bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Reliability and Repeatability of the Blood Glucose Response to Prolonged Exercise in Adolescent Boys with IDDM
Authors: McNiven Temple Marilyn Y , Bar-Or Oded , Riddell Michael C 
Published: March 2007

OBJECTIVE
To determine the intrasubject reliability and repeatability of the blood glucose response to prolonged exercise in adolescents with insulin-dependent diabetes mellitus (IDDM) when pre-exercise meal, exercise, and insulin regimens are kept constant.

RESEARCH DESIGN AND METHODS
Nine IDDM adolescent boys with diabetes duration of 9.7 ± 4.8 years participated in two testing sessions 5–17 days apart. Carbohydrate intake, subcutaneous insulin injections, exercise bouts, and their timing were identical in both sessions. Exercise started 1 h after breakfast and consisted of six 10-min cycling bouts at moderate intensity (heart rate 145–150 beats/min), separated by 5-min rest periods. During rest periods, blood samples for glucose were taken and a supplemental carbohydrate beverage was consumed. Subjects were asked periodically to guess their own blood glucose levels.

RESULTS
Intersession plasma glucose levels for each time period from the start of exercise to the end of the final recovery period were unchanged between sessions (P &gt; 0.05) and highly correlated (r = 0.88 to r = 0.96, P &lt; 0.01). The intraclass correlation for plasma glucose was 0.95. Decreases in plasma glucose from the start of exercise to the end of exercise were, at most, 5 mmol/l, and intersession decreases did not differ significantly (P &gt; 0.05). One subject experienced hypoglycemia. The decrease in plasma glucose did not differ significantly between fair and poor glycemie control (glycosylated hemoglobin ≤10% and &gt;10%, respectively). Subjects markedly underestimated their blood glucose levels when they were high, but their guesses were closer to the measured values at lower levels.

CONCLUSIONS
Intersession observations demonstrated that the intrasubject blood glucose responses to prolonged moderate-intensity exercise were reliable and repeatable when pre-exercise meal, exercise, and insulin regimens were kept constant. This is an important finding for implementing and evaluating educational strategies for improving the metabolic control associated with prolonged exercise, as well as for future research on means for preventing exercise-induced hypoglycemia.
Body Sway in Diabetic Neuropathy
Authors: Uccioli Luigi , Giacomini Pier Giorgio , Monticone Giovanna , Magrini Antonio , Durola Laura , Bruno Ernesto , Parisi Leo , Girolamo Stefano Di , Menzinger Guido 
Published: March 2007

OBJECTIVE
To evaluate the influence of peripheral neuropathy on body sway assessed by posturography.

RESEARCH DESIGN AND METHODS
The age-matched study subjects included 10 insulin-dependent diabetes mellitus (IDDM) patients with peripheral neuropathy (DN), 23 IDDM patients without peripheral neuropathy (D) according to the San Antonio Consensus Conference guidelines, and 21 control subjects (C). All subjects with symptoms and/or clinical signs of postural instability were excluded from the study.

RESULTS
The trace surface was significantly larger in the DN than in the C and D groups (P &lt; 0.05), and the trace length was longer in the DN than in the C and D groups (P &lt; 0.01). Mean velocity was faster in the DN than in the other two groups (P &lt; 0.001). A direct relationship was found between the parameters of posturography and some parameters of the nerve conduction velocity.

CONCLUSIONS
Diabetic patients with peripheral neuropathy demonstrate a relative deficit in their ability to maintain posture. Posturography allows an early disclosure of the failure of postural control.
Feasibility of Intraperitoneal Insulin Therapy With Programmable Implantable Pumps in IDDM: A multicenter study
Authors: Hanaire-Broutin Hélène , Broussolle Christiane , Jeandidier Nathalie , Renard Eric , Guerci Bruno , Haardt Marie-Joelle , Lassmann-Vague Veronique ,   The EVADIAC study group
Published: March 2007

OBJECTIVE
To report the overall French experience, obtained through the collaboration of seven centers (EVADIAC [Evaluation dans le Diabète du Traitement par Implants Actifs] register), on the safety, feasibility, and efficacy of intraperitoneal insulin therapy by programmable implantable pumps, using three different devices.

RESEARCH DESIGN AND METHODS
This is a multicenter prospective study involving 224 type I diabetic patients implanted with a programmable implantable pump (cumulative follow-up: 353 patient-years; mean duration: 1.5 ± 0.9 years [mean ± SD]). The Infusaid and the Promedos devices are equipped with a side port and refilled with U100 insulin (Hoechst 21 PH); the Minimed pump is not equipped with a side port and is refilled with U400 insulin (Hoechst 21 PH). Metabolic data and adverse events were recorded in a central register run by EVADIAC.

RESULTS
A total of 29 local pump-pocket events (8/100 patient-years) and 9 pump failures (2.5/100 patient-years) occurred. The major technical problems were 1) pump flow rate reduction related to insulin aggregates, reversible after alkaline rinsing of the pump, and 2) 47 catheter obstructions requiring laparoscopie or conventional surgery. Pump therapy was abandoned in only 11 patients. HbAlc (7.4 ±1.8 vs. 6.8 ± 1.0%, P &lt; 0.001), mean glycemia (8.7 ± 1.5 vs. 7.8 ± 1.0 mmol/l, P &lt; 0.001), and blood glucose SDs (3.8 ± 0.8 vs. 3.3 ± 0.8 mol/l, P &lt; 0.001) decreased significantly after 6 months and remained lower than baseline thereafter.

CONCLUSIONS
Intraperitoneal insulin infusion using an implantable programmable pump is a feasible and relatively safe technique that may improve metabolic control and glycemie stability. Long-term studies, however, are needed to demonstrate whether or not the improvement in glycemie control could be sustained for several years.
Dietary Composition, Body Weight, and NIDDM: Comparison of high-fiber, high-carbohydrate, and modified-fat diets
Authors: Walker Karen Z , O'Dea Kerin , Nicholson Geoffrey C , Muir Jane G 
Published: March 2007

OBJECTIVE
To examine the effects of a high-carbohydrate low-fat (HCLF) and a modified-fat (MF) diet on body weight and metabolic control in subjects with non-insulin-dependent diabetes mellitus (NIDDM) living at home.

RESEARCH DESIGN AND METHODS
Twenty-four NIDDM patients followed HCLF and MF diets alternately and in random order for a 3-month period while at home, with a 1-month baseline and washout between diets. Before and after each diet, fasting glucose and lipids, HbAlc, blood pressure, and body weight were measured. Dietary preferences were assessed by questionnaire.

RESULTS
Subjects consumed 50% of energy as carbohydrate and 23% as fat on the HCLF diet and 40% of energy as carbohydrate and 36% as fat (over half of which was monounsaturated fat) on the MF diet. Subjects lost weight on both HCLF and MF diets (mean loss 0.7 and 1.3 kg, respectively). Although the MF diet resulted in a small decrease in fasting glucose levels, there was no significant change in HbA1c. Similarly, there was no significant difference between the diets in changes in blood pressure or fasting blood lipids. Most subjects (65%) preferred the MF diet.

CONCLUSIONS
Although the MF diet is not a low-fat diet, it did not appear to facilitate weight gain in subjects with NIDDM living at home. The MF diet provides an alternative for individuals unable to comply with HCLF diets.
Captopril-Induced Acute Pancreatitis
Authors: Jeandidier N , Klewansky M , Plnget M 
Published: March 2007

OBJECTIVE
To increase awareness concerning abdominal pain asociated with the use of captopril, which is a molecule frequently used in diabetic patients.
CASE:— One case of acute pancreatitis associated with captopril, confirmed by a reintroduction, is described in a type II diabetes patient.

CONCLUSIONS
Captopril and other angiotensin-converting enzyme inhibitors are very frequently prescribed in diabetic patients. Therefore, it is important to be aware of the possibility of pancreatitis linked to these molecules and to withdraw the treatment in case of severe unexplained abdominal pain.
Risk Factors for Lower Extremity Amputation in Persons With Diabetes
Authors: Selby Joe V , Zhang Danya 
Published: March 2007

OBJECTIVE
To determine the predictors of lower extremity amputation (LEA) in a cohort of persons with diabetes (primarily non-insulin-dependent).

RESEARCH DESIGN AND METHODS
We conducted a nested case-control study among 10,068 patients from a large health maintenance organization who reported a diagnosis of diabetes at a multiphasic health checkup (MHC) (baseline) between 1964 and 1984. Average length of follow-up after baseline was 13.2 years. Case patients were 150 cohort members with a first, nontraumatic LEA after baseline. Control subjects were 278 cohort members who did not experience an LEA during follow-up, matched to patients on age, sex, and year of baseline MHC. The presence of diabetes at baseline was verified by chart review for both patients and control subjects. Cardiovascular disease risk factors were obtained at the baseline MHC; glucose control, other diabetes-related variables, preventive services, and other complications were obtained from chart review.

RESULTS
Level of glucose control (P &lt; 0.0001), duration of diabetes (P = 0.04), and baseline systolic blood pressure (P = 0.004) were independent predictors of amputation, as were microvascular complications (retinopathy, neuropathy, and nephropathy). History of stroke, but not myocardial infarction, was also independently predictive; type of diabetes, cigarette smoking, and total cholesterol level were not. Being African-American was unrelated to amputation risk in univariate or multivariate analyses in this insured population.

CONCLUSIONS
LEA shares a risk factor profile with other microvascular complication of diabetes. Thus, control of blood glucose and blood pressure should reduce risk for amputation. African-Americans do not appear to be at increased risk for diabetes-related amputation when access to medical care is comparable.
Determinants of 24-H Blood Pressure in IDDM Patients
Authors: Hansen Klavs W , Poulsen Per L , Christiansen Jens S , Mogensen Carl Erik 
Published: March 2007

OBJECTIVE
To assess the influence of basic clinical data on ambulatory blood pressure (AMBP) in insulin-dependent diabetes mellitus (IDDM) patients and to evaluate the reproducibility of the method.

RESEARCH DESIGN AND METHODS
AMBP was measured in 66 IDDM patients with urinary albumin excretion (UAE) &lt;20 μg/min and in 53 healthy subjects. Determinants of AMBP were identified in a stepwise multiple regression model. In addition, 14 diabetic patients were monitored on two days of the same type, and 14 patients were monitored on one work day and one day off.

RESULTS
In healthy subjects, sex was the most important determinant of 24-h blood pressure (BP), whereas UAE and age were the main covariates in diabetes patients. The male-female difference in 24-h diastolic BP (dBP) was 5.6 mmHg lower in diabetic patients than in healthy control subjects (P &lt; 0.05). In patients with long diabetes duration, nighttime dBP (69 ± 7 mmHg) was higher than in patients with medium diabetes duration (63 ± 8 mmHg, P &lt; 0.05; after matching for age and sex). Daytime dBP was 5 mmHg higher on a work day than on a day off (P &lt; 0.02). Standard deviation of the difference for repeated measurement of 24-h systolic/diastolic BP in the same subject was 5.7/2.5 mmHg.

CONCLUSIONS
The male-female difference in 24-h dBP was attenuated in diabetes. The influence of UAE on AMBP was noticed even in normoalbuminuric diabetic patients. Standardized AMBP was highly reproducible.
Prevalence of Diabetes and Hypertension in a Rural Population of Bangladesh
Authors: Sayeed M Abu , Banu Akhtar , Khan Abdur Rahman , Hussain M Zafirul 
Published: March 2007

OBJECTIVE
To determine the prevalence of non-insulin-dependent diabetes mellitus (NIDDM), impaired glucose tolerance (IGT), and hypertension in a rural community of Bangladesh.

RESEARCH DESIGN AND METHODS
A cluster sampling of 1,005 subjects &gt; 15 years of age in the rural community of Dohar was investigated. Capillary blood glucose of fasting and 2 h after 75 g oral glucose (2hBG) were estimated. World Health Organization criteria were used for diagnosis of NIDDM and IGT. Blood pressure, height, and weight were also measured.

RESULTS
The crude prevalence of NIDDM was 2.1% (men 3.1, women 1.3%) and IGT was 13.3% (men 14.4, women 12.4%). Age-adjusted (30–64 years of age) prevalence was 2.23% (95% confidence interval [CI] 1.01–3.45) for NIDDM and 15.67% (95% CI 12.59–18.75) for IGT. Prevalence of hypertension with systolic blood pressure (sBP) ≥140 mmHg was 10.5% and with diastolic blood pressure (dBP) &gt;90 mmHg was 9.0%. Increased age was the risk factor for NIDDM, IGT, and hypertension; whereas increased BMI showed inconsistent association with them. Relative risk for sBP with higher BMI (&lt;22.0 vs. ≥22.1) was 1.94 with CI 1.55–2.43 and for dBP it was 2.2 with CI 1.40–3.46. Correlation of sBP was significant with age, BMI, and 2hBG. Similar correlation was also observed with dBP.

CONCLUSIONS
High prevalences of NIDDM, IGT, and hypertension were observed among rural subjects. Increased age was shown to be an important risk factor for all these disorders, whereas BMI-associated risk was significant with NIDDM and hypertension but not with IGT.
Mortality and Morbidity Associated With Body Weight in People With IDDM: The WHO Multinational Study of Vascular Disease in Diabetes
Authors: Chaturvedi Nishi , Stevens Lynda K , Fuller John H ,   The WHO Multinational Study Group
Published: March 2007

OBJECTIVE
Strict glycemic control in people with insulin-dependent diabetes mellitus (IDDM) reduces the risk of microvascular complications, but improvementsin control are also associated with weight gain. Fears about the mortality risks of obesity may limit the acceptability of tight control. Therefore, we examined morbidity and mortality risks associated with body weight in people with IDDM.

RESEARCH DESIGN AND METHODS
This was a cohort study of 644 men and 576 women with IDDM from nine centers worldwide. Baseline examinations were performed in 1975–1977, and mortality follow-up continued until 1988.

RESULTS
Body weight was positively associated with blood pressure and, in men, with cholesterol. Fasting blood glucose was higher in the most obese groups in women only. There were 204 deaths among the men and 148 among the women. There was a reverse J-shaped relationship between body weight and all-cause mortality, with the highest mortality rates occurring in the leanest body mass index (BMI) category. The age-, duration-, and center-adjusted mortality rate ratio (95% confidence interval) comparing BMI category &lt; 20 kg/m2 with BMI category ≥22 and &lt;24 kg/m2 was 2.64 (1.59–4.38) in men and 1.54 (0.77–3.06) in women. Additional adjustment for smoking, blood pressure, glucose, cholesterol, and proteinuria did not qualitatively alter these findings.

CONCLUSIONS
We conclude that except in very lean people with IDDM, body weight is not significantly associated with mortality. Thus, efforts to improve glycemic control should not be restricted by concerns about the effects of weight gain on mortality.
Effects of Vitamin E on Susceptibility of Low-Density Lipoprotein and Low-Density Lipoprotein Subfractions to Oxidation and on Protein Glycation in NIDDM
Authors: Reaven Peter D , Herold David A , Barnett Joellen , Edelman Steve 
Published: March 2007

OBJECTIVE
To evaluate the effect of vitamin E supplementation on the susceptibility of low-density lipoprotein (LDL) and LDL subfractions to oxidation and on protein glycation in non-insulin-dependent diabetes mellitus (NIDDM).

RESEARCH DESIGN AND METHODS
Twenty-one men with NIDDM (HbA1c = 6-10%), ages 50–70, were randomly assigned to either 1,600 IU/day of vitamin E or placebo for 10 weeks after a 4-week placebo period. LDL and LDL subfractions were isolated after 4 weeks of placebo and after 6 and 10 weeks of therapy. Susceptibility of LDL to copper-mediated oxidation was measured by conjugated diene formation (lag time) and formation of thiobarbituric acid-reactive substances (TBARS). Fasting serum glucose, mean weekly blood glucose, HbA1c, and glycated plasma protein concentrations were also determined at these time points.

RESULTS
Vitamin E content in plasma and LDL increased 4.0- and 3.7-fold, respectively, in the vitamin E-treated group. Vitamin E decreased the susceptibility of LDL to oxidation in comparison with placebo (lag time, 243 ± 46 vs. 151 ± 22 min, P &lt; 0.01; 3 h TBARS, 24 ± 12 vs. 66 ± 18 nmol malondialdehyde/mg LDL, P &lt; 0.05). Vitamin E content also increased significantly in both buoyant and dense LDL subfractions, and their oxidation was dramatically reduced. The lag time of LDL oxidation correlated well with the content of vitamin E in both LDL and its subfractions (r = 0.69–0.92). Glycemic indexes did not change significantly in either group during the study. Protein glycation, including glycated hemoglobin, glycated albumin, glycated total plasma proteins, and glycated LDL were unchanged in the vitamin E group.

CONCLUSIONS
Supplementation of vitamin E in NIDDM leads to enrichment of LDL and LDL subfractions and reduced susceptibility to oxidation. Despite a greater percentage increase in vitamin E content in small dense LDL, it remained substantially more susceptible to oxidation than was buoyant LDL. This suggests that dense, LDL may gain less protection against oxidation from antioxidant supplementation than does larger, more buoyant LDL. In contrast to previous reports, vitamin E supplementation did not reduce glycation of intracellular or plasma proteins.
Reduction of Glycosylated Hemoglobin and Postprandial Hyperglycemia by Acarbose in Patients With NIDDM: A placebo-controlled dose-comparison study
Authors: Coniff Robert F , Shapiro Joann A , Robbins David , Kleinfield Robert , Seaton Timothy B , Beisswenger Paul , McGill Janet B 
Published: March 2007

OBJECTIVE
To compare the safety and efficacy of three doses of acarbose (100, 200, and 300 mg three times daily) with placebo for the treatment of non-insulin-dependent diabetes mellitus (NIDDM) in patients maintained on dietary therapy alone.

RESEARCH DESIGN AND METHODS
This multicenter double-blind placebo-controlled trial was 22 weeks in duration. The trial consisted of a 2-week screening period, a 4-week placebo run-in period, and a 16-week double-blind treatment period. The primary measure of drug efficacy was the mean change from baseline in HbA1c levels. Additional efficacy variables included the mean change from baseline in fasting and postprandial plasma glucose and serum insulin levels.

RESULTS
After 16 weeks of treatment, acarbose-treated patients had statistically significant reductions in mean HbA1c levels of 0.78, 0.73, and 1.10% (relative to placebo) in the 100-, 200-, and 300-mg t.i.d. groups, respectively. Significant reductions in fasting and postprandial plasma glucose levels, glucose area under the time-concentration curve, and maximum glucose concentration were also observed in acarbose-treated patients. Although there were no statistically significant differences among the 100-, 200-, and 300-mg treatment groups, there was a trend toward a dose-response relationship for most plasma glucose variables that were measured. Gastrointestinal side effects (e.g., abdominal pain, flatulence, and diarrhea) and serum transaminase elevations (e.g., aspartate aminotransferase [AST] and alanine aminotransferase [ALT] were more frequently reported in the acarbose-treated patients than in the placebo-treated control patients. Transaminase elevations occurred only at the 200-, and 300-mg dosages and were readily reversible on discontinuation of treatment.

CONCLUSIONS
Acarbose at doses of 100, 200, and 300 mg administered three times daily for 16 weeks significantly reduced HbA1c levels and postprandial hyperglycemia. Treatment with acarbose is a safe and effective adjunct to dietary therapy for the treatment of NIDDM.
Diabetes Care Policies and Practices in Michigan Nursing Homes, 1991
Authors: Funnell Martha M , Herman William H 
Published: March 2007

OBJECTIVE
To describe local standards of care for nursing home patients with diabetes, to characterize the care that nursing home patients with diabetes receive in Michigan, and to determine if the care provided meets local and national standards.

RESEARCH DESIGN AND METHODS
In March 1991, a questionnaire was administered and chart reviews were conducted as part of the Medical Review and Nursing Evaluation conducted by the Michigan Department of Public Health. The questionnaire was completed by the head nurses at 17 skilled nursing homes to learn about local institutional standards of care. Chart reviews were conducted on a sample of five patients with diabetes from each nursing home to describe the care provided and to compare it with local and national standards.

RESULTS
Almost all nursing homes had some diabetes care orders or protocols. Standing orders were most often present to guide nutritional and nursing care (e.g., diet, blood glucose monitoring, foot care). Standing orders were less often present to guide medical care (e.g., blood glucose parameters to contact physician) and surveillance of complications (e.g., eye exams). In general, the care provided did not meet local or national standards for diabetes care. Care practices were closer to national standards when registered dietitians (RDs) participated in meal planning and written institutional policies existed.

CONCLUSIONS
In this sample of Michigan nursing homes, those with RDs and standing orders provided care more in keeping with guidelines. There is room for improvement in diabetes care practices in nursing homes. It may be time for diabetesrelated organizations to re-examine standards for diabetes care in nursing homes.
A Double-Blind Placebo-Controlled Trial Evaluating the Safety and Efficacy of Acarbose for the Treatment of Patients With Insulin-Requiring Type II Diabetes
Authors: Coniff Robert F , Shapiro Jo Ann , Seaton Timothy B , Hoogwerf Byron J , Hunt John A 
Published: March 2007

OBJECTIVE
To determine whether a forced titration of acarbose (from 50 to 300 mg three times daily) administered over a 24-week period, in conjunction with diet and insulin therapy, improves glycemic control and reduces daily insulin requirements in insulin-requiring type II diabetes.

RESEARCH DESIGN AND METHODS
This multicenter, randomized, double-blind, placebo-controlled trial was 36 weeks in duration. The trial consisted of a 6-week pretreatment period, a 24-week double-blind treatment period, and a 6-week post-treatment follow-up period. The primary efficacy variables were the mean change from baseline in HbA1c levels and the mean percentage change from baseline in total daily insulin dose.

RESULTS
Treatment with acarbose was associated with significant reductions in HbA1c levels of 0.40% (P = 0.0001) and in total daily insulin dose of 8.3% (P = 0.0015). There were also significant reductions in all plasma glucose variables measured, including a 0.9 mmol/l reduction in fasting glucose (P = 0.0440), a 2.6 mmol/l reduction in glucose Cmax (P = 0.0001) and a 270 mmol·min−1·l−1 reduction in glucose area under the curve (P = 0.0002). Although acarbose treatment was associated with a greater incidence of adverse events than was placebo treatment, primarily flatulence and diarrhea, these events did not generally prevent patients from completing the study.

CONCLUSIONS
The results of this study suggest that acarbose is a safe and effective adjunct to diet and insulin therapy for the management of insulin-requiring type II diabetes.