bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of Type I Diabetes in the Liguria Region, Italy: Results of a prospective study in a 0- to 14-year age-group
Authors: Mazzella Massimo , Cotellessa Mario , Bonassi Stefano , Mulas Roberta , Caratozzolo Antonino , Gaber Shamir , Romano Cesare 
Published: March 2007

OBJECTIVE
To assess updated incidence of insulin-dependent diabetes mellitus (IDDM) in 0- to 14-year-old children in Liguria, a northwest region of Italy.

RESEARCH DESIGN AND METHODS
Incident cases were recorded prospectively from 1987 to 1991. Incidence rates (IRs) were directly standardized on the basis of the 1990 world population. The independent effect of age, sex, residence, and calendar year was estimated with a Poisson regression model. The degree of ascertainment was calculated in accordance with the capture/recapture method.

RESULTS
During 5 full calendar years, 117 new cases of IDDM in children were diagnosed in Liguria. The standardized IR over the 5-year period was 11.72 cases·100,000−1·year−1. The sex-specific IR among males and females was 11.45 and 12.01, respectively. The age-specific IR was higher in the 5–9 age-group.

CONCLUSIONS
The IR of IDDM in Liguria is among the highest in southern Europe and approaches that 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 IDDM does not seem to reflect the simple north-south gradient reported in several previous studies.
Effect of Fosinopril on Cardiac and Metabolic Parameters in Patients With NIDDM
Authors: Holdaway Ian M , Gamble Greg D , Sanders Gillian A , Greaves Sally C , Ellis-Pegler Elaine M , Sharpe Norman 
Published: March 2007

OBJECTIVE
To determine whether the angiotensin-converting enzyme (ACE) inhibitor fosinopril can favorably alter cardiac function in non-insulin-dependent diabetes mellitus NIDDM) patients who have either normal blood pressure (BP) or mild, untreated hypertension.

RESEARCH DESIGN AND METHODS
Fifty-five NIDDM subjects with normal BP or mild, untreated hypertension were randomized to treatment with the ACE-inhibitor fosinopril or placebo for 6 months in a randomized, double-blind trial to determine the effect of fosinopril on echocardiographic measurements.

RESULTS
Left ventricular mass index (LVMI) fell by 6.5 ± 4.7% (mean ± SD) with fosinopril and increased by 8.6 ± 3.5% during placebo treatment (P &lt; 0.02), and isovolumic relaxation time improved significantly in those with elevated baseline levels (P = 0.02). Systolic BP fell significantly, but this did not correlate with the change in LVMI, suggesting a possible direct action of fosinopril on the heart.

CONCLUSIONS
Fosinopril appears to have significant cardiac benefits in patients with NIDDM who have normal or mildly elevated BP. These benefits are achieved without adversely affecting renal status and without impairing metabolic control of diabetes.
Enhanced Pressor Responsiveness to Norepinephrine in Type II Diabetes: Effect of ACE inhibition
Authors: Ciavarella Adolfo , Mustacchio Anna , Ricci Chistina , Capelli Maurizio , Vannini Pietro 
Published: March 2007

OBJECTIVE
To evaluate the effect of angiotensin-converting enzyme (ACE) inhibition on the pressor responsiveness to norepinephrine in type II diabetes.

RESEARCH DESIGN AND METHODS
Eight normotensive subjects, eight mild-to-moderate hypertensive type II diabetic patients, and eight nondiabetic patients with essential hypertension were studied before and after 4 weeks of being administered enalapril. The pressor response to norepinephrine was assessed by infusing the hormone in an antecubital vein at incremental doses of 30 ng·kg−1 · min−1 for periods of 5 min until reaching an increase of 20 ± 2 mmHg in mean arterial pressure (MAP) measured by an automatic device at 1-min intervals. An effective dosage of norepinephrine that increased MAP by 20 mmHg (EDNE 20) was thereafter calculated. Before and during the last minute of norepinephrine infusion at maximum dosage, a venous blood sample was drawn to determine plasma renin activity (PRA), aldosterone, and norepinephrine levels.

RESULTS
In the three groups of patients, blood pressure and aldosterone were reduced while PRA was raised following ACE inhibition. Basal and maximum postinfusion levels of norepinephrine were not modified by enalapril. The EDNE 20 was basally lower in diabetic patients and remained unchanged after ACE inhibition, contrary to that observed in nondiabetic patients with essential hypertension.

CONCLUSIONS
Both normotensive and hypertensive type II diabetic patients have an increased pressor responsiveness to norepinephrine that is not modified by therapeutic doses of enalapril, contrary to what is observed in nondiabetic patients with essential hypertension.
Serum Sialic Acid, a Risk Factor for Cardiovascular Disease, Is Increased in IDDM Patients With Microalbuminuria and Clinical Proteinuria
Authors: Crook Martin A , Earle Kenneth , Morocutti Anna , Yip Jeannie , Viberti Giancarlo , Pickup John C 
Published: March 2007

OBJECTIVE
An elevated serum sialic acid concentration has recently beenshown to be a potent cardiovascular risk factor in the general population. Because clinical proteinuria is associated with a high frequency of cardiovascular disease, and because microalbuminuria predicts the development of renal and cardiovascular disease in diabetes, we investigated whether serum sialic acid levels are increased in insulin-dependent diabetes mellitus (IDDM) patients with microalbuminuria or clinical proteinuria.

RESEARCH DESIGN AND METHODS
We studied 23 patients with IDDM who had a normal urinary albumin excretion rate, 23 patients who had microalbuminuria, and 23 patients with clinical proteinuria. The patients were matched for age, sex, duration of diabetes, GHb levels, and body mass index (BMI). Fasting blood samples were taken for measurement of sialic acid, cholesterol, triglyceride, creatinine, and GHb.

RESULTS
Serum sialic acid was significantly higher in the microalbuminuric patients compared with the normoalbuminuric group (mean ± SD: 1.93 ± 0.26 vs. 1.76 ± 0.27 mM, P &lt; 0.01). Moreover, serum sialic acid was also significantly higher in the group with clinical proteinuria compared with the microalbuminuric patients (2.34 ± 0.24 vs. 1.93 ± 0.26 mM, P &lt; 0.001). Serum sialic acid was not related independently to age, BMI, diabetes duration, GHb, blood pressure, serum cholesterol, triglyceride, or creatinine concentration in any of the diabetic groups.

CONCLUSIONS
These observations suggest that the serum sialic acid concentration is raised in IDDM patients with both microalbuminuria and clinicalproteinuria and may play a role as a cardiovascular risk factor or disease marker in these conditions.
Evaluation of the Costs to Medicare of Covering Therapeutic Shoes for Diabetic Patients
Authors: Wooldridge Judith , Moreno Lorenzo 
Published: March 2007

OBJECTIVE
A three-year demonstration was fielded in three states to evaluate the cost to Medicare of a therapeutic shoes benefit for Medicare Part B beneficiaries with severe diabetic foot disease.

RESEARCH DESIGN AND METHODS
Eligible Medicare beneficiaries who applied were randomly assigned to either a treatment group that received the extra therapeutic shoe coverage or a control group that received only standard Medicare coverage. This study analyzes the Medicare payments and service use of 3,428 demonstration participants in California, Florida, and New York for whom data on a 12-month follow-up period were available. These results are comparable to those for the entire sample over a variable length follow-up period that averaged 20 months but ranged from 3 months to 3 years.

RESULTS
Differences between groups are not statistically significant. However, Medicare payments for all services among the treatment group were $451 (3.8%) higher than those for all services among the control group. Similarly, Medicare payments for foot-care services were $318 (14.6%) higher among beneficiaries in the treatment group, which considerably exceeded the cost of the shoe benefit ($118).

CONCLUSIONS
The demonstration produced no definitive evidence that expanding Medicare Part B to cover therapeutic shoes for beneficiaries with severe diabetic foot disease would increase total Medicare costs. However, our findings indicate that the demonstration was successful at increasing therapeutic shoe ownership and was instrumental in increasing beneficiaries' use of the shoes when walking outdoors.
The Prediction of Diabetic Neuropathic Plantar Foot Ulceration by Liquid-Crystal Contact Thermography
Authors: Benbow Susan J , Chan Ah W , Bowsher David R , Williams Gareth , Macfarlane Ian A 
Published: March 2007

OBJECTIVE
To assess whether the development of plantar foot ulceration could be predicted from the mean plantar foot temperature (MFT), as assessed by liquid-crystal contact thermography (LCT), in patients with peripheral neuropathy.

RESEARCH DESIGN AND METHODS
Fifty patients with painful diabetic sensorimotor neuropathy were studied prospectively. Initially, 30 patients had no significant peripheral vascular disease (PVD) (ankle:brachial systolic blood pressure ratio &gt;1.0). LCT was used to assess the MFT from eight standard plantar sites.

RESULTS
Initial MFT was higher in the patients without PVD (28.2 ± 2.9°C, mean ± SD) than in patients with PVD (25.6 ± 1.9°C, P &lt; 0.001) and in nondiabetic control subjects (25.7 ± 2.1°C, P &lt; 0.001). At review, on average 3.6 (range 3.0–4.1) years later, 11 patients had died (6 of whom had PVD), and one was lost to follow-up. Six patients (seven feet) from the group without PVD had developed neuropathic plantar foot ulcers. The initial MFT was significantly higher in these seven feet (30.5 ± 2.6°C) than in the 38 feet of the 19 survivors in this group (27.8 ± 2.3°C, P &lt; 0.01). Only one patient with PVD developed a plantar ulcer, although four required foot surgery for ischemie feet.

CONCLUSIONS
LCT is a simple, inexpensive, and noninvasive method of identifying the neuropathic foot at increased risk of ulceration. Patients with high plantar foot temperatures are at increased risk of neuropathic foot ulceration. A normal or low MFT in the neuropathic foot is a marker of PVD, which confers an increased risk of ischemie foot disease.
Feasibility of Insulin-Glucose Infusion in Diabetic Patients With Acute Myocardial Infarction: A report from the multicenter trial: DIGAMI
Authors: Malmberg Klas A , Efendic Suad , Rydén Lars E ,   For The Multicenter Study Group
Published: March 2007

OBJECTIVE
To investigate the effect of insulin-glucose infusion on metabolic control and hypoglycemie episodes and its feasibility and safety in patients with diabetes and myocardial infarction (MI) compared with conventional treatment.

RESEARCH DESIGN AND METHODS
Of 327 patients with suspected acute MI, 158 were randomized to insulin-glucose infusion for at least 24 h and 169 received conventional therapy. We determined the 24-h blood glucose profile in the infusion group, the degree of metabolic control, hypoglycemie events, and in-hospital complications within the two study groups.

RESULTS
Blood glucose fell from 14.6 ± 2.9 to 9.2 ± 2.9 mM during the first 24 h in patients receiving insulin-glucose and from 15.8 ± 4.3 to 12.0 ± 4.4 mM in control patients (P &lt; 0.01). Serum potassium decreased 0.21 ± 0.56 mM in the infusion group (P &lt; 0.001) and 0.11 ± 0.59 mM in the control group (P &lt; 0.05). The difference between the groups was not significant. Twenty-eight of the 158 patients developed an episode of hypoglycemia (blood glucose &lt; 3.0 mM) during the insulin-glucose infusion. There were no significant differences in the number of episodes of ventricular tachyarrhythmias or in ischemie events between patients with and without hypoglycemia.

CONCLUSIONS
The protocol outlined in this study gives more rapid and better metabolic control than does conventional treatment. This treatment seems to be a feasible alternative for clinical attempts. Before it can be recommended for general use, the impact on mortality needs to be evaluated.
Assessment of the DQB1-DQA1 Complete Genotype Allows Best Prediction for IDDM
Authors: Tosi Giovanna , Facchin Alberto , Pinelli Leonardo , Accolla Roberto S 
Published: March 2007

OBJECTIVE
To analyze the HLA-DQ (human leukocyte antigen) genetic association with insulin-dependent diabetes mellitus (IDDM) patients of the Northeast Italian population.

RESEARCH DESIGN AND METHODS
Fifty-one IDDM patients and 52 healthy control subjects were molecularly typed for DQB1 and DQA1 loci by using allele-specific oligonucleotide probes and polymerase chain reaction amplified genomie DNA. DNA enzyme immunoassay was used to assess allele specificities.

RESULTS
IDDM status strongly correlated with DQB1 alleles carrying a non-aspartic acid (non-Asp) residue in position 57 of DQα-chain and DQA1 alleles with an arginine (Arg) residue in position 52 of DQa-chain. Individuals with two DQB1 (non-Asp) alíeles and two DQAl(Arg) alleles had the highest relative risk for disease: they constituted ∼40% of IDDM patients compared with 0% of control subjects. Heterozy-gosis at either residue 57 of DQB1 or residue 52 of DQA1 was sufficient to abrogate statistical significance for disease association, although 47% of IDDM patients were included in these two groups compared with 21% of normal control subjects. On the other hand, the presence of two DQB1 alleles with Asp in position 57 was sufficient to confer resistance to disease irrespective of the DQA1 genotype.

CONCLUSIONS
The results demonstrate that the complete HLA-DQ genotype, more than a single DQB1 or DQA1 locus, should be determined to estimate the highest risk for disease. Screening a population for preventive purposes and/or early signs of IDDM should then take advantage of this result, and “susceptible homozygous” individuals should be followed very closely and considered the first group of choice for possible new therapeutic trials.
Epidemiology of IDDM in Switzerland: Increasing incidence rate and rural-urban differences in Swiss men born 1948-1972
Authors: Schoenle Eugen J , Molinari Luciano , Bagot Michael , Semadeni Sandra , Wiesendanger Monika 
Published: March 2007

OBJECTIVE
To determine the incidence of insulin-dependent diabetes mellitus (IDDM) in Switzerland by undertaking a retrospective analysis of the registry of the Swiss army, which contains updated medical files for all male Swiss citizens. Nationwide data for IDDM epidemiology have not been available in Switzerland.

RESEARCH DESIGN AND METHODS
Every male Swiss citizen is obliged to enlist in the Swiss military service at 19 years of age, when a personal, continuously updated medical file is established. Diabetes is an exclusion condition for military service and is clearly marked in the file. A total number of 514,747 files, corresponding to birth year cohorts 1948-1950, 1955-1957, 1962-1964, and 1970-1972, have been manually checked for the diagnosis of IDDM.

RESULTS
IDDM was identified in 926 cases in the four groups of three age-cohorts. The incidence at ≤15 years (per 100,000/year) was 4.5 in the age cohorts 1948-1950 and 7.2 in the age cohorts 1970-1972 (P &lt; 0.005). An additive age-cohort Poisson regression model fits the nationwide incidences adequately, neither a period effect nor age X cohort interactions being required. In the oldest age cohorts, the age-specific incidence of IDDM was calculated up to the age of 43 and was ∼7/ 100,000/year in men between 20 and 40. In these age cohorts, we found an ∼50% higher risk to develop IDDM at age ≤19 for men living in an urban region and a significantly (P &lt; 0.005) increased incidence between 20 and 40 years in rural regions compared with urban regions.

CONCLUSIONS
The incidence of IDDM in Switzerland is comparable to other countries in central Europe and has been increasing in the last 20 years. This is in accordance to most recent epidemiological studies worldwide. In addition, the data suggest exogenous factors inducing IDDM at a younger age in urban regions.
Children With Newly Diagnosed IDDM Have Increased Levels of Antibodies to Bovine Serum Albumin But Not to Ovalbumin
Authors: Saukkonen Tero , Savilahti Erkki , Vaarala Outi , Virtala Esa T , Tuomilehto Jaakko , Åkerblom Hans K ,   The Childhood Diabetes in Finland Study Group
Published: March 2007

OBJECTIVE
To study the humoral immune response to bovine serum albumin (BSA) and ovalbumin (OA) in children with newly diagnosed insulin-dependent diabetes mellitus (IDDM).

RESEARCH DESIGN AND METHODS
We examined serum samples from 505 children 0.8–14.9 years of age with newly diagnosed IDDM for antibodies to BSA and OA by enzyme-linked immunosorbent assay (ELISA). We also had two control groups: 85 unrelated control children (0.8–7.1 years of age) and 395 nondiabetic siblings (3.0–14.9 years of age). The specificity of antibodies detected in ELISA was confirmed by immunoblotting in a subset of sera with varying levels of antibodies.

RESULTS
Diabetic children &lt;7 years of age had a significantly higher level of IgG (immunoglobulin) antibodies to BSA than did unrelated control children (P &lt; 0.0001). The difference was greatest in the youngest group of children, 0.8–2.9 years of age. IgA antibodies to BSA were detected more frequently among diabetic than control children (P = 0.0009). Levels of IgG and IgA antibodies to ovalbumin did not differ between diabetic and control children. Diabetic children 3.0–14.9 years of age also had higher levels of IgG and IgA antibodies to BSA than did their age- and sex-matched nondiabetic siblings (P = 0.02 and P &lt; 0.0001, respectively). Those siblings who contracted IDDM during the follow-up period (n = 15) had a measurable level of IgA antibodies to BSA more often than did those who remained nondiabetic (60 and 34%, respectively; P = 0.04). Neither before nor after diagnosis of IDDM was there any significant trend in antibody levels.

CONCLUSIONS
A high level of antibodies to BSA commonly associates with IDDM, whereas the humoral immune response to OA is similar in diabetic and nondiabetic children.
Fibrinolysis and Diabetic Retinopathy in NIDDM
Authors: Mansfield Michael W , Grant Peter J 
Published: March 2007

OBJECTIVE
By contributing to a prothrombotic state, increased levels of plasminogen activator inhibitor-1 (PAI-1) may be involved in the pathogenesis of the vascular complications of non-insulin-dependent diabetes mellitus (NIDDM). The objective of this study was to compare levels of components of the fibrinolytic system in NIDDM subjects with and without retinopathy.

RESEARCH DESIGN AND METHODS
A total of 135 Caucasian NIDDM subjects treated with oral therapy or diet alone were classified by the presence or absence of retinopathy, and fasting blood samples were taken for assay of PAI-1 antigen and activity, tissue plasminogen activator (t-PA), t-PA complexed with PAI-1, euglobulin clot lysis time (a measure of overall fibrinolytic activity), glucose, HbA1c, cholesterol, triglyceride, and insulin levels.

RESULTS
Subjects with retinopathy had a longer disease duration than those without (9 vs. 5 years, P &lt; 0.0001) and had lower levels of PAI-1 (PAI-1 antigen) (geometric mean and 95% confidence interval), 13.9 (10.4–18.6) vs. 24.1 (21.2–27.4) ng/ml (P &lt; 0.0005); t-PA antigen, 9.6 (8.6–10.7) vs. 11.5 (10.8-12.3) ng/ml (P &lt; 0.01); t-PA—PAI-1 complexes, 6.2 (5.2–7.2) vs. 7.8 (6.8–8.8) ng/ml (P &lt; 0.05); and insulin, 11.5 (9.3-14.3) vs. 19.5 (17.0–22.3) mU/l (P &lt; 0.0005). Euglobulin clot lysis time was shorter in the subjects with retinopathy, 273 (238–312) vs. 327 (303–352) min. When entered into a logistic regression model, disease duration, PAI-1 antigen, and HbA1c remained as significant independent associates of the presence of retinopathy.

CONCLUSIONS
These results do not support the hypothesis that impaired fibrinolysis due to elevated PAI-1 is associated with the development of retinopathy because fibrinolysis is indeed enhanced and PAI-1 lower in subjects with retinopathy.
Maternal Metabolic Control and Risk of Microcephaly Among Infants of Diabetic Mothers
Authors: Greene Michael F , Allred Elizabeth N , Leviton Alan 
Published: March 2007

OBJECTIVE
To measure the incidence of microcephaly among infants of diabetic mothers (IDM) and assess its relationship to metabolic control during pregnancy.

RESEARCH DESIGN AND METHODS
Head circumference data for 556 consecutive live-born singleton infants of women with insulin-requiring diabetes antedating pregnancy delivered between 28 and 40 weeks of gestation and the results of 3,242 HbA1 determinations collected during their pregnancies were examined.

RESULTS
There were fewer head circumferences at or below the 3rd percentne and more at or above the 97th percentik than expected. Head circumference was not related to maternal metabolic control as documented by the HbA1 values.

CONCLUSIONS
The less-than-expected incidence of microcephaly observed in this patient population probably reflects the well-known tendency of IDM toward macrosomia.
Impaired Glucose Tolerance Leads to Delayed Diagnosis of AlstrÖm Syndrome
Authors: Holder Martin , Hecker Wolfgang , Gilli Guilio 
Published: March 2007

OBJECTIVE
To emphasis the need for timely diagnosis of AlstrÖm syndrome.

CASE
We report a case of late-detected AlstrÖm syndrome in a boy 15 1/2 years of age who was admitted because of poor wound healing and hyperglycemia.

RESULTS
Diagnosis was made and the patient's impaired glucose tolerance improved by diet.

CONCLUSIONS
Regular follow-ups are needed to recognize and possibly prevent late-appearing complications.
A Comparison of Premixed Insulin Preparations in Elderly Patients: Efficacy of 70/30 and 50/50 human insulin mixtures
Authors: Brodows Robert , Chessor Ruth 
Published: March 2007

OBJECTIVE
To compare the postprandial hyperglycemic response to a standard breakfast of two premixed humulin insulin mixtures, 50/50 (50% NPH human insulin and 50% regular human insulin) and 70/30 (70% NPH human insulin and 30% regular human insulin) in elderly non-insulin-dependent diabetes mellitus (NIDDM) patients.

RESEARCH DESIGN AND METHODS
On two mornings, each patient (n = 20) consumed a standard breakfast after a single dose of 50/50 or 70/30 insulin (0.3 U/kg) was administered in a randomized crossover fashion. Plasma glucose and serum free insulin concentrations were measured before and for 4 h after insulin administration.

RESULTS
Plasma glucose reached a peak at 60 min and a nadir at 240 min for both types of insulin. No differences in maximum and minimum glucose concentrations, time to maximum and minimum glucose concentrations, or areas under the curve were noted. Free insulin levels did not differ significantly.

CONCLUSIONS
These results suggest that small changes in the composition of premixed insulin mixtures in NIDDM patients may not result in improved postprandial glycemic control.