bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vitreous Levels of Vascular Cell Adhesion Molecule and Vascular Endothelial Growth Factor in Patients With Proliferative Diabetic Retinopathy
Authors: Hernández Cristina , Burgos Rosa , Cantón Ana , García-Arumí José , Segura Rosa María , Simó Rafael 
Published: March 2007

OBJECTIVE—To evaluate the intravitreous concentration of vascular cell adhesion molecule (VCAM)-1 in diabetic patients with proliferative diabetic retinopathy (PDR) and the relationship of VCAM-1 with vascular endothelial growth factor (VEGF).
RESEARCH DESIGN AND METHODS—Serum and vitreous fluid samples were obtained simultaneously at the onset of vitrectomy from 20 diabetic patients with PDR and 20 nondiabetic control subjects with nonproliferative ocular disease. Both groups were matched by serum levels of VCAM-1 and VEGF. VCAM-1 and VEGF were determined by enzyme-linked immunosorbent assay. Statistics were determined using the Mann-Whitney U test and Spearman’s rank correlation test.
RESULTS—The intravitreous concentration of VCAM-1 was significantly elevated in diabetic patients with PDR compared with control subjects (26 ng/ml [19–118] vs. 22 ng/ml [20–47], P &lt; 0.05). A direct correlation between VCAM-1 and total vitreous proteins was detected in diabetic patients (r = 0.64, P = 0.003), but not in control subjects. After adjusting for total intravitreous proteins, VCAM-1 was significantly lower in diabetic patients with PDR than in control subjects (8.2 ng/ml [4–31.4] vs. 43.1 ng/ml [9.7–100], P &lt; 0.001). Intravitreous VEGF concentrations were higher in patients with PDR than in control subjects in absolute terms (1.34 ng/ml [0.16–6.22] vs. 0.009 ng/ml [0.009–0.044], P &lt; 0.0001) and after correcting for total vitreal proteins (0.33 ng/ml [0.01–2.3] vs. 0.013 ng/ml [0.003–0.035], P = 0.0001). Finally, the vitreous ratio of VCAM-1 to proteins correlated with the vitreous ratio of VEGF to proteins in both diabetic patients (r = 0.74, P = 0.001) and control subjects (r = 0.84, P = 0.005).
CONCLUSIONS—The low proportion of VCAM-1 in relation to total vitreal proteins observed in diabetic patients with PDR suggests that VCAM-1 is quenched by diabetic retina. In addition, the direct correlation detected between VCAM-1 and VEGF suggests that cellular adhesion and neovascularization may be linked processes.
Sulfonylurea Treatment of Type 2 Diabetic Patients Does Not Reduce the Vasodilator Response to Ischemia
Authors: Spallarossa Paolo , Schiavo Mara , Rossettin Pierfranco , Cordone Stefano , Olivotti Luca , Cordera Renzo , Brunelli Claudio 
Published: March 2007

OBJECTIVE—Sulfonylureas block the activation of vascular potassium-dependent ATP channels and impair the vasodilating response to ischemia in nondiabetic individuals, but it is not known whether this occurs in type 2 diabetic patients under chronic treatment with these drugs. Glimepiride, a new sulfonylurea, apparently has no cardiovascular interactions. The aim of our study was to compare the effect of the widely used compound glibenclamide, the pancreas-specific glimepiride, and diet treatment alone on brachial artery response to acute forearm ischemia.
RESEARCH DESIGN AND METHODS—Brachial artery examination was performed by a high-resolution ultrasound technique on 20 type 2 diabetic patients aged (mean ± SD) 67 ± 2 years and on 18 nondiabetic patients matched for age, hypertension, and dislipidemia. Diabetic subjects underwent three separate evaluations at the end of each 8-week treatment period, during which they received glibenclamide, glimepiride, or diet alone according to crossover design. Scans were obtained before and after 4.5 min of forearm ischemia. Postischemic vasodilation and hyperemia were expressed as percent variations in vessel diameter and blood flow.
RESULTS—Postischemic vasodilation and hyperemia were, respectively, 5.42 ± 0.90 and 331 ± 38% during glibenclamide, 5.46 ± 0.69 and 326 ± 28% during glimepiride, and 5.17 ± 0.64 and 357 ± 35% during diet treatment (NS). These results were similar to those found in the nondiabetic patients (6.44 ± 0.68 and 406 ± 42%, NS).
CONCLUSIONS—In type 2 diabetic patients, the vasodilating response to forearm ischemia was the same whether patients were treated with diet treatment alone or with glibenclamide or glimepiride at blood glucose–lowering equipotent doses.
Diabetes, Impaired Fasting Glucose, and Elevated HbA1c in U.S. Adolescents: The Third National Health and Nutrition Examination Survey
Authors: Fagot-Campagna Anne , Saaddine Jinan B. , Flegal Katherine M. , Beckles Gloria L.A. 
Published: March 2007

OBJECTIVE—Using population-based data, we estimated the prevalence of diabetes, impaired fasting glucose, and elevated HbA1c (&gt;6%) levels in U.S. adolescents.
RESEARCH DESIGN AND METHODS—The Third National Health and Nutrition Examination Survey (1988–1994) examined a representative sample of the U.S. population, which included 2,867 adolescents aged 12–19 years who had serum glucose measured.
RESULTS—A total of 13 adolescents in the sample were considered to have diabetes; 9 reported using insulin, 2 reported using oral agents only, and 2 did not report any treatment but had high glucose levels (≥11.1 mmol/l regardless of length of fast or ≥7.0 mmol/l after an 8-h fast). Four of these cases (31% of the sample with diabetes) were considered to have type 2 diabetes. The estimated prevalence of diabetes (all types) per 100 adolescents ages 12–19 years was 0.41% (95% confidence interval 0–0.86). The prevalence of impaired fasting glucose (≥6.1 mmol/l) among adolescents without diabetes who had fasted for at least 8 h was 1.76% (0.02–3.50). The prevalence of elevated HbA1c (&gt;6%) was 0.39% (0.04–0.74).
CONCLUSIONS—National data reflect the presence of type 2 diabetes in U.S. adolescents, but the survey sample size was not large enough to obtain precise prevalence estimates because of the relatively low prevalence.
Deterioration of the Metabolic Risk Profile in Women
Authors: Pascot Agnés , Després Jean-Pierre , Lemieux Isabelle , Alméras Natalie , Bergeron Jean , Nadeau André , Prud’homme Denis , Tremblay Angelo , Lemieux Simone 
Published: March 2007

OBJECTIVE—To determine whether the impaired glucose tolerance (IGT) state contributes to the deterioration of the metabolic profile in women after taking into account the contribution of visceral adipose tissue (AT) accumulation, as measured by computed tomography.
RESEARCH DESIGN AND METHODS—We studied 203 women with normal glucose tolerance (NGT) and 46 women with IGT, defined as a glycemia between 7.8 and 11.1 mmol/l measured 2 h after a 75-g oral glucose load.
RESULTS—Women with IGT were characterized by a higher visceral AT accumulation and by higher concentrations of fasting plasma glucose, insulin, and C-peptide as well as by higher plasma concentrations of cholesterol, triglycerides, and apolipoprotein B (apoB) and by greater cholesterol–to–HDL-cholesterol ratio, reduced LDL peak particle size, lower HDL-cholesterol and HDL2-cholesterol concentrations, and higher blood pressure (P &lt; 0.01) than women with NGT. When we matched 27 pairs of women for visceral AT and fat mass as well as for menopausal status, differences previously found in LDL-cholesterol, LDL peak particle size, HDL-cholesterol, and HDL2-cholesterol concentrations as well as in the cholesterol–to–HDL-cholesterol ratio and blood pressure were eliminated, whereas triglyceride concentrations remained significantly higher in women with IGT.
CONCLUSIONS—A high visceral AT accumulation is a major factor involved in the deterioration of many metabolic variables in women with IGT, with the notable exception of triglyceride concentrations, which remained significantly different between women with NGT and women with IGT after adjustment for visceral fat.
Glycemic Control Is a Predictor of Survival for Diabetic Patients on Hemodialysis
Authors: Morioka Tomoaki , Emoto Masanori , Tabata Tsutomu , Shoji Tetsuo , Tahara Hideki , Kishimoto Hiroshi , Ishimura Eiji , Nishizawa Yoshiki 
Published: March 2007

OBJECTIVE—To investigate the impact of glycemic control on the survival of diabetic subjects with end-stage renal disease (ESRD) starting hemodialysis treatment.
RESEARCH DESIGN AND METHODS—This single-center prospective observational study enrolled 150 diabetic ESRD subjects (109 men and 41 women; age at hemodialysis initiation, 60.5 ± 10.2 years) at start of hemodialysis between January 1989 and December 1997. The subjects were divided into groups according to their glycemic control level at inclusion as follows: good HbA1c &lt;7.5%, n = 93 (group G), and poor HbA1c ≥7.5%, n = 57 (group P); and survival was followed until December 1999, with a mean follow-up period of 2.7 years.
RESULTS—Group G had better survival than group P (the control group) (P = 0.008). At inclusion, there was no significant difference in age, sex, systolic blood pressure (SBP), BMI, cardio-to-thoracic ratio (CTR) on chest X-ray, and serum creatinine (Cre) or hemoglobin (Hb) levels between the two groups. After adjustment for age and sex, HbA1c was a significant predictor of survival (hazard ratio 1.133 per 1.0% increment of HbA1c, 95% CI 1.028–1.249, P = 0.012), as were Cre and CTR.
CONCLUSIONS—Good glycemic control (HbA1c &lt;7.5%) predicts better survival of diabetic ESRD patients starting hemodialysis treatment.
Diabetes and the Risk of Infection-Related Mortality in the U.S.
Authors: Bertoni Alain G. , Saydah Sharon , Brancati Frederick L. 
Published: March 2007

OBJECTIVE—To determine whether diabetes predicts infection-related mortality and to clarify the extent to which this relationship is mediated by comorbid conditions that may themselves increase risk of infection.
RESEARCH DESIGN AND METHODS—We performed a retrospective cohort study using the Second National Health and Nutrition Examination Survey Mortality Study of 9,208 adults aged 30–74 years in 1976–1980. We defined demographic variables, diabetes, cardiovascular disease (CVD), and smoking by self-report; BMI, blood pressure, and serum cholesterol from baseline examination; and cause-specific mortality from death certificates.
RESULTS—Over 12–16 years of follow-up, 36 infection-related deaths occurred among 533 adults with diabetes vs. 265 deaths in 8,675 adults without diabetes (4.7 vs. 1.5 per 1,000 person-years, P &lt; 0.001). Diabetes (RR 2.0, 95% CI 1.2–3.2) and congestive heart failure (2.8, 1.6–5.1) were independent predictors of infection-related mortality after simultaneous adjustment for age, sex, race, poverty status, smoking, BMI, and hypertension. After subdividing infection-related deaths into those with (n = 145) and without (n = 156) concurrent cardiovascular diagnoses at the time of death, diabetic adults were at risk for infection-related death with CVD (3.0, 1.8–5.0) but not without CVD (1.0, 0.5–2.2).
CONCLUSIONS—These nationally representative data suggest that diabetic adults are at greater risk for infection-related mortality, and the excess risk may be mediated by CVD.
Prevalence of Polycystic Ovary Syndrome Among Premenopausal Women With Type 2 Diabetes
Authors: Peppard Heather R. , Marfori Jennifer , Iuorno Maria J. , Nestler John E. 
Published: March 2007

OBJECTIVE—Women with polycystic ovary syndrome (PCOS) have an increased risk for developing type 2 diabetes. Few studies have assessed women with type 2 diabetes to determine the frequency of PCOS in this population.
RESEARCH DESIGN AND METHODS—To determine the prevalence of PCOS among premenopausal women with type 2 diabetes, we conducted a retrospective cross-sectional prevalence study. We reviewed the medical records of all women seen in the Diabetes Clinic of the Medical College of Virginia Hospitals between January 1995 through February 2000. A diagnosis of PCOS was based on 1) oligomenorrhea, 2) hyperandrogenism (biochemical or clinical), and 3) exclusion of other related disorders.
RESULTS—We reviewed the medical records of 618 women with diabetes and identified 47 women eligible for study. Of the 47 women, 30 consented to an evaluation. Of the 30 women evaluated, 8 were identified as having PCOS (6 women reported a previous PCOS diagnosis and 2 women were newly diagnosed), resulting in a prevalence of 26.7%.
CONCLUSIONS—We concluded that PCOS occurs frequently among premenopausal women with type 2 diabetes.
The Synergistic Effect of Miglitol Plus Metformin Combination Therapy in the Treatment of Type 2 Diabetes
Authors: Chiasson Jean-Louis , Naditch Lisa ,   for the Miglitol Canadian University Investigator Group
Published: March 2007

OBJECTIVE—To investigate the efficacy and safety of miglitol in combination with metformin in improving glycemic control in outpatients in whom type 2 diabetes is insufficiently controlled by diet alone.RESEARCH DESIGN AND METHODS—In this multicenter, double-blind, placebo-controlled study, 324 patients with type 2 diabetes were randomized, after an 8-week placebo run-in period, to treatment with either placebo, miglitol alone, metformin alone, or miglitol plus metformin for 36 weeks. The miglitol was titrated to 100 mg three times a day and metformin was administered at 500 mg three times a day. The primary efficacy criterion was change in HbA1c from baseline to the end of treatment. Secondary parameters included changes in fasting and postprandial plasma glucose and insulin levels, serum triglyceride levels, and responder rate.RESULTS—A total of 318 patients were valid for intent-to-treat analysis. A reduction in mean placebo-subtracted HbA1c of −1.78% was observed with miglitol plus metformin combination therapy, which was significantly different from treatment with metformin alone (−1.25; P = 0.002). Miglitol plus metformin also resulted in better metabolic control than metformin alone for fasting plasma glucose (−44.8 vs. −20.4 mg/dl; P = 0.0025), 2-h postprandial glucose area under the curve (−59.0 vs. –18.0 mg/dl; P = 0.0001), and responder rate (70.6 vs. 45.52%; P = 0.0014). All therapies were well tolerated.CONCLUSIONS—In type 2 diabetic patients, miglitol in combination with metformin gives greater glycemic improvement than metformin monotherapy.
Gestational Diabetes Mellitus Diagnosed With a 2-h 75-g Oral Glucose Tolerance Test and Adverse Pregnancy Outcomes
Authors: Schmidt Maria I. , Duncan Bruce B. , Reichelt Angela J. , Branchtein Leandro , Matos Maria C. , Costa e Forti Adriana , Spichler Ethel R. , Pousada Judith M.D.C. , Teixeira Margareth M. , Yamashita Tsuyoshi ,   For the Brazilian Gestational Diabetes Study Group
Published: March 2007

OBJECTIVE—To evaluate American Diabetes Association (ADA) and World Health Organization (WHO) diagnostic criteria for gestational diabetes mellitus (GDM) against pregnancy outcomes.
RESEARCH DESIGN AND METHODS—This cohort study consecutively enrolled Brazilian adult women attending general prenatal clinics. All women were requested to undertake a standardized 2-h 75-g oral glucose tolerance test (OGTT) between their estimated 24th and 28th gestational weeks and were then followed to delivery. New ADA criteria for GDM require two plasma glucose values ≥5.3 mmol/l (fasting), ≥10 mmol/l (1 h), and ≥8.6 mmol/l (2 h). WHO criteria require a plasma glucose ≥7.0 mmol/l (fasting) or ≥7.8 mmol/l (2 h). Individuals with hyperglycemia indicative of diabetes outside of pregnancy were excluded.
RESULTS—Among the 4,977 women studied, 2.4% (95% CI 2.0–2.9) presented with GDM by ADA criteria and 7.2% (6.5–7.9) by WHO criteria. After adjustment for the effects of age, obesity, and other risk factors, GDM by ADA criteria predicted an increased risk of macrosomia (RR 1.29, 95% CI 0.73–2.18), preeclampsia (2.28, 1.22–4.16), and perinatal death (3.10, 1.42–6.47). Similarly, GDM by WHO criteria predicted increased risk for macrosomia (1.45, 1.06–1.95), preeclampsia (1.94, 1.22–3.03), and perinatal death (1.59, 0.86–2.90). Of women positive by WHO criteria, 260 (73%) were negative by ADA criteria. Conversely, 22 (18%) women positive by ADA criteria were negative by WHO criteria.
CONCLUSIONS—GDM based on a 2-h 75-g OGTT defined by either WHO or ADA criteria predicts adverse pregnancy outcomes.
Relationship Between Ethnicity and Glycemic Control, Lipid Profiles, and Blood Pressure During the First 9 Years of Type 2 Diabetes
Authors: Davis Timothy M. E. , Cull Carole A. , Holman Rury R. ,   for the U.K. Prospective Diabetes Study (UKPDS) Group
Published: March 2007

OBJECTIVE—To assess the relationship among self-reported ethnicity, metabolic control, and blood pressure during treatment of type 2 diabetes.
RESEARCH DESIGN AND METHODS—We studied 2,999 newly diagnosed type 2 diabetic patients recruited to the U.K. Prospective Diabetes Study who were randomized to conventional or intensive glucose control policies if their fasting plasma glucose levels remained &gt;6 mmol/l after a dietary run-in. A total of 2,484 patients (83%) were white Caucasian (WC), 265 patients (9%) were Afro-Caribbean (AC), and 250 patients (8%) were Asian of Indian origin (IA). Variables were assessed at 3, 6, and 9 years.
RESULTS—During the 9-year study period, body weight increased more in WC patients (mean 5.0 kg) than in AC (3.0 kg) and IA (2.5 kg) patients (P &lt; 0.001). After adjusting for age, sex, baseline value, treatment allocation, and change in weight, there were no consistent ethnic differences in mean change in fasting plasma glucose or HbA1c. After adjustment for antihypertensive therapy, increase in systolic blood pressure at 9 years was greatest in AC patients (7 mmHg; P &lt; 0.01 vs. WC patients). Mean diastolic blood pressure, total cholesterol, and LDL cholesterol decreased progressively during the 9 years in each group. In AC patients, the mean increase in HDL cholesterol (0.16 mmol/l) at 3 years, maintained to 9 years, and the mean decrease in plasma triglyceride level (0.4 mmol/l) at 9 years were greater than in WC and IA patients (P &lt; 0.001).
CONCLUSIONS—This study shows important ethnic differences in body weight, lipid profiles, and blood pressure, but not glycemic control, during 9 years after diagnosis of type 2 diabetes. AC patients maintained the most favorable lipid profiles, but hypertension developed in more AC patients than WC or IA patients. Ethnicity-specific glycemic control of type 2 diabetes seems unnecessary, but other risk factors need to be addressed independently.
Randomized Dose Ranging Study of the Reduction of Fasting and Postprandial Glucose in Type 2 Diabetes by Nateglinide (A-4166)
Authors: Gribble Fiona M. , Manley Susan E. , Levy Jonathan C. 
Published: March 2007

OBJECTIVE—This randomized crossover double-blind placebo-controlled study aimed to assess the efficacy of nateglinide (A-4166), a novel phenylalanine-derived insulin secretagogue, in type 2 diabetic subjects while fasting and 5 min before a standard meal.RESEARCH DESIGN AND METHODS—A single dose of nateglinide (60, 120, or 180 mg) or placebo was given to eight diet-treated overnight-fasted type 2 diabetic patients and to seven patients 5 min before a standard breakfast. Plasma glucose, radioimmunoassay insulin, and nateglinide were measured at baseline and for a further 180 min.RESULTS—The time-averaged 180-min postdose mean decrease in fasting plasma glucose concentration was greater after nateglinide (1.8 mmol/l; 95% CI 1.5–2.0) than after placebo (0.7 mmol/l; 95% CI 0.3–1.2) (P &lt; 0.001). Hypoglycemia did not develop in any of the subjects. Insulin concentrations increased 1.5-, 1.8-, and 1.9-fold with the 60-, 120-, and 180-mg doses, respectively (P &lt; 0.001), peaking ∼30 min after the dose. Nateglinide concentrations peaked after ∼30 min, decreasing to 21% of peak by 180 min. In the meal test, the mean increase (2.9 mmol/l, 2.3–3.6) in plasma glucose over 180 min after placebo was reduced by 1.8 mmol/l (P &lt; 0.001) with the two higher doses of nateglinide.CONCLUSIONS—A single dose of nateglinide administered to diet-treated type 2 diabetic patients with fasting hyperglycemia increased insulin secretion and reduced fasting glucose without hypoglycemia. Administered 5 min before a meal, nateglinide reduced the postprandial glucose excursion by 64%. With its rapid onset and short duration of action, nateglinide is a promising oral prandial therapy in type 2 diabetes.
Amniotic Fluid Insulin at 14–20 Weeks’ Gestation
Authors: Carpenter Marshall W. , Canick Jacob A. , Hogan Joseph W. , Shellum Curtis , Somers Margaret , Star Jami A. 
Published: March 2007

OBJECTIVE—To examine the hypothesis that early second trimester amniotic fluid (AF) insulin concentration is elevated and later fetal growth is augmented in gravidas demonstrating later oral glucose intolerance.
RESEARCH DESIGN AND METHODS—In this prospective observational cohort study, AF was sampled at 14–20 weeks’ gestation in 247 subjects, and 1-h 50-g oral glucose challenge tests (GCTs) were performed at ≥24 weeks. AF insulin was assayed by an automated immuno-chemiluminometric assay (8). Macrosomia was defined as birth weight above the 90th centile.
RESULTS—AF insulin concentration (range 1.4–44.5 pmol/l) correlated positively with gestational age and maternal weight. A logistic regression analysis, adjusted for maternal age and midpregnancy weight, showed increased AF insulin multiples of gestational age-specific medians to be associated with subsequently diagnosed gestational diabetes mellitus (GDM) (OR 1.9, CI 1.3–2.4, P = 0.029). Among 60 subjects with GCT values &gt;7.2 mmol/l, each unit increase in AF insulin multiple of median (MOM) was associated with a threefold increase in fetal macrosomia incidence (3.1, 1.3–4.9, P = 0.048).
CONCLUSIONS—An elevated AF insulin concentration at 14–20 weeks’ gestation is associated with subsequently documented maternal glucose intolerance. Among gravidas with GCT values &gt;7.2 mmol/l, elevated early AF insulin concentration is associated with fetal macrosomia. Maternal glucose intolerance may affect fetal insulin production before 20 weeks’ gestation.
Plantar Tissue Thickness Is Related to Peak Plantar Pressure in the High-Risk Diabetic Foot
Authors: Abouaesha Frag , van Schie Carine H.M. , Griffths Gareth D. , Young Robert J. , Boulton Andrew J.M. 
Published: March 2007

OBJECTIVE—To investigate the relationship among plantar foot pressure, plantar subcutaneous tissue thickness, severity of neuropathy (vibration perception threshold [VPT]), callus, and BMI in a large group of neuropathic diabetic patients at risk of foot ulceration.RESEARCH DESIGN AND METHODS—A total of 157 diabetic neuropathic patients (VPT &gt;25 V) without either peripheral vascular or ulcer history were studied. Plantar foot pressure and plantar tissue thickness were measured at each metatarsal head (MTH) using an optical pedobarograph and an ultrasound scanning platform, respectively.RESULTS—A significant association was observed between peak plantar pressure and plantar tissue thickness at all MTHs (−0.26 &lt; r &lt; −0.61, P &lt; 0.0001), with the least pronounced association at the first MTH. In addition, the pressure time integral was significantly associated with plantar tissue thickness (−0.24 &lt; r &lt; −0.57, P &lt; 0.0001). BMI was significantly related to plantar tissue thickness (0.18 &lt; r &lt; 0.45, P &lt; 0.05), but not to peak forefoot pressures. Subjects with callus had significantly reduced plantar tissue thickness at all MTHs except the first MTH and increased peak pressures at all MTHs (P &lt; 0.001).CONCLUSIONS—This study confirms a strong inverse relationship between plantar tissue thickness and dynamic foot pressure measurements. Long-term follow-up of this patient population will confirm whether reduced plantar tissue thickness predicts the development of diabetic foot ulcers.