bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differing Effects of Pancreas-kidney Transplantation With Systemic Versus Portal Venous Drainage on Cholesteryl Ester Transfer in IDDM Subjects
Authors: Bagdade John D , Ritter Mary C , Kitabchi Abbas E , Huss Emer , Thistlethwaite Richard , Gaber Osama , Lambeth Helen 
Published: March 2007

OBJECTIVE
Cholesteryl ester transfer (CET) is accelerated in patients with IDDM treated with conventional (subcutaneous) insulin therapy (CIT) and a number of other disorders associated with premature cardiovascular disease. We have shown that in IDDM this disturbance is closely linked to iatrogenic hyperinsulinemia (HI), because it was reversed when insulin was administered by the intraportal (IP) route. In this study, we sought to determine whether HI after successful pancreas-kidney transplantation (PKT) has the same adverse effect on CET.

RESEARCH DESIGN AND METHODS
CET was measured by both mass and isotopic assays and compared in two groups of euglycemic non-insulin-requiring IDDM PKT patients with either systemically draining allografts and persistent HI or grafts with portal vein anastomoses that were normoinsulinemic (PK-P). A third group of eight nondiabetic kidney transplant (KT) patients receiving the same immunosuppressive drugs served as control subjects.

RESULTS
CET in pancreas-kidney transplantation subjects with systemic venous drainage (PK-S) was increased (P &lt; 0.001) to the same level we have reported previously in IDDM patients receiving CIT and was significantly higher (P &lt; 0.001) than in those subjects with PK-P. CET in the PK-P group did not differ from that of the KT control patients.

CONCLUSIONS
CET is affected by variations in systemic insulin levels in pancreas transplant patients with allografts that have differing venous drainage. Because high systemic insulin levels are linked to the activation of (ET, euglycemic HI IDDM pancreas allograft recipients may continue to be at high risk for macrovascular complications.
A Prospective Analysis of the HOMA Model: The Mexico City Diabetes Study
Authors: Haffner Steven M , Gonzalez Clicerio , Miettinen Heikki , Kennedy Esmarie , Stern Michael P 
Published: March 2007

OBJECTIVE
Both insulin resistance (IR) and decreased insulin secretion have been shown to predict the development of NIDDM. However, methods to assess insulin sensitivity and secretion are complicated and expensive to apply in epidemiological studies. The homeostasis model assessment (HOMA) has been suggested as a method to assess IR and secretion from the fasting glucose and insulin concentrations.

RESEARCH DESIGN AND METHODS
We applied the HOMA model in the 3.5-year follow-up of the Mexico City Diabetes Study.

RESULTS
Out of 1,449 subjects, 97 developed diabetes. When modeled separately insulin resistance but not insulin secretion predicted NIDDM. However, when both variables were entered into the same regression model, both increased IR and decreased β-cell function significantly predicted NIDDM.

CONCLUSIONS
We conclude that the HOMA provides a useful model to assess ²-cell function in epidemiological studies and that it is important to take into account the degree of IR in assessing insulin secretion.
Metformin's Effects on Glucose and Lipid Metabolism in Patients with Secondary Failure to Sulfonylureas
Authors: Fanghänel Guillermo , Sánchez-Reyes Leticia , Trujillo Cesar , Sotres David , Espinosa-Campos Jorge 
Published: March 2007

OBJECTIVE
To compare results obtained with metformin versus those obtained with DNA-recombinant insulin in obese patients with NIDDM suffering from secondary failure to sulfonylureas.

RESEARCH DESIGN AND METHODS
We conducted an open, prospective, randomized, and comparative study comprising a total of 60 patients selected and placed in two parallel groups. We had previously confirmed that the subjects had secondary failure to high doses of sulfonylureas. The initial metformin dosage was a single 850 mg tablet, and the dosage was increased to two or three tablets depending on the patient's metabolic changes. The initial dosage of DNA-recombinant insulin was 24 U, subcutaneously administered and divided into two portions: two-thirds at around 8:00 A.M., before breakfast, and the remaining third at 8:00 P.M., before dinner. The dosage was adjusted based on the patient's clinical and metabolic response.

RESULTS
The initial average glucose value for the metformin group was 269.1 ± 32.2 mg/dl, decreasing by the end of the study to 159.7 ± 30.5 mg/dl. For the insulin group, these figures went from 270.7 ± 24.0 mg/dl at the beginning of the study to 134.8 ± 26.7 mg/dl. This decrease correlates with the reduction in glycosylated hemoglobin from 12.8 to 8.9% for the first group and from 12.3 to 8.2% for the second, as well as with the reduction in triglyceride values from 230.3 to 183.1 mg/dl and from 218.4 to 186.3 mg/dl, respectively. The BMI (27.5–26.4), blood pressure (systolic from 145.7–132.1 mmHg, diastolic from 90.3–84.8 mmHg), and total cholesterol levels (235–202 mg/dl) decreased in only the metformin group.

CONCLUSIONS
Metformin is an effective, safe, and well-tolerated treatment that improves metabolic control and favorably modifies secondary clinical alterations due to insulin resistance, such as arterial hypertension, overweight, and hyperlipidemia, in obese patients with NIDDM suffering from secondary failure to sulfonylureas.
Long-Term Effects of Fish Oil on Insulin Resistance and Plasma Lipoproteins in NIDDM Patients With Hypertriglyceridemia
Authors: Rivellese Angela A , Maffettone Ada , Iovine Ciro , Di Marino Lucrezia , Annuzzi Giovanni , Mancini Mario , Riccardi Gabriele 
Published: March 2007

OBJECTIVE
The aim of this study was to evaluate the long-term (6-month) effects of moderate fish oil supplementation on insulin sensitivity and plasma lipoproteins in NIDDM patients with hypertriglyceridemia.

RESEARCH DESIGN AND METHODS
The study has been performed according to a randomized double-blind placebo-controlled design with a parallel group sequence. After a washout period of 4 weeks and a run-in period of 3 weeks, 16 NIDDM patients with hypertriglyceridemia (triglyceride [TG], 2.25–5.65 mmol/l) were randomly assigned to either fish oil (2.7 g/day eicosapentaenoic plus docosahexaenoic acid for 2 months, then 1.7 g/day for 4 more months) (n = 8) or placebo (n = 8). Diet and hypoglycemic drugs remained unchanged throughout the whole experiment. At baseline and after 6 months, insulin sensitivity was measured by euglycemic hyperinsulinemic clamp (insulin infused, 2.0 mIU · kg−1 body wt · min−1). At the same time, blood glucose control, fasting and postprandial serum insulin and nonesterified fatty acid (NEFA) concentrations, and fasting plasma lipoprotein concentrations were evaluated.

RESULTS
In the group treated with ffish oil compared with the baseline, there was: 1) a significant reduction in both plasma TG (2.92 ± 0.23 vs. 3.85 ± 0.32 [mean ± SE] mmol/l, P &lt; 0.001) and VLDL-TG (2.35 ± 0.24 vs. 4.25 ± 0.66 mmol/l, P &lt; 0.01), without significant changes in blood glucose control; 2) a significant reduction in fasting NEFA concentrations (572 ± 100 vs. 825 ± 131 μmol/l, P &lt; 0.01); and 3) a significant enrichment in long-chain ω-3 fatty acids of erythrocyte membrane phospholipids. In the placebo group, there were no changes in any of the variables analyzed. The insulin-mediated glucose uptake was unchanged in both groups (fish oil, 4.04 ± 0.82 mg · kg−1 · min−1 at baseline and 3.96 ± 0.50 mg · kg−1 · min−1 at 6 months; placebo, 3.51 ± 0.62 mg · kg−1 · min−1 at baseline and 4.09 ± 0.49 mg · kg−1 · min−1 at 6 months).

CONCLUSIONS
In NIDDM patients with hypertriglyceridemia, moderate amounts of fish oil induce a long-term significant reduction in plasma triglycerides, VLDL triglycerides, and NEFA and a significant enrichment in the erythrocyte phospholipid content of long-chain ω-3 fatty acids, without deteriorating blood glucose control. However, this amount of ω-3 fatty acids was unable to improve insulin sensitivity in this group of patients.
Fish Oil in Diabetic Nephropathy
Authors: Rossing Peter , Hansen Birgitte V , Nielsen Flemming S , Myrup Bjarne , Hølmer Gunhild , Parving Hans-Henrik 
Published: March 2007

OBJECTIVE
Recent studies in nondiabetic kidney diseases suggest that dietary supplementation with n-3 polyunsaturated fatty acids (fish oil) may have beneficial effects on albuminuria, kidney function, arterial blood pressure, and dyslipidemia. Therefore, we evaluated the long-term effect of fish oil in diabetic nephropathy.

RESEARCH DESIGN AND METHODS
A 1-year double-blind randomized controlled study comparing fish oil (4.6 g n-3 fatty acids/day) with placebo (olive oil) was performed in an outpatient clinic in a tertiary referral center. Thirty-six normotensive IDDM patients with diabetic nephropathy were included; 18 were treated with fish oil. Seven patients dropped out (four received fish oil), and results for the remaining 29 are presented. Albuminuria (enzyme immunoassay), glomerular filtration rate (51Cr-labeled EDTA plasma clearance), 24-h ambulatory blood pressure, and lipid profile were determined every 6 months.

RESULTS
Albuminuria increased by 22% (1–46%) (mean [95% CI]) in the fish oil group vs. 15% (−11–49%) in the placebo group (NS). Glomerular filtration rate decreased from 116 ± 7 to 105 ± 7 ml · min−1 · 1.73 m−2 (mean ± SE) vs. from 108 ± 6 to 103 ± 7, fish oil and placebo, respectively (NS). No significant changes occurred in 24-h ambulatory blood pressure: from 141 ± 4/82 ± 2 mmHg to 142 ± 5/83 ± 2 vs. from 140 ± 4/78 ± 2 to 144 ± 4/80 ± 3, fish oil and placebo, respectively (NS). In the fish oil group, serum triglycerides (median [range]) decreased from 0.97 (0.5–4.0) mmol/l to 0.8 (0.4–3.0) vs. from 1.01 (0.4–2.0) to 1.09 (0.4–2.0) in the placebo group (P &lt; 0.05) and VLDL cholesterol decreased from 0.45 (0.23–1.88) to 0.37 (0.21–1.43) mmol/l vs. from 0.44 (0.21–0.94) to 0.41 (0.17–1.94) (P &lt; 0.05), but total and LDL cholesterol rose in the fish oil compared with the placebo group.

CONCLUSIONS
Our study does not suggest that fish oil has beneficial effects on albuminuria, kidney function, blood pressure, and dyslipidemia in normotensive IDDM patients suffering from diabetic nephropathy.
Metabolic Effects of Dietary Sucrose and Fructose in Type II Diabetic Subjects
Authors: Malerbi Domingos A , Paiva Ellen Simone A , Duarte Ana Lucia , Wajchenberg Bernardo L 
Published: March 2007

OBJECTIVE
To investigate the metabolic effects of dietary fructose and sucrose in type II diabetic patients.

RESEARCH DESIGN AND METHODS
Sixteen well-controlled type II diabetic subjects were fed three isocaloric diets for 28 days each. The three diets provided 50–55, 15, and 30–35% of total energy from carbohydrate, protein, and fat, respectively. In one diet, 20% of total calories were derived from fructose; in another, 19% of total calories were derived from sucrose; and in the control diet, only 5% of daily calories were derived from sugars, all other carbohydrates being supplied as polysaccharides.

RESULTS
No significant differences were observed between either the fructose or the sucrose diet and the control polysaccharide diet in any of the measures of glycemic control, serum lipid levels, or insulin and C-peptide secretion.

CONCLUSIONS
Our data suggest that in the short and middle terms, high fructose and sucrose diets do not adversely affect glycemia, lipemia, or insulin and C-peptide secretion in well-controlled type II diabetic subjects.
Adjunctive Systemic Hyperbaric Oxygen Therapy in Treatment of Severe Prevalently Ischemic Diabetic Foot Ulcer: A randomized study
Authors: Faglia Ezio , Favales Favales , Aldeghi Aldeghi , Calia Patrizia , Quarantiello Antonella , Oriani Giorgio , Michael Michael , Campagnoli Pietro , Morabito Alberto 
Published: March 2007

OBJECTIVE
To evaluate the effectiveness of systemic hyperbaric oxygen therapy (s HBOT) in addition to a comprehensive protocol in decreasing major amputation rate in diabetic patients hospitalized for severe foot ulcer.

RESEARCH DESIGN AND METHODS
From August 1993 to August 1995, 70 diabetic subjects were consecutively admitted into our diabetologic unit for foot ulcers. All the subjects underwent our diagnostic-therapeutic protocol and were randomized to undergo s-HBOT. Two subjects, one in the arm of the treated group and one in the arm of nontreated group, did not complete the protocol and were therefore excluded from the analysis of the results. Finally, 35 subjects received s-HBOT and another 33 did not.

RESULTS
Of the treated group (mean session = 38.8 ± 8), three subjects (8.6%) underwent major amputation: two below the knee and one above the knee. In the nontreated group, 11 subjects (33.3%) underwent major amputation: 7 below the knee and 4 above the knee. The difference is statistically significant (P = 0.016). The relative risk for the treated group was 0.26 (95% CI 0.08–0.84). The transcutaneous oxygen tension measured on the dorsum of the foot significantly increased in subjects treated with hyperbaric oxygen therapy: 14.0 ± 11.8 mmHg in treated group, 5.0 ± 5.4 mmHg in nontreated group (P = 0.0002). Multivariate analysis of major amputation on all the considered variables confirmed the protective role of s-HBOT (odds ratio 0.084, P = 0.033, 95% CI 0.008–0.821) and indicated as negative prognostic determinants low ankle-brachial index values (odds ratio 1.715, P = 0.013, 95% CI 1.121–2.626) and high Wagner grade (odds ratio 11.199, P = 0.022, 95% CI 1.406–89.146).

CONCLUSIONS
s-HBOT, in conjunction with an aggressive multidisciplinary therapeutic protocol, is effective in decreasing major amputations in diabetic patients with severe prevalently ischemic foot ulcers.
Increased Plasma Apolipoprotein(a) Levels in IDDM Patients With Diabetic Nephropathy
Authors: Tarnow Lise , Rossing Peter , Nielsen Flemming S , Hansen Birgitte V , Dyerberg Jørn , Parving Hans-Henrik 
Published: March 2007

OBJECTIVE
The relative mortality from cardiovascular disease (CVD) is increased 40-fold in IDDM patients suffering from diabetic nephropathy as compared with nondiabetic subjects on average. We assessed the potential contribution of dyslipidemia in general and elevated serum apolipoprotein (a) [apo(a)] in particular to CVD in nephropathic patients with IDDM.

RESEARCH DESIGN AND METHODS
We investigated 199 IDDM patients with diabetic nephropathy and 192 normoalbuminuric IDDM patients matched for sex, age, diabetes duration, and BMI.

RESULTS
The prevalence of CVD was 30 and 12% in patients with and without nephropathy, respectively (P &lt; 0.001). The level of apo(a) was significantly higher in patients with nephropathy, 189 (20–2,350) U/l as compared with the normoalbuminuric group, 103 (20–1,940) U/l (P &lt; 0.005). The prevalence of plasma apo(a) &gt; 300 U/l (at-risk level for cardiovascular pathogenicity) was 38% (31–45) vs. 22% (16–28) in patients with and without nephropathy, respectively (P &lt; 0.0005). In nephropathic patients, the prevalence of plasma apo(a) &gt; 300 U/l was raised in patients with CVD (48%, 36–61%) as compared with patients without (34%, 26–42%) (P = 0.05). Furthermore, the serum concentrations of the following apolipoproteins and lipids were higher in patients with nephropathy as compared with normoalbuminuric patients: apoB 1.33 ± 0.37 vs. 1.06 ± 0.26 g/l; total cholesterol 5.6 ± 1.2 vs. 4.8 ± 0.9 mmol/l; and triglycerides 1.22 (0.31–9.87) vs. 0.77 (0.28–3.05) mmol/l, P &lt; 0.0001. Multiple logistic regression analysis of cardiovascular risk factors revealed that plasma apo(a) concentration &gt; 300 U/l is an independent risk factor for coronary heart disease, odds ratio 1.86 (1.03–3.36) (P &lt; 0.05).

CONCLUSIONS
Dyslipidemia and raised plasma concentrations of apo(a), particularly &gt; 300 U/l, may contribute to the enhanced morbidity and mortality from CVD characteristically observed in IDDM patients with diabetic nephropathy.
Accuracy of home blood glucose meters during hypoglycemia
Authors: Trajanoski Z , Brunner GA , Gfrerer RJ , Wach P , Pieber TR 
Published: March 2007

OBJECTIVE
To evaluate the accuracy of home blood glucose meters during hypoglycemia.

METHODS
Six blood glucose meters—One Touch II (LifeScan, Milpitas, CA), Companion II (Medisense, Cambridge, U.K.), Reflolux (Boehringer Mannheim, Mannheim, Germany), Accutrend (Boehringer Mannheim), Elite (Bayer, Munich, Germany), and HemoCue (HemoCue, Ängelholm, Sweden)—were compared with a reference method (Beckman Glucose Analyzer 2). Glucose concentrations from arterialized venous blood samples were measured using all glucose meters (whole blood) and the reference method (plasma) during hypoglycemic-hyperinsulinemic clamps in 15 subjects.

RESULTS
In total, 663 blood glucose monitor readings and 119 reference values ranging from 2.28 to 3.89 mmol/l were analyzed. The correlation coefficients and the percentage of measurements within 20% and outside 40% of the reference values for each glucose meter were as follows: One Touch II: 0.91, 99.2% and 0%; Companion II: 0.81, 88.2% and 2.5%; Reflolux: 0.78, 85.0% and 0.9%; Accutrend: 0.88, 46.0% and 6.6%; Elite: 0.78, 75.6% and 4.2%; and HemoCue: 0.93, 96.6% and 0% (P &lt; 0.001).

CONCLUSIONS
There were substantial differences between the blood glucose meters during hypoglycemia, and none of the devices met the latest criteria recommended by the American Diabetes Association.
Comparison of LysB28, ProB29-Human Insulin Analog and Regular Human Insulin in the Correction of Incidental Hyperglycemia
Authors: Holleman Frits , Van Den Brand Joop JG , Hoven Roland ARA , Van Der Linden Jos M , Van Der Tweel Ingeborg , Hoekstra Joost B L , Erkelens D Willem 
Published: March 2007

OBJECTIVE
To obtain clinically applicable data on the effects of regular human insulin and the LysB28, ProB29-human insulin analogue (lispro) on the correction of incidental hyperglycemia.

RESEARCH DESIGN AND METHODS
The insulins were compared in a non-clamped randomized crossover study of 27 male IDDM patients. Hyperglycemia was induced by the withdrawal of the normal evening dose of insulin; the next morning patients fasted and received a single dose of study insulin according to a dosing nomogram. Blood glucose concentration and GR (a measure of glucose corrected for differences in administered insulin dose: GR = glucose concentration × BMI × insulin dose−1) were followed for 4 h.

RESULTS
The time courses of blood glucose concentration and GR were significantly different after regular insulin in comparison with lispro (multiple analysis of variance, P &lt; 0.001). At t = 120 min, glucose concentrations had decreased 1.4 mmol/l more with lispro than with regular insulin (95% confidence interval [CI] 0.6–2.3, P = 0.002). Similarly, GR had decreased 4.4 mol · kg · IU−1 · m−5 more with lispro than with regular insulin (95% CI 2.6–6.2, P &lt; 0.001). The overall difference in glucose values was 0.87 mmol/l (lispro &lt; regular insulin, P = 0.036), and the overall difference in GR values was 1.96 mol · kg · IU−1 · m−5 (lispro &lt; regular insulin, P = NS). Unexpectedly, the intrinsic variability of GR was higher for lispro than for regular insulin.

CONCLUSIONS
The more rapid action of lispro is an advantage in the correction of hyperglycemia, even though actual differences in glucose concentrations are smaller than suggested by previous clamped studies.
Influence of Simulated Altitude on the Performance of Five Blood Glucose Meters
Authors: Gautier Jean-Francois , Bigard Andre Xavier , Douce Philippe , Duvallet Alain , Cathelineau Gerard 
Published: March 2007

OBJECTIVE
To determine the reliability of five blood glucose meters (BGMs) at various simulated altitudes using a hypobaric chamber.

RESEARCH DESIGN AND METHODS
Blood glucose levels (ranged from 1.5 to 26.3 mmol/l, according to the reference method) were measured in 18 venous blood samples by each BGM at 200, 1,000, and every 500 m up to 4,000 m in a hypobaric chamber, where temperature and humidity were held constant.

RESULTS
Four BGMs underestimated and one overestimated blood glucose concentration while barometric pressure decreased. The average percent error varied in relation to simulated altitude from 0.26 ± 4.8% (SD) at 200 m to −28.9 ± 4.5% at 4,000 m (Glucometer 3; P &lt; 0.05), from 28.4 ± 5.7 to 49.3 ± 5.9% (Accu-Chek Easy; P &lt; 0.05), from −10.5 ± 2.6 to 19.8 ± 4.3% (Tracer, P &lt; 0.05), from −5.5 ± 2.6 to −11.2 ± 3.0% (Reflolux; NS), and from 17.8 ± 4.3 to 14.8 ± 3.6% (One Touch; NS). The most accurate seemed to be the Reflolux, except for high blood glucose levels at simulated high altitudes. The One Touch II showed a good agreement, whatever the barometric pressure and the range of blood glucose concentrations. The highest underestimation was seen with the Glucometer 3.

CONCLUSIONS
Except for the Accu-Chek Easy, low barometric pressure underestimated the BGM results in comparison with measurements taken at simulated low altitudes. The lack of accuracy and consistency of performance &gt; 2,000 m should be known by diabetic patients practicing sports activities, such as trekking or skiing at high altitudes.
Influence of Intensive Diabetes Treatment on Quality-of-Life Outcomes in the Diabetes Control and Complications Trial
Authors:   The Diabetes Control and Complications Trial Research Group
Published: March 2007

OBJECTIVE
To evaluate the effect of intensive diabetes treatment on patient quality of life assessed by the Diabetes Quality-of-Life Measure, the Symptom Checklist-90R, the Medical Outcome Study 36-Item Short Form Survey, and intercurrent psychosocial events in the Diabetes Control and Complications Trial (DCCT).

RESEARCH DESIGN AND METHODS
The DCCT was a 29-center prospective controlled clinical trial that demonstrated the beneficial effect of intensive diabetes treatment on retinopathy, nephropathy, and neuropathy. The 1,441 volunteers with IDDM, aged 13–39 years, were randomly assigned to intensive or conventional diabetes therapy. The volunteers were followed for a mean of 6.5 years (range 3–9 years). Quality-of-life data were collected during annual visits. Of the volunteers, 99% completed the study, and &gt;95% of scheduled tests were completed.

RESULTS
All analyses of quality of life, psychiatric symptom indexes, and psychosocial event data showed no differences between intensive and conventional diabetes treatment.

CONCLUSION
Under careful treatment conditions, such as those followed in the DCCT, patients undergoing intensive diabetes treatment do not face deterioration in the quality of their lives, even while the rigor of their diabetes care is increased.