P &lt; 0.001) insulin infusion study. The mean 24-h C-peptide concentration was less suppressed if insulin was infused overnight than during the day (1.3 ± 0.2 vs. 1.1 ± 0.2 nM, P &lt; 0.01). The mean 24-h plasma glucose concentrations were identical in both studies (11.1 ±0.6 vs. 11.4 ± 0.7 mM, daytime versus nocturnal insulin infusion). We also searched for factors predicting the decrease in the blood glucose concentration during the nocturnal insulin infusion. The best predictors were a high initial blood glucose concentration at 2200 and a low fasting C-peptide concentration. These factors explained, independent of each other, 50% of the rate of decrease in the plasma glucose concentration.

CONCLUSIONS
Despite better suppression of lipolysis and less suppression of endogenous insulin secretion by nocturnal than daytime insulinization, the hypoglycemic effect of these two treatments is similar.
Platelet Plasminogen Activator Inhibitor 1 in Patients With Type II Diabetes
Authors: Jokl Rudolf , Laimins Marta , Klein Richard L , Lyons Timothy J , Lopes-Virella Maria F , Colwell John A 
Published: March 2007

OBJECTIVE
To compare platelet plasminogen activator inhibitor 1 (PAI-1) concentration in type 11 diabetic patients and healthy control subjects.

RESEARCH DESIGN AND METHODS
We studied a group of 12 diabetic patients whose disease was controlled by diet or sulfonylurea therapy and a group of 17 nondiabetic control subjects. All subjects were free of clinically advanced vascular disease. PAI-1 antigen concentrations were measured in 5 × 108 isolated platelets, which were lysed by 1% Triton X-100.

RESULTS
Mean platelet PAI-1 was significantly higher in diabetic patients (264 ± 83 ng/5 × 108 platelets) compared with control subjects (202 ±71 ng/5 × 108platelets) (P &lt; 0.05). A significant independent positive correlation was found between platelet PAI-1 concentrations and fasting plasma specific insulin levels in the diabetic patients (r = 0.63, P = 0.03).

CONCLUSIONS
These findings suggest that 1) a higher platelet PAI-1 concentration may contribute to enhanced thrombosis in type II diabetes and 2) megakaryo-cyte PAI-1 synthesis may be under the control of insulin.
Fetal Hemoglobin in Diabetic Patients
Authors: Koskinen Leena K , Lahtela Jorma T , Koivula Timo A 
Published: March 2007

OBJECTIVE
To determine the occurrence of elevated fetal hemoglobin (HbF) among the diabetic population and determine the clinical situation of importance.

RESEARCH DESIGN AND METHODS
A cross-sectional study was conducted. HbA1c. and HbF were measured with high-performance liquid chromatogra-phy in 1,104 consecutive diabetic patients attending our clinic for HbA1c determination. The expression of clinical correlations between the high and low HbF group was performed for adults (≥15 years). A nondiabetic control group (n = 258) with the same age and sex distribution was included.

RESULTS
HbF was elevated (&gt;1.0% of total hemoglobin) in 7.5% of the total diabetic group. In the adult diabetic group, HbF was elevated in 6.5% of the patients, and in the control group, HbF was elevated in 1.9% (P &lt; 0.01). In the insulin-treated adult group, HbF was elevated in 10.2% of the patients, and in the non-insulin-treated group, HbF was elevated in 3.8%. The mean HbA1c was 8.90 ± 2.00% among the patients and 5.52 ± 0.53% in the control subjects (P &lt; 0.001). Patients with elevated HbF were younger (P &lt; 0.02) and more often on insulin therapy (P &lt; 0.001) or type I diabetic patients (P &lt; 0.001). Sex, glycemic control, or duration of diabetes were not significantly different in the patients with high or low HbF. Correlation was not detected between the amount of HbF and HbA1c or age in the group of patients with elevated HbF. Hemoglobinopathies, anemias, or malignancies were not diagnosed from the patients with high HbF.

CONCLUSIONS
Level of HbF is increased (&gt;1.0%) among 7.5% of unselected diabetic patients. In adult (≥15 years) diabetic patients, it is increased among 6.5%, which is 3.4 times more often than in the control population. Acute hematological conditions or malignancies do not explain the difference. Elevated HbF seems to be associated with type I diabetes and insulin treatment.
A Telephone-Delivered Intervention for Patients With NIDDM: Effect on coronary risk factors
Authors: Kirkman M Sue , Weinberger Morris , Landsman Pamela B , Samsa Gregory P , Shortliffe E Anne , Simel David L , Feussner John R 
Published: March 2007

OBJECTIVE
To examine whether a telephone-delivered intervention (TDI), designed to improve glycemie control in patients with non-insulin-dependent diabetes mellitus (N1DDM), improved coronary risk factors in high-risk patients.

RESEARCH DESIGN AND METHODS
This randomized controlled trial involved 275 veterans with N1DDM followed in a general medical clinic. Intervention (TDI) patients were telephoned at least monthly by a nurse. Calls emphasized compliance with the medical regimen (diet, medications, and exercise), encouraged behavioral changes, and facilitated referrals to a dietitian or smoking cessation clinic. Control patients received no such calls. Baseline and 12-month follow-up measurements included fasting lipid profiles, weight, smoking status (self-reported; cessation verified by measurement of exhaled CO), adherence to diet and exercise (self-reported), appointments, and medications (hospital computerized data base).

RESULTS
After 12 months, equal numbers of obese patients in the two groups reported adhering to a diabetic diet and exercising, although more obese TDI patients had seen a dietitian (30 vs. 7%, P = 0.003). Weight loss was not seen in either group (—0.9 ± 5.3 vs. —0.1 ± 3.6 kg, P = 0.202). Hyperlipidemic TDI patients were more likely to see a dietitian (31 vs. 6%, P = 0.003) and receive lipid-lowering medications (22 vs. 9%, P = 0.096), but serum cholesterol reduction was similar between groups (–11.7 ± 33.4 vs. –4.3 ± 32.7 mg/dl, P = 0.270); comparable results were seen for high-density lipoprotein, low-density lipoprotein, and triglyceride levels. More TDI group smokers reported quitting (26 vs. 0%, P = 0.033), but the difference was not significant for CO-verified abstention (10 vs. 0%, P = 0.231).

CONCLUSIONS
The TDI improved self-reported adherence to regimens that might reduce coronary risk, but had little effect on objective measures of risk.
A Population Survey on the Prevalence of Diabetes in Kin-Hu, Kinmen
Authors: Chou Pesus , Liao Ming-Jen , Kuo Hsu-Sung , Hsiao Kwang-Jen , Tsai Shih-Tzer 
Published: March 2007

OBJECTIVE
To investigate the prevalence of non-insulin-dependent-diabetes mellitus in Kin-Hu, Kinmen.

RESEARCH DESIGN AND METHODS
This is a community-based population survey. The target population are residents ≥30 years of age in Kin-Hu, Kinmen, according to the official household registry in 1990. Face to face interviews were conducted by the Yang-Ming Crusade in 1991 using a structured questionnaire. Fasting blood samples were drawn by public health nurses, and a 75-g oral glucose tolerance test was performed for definite diagnosis of diabetes.

RESULTS
; There were 4,097 eligible subjects (2,026 men and 2,071 women), and 3,236 had complete fasting plasma glucose data (1,536 men and 1,700 women). The response rate was 79% (76% for men and 82% for women). The age-specific response rates were 81% for the 30- to 39-year and 50- to 59-year age-groups, 84% for the 40- to 49-year age-group, and 69% for the ≥60-year age-group. The crude prevalence of diabetes in Kin-Hu was 6.5% (2.0% previous and 4.5% new). With the standard world population of Segi, the age-adjusted prevalence rate was 4.9% (4.5% for men and 5.4% for women). The prevalence rate of diabetes increased significantly with age. The prevalence of previously diagnosed diabetes accounted for less than one third of the total rate.

CONCLUSIONS
The population survey in Kin-Hu, Kinmen, had a high response rate of 79%. The crude prevalence rate of diabetes was 6.5%, and the age-adjusted prevalence rate was 4.9%. The low ratio of previously diagnosed to newly diagnosed diabetic cases may be due to lack of public awareness and medical services in this community.
Different Change in Lipoprotein(a) Levels From Lipid Levels of Other Lipoproteins With Improved Glycemie Control in Patients With NIDDM
Authors: Kikuchi Toru , Onuma Tomio , Shimura Michitaka , Tsutsui Masahiro , Boku Akitoshi , Matsui Jun , Takebe Kazuo 
Published: March 2007

OBJECTIVE
To evaluate change both in lipoprotein(a) [Lp(a)] and lipid levels in other lipoproteins in non-insulin-dependent diabetes mellitus (NIDDM) after short-term improvement of glycemie control.

RESEARCH DESIGN AND METHODS
We compared Lp(a) levels in 210 NIDDM patients with those in 46 control subjects and evaluated the relationship between glycemie control and Lp(a) levels in diabetic patients. In addition, changes in Lp(a) levels and lipid levels were assessed after the improvement of glycemie control in 54 poorly controlled NIDDM patients.

RESULTS
In NIDDM, Lp(a) levels in all patients, 62 patients with HbA1c &lt;6.0%, and 75 patients with HbA1c between 6.0 and 8.0%, were significantly higher than those in control subjects (19.1 [1.7-106.6], 19.2 [6.0-106.6], and 20.3 [2.7-75.3] vs. 15.4 [2.0-61.7] mg/dl, median [range], P &lt; 0.05). Lp(a) levels in 73 patients with HbA1c of ≥8.0% (18.7 [1.7-58.8] mg/dl) were not significantly different from those in control subjects. After glycemie control, lipid levels in plasma and in other lipoproteins fell significantly, but Lp(a) did not change (from 18.3 [1.7-58.8] to 18.4 [6.6-95.3] mg/dl). Changes in lipid levels, including Lp(a), did not correlate with those in fasting plasma glucose or HbAlc.

CONCLUSIONS
These results suggest that elevated Lp(a) levels do not reflect poor glycemie control and that Lp(a) levels are independent of lipid levels in other lipoproteins after improved glycemie control in NIDDM.
Anti-Insulin Antibodies Are a Cause of Hypoglycemia Following Pancreas Transplantation
Authors: Tran Minou P , Larsen Jennifer L , Duckworth William C , Ruby Elizabeth I , Miller Suzanne A , Frisbie Kecia , Taylor Rodney J , Stratta Robert J 
Published: March 2007

OBJECTIVE
Hypoglycemie symptoms have been reported by more than half of pancreas transplantation (PTX) recipients. To better understand the mechanism for the hypoglycemia documented in some of these patients, we studied the glucose and pancreatic hormone response to Sustacal in patients with and without hypoglycemia following PTX.

RESEARCH DESIGN AND METHODS
Twelve patients with established, repeated episodes of hypoglycemia following PTX (hypo) were case-matched to PTX recipients without hypoglycemie symptoms (control; n = 7). On the day of the study, fasting glucose, free and total immunoreactive insulin (IR1), C-peptide, proinsulin, and glucagon were drawn (time 0); Sustacal was administered; and glucose, free and total IRI, and C-peptide were assayed at 15,30,45, 75,120,150,180, and 240 min. Based on the glucose response to Sustacal, the hypo group was further divided into those whose glucose rose after Sustacal (hypo-high; n = 7) and those with no increase in glucose from baseline concentration (hypo-flat; n = 5).

RESULTS
Before the administration of Sustacal, the hypo-high group had a lower fasting free/total IRI (0.26 ± 0.06, mean ± SE) than the hypo-flat (0.51 ± 0.02) or control (0.52 ± 0.04) groups (both P &lt; 0.05 compared with hypo-high). The glucose response to Sustacal was greatest in the hypo-high group as defined. Area under the curve (AUC) for total IRI following Sustacal was also greatest in the hypo-high group (P &lt; 0.05 compared with both control and hypo-flat groups), but there was no significant difference in free IRI AUC following Sustacal between the three groups. Two individuals developed hypoglycemia during the Sustacal challenge, both in the hypo-high group.

CONCLUSIONS
The lower fasting free/total IRI ratio and greater increase in glucose and total IRI in response to Sustacal in the hypo-high group compared with either the hypo-flat or control groups are consistent with the presence of significant quantities of anti-insulin antibodies in the hypo-high group. Because anti-insulin antibodies are, in turn, an established cause of episodic hypoglycemia, this study provides the first data to support the hypothesis that significant quantities of anti-insulin antibodies are a cause of symptomatic hypoglycemia following PTX in some recipients.
Osteopenia, Neurological Dysfunction, and the Development of Charcot Neuroarthropathy
Authors: Young Matthew J , Marshall Andrew , Adams Judith E , Selby Peter L , Boulton Andrew JM 
Published: March 2007

OBJECTIVE
To determine factors that might be associated with the development of Charcot neuroarthropathy.

RESEARCH DESIGN AND METHODS
This cross-sectional prevalence study examined neurological function and bone density in matched groups of neuropathic diabetic patients with and without radiological evidence of Charcot neuroarthropathy.

RESULTS
Patients with Charcot neuroarthropathy had a global impairment of neurological function that was significantly greater than that of otherwise matched non-Charcot neuropathic patients. All 17 Charcot patients had evidence of autonomic neuropathy compared with 10 of the control subjects (P = 0.03). The Charcot patients had evidence of reduced bone density in the lower limbs compared with the neuropathic control subjects (P = 0.009), but relatively preserved bone density in the spine (P = 0.4 vs. control subjects).

CONCLUSIONS
We conclude that minor trauma in diabetic patients with peripheral neuropathy might result in a fracture in those with a reduced bone density and thus trigger the development of Charcot neuroarthropathy.
A Comparison of Fish Oil or Corn Oil Supplements in Hyperlipidemic Subjects with NIDDM
Authors: Morgan Wanda A , Raskin Philip , Rosenstock Julio 
Published: March 2007

OBJECTIVE
To examine the effects on blood lipids and glycemic control of fish oil and corn oil supplementation at two levels in subjects with hyperlipidemia and non-insulin-dependent diabetes mellitus (NIDDM).

RESEARCH DESIGN AND METHODS
Forty subjects (18 men and 22 women; aged 53.9 ± 7.0 years) with NIDDM and hyperlipidemia were randomly assigned to one of four treatment groups: 9 g of fish oil, 18 g of fish oil, 9 g of corn oil, or 18 g of corn oil daily supplementation for 12 weeks.

RESULTS
The level of oil supplements (9 g compared with 18 g) did not have a significant effect within each oil group on glycemic control and lipids. Significant differences (P &lt; 0.05) in lipids were found when the 9-g and 18-g groups were combined. In subjects consuming fish oil, plasma very-low-density lipoprotein (VLDL) cholesterol (P = 0.0001), plasma triglyceride (TG) (P = 0.0001), and plasma VLDL TGs (P = 0.02 at 6 weeks and P = 0.0001 at 12 weeks) were significantly lowered compared with subjects consuming corn oil. Plasma VLDL cholesterol increased across time in the corn oil group (P = 0.04). Plasma low-density lipoprotein (LDL) cholesterol was temporarily increased (P = 0.008) in the fish oil group at 6 weeks, but the effect was no longer present at 12 weeks. No significant differences between fish oil–or corn oil-supplemented diets were found in total plasma cholesterol, high-density lipoprotein cholesterol, fasting plasma glucose, glycosylated HbA1c, weight, and blood pressure.

CONCLUSIONS
In this study, fish oil supplementation improved plasma VLDL cholesterol, VLDL TGs, and total TGs while having a transient deterioration in LDL cholesterol in subjects with NIDDM. Furthermore, fish oil supplementation had no significant deleterious effect on glycemic control.
Psychological Stress and the Onset of IDDM in Children: A case-control study
Authors: Thernlund Gunilla M , Dahlquist Gisela , Hansson Kjell , Ivarsson Sten A , Ludvigsson Johnny , Sjöblad Sture , Hägglöf Bruno 
Published: March 2007

OBJECTIVE
The purpose of the study was to determine whether psychosocial stress during different life periods could be a risk factor in the etiology/pathogenesis of insulin-dependent diabetes mellitus (IDDM) in children.

RESEARCH DESIGN AND METHODS
In a population-based sample of 67 case patients 0–14 years of age and 61 matched healthy control subjects, life events during the entire lifespan before the onset of IDDM were recorded as well as measures of child behavior before onset, social support, and family function.

RESULTS
Negative life events occurring during the first 2 years of life, life events with difficult adaptation, child behavioral deviances, and a more chaotic family function were more common in the case group. A stepwise logistic regression indicated that negative life events in the first 2 years increased the risk of IDDM and that premorbid child behavior as well as dysfunctional hierarchical family pattern affect the risk.

CONCLUSIONS
Stress early in life may increase the risk for IDDM, presumably by affecting the autoimmune process. To confirm these results, it is necessary to make a truly prospective study.
Psychosocial Status of Children With Diabetes in the First 2 Years After Diagnosis
Authors: Grey Margaret , Cameron Mary Emily , Lipman Terri H , Thurber Frances W 
Published: March 2007

OBJECTIVE
The purpose of this study was to determine the pattern of adjustment over time of a cohort of children with newly diagnosed diabetes compared with a cohort of peer-selected children without diabetes over the first 2 years after the diagnosis of insulin-dependent diabetes mellitus (IDDM).

RESEARCH DESIGN AND METHODS
Children (n = 89 with IDDM, n = 53 without IDDM) ages 8–14 years were studied with the Children's Depression Inventory, State-Trait Anxiety Inventory for Children, Child and Adolescent Adjustment Profile, Self-Perception Profile for Children, and a general health scale. Initial data were collected within 6 weeks of the diagnosis of IDDM and at 3, 6, 12, and 24 months thereafter.

RESULTS
There were no demographic differences between the two groups. Initially, children with diabetes were more depressed, more dependent, and more withdrawn than their peers. By 1 year postdiagnosis, there were no significant differences in psychosocial status between the two groups. By 2 years postdiagnosis, depression, dependency, and withdrawal were significantly higher in children with diabetes than in their peers without IDDM. Self-perceived competence remained similar between the two groups at all time points.

CONCLUSIONS
After an initial period of adjustment, children with IDDM have equivalent psychosocial status to children without IDDM, but by 2 years after diagnosis, they have experienced twice the amount of depression and adjustment problems as their peers. Interventions should be aimed at this critical period between 1 and 2 years postdiagnosis.