bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical Activity, Physical Fitness, and Insulin and Glucose Concentrations in an Isolated Native Canadian Population Experiencing Rapid Lifestyle Change
Authors: Kriska Andrea M. , Hanley Anthony J.G. , Harris Stewart B. , Zinman Bernard 
Published: March 2007

OBJECTIVE—Little is known about the relation of physical activity and physical fitness to insulin resistance and glucose intolerance in isolated subarctic Native Canadian populations. The purpose of this effort was to examine the relation between activity and fitness and obesity and glucose concentrations in such a unique population.
RESEARCH DESIGN AND METHODS—This study describes 530 men and women from the community of Sandy Lake, Ontario, located in the boreal forest region of central Canada. Fasting blood glucose and insulin concentrations were determined after an overnight fast. Past year physical activity levels were assessed using a modified version of an interviewer-administered questionnaire. Maximal oxygen uptake, a measure of cardiovascular fitness, was estimated using a submaximal step test.
RESULTS—Total (leisure and occupational) physical activity and physical fitness were significantly associated with fasting insulin concentrations after adjusting for age, BMI or percent body fat, waist circumference, and fasting glucose concentration in men but not in women. The relations between physical activity, fitness, and fasting glucose concentrations were not as strong or as consistent as they were when fasting insulin concentration was the dependent variable.
CONCLUSIONS—In this isolated Native Canadian community, both physical activity and fitness were independently associated with fasting insulin concentrations, suggesting a beneficial role of physical activity/fitness on insulin sensitivity that is separate from any influence of activity on body composition. The fact that this relation was found in men but not in women is most likely explained by issues related to the measurement of activity and fitness in this study and the fact that the women in this population appear to be less active than the men.
Short-Term Moderate Weight Loss and Resistance Training Do Not Affect Insulin-Stimulated Glucose Disposal in Postmenopausal Women
Authors: Joseph Lyndon J.O. , Trappe Todd A. , Farrell Peter A. , Campbell Wayne W. , Yarasheski Kevin E. , Lambert Charles P. , Evans William J. 
Published: March 2007

OBJECTIVES—Moderate weight loss and exercise have been proposed as important tools in the treatment and prevention of type 2 diabetes. Therefore, we tested the hypothesis that short-term (4 weeks) moderate energy restriction (−750 kcal/day) would result in a significant increase in insulin-stimulated glucose disposal (40 mU · m−2 · min−1 hyperinsulinemic-euglycemic clamp) in moderately overweight postmenopausal women and that when combined with resistance training (RT) an even greater effect would be seen.
RESEARCH DESIGN AND METHODS—Older women were randomly assigned to energy restriction (WLoss group; n = 9) or energy restriction plus RT (RT + WLoss group; n = 10).
RESULTS—For the WLoss versus the RT + WLoss groups, changes in body weight (−3.0 ± 0.2 kg vs. −3.2 ± 0.3 kg), fat mass (FM) (−3.0 ± 0.3 kg vs. −3.2 ± 0.3 kg), and percent body fat (BF) (−2.1 ± 0.4 vs. −2.4 ± 0.3%) were not different between groups. Muscle mass (group-by-time interaction, P = 0.04) was preserved in RT + WLoss (0.40 ± 0.40 kg) and reduced in WLoss (−0.64 ± 0.18 kg). There were no changes in fat-free mass (FFM) and waist-to-hip ratio in either group. Whole body glucose disposal (WLoss 6.14 ± 0.57 vs. 6.03 ± 0.53, RT + WLoss 5.85 ± 0.60 vs. 6.09 ± 0.56 mg/kg of FFM/min) did not change in either group.
CONCLUSIONS—The results of this study demonstrate that short-term energy restriction resulting in moderate decreases in body weight (4.0 ± 0.3%) and FM (8.2 ± 0.7%) did not improve insulin-stimulated glucose disposal. The addition of RT to the hypoenergetic diet preserved muscle mass but provided no synergistic effect on insulin action. These results suggest that a greater change in body weight or FM may be necessary to observe a significant improvement in insulin action.
The Impact of Blood Glucose Self-Monitoring on Metabolic Control and Quality of Life in Type 2 Diabetic Patients
Authors: Franciosi Monica , Pellegrini Fabio , De Berardis Giorgia , Belfiglio Maurizio , Cavaliere Donatella , Di Nardo Barbara , Greenfield Sheldon , Kaplan Sherrie H. , Sacco Michele , Tognoni Gianni , Valentini Miriam , Nicolucci Antonio ,   for the QuED Study Group
Published: March 2007

OBJECTIVE—The role of self-monitoring of blood glucose (SMBG) in type 2 diabetes is still a matter of debate. In the framework of a nationwide outcomes research program, we investigated the frequency of SMBG and its association with metabolic control and quality of life (QoL).
RESEARCH DESIGN AND METHODS—The study involved 3,567 patients with type 2 diabetes who were recruited by 101 outpatient diabetes clinics and 103 general practitioners. Patients completed a questionnaire investigating SMBG practice and QoL (diabetes-related stress, diabetes health distress, diabetes-related worries, and Centers for Epidemiologic Studies-Depression scale).
RESULTS—Data on SMBG were available for 2,855 subjects (80% of the entire study population). Overall, 471 patients (17%) stated that they tested their blood glucose levels at home ≥1 time per day, 899 patients (31%) tested their blood glucose levels ≥1 time per week, and 414 patients (14%) tested their blood glucose levels &lt;1 time per week, whereas 1,071 patients (38%) stated that they never practiced SMBG. A higher frequency of SMBG was associated with better metabolic control among subjects who were able to adjust insulin doses, whereas no relationship was found in all other patients, irrespective of the kind of treatment. Multivariate analyses showed that an SMBG frequency ≥1 time per day was significantly related to higher levels of distress, worries, and depressive symptoms in non–insulin-treated patients.
CONCLUSIONS—Our findings suggest that SMBG can have an important role in improving metabolic control if it is an integral part of a wider educational strategy devoted to the promotion of patient autonomy. In patients not treated with insulin, self-monitoring is associated with higher HbA1c levels and psychological burden. Our data do not support the extension of SMBG to this group.
From Policemen to Policies: What Is the Future for 2-h Glucose?
Authors: Eschwège Eveline , Charles Marie Aline , Simon Dominique , Thibult Nadine , Balkau Beverley 
Published: March 2007

OBJECTIVE—To describe the characteristics and vital prognosis of men with diabetes diagnosed by one fasting plasma glucose (FPG) concentration ≥7.0 mmol/l, with diabetes diagnosed by one isolated postchallenge hyperglycemia (IPH) (FPG &lt;7.0 mmol/l and a 2-h plasma glucose concentration ≥11.1 mmol/l), or with impaired glucose tolerance (IGT).
RESEARCH DESIGN AND METHODS—This study involved a cohort of 6,881 Caucasian nondiabetic men from the Paris Prospective Study, aged 44–55 years, who were followed for cause of death for 20 years.
RESULTS—Diabetes was diagnosed in 4.3% of the men (1.0% diabetes diagnosed by IPH), and IGT was diagnosed in 9% of the men. At baseline, the men with diabetes diagnosed by IPH had a lower cardiovascular risk profile than those with diabetes diagnosed by FPG, as did the men with IGT and a normal fasting glucose level (&lt;6.1 mmol/l, IGT and normal fasting glucose), compared with men with impaired fasting glucose (6.1–6.9 mmol/l, IGT and impaired fasting glucose [IFG]). At 20 years of follow-up, all-cause and cancer death rates were higher in men with diabetes diagnosed by IPH than in men with diabetes diagnosed by FPG (55 vs. 44%, P &lt; 0.1 and 31 vs. 17%, P &lt; 0.01, respectively) but were not significantly different for coronary causes (6 vs. 11%). Men with IGT and normal fasting glucose also had significantly higher cancer death rates than men with IGT and IFG.
CONCLUSIONS—The most likely explanation for the high cancer and low coronary death rates is that men with diabetes diagnosed by IPH consumed alcohol; the men in this study drank 49 g of pure alcohol on average per day, equivalent to 0.6 l of wine. If these results are confirmed by other prospective studies, screening subjects for isolated postchallenge hyperglycemia may not be worthwhile.
Plasma Glucose Levels Throughout the Day and HbA1c Interrelationships in Type 2 Diabetes
Authors: Bonora Enzo , Calcaterra Francesco , Lombardi Simonetta , Bonfante Nicoletta , Formentini Gianni , Bonadonna Riccardo C. , Muggeo Michele 
Published: March 2007

OBJECTIVE—To evaluate the extent of plasma glucose excursions with meals, the relations between plasma glucose levels at different times of the day, and the relations between the latter and HbA1c in non–insulin-treated type 2 diabetic subjects.
RESEARCH DESIGN AND METHODS—Daily glucose profiles were assessed in non–insulin-treated type 2 diabetic patients. Outpatients at the diabetes clinic (n = 371; one daily plasma glucose profile) and at home (n = 30; five daily blood glucose profiles over 1 month) as well as inpatients (n = 455; profile of plasma glucose on the day of admission) were examined. Subjects had plasma/blood glucose assessment before and 2–3 h after breakfast, lunch, and dinner. HbA1c was also measured.
RESULTS—After the meals many subjects had glucose levels &gt;8.9 mmol/l (160 mg/dl) and/or glucose excursions &gt;2.2 mmol/l (40 mg/dl). This was also often found when HbA1c was satisfactory (&lt;7%). The coefficients of simple correlation among plasma/blood glucose at different times of the day ranged from 0.52 to 0.88. Correlations between HbA1c and plasma/blood glucose at different times of the day ranged from 0.44 to 0.67. The strongest correlation was between HbA1c and mean daily glucose (r = 0.57–0.69). Multiple regression analyses showed that premeal but not postmeal plasma/blood glucose levels were independent predictors of HbA1c.
CONCLUSIONS—These results suggest that 1) the majority of non–insulin-treated type 2 diabetic patients have exaggerated plasma/blood glucose excursions with meals, and many of them have higher-than-recommended glucose concentrations 2 h after the meals; 2) plasma/blood glucose levels throughout the day are not as strongly interrelated as one might believe; and 3) HbA1c is more related to preprandial than postprandial plasma/blood glucose levels. These findings have potential implications for treatment and monitoring of metabolic control in type 2 diabetes.
Smoking and Mortality Among Women With Type 2 Diabetes
Authors: Al-Delaimy Wael K. , Willett Walter C. , Manson JoAnn E. , Speizer Frank E. , Hu Frank B. 
Published: March 2007

OBJECTIVE—To assess the relationship between cigarette smoking and mortality among women with type 2 diabetes in the Nurses’ Health Study cohort.
RESEARCH DESIGN AND METHODS—The Nurses’ Health Study, a prospective cohort of U.S. female registered nurses, included 7,401 women with type 2 diabetes diagnosed at baseline or during follow-up from 1976 to 1996. Total and cause-specific mortality of these diabetic women were the outcomes of interest.
RESULTS—We documented 724 deaths during 20 years of follow-up (67,420 person-years) among women with type 2 diabetes. In multivariate analyses, adjusting for age, history of high blood pressure and high cholesterol, and other cardiovascular risk factors, compared with never smokers, the RRs of mortality were 1.31 (95% CI 1.11–1.55) for past smokers, 1.43 (0.96–2.14) for current smokers of 1–14 cigarettes/day, 1.64 (1.24–2.17) for current smokers of 15–34 cigarettes/day, and 2.19 (1.32–3.65) for current smokers of ≥35 cigarettes/day (P for trend = 0.0002). Women with type 2 diabetes who had stopped smoking for ≥10 years had a mortality RR of 1.11 (0.92–1.35) compared with diabetic women who were never smokers.
CONCLUSIONS—Cigarette smoking is associated in a dose-response manner with an increased mortality among women with type 2 diabetes. Furthermore, quitting smoking appears to decrease this excess risk substantially. Diabetes patients should be strongly advised against smoking.
Was the Historic Contribution of Spain to the Mexican Gene Pool Partially Responsible for the Higher Prevalence of Type 2 Diabetes in Mexican-Origin Populations?
Authors: Lorenzo Carlos , Serrano-Rios Manel , Martinez-Larrad Maria T. , Gabriel Rafael , Williams Ken , Gonzalez-Villalpando Clicerio , Stern Michel P. , Hazuda Helen P. , Haffner Steven M. 
Published: March 2007

OBJECTIVE—Mexican-American populations in San Antonio, Texas (SA-MA) and Mexico have a higher prevalence of type 2 diabetes than non-Hispanic whites in San Antonio (SA-NHW). However, the higher prevalence of type 2 diabetes in Mexican-origin populations might be related, in part, not to Native American genetic admixture but to Spanish genetic admixture.
RESEARCH DESIGN AND METHODS—Four population-based epidemiological surveys conducted with Mexican-origin and European-origin samples provided data relevant to this question. In all four surveys, type 2 diabetes was defined as fasting plasma glucose ≥7.0 mmol/l or 2-h glucose ≥11.1 mmol/l or use of antidiabetic agents.
RESULTS—A comparison of the two Mexican-origin populations showed that the age- and sex-adjusted prevalence of type 2 diabetes was lower in Mexico than in SA-MA (15.1 vs. 17.9%, P = 0.032). Between the two European-origin populations, the prevalence of type 2 diabetes was lower in SA-NHW than in Spain (6.2 vs. 9.1%, P &lt; 0.0001), but differences were attenuated by adjustment for BMI or after stratification by education. In logistic regression analyses, type 2 diabetes was associated with Mexican ethnic origin after adjusting for age, education, BMI, and waist-to-hip ratio.
CONCLUSIONS—The prevalence of type 2 diabetes in Spain was intermediate between that in Mexican-origin populations and SA-NHW. Although the higher degree of Native American admixture is a major contributor to the higher rates of type 2 diabetes, we cannot completely rule out a partial contribution of Spanish admixture to diabetes susceptibility among Mexican- origin populations.
Increased Arterial Wall Stiffness Limits Flow Volume in the Lower Extremities in Type 2 Diabetic Patients
Authors: Suzuki Eiji , Kashiwagi Atsunori , Nishio Yoshihiko , Egawa Katsuya , Shimizu Shinya , Maegawa Hiroshi , Haneda Masakazu , Yasuda Hitoshi , Morikawa Shigehiro , Inubushi Toshiro , Kikkawa Ryuichi 
Published: March 2007

OBJECTIVE—To document an association between arterial wall stiffness and reduced flow volume in the lower-extremity arteries of diabetic patients.
RESEARCH DESIGN AND METHODS—We recruited 60 consecutive type 2 diabetic patients who had no history or symptoms of peripheral arterial disease (PAD) in the lower extremities and normal ankle/brachial systolic blood pressure index at the time of the study (non-PAD group) and 20 age-matched nondiabetic subjects (control group). We used an automatic device to measure pulse wave velocity (PWV) in the lower extremities as an index of arterial wall stiffness. At the popliteal artery, we evaluated flow volume and the resistive index as an index of arterial resistance to blood flow using gated two-dimensional cine-mode phase-contrast magnetic resonance imaging.
RESULTS—Consistent with previous reports, we confirmed that the non-PAD group had an abnormally higher PWV compared with that of the control group (P &lt; 0.001). To further demonstrate decreased flow volume and abnormal flow pattern at the popliteal artery in patients with a higher degree of arterial wall stiffness, we assigned the 60 non-PAD patients to tertiles based on their levels of PWV. In the highest group, magnetic resonance angiograms of the calf and foot arteries showed decreased intravascular signal intensity, indicating the decreased arterial inflow in those arteries. The highest group was also characterized by the lowest late diastolic and total flow volumes as well as the highest resistive index among the groups. From stepwise multiple regression analysis, PWV and autonomic function were identified as independent determinants for late diastolic flow volume (r2 = 0.300; P &lt; 0.001).
CONCLUSIONS—Arterial wall stiffness was associated with reduced arterial flow volume in the lower extremities of diabetic patients.
Aspirin Use Among Adults With Diabetes
Authors: Rolka Deborah B. , Fagot-Campagna Anne , Narayan K.M. Venkat 
Published: March 2007

OBJECTIVE— Since 1997, the American Diabetes Association has recommended that aspirin therapy be considered for adults with diabetes who have cardiovascular disease (CVD) or CVD risk factors. We examined the prevalence of regular aspirin use among adults in the U.S. with diagnosed diabetes.
RESEARCH DESIGN AND METHODS— The Third National Health and Nutrition Examination Survey (1988-1994) used a probability sample of the U.S. population and included an interview, physical examination, and laboratory studies. Among the survey participants were 1,503 adults (age ≥21 years)with self-reported diabetes. We defined regular aspirin use as reported having taken aspirin ≥15 times in the previous month. CVD conditions were self-reported heart attack and stroke and symptoms of angina and claudication. CVD risk factors included smoking, hypertension, obesity, albuminuria, lipid abnormalities, and family history of heart attack.
RESULTS— An estimated 27% of adults with diabetes had CVD, and an additional 71% had one or more CVD risk factors. Aspirin was used regularly by 37% of those with CVD and by 13% of those with risk factors only. Adjusted odds of regular aspirin use were significantly greater for individuals with CVD than for those with one CVD risk factor (odds ratio [OR] = 4.3); for non-Hispanic whites than for blacks, Mexican-Americans, and others (OR = 2.5);and for individuals age 40-59 years than for those &lt;40 years (OR =33.3).
CONCLUSIONS— Nearly every adult in the U.S. with diabetes has at least one risk factor for CVD and thus may be considered a potential candidate for aspirin therapy. During 1988-1994, only 20% (95% CI 16-23) took aspirin regularly. Major efforts are needed to increase aspirin use.
The Potentially Poor Response to Outpatient Diabetes Care in Urban African-Americans
Authors: Cook Curtiss B. , Lyles Robert H. , El-Kebbi Imad , Ziemer David C. , Gallina Daniel L. , Dunbar Virginia G. , Phillips Lawrence S. 
Published: March 2007

OBJECTIVE— HbAlc levels can be reduced in populations of diabetic patients, but some individuals may exhibit little improvement. To search for reasons underlying differences in HbAlcoutcome, we analyzed patients managed in an outpatient diabetes clinic.
RESEARCH DESIGN AND METHODS— African-Americans with type 2 diabetes were categorized as responders, intermediate responders or poor responders according to their HbAlc level after 1 year of care. Logistical regression was used to determine baseline characteristics that distinguished poor responders from responders. Therapeutic strategies were examined for each of the response categories.
RESULTS— The 447 patients had a mean age and disease duration of 58 and 5 years, respectively, and BMI of 32 kg/m2. Overall, the mean HbAlc level fell from 9.6 to 8.1% after 12 months. Mean HbAlc levels improved from 8.8 to 6.2% in responders, and from 9.5 to 7.9% in intermediate responders. In poor responders, the average HbAlc level was 10.8% on presentation and 10.9% at 1 year. The odds of being a poor responder were significantly increased with longer disease duration, higher initial HbAlc level, and greater BMI. Although doses of oral agents and insulin were significantly higher among poor responders at most visits, the acceleration of insulin therapy did not occur until late in the follow-up period.
CONCLUSIONS— Clinical diabetes programs need to devise methods to identify patients who are at risk for persistent hyperglycemia. Whereas patient characteristics explain some heterogeneity of HbAlc outcome(and may aid in earlier identification of patients who potentially may not respond to conventional treatment), insufficient intensification of therapy may also be a component underlying the failure to achieve glycemic goals.
Comparison of Single-Mother and Two-Parent Families on Metabolic Control of Children With Diabetes
Authors: Thompson Sanna J. , Auslander Wendy F. , White Neil H. 
Published: March 2007

OBJECTIVE— To understand the impact of family structure on the metabolic control of children with diabetes, we posed two research questions: 1) what are the differences in sociodemographic, family, and community factors between single-mother and two-parent families of diabetic children? and 2) to what extent do these psychosocial factors predict metabolic control among diabetic children from single-mother and two-parent families?
RESEARCH DESIGN AND METHODS— This cross-sectional study included 155 diabetic children and their mothers or other female caregivers. The children were recruited if they had been diagnosed with diabetes for at least 1 year, had no other comorbid chronic illnesses, and were younger than 18 years of age. Interviews and self-report questionnaires were used to assess individual, family, and community variables.
RESULTS— The findings indicate that diabetic children from single-mother families have poorer metabolic control than do children from two-parent families. Regression models of children's metabolic control from single-mother families indicate that age and missed clinic appointments predicted HbAlc levels; however, among two-parent families,children's ethnicity and adherence to their medication regimen significantly predicted metabolic control.
CONCLUSIONS— This study suggests that children from single-mother families are at risk of poorer metabolic control and that these families have more challenges to face when raising a child with a chronic illness. Implications point to a need for developing strategies sensitive to the challenges of single mothers.
Limited Value of the Homeostasis Model Assessment to Predict Insulin Resistance in Older Men With Impaired Glucose Tolerance
Authors: Ferrara Cynthia M. , Goldberg Andrew P. 
Published: March 2007

OBJECTIVE— Insulin resistance (IR) in older individuals is associated with risk factors for coronary artery disease. The glucose clamp measures IR directly, but the homeostasis model assessment (HOMA) of IR,referred to here as HOMA-IR, is based on fasting glucose and insulin and is less invasive and labor intensive. This method requires validation in the elderly.
RESEARCH DESIGN AND METHODS— We assessed the validity of HOMA-IR as an index of IR by comparing it to glucose infusion rates (GIRs)measured by a glucose clamp (600 pmol · m-2 ·min-1) in 45 obese men (61 ± 8 years of age, mean ±SD) with normal glucose tolerance (NGT) (n = 21) or impaired glucose tolerance (IGT) (n = 24). We also evaluated relationships between body composition, exercise capacity, and IR.
RESULTS— Subjects with NGT had lower BMI (28 ± 3 vs. 31± 3 kg/m2), waist circumference (97 ± 9 vs. 105± 9 cm), waist-to-hip ratio (WHR) (0.93 ± 0.06 vs. 0.97 ±0.05), and percent body fat (25 ± 6 vs. 30 ± 6) than subjects with IGT. Subjects with NGT also had lower areas above basal during the 2-h oral glucose tolerance test for glucose (274 ± 95 vs. 419 ± 124 mmol · min/l) and insulin (38,142 ± 18,206 vs. 58,383 ±34,408 pmol · min/l) and lower HOMA-IR values (2.2 ± 0.8 vs. 4.2± 2.6) than subjects with IGT. GIR (μmol · kg-1FFM · min-1) was higher in subjects with NGT than in subjects with IGT (53 ± 11 vs. 43 ± 14). HOMA-IR correlated with GIR in subjects with NGT (r = -0.59), but not in subjects with IGT(r = -0.13). GIR correlated with Vo2max in subjects with NGT (r = 0.58) and IGT (r = 0.42), but with WHR only in subjects with NGT (r = -0.53). HOMA-IR correlated with Vo2max (r = -0.57) and waist circumference (r =0.54) in subjects with NGT, but with percent body fat in subjects with IGT(r = 0.54).
CONCLUSIONS— These findings indicate that HOMA-IR should not be used as an index of IR in older individuals who may be at risk for IGT, and suggest that lifestyle changes that increase Vo2max and decrease body fat may reduce IR in older people.