bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eikenella corrodens Infections. Case report in two adolescent females with IDDM
Authors: Newfield Ron S , Vargas Ileana , Huma Zilla 
Published: March 2007

OBJECTIVE
To alert physicians caring for patients with diabetes to the microorganism Eikenella corrodens and to discuss the appropriate preventive and therapeutic measures to take against this potentially morbid opportunistic Gram-negative bacilli.

CASES
We present two cases of extra-oral E. corrodens infections in adolescent females with IDDM. The first patient had diabetes of 4 years' duration, which was moderately well controlled. Chronic finger biting resulted in a complex felon that evolved gradually and worsened while the patient received cephalexin orally. Delay in seeking further intervention resulted in necrosis of her distal fingertip and nail bed. The second patient had poorly controlled diabetes for 5 years. She developed an acute thigh abscess at an insulin injection site that resolved after drainage and intravenous antibiotics.

CONCLUSIONS
E. corrodens commonly inhabits the human oral cavity and becomes a pathogen mostly when host defenses are impaired, causing abscesses and infections that are at times fatal. Patients with IDDM are compromised hosts and with daily microtrauma to their skin via glucose monitoring and insulin injections, are prone to develop E. corrodens infections that can be introduced through oral secretions by licking or biting their skin. Educational efforts aimed at preventing exposure of traumatized skin to oral secretions can minimize the risk of E. corrodens infections in compromised hosts. Early intravenous administration of antibiotics, bearing in mind E. corrodens resistance to clindamycin, metronidazole, and other antibiotics, coupled with prompt surgical intervention, is essential in successfully managing E. corrodens infections.
Familial Aggregation of Medial Arterial Calcification in Pima Indians With and Without Diabetes
Authors: Narayan K M Venkat , Pettitt David J , Hanson Robert L , Bennett Peter H , Fernandes Richard J , Courten Maximilian De , Rose Frederick A , Knowler William C 
Published: March 2007

OBJECTIVE
Little is known about medial arterial calcification (MAC) other than its association with age, sex, diabetes, and diabetes complications. Familial aggregation of this disorder was studied to determine the importance of potential genetic factors and to assess whether such familial aggregation was independent of that of diabetes.

RESEARCH DESIGN AND METHODS
Members of 1,256 Pima Indian nuclear families with 3,339 offspring were examined radiologically for MAC of the feet. Multiple logistic regression analyses were used to compare the presence of the disorder in a parent with the presence of MAC in an offspring and to determine whether familial aggregation of MAC was independent of parental diabetes.

RESULTS
Controlled for age, sex, diabetes, serum cholesterol, and blood pressure, offspring of one parent with MAC had 3.3 (95% CI 1.5–7.6) times the odds of MAC as did offspring of parents without MAC, and offspring with both parents affected had an even higher risk (odds ratio, 8.1; 95% CI 3.4–18.8). Controlled for offspring age and sex and for parental age and diabetes, parental MAC was associated with the disorder in offspring (P &lt; 0.001), but the effect of parental diabetes on MAC in the offspring was not significant when controlled for parental MAC (P = 0.36). Furthermore, offspring of nondiabetic parents with MAC, controlled for age, sex, diabetes, and diabetes duration, had 1.7 (95% CI 0.9–3.1) times the odds of MAC than did offspring of diabetic parents with MAC.

CONCLUSIONS
Independent of parental age and diabetes and offspring age, sex, diabetes, and diabetes complications, parental MAC confers an increased risk of MAC in offspring. These findings suggest that the factors responsible for the familial clustering of MAC may be different from those for diabetes.
Lifestyle Changes May Reverse Development of the Insulin Resistance Syndrome. The Oslo Diet and Exercise Study: a randomized trial
Authors: Torjesen P A , Birkeland K I , Anderssen S A , Hjermann I , Holme I , Urdal P 
Published: March 2007

OBJECTIVE
To compare and assess the single and joint effect of diet and exercise intervention for 1 year on insulin resistance and the development leading toward the insulin resistance syndrome.

RESEARCH DESIGN AND METHODS
An unmasked, randomized 2 × 2 factorial intervention trial was applied with a duration of 1 year for each participant. The trial comprised 219 men and women with diastolic blood pressure of 86–99 mmHg, HDL cholesterol &lt; 1.20 mmol/l, triglycerides &gt; 1.4 mmol/l, total cholesterol of 5.20–7.74 mmol/l, and BMI &gt; 24 kg/m2. Participants were randomly allocated to diet group (n = 35), diet and exercise group (n = 67), exercise group (n = 54), and control group (n = 43). The diet included increased intake of fish and reduced total fat intake. The exercise program entailed supervised endurance exercise three times a week. Baseline cross-sectional changes and 1-year changes in insulin resistance, fasting serum levels of insulin, C-peptide, proinsulin, glucose, and lipids as well as weight, mean blood pressure, and plasminogen activator inhibitor 1 (PAI-1) values were recorded.

RESULTS
The cross-sectional results at baseline showed significant correlations between the calculated insulin resistance and BMI (r = 0.54) and correlations between the mean blood pressure (mBP) (r = 0.26) and PAI-1 (r = 0.40). The 1-year diet intervention gave a significant decrease in the calculated insulin resistance from 4.6 to 4.2 and a positive correlation between the changes in insulin resistance and changes in BMI (r = 0.40). The diet and exercise intervention also led to significantly decreased insulin resistance (from 5.0 to 4.0). The exercise intervention did not significantly change insulin resistance.

CONCLUSIONS
The cross-sectional and 1-year intervention results supported each other and underscored the important connection between increased BMI and the development leading toward the insulin resistance syndrome.
Cognitive Function in Younger Type II Diabetes
Authors: Dey Jayant , Misra Anoop , Desai Nimesh G , Mahapatra A K , Padma M V 
Published: March 2007

OBJECTIVE
To examine central nervous system involvement as a possible complication of diabetes by performing a comprehensive neuropsychological evaluation of relatively young (age &lt; 55 years) NIDDM patients and a group of control subjects.

RESEARCH DESIGN AND METHODS
A cross-sectional comparative study of 28 patients, with duration of diabetes 5–18 years (mean ± SD ± 3.2 years), screened for acceptable glycemic control and absence of hypoglycemia on the day of examination, compared with 28 demographically similar, nondiabetic control subjects. Neuropsychometric tests performed were Mini-Mental Status Examination (MMSE), Neurobehavioral Cognitive Status Examination (NCSE), and P300 latencies (endogenous evoked potentials).

RESULTS
Seven (25.0%) patients reported history suggestive of cognitive impairment during day-to-day activities, and 17 (60.7%) had distal symmetrical polyneuropathy. Average P300 latencies were significantly delayed among the diabetic patients compared with the control subjects (349.5 ± 28.2 vs. 312.9 ± 19.3 ms; t = 5.68, P &lt; 0.001). Although there was no significant difference in MMSE scores, compared with control subjects significantly more patients had impairment in NCSE tests of attention (χ2 = 7.38, P &lt; 0.01), repetition (χ2 = 4.073, P &lt; 0.05), and memory (χ2 = 5.83, P &lt; 0.05), while there was no significant difference in tests of comprehension, naming, construction, and calculation. Duration of diabetes, HbA1c levels, and the presence of distal symmetrical polyneuropathy among patients each did not correlate with any of the parameters of cognitive function evaluated. Higher blood glucose levels during the electrophysiological testing were associated with less delay in P300 latencies among the patients.

CONCLUSIONS
Central nervous system impairment, manifesting as mild impairments in certain cognitive skills, should be recognized as a possible complication of long-standing NIDDM, even in relatively younger individuals.
Self-Monitoring of Blood Glucose in Type I Diabetic Patients: Comparison With Continuous Microdialysis Measurements of Glucose in Subcutaneous Adipose Tissue During Ordinary Life Conditions
Authors: Bolinder Jan , Hagström-Toft Eva , Ungerstedt Urban , Arner Peter 
Published: March 2007

OBJECTIVE
To evaluate whether frequent self-monitoring of blood glucose (SMBG) sufficiently reflects the true diurnal glucose control during ordinary daily life in type I diabetic patients.

RESEARCH DESIGN AND METHODS
By using a microdialysis technique, continuous monitoring of adipose tissue glucose was performed in 24 type I diabetic patients during ambulatory conditions. A microdialysis probe was implanted subcutaneously and perfused by a portable microinfusion pump. Dialysate fractions were collected in 1- to 2-h samples during 3 consecutive days. The diurnal microdialysis glucose profiles were compared with those obtained by SMBG recordings performed seven times a day.

RESULTS
In seven patients, the SMBG profiles showed marked aberrations as compared to the continuous microdialysis glucose recordings; during the 3-day study period, 5–6 inconsistencies were registered. In only 4 patients (17%) did SMBG provide a valid reflection (0–2 inconsistencies) of the diurnal glucose profile, whereas in 13 patients the SMBG recordings paralleled the diurnal adipose tissue glucose profiles in an intermediate way (3–4 major inconsistencies). The inaccuracy of the SMBG data was due more often to the fact that wide glucose swings remained unrecognized, rather than to erroneous testing techniques (P &lt; 0.05), and it was more evident during the night (P &lt; 0.05).

CONCLUSIONS
In many type I diabetic patients, the true diurnal variability in glycemia is too great to be accurately reflected even by frequent self-monitoring of blood glucose.
Effective Postponement of Diabetic Nephropathy With Enalapril in Normotensive Type 2 Diabetic Patients With Microalbuminuria
Authors: Ahmad Jamal , Siddiqui Mohammad A , Ahmad Habib 
Published: March 2007

OBJECTIVE
This study determines the long-term efficacy of the ACE inhibitor, enalapril, in reducing the progression of microalbuminuria to clinical albuminuria in normotensive patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS
There were 103 normotensive type 2 diabetic patients with persistent albumin excretion rate (AER) 20–200 micrograms/min and normal renal function followed for 5 years in a prospective randomized single-blind placebo-controlled trial. AER, blood pressure, fasting plasma glucose, and HbA1 were measured every 3–4 months and glomerular filtration rate (GFR), renal plasma flow (RPF), and urinary urea every 12 months.

RESULTS
In the patients treated with enalapril, AER decreased from 55 ± 33 to 20 ± 59 micrograms/min (geometric mean ± SD), whereas in the placebo group, AER increased from 53 ± 31 to 85 ± 90 micrograms/min after 5 years. Within 5 years, 7.7% (4/52) of enalapril-treated subjects and 23.5% (12/51) of placebo-treated subjects progressed to clinical albuminuria defined as AER &gt; 200 micrograms/min and at least 34% above baseline (risk reduction = 66.7%, P &lt; 0.001). AER increased at an annual rate of 12.3% (95% CI 9.8–14.9) in the placebo group, while it declined by 16.7% (95% CI −18.3 to −15.2) in the enalapril group (P &lt; 0.001). In addition, 8 of the 12 placebo-treated patients had evidence of coronary artery disease. The rest of the parameters remained practically unchanged in the two groups.

CONCLUSIONS
After 5 years of therapy with enalapril, compared with placebo, normotensive subjects with type 2 diabetes experienced significantly less progression of microalbuminuria to clinical albuminuria, reduced AER, and preserved GFR.
The Recurrence of Gestational Diabetes: Could Dietary Differences in Fat Intake Be an Explanation?
Authors: Moses Robert G , Shand Judi L , Tapsell Linda C 
Published: March 2007

OBJECTIVE
To present the results of a comprehensive dietary review of a group of women with a recurrence of gestational diabetes mellitus (GDM), compared with a group of women with no recurrence of GDM during a subsequent pregnancy.

RESEARCH DESIGN AND METHODS
The dietary intake of 14 women with a recurrence of GDM was compared with 21 women with no recurrence of GDM. Women with GDM in one pregnancy have a recurrence rate of only 30–50%. While the reasons for this have not been determined, dietary factors have been considered probable.

RESULTS
The women with a recurrence of GDM consumed 38.4 (by diet history) and 41.4% (by food record) of their total energy intake as fats, compared with 34.1 (P &lt;0.01) and 33.1% (P &lt;0.001), respectively, for women with no recurrence. The percentage intake of polyunsaturated, monounsaturated, and saturated fatty acids was similar in both groups. There was a proportionate reduction in carbohydrate intake as a percentage of total energy and in fiber intake in grams for the women with a recurrence of GDM.

CONCLUSIONS
When the relationship between saturated fat intake and insulin resistance is considered, the possibility exists that dietary modification of fat intake before and during pregnancy may reduce the recurrence rate of GDM.
Metabolic Effects of Alterations in Meal Frequency in Type 2 Diabetes
Authors: Arnold Leeanne , Mann Jim I , Ball Madeleine J 
Published: March 2007

OBJECTIVE
The effects of altering meal frequency on measures of glucose and lipid metabolism in type 2 diabetes were examined by comparing isocaloric dietary regimens in which daily food intake was provided by three or nine meals each day.

RESEARCH DESIGN AND METHODS
A total of 13 free-living men and women with type 2 diabetes or persistently impaired glucose tolerance participated in a randomized crossover study in which three- and nine-meal regimes were followed for 4-week periods. Fasting plasma lipid and lipoprotein, glucose and insulin concentrations were measured at weekly intervals and glucose, insulin, and triglyceride responses following a 75-g glucose load at weeks 2 and 4 of each diet period. Dietary intake was also recorded during these weeks.

RESULTS
Nutrient intakes and all measures of carbohydrate and lipid metabolism were similar on the three- and nine-meal regimes.

CONCLUSIONS
This longer-term study could not confirm the potential benefits of increased meal frequency suggested by comparable 4-week studies in type 2 diabetic individuals and acute experiments in individuals with diabetes. However, as there were no adverse effects of consuming nine meals per day, it would seem appropriate that meal frequency in those with type 2 diabetes should be left to personal choice, provided that energy balance is maintained.
Diabetic Peripheral Neuropathy: Amelioration of Pain With Transcutaneous Electrostimulation
Authors: Kumar Dinesh , Marshall Howard J 
Published: March 2007

OBJECTIVE
To evaluate the efficacy of transcutaneous electrotherapy for chronic painful peripheral neuropathy in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS
Thirty-one patients with symptoms and signs of peripheral neuropathy were randomized to the electrotherapy or sham treatment (control) group. The electrostimulation was given by a portable unit (H-Wave machine) than generated a biphasic, exponentially decaying waveform (pulse width 4 ms, 25–35 V, ≥ 2 Hz). Patients treated each of their lower extremities for 30 min daily for 4 weeks at home. Nine patients from the sham-treatment group participated for a second period, during which all of them received the active electrotherapy. Patient's degree of pain and discomfort was graded on a scale of 0 to 5.

RESULTS
In the sham-treated group (n = 13), the neuropathic symptoms improved in five (38%) patients, and the pain score declined from 2.92 ± 0.13 to 2.38 ± 0.26 (P &lt; 0.04), suggesting a procedure-related placebo effect. In the electrotherapy group (n = 18), symptomatic improvement was seen in 15 (83%) cases, 3 of which were completely asymptomatic; the pain score declined from 3.17 ± 0.12 to 1.44 ± 0.25 (P &lt; 0.01) and the posttreatment pain scores were considerably lower (P &lt; 0.03), indicating a substantial treatment effect over and above any placebo influence. Patients in the electrotherapy group reported greater reduction in symptoms (52 ± 7% vs. 27 ± 10% in control subjects, P &lt; 0.05) on an analog scale. Moreover, the electrotherapy decreased pain scores (from 3.0 ± 0.62 to 1.56 ± 0.32, P &lt; 0.02) in nine patients who had received sham treatment earlier.

CONCLUSIONS
A form of transcutaneous electrotherapy ameliorated the pain and discomfort associated with peripheral neuropathy. This novel modality offers a potential non-pharmacological treatment option.
Reduction of Albumin Excretion Rate in Normotensive Microalbuminuric Type 2 Diabetic Patients During Long-Term Simvastatin Treatment
Authors: Tonolo Glancarlo , Ciccarese Milco , Brizzi Patrizia , Puddu Loreta , Secchi Giannina , Calvia Pierangela , Atzeni Maria M , Melis Maria G , Maioli Mario 
Published: March 2007

OBJECTIVE
To study the long-term effects of simvastatin on urinary albumin excretion rate (AER) in normotensive microalbuminuric type 2 diabetic patients with hypercholesterolemia.

RESEARCH DESIGN AND METHODS
A total of 19 normotensive microalbuminuric hypercholesterolemic type 2 diabetic patients entered a double-blind crossover study for 2 years, receiving either simvastatin (20 mg/day) or placebo (each treatment for 1 year).

RESULTS
Simvastatin significantly decreased plasma cholesterol (total and LDL) after 52 weeks of treatment. A concomitant significant decrease of AER (25% from basal) with no significant changes in creatinine clearance was observed during the same period.

CONCLUSIONS
Our data are in keeping with the hypothesis that simvastatin might be used as an additional means to preserve renal function in microalbuminuric hypercholesterolemic type 2 diabetic patients.
Antibodies to GAD and Glycemic Control in Recent-Onset IDDM
Authors: Hoeldtke Robert D , Bryner Kimberly D , Horvath Gabriella G , Byerly Michele R , Hobbs Gerald R , Marcovina Santica M , Lernmark Ake 
Published: March 2007

OBJECTIVE
To analyze the effect of antibodies to glutamic acid decarboxylase (GAD65Ab) and islet cells (ICA512Ab) on glycemic control early in IDDM.

RESEARCH DESIGN AND METHODS
GAD65Ab and ICA512Ab were measured twice in 35 patients (10 male, 25 female; age 10–40 years) initially within 2 years of diagnosis and again 1 year later. The glycosylated hemoglobin was measured one to four times each year, and the average glycosylated hemoglobin for the preceding year was calculated each time the antibodies were measured.

RESULTS
The mean HbA1 at the time of the initial evaluation was 8.04 ± 0.30 (reference range 4.7–7.3% for nondiabetic patients), the average GAD65Ab index was 0.735 ± 0.306, and the mean ICA512Ab index was 1.94 ± 0.65. The GAD65Ab index correlated with HbA1 (r = 0.41, P &lt; 0.025), whereas the ICA512Ab index did not (r = 0.13). One year later, the mean GAD65Ab index was 0.94 ± 0.34, the mean ICA512Ab index was 1.04 ± 0.40, and the mean HbA1 was 9.03 ± 0.30. The GAD65Ab index correlated with HbA1 (r = 0.61 P &lt; 0.001), whereas the ICA512Ab index did not (r = −0.06). Stratification of patients into tertiles according to the average GAD65 index revealed, at the follow-up evaluation, that the better glycemic control in the lowest GAD65Ab tertile was accomplished with significantly less insulin (0.43 ± 0.08 U/kg for the lowest tertile vs. 0.71 ± 0.09 and 0.64 ± 0.09 for the middle and highest tertiles, respectively; P &lt; 0.05).

CONCLUSIONS
In summary, patients with IDDM and low GAD65Ab have better glycemic control even though they require less insulin. The ICA512Ab index, however, fails to correlate with glycemia.
Subclinical and Clinical Eating Disorders in IDDM Negatively Affect Metabolic Control
Authors: Affenito Sandra G , Backstrand Jeffrey R , Welch Garry W , Lammi-Keefe Carol J , Rodriguez Nancy R , Adams Cynthia H 
Published: March 2007

OBJECTIVE
To characterize the relationship of subclinical and clinical eating disorders to HbA1c values in women with IDDM.

RESEARCH DESIGN AND METHODS
Ninety women with IDDM (18–46 years of age) were recruited from diabetes clinics throughout Connecticut and Massachusetts. Subjects were categorized into one of three groups according to the Diagnostic Statistical Manual of Mental Disorders (DSM-III-R) criteria for eating disorders as follows: the clinical group (n = 14), the subclinical group (partially fulfilling the diagnostic criteria; n = 13), and the control group (n = 63). Group differences in the degree of dietary restraint, binge eating, and bulimic behaviors and weight, shape, and eating concerns were assessed with the Eating Disorder Examination (EDE) and the Bulimia Test Revised (BULIT-R).

RESULTS
Women with subclinical and clinical eating disorders had clinically elevated HbA1c results and more diabetes-related complications, compared with the control subjects. The severity of bulimic behaviors, weight concerns, reduced BMI, and decreased frequency of blood glucose monitoring were associated with elevated HbA1c.

CONCLUSIONS
HbA1c may have clinical utility in the identification of eating disorder behavior in females with IDDM. Health care professionals should be aware of the potent effect of subclinical and clinical eating behaviors including insulin misuse in weight-conscious women with IDDM who have poor glycemic control.