bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rates and Risk Factors for Recurrence of Gestational Diabetes
Authors: MacNeill Stephanie , Dodds Linda , Hamilton David C. , Armson B. Anthony , VandenHof M. 
Published: March 2007

OBJECTIVE—To determine the recurrence rate of gestational diabetes (GDM) during a subsequent pregnancy among women who had GDM during an index pregnancy and to identify factors associated with the probability of recurrence.
RESEARCH DESIGN AND METHODS—A retrospective longitudinal study was performed in Nova Scotia, Canada, of women who were diagnosed as having GDM during a pregnancy between the years of 1980 and 1996 and who had at least one subsequent pregnancy during this time period. When only the index and first subsequent pregnancy were analyzed, the cohort included 651 women. The recurrence rate of GDM in the pregnancy after the pregnancy with the initial diagnosis of GDM was determined. Multivariate regression models were constructed to model the recurrence of GDM in a subsequent pregnancy as functions of potential predictors to estimate RRs and CIs.
RESULTS—The rate of recurrence of GDM in the pregnancy subsequent to the index pregnancy was found to be 35.6% (95% CI = 31.9–39.3%). Multivariate regression models showed that infant birth weight in the index pregnancy and maternal prepregnancy weight before the subsequent pregnancy were predictive of recurrent GDM.
CONCLUSIONS—In this large cohort of women, slightly more than one-third of the subjects had diabetes in a subsequent pregnancy, which is consistent with recurrence rates in other predominately white populations. Strategies to reduce the occurrence of neonatal macrosomia and maternal prepregnancy obesity may help lower the rate of recurrence of GDM.
Comprehensive Evaluation of Community-Based Diabetic Patients
Authors: Hiss Roland G. , Gillard Mary Lou , Armbruster Betty A. , McClure Leslie A. 
Published: March 2007

OBJECTIVE—To demonstrate improvements in diabetes care stimulated by comprehensive evaluation of community-based diabetic patients with feedback to the patients and their physicians.
RESEARCH DESIGN AND METHODS—A comprehensive evaluation of community-based diabetic patients with annotated reporting of results to both patients and their physicians (universal intervention) was followed by random assignment of 50% of patients to individual counseling (randomized intervention). In four communities, two large and two small, 55 type 1 and 376 type 2 diabetic patients were recruited, evaluated, and reassessed at 1 year. Outcome measures were HbA1c, serum cholesterol, and systolic and diastolic blood pressure.
RESULTS—There were significant improvements in all outcome measures for type 2 diabetic patients randomized to individual counseling (P = 0.03; follow-up rate 84%) and significant improvements in all outcome measures for all high-risk type 2 patients (highest P value = 0.004; follow-up rate 85%).
CONCLUSIONS—Comprehensive evaluation of diabetic patients at the community level with annotated reporting of results to the patients and their physicians was associated with improvement of mean HbA1c, cholesterol, and systolic and diastolic blood pressure, particularly in patients in high-risk status for these outcome variables. Individual counseling of 50% of patients, randomly selected, enhanced these results.
Serum 8-Hydroxy-Guanine Levels Are Increased in Diabetic Patients
Authors: Shin Chan Soo , Moon Byung Sool , Park Kyong Soo , Kim Seong Yeon , Park Su Jin , Chung Myung Hee , Lee Hong Kyu 
Published: March 2007

OBJECTIVE—The production of reactive oxygen species is increased in diabetic patients, especially in those with poor glycemic control. We have investigated oxidative damage in type 2 diabetic patients using serum 8-hydroxyguanine (8-OHG) as a biomarker.
RESEARCH DESIGN AND METHODS—We studied 41 type 2 diabetic patients and compared them with 33 nondiabetic control subjects. Serum 8-OHG concentration was assayed using high-pressure liquid chromatography.
RESULTS—The type 2 diabetic patients had significantly higher concentrations of 8-OHG in their serum than the control subjects (5.03 ± 0.69 vs. 0.96 ± 0.15 pmol/ml; P &lt; 0.01). There was no association between the levels of 8-OHG and HbA1c. We also could not find any correlation between serum 8-OHG levels and age, duration of diabetes, serum lipids, or creatinine or albumin excretion rate. Creatinine clearance showed marginal correlation with serum 8-OHG levels (P = 0.06). Among the diabetic patients, those with proliferative retinopathy had significantly higher 8-OHG levels than those with nonproliferative retinopathy or without retinopathy. Likewise, the serum 8-OHG levels in patients who had advanced nephropathy (azotemia) were higher than in patients with normoalbuminuria, microalbuminuria, or overt proteinuria.
CONCLUSIONS—Our findings show that measuring serum 8-OHG is a novel convenient method for evaluating oxidative DNA damage. Diabetic patients, especially those with advanced microvascular complications, had significantly higher serum 8-OHG levels; this suggests that such changes may contribute to the development of microvascular complications of diabetes.
TNFRSF1Bin Genetic Predisposition to Clinical Neuropathy and Effect on HDL Cholesterol and Glycosylated Hemoglobin in Type 2 Diabetes
Authors: Benjafield Adam V. , Glenn Cheryl L. , Wang Xing Li , Colagiuri Stephen , Morris Brian J. 
Published: March 2007

OBJECTIVE—Genetic variation in the tumor necrosis factor (TNF) receptor 2 gene (TNFRSF1B) has shown association with insulin resistance in type 2 diabetes, hypercholesterolemia, coronary artery disease, and essential hypertension. Here we tested the TNFRSF1B marker used in the latter studies in type 2 diabetes patients.RESEARCH DESIGN AND METHODS—A case-control study of a microsatellite marker with five alleles (CA13– CA17) in intron 4 of TNFRSF1B was performed in 357 well-characterized white patients and 183 healthy control subjects.RESULTS—The CA16 allele was associated with clinical neuropathy (frequency = 27% in 69 patients with the condition versus 16% in 230 subjects without the condition; χ2 = 9.0, P = 0.011; odds ratio = 2.1 [95% CI 1.2–3.8]). No association was seen with other complications or diabetes itself. The CA16 allele tracked with elevation plasma HDL cholesterol (1.3 ± 0.2, 1.2 ± 0.4, and 1.1 ± 0.2 for CA16/CA16, CA16/–, and –/–, respectively; n = 9, 110, and 218, respectively; P = 0.009) and reduction in plasma glycosylated hemoglobin (6.6 ± 0.3, 8.3 ± 0.2, and 8.1 ± 0.1 for CA16/CA16, CA16/–, and –/–, respectively; n = 9, 102, 205, respectively; P = 0.007). Significance remained after Bonferroni correction for multiple testing.CONCLUSIONS—Genetic variation in or near TNFRSF1B may predispose clinical neuropathy, reduced glycosylated hemoglobin, and increased HDL cholesterol in type 2 diabetes patients. The latter could be part of a protective response.
Abnormal Glucose Tolerance in Transfusion-Dependent β-Thalassemic Patients
Authors: Chern Jimmy P.S. , Lin Kai-Hsin , Lu Meng-Yao , Lin Dong-Tsam , Lin Kuo-Sin , Chen Jong-Dar , Fu Cheng-Chung 
Published: March 2007

OBJECTIVE—To study the prevalence of and risk factors for abnormal glucose tolerance in transfusion-dependent β-thalassemic patients.
RESEARCH DESIGN AND METHODS—A total of 89 transfusion-dependent β-thalassemic patients were interviewed. Diabetes was previously diagnosed in 14 of them. In the remaining 75 patients, 68 participated in an oral glucose tolerance test. Potential risk factors were identified using the independent t test, χ2 test, and Fisher’s exact test. Logistic regression analysis was used to select the independent risk factors that best predicted abnormal glucose tolerance. A two-tailed P value of &lt;0.05 was considered to be statistically significant.
RESULTS—The prevalence of impaired glucose tolerance was 8.5% (7 of 82) and that of diabetes was 19.5% (16 of 82). Presentation with diabetic ketoacidosis was 31.1% (5 of 16). The risk factors for abnormal glucose tolerance found in transfusion-dependent β-thalassemic patients were serum ferritin concentration and hepatitis C infection.
CONCLUSIONS—The interaction of iron overload and hepatitis C infection worsened the prognosis of thalassemic patients. Aggressive iron-chelation therapy as well as prevention and treatment of hepatitis C infection should be mandatory in managing glucose homeostasis in transfusion-dependent β-thalassemic patients in Taiwan.
Elevation of N-(Carboxymethyl)valine Residue in Hemoglobin of Diabetic Patients
Authors: Uchimura Tomonori , Nakano Kazushi , Hashiguchi Teruto , Iwamoto Hisahiko , Miura Keisuke , Yoshimura Yoshimichi , Hanyu Naohiro , Hirata Koichiro , Imakuma Misturu , Motomiya Yoshihiro , Maruyama Ikuro 
Published: March 2007

OBJECTIVE—Advanced glycation end products (AGEs) are a risk factor for diabetic complications. We have developed an assay method for N-(carboxymethyl)valine (CMV) of the hemoglobin (CMV-Hb), which is an AGE generated from HbA1c. Herein, we describe the clinical utility of CMV-Hb measurement for the diagnosis of diabetic nephropathy.
RESEARCH DESIGN AND METHODS—BALB/c mice were immunized with carboxymethylated Hb and monoclonal antibody raised against CMV-Hb. This antibody was characterized by a surface plasmon resonance. We developed a latex immunoassay using the antibody and measured CMV-Hb from erythrocytes in type 2 diabetic patients and healthy control subjects (age 64.6 ± 12.0 vs. 61.1 ± 13.2 years, NS; HbA1c 6.9 ± 1.5 vs. 5.2 ± 0.4%, P &lt; 0.0001).
RESULTS—A monoclonal antibody against CMV-Hb β-chain NH2-terminal and an assay method for measurement for CMV-Hb were both developed in our laboratory. CMV-Hb levels were significantly greater in the diabetic patients than in the control subjects (18.2 ± 6.9 vs. 12.7 ± 6.9 pmol CMV/mg Hb, P &lt; 0.0001). No correlation was found between CMV-Hb and HbA1c or CMV-Hb and glycated albumin. Levels of CMV-Hb increased as the diabetic nephropathy progressed.
CONCLUSIONS—We established an assay method for CMV-Hb and confirmed the presence of CMV-Hb in circulating erythrocytes. CMV-Hb was more prevalent in diabetic patients than in healthy subjects. Furthermore, it was significantly higher in patients with diabetic nephropathy, suggesting that the presence of CMV-Hb may be a valuable marker for the progression of diabetic nephropathy.
Disturbances of Glucose Metabolism in Men Referred for Coronary Arteriography
Authors: Kowalska Irina , Prokop Jolanta , Bachórzewska-Gajewska Hanna , Telejko Beata , Kinalskal Ida , Kochman Waclaw , Musial Wlodzimierz 
Published: March 2007

OBJECTIVE—In some studies, fasting and postload glycemia are a strong predictor of coronary events and cardiac death. Therefore, we investigated the relationship between fasting and postload glucose concentrations and coronary status in 363 men referred for coronary arteriography without a previous history of diabetes.
RESEARCH DESIGN AND METHODS—A total of 363 men (mean age 53.0 ± 9.1 years, mean BMI 27.9 ± 3.7 kg/m2) with positive results of exercise testing were included in the study. A standard oral glucose tolerance test (OGTT) with glucose and insulin estimations was performed on all subjects. The concentrations of total cholesterol, HDL cholesterol, triglycerides, and HbA1c were also measured. All patients were divided into four groups, according to coronary status: no changes in coronary arteries (group 0, n = 61), one-vessel disease (group I, n = 113), two-vessel disease (group II, n = 116), and three-vessel disease (group III, n = 73).
RESULTS—The highest postload glucose concentrations were observed in group III. Also, insulin concentrations and HbA1c increased with the progression of atherosclerotic lesions in the coronary arteries. Based on results of the OGTT, 16% of the patients (n = 59) fulfilled the World Health Organization criteria for type 2 diabetes and 36% of the patients (n = 131) met criteria for impaired glucose tolerance. Significant correlations were observed between the number of involved vessels and postload glycemia, HbA1c, fasting insulin, and postload insulin. The multiple stepwise regression analysis showed that age, total cholesterol, and HDL cholesterol independently correlated with the number of involved vessels.
CONCLUSIONS—We conclude that patients with advanced changes in the coronary arteries experience more pronounced metabolic disturbances. Postload glycemia could be an important predictor of nondiagnosed disturbances of glucose metabolism.
Effect of Mild Exercise Training on Glucose Effectiveness in Healthy Men
Authors: Nishida Yuichiro , Higaki Yasuki , Tokuyama Kumpei , Fujimi Kanta , Kiyonaga Akira , Shindo Munehiro , Sato Yuzo , Tanaka Hiroaki 
Published: March 2007

OBJECTIVE—To detect whether mild exercise training improves glucose effectiveness (SG), which is the ability of hyperglycemia to promote glucose disposal at basal insulin, in healthy men.
RESEARCH DESIGN AND METHODS—Eight healthy men (18–25 years of age) underwent ergometer training at lactate threshold (LT) intensity for 60 min/day for 5 days/week for 6 weeks. An insulin-modified intravenous glucose tolerance test was performed before as well as at 16 h and 1 week after the last training session. SG and insulin sensitivity (SI) were estimated using a minimal-model approach.
RESULTS—After the exercise training, Vo2max and Vo2 at LT increased by 5 and 34%, respectively (P &lt; 0.05). The mild exercise training improves SG measured 16 h after the last training session, from 0.018 ± 0.002 to 0.024 ± 0.001 min−1 (P &lt; 0.05). The elevated SG after exercise training tends to be maintained regardless of detraining for 1 week (0.023 ± 0.002 min−1, P = 0.09). SI measured at 16 h after the last training session significantly increased (pre-exercise training, 13.9 ± 2.2; 16 h, 18.3 ± 2.4, ×10−5 · min−1 · pmol/l−1, P &lt; 0.05) and still remained elevated 1 week after stopping the training regimen (18.6 ± 2.2, ×10−5 · min−1 · pmol/l−1, P &lt; 0.05).
CONCLUSIONS—Mild exercise training at LT improves SG in healthy men with no change in the body composition. Improving not only SI but also SG through mild exercise training is thus considered to be an effective method for preventing glucose intolerance.
Lipid and Blood Pressure Treatment Goals for Type 1 Diabetes
Authors: Orchard Trevor J. , Forrest Kimberly Y.-Z. , Kuller Lewis H. , Becker Dorothy J. 
Published: March 2007

OBJECTIVE—Subjects with type 1 diabetes are at high risk for many long-term complications, including early mortality and coronary artery disease (CAD). Few data are available on which to base goal levels for two major risk factors, namely blood pressure and lipid/lipoproteins. The objective of this study was to determine at which levels of LDL and HDL cholesterol, triglycerides, and blood pressure the relative risks of type 1 diabetic complications increase significantly.
RESEARCH DESIGN AND METHODS—Observational prospective study of 589 patients with childhood-onset type 1 diabetes (&lt;17 years) aged ≥18 years at baseline; 10-year incidence of mortality, CAD, lower-extremity arterial disease, proliferative retinopathy, distal symmetric polyneuropathy, and overt nephropathy. Relative risks were determined using traditional groupings of blood pressure and lipid/lipoproteins, measured at baseline, using the lowest groupings (&lt;100 mg/dl [2.6 mmol/l] LDL cholesterol, &lt;45 mg/dl [1.1 mmol/l] HDL cholesterol, &lt;100 mg/dl [1.1 mmol/l] triglycerides, &lt;110 mmHg systolic blood pressure, and &lt;80 mmHg diastolic blood pressure) as reference. Adjustments for age, sex, and glycemic control were examined.
RESULTS—Driven mainly by strong relationships (RR range 1.8–12.1) with mortality, CAD, and overt nephropathy, suggested goal levels are as follows: LDL cholesterol &lt;100 mg/dl (2.6 mmol/l), HDL cholesterol &gt;45 mg/dl (1.1 mmol/l), triglycerides &lt;150 mg/dl (1.7 mmol/l), systolic blood pressure &lt;120 mmHg, and diastolic blood pressure &lt;80 mmHg. Age, sex, and glycemic control had little influence on these goals.
CONCLUSIONS—Although observational in nature, these data strongly support the case for vigorous control of lipid levels and blood pressure in patients with type 1 diabetes.
A Systematic Approach to Risk Stratification and Intervention Within a Managed Care Environment Improves Diabetes Outcomes and Patient Satisfaction
Authors: Clark Charles M. , Snyder James W. , Meek Robert L. , Stutz Linda M. , Parkin Christopher G. 
Published: March 2007

OBJECTIVE—To determine whether a comprehensive diabetes management program that included risk stratification and social marketing would improve clinical outcomes and patient satisfaction within a managed care organization (MCO).
RESEARCH DESIGN AND METHODS—The 12-month prospective trial was conducted at primary care clinics within a MCO and involved 370 adults with diabetes. Measurements included 1) the frequency of dilated eye and foot examinations, microalbuminuria assessment, blood pressure measurement, lipid profile, and HbA1c measurement; 2) changes in blood pressure, lipid levels, and HbA1c levels; and 3) changes in patient satisfaction.
RESULTS—Complete data are reported for the 193 patients who had been enrolled for 12 months; life table analysis is reported for all patients who remained enrolled at the study’s end as well as for a comparative control group of 623 patients. For the 193 patients for whom 12-month data were available, the number of patients in the low-risk category (HbA1c &lt;7%) increased by 51.1%. A total of 97.4% of patients with an HbA1c &gt;8% at baseline had a change in treatment regimen. Patients at the highest risk for coronary heart disease (LDL &gt;130 mg/dl) decreased from 25.4% at baseline to 20.2%. Patients with a blood pressure &lt;130/85 mmHg increased from 23.8 to 44.6%. Of these patients, 63.0% had changes in medication. Patients and providers expressed significant increases in satisfaction with the program.
CONCLUSIONS—The program was successful in initiating the recommended changes in the diabetic therapeutic regimen, resulting in improved glycemic control, increased monitoring/management of diabetic complications, and greater patient and provider satisfaction. These results should have great significance in the design of future programs in MCOs aimed at improving the care of people with diabetes and other chronic diseases.
The Relationship of Fasting Plasma Glucose Values and Other Variables to 2-h Postload Plasma Glucose in Japanese Subjects
Authors: Bando Yukihiro , Ushiogi Yasuyuki , Okafuji Kazuhiro , Toya Daisyu , Tanaka Nobuyoshi , Fujisawa Masakiyo 
Published: March 2007

OBJECTIVE—To investigate the relationship between fasting plasma glucose (FPG) values and other variables (e.g., age, sex, and BMI) to 2-h post–75-g oral glucose load glycemia (PG) in Japanese subjects.
RESEARCH DESIGN AND METHODS—Subjects included 13,694 Japanese subjects between 20 and 83 years of age (10,677 men and 3,017 women) who were undergoing a 75-g oral glucose tolerance test (OGTT) during a health screening performed at our hospital. The influences of age for 2-h PG at a fixed fasting plasma glucose (FPG) level of 126 mg/dl were analyzed. Multiple linear regression analysis was performed using a model in which the dependent variable was 2-h PG using the following explanatory variables: FPG, age, sex, BMI, blood pressure, plasma cholesterol, and triglyceride (TG) levels.
RESULTS—The 2-h PG at a fixed FPG of 126 mg/dl increased by 0.94 mg/dl per year in patients aged between 30 and 78 years (r = 0.68, P &lt; 0.0001). In multiple regression, five explanatory variables (FPG, age, BMI, plasma TG levels, and systolic blood pressure levels) were all positively associated with 2-h PG. The percentages of patients with 2-h diabetes (isolated postchallenge hyperglycemia [IPH]) versus fasting plus 2-h diabetes by the World Health Organization criteria significantly (P = 0.005) increased as the patients’ decades increased, whereas the impact of BMI on the percentages was significant only in young patients (P = 0.001).
CONCLUSIONS—Aging was found to be the second best predictor of 2-h PG on multiple regression. Therefore, OGTT should be performed especially in elderly patients because they show IPH more frequently.
Diabetes and Risk of Fracture
Authors: Ivers Rebecca Q. , Cumming Robert G. , Mitchell Paul , Peduto Anthony J. 
Published: March 2007

OBJECTIVE—To examine associations between measures of diabetes and risk of fracture in a population-based sample of older Australians.
RESEARCH DESIGN AND METHODS—This was a prospective study of 3,654 subjects aged 49 years and older who were residents in the Blue Mountains, west of Sydney, Australia. At baseline, subjects were asked questions about history and treatment of diabetes, and fasting blood samples were taken. Photographs were taken of the retina and lens to grade retinopathy and cataract. Details of fractures (excluding rib and vertebral fractures) were collected by a combination of self-report and medical record searches; all fractures were radiologically confirmed.
RESULTS—After 2 years of follow-up, we found that several diabetes-related factors were significantly associated (in multivariate models) with increased risk of all fractures combined, including presence of diabetic retinopathy (adjusted RR 5.4, 95% CI 2.7–10.8), diabetes duration ≥10 years (3.3, 1.3–8.2), cortical cataract involving ≥25% of the lens area (2.5, 1.3–4.7), and insulin treatment (5.9, 2.6–13.5). The proximal humerus was the only individual fracture site associated with diabetes. Diabetic retinopathy (10.3, 2.2–48.0), diabetes duration (for ≥10 years duration; 11.4, 2.4–54.2), and insulin treatment (18.8, 4.0–88.7) were all associated with proximal humerus fracture.
CONCLUSIONS—These data suggest a significantly increased risk of fracture associated with diabetic retinopathy, advanced cortical cataract, longer diabetes duration, and insulin treatment. However, there are some shortcomings in this study that may limit these findings.