bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomized Prospective Double-Blind Trial in Healing Chronic Diabetic Foot Ulcers: CT-102 activated platelet supernatant, topical versus placebo
Authors: Steed David L , Goslen J Blake , Holloway G Allen , Malone James M , Bunt T J , Webster Marshall W 
Published: March 2007

OBJECTIVE
To assess the efficacy of topically applied CT-102 APST for treating diabetic neurotrophic foot ulcers.

RESEARCH DESIGN AND METHODS
Thirteen patients entered a randomized, double-blind trial of topically applied CT-102 APST vs. placebo (normal saline) gauze dressings for the treatment of nonhealing diabetic neurotrophic foot ulcers. CT-102 APST (Curative Technologies, Setauket, NY) was prepared from homologous platelets and contained multiple growth factors including PDGF, PDAF, EGF, PF-4, TGF-β, aFGF, and bFGF. Inclusion criteria for subjects included diabetes, ulcer of &gt; 8 wk duration, peri-wound transcutaneous oxygen tension &gt; 30 mmHg, platelet count &gt; 100,000/mm3, and no wound infection. Wounds were excised before entry and were &gt; 700 mm3 but &lt; 50,000 mm3 in volume, &lt; 100 cm2 in area, and involved subcutaneous tissue.

RESULTS
In the CT-102 group, 5 of 7 ulcers were healed (100% epithelialized) by 15 wk, but only 1 of 6 ulcers was healed by 20 wk with placebo (P &lt; 0.05). Average percent reduction in ulcer area at 20 wk was 94% for CT-102 vs. 73% for placebo. Daily reduction in ulcer volume was 73.8 ± 42.4 mm3/day (mean ± SE) for CT-102 vs. 21.8 ± 8.1 mm3/day for placebo (P &lt; 0.05). Daily reduction in ulcer area was 6.2 ± 1.8 mm2/day for CT-102 vs. 1.8 ± 0.4 mm2/day for placebo (P &lt; 0.05).

CONCLUSIONS
CT-102 significantly accelerated wound closure in diabetic leg ulcers when administered as part of a comprehensive program for the healing of chronic ulcers.
Moderate Exercise Increases Platelet Function in Type I Diabetic Patients Without Severe Angiopathy and in Good Control
Authors: Trovati Mariella , Anfossi Giovanni , Facis Roberto De , Mularoni Elena , Massucco Paola , Cavalot Franco , Burzacca Serenella , Mattiello Luigi , Lucchina Pietro Greco 
Published: March 2007

OBJECTIVE
The aim of this study was to investigate whether a 45-min moderate exercise, performed postprandially with a timing that partially prevented the risk of hypoglycemia, was able to modify platelet function in patients affected by insulin-dependent (type I) diabetes mellitus without severe late complications and in a good metabolic control.

RESEARCH DESIGN AND METHODS
We submitted 6 male type I diabetic patients (27.2 ± 3.4 yr; body mass index, 21.4 ± 0.6 kg/m2; HbA1c, 7.6 ± 0.9%) on a daily three-insulin injection regimen, without severe late complications of diabetes, to a 45-min moderate exercise (about 50% of maximal oxygen consumption) with a cycle ergometer, beginning 180 min after breakfast and 195 min after a subcutaneous shot of regular insulin. Serial venous blood samples were conducted to measure plasma glucose, free insulin, counterregulatory hormones (glucagon, growth hormone, cortisol, and catecholamines), platelet sensitivity to ADP, platelet activating factor and collagen, and plasma concentrations of the platelet-specific protein beta-thromboglobulin (a marker of the platelet release reaction in vivo).

RESULTS
Exercise was accompanied by a decrease of plasma glucose (from 5.9 ± 1.2 to 4.6 ± 1 mmol/L, P = 0.067) and free insulin (from 180 ± 36 to 114 ± 30 pmol/L, P = 0.003), and by a significant increase of growth hormone (from 5 ± 1 to 15 ± 4 μg/L, P = 0.045), cortisol (from 240 ± 30 to 406 ± 69 nmol/L, P = 0.018), epinephrine (from 1005 ± 240 to 5143 ± 1753 pmol/L, P = 0.077), and norepinephrine (from 5.04 ± 1.08 to 13.48 ± 2.98 nmol/L, P = 0.009). Platelet sensitivity to the agonists and plasma concentrations of β-thromboglobulin increased during the exercise period. In particular, ADP ED50 reached during exercise 61 ± 16% of basal values (P = 0.048), platelet activating factor ED50 reached 73 ± 11% (P = 0.043), and collagen ED50 reached 68 ± 9% (P = 0.008). β-Thromboglobulin rose from 24 ± 2 to 32 ± 3 μg/L (P = 0.007).

CONCLUSIONS
Moderate exercise enhances platelet function in type I diabetic patients without severe angiopathy and in a good metabolic control.
Psychosocial Factors and Complications of IDDM. The Pittsburgh Epidemiology of Diabetes Complications Study. VIII
Authors: Lloyd Cathy E , Matthews Karen A , Wing Rena R , Orchard Trevor J 
Published: March 2007

Objective
— To investigate whether psychosocial factors are associated with diabetic complications.

Research Design and Methods
— Questionnaires on quality of life, depressive symptomatology, and personality type were completed and a clinical assessment was performed. The study population was an incident cohort of childhood-onset insulin-dependent diabetic (IDDM) subjects whose duration of IDDM was ≥ 25 yr (n = 175).

Results
— Patients with macrovascular disease (P &lt; 0.01) or nephropathy (P &lt; 0.05) reported significantly poorer quality of life compared with those who were free from all complications. Patients with macrovascular disease also reported greater depressive symptomatology (P &lt; 0.05). Quality of life significantly deteriorated according to the presence of multiple (≥ 4) complications (P &lt; 0.001). Higher depression symptom scores were also related to the presence of ≥4 complications (P &lt; 0.001). Those with multiple complications reported less type A behavior than those without any complications (P &lt; 0.05).

Conclusions
— This study shows that psychosocial differences exist according to both the number and the type of diabetic complications present. Because poorer quality of life and symptoms of depression may both result form complications, prospective follow-up is needed to clarify their temporal interrelationships, and to determine whether type A personality affords any protection against complications or is diminished as a result of developing complications.
Lifetime Prevalence of Major Depression and Its Effect on Treatment Outcome in Obese Type II Diabetic Patients
Authors: Marcus Marsha D , Wing Rena R , Guare John , Blair Elaine H , Jawad Abbas 
Published: March 2007

Objective
— To assess the lifetime prevalence of major depression (MD) and its relation to glycemic control among a group of non-insulin-dependent (type II) diabetic subjects seeking obesity treatment and to determine whether a history of MD affected response to treatment.

Research Design and Methods
— Sixty-six obese subjects with type II diabetes (22 men, 44 women) completed the Inventory to Diagnose Depression-Lifetime Version before a 52-wk behavioral weight-control program. Weight, glycosylated hemoglobin, fasting blood glucose, and mood were assessed at pre-and posttreatment.

Results
— Thirty-two percent of the subjects reported a history of MD. Neither a history of MD nor current depressive symptoms were associated with pretreatment glycemic control. However, a history of MD was related to treatment attrition (52.4 vs. 22.2%, P = 0.03). Subjects with and without a history of MD showed comparable improvements in weight, glycemic control, and mood.

Conclusions
— A history of MD among type II diabetic patients seeking obesity treatment was not related to pretreatment glycemic control but was associated with higher rates of attrition from treatment. Individuals with a history of MD who completed the program did not differ from those with no history of MD in response to treatment.
Insulinotropic Action of Glucagonlike Peptide-I-(7–37) in Diabetic and Nondiabetic Subjects
Authors: Nathan David M , Schreiber Eric , Fogel Howard , Mojsov Svetlana , Habener Joel F 
Published: March 2007

Objective
Whether glucagonlike peptide-I-(7–37) (GLP-I-[7–37]), a naturally occurring intestinal peptide, is insulinotropic in nondiabetic and non-insulindependent (type II) diabetic subjects.

Research Design and Methods
GLP-I-(7–37) or saline placebo was infused (1–5 ng · kg−1 · min−1 for 30 min) in 4 nondiabetic and 11 type II diabetic subjects in the fasting and prandial state. Glucose, insulin, and GLP-I-(7–37) levels were measured.

Results
GLP-I-(7–37) infusion resulted in a 3- to 10-fold increase in peak insulin levels and in insulin area under the curve in nondiabetic and diabetic subjects. In diabetic subjects, infusion concurrent with a standard meal eliminated the postprandial glucose excursion for 60 min after the meal. Insulin-releasing potency of GLP-I-(7-37) was attenuated at decreased glucose levels.

Conclusions
GLP-I-(7–37) has potent insulinotropic effects in nondiabetic and diabetic subjects. Whether GLP-I-(7–37) is useful as a therapeutic medication in type II diabetes requires further investigation.
Nonselective Loss of Contrast Sensitivity in Visual System Testing in Early Type I Diabetes
Authors: Di Leo Mauro AS , Caputo Salvatore , Falsini Benedetto , Porciatti Vittorio , Minnella Angelo , Greco Aldo V , Ghirlanda Giovanni 
Published: March 2007

Objective
Psychophysical methods in patients with diabetes mellitus reveal deficits of central or foveal vision. Our aim was to evaluate the contrast-sensitivity thresholds in 24 insulin-dependent (type I) diabetic patients with a short disease duration and without retinopathy, taking into account metabolic control.

Research Design and Methods
The control group consisted of age-matched nondiabetic subjects. None had visual or systemic symptoms. Contrast sensitivity measured at eight different spatial frequencies to sinusoidal bar patterns of 0.6–12.2 cycles/deg can detect functional defects in the spatially sensitive retinal ganglion cells or in higher visual pathways. We performed two different temporal types of contrast-sensitivity testing, dynamic (8 Hz) and static (0 Hz).

Results
Significant losses with dynamic contrast-sensitivity test at all but the highest spatial frequencies (i.e., 12.2 cycles/deg) were shown, whereas there was significant attenuation of contrast sensitivity at five spatial frequencies (1.0, 1.4, 2.2, 7.1, and 9.6 cycles/deg) in the static mode. Grating losses (&lt;2SD of control means) of contrast sensitivity were found in 33.3% (dynamic) and in 72.9% (static) of eyes of diabetic patients. HbA1c values were positively correlated at variable spatial frequencies (1.0, 1.4, and 2.2 cycles/deg for dynamic test and 0.6, 1.0, 1.4, 2.2, 4.8, and 7.1 cycles/deg for static test).

Conclusions
Our results suggest an early, generally nonselective neuronal damage of visual pathways that occurs before the onset of clinically detectable retinopathy. The visual deficit may be related directly to the effects of diabetes; repetitive minor hypoglycemic insults may contribute more than a marked hyperglycemic condition to the mechanisms underlying physiological changes along the optic nerve.
Does Glycemic Control of Type II Diabetes Suffice to Control Diabetic Dyslipidemia?: A Community Perspective
Authors: Stern Michael P , Mitchell Braxton D , Haffner Steven M , Hazuda Helen P 
Published: March 2007

Objective
–To assess the extent to which glycemic control by itself results in satisfactory control of diabetic dyslipidemia.

Research Design and Methods
A population-based case series consisting of 386 Mexican Americans and 94 non-Hispanic whites with non-insulin-dependent (type II) diabetes was studied. All subjects answered questions about their medical history and care received and underwent a standardized oral glucose tolerance test and measurements of fasting serum lipid and lipoprotein concentrations. Three definitions of dyslipidemia were used: total cholesterol &gt;6.20 mM (240 mg/dl), triglyceride &gt;2.82 mM (250 mg/dl), and high-density lipoprotein cholesterol &lt;0.90 mM (35 mg/dl).

Resulrs
Despite having removed subjects receiving lipid-lowering drugs, diabetic subjects who had been previously diagnosed and were under medical care exhibited a lower prevalence of hypertriglyceridemia than those who were newly diagnosed at the time of their survey visit, suggesting that conventional management was associated with a reduced frequency of this dyslipidemia. Among previously diagnosed cases, the prevalence of dyslipidemia rose with worsening glycemic control but there was little association with type of therapy (diet only, oral agents, or insulin) or frequency of physician visits. In general, the prevalence of dyslipidemia in diabetic subjects remained higher than in nondiabetic subjects, despite hypoglycemic therapy.

Conclusions
The results suggest that glycemic control by itself does not suffice to control diabetic dyslipidemia and that significant numbers of diabetic subjects will need direct lipid management. Clinical trials are urgently needed to define the optimum management strategy for diabetic dyslipidemia.
Morning or Bedtime NPH Insulin Combined With Sulfonylurea in Treatment of NIDDM
Authors: Groop Leif C , Widén Elisabeth , Ekstrand Agneta , Saloranta Carola , Franssila-Kallunki Anja , Schalin-Jäntti Camilla , Eriksson Johan G 
Published: March 2007

Objective
To compare the effect of morning and bedtime NPH insulin combined with daytime sulfonylurea on glycemic control in non-insulin-dependent diabetes mellitus (NIDDM) patients no longer responding to treatment with sulfonylureas alone.

Research Design and Methods
Twenty-four NIDDM patients who fulfilled these criteria were randomized to treatment with Protaphan human insulin in the morning or at bedtime (22 ± 1 IU) plus 3.5 mg glibenclamide twice a day.

Results
Morning and bedtime NPH insulin resulted in equal reduction of HbA1 (from 13.5 ± 0.3 to 9.4 ± 0.1 and 9.6 ± 0.2%, respectively) and mean self-monitored blood glucose (9.2 ± 0.5 vs. 10.1 ± 0.4 mM). Bedtime insulin resulted in lower morning blood glucose (7.8 ± 0.5 vs. 9.1 ± 0.4 mM; P &lt; 0.01), whereas morning insulin resulted in lower evening blood glucose (10.1 ± 0.6 vs 12.1 ± 0.6 mM, P &lt; 0.01).

Conclusions
Morning and bedtime NPH insulin combined with glibenclamide are equipotent in the treatment of NIDDM patients with secondary failure to sulfonylurea. However, this treatment regimen normalizes blood glucose only in a small group of patients. Therefore, more intensified insulin therapy seems to be required to achieve this goal.
Stress Buffering and Glycemic Control: The Role of Coping Styles
Authors: Peyrot Mark F , McMurry James F 
Published: March 2007

Objective
To test the hypotheses that chronic psychosocial stress is associated with worse glycemic control and that coping moderates (buffers) this effect.

Research Design and Methods
Subjects consisted of 105 insulin-treated adults from the Diabetes Division of Henry Ford Hospital who filled out questionnaires on stress and coping and received an HbA1 test at a clinic appointment. Six coping styles were examined, including both emotion- and problem-focused styles. Two standardized stress inventories were administered. Ineffective coping was defined as scoring below the median for stress-dampening coping styles and above the median for stress-exacerbating styles.

Results
Stress was significantly (P &lt; 0.05) correlated with higher HbA1 in all but one ineffective coping subgroup. Conversely, none of 12 correlations between stress and glycemic control was significant in the effective coping subgroups.

Conclusions
Chronic psychosocial stress is associated with worse glycemic control among those who do not cope effectively with stress. Effective coping can protect individuals from the deleterious effects of stress.
Controversial Beliefs About Diabetes and its Care
Authors: Anderson Robert M , Donnelly Michael B , Davis Wayne K 
Published: March 2007

Objective
The purpose of this study was to identify specific beliefs that differentiate health-care professionals whose attitudes toward diabetes agreed most strongly with a group of national diabetes experts from those whose attitudes disagreed most strongly.

Research Design and Methods
The sample for this study included 271 physicians, 834 nurses, and 546 dietitians who completed a Diabetes Attitudes Survey. The sample included specialists in diabetes care and nonspecialists. Controversial beliefs about diabetes and its care were determined by comparing the beliefs of the 10% of the sample whose attitudes were most concordant (with the national panel) with the beliefs of the 10% of the sample whose attitudes were the most discordant. Ten beliefs met the criteria for being defined as controversial.

Results
The most controversial beliefs concerned whether the patient or the physician should be the primary decision maker in diabetes care, the meaning of patient noncompliance, and the seriousness of non-insulin-dependent diabetes mellitus. The 10% of the sample with the most discordant attitudes contained a disproportionately large number of physicians, nonspecialists in diabetes, and health-care professionals who had been in practice longer than the other members of the sample.

Conclusions
This study identifies some important differences in beliefs between younger health-care professionals who specialize in diabetes and older nonspecialists. Such beliefs should be addressed in continuing education programs with the aim being to foster the widespread adoption of a contemporary approach to diabetes care.
Temporal Variation in Incidence of IDDM in Canterbury, New Zealand
Authors: Scott Russell S , Brown Laurie J , Darlow Brain A , Forbes Louisa V , Moore M Peter 
Published: March 2007

Objective
To establish the statistical significance of observed variations over the last decade in the incidence of insulin-dependent diabetes mellitus (IDDM) in the 0- to 19-yr-old age-group and to determine whether incidence has increased in Canterbury, New Zealand.

Research Design and Methods
The Canterbury, New Zealand, Diabetes Registry has recorded all incidence cases of diabetes mellitus prospectively since 1982. All IDDM subjects aged 0–19 yr at diagnosis and using insulin are included in the study. Ascertainment is believed to be 100%. Prevalence was recorded at 1 January 1982 and 1 January 1990. Annual incidence for 1982–1990 was determined using age and sex cross-sectional census population denominators. The statistical significance of temporal, age, sex, and seasonal variations in incidence rates was ascertained by Poisson regression models (GLIM statistical software).

Results
Prevalence on 1 January 1990 was 115/100,000. Incidence rates during the 9 yr were periodic, with two major peaks—one in the early 1980s, the other in 1989 continuing into 1990. The temporal variation (P &lt; 0.02) was not age or sex specific. Incidence rates for boys were three- to fourfold higher during peak versus trough years, with a peak level of 20.7/100,000 in 1990. For girls, there was less variation, with a peak rate of 21.6/100,000 in 1990. There has been no significant increase in IDDM incidence over time. The mean rate of incidence across all age-groups for 1982–1990 was 12.7/100,000 person-yr. A significant seasonal association to the onset of IDDM was found only in boys, with incidence rates being significantly higher in winter than in summer (P &lt; 0.01).

Conclusions
IDDM in Canterbury, New Zealand, presents in cycles of incidence peaks and troughs, each spanning 2–3 yr.
Prevalence of Cardiovascular Autonomic Dysfunction Assessed by Spectral Analysis and Standard Tests of Heart-Rate Variation in Newly Diagnosed IDDM Patients
Authors: Ziegler Dan , Dannehl Karsten , Mühlen Hansjürg , Spüler Manfred , Gries F Arnold 
Published: March 2007

Objective
To determine the prevalence of cardiovascular autonomic nerve dysfunction in patients with newly diagnosed insulin-dependent diabetes mellitus (IDDM) compared with healthy nondiabetic subjects.

Research Design and Methods
A battery of cardiovascular reflex tests was performed in 130 newly diagnosed IDDM patients aged 12–40 yr at mean blood glucose levels of 7.2 mM after insulin had been administered for 3–39 days. Age-dependent lower limits of normal of these tests were defined at the 2.3 percentile in 120 nondiabetic subjects. Tests of heart-rate variation (HRV) included the coefficient of variation (C.V.) and the low-frequency (LF), midfrequency (MF), and high-frequency (HF) bands of spectral analysis at rest, HRV during deep breathing (C.V., expiratory-inspiratory ratio, and mean circular resultant), Valsalva ratio, and maximum/minimum 30:15 ratio. In addition, spectral analysis on standing, the change in systolic blood pressure to standing, and diastolic blood pressure response to sustained handgrip were determined in 50 patients.

Results
A significantly higher percentage of abnormal test responses in the diabetic group compared with the control group was noted for power spectrum in the LF band (7.3 vs. 0.8%, P &lt; 0.05) and MF band (10.6 vs. 0%, P &lt; 0.001) at rest and HF band on standing (10.0 vs. 0.9%, P &lt; 0.05), maximum/minimum 30:15 ratio (25.4 vs. 5.0%, P &lt; 0.001), and Valsalva ratio (17.5 vs. 4.2%, P &lt; 0.001). There were no significant differences between both groups in regard to the remaining parameters. Ten (7.7%) diabetic patients but none of the nondiabetic subjects had cardiovascular autonomic neuropathy defined by the strict criterion of abnormal results in more than three of six tests (P &lt; 0.001). In addition, 12 (9.2%) patients but only 2 (1.7%) control subjects had abnormal results in two of six tests (P &lt; 0.01).

Conclusions
Cardiovascular autonomic nerve dysfunction is relatively common in newly diagnosed IDDM patients after correction of the initial metabolic imbalance. A combination of tests based on spectral and conventional analysis of HRV appears suitable for detection of early abnormalities in autonomic function in diabetes.
Use of Blood Glucose Data by Families of Children and Adolescents with IDDM
Authors: Wysocki Tim , Hough Brenda S , Ward Kory M , Allen Anthony A , Murgai Neena 
Published: March 2007

OBJECTIVE
Prospective evaluation of the use of blood glucose test results for treatment actions by families of youth with IDDM.

RESEARCH DESIGN AND METHODS
Forty-seven patients with IDDM used reflectance meters with memory for SMBG for 28 days. Parents kept weekly diaries of six types of uses of SMBG data. We collected SMBG data from the reflectance meters, HbA1 and serum fructosamine assays, and measures of behavioral factors that could affect use of SMBG data.

RESULTS
Families recorded a mean of 4.85 data-based actions during the 28-day study, and 74% of the families reported at least one such action. Fifty percent of recorded actions consisted of management of hypoglycemia and, among the remainder, only 18% were anticipatory, proactive actions. Partial correlation analysis showed that families with more frequent use of SMBG data had less parent-child conflict about diabetes, more diabetes knowledge, and better overall treatment adherence. Use of SMBG data was unrelated to objective indices of the need for treatment adjustments or to diabetic control.

CONCLUSIONS
Most families made active use of their SMBG data, but few of these actions were proactive. Behavioral factors were stronger predictors of family use of SMBG data than were objective indices of the need for treatment adjustments. The results illustrate the need for further research on use of SMBG data and methods to enhance its impact on diabetic control.