bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meta-Analysis of the Effect of Insulin Lispro on Severe Hypoglycemia in Patients With Type 1 Diabetes
Authors: Brunelle Rocco L , Llewelyn Julie , Anderson James H , Gale Edwin A M , Koivisto Veikko A 
Published: March 2007

OBJECTIVE
A precise time-action profile of insulin lispro (Humalog) at mealtime may reduce the incidence of severe hypoglycemia. Because it is a rare complication, we performed a cumulative meta-analysis to compare the frequency of severe hypoglycemia during insulin lispro and human regular insulin therapy in type 1 diabetic patients.

RESEARCH DESIGN AND METHODS
The analysis included eight large multicenter clinical trials, three with parallel and five with crossover designs. The studies included 2,576 type 1 diabetic patients in total, with 2,327 receiving insulin lispro and 2,339 receiving regular human insulin, representing &gt;1,400 patient-years of insulin therapy. Severe hypoglycemia was defined as coma or requiring glucagon or intravenous glucose. The patients received either NPH or ultralente as their basal insulin and insulin lispro or regular human insulin before each meal.

RESULTS
Seventy-two patients (3.1%) had a total of 102 severe hypoglycemic episodes during insulin lispro therapy, compared with 102 patients (4.4%) with a total of 131 episodes during regular human insulin therapy (P = 0.024).

CONCLUSIONS
The results of this meta-analysis demonstrate that in type 1 diabetic patients, the frequency of severe hypoglycemia can be reduced by taking insulin lispro as compared with regular human insulin therapy.
Differential Glucose Tolerance in Dipper and Nondipper Essential Hypertension: The implications of circadian blood pressure regulation on glucose tolerance in hypertension
Authors: Chen Jaw-Wen , Jen Shu-Long , Lee Wen-Lieng , Hsu Nai-Wei , Lin Shing-Jong , Ting Chih-Tai , Chang Mau-Song , Wang Ping H 
Published: March 2007

OBJECTIVE
The goals of this study were to compare glucose tolerance in dipper and nondipper hypertensive patients and to explore the cause of glucose intolerance in essential hypertension.

RESEARCH DESIGN AND METHODS
A total of 50 patients &lt;45 years old who had essential hypertension were recruited and studied by 24-h blood pressure monitoring and an oral glucose tolerance test (OGTT). Autonomic function was assessed with spectral analysis of heart rate variability.

RESULTS
Dipper hypertensive patients (n = 25) had lower nocturnal blood pressure than nondipper (n = 25) patients. During OGTT, postprandial glucose levels were higher in the nondippers at 0,90, and 120 min (all P &lt; 0.05). Nondippers had a higher fasting insulin/glucose ratio than was apparent in normal control subjects. Despite higher postprandial glucose levels, nondippers had lower postprandial insulin levels. These results suggest that nondippers were insulin resistant and that their pancreatic β-cell function was impaired. For all patients, nocturnal reduction of blood pressure was inversely related to total glucose levels under the OGTT curve and was positively related to postprandial insulin levels. Daytime heart rate did not differ between the dippers and nondippers, but nocturnal heart rate was higher in the nondippers, suggesting that nocturnal sympathetic activities were higher among the nondippers. Spectral analysis of heart rate variability suggests that the nondippers had lower parasympathetic activities and unbalanced sympathetic/parasympathetic outflow.

CONCLUSIONS
These findings indicate that nondipper hypertensive patients are more glucose intolerant than are dipper patients. The abnormalities of glucose metabolism in nondippers could be explained by insulin resistance and β-cell dysfunction. The results of spectral analysis suggest that abnormal autonomic outflow may represent a possible link between hypertension and associated metabolic dysfunction.
Genes Versus Environment: The relationship between dietary fat and total and central abdominal fat
Authors: Samaras Katherine , Kelly Paul J , Chiano Mathias N , Arden Nigel , Spector Timothy D , Campbell Lesley V 
Published: March 2007

OBJECTIVE
The influence of diet on body fat has not been quantified independently of genetic influences, although both are held to contribute to regulation of body fat stores. This study examined 1) the relationship between recent diet and total body and central abdominal fat inmiddle-aged female twins independent of genetic and important environmental factors and 2) evidence of interaction between diet and genetic predisposition

RESEARCH DESIGN AND METHODS
Measurements in 436 healthy female twins (aged 58 ± 10 years) included dietary intake by food frequency questionnaire (validated against a 7-day food diary, n = 162), BM1, total body and central abdominal fat by dual-energy X-ray absorptiometry and environmental covariates (smoking habit, hormone replacement, and physical activity) by standardized questionnaire. Dietary energy underreporters were excluded.

RESULTS
Intake of dietary fat (total and subtype) and carbohydrates was not related to BM1 or to total or central fat, confirmed in quintile analysis. With genetic and environmental factors controlled in 90 monozygotic pairs, differences in the intake of energy, fat, or protein were not related to intrapair differences in total and central body fat. However, a minor inverse relationship between carbohydrate intake and total adiposity was confirmed (r = −0.25, P = 0.02). In paired analyses, the twin with the higher intake of total sugars had significantly lower total body and central abdominal adiposity. There was no evidence of a gene-environment interaction between intake of fat or carbohydrates contributing to greater body fat mass in subjects genetically predisposed to obesity.

CONCLUSIONS
Using validated dietary measures and direct measures of body fat and excluding underreporters, no relationship between dietary fat and body fat was found in middle-aged women, particularly after controlling for genetic and some environmental factors. The role of dietary factors in determining total body and central abdominal fat appears to have been overestimated in past cross-sectional studies
Randomized Study of Two Different Target Levels of Glycemic Control Within the Acceptable Range in Type 2 Diabetes: Effects on well-being at 1 year
Authors: Does Ferdinand E E Van Der , Neeling J Nico D De , Snoek Frank J , Grootenhuis Peter A , Kostense Pieter J , Bouter Lex M , Heine Robert J 
Published: March 2007

OBJECTIVE
A randomized trial with 1-year follow-up was conducted in 23 general practices to study the relationship between target values for glycemic control and well-being in type 2 diabetes

RESEARCH DESIGN AND METHODS
A total of 176 patients with type 2 diabetes, aged 40–75 years, were included. General practitioners were encouraged to make decisions according to a standardized step-up regimen until the target levelof glycemic control was reached. The random allocation to a strict or a less strict target level of glycemic control (fasting capillary glucose &lt;6.5 or &lt;8.5 mmol/;1), change in HbAlc and fasting glucose, and initiating insulin or treatment with oral hypoglycemic agents were studied as putative determinants of scores on a type 2 diabetes symptom checklist, a profile ofmood states, an affect balance scale, and general well-being. Adjustments were made for baseline scores on the outcome at issue.

RESULTS
Positive affect (an odds ratio [OR] [95% CI] of 0.39 [0.19–0.83]) and perceived treatment burden (OR 0.48[0.23–0.98]) were unfavorably altered in the group randomly allocated to stricter target levels (fasting capillary glucose &lt;6.5 mmol/l). Patients who had a decrease in HbA1c of 1% or more tended to have comparatively favorable mood (OR displeasure score 0.35 [0.13–0.94]) and general well-being scores at 1 year (ORs of having unfavorable scores ranged from 0.4 to 0.5, NS).

CONCLUSIONS
Perceived treatment burden and positive effect are unfavorably affected by random allocation to a strict target level for glycemic control. Improved glycemic control is associated with favorable mood and possibly general well-being in type 2 diabetes.
Multiple Metabolic Syndrome Is Associated With Lower Heart Rate Variability: The Atherosclerosis Risk in Communities Study
Authors: Liao Duanping , Sloan Richard P , Cascio Wayne E , Folsom Aaron R , Liese Angela D , Evans Gregory W , Cai Jianwen , Sharrett A Richey 
Published: March 2007

OBJECTIVE
To test at the population level whether people with multiple metabolic syndrome (MMS) disorders have reduced cardiac autonomic activity (CAA).

RESEARCH DESIGN AND METHODS
We examined the association between the level of CAA and MMS disorders, at the degree of clustering and the segregate combination levels, using a random sample of 2,359 men and women aged 45–64 years from the biracial, population-based Atherosclerosis Risk in Communities (AR1C) Study. Supine resting 2-min beat-to-beat heart rate data were collected. High-frequency (HF) (0.15–0.35 Hz) and low-frequency (LF) (0.025–0.15 Hz) spectral powers, the ratio of LF to HF, and the SD of all normal R-R intervals (SDNN) were used as the conventional indices of heart rate variability (HRV) to measure CAA. The MMS disorders included hypertension, type 2 diabetes, and dyslipidemia.

RESULTS
HRV indices were significantly lower in individuals with MMS disorders. The multivariable adjusted mean HF was 0.85 (beat/min)2 in subjects with all three MMS disorders, in contrast to 1.31 beat/min)2 in subjects without any MMS disorder. At the segregated combination level, the multivariable adjusted means ± SEM of HF were 1.34 ± 0.05, 1.16 ± 0.05, 1.01 ± 0.17, and 1.34 ± 0.05 (beat/min)2, respectively, for subjects without any MMS disorder, with hypertension only, with diabetes only, and with dyslipidemia only, and the means ± SEM of HF were 0.93 ± 0.04,0.70 ± 0.15, and 1.20 ± 0.05 eat/min)2, respectively, for subjects with diabetes and hypertension, diabetes and dyslipidemia, and hypertension and dyslipidemia. An increase in fasting insulin of 1 SD was associated with 88% higher odds of having a lower HF The pattern of associations was similar for LF and SDNN.

CONCLUSIONS
These findings suggest that MMS disorders adversely affect cardiac autonomic control and a reduced cardiac autonomic control may contribute to the increased risk of subsequent cardiovascular events in individuals who exhibit MMS disorders.
Slicing the Pie: Correlating HbA1c values with average blood glucose values in a pie chart form
Authors: Brewer Karl W , Chase H Peter , Owen Susie , Garg Satish K 
Published: March 2007

OBJECTIVE
The purpose of this study was to define the correlation between HbA1c values and the percentage of home blood glucose (HBG) measurements within given ranges in a pie chart in three age-groups of subjects with type 1 diabetes.

RESEARCH DESIGN AND METHODS
HbA1c values were compared with HBG measurements in subjects who did at least three blood glucose tests per day over 30 days in three age-groups: 5–11, 12–16, and 17–35 years. The blood glucose values were arbitrarily divided into three groups, defined as the percentage of HBG measurements within, above, and below target range. Each range was then compared with the corresponding HbA1c value. Longitudinal data were also collected for 279 of the subjects after a mean of 139 days.

RESULTS
A strong correlation (P = 0.001) was found between HbA1c values and the average blood glucose, and also with the percentage of HBG measurements within, above, and below target range in each of the three age-groups (P &lt; 0.001). Analyses of longitudinal data showed a strong correlation of the changes in HbA1c values to the changes in blood glucose values.

CONCLUSIONS
These data showed that a pie-shaped graph of the HBG data can be useful as a clinical parameter in helping patients and families attain desired HbA1c values.
Gender, Autoantibodies, and Obesity in Newly Diagnosed Diabetic Patients Aged 40–75 Years
Authors: Wroblewski Marek , Gottsater Anders , Lindgarde Folke , Fernlund Per , Sundkvist Goran 
Published: March 2007

OBJECTIVE
To evaluate the frequency of autoimmune markers (islet cell antibodies [ICA] and glutamic acid decarboxylase antibodies [GADA]) and clinical features in newly diagnosed people with diabetes aged 40–75 years.

RESEARCH DESIGN AND METHODS
Two hundred fifty-nine consecutive patients (aged 40–75 years) with newly suspected diabetes diagnosed during a 2-year period were studied. The diagnosis of newly discovered diabetes was confirmed in 203 patients. Gender, BMI, HbAic, fasting C-peptide, ICA, and GADA were evaluated. The frequency of obesity was estimated using two different sets of criteria: 1) National Diabetes Data Group (NDDG) criteria, and 2) criteria based on a Swedish reference population.

RESULTS
The annual incidence of diabetes was 106 per 100,000 people. The incidence of diabetes in those patients who were 40–54 years old was significantly higher in men than in women (odds ratio: 2.16; P = 0.001). ICA were detected in 16 of 203 patients (8%), whereas 17 of 203 patients (8%) were GADA+; 10 of 203 (5%) patients were positive for both ICA and GADA. Among the 203 diabetic patients, 19 (9.4%) were classified as having IDDM, giving an IDDM incidence of 10 per 100,000 people aged 40–75 years. The frequency of obesity in NIDDM was high but varied with its definition; the frequency of obesity was highest (P &lt; 0.001) when NDDG criteria, and not Swedish reference values, were used (57 of 75 [76%] vs. 40 of 75 [53%] for women and 66 of 109 [61%] vs. 45 of 109 [41%] for men).

CONCLUSIONS
A striking male preponderance was found among incident cases of diabetes in people aged 40–54 years. Autoimmune markers were detected in 10% of incident cases of diabetes in people aged 40–75 years. Using a conservative estimation, as many as 10 of 100,000 middle-aged and elderly subjects developed IDDM. The frequency of obesity in NIDDM was high but this was also the case in the reference population.
Effects of Voglibose on Glycemic Excursions, Insulin Secretion, and Insulin Sensitivity in Non-lnsulin-ireated NIDDM Patients
Authors: Matsumoto Kazunari , Yano Mayumi , Miyake Seibei , Ueki Yukitaka , Yamaguchi Yoshihiko , Akazawa Shoichi , Tominaga Yuko 
Published: March 2007

OBJECTIVE
To investigate the effects of voglibose, an α-glucosidase inhibitor, on daily glycemic excursions, insulin secretion, and insulin sensitivity in non-insulin-treated NIDDM patients.

RESEARCH DESIGN AND METHODS
An open prospective study was conducted in 27 NIDDM patients receiving diet therapy alone or treatment with a sulfonylurea drug. Of the study subjects, 14 patients were treated with voglibose; the remaining 13 patients served as the control group. The metabolic parameters were evaluated before treatment and at week 4 of treatment as follows: glycemic excursions by M-value and 1,5-anhydro-D-glucitol (1,5-AG), insulin secretion by area under the curve of daily serum insulin (AUCinsulin), and insulin sensitivity by the K index of the insulin tolerance test (KITT).

RESULTS
After the study treatment, HbA1c and plasma glucose in the patients who had received voglibose were comparable to those of patients in the control group. M-value was lower in the patients treated with voglibose than in the control subjects (5.7 ± 0.9 vs. 9.8 ± 1.2, P &lt; 0.05). 1,5-AG was higher in the patients treated with voglibose than in the control subjects (12.2 ± 1.0 vs. 8.2 ± 0.7 μg/ml, P &lt; 0.01). A statistically significant decrease in AUCinsuiin occurred after treatment with voglibose (2,223.5 ± 390.6 to 1,546.7 ± 303.4 pmol · l−1 · h, P &lt; 0.05), but no change occurred in the control group (2,364.5 ± 315.4 to 2,464.2 ± 269.3 pmol · l−1 · h, P = 0.60). Insulin sensitivity (KITT) was improved to a statistically significant level in both the patients treated with voglibose and the patients in the control group. KITT in the patients after voglibose treatment was comparable to that of the control group (3.18 ± 0.30 vs. 3.21 ± 0.23%/min, P = 0.94).

CONCLUSIONS
The results suggest that voglibose lowers the daily glycemic excursions and inhibits overwork of the pancreatic β-cells but has little effect on insulin sensitivity in NIDDM patients.
Evaluation of GHb Assays in France by National Quality Control Surveys
Authors: Gillery Philippe , Dumont Gilles , Vassault Anne 
Published: March 2007

OBJECTIVE
To evaluate the state of the art concerning GHb assays through analysis of a large-scale quality control survey and to compare the results with those of previous surveys.

RESEARCH DESIGN AND METHODS
A lyophilized hemolyzate prepared from human erythrocytes containing a physiological HbA1c level (5.5%) was sent to 3,500 French laboratories in February of 1995 and assayed as a patient's sample under routine conditions. Distribution of values was analyzed from the reported results for each method. The results were compared with the assigned value (acceptable range: ± 20%) and with the upper value of the reference range currently used.

RESULTS
Results were obtained from 2,674 laboratories, among which 39% used cationexchange chromatography methods, 37.5% affinity chromatography, 16% immunological methods, and 7.5% electrophoresis. The number of laboratories using immunological methods increased from 100 to 400 between 1993 and 1995. The overall interlaboratory coefficient of variation (CV) was 20.2%, with within-method CVs ranging between 3.2 and 29.5%. Method-to-method accuracy varied dramatically, with mean HbA1c values ranging from 4.4 to 8.2%. Results from 75% of the laboratories were comprised in the acceptable range; 88% of them reported a value within the normal range of the method used.

CONCLUSIONS
The interlaboratory variability of results illustrates the difficulties encountered by diabetologists in the follow-up of diabetic patients using results obtained from different laboratories. It demonstrates the usefulness of the internationally developed standardization process of GHb measurements and points out the need for laboratories to fulfill good practices.
Preserved Endothelial Function in IDDM Patients, but Not in NIDDM Patients, Compared With Healthy Subjects
Authors: Enderle Markus-D , Benda Norbert , Schmuelling Reinhold-M , Haering Hans U , Pfohl Martin 
Published: March 2007

OBJECTIVE
To examine endothelial function (EF) noninvasively in IDDM and NIDDM patients with long diabetes duration.

RESEARCH DESIGN AND METHODS
We studied EF in 17 IDDM patients without diabetic complications and in 25 NIDDM patients with comparable glycemic control and with diabetic complications and compared both with nondiabetic control subjects matched for age, sex, and lumen diameter. Using high-resolution ultrasound, we measured the endothelialdependent (FAD%) and independent vasodilation (GTN%); the blood flow at rest, postocclusive, and after application of 400 μg glyceroltrinitrate of the brachial artery; and the intima media thickness (IMT) of the common carotid artery.

RESULTS
In the IDDM patients, neither FAD% (8.2 ± 4.6 vs. 7.6 ± 4.2%), GTN% (16.3 ± 4.9 vs. 18.4 ± 6.4%), nor postocclusive blood flow (40.6 ± 19.1 vs. 39.3 ± 23.6 cm/s) differed from the control subjects. IMT (0.59 ± 0.10 vs. 0.55 ± 0.14 mm) was slightly, but not significantly, elevated. In contrast, the NIDDM patients showed an impaired FAD% (3.8 ± 3.3 vs. 6.9 ± 4.4%, P &lt; 0.01), no difference in GTN%, and a decreased postocclusive blood flow (18.5 ± 13.8 vs. 32.7 ± 20.0 cm/s, P &lt; 0.01). IMT was significantly increased in NIDDM patients (0.77 ± 0.14 vs. 0.62 ± 0.10 mm, P &lt; 0.001).

CONCLUSIONS
In contrast to NIDDM patients with cardiovascular complications, IDDM patients with long diabetes duration and good long-term metabolic control do not have impaired EF compared with control subjects.
Well-Being, Cerebral Function, and Physical Fatigue After Nocturnal Hypoglycemia in IDDM
Authors: King Paromita , Kong Marie-France , Parkin Heather , Macdonald Ian A , Tattersall Robert B 
Published: March 2007

OBJECTIVE
This study assessed the effect of nocturnal hypoglycemia on well-being cerebral function, and physical fatigue the next day in 10 subjects with IDDM.

RESEARCH DESIGN AND METHODS
After an exercise test to determine work-loads corresponding to 30 and 60% VO2max, volunteers were studied twice, 4 weeks apart. Blood glucose was lowered one night to 2.3–2.7 mmol/l for 1 h, and at the control visit, hypoglycemia was avoided. The next morning, well-being was assessed using the minor symptom evaluation profile (MSEP), and cerebral function was assessed with the paced auditory serial addition test, the digit symbol substitution test, trail making part B, four-choice reaction time, and auditory P300 latency. Subjects then exercised at predetermined workloads corresponding to 30% VO2max for 30 min and 60% VO2max until exhaustion. Fatigue was assessed every 10 min using the Borg scale for rating of perceived exertion.

RESULTS
All three components of the MSEP scored higher (indicating more symptoms) after the hypoglycemic night compared with the control night (P &lt; 0.01 contentment, sleep; P &lt; 0.001 vitality). None of the cerebral function tests performed the next day was affected by hypoglycemia. Exercise capacity was similar at both visits, but subjects were more fatigued after the hypoglycemic night (P &lt; 0.01, analysis of variance). There were no differences in potassium, catecholamine, glucose, or lactate concentrations between visits either before or during exercise.

CONCLUSIONS
One hour of hypoglycemia at night affects a subject's sense of well-being, but not cerebral function, the next day. The greater fatigue after the hypoglycemic night cannot be explained by the biochemical parameters measured.
The Relationship of Menstrual Irregularity to Type 2 Diabetes in Pima Indian Women
Authors: Roumain Janine , Charles M Aline , Courten Maximilian P De , Hanson Robert L , Brodie Todd D , Pettitt David J , Knowler William C 
Published: March 2007

OBJECTIVE
Menstrual irregularity is associated with hyperinsulinemia and hyperandrogenemia in nondiabetic Pima Indian women of child-bearing age. In this population-based study, we determined the relationship of menstrual irregularity to type 2 diabetes in Pima Indian women.

RESEARCH DESIGN AND METHODS
Participants for this cross-sectional analysis were 695 nonpregnant Pima Indian women, aged 18–44 years, involved in an ongoing epidemiologic study of diabetes among residents of the Gila River Indian Community of Arizona. Clinical data were collected by questionnaire and an examination that included a 75-g oral glucose tolerance test; diabetes was diagnosed by World Health Organization criteria. Menstrual irregularity was defined as an interval of 3 months or more between menses, when not pregnant, since age 18 years.

RESULTS
History of menstrual irregularity was significantly associated with a high prevalence of diabetes (37 vs. 13%; odds ratio = 4.2, 95% CI = 1.6–10.8) in the least obese women (BMI &lt; 30 kg/m2), adjusted for the effects of age and overall obesity. This association was, in part, because of greater central obesity in women with irregular menses. In more obese women, there was little association with menstrual irregularity, and diabetes was frequent regardless of menstrual history.

CONCLUSIONS
Prevalence of type 2 diabetes is higher among Pima indian women with a history of menstrual irregularity. The difference is most pronounced among the least obese group of women. This association may be because of insulin resistance and hyperinsulinemia, which predict type 2 diabetes, also causing hyperandrogenism and menstrual irregularity. The findings reinforce the need to evaluate women with menstrual irregularity for hyperglycemia.