bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Effects of Protein-Restricted Diet on Albuminuria and Renal Function in IDDM Patients Without Clinical Nephropathy and Hypertension
Authors: Dullaart Robin P F , Beusekamp Berta J , Meijer Sytze , Doormaal Jasper J Van , Sluiter William J 
Published: March 2007

OBJECTIVE
To determine the long-term effects of an LPD on albuminuria and renal hemodynamics in IDDM patients without nephropathy.

RESEARCH DESIGN AND METHODS
We selected 31 patients with overnight albuminuria between 10 and 200 g/min and without hypertension from a referral-based diabetic clinic. One participant dropped out. A 2-yr randomized prospective study was conducted on 14 patients assigned to an LPD (0.6 g · kg−1 · day−1) and 16 patients assigned to continue their UPD. Protein intake was assessed by using urinary urea excretion. Albuminuria (three overnight collections) was measured at baseline and on seven occasions thereafter. GFR and ERPF were measured annually using [125I]iothalamate and [131I]hippuran, respectively.

RESULTS
In the LPD group, protein intake decreased from 1.05 ± 0.32 to 0.79 ± 0.16 g · kg−1 [ day−1 (P &lt; 0.005), but only seven participants consumed &lt; 0.8 g [ kg−1 [ day−1. Protein intake was unaltered in the UPD group (P &lt; 0.001 vs. LPD). Baseline albuminuria and renal hemodynamics were not different in the groups. In the LPD group albuminuria decreased from 36 (95% CI, 16–83) to 30 μg/min (95' CI, 14–67) (P &lt; 0.05). After adjustment for MAP and diabetes duration, the decrease in albuminuria in the LPD group was 26% (95% CI, 13–36) (P &lt; 0.001), which was significantly different from the 5% (95% CI, −10–22) change in the UPD group (P &lt; 0.005 vs. LPD). Multiple regression analysis showed the actual decrease in protein intake lessened (P &lt; 0.005), whereas prevailing MAP accelerated albuminuria (P &lt; 0.001). Low-protein intake independently reduced ERPF (P = 0.009) and GFR (indirectly via ERPF, P &lt; 0.001) after 1 yr. Only minor changes in renal hemodynamics occurred in the second yr.

CONCLUSIONS
This study suggests that long-term dietary protein restriction beneficially reduces albuminuria and renal hemodynamics in IDDM patients with mildly elevated albuminuria. Systemic BP counteracts these effects even in the absence of hypertension. Suboptimal compliance limits diet efficacy.
Influencing the Attitudes of Medical Students Toward Diabetes: Results of a controlled study
Authors: Anderson Robert M , Donnelly Michael B , Gorenflo Daniel W , Funnell Martha M , Sheets Kent J 
Published: March 2007

OBJECTIVE
To determine the effect of two educational interventions on the diabetes-related attitudes of medical students.

RESEARCH DESIGN AND METHODS
We studied 67 junior and senior medical students who were participating in the University of Michigan Medical School's Family Practice elective clerkship. Students were assigned to one of two interventions. The first was a 1-wk living-with-diabetes behavioral simulation that involved injections, blood glucose monitoring, diet, exercise, and record keeping. The second intervention involved reading an autobiography about living with diabetes and viewing a videotape about the psychosocial impact of diabetes.

RESULTS
No differential impact was found between the two interventions. However, both interventions were followed by a modest positive change in the attitudes of the medical students (which were very positive to begin with) toward the importance of patient autonomy and the value of the team approach to diabetes care. The attitude gains persisted at follow-up for patient autonomy but returned to baseline for team care.

CONCLUSIONS
This study suggests that these two educational interventions resulted in modest increases in the already positive attitudes of medical students toward the importance of patient autonomy and team care in diabetes. However, because the study did not include a group that received no treatment, we cannot be certain on this point. The attitude gain related to team care did not persist at follow-up. These findings are consistent with classical attitude research, which suggests that attitudes are sensitive to influences such as these interventions, but that attitude changes may not persist when those influences are changed or withdrawn. We were not able to find a differential impact between the two interventions and suspect that the general nature of the DAS used as the dependent measure may not have been sensitive enough to capture such a differential impact.
Prevalence of Diabetes and Impaired Glucose Tolerance in Funagata Area, Japan
Authors: Sekikawa Akira , Tominaga Makoto , Takahashi Kenji , Eguchi Hideyuki , Igarashi Masahiko , Ohnuma Hiroshi , Sugiyama Kazuhiko , Manaka Hideo , Sasaki Hideo , Fukuyama Haru , Miyazawa Kouzui 
Published: March 2007

OBJECTIVE
To determine the prevalence of diabetes mellitus and IGT in the Funagata area of Japan.

RESEARCH DESIGN AND METHODS
The total eligible subjects was 1163, all were &gt; or ≥45 yr of age, and 52 were known diabetic patients. Data collected included body height, weight, and answers to medical questionnaires. A 75-g OGTT was done in the morning. WHO criteria were used to classify the current diabetes status of study participants.

RESULTS
Of the 1111 scheduled for the OGTT, 868 took the test; the participation rate was 77.8%. The prevalence of diabetes was 10.5 and 12.9%, and the prevalence of IGT was 14.7 and 18.0% for men and women, respectively. The prevalence of undiagnosed diabetes (4.9%) was almost equal to that of previously diagnosed diabetes (4.5%).

CONCLUSIONS
The prevalence of diabetes in the Funagata area was two to four times higher than that of previous reports in Japan, in which many investigators used a urinary glucose test as a preliminary test. This difference is attributed to the method of determining the prevalence of diabetes.
Effects of Gemfibrozil on Low-Density Lipoprotein Particle Size, Density Distribution, and Composition in Patients With Type II Diabetes
Authors: Lahdenperä Sanni , Tilly-Kiesi Marju , Vuorinen-Markkola Helena , Kuusi Timo , Taskinen Marja-Riitta 
Published: March 2007

OBJECTIVE
To study the effects of gemfibrozil treatment on LDL particle size, density distribution, and composition in NIDDM patients.

RESEARCH DESIGN AND METHODS
We performed LDL analyses on 16 NIDDM patients with stable glycemic control. They were randomly allocated to receive either gemfibrozil (n = 8) or a placebo (n = 8) for 3 mo in a double-blind study. The LDL particle size distribution and the particle diameter of the major LDL peak were measured with nondenaturing polyacrylamide gradient gel electrophoresis. The density distribution and composition of LDL were determined with the density gradient ultracentrifugation method.

RESULTS
In the gemfibrozil group the mean serum TG concentration decreased by 38%, HDL cholesterol concentration increased by 10%, and LDL cholesterol concentration by 17% (P &lt; 0.05). During gemfibrozil therapy the mean particle diameter of the major LDL peak increased from 244 to 251 Å (P &lt; 0.05), whereas in the placebo group the mean LDL particle diameter remained unchanged. We found an inverse correlation between the changes of serum TG and the particle diameters of the major LDL peak (r = 0.85, P &lt; 0.01). Gemfibrozil produced a shift in the LDL density distribution toward lower density. The mean peak density decreased from 1.0371 to 1.0345 g/ml because of a significant rise in the light LDL concentration from 141.0 to 183.2 mg/dl (P &lt; 0.05), whereas the concentration of dense LDL had a tendency to decrease. In the placebo group the LDL density distribution did not change. Gemfibrozil increased the CE-to-TG ratio in LDL core lipids by 27% (P &lt; 0.05); otherwise, the LDL composition was only slightly affected.

CONCLUSIONS
The results indicate gemfibrozil-induced changes in LDL properties in NIDDM patients are similar to those previously reported in nondiabetic individuals and are related to changes in serum TG level.
Microalbuminuria in NIDDM
Authors: Bashyam Mani M , O'Sullivan Neil J , Baker Habib H , Duggan Patrick F , Mitchell Teresa H 
Published: March 2007

OBJECTIVE
To determine an effective screening procedure for microalbuminuria.

RESEARCH DESIGN AND METHODS
The prevalence of microalbuminuria in NIDDM patients whose urine was negative on routine Albustix testing was studied. Microalbuminuria was measured in overnight urine samples from 128 NIDDM patients on at least two of three occasions over a 6-mo period. Patients were tested with Micro-Bumintest or Micral-Test.

RESULTS
Ten of 128 patients had albumin concentrations ≥ or = 20 mg/L on two or more occasions, 14 patients had A-C ratios ≥ or = 3 mg/M on two or more occasions, and 9 patients had both.

CONCLUSIONS
Neither Micro-Bumintest nor Micral-Test is a useful or feasible screening procedure for microalbuminuria.
Racial Differences in the Relationship Between Blood Pressure and Risk of Retinopathy Among Individuals With NIDDM
Authors: Harris Emily L , Feldman Susan , Robinson C Rahj , Sherman Steven , Georgopoulos Angeljki 
Published: March 2007

OBJECTIVE
To assess whether the prevalence of retinopathy differs between blacks and whites with diabetes and to examine differences between blacks and whites in the relationship between risk factors for and prevalence of retinopathy. Population data suggest diabetic retinopathy is either more prevalent or more severe in blacks than in whites.

RESEARCH DESIGN AND METHODS
We analyzed data from a screening study for retinopathy among patients with diabetes, conducted in Maryland from 1986–1990.

RESULTS
After adjusting for age, duration of diabetes, type of treatment for diabetes, and presence or absence of high blood pressure, black men with NIDDM were ∼23% more likely to have retinopathy than other race-sex groups (not statistically significant). We also found a different relationship between systolic blood pressure and retinopathy prevalence in blacks than in whites among individuals with NIDDM. Among blacks, the risk increased as systolic blood pressure increased, even within the normal range, and reached statistical significance at &gt; 150 mmHg. Among whites, the risk was increased only among those with high systolic blood pressure (&gt;140 mmHg) and did not reach statistical significance.

CONCLUSIONS
Our data are consistent with the hypothesis that differences exist between blacks and whites in risk of diabetic retinopathy, and that the effect of blood pressure on risk of retinopathy differs between blacks and whites.
Survey of Physician Practice Behaviors Related to Diabetes Mellitus in the U.S.: I. Design and Methods
Authors: Siebert Carolyn , Lipsett Lois F , Greenblatt Janet , Silverman Robert E 
Published: March 2007

OBJECTIVE
To conduct a survey among a representative sample of primary care physicians in the U.S. to assess practice behaviors, treatment goals, and beliefs related to management of diabetes mellitus and prevention of its complications.

RESEARCH DESIGN AND METHODS
A mail survey with telephone follow-up was conducted among 3481 primary care physicians in active practice in the continental U.S. A stratified probability sample was selected using the files of the American Medical Association and American Osteopathic Association. Four specialties were selected to be included in the study: family physician, general practitioner, internist, and pediatrician. Two versions of a questionnaire were constructed: one for pediatricians containing questions about IDDM only and one for the other three specialties containing questions about both IDDM and NIDDM. Physicians who were not actively engaged in practice or did not see patients with diabetes were excluded.

RESULTS
Completed questionnaires were received from 1502 of 3481 sampled physicians. Based on various assumptions of eligibility among nonresponders, an overall response rate to the survey was estimated to be between 65.7 and 86.5%. Discrepancies between specialty identifications as noted on the American Medical Association/American Osteopathic Association files and as self-designated were noted.

CONCLUSIONS
This report describes the methodology used in the design and conduct of the survey, and data are provided to document the technical success of survey execution. This report provides the methodological basis for a series of separate reports on demographic characteristics of the physicians, their practices and their patients, and on specific attitudes, beliefs, and practice behaviors of primary care physicians in the U.S. with regard to diabetes mellitus.
Immunogenetic and Clinical Characterization of Slowly Progressive IDDM
Authors: Kobayashi Tetsuro , Tamemoto Koji , Nakanishi Koji , Kato Norihiro , Okubo Minoru , Kajio Hiroshi , Sugimoto Tadao , Murase Toshio , Kosaka Kinori 
Published: March 2007

OBJECTIVE
To examine the clinical and immunogenetic heterogeneity of IDDM.

RESEARCH DESIGN AND METHODS
We divided 207 IDDM patients into groups based on the interval from clinical onset to initiation of insulin therapy: group A (&lt;3 mo, acute clinical-onset group, n = 134), group B (3–12 mo, intermediate group, n = 31), and group C (&gt;13 mo, slowly progressive group, n = 42). Immunogenetic and clinical markers were compared between group A and group C.

RESULTS
The mode age of onset was higher in group C (52 yr) than group A (10 yr). Group C had a higher prevalence of islet cell antibodies (42.9%, 18 of 42) than group A (25.4%, 34 of 134, P = 0.05). Serum C-peptide immunoreactivity assayed by radioimmunoassay in response to a 100-g oral glucose tolerance test was significantly higher in group C uhan in group A. Group C patients were also more likely to have a family history of NIDDM (26.1%, 11 of 42) among their first-degree relatives than group A patients (11.2%, 15 of 134, P = 0.039). The prevalences of family history of IDDM and endocrine autoimmune diseases were not different between groups C and A. The frequency of complications of endocrine autoimmune disease was not different between group A (6.7%, 9 of 134) and group C (2.3%, 1 of 42). Significant associations with two class I major histocompatibility complex antigens (HLA-A24 and -Bw54) and one class II antigen (HLA-DR4) were observed in group A. Group A patients were assocciated with three diabetogenic HLA-DQ haplotypes including DQA1*0301-DQB1*0401, DQAl*0301-DQBl*0302, and DQA1 *0301-DQB 1*0303. In contrast, group C lacked the association with class I antigens, although HLA-DR4 and HLA-DQA1* 0301-DQB 1*0401 were more common in this group than in control subjects.

CONCLUSIONS
These results indicate that the clinical subtype with slowly progressive course (slowly progressive IDDM) has distinct findings including late-age onset, high prevalence of islet cell antibodies, preserved β-cell function, and high family history of NIDDM. An additive effect of class I and class II major histocompatibility complex antigens is suggested as an explanation for the acute clinical manifestations and more severe β-cell destruction in group A patients.
Lack of Regional Variation in IDDM Risk in Japan
Authors:   Japan IDDM Epidemiology Study Group
Published: March 2007

OBJECTIVE
To examine the intracountry variation of IDDM incidence in Japan and compare it with data from the British Isles and the U.S.

RESEARCH DESIGN AND METHODS
IDDM incidence was determined with a standardized registry approach in five geographically different areas in Japan (Hokkaido, Tokyo, Yokohama, Osaka, and Kagoshima) with a total at-risk population &lt; 15 yr of age of 4.4 million. Data collection was completed under the guidelines of the World Health Organization Diamond project.

RESULTS
The incidence and patterns of disease were remarkably similar across the five environmentally different areas. Incidence rates per 100,000 were very low and almost identical from northern to southern Japan (Hokkaido, 2.07; Tokyo, 1.65; Yokohama, 1.66; Osaka, 1.78; and Kagoshima, 1.93). This remarkably low intracountry variation of 0.4/100,000 stands in sharp contrast with the 13.0/100,000 regional variation in the British Isles and the 10.6/100,000 variation in the U.S.

CONCLUSIONS
The results suggest that the remarkable genetic homogeneity in Japan may produce uniformity of incidence.
Social and Economic Impact on Youth-Onset Diabetes in Japan
Authors: Matsushima Masato , Tajima Naoko , Agata Toshihiko , Yokoyama Junichi , Ikeda Yoshio , Isogai Yukihide 
Published: March 2007

OBJECTIVE
To investigate the social and economic backgrounds of youth-onset insulin-treated diabetes mellitus in Japan.

RESEARCH DESIGN AND METHODS
We conducted a case-control study on 35 diabetic patients with age at onset of 19.5 ±; 5.1 yr and duration of diabetes 14.9 ±; 6.7 yr. Sex- and age-matched (within 5 yr) siblings were selected as control subjects. Thirty-five matched pairs were asked to complete a questionnaire, including employment status and educational achievement.

RESULTS
Overall, diabetic patients were more likely to encounter job refusal in their lives than sibling control subjects (20 vs. 0%), and most patients (6/7) who had an experience of job refusal told job interviewers about their diabetes. Although the full-time employment rate and unemployment rate did not differ significantly between patients and control subjects, income levels were lower among patients than in the sibling (1600 vs. 2500 thousand yen). A multivariate analysis indicated that patients had lower incomes than control subjects after adjusting for the effect of physical disability. Educational achievements in the patients were similar to those in the siblings.

CONCLUSIONS
These results suggested that diabetic patients had several social and economic problems in Japan. Further studies in more subjects are required to grasp the social and economic impact on diabetes precisely, and minimize the social handicaps on diabetic patients.
Effect of Added Fat on Plasma Glucose and Insulin Response to Ingested Potato in Individuals With NIDDM
Authors: Gannon Mary C , Ercan Nacide , Westphal Sydney A , Nuttall Frank Q 
Published: March 2007

OBJECTIVE— In normal subjects, ingestion of butter with potato resulted in considerably lower blood glucose levels but similar or higher insulin concentrations compared with those observed in the same subjects after potato ingestion alone. We determined whether butter ingested with potato would result in a greater stimulation in insulin secretion than ingestion of potato alone in subjects with NIDDM.
RESEARCH DESIGN AND METHODS— Seven male subjects with untreated NIDDM ingested 50 g CHO alone or 50 g CHO with 5, 15, 30, or 50 g fat as a breakfast meal. Fat was ingested in the form of butter, and CHO was given in the form of potato. Subjects received 50 g glucose on two separate occasions for comparative purposes. The subjects also were given only water and were studied over the same time period (water control). Plasma glucose, glucagon, alpha-amino nitrogen, nonesterified fatty acids, serum insulin, C-peptide, and triglyceride concentrations were determined over 5 h. The integrated area responses were quantified over the 5-h period using the water control as a baseline.
RESULTS— The mean plasma glucose area response after ingestion of potato with or without the various amounts of butter were all similar and were 82% of that observed after ingestion of 50 g glucose. The mean insulin area response to potato alone was 532 pmol · h · L−1. The mean insulin area responses to potato plus 5,15,30, and 50 g of fat meals were 660,774,750, and 756 pmol · h · L−1, respectively. Thus, the mean insulin areas were all greater than for ingestion of potato alone, and a maximal response was observed with addition of 15 g fat (1.4-fold). The C-peptide data did not confirm an increase in insulin secretion. Overall the area responses after ingestion of meals containing fat were not different from the response to potato ingestion alone, although the responses were erratic. The glucagon area response was positive after ingestion of all fat containing meals except for that containing only 5 g fat, and there was a dose-response relationship. The plasma alpha-amino nitrogen and nonesterified fatty acid area responses were negative after potato ingestion and were not significantly different when fat was added. The serum triglyceride concentration increase was greater after the ingestion of butter with the potato as expected.
CONCLUSIONS— In contrast to the results in normal subjects after ingestion of butter with potato, the glucose response was not smaller in subjects with NIDDM. The insulin response was greater. The insulin area response data indicated the presence of a dose-response relationship. Whether similar responses will be observed with other dietary fat and CHO sources remains to be determined.
Severe Insulin-Induced Lipohypertrophy Successfully Treated by Liposuction
Authors: Hardy Kevin J , Gill Geoffrey V , Bryson J Richard 
Published: March 2007

OBJECTIVE— To examine the usefulness of liposuction surgery on diabetic patients with lipohypertrophy.
RESEARCH DESIGN AND METHODS— We treated a diabetic patient who suffered from severe localized thigh lipohypertrophy. When she did not respond to conventional treatment of resting the injection site, we recommended liposuction surgery.
RESULTS— Our patient's lipohypertrophy was immediately cured by the liposuction procedure.
CONCLUSIONS— Liposuction surgery could be useful in patients with diabetic lipohypertrophy who do not respond to more conservative treatments.
Smell Dysfunction and Related Factors in Diabetic Patients
Authors: Le Floch Jean-Pierre , Le Lièvre Gilles , Labroue Michael , Paul Muriel , Peynegre Roger , Perlemuter Leon 
Published: March 2007

OBJECTIVE— To analyze smell function in diabetic patients and healthy control subjects, with reference to individual characteristics and major complications of the disease.
RESEARCH DESIGN AND METHODS— A cross-sectional study of smell recognition in 68 diabetic patients and 30 control subjects without known cause of smell impairment was conducted. Smell was studied using a kit of flavors that patients were asked to recognize, leading to a smell recognition score ranging from 0 (no recognition) to 20 (perfect recognition). Demographic and clinical data, and the electrogustometric threshold were recorded in both groups. Metabolic control and degenerative complications were studied in diabetic patients.
RESULTS— The SRS was significantly lower in diabetic patients than in control subjects (12.4 ± 0.5 vs. 15.1 ± 0.5, P &lt; 0.001). By use of univariate and multivariate analyses, this difference could not be explained by individual factors such as age, sex, body mass index, blood pressure, or tobacco or alcohol consumption but was related to diabetes. SRS correlated with EGT (r = 0.70, P &lt; 0.001). In the diabetic group, SRS was associated with age (r = 0.29, P &lt; 0.05), duration of diabetes (r = 0.27, P &lt; 0.05), microalbuminuria (12.2 ± 0.8 vs. 14.4 ± 0.9, P &lt; 0.05), peripheral neuropathy (10.3 ± 1.0 vs. 14.1 ± 0.9, P &lt; 0.01), and EGT (r = 0.39; P &lt; 0.001). By use of multivariate analysis, the strongest association was found with EGT (R2 = 0.15).
CONCLUSIONS— These results suggest that smell recognition is impaired in patients with diabetes mellitus. Smell dysfunction is associated with age and degenerative complications of diabetes, suggesting a degenerative mechanism related to diabetes.