bluuebunny/crossref_metadata_2025_split huggingface dataset:
Type 1 Diabetes Among Sardinian Children Is Increasing
Authors: Casu Anna , Pascutto Cristiana , Bernardinelli Luisa ,   the Sardinian IDDM Epidemiology Study Group, Songini Marco 
Published: March 2007

OBJECTIVE—The Sardinian type 1 diabetes register represented the basis to determine the most recent trends and the age distribution of type 1 diabetes incidence among Sardinians &lt;15 years of age during 1989–1999. Part of the data (1989–1998) has been already published by the EURODIAB Group with a lower completeness of ascertainment (87%). The geographical distribution of type 1 diabetes risk was also investigated.
RESEARCH DESIGN AND METHODS—The new cases of type 1 diabetes in children aged 0–14 years in Sardinia were prospectively registered from 1989 to 1999 according to the EURODIAB ACE criteria. The completeness of ascertainment calculated applying the capture-recapture method was 91%. Standardized incidence rates and 95% CI were calculated assuming the Poisson distribution. Trend of type 1 diabetes incidence was analyzed using the Poisson regression model. Maps of the geographical distribution of type 1 diabetes risk for the whole time period and separately for 1989–1994 and 1995–1999 were produced applying a Bayesian method.
RESULTS—A total of 1,214 type 1 diabetic patients were registered yielding to an overall age- and sex-standardized incidence rate of 38.8/100,000 (95% CI 36.7–41.1). There was a male excess with an overall male-to-female ratio of 1.4 (1.3–1.8). The increase of incidence during the 11 years analyzed was statistically significant (P = 0.002) with a yearly increasing rate of 2.8% (1.0–4.7). No evidence of an effect of age and sex on this trend has been found. The geographical distribution of type 1 diabetes relative risk (RR) showed that the highest risk areas are located in the southern and central-eastern part of the island and the lowest risk in the northeastern part, even if most of these differences were not statistically significant. This geographical distribution seemed to remain mainly the same between 1989–1994 and 1995–1999.
CONCLUSIONS—The homogeneity of diabetes risk and the increase of incidence over the age-groups in the Sardinian population stress the role of an environmental factor uniformly distributed among the genetically high-risk Sardinians.
Muscle Weakness and Foot Deformities in Diabetes
Authors: van Schie Carine H.M. , Vermigli Cristiana , Carrington Anne L. , Boulton Andrew 
Published: March 2007

OBJECTIVE—To examine the relationships among muscle weakness, foot deformities, and peroneal and tibial nerve conduction velocity in diabetic and nondiabetic men.
RESEARCH DESIGN AND METHODS—A neuropathic and foot evaluation was undertaken in 10 nondiabetic control subjects (group C) and in 36 consecutive diabetic patients attending Diabetes Centre clinics, including 10 diabetic control subjects (group D), 15 diabetic neuropathic patients (group DN), and 11 diabetic patients with a history of ulceration (group DU). Neuropathy was defined as a peroneal motor nerve conduction &lt;40 m/s. Muscle weakness was assessed in seven intrinsic and seven extrinsic muscles of the foot using a semiquantitative score (max score per muscle = 3). Foot deformities were assessed using a foot deformity score (max score = 3). A higher score indicated increased muscle weakness or more severe foot deformities. Muscle weakness and foot deformities were assessed without prior knowledge of patient and neuropathy status.
RESULTS—Peroneal and tibial nerve conduction velocity were associated with weakness in muscles innervated by, respectively, the peroneal and tibial nerve (r = −0.70 and r = −0.51, P &lt; 0.01) and foot deformities (r = −0.60 and r = −0.59, P &lt; 0.001). The DN and DU groups had more weakness in intrinsic and extrinsic muscles compared with the C and D groups. Muscles innervated by the tibial nerve had a greater proportional muscle weakness than those innervated by the peroneal nerve in the DN and DU groups. The DN and DU patients had more foot deformities (median food deformity score [interquartile range]) (3 [2–3] and 2 [2–3]) compared with D and C patients (0 [0–0.75] and 0 [0–0]).
CONCLUSIONS—Important relationships have been shown between motor nerve conduction deficit and muscle weakness; however, it is still not clear whether abnormal nerve function, leading to a decrease in muscle strength, could be responsible for the development of foot deformities.
Relationship Between Adiponectin and Glycemic Control, Blood Lipids, and Inflammatory Markers in Men With Type 2 Diabetes
Authors: Schulze Matthias B. , Rimm Eric B. , Shai Iris , Rifai Nader , Hu Frank B. 
Published: March 2007

OBJECTIVE—Adiponectin, synthesized in the adipose tissue, appears to play an important role in hyperglycemia and dyslipidemia, as well as in inflammatory mechanisms, which lead to a markedly increased atherosclerotic risk in diabetic subjects. However, previous studies did not evaluate the complex relationships between adiponectin and the array of metabolic abnormalities commonly observed in diabetes.
RESEARCH DESIGN AND METHODS—To examine the associations between plasma levels of adiponectin and HbA1c, blood lipids, and inflammatory markers, we obtained blood samples from 741 participants in the Health Professionals Follow-up Study with a diagnosis of type 2 diabetes.
RESULTS—Plasma adiponectin levels were positively correlated with HDL cholesterol and negatively correlated with triglycerides, apolipoprotein B-100 (apoB100), C-reactive protein (CRP), and fibrinogen. These associations were not appreciably altered after controlling for lifestyle exposures, medical conditions, and obesity-associated variables. A 10-μg/ml higher level of plasma adiponectin was associated with lower HbA1c (−0.21% points, P = 0.001), triglycerides (−0.39 mmol/l, P &lt; 0.001), apoB100 (−0.04 g/l, P &lt; 0.001), CRP (−0.51 mg/l, P = 0.003), and fibrinogen (−0.53 μmol/l, P &lt; 0.001) and higher HDL cholesterol (0.13 mmol/l, P &lt; 0.001). Associations between adiponectin and inflammatory markers were furthermore independent of HbA1c and HDL cholesterol, suggesting that the anti-inflammatory properties of adiponectin are not mediated by potential effects on glycemic control and blood lipids. Our results were consistent among obese and nonobese men.
CONCLUSIONS—Our study supports the hypothesis that increased adiponectin levels might be associated with better glycemic control, better lipid profile, and reduced inflammation in diabetic subjects. Measures that increase adiponectin levels might be valuable targets for decreasing the atherosclerotic risk present in diabetes.
Quinapril, an ACE Inhibitor, Reduces Markers of Oxidative Stress in the Metabolic Syndrome
Authors: Khan Bobby V. , Sola Srikanth , Lauten Wright B. , Natarajan Rama , Hooper W. Craig , Menon Rekha G. , Lerakis Stamatios , Helmy Tarek 
Published: March 2007

OBJECTIVE—Patients with the metabolic syndrome often have abnormal levels of proinflammatory and pro-oxidative mechanisms within their vasculature. We sought to determine whether the ACE inhibitor quinapril regulates markers of oxidative stress in the metabolic syndrome.
RESEARCH DESIGN AND METHODS—Forty patients with the metabolic syndrome were randomized in a double-blind manner to either the ACE inhibitor quinapril (20 mg/day) or matching placebo for 4 weeks. Serum markers of vascular oxidative stress were measured.
RESULTS—After 4 weeks of therapy, serum 8-isoprostane was reduced by 12% in the quinapril group when compared with placebo (quinapril, 46.7 ± 1.0; placebo, 52.7 ± 0.9 pg/ml; P = 0.001). Erythrocyte superoxide dismutase activity increased 35% in the quinapril group when compared with placebo (quinapril, 826.3 ± 17.1; placebo, 612.3 ± 6.9 units/g Hb; P &lt; 0.001). In addition, lag time to oxidation of LDL, a marker of oxidative stress, was increased by 48% in the quinapril group when compared with placebo (quinapril 89.2 ± 9.2 vs. placebo 60.1 ± 12.3 min; P &lt; 0.001). Therapy with quinapril was well tolerated.
CONCLUSIONS—The addition of the ACE inhibitor quinapril reduces markers of vascular oxidative stress and may attenuate the progression of the pathophysiology seen in the metabolic syndrome.
Plasma Adiponectin, Insulin Sensitivity, and Subclinical Inflammation in Women With Prior Gestational Diabetes Mellitus
Authors: Winzer Christine , Wagner Oswald , Festa Andreas , Schneider Barbara , Roden Michael , Bancher-Todesca Dagmar , Pacini Giovanni , Funahashi Tohru , Kautzky-Willer Alexandra 
Published: March 2007

OBJECTIVE—Women with prior gestational diabetes mellitus (pGDM) are at increased risk of developing type 2 diabetes and associated vasculopathy. Because increased fat mass and inflammatory processes are angiopathic risk factors, the relationship between insulin sensitivity, parameters of subclinical inflammation, and plasma concentrations of adipocytokines was investigated in pGDM both at 3 months and 12 months after delivery.
RESEARCH DESIGN AND METHODS—Insulin sensitivity (through a frequently sampled intravenous glucose tolerance test) and plasma concentrations of ultrasensitive C-reactive protein (CRP), adiponectin, plasminogen activator inhibitor (PAI)-1, tumor necrosis factor-α, leptin, and interleukin-6 were measured in 89 pGDM (BMI 26.9 ± 0.5 kg/m2, age 32 ± 0.5 years) and in 19 women with normal glucose tolerance during pregnancy (NGT) (23.7 ± 0.9 kg/m2, 31 ± 1.3 years).
RESULTS—pGDM showed lower (P &lt; 0.0001) plasma adiponectin (6.7 ± 0.2 μg/ml) than NGT (9.8 ± 0.6 μg/ml) and a decreased (P &lt; 0.003) insulin sensitivity index (Si) and disposition index (P &lt; 0.03), but increased plasma leptin (P &lt; 0.003), PAI-1 (P &lt; 0.002), and CRP (P &lt; 0.03). After adjustment for body fat mass, plasma adiponectin remained lower in pGDM (P &lt; 0.004) and correlated positively with Si (P &lt; 0.003) and HDL cholesterol (P &lt; 0.0001) but negatively with plasma glucose (2-h oral glucose tolerance test [OGTT]) (P &lt; 0.0001), leptin (P &lt; 0.01), CRP (P &lt; 0.007), and PAI-1 (P &lt; 0.0001). On regression analysis, only HDL cholesterol, postload (2-h OGTT) plasma glucose, and Si remained significant predictors of plasma adiponectin, explaining 42% of its variability. Of note, adiponectin further decreased (P &lt; 0.05) only in insulin-resistant pGDM despite unchanged body fat content and distribution after a 1-year follow-up.
CONCLUSIONS—Lower plasma adiponectin concentrations characterize women with previous GDM independently of the prevailing insulin sensitivity or the degree of obesity and are associated with subclinical inflammation and atherogenic parameters.
The Effect of Liraglutide, a Long-Acting Glucagon-Like Peptide 1 Derivative, on Glycemic Control, Body Composition, and 24-h Energy Expenditure in Patients With Type 2 Diabetes
Authors: Harder Helle , Nielsen Lene , Thi Tu D.T. , Astrup Arne 
Published: March 2007

OBJECTIVE—Glucagon-like peptide (GLP)-1 is a gut hormone that exerts incretin effects and suppresses food intake in humans, but its therapeutic use is limited due to its short half-life. This was a randomized, double-blind, parallel-group, placebo-controlled trial investigating the effect of the long-acting GLP-1 derivative liraglutide (NN2211) on glycemic control, body weight, body composition, and 24-h energy expenditure in obese subjects with type 2 diabetes.
RESEARCH DESIGN AND METHODS—Thirty-three patients (mean ± SD) aged 60.0 ± 9.5 years, with HbA1c 7.5 ± 1.2% and BMI 36.6 ± 4.1 kg/m2, were randomized to treatment with a single daily subcutaneous dose of 0.6 mg liraglutide (n = 21) or placebo (n = 12) for 8 weeks. In addition to weight and glycemic parameters, body composition was assessed by dual-energy X-ray absorptiometry (DEXA) scanning and 24-h energy expenditure in a respiratory chamber.
RESULTS—After 8 weeks, liraglutide reduced fasting serum glucose (liraglutide, −1.90 mmol/l, and placebo, 0.27 mmol/l; P = 0.002) and HbA1c (liraglutide, −0.33%, and placebo, 0.47%; P = 0.028) compared with placebo. No change in body weight was detected (liraglutide, −0.7 kg, and placebo, −0.9 kg; P = 0.756). There was a nonsignificant trend toward a decrease in total fat mass (liraglutide, −0.98%, and placebo, −0.12%; P = 0.088) and toward an increase in lean body mass (liraglutide, 1.02%, and placebo, 0.23%; P = 0.118) in the liraglutide group compared with the placebo group. Twenty-four-hour energy expenditure was unaffected by the treatment (liraglutide, −12.6 kJ/h, and placebo, −13.7 kJ/h; P = 0.799).
CONCLUSIONS—Eight weeks of 0.6-mg liraglutide treatment significantly improved glycemic control without increasing weight in subjects with type 2 diabetes compared with those on placebo. No influence on 24-h energy expenditure was detected.
Elevated Plasma Levels of Nt-proBNP in Patients With Type 2 Diabetes Without Overt Cardiovascular Disease
Authors: Magnusson Martin , Melander Olle , Israelsson Bo , Grubb Anders , Groop Leif , Jovinge Stefan 
Published: March 2007

OBJECTIVE—The NH2-terminal portion of the precursor of brain natriuretic peptide (Nt-proBNP) has been reported to be elevated in left ventricular dysfunction. This peptide is a split product from the proBNP molecule, and its level in the circulation is not, as the mature BNP peptide, dependent on the peripheral number of BNP receptors. We aimed to test the hypothesis that asymptomatic left ventricular dysfunction (ALVD), as estimated by Nt-proBNP, would be more prevalent in patients with type 2 diabetes without overt cardiovascular disease in comparison with matched control subjects.
RESEARCH DESIGN AND METHODS—The study population consisted of 253 patients with type 2 diabetes and 230 matched control subjects aged 40–70 years without any overt heart disease from primary care centers in Western Finland and Southern Sweden. Nt-proBNP was measured in plasma by competitive enzyme immunosorbent assay.
RESULTS—Patients with type 2 diabetes were shown to have higher Nt-proBNP values (360.9 pmol/l [262.6–467.9]) than control subjects (302.7 pmol/l [215.4–419.2]) (P &lt; 0.001). Nt-proBNP levels were independently related to diabetes after adjustment for age, sex, systolic and diastolic blood pressure, BMI, heart rate, drug treatment, serum creatinine, and cystatin C.
CONCLUSIONS—Our data suggest that the secretion of Nt-proBNP is increased in type 2 diabetic patients with no overt heart disease, suggesting that type 2 diabetes is associated with a higher prevalence of ALVD than hitherto thought. Nt-proBNP may thus serve as a screening instrument to select patients with type 2 diabetes who could benefit from an echocardiographical examination.
Variability in Activity May Precede Diabetic Foot Ulceration
Authors: Armstrong David G. , Lavery Lawrence A. , Holtz-Neiderer Katherine , Mohler Martha J. , Wendel Christopher S. , Nixon Brent P. , Boulton Andrew J.M. 
Published: March 2007

OBJECTIVE—To evaluate the role of activity in the development of neuropathic foot ulceration in individuals with diabetes.
RESEARCH DESIGN AND METHODS—We evaluated the first 100 consecutive individuals with diabetes (95.0% male, aged 68.5 ± 10.0 years with concomitant neuropathy, deformity, and/or a history of lower-extremity ulceration/partial foot amputation) enrolled in an ongoing prospective longitudinal activity study. Subjects used a high-capacity continuous computerized activity monitor. Data were collected continuously over a minimum of 25 weeks (or until ulceration) with daily activity units expressed as means ± SD.
RESULTS—Eight subjects ulcerated during the evaluation period of 37.1 ± 12.3 weeks. The average daily activity was significantly lower in individuals who ulcerated compared with individuals who did not ulcerate (809.0 ± 612.2 vs. 1,394.5 ± 868.5, P = 0.03). Furthermore, there was a large difference in variability between groups. The coefficient of variation was significantly greater in the ulceration group compared with the no ulceration group (96.4 ± 50.3 vs. 44.7 ± 15.4%, P = 0.0001). In the 2 weeks preceding the ulcerative event, the coefficient of variation increased even further (115.4 ± 43.0%, P = 0.02), but there was no significant difference in average daily activity during that period (P = 0.5).
CONCLUSIONS—The results of this study suggest that individuals with diabetes who develop ulceration may actually have a lower overall activity than their counterparts with no ulceration, but the quality of that activity may be more variable. Perhaps modulating the “peaks and valleys” of activity in this population through some form of feedback might prove to reduce risk for ulceration in this very-high-risk population.
Aldose Reductase Gene Polymorphisms and Peripheral Nerve Function in Patients With Type 2 Diabetes
Authors: Sivenius Katariina , Pihlajamäki Jussi , Partanen Juhani , Niskanen Leo , Laakso Markku , Uusitupa Matti 
Published: March 2007

OBJECTIVE—We screened the human aldose reductase (ALR) gene for DNA sequence variants in type 2 diabetic and nondiabetic subjects and investigated whether the previously reported and novel polymorphisms were associated with neurophysiologic deterioration and clinical peripheral neuropathy.
RESEARCH DESIGN AND METHODS—The study population included 85 Finnish type 2 diabetic and 126 nondiabetic subjects. The genetic analyses were performed using the PCR, single-strand conformation polymorphism, restriction fragment-length polymorphism, and automated laser fluorescence scanning analyses. A detailed neurologic examination and neurophysiologic analyses were performed at the time of diagnosis and at the 10-year examination.
RESULTS—The genetic screening identified four polymorphisms: C-106T, C-11G, A11370G, and C19739A. The C and Z-2 alleles of the C-106T polymorphism and the previously reported (CA)n repeat marker were more frequent in type 2 diabetic subjects than in nondiabetic subjects. At baseline, the diabetic subjects with the T allele of the C-106T polymorphism had lower sensory response amplitude values in the peroneal (P = 0.025), sural (P = 0.007), and radial (P = 0.057) nerves and, during follow-up, a greater decrease in the conduction velocity of the motor peroneal nerve than those with the C-106C genotype. No associations were found between the polymorphisms examined and clinical polyneuropathy.
CONCLUSIONS—The C-106T polymorphism of the ALR gene may contribute to an early development of neurophysiologic deterioration in type 2 diabetic patients.
Rates of Glucose Change Measured by Blood Glucose Meter and the GlucoWatch Biographer During Day, Night, and Around Mealtimes
Authors: Dunn Timothy C. , Eastman Richard C. , Tamada Janet A. 
Published: March 2007

OBJECTIVE—The purpose of this study was to characterize the distribution of the rate of change of blood glucose for a diabetic population.
RESEARCH DESIGN AND METHODS—The study population consisted of 124 adults with type 1 or type 2 diabetes requiring insulin. Study participants applied a GlucoWatch Biographer during the day at home for 5 consecutive days and took finger-prick blood glucose measurements hourly. Subjects kept a diary of meals. The Biographer frequently and automatically measured glucose up to three times per hour for up 12 h. Rates of glucose change were calculated for both Biographer and blood glucose measurements. Rates of glucose change during a separate study of 134 subjects were determined for daytime and nighttime use.
RESULTS—Mean (±SD) rates of change of glucose of −0.36 ± 0.95 and 0.36 ± 0.99 mg · dl−1 · min−1 were found before and after lunch using blood glucose data and −0.31 ± 1.23 and 0.43 ± 1.26 using Biographer data. For both types of diabetes, rates of glucose change exceeded 2 mg · dl−1 · min−1 before and after meals ∼10% of the time. Periprandial glucose patterns showed some significant differences between type 1 and type 2 diabetic subjects. Glucose levels changed more gradually at night than during the day.
CONCLUSIONS—Glucose values were almost equally unstable before and after meals. Glycemic instability around dinner was different in type 1 and type 2 diabetes. The GlucoWatch Biographer was found to be effective in tracking trends in glucose levels and yielded similar results as obtained by finger-prick blood samples.
Data Resources in the Department of Veterans Affairs
Authors: Maynard Charles , Chapko Michael K. 
Published: March 2007

OBJECTIVE—To provide an overview of databases that are maintained by the Department of Veterans Affairs (VA) and are of relevance to investigators involved in epidemiologic, clinical, and health services research.
RESEARCH DESIGN AND METHODS—We reviewed both national and local VA databases and identified their strengths and limitations. We also referenced specific studies that have assessed the validity and reliability of VA databases.
RESULTS—There are numerous national databases housed at the Austin Automation Center in Austin, Texas. These include the Patient Treatment File (hospital abstracts), the Outpatient Care File, the Beneficiary Identification Record Locator System death file for assessing vital status, and the Decision Support System, which provides integrated clinical and financial information for managerial decision making. The major limitation of these databases is that clinical detail below the level of ICD-9-CM diagnosis and procedure codes is not uniformly available nationally. These databases offer an excellent opportunity to monitor the health of veterans over time because they track all inpatient and outpatient utilization in the VA. However, at the local or medical center level, the Veterans Health Information and Systems and Technology Architecture contains extensive clinical information, but has fewer patients, varies in format across medical centers, and poses difficulties with data extraction for statistical analysis.
CONCLUSIONS—Both local and national VA databases are valuable resources for investigators who have interests in a wide array of research topics, including diabetes. The potential for investigating important scientific questions with VA databases becomes greater as communications and database management technologies improve.
Diabetes and Renal Disease in Veterans
Authors: Young Bessie A. , Pugh Jacqueline A. , Maynard Charles , Reiber Gayle 
Published: March 2007

OBJECTIVE—To describe the frequency and sequelae of diabetic renal disease in veterans who receive health care from the Veterans Administration (VA).
RESEARCH DESIGN AND METHODS—Veterans with a diagnosis of diabetes, diabetic nephropathy, other kidney diseases, and end-stage renal disease (ESRD) were identified by diagnosis codes from national VA databases for FY1998. Data were obtained and analyzed for prevalence of renal disease, comorbid conditions, and 1-year mortality.
RESULTS—A total of 44,671 (10.7%) of the 415,910 veterans with diabetes had a concomitant diagnosis of any renal disease. The average age was 67 years; 98% were male and 60% were white. The prevalence of diabetic nephropathy was 6.0% (n = 25,263). ESRD secondary to diabetes was present in 4.2% (17,636) of subjects. The age-standardized prevalence of diabetes and any renal disease was 72.6/1,000 persons and differed by race (white 76.1/1,000, black 103.4/1,000 persons). Diabetes-associated ESRD prevalence was higher among black versus white veterans and male versus female veterans. One-year age-standardized mortality was 10.7%.
CONCLUSIONS—Nephropathy is prevalent in veterans with diabetes. Greater mortality is observed among those with renal disease compared with those without renal disease. Additional surveillance is needed to identify persons likely to progress to diabetic nephropathy and to plan for appropriate and timely health care for these individuals.