bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for the Development of NIDDM in Yonchon County, Korea
Authors: Shin Chan Soo , Lee Hong Kyu , Koh Chang-Soon , Kim Yong Ik , Shin Young Soo , Yoo Keun Young , Paik Hee Young , Park Yong Soo , Yang Byung Goog 
Published: March 2007

OBJECTIVE
To determine the risk factors for the development of NIDDM in Yonchon County of Korea.

RESEARCH DESIGN AND METHODS
We studied 1,193 Korean nondiabetic subjects at baseline who participated in a 2-year follow-up study on diabetes in Yonchon County. A 75-g oral glucose tolerance test was performed 2 years after the baseline examination. Age, sex, and anthropometric and metabolic characteristics at baseline were analyzed simultaneously as potential predictors of conversion to NIDDM. We also designed a nested case-control study to determine the role of hyperinsulinemia and/or hyperproinsulinemia in the conversion to NIDDM in patients with newly developed diabetes and control subjects matched for age, sex, BMI, and waist-to-hip-ratio.

RESULTS
At 2 years, 67 subjects developed diabetes, as defined by World Health Organization criteria. The age-adjusted incidence was significantly higher in men (6.4%) than in women (3.0%), and the incidence increased as age increased in both sexes. Multiple logistic regression analysis revealed age, male sex, and fasting and 2-h glucose levels to be significant risk factors for the development of NIDDM, whereas waist-to-hip ratio and BMI were not. In a nested case-control study, baseline proinsulin but not insulin levels were significantly higher in subjects who progressed to NIDDM than in those who did not.

CONCLUSIONS
In the Korean population, β-cell dysfunction, as measured by high proinsulin levels, seems to be associated with subsequent development of NIDDM, whereas regional and general obesity and fasting insulin levels, which may be a surrogate for insulin resistance, were not.
Hyperhomocyst(e)inemia and Endothelial Dysfunction in IDDM
Authors: Hofmann Marion A , Kohl Brigitte , Zumbach Martina S , Borcea Valentin , Bierhaus Angelika , Henkels Mechthild , Amiral Jean , Fiehn Walter , Ziegler Reinhard , Wahl Peter , Nawroth Peter P 
Published: March 2007

OBJECTIVE
While elevated blood levels of homocyst(e)ine represent an independent risk factor for macrovascular disease, we assessed the link between hyperhomocyst(e)inemia and diabetic microvascular diseases.

RESEARCH DESIGN AND METHODS
Plasma levels of homocyst(e)ine and thrombomodulin (TM), markers of endothelial cell damage, were measured before and 3 h after oral methionine loading in 75 patients with IDDM and 40 healthy control subjects matched for sex and age. Exclusion criteria were hyperlipidemia, hypertension, smoking, or positive family history for cardiovascular disease.

RESULTS
IDDM patients had higher pre- and postload plasma levels of homocyst(e)ine than did healthy control subjects (12.0 vs. 7.7 μmol/l and 27.6 vs. 16.0 μmol/l; P &lt; 0.001). Of 75 IDDM patients, 26 had plasma homocyst(e)ine levels above the normal range (means ± 2 SD of values obtained in the control group). These IDDM patients with hyperhomocyst(e)inemia had higher plasma TM levels (62.2 vs. 38.2 ng/ml, P &lt; 0.001), higher albumin excretion rates (485 vs. 115 mg/l, P &lt; 0.005), and a higher prevalence of late diabetic complications (nephropathy, 76 vs. 33% retinopathy, 69 vs. 51% neuropathy, 57 vs. 41% and macroangiopathy, 57 vs. 33%) compared with IDDM patients with normal plasma homocyst(e)ine. In vitro experiments with human umbilical vein cells showed an increased release of TM into the culture supernatant only when endothelial cells were pretreated with advanced glycation end product (AGE)-albumin before L-homocystine was added. A synergistic action of homocyst(e)ine and AGEs might contribute to vascular complications in patients with diabetes.

CONCLUSIONS
Hyperhomocyst(e)inemia is common in nephropathic diabetic patients and may contribute to the enhanced morbidity and mortality from cardiovascular diseases characteristically observed in IDDM patients with diabetic nephropathy.
Serum Autoantibodies Against Sulfatide and Phospholipid in NIDDM Patients With Diabetic Neuropathy
Authors: Shigeta Hirofumi , Yamaguchi Makiko , Nakano Koji , Obayashi Hiroshi , Takemura Reiji , Fukui Michiaki , Fujii Mitsuhiro , Yoshimori Kuniaki , Hasegawa Goji , Nakamura Naoto , Kitagawa Yoshihiro , Kondo Motoharu 
Published: March 2007

OBJECTIVE
We investigated the presence of antisulfatide and antiphospholipid antibodies and the relationship between these antibodies and the results of quantitative tests of nerve function in NIDDM patients with diabetic neuropathy.

RESEARCH DESIGN AND METHODS
Antisulfatide and antiphospholipid antibodies were measured in serum samples obtained from 68 NIDDM patients with diabetic neuropathy by an enzyme-linked immunosorbent assay (ELISA). Each patient was classified into one of three groups based on the combined neuropathy score (determined by the symptom score, the results of autonomic nerve function tests, and the vibration perception test), as follows: mild (n = 26), moderate (n = 22), and severe (n = 20). Nerve conduction studies were performed in a subgroup of 37 patients.

RESULTS
The antisulfatide antibody was detected in 1 (4%) of 26 patients in the mild group, 4 (18%) of 22 patients in the moderate group, and 8 (40%) of 20 patients in the severe group (P &lt; 0.01 vs. mild group). The antiphospholipid antibody was detected in none of the patients in the mild group, 8 (36%) of 22 patients in the moderate group (P &lt; 0.001 vs. mild group), and 6 (30%) of 20 patients in the severe group (P &lt; 0.01 vs. mild group). The threshold amplitude, determined by the vibration perception test, was significantly higher in antibody-positive patients than in antibody-negative patients: antisulfatide antibody, 55.9 ± 46.8 μm (n = 13) vs. 22.9 ± 13.7 μm (n = 55), P &lt; 0.001; antiphospholipid antibody, 47.2 ± 32.5 μm (n = 14) vs. 24.5 ± 23.2 μm (n = 54), P &lt; 0.01. The conduction velocity of the sural nerve was slower in the antisulfatide antibody-positive group (37.9 ± 11.1 m/s, n = 12) than in the antisulfatide antibody-negative group (45.2 ± 6.0 m/s, n = 19) (P &lt; 0.05).

CONCLUSIONS
These results suggest that autoimmune nerve destruction may be involved in diabetic neuropathy in NIDDM patients.
Diabetes, Asymptomatic Hyperglycemia, and 22-Year Mortality in Black and White Men: The Chicago Heart Association Detection Project in Industry Study
Authors: Lowe Lynn P , Liu Kiang , Greenland Philip , Metzger Boyd E , Dyer Alan R , Stamler Jeremiah 
Published: March 2007

OBJECTIVE
To assess relationships of diabetes and asymptomatic hyperglycemia at baseline to the risk of cardiovascular disease (CVD) and all-cause (ALL) mortality in employed, white and black middle-aged men.

RESEARCH DESIGN AND METHODS
A prospective cohort study of 11,554 white men and 666 black men between the ages 35 and 64 from 1967 to 1973 was conducted using data from the Chicago Heart Association (CHA) Detection Project in Industry 22-year mortality follow-up. cox proportional hazards models, adjusted fro age and other CVD risk factors, were used to estimate the relative risk (RR) and the 95% CI of mortality associated with baseline glycemic status.

RESULTS
Age-adjusted baseline prevalence of clinical diabetes was similar in white (3.7%) and black (4.3%) men; asymptomatic hyperglycemia (glucose post–50-g load ≥ 11.1 mmol/l) was present in 11.1% of whites and 7.8% of blacks. After controlling for age, lifestyle, and other CVD risk factors, mortality risk was increased among white men with clinical diabetes (CVD: RR 2.51, CI 2.08−3.02; ALL: RR 1.88, CI 1.63−2.17) and asymptomatic hyperglycemia (CVD: RR 1.18, CI 1.01−1.37; ALL: RR 1.24, CI 1.11−1.37), compared with men with postload glucose &lt; 8.9 mmol/l. Risks were similarly, though nonsignificantly (owing to low statistical power), increased among black men with clinical diabetes (CVD: RR 1.60, CI 0.60−4.29; ALL: RR 1.78, CI 0.97−3.25) and asymptomatic hyperglycemia (CVD: RR 1.29, CI 0.61−2.72; ALL: RR 1.37, CI 0.85−2.20).

CONCLUSIONS
Asymptomatic hyperglycemia and clinical diabetes appear to confer increased mortality risk in both white and black men. In addition, mortality risk is increased with increased severity of glycemia. These findings indicate the importance of applying efforts to reduce risk factors and prevent diabetes in both blacks and whites.
The Safety of Injecting Insulin Through Clothing
Authors: Fleming Doris R , Jacober Scott J , Vandenberg Melissa A , Fitzgerald James T , Grunberger George 
Published: March 2007

OBJECTIVE
Many of the “antiseptic” practices recommended by health care professionals for insulin injection have been successfully challenged as unnecessary. Since people with diabetes have long been observed to inject their insulin through their clothing, this study was undertaken to determine the safety and perceived benefits of administering insulin by this “rogue” technique.

RESEARCH DESIGN AND METHODS
Fifty people with insulin-treated diabetes were randomized into a 20-week single-blinded prospective crossover study comparing the conventional subcutaneous injection technique (with skin preparation) to an experimental injection technique through clothing. Skin assessment, glycated hemoglobin levels, and leukocyte count were determined before randomization, at 10 weeks (before crossover), and again at 20 weeks (at completion). The participants injected through a single layer of fabric, which ranged from nylon to denim. Problems, benefits, type of clothing, and other comments were recorded by the subjects in an injection log.

RESULTS
Forty-two (84%) subjects completed the study. The mean age was 41 years (range, 23–63 years), 50% were women, 86% were Caucasian, and 80% had type I diabetes. The mean duration of diabetes was 14 years (range, 1–33 years). Fifty-one percent had &gt; 16 years of education. The demographic characteristics of the dropouts were similar to those who completed the study. Over the 20-week period ∼ 13,720 injections were performed by participants. None of the subjects experienced erythema, induration, or abscess at injection sites. Neither the glycated hemoglobin levels nor the leukocyte counts differed between the conventional and experimental regimens. During the injection-through-clothing phase of the study, only minor problems, such as blood stains on clothing and bruising, were recorded in the logbooks. However, subjects reported that injection through clothing offered benefits such as convenience and saving time.

CONCLUSIONS
It is safe and convenient to inject insulin through clothing.
Acarbose in the Treatment of Type I Diabetes
Authors: Hollander Priscilla , Pi-Sunyer Xavier , Coniff Robert F 
Published: March 2007

OBJECTIVE
This 36-week multicenter double-blind placebo-controlled study was designed to assess the safety and efficacy of acarbose, administered in conjunction with diet and insulin therapy, for the treatment of patients with type I diabetes.

RESEARCH DESIGN AND METHODS
Acarbose was administered using a forced titration protocol in dosages ranging from 50 to 300 mg t.i.d.

RESULTS
Treatment with acarbose was associated with a mean reduction in postprandial glucose levels (60 min after the administration of a test meal) of 59 mg/dl and a mean reduction in HbA1c levels of 0.48%. There was no difference in the incidence of hypoglycemia between treatment groups. Gastrointestinal events, including flatulence, diarrhea, and abdominal pain, were reported more frequently in acarbose-treated patients than in placebo-treated patients.

CONCLUSIONS
Acarbose was found to be a safe and effective agent, when used in combination with diet and insulin therapy, for the treatment of type I diabetes.
Factors Influencing Height and Weight Development in Children With Diabetes: Results of the Berlin Retinopathy Study
Authors: Danne Thomas , Kordonouri Olga , Enders Ingo , Weber Bruno 
Published: March 2007

OBJECTIVE
To investigate the influence of glycemic control and insulin therapy on the longitudinal growth and weight development of children with diabetes.

RESEARCH DESIGN AND METHODS
Prospective measurements of standing height and weight were recorded longitudinally in 634 children after IDDM onset (median age at onset, 9 years [range 1–15 years]; median diabetes duration at final examination, 11 years [range 1–19]; 3,236 patient-years on two or three injections daily; 399 patient-years on multiple injection therapy [MIT]).

RESULTS
Normal development was found until puberty, with a tendency toward stunted growth and overweight (weight &gt; 97th centile) thereafter. Female sex (P &lt; 0.01) and MIT (P &lt; 0.01) were associated with overweight. Final height was evaluated in a subgroup of 197 young adults followed until age 18 years. Relative growth was calculated as the difference between the standard deviation scores (SDSs) at manifestation (median 0.2 [range −3.5 to 2.9]) and at 18 years of age (reduction of −0.5 [−2.5 to 1.8]), equivalent to a median loss of 2.9 cm in boys and 2.3 cm in girls. Significant linear correlations with the change in height SDS after diabetes manifestation were found for age at manifestation (r = 0.21, P &lt; 0.001) and prepubertal (r = −0.40, P &lt; 0.001) and postpubertal HbA1c (r = −0.15, P &lt; 0.001). While children with poorer relative growth also had a higher BMI (P &lt; 0.05), no influences of sex, prevalence of limited joint mobility, or presence of retinopathy were found.

CONCLUSIONS
Female sex and MIT are associated with diabetes-related obesity. Prepubertal and postpubertal glycemic control appear to be of importance for the diabetes-associated relative growth deficit.
Risk of Hypoglycemia in Users of Human Insulin: The Wisconsin Epidemiologic Study of Diabetic Retinopathy
Authors: Klein Barbara E K , Klein Ronald , Moss Scot E 
Published: March 2007

OBJECTIVE
To evaluate whether there has been a change in frequency of hypoglycemic reactions associated with use of insulin of animal or human type.

RESEARCH DESIGN AND METHODS
Data are from a longitudinal population-based study of people with diabetes onset before 30 years of age who were receiving primary care in an 11-county area of south central Wisconsin in 1980. Interviews of study participants were conducted regarding occurrence of hypoglycemic reactions and the frequency, dose, and type of insulin used. At the 4-year follow-up, 727 of the 765 subjects were using only animal insulin and 33 were using human insulin; by the 10-year follow-up, 352 were using animal insulin and 388 were using human insulin.

RESULTS
Those using animal insulin reported fewer hypoglycemic reactions than did users of human insulin (X12 = 4.66, P = 0.03). Those who changed insulin type between visits were no more likely to report more hypoglycemic reactions during the year before the visit than those who remained on the same type at the two examinations (X24 = 3.37, P = 0.50). At the 10-year exam, users of human insulin were more likely to be taking multiple doses of insulin (86.6%) than were users of animal insulin (73.9%; P &lt; 0.0001). In multiple logistic regression, the following variables were significantly related to the frequency of hypoglycemic reactions at the 10-year visit: body mass index (lower), glycosylated hemoglobin (lower), and being female.

CONCLUSIONS
In this population, level of glycemia is related to the frequency of hypoglycemic reactions. While type of insulin (human vs. animal) may be related to glycemia, it appears to have little independent effect on the frequency of reactions.
Diabetic Ketoacidosis Charges Relative to Medical Charges of Adult Patients With Type I Diabetes
Authors: Javor Kimberly A , Kotsanos James G , McDonald Robert C , Baron Alain D , Kesterson Joseph G , Tierney William M 
Published: March 2007

OBJECTIVE
To determine the medical charges for treating diabetic ketoacidosis (DKA) episodes relative to direct medical care charges of adult patients with type I diabetes.

RESEARCH DESIGN AND METHODS
Using data from an electronic medical record system, we identified adult patients with type I diabetes who had received inpatient or outpatient care on at least two occasions between 1 January 1993 and 30 June 1994. Resources and charges for hospitalizations, emergency room visits, outpatient visits, and pharmaceuticals were recorded during this period. One additional year of information was collected to assess the resources and charges associated with multiple DKA episodes.

RESULTS
A total of 200 patients were identified, of whom 72 (36.0%) experienced a total of 161 DKA episodes. The direct medical care charges associated with DKA episodes represented 28.1% of the direct medical care charges for the cohort of patients with type I diabetes. The average charge per DKA episode was $6,444. The estimated annual medical care charge for each patient was $7,855 ($13,096 per patient experiencing a DKA episode versus $4,907 per patient not experiencing an episode). Multiple DKA episodes were experienced by 24 (12.0%) of the study patients and accounted for 55.6% of the direct medical care charges for these patients.

CONCLUSIONS
DKA episodes represented more than $1 of every $4 spent on direct medical care for adult patients with type I diabetes and $1 of every $2 in those patients experiencing multiple episodes. Interventions that are capable of even a modest reduction in the number of DKA episodes could produce substantial cost savings in a health care system and could be particularly cost-effective in adult patients with recurrent DKA.
Effect of Chronic Quinapril Administration on Heart Rate Variability in Patients With Diabetic Autonomic Neuropathy
Authors: Kontopoulos Athanasios G , Athyros Vasilios G , Didangelos Trianiaffilos P , Papageorgiou Athanasios A , Avramidis Michael J , Mayroudi Melahrini C , Karamitsos Dimitrios T 
Published: March 2007

OBJECTIVE
Heart rate variability (HRV) time and frequency domain indexes are strong predictors of malignant arrhythmias and sudden cardiac death. Patients with diabetic autonomic neuropathy (DAN) have an increased cardiovascular mortality rate compared with diabetic patients without DAN.

RESEARCH DESIGN AND METHODS
The present double-blind, randomized, and placebo-controlled study analyzed the effect of quinapril, an ACE inhibitor, on HRV time and frequency domain variables in patients with DAN. Forty patients (17 men and 23 women) of a mean age of 51 (range 19–68) years, free of coronary artery disease and arterial hypertension, were randomized into a quinapril or placebo group. HRV was recorded at months 0, 3, and 6. The parameters measured were 1) time domain indexes: SD of all 24-h R-R intervals (intervals between consecutive electrocardiogram R waves), or SDNN/24-h; mean of SD of R-R intervals of all 5-min segements (SDNN/5-min); root-mean-square of the differences of successive R-R intervals (RMSSD); and percentage of the R-R intervals differing more than 50 ms (pNN50); and 2) frequency domain indexes: total power (TP), high-frequency power (HFP), low-frequency power (LFP), and very-low-frequency power (VLFP). HRV level of the 40 patients were compared with one of 20 matched diabetic patients, of analogous glycemic control without DAN, and 20 healthy control subjects.

RESULTS
Quinapril, compared with placebo, increased total HRV: SDNN/24-h (P &lt; 0.05), TP (P &lt; 0.05), and HRV parameters related to parasympathetic activity: pNN50 (P &lt; 0.01). RMSSD (P &lt; 0.05), and HFP in absolute and normalized units (P &lt; 0.01). LFP/HFP ratio was decreased (P &lt; 0.01). Despite the beneficial effect of quinapril on parasympathetic variables of HRV these remained &lt; those of diabetic patients without DAN and healthy control subjects.

CONCLUSIONS
Our findings suggest that quinapril significantly increases parasympathetic activity in patients with DAN 3 months after treatment initiation and sustains this effect until the 6th month. This might contribute to the reduction of the risk for malignant ventricular arrhythmias in these patients.
Effects of Treatment With the Antioxidant α-Lipoic Acid on Cardiac Autonomic Neuropathy in NIDDM Patients: A 4-month randomized controlled multicenter trial (DEKAN Study)
Authors: Ziegler Dan , Schatz Helmut , Conrad Frank , Gries F Arnold , Ulrich Heinz ,   The DEKAN Study Group, Reichel Gerhard 
Published: March 2007

OBJECTIVE
To evaluate the efficacy and safety of oral treatment with the antioxidant alpha-lipoic acid (ALA) in NIDDM patients with cardiac autonomic neuropathy (CAN), assessed by heart rate variability (HRV).

RESEARCH DESIGN AND METHODS
In a randomized, double-blind placebo-controlled multicenter trial (Deutsche Kardiale Autonome Neuropathie [DEKAN] Study), NIDDM patients with reduced HRV were randomly assigned to treatment with daily oral dose of 800 mg ALA (n = 39) or placebo (n = 34) for 4 months. Parameters of HRV at rest included the coefficient of variation (CV), root mean square successive difference (RMSSD), and spectral power in the low-frequency (LF; 0.05–0.15 Hz) and high-frequency (HF; 0.15–0.5 Hz) bands. In addition, cardiovascular autonomic symptoms were assessed.

RESULTS
Seventeen patients dropped out of the study (ALA n = 10; placebo n = 7). Mean blood pressure and HbA1 levels did not differ between the groups at baseline and during the study, but heart rate at baseline was higher in the group treated with ALA (P &lt; 0.05). RMSSD increased from baseline to 4 months by 1.5 ms (−37.6 to 77.1) [median (minimum-maximum)] in the group given ALA and decreased by −0.1 ms (−19.2 to 32.8) in the placebo group (P &lt; 0.05 for ALA vs. placebo). Power spectrum in the LF band increased by 0.06 bpm2 (−0.09 to 0.62) in ALA, whereas it declined by −0.01 bpm2 (−0.48 to 1.86) in placebo (P &lt; 0.05 for ALA vs. placebo). Furthermore, there was a trend toward a favorable effect of ALA versus placebo for the CV and HF band power spectrum (P = 0.097 and P = 0.094 for ALA vs. placebo). The changes in cardiovascular autonomic symptoms did not differ significantly between the groups during the period studied. No differences between the groups were noted regarding the rates of adverse events.

CONCLUSIONS
These findings suggest that treatment with ALA using a well-tolerated oral dose of 800 mg/day for 4 months may slightly improve CAN in NIDDM patients.
Granulocyte Function in Women With Diabetes and Asymptomatic Bacteriuria
Authors: Balasoiu Daniela , van Kessel Kok C , van Kats-Renaud Hennie J , Collet Theo J , Hoepelman Andy I 
Published: March 2007

OBJECTIVE
To study whether diabetic women with asymptomatic bacteriuria have impaired granulocyte function and compare them with nonbacteriuric diabetic women.

RESEARCH DESIGN AND METHODS
A prevalence study with granulocyte function testing in a randomly selected number of patients was conducted; the setting was the university. The patients consisted of 63 women visiting the outpatient clinic for routine control of their diabetes. Measurements of routine blood controls and urine cultures were conducted in all patients. Granulocyte function testing (chemotaxis, opsonization, oxidative burst, phagocytosis, and killing) was performed in the first 20 patients (10 with and 10 without asymptomatic bacteriuria) and in 7 healthy control subjects.

RESULTS
The prevalence of bacteriuria was 32%. Demographic characteristics were not significantly different between bacteriuric and nonbacteriuric women. Leukocytes were found more often in the urine of bacteriuric women (P &lt; 0.05). No differences in any of the granulocyte function tests were documented among diabetic women with true asymptomatic bacteriuria, nonbacteriuric women, and healthy control subjects.

CONCLUSIONS
The prevalence of asymptomatic bacteriuria is increased in women with diabetes. Granulocyte function impairment, however, cannot be the explanation for this finding.