bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gestational Diabetes
Authors: Moses Robert G. , Mackay Maria T. 
Published: March 2007

OBJECTIVE—To assess the relationship between leg length and glucose tolerance in pregnancy.
RESEARCH DESIGN AND METHODS—The leg length and leg-to-height percentage were prospectively determined on 161 glucose-tolerant women during pregnancy and 61 women with gestational diabetes mellitus (GDM).
RESULTS—Women with GDM were a mean of 2.8 cm shorter than women who were glucose tolerant, due entirely to their leg lengths being a mean of 3.2 cm shorter. With respect to the 2-h result on the glucose tolerance test (GTT), there were negative correlations for height (r = −0.161, P = 0.017), leg length (r = −0.266, P &lt; 0.0005), and the leg-to-height percentage (r = −0.294, P &lt; 0.0005). The correlation between the leg-to-height percentage and the 2-h result on the GTT remained significant after adjustment for age (r = −0.252, P &lt; 0.0005) and for age and BMI (r = −0.224, P = 0.001).
CONCLUSIONS—Women with GDM are shorter than glucose-tolerant women and have a lower leg-to-height percentage. Consideration of short stature as a risk factor for GDM is not valid without taking into account the leg-to-height percentage.
Global Prevalence of Diabetes
Authors: Wild Sarah , Roglic Gojka , Green Anders , Sicree Richard , King Hilary 
Published: March 2007

OBJECTIVE—The goal of this study was to estimate the prevalence of diabetes and the number of people of all ages with diabetes for years 2000 and 2030.RESEARCH DESIGN AND METHODS—Data on diabetes prevalence by age and sex from a limited number of countries were extrapolated to all 191 World Health Organization member states and applied to United Nations’ population estimates for 2000 and 2030. Urban and rural populations were considered separately for developing countries.RESULTS—The prevalence of diabetes for all age-groups worldwide was estimated to be 2.8% in 2000 and 4.4% in 2030. The total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030. The prevalence of diabetes is higher in men than women, but there are more women with diabetes than men. The urban population in developing countries is projected to double between 2000 and 2030. The most important demographic change to diabetes prevalence across the world appears to be the increase in the proportion of people &gt;65 years of age.CONCLUSIONS—These findings indicate that the “diabetes epidemic” will continue even if levels of obesity remain constant. Given the increasing prevalence of obesity, it is likely that these figures provide an underestimate of future diabetes prevalence.
Insulin Detemir Offers Improved Glycemic Control Compared With NPH Insulin in People With Type 1 Diabetes
Authors: Home Philip , Bartley Paul , Russell-Jones David , Hanaire-Broutin Hélène , Heeg Jan-Evert , Abrams Pascale , Landin-Olsson Mona , Hylleberg Birgitte , Lang Hanne , Draeger Eberhard ,   on behalf of the Study to Evaluate the Administration of Detemir Insulin Efficacy, Safety and Suitability (Steadiness) Study Group
Published: March 2007

OBJECTIVE—Insulin detemir is a soluble long-acting basal insulin analog designed to overcome the limitations of conventional basal insulin formulations. Accordingly, insulin detemir has been compared with NPH insulin with respect to glycemic control (HbA1c, prebreakfast glucose levels and variability, and hypoglycemia) and timing of administration.
RESEARCH DESIGN AND METHODS—People with type 1 diabetes (n = 408) were randomized in an open-label, parallel-group trial of 16-week treatment duration using either insulin detemir or NPH insulin. Insulin detemir was administered twice daily using two different regimens, either before breakfast and at bedtime (IDetmorn+bed) or at a 12-h interval (IDet12h). NPH insulin was administered before breakfast and at bedtime. Mealtime insulin was given as the rapid-acting insulin analog insulin aspart.
RESULTS—With both insulin detemir groups, clinic fasting plasma glucose was lower than with NPH insulin (IDet12h vs. NPH, −1.5 mmol/l [95% CI −2.51 to −0.48], P = 0.004; IDetmorn+bed vs. NPH, −2.3 mmol/l (−3.32 to −1.29), P &lt; 0.001), as was self-measured prebreakfast plasma glucose (P = 0.006 and P = 0.004, respectively). The risk of minor hypoglycemia was lower in both insulin detemir groups (25%, P = 0.046; 32%, P = 0.002; respectively) compared with NPH insulin in the last 12 weeks of treatment, this being mainly attributable to a 53% reduction in nocturnal hypoglycemia in the IDetmorn+bed group (P &lt; 0.001). Although HbA1c for each insulin detemir group was not different from the NPH group, HbA1c for the pooled insulin detemir groups was significantly lower than for the NPH group (mean difference −0.18% [−0.34 to −0.02], P = 0.027). Within-person between-day variation in self-measured prebreakfast plasma glucose was lower for both detemir groups (both P &lt; 0.001). The NPH group gained weight during the study, but there was no change in weight in either of the insulin detemir groups (IDet12h vs. NPH, −0.8 kg [−1.44 to −0.24], P = 0.006; IDetmorn+bed vs. NPH, −0.6 kg [−1.23 to −0.03], P = 0.040).
CONCLUSIONS—Overall glycemic control with insulin detemir was improved compared with NPH insulin. The data provide a basis for tailoring the timing of administration of insulin detemir to the individual person’s needs.
Effect of Diabetes on Long-Term Mortality Following Contemporary Percutaneous Coronary Intervention
Authors: Wilson Sean R. , Vakili Babak A. , Sherman Warren , Sanborn Timothy A. , Brown David L. 
Published: March 2007

OBJECTIVE—Diabetic patients are known to have reduced long-term survival following percutaneous transluminal coronary angioplasty compared with nondiabetic patients. However, it is unknown whether this survival disadvantage has persisted in the era of contemporary percutaneous coronary intervention (PCI) techniques, which include the widespread use of stents and the availability of platelet glycoprotein (GP) IIb/IIIa inhibitors.
RESEARCH DESIGN AND METHODS—Three hospitals in New York City contributed prospectively defined data on 4,284 patients undergoing PCI. The primary end point was all-cause mortality following hospital discharge for PCI.
RESULTS—Hypertension, renal insufficiency, and renal failure requiring dialysis were all more common in diabetic patients, whereas active smoking was less frequent. Congestive heart failure on admission was more common in diabetic than nondiabetic patients (7.7 vs. 4.0%, P &lt; 0.001). Stents were placed in 78% of nondiabetic patients and 75% of diabetic patients (P = 0.045). Platelet GP IIb/IIIa antagonists were administered to 23% of nondiabetic and 24% of diabetic patients (P = NS). At a mean follow-up of 3 years, mortality was 8% among nondiabetic patients and 13% for diabetic patients (P &lt; 0.001). After adjustment for differences in baseline characteristics between nondiabetic and diabetic patients, diabetes remained a significant independent hazard for late mortality (hazard ratio 1.462, 95% CI 1.169–1.828; P = 0.001).
CONCLUSIONS—Following contemporary PCI, diabetic patients continue to have worse survival than nondiabetic patients.
Connective Tissue Growth Factor Is Increased in Plasma of Type 1 Diabetic Patients With Nephropathy
Authors: Roestenberg Peggy , van Nieuwenhoven Frans A. , Wieten Lotte , Boer Peter , Diekman Theo , Tiller Anna M. , Wiersinga Wilmar M. , Oliver Noelynn , Usinger William , Weitz Stephen , Schlingemann Reinier O. , Goldschmeding Roel 
Published: March 2007

OBJECTIVE—Connective tissue growth factor (CTGF) is strongly upregulated in fibrotic disorders and has been hypothesized to play a role in the development and progression of diabetes complications. The aim of the present study was to investigate the possible association of plasma CTGF levels in type 1 diabetic patients with markers relevant to development of diabetes complications.
RESEARCH DESIGN AND METHODS—Plasma CTGF levels (full-length and NH2-terminal fragments) were determined in 62 well-characterized patients with type 1 diabetes and in 21 healthy control subjects. Correlations of these plasma CTGF levels with markers of glycemic control, platelet activation, endothelial activation, nephropathy, and retinopathy were investigated.
RESULTS—Elevated plasma NH2-terminal fragment of CTGF (CTGF-N) levels were detected in a subpopulation of type 1 diabetic patients and were associated with diabetic nephropathy. Stepwise regression analysis revealed contribution of albuminuria, creatinine clearance, and duration of diabetes as predictors of plasma CTGF-N level. Elevation of plasma CTGF-N levels in patients with retinopathy was probably due to renal comorbidity.
CONCLUSIONS—Plasma CTGF-N levels are elevated in type 1 diabetic patients with nephropathy and appear to be correlated with proteinuria and creatinine clearance. Further studies will be needed to determine the relevance of plasma CTGF as a clinical marker and/or pathogenic factor in diabetic nephropathy.
Can We Apply the National Cholesterol Education Program Adult Treatment Panel Definition of the Metabolic Syndrome to Asians?
Authors: Tan Chee-Eng , Ma Stefan , Wai Daniel , Chew Suok-Kai , Tai E.-Shyong 
Published: March 2007

OBJECTIVE—Limited information is available about the metabolic syndrome in Asians. Furthermore, the definition of central obesity using waist circumference may not be appropriate for Asians. The objectives of this study were to determine the optimal waist circumference for diagnosing central obesity in Asians and to estimate the prevalence of the metabolic syndrome in an Asian population.
RESEARCH DESIGN AND METHODS—We used data from the 1998 Singapore National Health Survey, a cross-sectional survey involving 4,723 men and women of Chinese, Malay, and Asian-Indian ethnicity aged 18–69 years. Receiver operating characteristic analysis suggested that waist circumference &gt;80 cm in women and &gt;90 cm in men was a more appropriate definition of central obesity in this population. The prevalence of the metabolic syndrome was then determined using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria with and without the modified waist circumference criteria.
RESULTS—In Asians, decreasing waist circumference increased the crude prevalence of the metabolic syndrome from 12.2 to 17.9%. Using the modified Asian criteria, the prevalence of the metabolic syndrome increased from 2.9% in those aged 18–30 years to 31.0% in those aged 60–69 years. It was more common in men (prevalence 20.9% in men versus 15.5% in women; P &lt; 0.001) and Asian Indians (prevalence 28.8% in Asian-Indians, 24.2% in Malays, and 14.8% in Chinese; P &lt; 0.001).
CONCLUSIONS— NCEP ATP III criteria, applied to an Asian population, will underestimate the population at risk. With a lower waist circumference cutoff, the prevalence of the metabolic syndrome is comparable to that in Western populations. Ethnic differences are likely to exist between populations across Asia.
Does the Association of Habitual Physical Activity With the Metabolic Syndrome Differ by Level of Cardiorespiratory Fitness?
Authors: Franks Paul W. , Ekelund Ulf , Brage Søren , Wong Man-Yu , Wareham Nicholas J. 
Published: March 2007

OBJECTIVE—Cardiovascular fitness (Vo2max) and physical activity are both related to risk of metabolic disease. It is unclear, however, whether the metabolic effects of sedentary living are the same in fit and unfit individuals. The purpose of this study was, therefore, to describe the association between physical activity and the metabolic syndrome and to test whether fitness level modifies this relationship.
RESEARCH DESIGN AND METHODS—Physical activity was measured objectively using individually calibrated heart rate against energy expenditure. Vo2max was predicted from a submaximal exercise stress test. Fat mass and fat-free mass (FFM) were calculated using impedance biometry. A metabolic syndrome score was computed by summing the standardized values for obesity, hypertension, hyperglycemia, insulin resistance, hypertriglyceridemia, and the inverse level of HDL cholesterol and was expressed as a continuously distributed outcome. To correct for exposure measurement error, a random subsample (22% of cohort) re-attended for three repeat measurements in the year following the first assessment.
RESULTS—The relationship of Vo2max (ml O2 · kgFFM−1 · min−1) and the metabolic syndrome score was of borderline significance after adjusting for age, sex, physical activity, and measurement error (β = −0.58, P = 0.06). The magnitude of the association between physical activity (kJ · d–1 · kgFFM−1) and the metabolic syndrome was more than three times greater than for Vo2max (standardized β = −1.83, P = 0.0042). Vo2max, however, modified the relationship between physical activity energy expenditure and metabolic syndrome (P = 0.036).
CONCLUSIONS—This study demonstrates a strong inverse association between physical activity and metabolic syndrome, an association that is much steeper in unfit individuals. Thus, prevention of metabolic disease may be most effective in the subset of unfit inactive people.
Effect of Apolipoprotein E4 Allele on Plasma LDL Cholesterol Response to Diet Therapy in Type 2 Diabetic Patients
Authors: Saito Mieko , Eto Masaaki , Nitta Hayami , Kanda Yukiko , Shigeto Makoto , Nakayama Katsura , Tawaramoto Kazuhito , Kawasaki Fumiko , Kamei Shinji , Kohara Kenji , Matsuda Masafumi , Matsuki Michihiro , Kaku Kohei 
Published: March 2007

OBJECTIVE—The aim of this study was to investigate the effect of apolipoprotein (apo)E4 allele on plasma LDL cholesterol response to calorie-restricted diet therapy in type 2 diabetic patients.
RESEARCH DESIGN AND METHODS—Twenty-four diabetic patients with the apoE3/3 genotype and 11 diabetic patients with the apoE4/3 genotype were recruited. Participants were hospitalized for calorie-restricted diet therapy (25.0 kcal · kg body wt−1 · day−1) for 14 days. Body weight, fasting plasma glucose (FPG) levels, and plasma lipid levels on hospital days 1 and 14 were compared between the two apoE genotype groups.
RESULTS—There were no significant differences in baseline FPG levels, HbA1c levels, BMI, and plasma levels of total cholesterol, triglyceride, and HDL cholesterol between the two apoE genotype groups, but baseline plasma levels of LDL cholesterol were significantly higher in the apoE4/3 group than in the apoE3/3 group. Body weight decreased slightly and FPG levels decreased significantly after diet therapy in both apoE genotype groups. In the apoE3/3 group, only plasma levels of triglyceride decreased significantly after diet therapy, whereas in the apoE4/3 group, plasma levels of triglyceride, total cholesterol, and LDL cholesterol decreased significantly after diet therapy. The decrease (percentage of change) in total cholesterol (−16.3 vs. −6.6%) and LDL cholesterol (−15.6 vs. −0.7%) after diet therapy was significantly greater in the apoE4/3 group than in the apoE3/3 group.
CONCLUSIONS—Calorie-restricted diet therapy is more effective in reducing plasma LDL cholesterol in type 2 diabetic patients with the apoE4 allele.
Mortality and Predictors of Mortality in a Cohort of Brazilian Type 2 Diabetic Patients
Authors: Salles Gil F. , Bloch Katia V. , Cardoso Claudia R.L. 
Published: March 2007

OBJECTIVE—To investigate mortality rates and predictors of mortality in Brazilian type 2 diabetic patients.
RESEARCH DESIGN AND METHODS—A prospective follow-up study was carried out with 471 type 2 diabetic outpatients. Primary end points were all-cause, diabetes-related, and cardiovascular deaths. Excess mortality in this cohort was evaluated by calculating standardized mortality ratios (SMRs) in relation to those of the Rio de Janeiro population. Predictors of mortality were assessed by Kaplan-Meier survival curves and by uni- and multivariate Cox survival analyses.
RESULTS—During a median follow-up of 57 months (range 2–84 months), 121 (25.7%) patients died, 91 (75.2%) from diabetes-related causes and 44 (36.4%) from cardiovascular diseases. After adjusting for age and sex, the all-cause SMR was 3.36 (95% confidence interval [CI] 2.81–4.02) and the cardiovascular SMR was 3.28 (CI 2.44–4.41). In the Cox multivariate analysis, the predictors of mortality were older age, increased 24-h proteinuria, preexisting vascular disease, presence of frequent ventricular premature contractions and prolonged maximum heart rate−corrected QT interval on baseline electrocardiogram, and decreased serum HDL cholesterol. The use of β-blockers was a protective factor. In Kaplan-Meier curves, these variables were capable of distinguishing subgroups of patients with significantly different prognoses.
CONCLUSIONS—Brazilian type 2 diabetic patients had a more than threefold excess mortality than the general population, largely because of increased cardiovascular mortality risk. Several clinical, laboratory, and electrocardiographic predictors of mortality were identified that could possibly be modified to decrease the mortality burden of type 2 diabetes in Brazil.
Results of Blood Inflammatory Markers Are Associated More Strongly With Toe-Brachial Index Than With Ankle-Brachial Index in Patients With Type 2 Diabetes
Authors: Aso Yoshimasa , Okumura Ki-ichi , Inoue Teruo , Matsutomo Rika , Yoshida Noboru , Wakabayashi Sadao , Takebayashi Kohzo , Inukai Toshihiko 
Published: March 2007

OBJECTIVE—Three blood markers of inflammation (high-sensitivity C-reactive protein [hsCRP], interleukin [IL]-6, and fibrinogen) were compared with markers of atherosclerotic cardiovascular disease (CVD) (history of stroke or cardiac ischemia and measured toe-brachial index [TBI]) to determine whether inflammatory markers are associated with atherosclerosis in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—Of 103 patients with type 2 diabetes, 26 had CVD. TBI was plethysmographically determined in both great toes. Serum hsCRP was immunonephelometrically determined. Plasma IL-6 was measured by an enzyme immunoassay.
RESULTS—Both ABI and TBI were lower in diabetic patients with CVD than in those without CVD (1.05 ± 0.19 vs. 1.14 ± 0.09, P &lt; 0.05, and 0.75 ± 0.20 vs. 0.95 ± 0.21, P &lt; 0.001, respectively). By linear regression, right TBI but not right ABI showed a significant negative correlation with serum hsCRP (r = −0.372, P &lt; 0.01) and plasma fibrinogen (r = −0.224, P &lt; 0.05). Serum hsCRP was also negatively correlated with lower TBI, but not lower ABI. We found no significant correlation between plasma IL-6 and ABI or TBI.
CONCLUSIONS—TBI was strongly associated with CVD, serum hsCRP, and plasma fibrinogen. Of these inflammatory markers, serum hsCRP may be the most promising marker for vascular inflammation.
Relation Between Acanthosis Nigricans and Insulin Sensitivity in Overweight Hispanic Children at Risk for Type 2 Diabetes
Authors: Kobaissi Hassan A. , Weigensberg Marc J. , Ball Geoff D.C. , Cruz Martha L. , Shaibi Gabriel Q. , Goran Michael I. 
Published: March 2007

OBJECTIVE—To investigate in a population of Hispanic children if 1) the presence of acanthosis nigricans (AN) is related to insulin sensitivity (Si) independent of adiposity and 2) scale scoring AN severity adds to the clinical estimation of insulin sensitivity, above and beyond the presence or absence AN alone.
RESEARCH DESIGN AND METHODS—The study population, 131 Hispanic overweight children (mean BMI percentile 97.0 ± 3.1, 72 boys, 59 girls, ages 8–13 years, mean Tanner stage 2.4 ± 1.5) with a family history of type 2 diabetes, underwent a physical examination of the neck to determine AN absence or presence (0–1), AN extent score (0–4 scale), AN texture score (0–3 scale), and an AN combined score (extent + texture; 0–7 scale). Si was measured by the frequently sampled intravenous glucose tolerance test and minimal modeling. Multivariate linear regression analysis was used to determine the role of BMI and AN in predicting Si.
RESULTS—BMI was the main predictor of Si, explaining ∼41% of the variance. The presence of AN explained an additional 4% of the variability in Si; scale scoring of AN extent or texture did not significantly improve the prediction.
CONCLUSIONS—Although AN is an independent risk factor for insulin resistance in overweight Hispanic children at risk for type 2 diabetes, body adiposity is the primary determinant of insulin sensitivity. In addition, scale scoring AN seems of minimal usefulness in clinically estimating the severity of insulin resistance over and above assessing the presence or absence of AN and calculating BMI.
Mortality in Diabetic and Nondiabetic Patients After Amputations Performed From 1990 to 1995
Authors: Tentolouris Nicholas , Al-Sabbagh Sameer , Walker Michael G. , Boulton Andrew J.M. , Jude Edward B. 
Published: March 2007

OBJECTIVE—To compare survival rates after first amputation between patients with and without diabetes.
RESEARCH DESIGN AAND METHODS—We performed a retrospective study of all nontraumatic amputations performed at our center in the years 1990–1995 in patients with (n = 100) and without (n = 151) diabetes. Survival status was assessed from the first amputation until 31 December 2001.
RESULTS—Altogether, 61% of the patients with and 54.3% of those without diabetes died 5.2 (4.5–5.8) and 5.3 (4.7–5.9) [mean (95% CI)] years after the first amputation, respectively (P = 0.80). Survival was not different between patients with and without diabetes after controlling for the level (major versus minor) (P = 0.67) or the cause (ischemia versus infection) of amputation (P = 0.72). No sex differences were found for survival in either study group. Independent predictors of mortality in the diabetic group were duration of diabetes (P = 0.05), history of stroke (P = 0.02), and serum creatinine level (P &lt; 0.0001), while in the nondiabetic group independent predictors were history of stroke (P = 0.04), serum creatinine level (P = 0.005), and higher white blood cell count (P = 0.02). The peak incidence of amputations was observed in the decade of 67–76 years of age in both groups. Major amputations were more common among nondiabetic patients in all age-groups. Median hospital stay and postoperative complications were comparable between the two groups.
CONCLUSIONS—All-cause mortality is high after an amputation in both diabetic and nondiabetic patients. Mortality rates, hospital stay, and postoperative complications are not different between diabetic and nondiabetic amputees. No modifiable factors, with the exception of nephropathy, were found to improve survival in amputees. Peripheral vascular disease and neuropathy are the main cause of amputations; prevention, therefore, of these complications is warranted to prevent amputations and the subsequent high mortality.