bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Systematic Review of Adherence With Medications for Diabetes
Authors: Cramer Joyce A. 
Published: March 2007

OBJECTIVE—The purpose of this study was to determine the extent to which patients omit doses of medications prescribed for diabetes.
RESEARCH DESIGN AND METHODS—A literature search (1966–2003) was performed to identify reports with quantitative data on adherence with oral hypoglycemic agents (OHAs) and insulin and correlations between adherence rates and glycemic control. Adequate documentation of adherence was found in 15 retrospective studies of OHA prescription refill rates, 5 prospective electronic monitoring OHA studies, and 3 retrospective insulin studies.
RESULTS—Retrospective analyses showed that adherence to OHA therapy ranged from 36 to 93% in patients remaining on treatment for 6–24 months. Prospective electronic monitoring studies documented that patients took 67–85% of OHA doses as prescribed. Electronic monitoring identified poor compliers for interventions that improved adherence (61–79%; P &lt; 0.05). Young patients filled prescriptions for one-third of prescribed insulin doses. Insulin adherence among patients with type 2 diabetes was 62–64%.
CONCLUSIONS—This review confirms that many patients for whom diabetes medication was prescribed were poor compliers with treatment, including both OHAs and insulin. However, electronic monitoring systems were useful in improving adherence for individual patients. Similar electronic monitoring systems for insulin administration could help healthcare providers determine patients needing additional support.
Development of a Diabetes Diet-Related Quality-of-Life Scale
Authors: Sato Eiko , Suzukamo Yoshimi , Miyashita Mitsunori , Kazuma Keiko 
Published: March 2007

OBJECTIVE—The purpose of this study was to assess the reliability and validity of the Diabetes Diet-Related Quality-of-Life (DDRQOL) scale, which is a measure of the influence of diet therapy on patients’ quality of life (QOL).
RESEARCH DESIGN AND METHODS—Patients with type 2 diabetes (n = 236) who were being treated on an outpatient basis were asked to complete the self-administered DDRQOL instrument. The factor validity, convergent and discriminant validity, internal consistency, and reproducibility of the DDRQOL scale were then assessed. Spearman’s rank correlation coefficients among the DDRQOL scale and each of the SF-36 subscale scores were calculated to evaluate its convergent and discriminant validity.
RESULTS—Based on the results of the factor analysis, the following seven subscales were adopted for the DDRQOL: “satisfaction with diet,” “burden of diet therapy,” “perceived merits of diet therapy,” “general perception of diet,” “restriction of social functions,” “vitality,” and “mental health.” As hypothesized, the DDRQOL scale was associated with each of the SF-36 subscales, with convergent and discriminant validity being generally exhibited. Cronbach’s α-coefficient was between 0.71 and 0.84, suggesting strong internal consistency. The intraclass correlation coefficient of the subscales, with the results of a test-retest conducted 2 weeks later, was between 0.46 and 0.75, suggesting some degree of reproducibility.
CONCLUSIONS—These findings indicate that the DDRQOL scale has a reasonable degree of reliability and validity, and its application for the assessment of the needs of a patient’s diet and the evaluation of diet education with regard to QOL is awaited.
The Coping Styles of Adolescents With Type 1 Diabetes Are Associated With Degree of Metabolic Control
Authors: Graue Marit , Wentzel-Larsen Tore , Bru Edvin , Hanestad Berit Rokne , Søvik Oddmund 
Published: March 2007

OBJECTIVE—To systematically study the various coping styles in a population-based sample of adolescents with type 1 diabetes, exploring the association of different coping styles with metabolic control and adolescent self-reported diabetes-related quality of life.
RESEARCH DESIGN AND METHODS—Of a total population of 116 adolescents with type 1 diabetes (age 13–18 years), 103 (89%) participated in the study, completing a questionnaire to obtain information on coping styles and perception of diabetes-specific quality of life. The mean age (±SD) was 14.9 ± 1.6 years, diabetes duration 7.1 ± 3.8 years, HbA1c 9.4 ± 1.6%, and male-to-female ratio 52:51.
RESULTS—There was a significant correlation between higher HbA1c values and higher degree of mental (r = 0.25, P &lt; 0.05) and behavioral (r = 0.33, P &lt; 0.01) disengagement and aggressive coping (r = 0.33, P &lt; 0.01). Stepwise multiple regression analyses indicated that greater use of aggressive coping (P &lt; 0.05) and behavioral disengagement (P &lt; 0.05) were significantly related to increase in HbA1c. Greater use of active coping (P &lt; 0.05) was significantly related to a decrease in HbA1c. Partial correlation analysis showed that lower scores on diabetes-specific quality of life were significantly related to greater use of emotion-focused coping (r = −0.22 to −0.49). Stepwise multiple regression analyses showed that greater use of mental disengagement was significantly related to lower degree of perceived diabetes-related impact.
CONCLUSIONS—Poor metabolic control and lower degree of diabetes-related quality of life are associated with greater use of emotion-focused coping in adolescents with type 1 diabetes.
Adipocytokines Attenuate the Association Between Visceral Adiposity and Diabetes in Older Adults
Authors: Kanaya Alka M. , Harris Tamara , Goodpaster Bret H. , Tylavsky Fran , Cummings Steven R. ,   for the Health, Aging, and Body Composition (ABC) Study
Published: March 2007

OBJECTIVE—To examine whether adiponectin is independently associated with diabetes and whether adiponectin and other adipocytokines account for the relationship between fat and diabetes.
RESEARCH DESIGN AND METHODS—A nested case-control study from the Health, Aging, and Body Composition (Health ABC) study. We measured four adipocytokines: adiponectin, interleukin (IL)-6, tumor necrosis factor-α, and plasminogen activator inhibitor 1 (PAI-1). Regional fat area was determined by computed tomography scan. The 519 case subjects had diabetes defined by fasting plasma glucose level ≥126 mg/dl or by use of diabetes medications. The 519 control subjects had normal glucose tolerance and were matched by sex, race, and study site. Sex-specific logistic models were adjusted for age, race, site, total adiposity, smoking, and physical activity.
RESULTS—Higher adiponectin levels were associated with lower risk of diabetes (P &lt; 0.001). Visceral fat was the only adiposity measure associated with diabetes after adjusting for BMI (odds ratio 3.0 [2.1–4.3] in women and 1.3 [1.0–1.6] in men, P &lt; 0.001 between-sex comparison). Adipocytokines attenuated the association between visceral fat and diabetes for both sexes but more strongly in men (women 2.3 [1.5–3.3], men 1.1 [0.9–1.4]). In men, adiponectin, IL-6, and PAI-1 remained independently associated with diabetes after adjusting for fat depots; in women, adiponectin was the only independently associated adipocytokine. Controlling for insulin, HDL, triglycerides, and blood pressure did not change these results.
CONCLUSIONS—Adiponectin is associated with lower odds of diabetes in older men and women. Whereas several adipocytokines explained the relationship between visceral adiposity and diabetes in men, only adiponectin partially mediated this association among women.
Improved Glycemic Control Without Weight Gain Using Triple Therapy in Type 2 Diabetes
Authors: Strowig Suzanne M. , Avilés-Santa M. Larissa , Raskin Philip 
Published: March 2007

OBJECTIVE—To evaluate the safety and effectiveness of triple therapy using insulin, metformin, and a thiazolidinedione following a course of dual therapy using insulin and metformin or insulin and a thiazolidinedione in type 2 diabetes.RESEARCH DESIGN AND METHODS—Twenty-eight type 2 diabetic subjects using insulin monotherapy (baseline HbAlc level 8.5%) who had been randomly assigned to insulin (INS) and metformin (MET) (INS + MET, n = 14) or INS and the thiazolidinedione troglitazone (TGZ) (INS + TGZ, n = 14) (dual therapy) for 4 months were given INS, MET, and TGZ (triple therapy: INS + MET, add TGZ; or INS + TGZ, add MET) for another 4 months. The INS dose was not increased.RESULTS—HbA1c levels decreased in both groups during dual therapy and improved further during triple therapy (INS + MET 7.0 ± 0.8, INS + TGZ 6.2 ± 0.8, P &lt; 0.0001; INS + MET, add TGZ 6.1 ± 0.4%, P &lt; 0.001; INS + TGZ, add MET 5.8 ± 0.6%, P &lt; 0.05; and INS + TGZ vs. INS + MET, P = 0.02). Significant reductions in total daily insulin dose occurred in the INS + TGZ (−14.1 units, P &lt; 0.0001), INS + TGZ add MET (−13.7 units, P &lt; 0.01), and the INS + MET add TGZ groups (−17.3 units, P &lt; 0.003), but not in the INS + MET group (−3.2 units) (INS + TGZ vs. INS + MET P &lt; 0.05). Subjects in the INS + TGZ group experienced significant weight gain (4.4 ± 2.7 kg, P &lt; 0.0005). No weight gain occurred in the INS + MET, INS + MET add TGZ, and INS + TGZ add MET groups.CONCLUSIONS—Triple therapy using INS, MET, and TGZ resulted in lower HbAlc levels and total daily insulin dose than during dual therapy. The use of triple therapy resulted in 100% of subjects achieving an HbAlc &lt;7.0%, while decreasing the dose of INS. Weight gain was avoided when MET therapy preceded the addition of TGZ therapy. The addition of TGZ resulted in the greatest reductions in HbAlc levels and insulin dose. Triple therapy using INS, MET, and a thiazolidinedione (such as TGZ) can be a safe and effective treatment in type 2 diabetes.
Elevated Plasma Glucose-Dependent Insulinotropic Polypeptide Associates With Hyperinsulinemia in Impaired Glucose Tolerance
Authors: Theodorakis Michael J. , Carlson Olga , Muller Denis C. , Egan Josephine M. 
Published: March 2007

OBJECTIVE—The role of gut-derived incretin, glucose-dependent insulinotropic polypeptide (also known as gastric inhibitory peptide [GIP]), in compensatory β-cell hypersecretion during insulin-resistant states and in transition to β-cell failure in type 2 diabetes is unknown.
RESEARCH DESIGN AND METHODS—We carried out oral glucose tolerance testing followed by blood sampling 10 times for 2 h on 68 age- and BMI-matched participants of the Baltimore Longitudinal Study on Aging (BLSA) with normal glucose tolerance (34 subjects), impaired glucose tolerance (IGT) (18 subjects with both impaired fasting and 2-h plasma glucose levels), and type 2 diabetes (16 subjects with both diabetic fasting and 2-h plasma glucose levels). We assayed plasma glucose, insulin, C-peptide, glucagon, and intact and total GIP levels and quantitated glucose and hormone responses to the oral glucose tolerance test. We also compared GIP and insulin release and sensitivity indexes between groups.
RESULTS—After glucose ingestion, subjects with IGT had both hyperinsulinemia and hyperemia, while subjects with type 2 diabetes had both β- and GIP-cell deficiency. In the former group, there was also a significant positive correlation between the augmented plasma intact and total GIP levels and both fasting and post-oral glucose load plasma insulin levels.
CONCLUSIONS— Elevated plasma GIP levels are correlated with hyperinsulinemia in the impaired glucose-tolerant state, whereas type 2 diabetes is associated with a failure to secrete adequate amounts of both GIP and insulin, indicating a common pathway of resistance to and eventually failure of glucose responsiveness in β- and GIP-cells.
Treatment of Diabetic Ketoacidosis With Subcutaneous Insulin Aspart
Authors: Umpierrez Guillermo E. , Cuervo Ruben , Karabell Ana , Latif Kashif , Freire Amado X. , Kitabchi Abbas E. 
Published: March 2007

OBJECTIVE—In this prospective, randomized, open trial, we compared the efficacy and safety of aspart insulin given subcutaneously at different time intervals to a standard low-dose intravenous (IV) infusion protocol of regular insulin in patients with uncomplicated diabetic ketoacidosis (DKA).
RESEARCH DESIGN AND METHODS—A total of 45 consecutive patients admitted with DKA were randomly assigned to receive subcutaneous (SC) aspart insulin every hour (SC-1h, n = 15) or every 2 h (SC-2h, n = 15) or to receive IV infusion of regular insulin (n = 15). Response to medical therapy was evaluated by assessing the duration of treatment until resolution of hyperglycemia and ketoacidosis. Additional end points included total length of hospitalization, amount of insulin administration until resolution of hyperglycemia and ketoacidosis, and number of hypoglycemic events.
RESULTS—Admission biochemical parameters in patients treated with SC-1h (glucose: 44 ± 21 mmol/l [means ± SD], bicarbonate: 7.1 ± 3 mmol/l, pH: 7.14 ± 0.09) were similar to those treated with SC-2h (glucose: 42 ± 21 mmol/l, bicarbonate: 7.6 ± 4 mmol/l, pH: 7.15 ± 0.12) and IV regular insulin (glucose: 40 ± 13 mmol/l, bicarbonate 7.1 ± 4 mmol/l, pH: 7.11 ± 0.17). There were no statistical differences in the mean duration of treatment until correction of hyperglycemia (6.9 ± 4, 6.1 ± 4, and 7.1 ± 5 h) or until resolution of ketoacidosis (10 ± 3, 10.7 ± 3, and 11 ± 3 h) among patients treated with SC-1h and SC-2h or with IV insulin, respectively (NS). There was no mortality and no differences in the length of hospital stay, total amount of insulin administration until resolution of hyperglycemia or ketoacidosis, or the number of hypoglycemic events among treatment groups.
CONCLUSIONS—Our results indicate that the use of subcutaneous insulin aspart every 1 or 2 h represents a safe and effective alternative to the use of intravenous regular insulin in the management of patients with uncomplicated DKA.
Sagittal Abdominal Diameter Is a Strong Anthropometric Marker of Insulin Resistance and Hyperproinsulinemia in Obese Men
Authors: Risérus Ulf , Ärnlöv Johan , Brismar Kerstin , Zethelius Björn , Berglund Lars , Vessby Bengt 
Published: March 2007

OBJECTIVE—It is clinically important to find noninvasive markers of insulin resistance and hyperproinsulinemia because they both predict cardiovascular and diabetes risk. Sagittal abdominal diameter (SAD) or “supine abdominal height” is a simple anthropometric measure previously shown to predict mortality in men, but its association with insulin resistance and hyperproinsulinemia is unknown.
RESEARCH DESIGN AND METHODS—In a common high-risk group of 59 moderately obese men (aged 35–65 years, BMI 32.6 ± 2.3 kg/m2), we determined anthropometry (SAD, BMI, waist girth, and waist-to-hip ratio [WHR]); insulin sensitivity (euglycemic-hyperinsulinemic clamp); and plasma concentrations of intact proinsulin, specific insulin, C-peptide, glucose, and serum IGF binding protein-1 (IGFBP-1). To compare SAD with other anthropometric measures, univariate and multiple regression analyses were used to determine correlations between anthropometric and metabolic variables.
RESULTS—SAD showed stronger correlations to all measured metabolic variables, including insulin sensitivity, than BMI, waist girth, and WHR. SAD explained the largest degree of variation in insulin sensitivity (R2 = 0.38, P &lt; 0.0001) compared with other anthropometric measures. In multiple regression analyses, including all anthropometric measures, SAD was the only independent anthropometric predictor of insulin resistance (P &lt; 0.001) and hyperproinsulinemia (P &lt; 0.001).
CONCLUSIONS—In obese men, SAD seems to be a better correlate of insulin resistance and hyperproinsulinemia (i.e., cardiovascular risk) than other anthropometric measures. In overweight and obese individuals, SAD could represent a simple, cheap, and noninvasive tool that could identify the most insulin resistant in both the clinic and clinical trials evaluating insulin sensitizers. These results need confirmation in larger studies that also include women and lean subjects.
Cost-Effectiveness Analysis of Different Screening Procedures for Type 2 Diabetes
Authors: Icks Andrea , Haastert Burkhard , Gandjour Afschin , John Jürgen , Löwel Hannelore , Holle Rolf , Giani Guido , Rathmann Wolfgang ,   on behalf of the KORA Study Group
Published: March 2007

OBJECTIVE—To compare the cost-effectiveness of different type 2 diabetes screening strategies using population-based data (KORA Survey; Augsburg, Germany; subjects aged 55–74 years), including participation data.RESEARCH DESIGN AND METHODS—The decision analytic model, which had a time horizon of 1 year, used the following screening strategies: fasting glucose testing, the oral glucose tolerance test (OGTT) following fasting glucose testing in impaired fasting glucose (IFG) (fasting glucose + OGTT), OGTT only, and OGTT if HbA1c was &gt;5.6% (HbA1c + OGTT), all with or without first-step preselection (p). The main outcome measures were costs (in Euros), true-positive type 2 diabetic cases, incremental cost-effectiveness ratios (ICERs), third-party payers, and societal perspectives.RESULTS—After dominated strategies were excluded, the OGTT and HbA1c + OGTT from the perspective of the statutory health insurance remained, as did fasting glucose + OGTT and HbA1c + OGTT from the societal perspective. OGTTs (€4.90 per patient) yielded the lowest costs from the perspective of the statutory health insurance and fasting glucose + OGTT (€10.85) from the societal perspective. HbA1c + OGTT was the most expensive (€21.44 and €31.77) but also the most effective (54% detected cases). ICERs, compared with the next less effective strategies, were €771 from the statutory health insurance and €831 from the societal perspective. In the Monte Carlo analysis, dominance relations remained unchanged in 100 and 68% (statutory health insurance and societal perspective, respectively) of simulated populations.CONCLUSIONS—The most effective screening strategy was HbA1c combined with OGTT because of high participation. However, costs were lower when screening with fasting glucose tests combined with OGTT or OGTT alone. The decision regarding which is the most favorable strategy depends on whether the goal is to identify a high number of cases or to incur lower costs at reasonable effectiveness.
Lack of Agreement Between the Revised Criteria of Impaired Fasting Glucose and Impaired Glucose Tolerance in Children With Excess Body Weight
Authors: Gómez-Díaz Rita , Aguilar-Salinas Carlos A. , Morán-Villota Segundo , Barradas-González Rosalinda , Herrera-Márquez Rocio , Cruz López Miguel , Kumate Jesus , Wacher Niels H. 
Published: March 2007

OBJECTIVE—The aim of this study was to describe the agreement between impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) in children with excess body weight using the original and the revised definitions of IFG.RESEARCH DESIGN AND METHODS—Obese and overweight children aged 4–17 years were included (n = 533). Anthropometric parameters and biochemical tests (fasting and 2-h glucose tests after an oral glucose load [1.75 g/kg]) were performed. Case subjects with a fasting plasma glucose ≥126 mg/dl were excluded. The diagnostic parameters of the original and the revised definitions of IFG for detecting IGT were estimated. The analysis of agreement between these categories was made using the κ test.RESULTS—The prevalence of IFG increased from 6.2 to 13.3% using the new criteria. The prevalence of IFG became closer to the prevalence of IGT (14.8%). The revised criteria increased the sensitivity from 26.6 to 36.7%. However, the new IFG definition was not useful for identifying IGT cases. Of the 71 case subjects with IFG, only 29 (40.8%) had IGT. In addition, 50 case subjects with IGT (9.4%) and 13 with diabetes (2.4%) had a fasting glycemia &lt;100 mg/dl. A poor agreement was found between the 2003 IFG definition and abnormal 2-h postchallenge plasma glucose (κ = 0.359). The proportion of false-positive cases increased (36.3–59.1%) under the new definition.CONCLUSIONS—The new definition modestly increases the sensitivity of IFG for detecting IGT in children with excess body weight. Despite this, more than one-half of these cases are not detected. In addition, the false-positive rate was increased by 61%.
Cardiovascular Disease Risk Factors Predict the Development of Type 2 Diabetes
Authors: D’Agostino Ralph B. , Hamman Richard F. , Karter Andrew J. , Mykkanen Leena , Wagenknecht Lynne E. , Haffner Steven M. ,   for the Insulin Resistance Atherosclerosis Study Investigators
Published: March 2007

OBJECTIVE—In a few previous studies, cardiovascular disease (CVD) risk factors (RFs) have been shown to predict diabetes. Our objective was to determine whether the presence of CVD RFs predict the eventual development of diabetes after controlling for known RFs, such as directly measured insulin resistance and obesity.
RESEARCH DESIGN AND METHODS—We studied 872 participants with normal or impaired glucose tolerance (IGT) who were enrolled at baseline in the Insulin Resistance Atherosclerosis Study (IRAS). Of these, 143 (16%) developed type 2 diabetes in 5 years. Using these participants, a series of logistic regression models were fit to address the question.
RESULTS—Significant RFs for developing type 2 diabetes included high plasminogen activator inhibitor-1, hypertension, high triglycerides, low levels of HDL cholesterol, and IGT. The 5-year cumulative incidence of type 2 diabetes by the number of RFs (0–5) was as follows: no RFs, 11 of 230 = 5%; one RF, 31 of 278 = 11%; two RFs, 36 of 202 = 18%; three RFs, 41 of 110 = 37%; four RFs, 19 of 42 = 45%; and five RFs, 5 of 10 = 50% (P &lt; 0.001). The odds ratio (OR) for conversion to type 2 diabetes for each additional RF was 2.1 (95% CI 1.78–2.46) after adjusting for age, sex, ethnicity, and center. After further adjustment for insulin resistance, determined by the frequently sampled intravenous glucose tolerance test and waist circumference, each additional CVD RF increased the risk of type 2 diabetes significantly (OR 1.81, 95% CI 1.49–2.20).
CONCLUSIONS—Individuals with multiple CVD RFs are at increased risk of type 2 diabetes, which is only partially mediated by insulin resistance or central adiposity. This information should be useful for identifying high-risk patients for developing diabetes through RF assessments.
Specific Effects of Biliopancreatic Diversion on the Major Components of Metabolic Syndrome
Authors: Scopinaro Nicola , Marinari Giuseppe Maria , Camerini Giovanni Bruno , Papadia Francesco Saverio , Adami Gian Franco 
Published: March 2007

OBJECTIVE—Gastric bypass and biliopancreatic diversion (BPD) are known to have a beneficial effect on glucose metabolism superior to that of the other bariatric operations. Thanks to its excellent weight loss results and to its specific actions, BPD has proven able to guarantee permanent normalization of serum glucose, triglygeride, and cholesterol levels in the vast majority, if not the totality, of operated patients. However, clinical studies on the duration of these effects in large patient populations are still lacking.
RESEARCH DESIGN AND METHODS—The files of 312 BPD obese patients with type 2 diabetes operated on from June 1984 to January 1993 were examined. Pre- and postoperative serum glucose, triglyceride, and cholesterol levels, along with arterial pressure measurements, were considered.
RESULTS—After BPD, fasting serum glucose concentration fell within normal values in all but two of the operated subjects and remained in the physiological range in all but six up until 10 years. Serum triglyceride and total cholesterol steadily normalized in all subjects with abnormally high preoperative values, and arterial hypertension disappeared in the vast majority of the preoperatively hypertensive patients.
CONCLUSIONS—BPD proved able to reverse all the major components of the metabolic syndrome in nearly all the operated subjects, with results being strictly maintained over a 10-year follow-up period. This outcome, which far exceeds those following similar weight loss at short or long term obtained by any other means, confirms the existence of specific actions of BPD on the major components of metabolic syndrome.