bluuebunny/crossref_metadata_2025_split huggingface dataset:
HYAFF 11-Based Autologous Dermal and Epidermal Grafts in the Treatment of Noninfected Diabetic Plantar and Dorsal Foot Ulcers
Authors: Caravaggi Carlo , De Giglio Roberto , Pritelli Chiara , Sommaria Manuela , Dalla Noce Sergio , Faglia Ezio , Mantero Manuela , Clerici Giacomo , Fratino Pietro , Dalla Paola Luca , Mariani Giulio , Mingardi Roberto , Morabito Alberto 
Published: March 2007

OBJECTIVE—To evaluate the clinical efficacy and safety of HYAFF 11-based autologous dermal and epidermal grafts in the management of diabetic foot ulcers.
RESEARCH DESIGN AND METHODS—A total of 79 patients with diabetic dorsal (n = 37) or plantar (n = 42) ulcers were randomized to either the control group with nonadherent paraffin gauze (n = 36) or the treatment group with autologous tissue-engineered grafts (n = 43). Weekly assessment, aggressive debridement, wound infection control, and adequate pressure relief (fiberglass off-loading cast for plantar ulcers) were provided in both groups. Complete wound healing was assessed within 11 weeks. Safety was monitored by adverse events.
RESULTS—Complete ulcer healing was achieved in 65.3% of the treatment group and 49.6% of the control group (P = 0.191). The Kaplan-Meier mean time to closure was 57 and 77 days, respectively, for the treatment versus control groups. Plantar foot ulcer healing was 55% and 50% in the treatment and control groups, respectively. Dorsal foot ulcer healing was significantly different, with 67% in the treatment group and 31% in the control group (P = 0.049). The mean healing time in the dorsal treatment group was 63 days, and the odds ratio for dorsal ulcer healing compared with the control group was 4.44 (P = 0.037). Adverse events were equally distributed between the two groups, and none were related to the treatments.
CONCLUSIONS—The autologous tissue-engineered treatment exhibited improved healing in dorsal ulcers when compared with the current standard dressing. For plantar ulcers, the off-loading cast was presumably paramount and masked or nullified the effects of the autologous wound treatment. This treatment, however, may be useful in patients for whom the total off-loading cast is not recommended and only a less effective off-loading device can be applied.
Prospective Study of the Association Between the Proline to Alanine Codon 12 Polymorphism in the PPARγ Gene and Type 2 Diabetes
Authors: Memisoglu Asli , Hu Frank B. , Hankinson Susan E. , Liu Simin , Meigs James B. , Altshuler David M. , Hunter David J. , Manson JoAnn E. 
Published: March 2007

OBJECTIVE—To determine whether the Pro12Ala polymorphism in the PPARγ gene was associated with risk of type 2 diabetes in the Nurses’ Health Study.
RESEARCH DESIGN AND METHODS—The study was a nested case-control study of 387 incident cases of type 2 diabetes and 771 matching control subjects nested within the Nurses’ Health Study, a prospective cohort study. Association between PPARγ genotype and incident type 2 diabetes was estimated using logistic regression.
RESULTS—Carriers of the PPARγ variant 12Ala allele had reduced risk of type 2 diabetes compared with noncarriers. Unadjusted and adjusted odds ratios of type 2 diabetes were 0.74 (95% CI 0.55–1.00) and 0.72 (0.52–0.99), respectively.
CONCLUSIONS—The results of this study provide further support for an inverse association between the PPARγ variant 12Ala allele and risk of type 2 diabetes.
Enhancing Incretin Action for the Treatment of Type 2 Diabetes
Authors: Drucker Daniel J. 
Published: March 2007

OBJECTIVE—To examine the mechanisms of action, therapeutic potential, and challenges inherent in the use of incretin peptides and dipeptidyl peptidase-IV (DPP-IV) inhibitors for the treatment of type 2 diabetes.
RESEARCH DESIGN AND METHODS—The scientific literature describing the biological importance of incretin peptides and DPP-IV inhibitors in the control of glucose homeostasis has been reviewed, with an emphasis on mechanisms of action, experimental diabetes, human physiological experiments, and short-term clinical studies in normal and diabetic human subjects.
RESULTS—Glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) exert important effects on β-cells to stimulate glucose-dependent insulin secretion. Both peptides also regulate β-cell proliferation and cytoprotection. GLP-1, but not GIP, inhibits gastric emptying, glucagon secretion, and food intake. The glucose-lowering actions of GLP-1, but not GIP, are preserved in subjects with type 2 diabetes. However, native GLP-1 is rapidly degraded by DPP-IV after parenteral administration; hence, degradation-resistant, long-acting GLP-1 receptor (GLP-1R) agonists are preferable agents for the chronic treatment of human diabetes. Alternatively, inhibition of DPP-IV–mediated incretin degradation represents a complementary therapeutic approach, as orally available DPP-IV inhibitors have been shown to lower glucose in experimental diabetic models and human subjects with type 2 diabetes.
CONCLUSIONS—GLP-1R agonists and DPP-IV inhibitors have shown promising results in clinical trials for the treatment of type 2 diabetes. The need for daily injections of potentially immunogenic GLP-1–derived peptides and the potential for unanticipated side effects with chronic use of DPP-IV inhibitors will require ongoing scrutiny of the risk-benefit ratio for these new therapies as they are evaluated in the clinic.
Cigarette Smoking and the Risk of Gestational and Pregestational Diabetes in Two Consecutive Pregnancies
Authors: Terry Paul D. , Weiderpass Elisabete , Östenson Claes-Göran , Cnattingius Sven 
Published: March 2007

OBJECTIVE—Cigarette smoking during pregnancy may increase the risk of gestational diabetes mellitus (GDM) or pregestational diabetes mellitus (PDM). Smoking has been associated positively with hyperinsulinemia and insulin resistance in experimental studies, although the association with diabetes remains unclear. To further explore this issue, we examined the association with smoking in the largest prospective cohort study of GDM and PDM to date.
RESEARCH DESIGN AND METHODS—The study population comprised 212,190 women in the population-based Swedish Birth Registry who had their first and second deliveries between January 1987 and December 1995. Maternal characteristics were recorded in a standardized manner at the first prenatal visit, followed by a clinical examination and a standardized in-person interview to assess lifestyle habits. Women were categorized as nonsmokers, light smokers (one to nine cigarettes per day), or moderate-to-heavy smokers (at least 10 cigarettes per day).
RESULTS—Women with GDM in their first pregnancy experienced an eight- to ninefold increased risk of GDM or PDM in their second pregnancy. Cigarette smoking was not associated with increased risk of these conditions. Neither women who smoked during their first and second pregnancies nor those who commenced smoking between pregnancies had a higher risk of GDM or PDM than nonsmokers.
CONCLUSIONS—Our findings do not support an association between cigarette smoking and risk of GDM or PDM in young women of childbearing age.
High Prevalence of Diabetes in Adana, a Southern Province of Turkey
Authors: Gokcel Adnan , Ozsahin Akatli Kursat , Sezgin Nurzen , Karakose Hatice , Ertorer Melek Eda , Akbaba Muhsin , Baklaci Nuh , Sengul Aysegul , Guvener Nilgun 
Published: March 2007

OBJECTIVE—To determine the prevalence of diabetes and glucose intolerance and their relationship with risk factors in Adana, a southern province of Turkey, where risk factors are more prominent, probably because of social and economic reasons.
RESEARCH DESIGN AND METHODS—The study population included 1,637 randomly selected adults aged 20–79 years. Diagnosis of diabetes was based on plasma glucose values using the 1999 diagnostic criteria recommended by the World Health Organization.
RESULTS—The crude prevalence of diabetes was 12.9% in men and 10.9% in women (P = 0.207). Total prevalence of diabetes was 11.6%. The screening process identified previously undiagnosed diabetes in 4.2% of individuals and impaired glucose homeostasis (consisting of impaired glucose tolerance and impaired fasting glucose) in an additional 4.3% of subjects. The prevalence of hypertension was 26.4% among men and 36.6% among women (P &lt; 0.0001). Total prevalence of hypertension was 32.9%, and prevalence of obesity was 43.4%. Age, sex, BMI, waist circumference, hypertension, family history of diabetes, and triglycerides were independently associated with diabetes.
CONCLUSIONS—The prevalence of diabetes in Adana is higher than expected in both urban and rural areas. Obesity and hypertension also seem to be common metabolic disorders in this area. Age, hypertension, obesity, high triglyceride level, and family history of diabetes are independently associated with diabetes. Therefore, primary prevention through lifestyle modifications may have a critical role in the control of diabetes.
Randomized Controlled Trial of a New Dietary Education Program to Prevent Type 2 Diabetes in a High-Risk Group of Japanese Male Workers
Authors: Watanabe Mariko , Yamaoka Kazue , Yokotsuka Masako , Tango Toshiro 
Published: March 2007

OBJECTIVE—The aim of this study was to assess the effectiveness of a new dietary education (NDE) program in reducing plasma glucose (PG) levels in Japanese male workers at high risk for type 2 diabetes through a randomized controlled trial.
RESEARCH DESIGN AND METHODS—We randomly assigned 173 high-risk men (mean age, 55 years) to either the NDE or the control (conventional dietary education) group. Each subject in the NDE group received two individualized interventions especially aimed at reducing total energy intake at dinner by modifying dietary intake. The control group received conventional group counseling. An “overintake/underintake fraction” for total energy intake was used to measure the status of dietary intake. Our hypothesis was that the NDE group would have a 10% decrease in 2-h PG 1 year after the start of the education. Outcome measures were compared with ANCOVA by adjusting for baseline values.
RESULTS—The NDE group had a significantly lower total energy intake at dinner and daily than the control group. The adjusted differences in changes from baseline in the absolute value of the “overintake/underintake fraction” were −15.3% (95% CI −24.6 to −6.0%, P = 0.002) for the NDE group and −6.0% (−9.8 to −2.2%, P = 0.002) for the control group. The NDE group had a decreased 2-h PG after 1 year, whereas that value was increased in the control group. The adjusted difference in the percent change of 2-h PG was significant (−15.2%, −22.0 to −8.4%, P &lt; 0.001).
CONCLUSIONS—The NDE was shown to reduce glucose levels in high-risk subjects for type 2 diabetes.
Clinical Efficacy of the First Metatarsophalangeal Joint Arthroplasty as a Curative Procedure for Hallux Interphalangeal Joint Wounds in Patients with Diabetes
Authors: Armstrong David G. , Lavery Lawrence A. , Vazquez Jefferey R. , Short Brian , Kimbriel Heather R. , Nixon Brent P. , Boulton Andrew J.M. 
Published: March 2007

OBJECTIVE—To evaluate the safety and efficacy of first metatarsophalangeal joint arthroplasty compared with standard, nonsurgical management of wounds at the plantar hallux interphalangeal joint in patients with diabetes.RESEARCH DESIGN AND METHODS—We evaluated 41 patients with ulcers classified as University of Texas Grade 1A or 2A at the plantar aspect of the first metatarsophalangeal joint using a case-control model. Case subjects were patients treated with resectional arthroplasty and control subjects received standard nonsurgical care. Both groups received standard off-loading and wound care. Outcomes included time to healing, reulceration, infection, and amputation.RESULTS—The surgery group healed significantly faster than patients in the standard therapy group (standard 67.1 ± 17.1 versus sugery 24.2 ± 9.9 days, P = 0.0001), and they had fewer recurrent ulcers (standard 35.0 versus surgery 4.8%, P = 0.02, odds ratio 7.6, 95% CI 1.1–261.7) Both groups had similar rates of infection (standard 38.1 versus surgery 40.0%, P = 0.9) and amputation (standard 10.0 versus surgery 4.8%, P = 0.5).CONCLUSIONS—Results suggest that resectional arthroplasty is a safe and effective procedure to treat wounds of the plantar hallux compared with nonsurgical therapy.
Longitudinal Studies of Incidence and Progression of Diabetic Retinopathy Assessed by Retinal Photography in Pima Indians
Authors: Looker Helen C. , Krakoff Jonathan , Knowler William C. , Bennett Peter H. , Klein Ronald , Hanson Robert L. 
Published: March 2007

OBJECTIVE—To examine incidence and progression of retinopathy using retinal photographs in Pima Indians and to compare the results with those obtained when retinopathy is assessed by direct ophthalmoscopy.
RESEARCH DESIGN AND METHODS—We undertook an analysis of examinations conducted between 1 April 1982 and 31 December 1990 in residents of the Gila River Community in central Arizona. Data were taken from 411 people with diabetes who had at least two examinations during this period. Incidence and progression of retinopathy were evaluated by retinal photography and fundoscopy, and hazard rate ratios were calculated for various potential risk factors measured at baseline.
RESULTS—Previously diagnosed retinopathy tended to progress, except in individuals with minimal nonproliferative retinopathy, among whom follow-up examinations were more likely to show no retinopathy. Diabetes duration (hazard rate ratio [HRR], 1.06 per year difference [P = 0.007]), hyperglycemia (HbA1 HRR, 1.27 per 1% difference [P &lt; 0.0001]), the type of treatment for diabetes (insulin use HRR, 3.06 [P = 0.0007], and oral hypoglycemic use HRR, 2.40 [P = 0.0034], compared with individuals on no pharmacotherapy), and macroalbuminuria (HRR, 2.86, compared with individuals without macroalbuminuria [P = 0.0486]) were associated with the development of retinopathy. Although fundoscopy detected fewer cases of retinopathy, HRRs for most risk factors were similar when retinopathy was assessed by fundoscopy rather than retinal photography.
CONCLUSIONS—Although retinopathy tends to worsen over time, some eyes show improvement, especially in patients with minimal nonproliferative retinopathy. As in other populations, glycemic control is the major modifiable risk factor for the development and progression of retinopathy.
Association Between Regional Adipose Tissue Distribution and Both Type 2 Diabetes and Impaired Glucose Tolerance in Elderly Men and Women
Authors: Goodpaster Bret H. , Krishnaswami Shanthi , Resnick Helaine , Kelley David E. , Haggerty Catherine , Harris Tamara B. , Schwartz Ann V. , Kritchevsky Steven , Newman Anne B. 
Published: March 2007

OBJECTIVE—We examined whether regional adipose tissue distribution, specifically that of skeletal muscle fat and visceral abdominal fat aggregation, is characteristic of elderly individuals with hyperinsulinemia, type 2 diabetes, and impaired glucose tolerance (IGT).
RESEARCH DESIGN AND METHODS—A total of 2,964 elderly men and women (mean age 73.6 years) were recruited for cross-sectional comparisons of diabetes or glucose tolerance, generalized obesity with dual-energy X-ray absorptiometry, and regional body fat distribution with computed tomography.
RESULTS—Approximately one-third of men with type 2 diabetes and less than half of women with type 2 diabetes were obese (BMI ≥30 kg/m2). Despite similar amounts of subcutaneous thigh fat, intermuscular fat was higher in subjects with type 2 diabetes and IGT than in subjects with normal glucose tolerance (NGT) (11.2 ± 9.4, 10.3 ± 5.8, and 9.2 ± 5.9 cm2 for men; 12.1 ± 6.1, 10.9 ± 6.5, and 9.4 ± 5.3 cm2 for women; both P &lt; 0.0001). Visceral abdominal fat was also higher in men and women with type 2 diabetes and IGT than in subjects with NGT (172 ± 79, 163 ± 72, and 145 ± 66 cm2 for men; 162 ± 66, 141 ± 60, and 116 ± 54 cm2 for women; both P &lt; 0.0001 across groups). Higher rates of intermuscular fat and visceral abdominal fat were associated with higher fasting insulin in normal-weight (BMI &lt;25 kg/m2) men (r = 0.24 for intermuscular fat, r = 0.37 for visceral abdominal fat, both P &lt; 0.0001) and women (r = 0.20 for intermuscular fat, r = 0.40 for visceral abdominal fat, both P &lt; 0.0001). These associations were not found in obese subjects.
CONCLUSIONS—Elderly men and women with normal body weight may be at risk for metabolic abnormalities, including type 2 diabetes, if they possess an inordinate amount of muscle fat or visceral abdominal fat.
Effects of Ethnicity and Nephropathy on Lower-Extremity Amputation Risk Among Diabetic Veterans
Authors: Young Bessie A. , Maynard Charles , Reiber Gayle , Boyko Edward J. 
Published: March 2007

OBJECTIVE—To describe ethnic differences in the risk of amputation in diabetic patients with diabetic nephropathy.RESEARCH DESIGN AND METHODS—A retrospective cohort study was conducted on a national cohort of diabetic patients who received primary care within the Veterans Affairs (VA) Health Care System. Hospitalizations for lower-limb amputations were established by ICD-9-CM procedure codes. Relative risk of amputation in diabetic patients with and without diabetic nephropathy was determined using Cox proportional hazard modeling for unadjusted and adjusted models.RESULTS—Of the 429,918 subjects identified with diabetes (mean age 64 ± 11 years, 97.4% male), 3,289 individuals were determined to have had a lower-limb amputation during the study period. Compared with diabetic patients without amputations, amputees were on average older, more likely to belong to a minority group, and were more likely to have received treatment for more comorbid conditions. Asians were more likely to have toe amputations compared with whites or other ethnicities, while Native Americans were more likely to have below-the-knee amputations. Native Americans had the highest risk of amputation (RR 1.74, 95% CI 1.39–2.18), followed by African Americans (RR 1.41, 95% CI 1.34–1.48) and Hispanics (RR 1.28, 95% CI 1.20–1.38) compared with whites. The presence of diabetic nephropathy increased the risk of amputation threefold in all groups. Asian subjects with diabetes had the lowest adjusted relative risk of amputation (RR 0.31, 95% CI 0.19–0.50).CONCLUSIONS—Among diabetic patients, certain ethnic minority individuals have an increased risk of lower-extremity amputation compared with whites. Presence of diabetic nephropathy further increases this risk.
Quantifying the Risk of Infectious Diseases for People With Diabetes
Authors: Shah Baiju R. , Hux Janet E. 
Published: March 2007

OBJECTIVE—In vitro evidence shows that immune function is compromised in people with diabetes. Although certain rare infections are more common and infection-related mortality is higher, the risk of acquiring an infectious disease for diabetic patients has never been quantified.
RESEARCH DESIGN AND METHODS—A retrospective cohort study using administrative data compared all people with diabetes in Ontario, Canada, on 1 April 1999 to matched nondiabetic people (n = 513,749 in each group). The risk ratios of having an infectious disease and of death attributable to infectious disease between those with and without diabetes were calculated. Secondary analysis individually examined common infectious diseases. The study was repeated using a second pair of cohorts defined in 1996 to confirm stability of the estimates.
RESULTS—Nearly half of all people with diabetes had at least one hospitalization or physician claim for an infectious disease in each cohort year. The risk ratio for diabetic versus nondiabetic people was 1.21 (99% CI 1.20–1.22) in both cohort years. The risk ratio for infectious disease-related hospitalization was up to 2.17 (99% CI 2.10–2.23). The risk ratio for death attributable to infection was up to 1.92 (1.79–2.05). Many individual infections were more common in people with diabetes, especially serious bacterial infections.
CONCLUSIONS—Diabetes confers an increased risk of developing and dying from an infectious disease, corroborating both in vitro evidence and commonly held clinical belief. In addition to microvascular and macrovascular sequelae, clinicians should consider infection a complication of diabetes.
Exercise Training, Without Weight Loss, Increases Insulin Sensitivity and Postheparin Plasma Lipase Activity in Previously Sedentary Adults
Authors: Duncan Glen E. , Perri Michael G. , Theriaque Douglas W. , Hutson Alan D. , Eckel Robert H. , Stacpoole Peter W. 
Published: March 2007

OBJECTIVE—To determine the effects of exercise, without weight loss, on insulin sensitivity (SI), postheparin plasma lipase activity (PHPL), intravenous fat clearance rate (K2), and fasting lipids in sedentary adults.
RESEARCH DESIGN AND METHODS—At baseline and after 6 months of walk training (intensity 45–55 or 65–75% heart rate reserve, frequency 3–4 or 5–7 days/week, duration 30 min/session), anthropometric indexes, SI, PHPL, K2, and fasting lipids were measured in 18 sedentary adults (12 women, 6 men; 51.9 ± 5.8 years of age, BMI 28.9 ± 4.6 kg/m2).
RESULTS—Exercise increased SI (2.54 ± 2.74 vs. 4.41 ± 3.30 μU · ml−1 · min−1, P &lt; 0.005) and both lipoprotein lipase (LPL) (1,890 ± 1,380 vs. 4,926 ± 1,858 nEq free fatty acid [FFA] · ml−1 · h−1) and hepatic lipase (HL) activities (3,326 ± 1,605 vs. 4,636 ± 1,636 nEq FFA · ml−1 · h−1) (both P &lt; 0.001), without altering BMI, waist circumference, K2, or fasting lipids. Correlations between changes in LPL and the total:HDL cholesterol ratio (r = −0.54) and changes in the LPL:HL ratio and waist circumference (r = −0.50) were significant (P &lt; 0.05).
CONCLUSIONS—Exercise, without weight loss, increases SI and PHPL activity in previously sedentary adults, without changing K2 or fasting lipid levels. Furthermore, increased LPL is associated with a decreased total:HDL ratio, and an increased LPL:HL ratio is associated with a decreased waist circumference. Therefore, even modest amounts of exercise in the absence of weight loss positively affect markers of glucose and fat metabolism in previously sedentary, middle-aged adults.
Amino Acid Ingestion Strongly Enhances Insulin Secretion in Patients With Long-Term Type 2 Diabetes
Authors: van Loon Luc J.C. , Kruijshoop Margriet , Menheere Paul P.C.A. , Wagenmakers Anton J.M. , Saris Wim H.M. , Keizer Hans A. 
Published: March 2007

OBJECTIVE—Insulin secretion in response to carbohydrate intake is blunted in type 2 diabetic patients. However, it is not clear whether the insulin response to other stimuli, such as amino acids, is also diminished. Recently, we defined an optimal insulinoptropic mixture containing free leucine, phenylalanine, and a protein hydrolysate that substantially enhances the insulin response in healthy young subjects when coingested with carbohydrate. In this study, we aimed to investigate the insulinotropic capacity of this mixture in long-term type 2 diabetic patients.
RESEARCH DESIGN AND METHODS—Ten type 2 diabetic patients (aged 59.1 ± 2.0 years, BMI 26.5 ± 0.7 kg/m2) and 10 healthy control subjects (58.8 ± 2.1 years, 26.5 ± 0.7 kg/m2) visited our lab twice, during which insulin responses were determined following ingestion of carbohydrate only (CHO) or carbohydrate with the free amino acid/protein mixture (CHO+PRO). All subjects received 0.7 g · kg−1 · h−1 carbohydrate with or without 0.35 g · kg−1 · h−1 of the amino acid/protein mixture.
RESULTS—Insulin responses were dramatically increased in the CHO+PRO trial in both the type 2 diabetic and control groups (189 and 114%, respectively) compared with the CHO trial (P &lt; 0.01). Plasma glucose, glucagon, growth hormone, cortisol, IGF-I, and IGF binding protein 3 responses were not different between trials within the 2-h time frame.
CONCLUSIONS—The insulin secretory capacity in long-term type 2 diabetic patients is substantially underestimated, as the insulin response following carbohydrate intake can be nearly tripled by coingestion of a free amino acid/protein mixture. Future research should be performed to investigate whether such nutritional interventions can improve postprandial glucose disposal.