bluuebunny/crossref_metadata_2025_split huggingface dataset:
Type 2 Diabetes Prevalence in Asian Americans
Authors: McNeely Marguerite J. , Boyko Edward J. 
Published: March 2007

OBJECTIVE—Asians are thought to be at high risk for diabetes, yet there is little population-based information about diabetes in Asian Americans. The purpose of this study was to directly compare the prevalence of type 2 diabetes in Asian Americans with other racial and ethnic groups in the U.S. using data from the 2001 Behavioral Risk Factor Surveillance System (BRFSS).
RESEARCH DESIGN AND METHODS—The BRFSS is a population-based telephone survey of the health status and health behaviors of Americans in all 50 states, Guam, Puerto Rico, and the U.S. Virgin Islands. Subjects included 3,071 Asians, 12,561 blacks, 12,153 Hispanics, 2,299 Native Americans, 626 Pacific Islanders, and 129,116 non-Hispanic whites aged ≥30 years. Subjects who reported a physician-diagnosis of diabetes were considered to have type 2 diabetes unless they were diagnosed before age 30.
RESULTS—Compared with whites, odds ratios (95% CIs) for diabetes, adjusted for age and sex, were 1.0 (0.7–1.4) for Asians, 2.3 (2.1–2.6) for blacks, 2.0 (1.8–2.3) for Hispanics, 2.2 (1.6–2.9) for Native Americans, and 3.1 (1.4–6.8) for Pacific Islanders. Results adjusted for BMI, age, and sex were 1.6 (1.2–2.3) for Asians, 1.9 (1.7–2.2) for blacks, 1.9 (1.6–2.1) for Hispanics, 1.8 (1.3–2.5) for Native Americans, and 3.0 (1.4–6.7) for Pacific Islanders.
CONCLUSIONS—Similar proportions of Asian and non-Hispanic white Americans report having diabetes, but after accounting for the lower BMI of Asians, the adjusted prevalence of diabetes is 60% higher in Asian Americans.
Exercise Capacity and Body Composition as Predictors of Mortality Among Men With Diabetes
Authors: Church Timothy S. , Cheng Yiling J. , Earnest Conrad P. , Barlow Carolyn E. , Gibbons Larry W. , Priest Elisa L. , Blair Steven N. 
Published: March 2007

OBJECTIVE—To quantify the relation of fitness to mortality among men with diabetes, adjusted for BMI and within levels of BMI.
RESEARCH DESIGN AND METHODS—In this observational cohort study, we calculated all-cause death rates in men with diabetes across quartiles of fitness and BMI categories. Study participants were 2,196 men with diabetes (average age 49.3 years, SD 9.5) who underwent a medical examination, including a maximal exercise test, during 1970 to 1995, with mortality follow-up to 31 December 1996.
RESULTS—We identified 275 deaths during 32,161 person-years of observation. Risk of all-cause mortality was inversely related to fitness. For example, in the fully adjusted model, the risk of mortality was 4.5 (2.6–7.6), 2.8 (1.6–4.7), and 1.6 (0.93–2.76) for the first, second, and third fitness quartiles, respectively, with the fourth quartile (highest fitness level) as the referent (P for trend &lt;0.0001). There was no significant trend across BMI categories for mortality after adjustment for fitness. Similar results were found when the fitness-mortality relation was examined within levels of body composition. In normal-weight men with diabetes, the relative risks of mortality were 6.6 (2.8–15.0), 3.2 (1.4–7.0), and 2.2 (1.1–4.6) for the first, second, and third quartiles of fitness, respectively, as compared with the fourth quartile (P for trend &lt;0.0001). We found similar results in the overweight and obese weight categories.
CONCLUSIONS—There was a steep inverse gradient between fitness and mortality in this cohort of men with documented diabetes, and this association was independent of BMI.
The Treatment of Diabetic Gastroparesis With Botulinum Toxin Injection of the Pylorus
Authors: Lacy Brian E. , Crowell Michael D. , Schettler-Duncan Ann , Mathis Carole , Pasricha Pankaj J. 
Published: March 2007

OBJECTIVE—Gastroparesis is a disorder of delayed gastric emptying that is often chronic in nature. Up to 50% of type 1 diabetic subjects have symptoms of gastroparesis, which include nausea, vomiting, and early satiety. Elevated pyloric pressures may be responsible for delayed gastric emptying in diabetic subjects. Botulinum toxin inhibits the release of acetylcholine and produces transient paralysis when injected into smooth muscle. The aim of this study was to determine whether injection of the pylorus with botulinum toxin in patients with diabetic gastroparesis improves symptoms of gastroparesis, alters gastric emptying scan time, and/or changes weight and insulin use.
RESEARCH DESIGN AND METHODS—This was an open-label trial with age- and sex-matched control subjects from a tertiary care referral center for patients with gastroparesis. Eight type 1 diabetic subjects (six women and two men; mean age 41 years; mean years with diabetes 25.3) who had failed standard therapy were enrolled. Intervention consisted of injection of the pylorus with 200 units of botulinum toxin during upper endoscopy. Symptoms, antropyloric manometry, gastric emptying scan times, weight, and insulin use were all recorded before intervention and during a 12-week follow-up period.
RESULTS—Seven of the eight patients completed the full 12-week follow-up period. No complications were noted. Mean symptom scores declined from 27 to 12.1 (P &lt; 0.01), whereas the SF-36 physical functioning domain also improved (P &lt; 0.05). Four patients noted an increase in insulin use of &gt;5 units/day. Six of the seven patients gained weight (P = 0.05). Gastric emptying scan time improved in four patients.
CONCLUSIONS—Botulinum toxin injection of the pylorus is safe and improves symptoms in patients with diabetic gastroparesis. These results warrant further investigation with a large, double-blind, placebo-controlled trial.
Atrophy of Foot Muscles
Authors: Andersen Henning , Gjerstad Michaela D. , Jakobsen Johannes 
Published: March 2007

OBJECTIVE—Diabetic neuropathy is a length-dependent process that leads to reduced muscle strength and atrophy of leg muscles in some patients. We hypothesized that intrinsic foot muscles are atrophied in diabetic neuropathy and that the degree of atrophy is a measure of motor dysfunction closely related to the neuropathic process.
RESEARCH DESIGN AND METHODS—Consecutive cross-sectional magnetic resonance images of the nondominant foot were obtained for stereological determination of the total volume of the intrinsic foot muscles (VFM) in 23 long-term diabetic patients with (n = 15) and without (n = 8) chronic neuropathy and in 23 matched healthy nondiabetic control subjects. Based on clinical examination, nerve conduction studies, and quantitative sensory examination, a neuropathy rank-sum score was calculated for each patient.
RESULTS—Total VFM was 86 ± 52, 165 ± 34, and 168 ± 42 cm3 in neuropathic patients, nonneuropathic patients, and healthy control subjects, respectively (P &lt; 0.001). There was a close inverse relationship between the neuropathy rank-sum score and the VFM (r = −0.75, P &lt; 1 × 10−5).
CONCLUSIONS—Total volume of the foot muscles is halved in patients with diabetic neuropathy. Atrophy of foot muscles is closely related to the severity of neuropathy and reflects motor dysfunction.
Increased 24-h Energy Expenditure in Type 2 Diabetes
Authors: Bitz Christian , Toubro Søren , Larsen Thomas M. , Harder Helle , Rennie Kirsten L. , Jebb Susan A. , Astrup Arne 
Published: March 2007

OBJECTIVE—The aim of this study was to determine whether overweight and obese individuals with type 2 diabetes have higher basal and 24-h energy expenditure compared with healthy control subjects before and after adjustment for body composition, spontaneous physical activity (SPA), sex, and age.
RESEARCH DESIGN AND METHODS—Data from 31 subjects with type 2 diabetes and 61 nondiabetic control subjects were analyzed. The 24-h energy expenditure, basal metabolic rate (BMR), and sleeping energy expenditure (EEsleep) between 1:00 a.m. and 6:00 a.m. were measured in whole-body respiratory chambers. Body composition was assessed by dual-energy X-ray absorptiometry (DXA).
RESULTS—No significant differences in unadjusted EEsleep, BMR, and 24-h energy expenditure were observed between the type 2 diabetic group and the control group. After adjustment for fat-free mass (FFM), fat mass, SPA, sex, and age, EEsleep and BMR were, respectively, 7.7 and 6.9% higher in the type 2 diabetic group compared with the control group. This was equivalent to 144 ± 40 kcal/day (P = 0.001) and 139 ± 61 kcal/day (P = 0.026), respectively. Adjusted 24-h energy expenditure was 6.5% higher in the type 2 diabetic group compared with the nondiabetic control subjects (2,679 ± 37 vs. 2,515 ± 23 kcal/day, P = 0.002). In multiple regression analyses, FFM, fat mass, SPA, and diabetes status were all significant determinants of EEsleep and 24-h energy expenditure, explaining 83 and 81% of the variation, respectively.
CONCLUSIONS—This study confirms reports in Pima Indians that basal and 24-h energy expenditure adjusted for body composition, SPA, sex, and age are higher in individuals with type 2 diabetes compared with nondiabetic control subjects and may be even more pronounced in Caucasians.
Circulating Adiponectin and Resistin Levels in Relation to Metabolic Factors, Inflammatory Markers, and Vascular Reactivity in Diabetic Patients and Subjects at Risk for Diabetes
Authors: Shetty Greeshma K. , Economides Panayiotis A. , Horton Edward S. , Mantzoros Christos S. , Veves Aristidis 
Published: March 2007

OBJECTIVE—Adiponectin and resistin, two recently discovered adipocyte-secreted hormones, may link obesity with insulin resistance and/or metabolic and cardiovascular risk factors. We performed a cross-sectional study to investigate the association of adiponectin and resistin with inflammatory markers, hyperlipidemia, and vascular reactivity and an interventional study to investigate whether atorvastatin mediates its beneficial effects by altering adiponectin or resistin levels.
RESEARCH DESIGN AND METHODS—Associations among vascular reactivity, inflammatory markers, resistin, and adiponectin were assessed cross-sectionally using fasting blood samples obtained from 77 subjects who had diabetes or were at high risk to develop diabetes. The effect of atorvastatin on adiponectin and resistin levels was investigated in a 12-week-long randomized, double-blind, placebo-controlled study.
RESULTS—In the cross-sectional study, we confirm prior positive correlations of adiponectin with HDL and negative correlations with BMI, triglycerides, C-reactive protein (CRP), and plasma activator inhibitor (PAI)-1 and report a negative correlation with tissue plasminogen activator. The positive association with HDL and the negative association with PAI-1 remained significant after adjusting for sex and BMI. We also confirm prior findings of a negative correlation of resistin with HDL and report for the first time a positive correlation with CRP. All of these associations remained significant after adjusting for sex and BMI. No associations of adiponectin or resistin with any aspects of vascular reactivity were detected. In the interventional study, atorvastatin decreased lipid and CRP levels, but adiponectin and resistin were not specifically altered.
CONCLUSIONS—We conclude that adiponectin is significantly associated with inflammatory markers, in part, through an underlying association with obesity, whereas resistin’s associations with inflammatory markers appear to be independent of BMI. Lipid profile and inflammatory marker changes produced by atorvastatin cannot be attributed to changes of either adiponectin or resistin.
Antihypertensive Therapy and Incidence of Type 2 Diabetes in an Elderly Cohort
Authors: Padwal Raj , Mamdani Muhammad , Alter David A. , Hux Jan E. , Rothwell Deanna M. , Tu Karen , Laupacis Andreas 
Published: March 2007

OBJECTIVE—The aim of this study was to determine whether the incidence of type 2 diabetes differed among elderly users of four major antihypertensive drug classes.
RESEARCH DESIGN AND METHODS—This was a retrospective, observational cohort study of previously untreated elderly patients (aged ≥66 years) identified as new users of an antihypertensive drug class between April 1995 and March 2000. Using a Cox proportional hazards model, the primary analysis compared diabetes incidence in users of ACE inhibitors, β-blockers, and calcium channel blockers (CCBs), with thiazide diuretics allowed as second-line therapy. In the secondary analysis, thiazide diuretics were added as a fourth study group.
RESULTS—In the multivariable-adjusted primary analysis (n = 76,176), neither ACE inhibitor use (hazard ratio 0.96 [95% CI 0.84–1.1]) nor β-blocker use (0.86 [0.74–1.0]) was associated with a statistically significant difference in type 2 diabetes incidence compared with the CCB control group. In the secondary analysis (n = 100,653), compared with CCB users, type 2 diabetes incidence was not significantly different between users of ACE inhibitors (0.97 [0.83–1.1]), β-blockers (0.84 [0.7–1.0]), or thiazide diuretics (1.0 [0.89–1.2]).
CONCLUSIONS—Type 2 diabetes incidence did not significantly differ among users of the major antihypertensive drug classes in this elderly, population-based administrative cohort. These results do not support the theory that different antihypertensive drug classes are relatively more or less likely to cause diabetes.
Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Injections
Authors: Retnakaran Ravi , Hochman Jackie , DeVries J. Hans , Hanaire-Broutin Helene , Heine Robert J. , Melki Vincent , Zinman Bernard 
Published: March 2007

OBJECTIVE—Rapid-acting insulin analogs (insulin lispro and insulin aspart) have emerged as the meal insulin of choice in both multiple daily insulin injection (MDII) therapy and continuous subcutaneous insulin infusion (CSII) for type 1 diabetes. Thus, a comparison of efficacy between CSII and MDII should be undertaken only in studies that used rapid-acting analogs for both intensive regimens.
RESEARCH DESIGN AND METHODS—We performed a pooled analysis of the randomized controlled trials that compared CSII and optimized MDII therapy using rapid-acting analogs in adults with type 1 diabetes.
RESULTS—The three studies that met inclusion criteria provided data on 139 patients, representing 596 patient-months for CSII and 529 patient-months for MDII. Mean age was 38.5 years, with duration of diabetes of 18.0 years. The studies differed significantly in mean baseline A1c (7.95, 8.20, and 9.27%). The pooled estimate of treatment effect comparing the percentage reduction in A1c by CSII with that by MDII (CSII − MDII) was 0.35% (95% CI −0.10 to 0.80, P = 0.08) using a random effect to account for heterogeneity between studies. Importantly, the interaction between baseline A1c and treatment modality emerged as an independent predictor of treatment effect (CSII − MDII) (P = 0.002). The relative benefit of CSII over MDII was found to increase with higher baseline A1c. A model derived from these data predicts that in a patient with a baseline A1c of 10%, CSII would reduce the A1c by an additional 0.65% compared with MDII. Conversely, there would be no A1c benefit of CSII compared with MDII if baseline A1c were 6.5%. There was no significant difference between CSII and MDII in the rate of hypoglycemic events.
CONCLUSIONS—When using rapid-acting insulin analogs in CSII and MDII regimens in adult patients with type 1 diabetes, insulin pump therapy is associated with better glycemic control, particularly in those individuals with higher baseline A1c. Thus, CSII emerges as an important modality for implementing intensive therapy and may be uniquely advantageous in patients with poor glycemic control.
Physical Activity and Television Viewing in Relation to Risk of Undiagnosed Abnormal Glucose Metabolism in Adults
Authors: Dunstan David W. , Salmon Jo , Owen Neville , Armstrong Timothy , Zimmet Paul Z. , Welborn Timothy A. , Cameron Adrian J. , Dwyer Terence , Jolley Damien , Shaw Jonathan E. ,   on behalf of the AusDiab Steering Committee
Published: March 2007

OBJECTIVE—The goal of this study was to assess the associations of physical activity time and television (TV) time with risk of “undiagnosed” abnormal glucose metabolism in Australian adults.
RESEARCH DESIGN AND METHODS—This population-based cross-sectional study using a stratified cluster design involving 42 randomly selected Census Collector Districts across Australia included 8,299 adults aged 25 years or older who were free from new type 2 diabetes and self-reported ischemic disease and did not take lipid-lowering or antihypertensive drugs. Abnormal glucose metabolism (impaired fasting glycemia [IFG], impaired glucose tolerance [IGT], or new type 2 diabetes) was based on an oral glucose tolerance test. Self-reported physical activity time and TV time (previous week) were assessed using interviewer-administered questionnaires.
RESULTS—After adjustment for known confounders and TV time, the odds ratio (OR) of having abnormal glucose metabolism was 0.62 (95% CI 0.41–0.96) in men and 0.71 (0.50–1.00) in women for those engaged in physical activity ≥2.5 h/week compared with those who were sedentary (0 h/week). The ORs of having abnormal glucose metabolism were 1.16 (0.79–1.70) in men and 1.49 (1.12–1.99) in women who watched TV &gt;14 h/week compared with those who watched ≤7.0 h/week. Higher TV viewing (&gt;14 h/week) was also associated with an increased risk of new type 2 diabetes in men and women and IGT in women compared with those watching &lt;14 h/week. Total physical activity of ≥2.5 h/week was associated with a reduced risk of IFG, IGT, and new type 2 diabetes in both sexes; however, only the association with IGT in women was statistically significant.
CONCLUSIONS—These findings suggest a protective effect of physical activity and a deleterious effect of TV time on the risk of abnormal glucose metabolism in adults. Population strategies to reduce risk of abnormal glucose metabolism should focus on reducing sedentary behaviors such as TV time, as well as increasing physical activity.
Renal Impairment Associated With Diabetes in the Elderly
Authors: Wasén Elise , Isoaho Raimo , Mattila Kari , Vahlberg Tero , Kivelä Sirkka-Liisa , Irjala Kerttu 
Published: March 2007

OBJECTIVE—To characterize renal impairment associated with diabetes in older adults by serum markers of glomerular filtration rate and microalbuminuria tests.
RESEARCH DESIGN AND METHODS—The study population consisted of 187 diabetic and 1,073 nondiabetic subjects (age range 64–100 years) participating in a cross-sectional, population-based survey in southwestern Finland. Renal function was estimated by serum cystatin C (Cys C), serum creatinine (Cr), and the urinary albumin-to-creatinine ratio, and determinants of elevated levels were assessed by multivariate analysis.
RESULTS—Diabetes, compared to hypertension, was a more powerful determinant of elevated Cys C and Cr levels in the very old (age ≥80 years), whereas the impact of hypertension was more pronounced in the younger group (age &lt;80 years). The prevalence of microalbuminuria among diabetic subjects was 29.7%, and 15% had elevated Cr levels, whereas the prevalence of elevated Cys C levels varied considerably depending on whether adult or age-adjusted reference limits were used (64.7 vs. 21.4%). In 64.1% of diabetic subjects with elevated Cys C levels based on age-adjusted reference limits and in 48.2% of subjects with elevated Cr levels, microalbuminuria was absent.
CONCLUSIONS—The impact of diabetes on renal impairment changes with increasing age. Serum markers of glomerular filtration rate and microalbuminuria identify renal impairment in different segments of the diabetic population, indicating that serum markers as well as microalbuminuria tests should be used in screening for nephropathy in diabetic older people. The appropriate reference limit for Cys C in geriatric clinical practice must be defined by further research.
Preventative Effects of Rosiglitazone on Restenosis After Coronary Stent Implantation in Patients With Type 2 Diabetes
Authors: Choi Donghoon , Kim Soo-Kyung , Choi Sung-Hee , Ko Young-Guk , Ahn Chul-Woo , Jang Yangsoo , Lim Sung-Kil , Lee Hyun-Chul , Cha Bong-Soo 
Published: March 2007

OBJECTIVE—Despite the popularity of coronary stenting in coronary artery disease (CAD), restenosis remains a challenging clinical problem. This study evaluated the efficacy of rosiglitazone for preventing in-stent restenosis in type 2 diabetic patients.
RESEARCH DESIGN AND METHODS—We conducted a prospective, randomized, case-controlled trial involving 95 diabetic patients with CAD who were randomly assigned to either the control or rosiglitazone group (48 and 47 patients, respectively). Quantitative coronary angiography (QCA) was performed at study entry and again at 6-month follow-up. The primary end point was the restenosis rate, which was determined by QCA.
RESULTS—Eighty-three patients (45 patients with 55 lesions in the control group and 38 patients with 51 lesions in the rosiglitazone group) completed follow-up angiography. Rosiglitazone treatment for 6 months reduced fasting insulin concentration. The high-sensitivity C-reactive protein concentration was significantly reduced in the rosiglitazone group compared with that in the control group (from 2.92 ± 1.98 to 0.62 ± 0.44 mg/l, P &lt; 0.001 vs. from 2.01 ± 1.33 to 1.79 ± 1.22 mg/l, P = NS). However, the baseline and follow-up glucose and lipid concentrations were not different between two groups. The rate of in-stent restenosis was significantly reduced in the rosiglitazone group compared with the control group (for stent lesions: 17.6 vs. 38.2%, P = 0.030). The rosiglitazone group had a significantly lower degree of diameter stenosis (23.0 ± 23.4% vs. 40.9 ± 31.9%, P = 0.004) compared with the control group.
CONCLUSIONS—We demonstrated that treatment with rosiglitazone significantly reduces in-stent restenosis in diabetic patients with CAD who underwent coronary stent implantation.
Depressive Symptoms, Insulin Resistance, and Risk of Diabetes in Women at Midlife
Authors: Everson-Rose Susan A. , Meyer Peter M. , Powell Lynda H. , Pandey Dilip , Torréns Javier I. , Kravitz Howard M. , Bromberger Joyce T. , Matthews Karen A. 
Published: March 2007

OBJECTIVE—To examine depression and 3-year change in insulin resistance and risk of diabetes and whether associations vary by race.
RESEARCH DESIGN AND METHODS—We analyzed data from 2,662 Caucasian, African-American, Hispanic, Japanese-American, and Chinese-American women without a history of diabetes from the Study of Women’s Health Across the Nation. We estimated regression coefficients and odds ratios to determine whether depression (Center for Epidemiological Studies Depression Scale score ≥16) predicted increases in homeostasis model assessment of insulin resistance (HOMA-IR) and greater risk of incident diabetes, respectively, over 3 years.
RESULTS—Mean baseline HOMA-IR was 1.31 (SD 0.86) and increased 0.05 units per year for all women (P &lt; 0.0001). A total of 97 incident cases of diabetes occurred. Depression was associated with absolute levels of HOMA-IR (P &lt; 0.04) but was unrelated to changes in HOMA-IR; associations did not vary by race. The association between depression and HOMA-IR was eliminated after adjustment for central adiposity (P = 0.85). Depression predicted a 1.66-fold greater risk of diabetes (P &lt; 0.03), which became nonsignificant after adjustment for central adiposity (P = 0.12). We also observed a depression-by-race interaction (P &lt; 0.05) in analyses limited to Caucasians and African Americans, the only groups with enough diabetes cases to reliably test this interaction. Race-stratified models showed that depression predicted 2.56-fold greater risk of diabetes in African Americans only, after risk factor adjustment (P = 0.008).
CONCLUSIONS—Depression is associated with higher HOMA-IR values and incident diabetes in middle-aged women. These associations are mediated largely through central adiposity. However, African-American women with depression experience increased risk of diabetes independent of central adiposity and other risk factors.