bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age- and Sex-Specific Prevalence of Diabetes and Impaired Glucose Regulation in 11 Asian Cohorts
Authors:   the DECODA Study Group
Published: March 2007

OBJECTIVE—To report the age- and sex-specific prevalence of diabetes and impaired glucose regulation (IGR) according to revised World Health Organization criteria for diabetes in Asian populations.
RESEARCH DESIGN AND METHODS—We performed 11 studies of 4 countries, comprising 24,335 subjects (10,851 men and 13,484 women) aged 30–89 years who attended the 2-h oral glucose tolerance test and met the inclusion criteria for data analysis.
RESULTS—The prevalence of diabetes increased with age and reached the peak at 70–89 years of age in Chinese and Japanese subjects but peaked at 60–69 years of age followed by a decline at the 70 years of age in Indian subjects. At 30–79 years of age, the 10-year age-specific prevalence of diabetes was higher in Indian than in Chinese and Japanese subjects. Indian subjects also had a higher prevalence of IGR in the younger age-groups (30–49 years) compared with that for Chinese and Japanese subjects. Impaired glucose tolerance was more prevalent than impaired fasting glycemia in all Asian populations studied for all age-groups.
CONCLUSIONS—Indians had the highest prevalence of diabetes among Asian countries. The age at which the peak prevalence of diabetes was reached was ∼10 years younger in Indian compared with Chinese and Japanese subjects. Diabetes and IGR will be underestimated in Asians based on the fasting glucose testing alone.
The Health Care Costs of Diabetic Peripheral Neuropathy in the U.S.
Authors: Gordois Adam , Scuffham Paul , Shearer Arran , Oglesby Alan , Tobian Janet Ash 
Published: March 2007

OBJECTIVE—Peripheral neuropathy is common among people with diabetes and can result in foot ulceration and amputation. The aim of this study was to quantify the annual medical costs of peripheral neuropathy and its complications among people with type 1 and type 2 diabetes in the U.S.
RESEARCH DESIGN AND METHODS—A cost-of-illness model was used to estimate the numbers of diabetic individuals in the U.S. who have diabetic peripheral neuropathy (DPN) and/or neuropathic foot ulcers (both those with no deep infection and those accompanied by cellulitis or osteomyelitis) at a given point in time, and/or a toe, foot, or leg amputation during a year. Prevalence and incidence rates were estimated from published studies and applied to the general U.S. population. All costs were estimated in 2001 U.S. dollars. In a sensitivity analysis, we varied the rates of complications to assess the robustness of the cost estimates.
RESULTS—The annual costs of DPN and its complications in the U.S. were $0.8 billion (type 1 diabetes), $10.1 billion (type 2 diabetes), and $10.9 billion (total). After allowing for uncertainty in the point estimates of complication rates, the range of costs were between $0.3 and $1.0 billion (type 1 diabetes), $4.3b and $12.7 billion (type 2 diabetes), and $4.6 and $13.7 billion (type 1 and type 2 diabetes).
CONCLUSIONS—The total annual cost of DPN and its complications in the U.S. was estimated to be between $4.6 and $13.7 billion. Up to 27% of the direct medical cost of diabetes may be attributed to DPN.
Cost Effectiveness of Statin Therapy for the Primary Prevention of Major Coronary Events in Individuals With Type 2 Diabetes
Authors: Brandle Michael , Davidson Mayer B. , Schriger David L. , Lorber Brett , Herman William H. 
Published: March 2007

OBJECTIVE—To assess the cost and cost effectiveness of hydroxymethylglutaryl (HMG)-CoA reductase inhibitor (statin) therapy for the primary prevention of major coronary events in the U.S. population with diabetes and LDL cholesterol levels ≥100 mg/dl, especially in the population with LDL cholesterol levels 100–129 mg/dl.
RESEARCH DESIGN AND METHODS—Analyses were performed using population estimates from National Health and Nutrition Examination Survey (NHANES)-III, cost estimates from a health system perspective, statin LDL-lowering effectiveness from pivotal clinical trials, and treatment effectiveness from the diabetic subgroup analysis of the Heart Protection Study.
RESULTS—There are ∼8.2 million Americans with diabetes, LDL cholesterol levels ≥100 mg/dl, and no clinical evidence of cardiovascular disease. Each year, statin therapy could prevent ∼71,000 major coronary events in this population. In the subgroup with LDL cholesterol levels 100–129 mg/dl, the annual cost of statin treatment ranges from $600 to $1,000 per subject. In the population with LDL cholesterol levels ≥130 mg/dl, the annual cost ranges from $700 to $2,100. Annual incremental cost per subject, defined as the cost of statin treatment plus the cost of major coronary events with statin treatment minus the cost of major coronary events without statin treatment, ranges from $480 to $950 in the subgroup with LDL cholesterol levels 100–129 mg/dl and from $590 to $1,920 in the population with LDL cholesterol levels ≥130 mg/dl.
CONCLUSIONS—Statin therapy for the primary prevention of major coronary events in subjects with type 2 diabetes and LDL cholesterol levels 100–129 mg/dl is affordable and cost effective relative to statin therapy in subjects with higher LDL cholesterol levels.
On the Association Between Diabetes and Mental Disorders in a Community Sample
Authors: Kruse Johannes , Schmitz Norbert , Thefeld Wolfgang 
Published: March 2007

OBJECTIVE—To determine the relationship between mental disorders and diabetes in a representative community sample.
RESEARCH DESIGN AND METHODS—This was a cross-sectional study. Data on diabetes and HbA1c values were obtained by structured questionnaires and by laboratory assessments. Current psychiatric disorders were diagnosed by a modified version of the Composite International Diagnostic Interview (CIDI).
RESULTS—People with diabetes (PWD) were not more likely to meet Diagnostic and Statistical Manual of Psychiatric Disorders, 4th edition (DSM-IV) criteria for at least one mental disorder than were individuals without diabetes. However, a different diagnostic pattern occurred compared with the general population: odds ratios (ORs) for anxiety disorders in PWD were higher (OR 1.93, 95% CI 1.19–3.14). Although PWD had higher prevalence rates of affective disorders, the relationship between diabetes and affective disorders was not statistically significant after controlling for age, sex, marital status, and socioeconomic status. In contrast, the relationship between diabetes and anxiety disorders remained significant after controlling for these variables. In contrast to individuals without mental disorders, PWD with affective or anxiety disorders more frequently had adequate glycemic control.
CONCLUSIONS—Diabetes was associated with an increased likelihood of anxiety disorders. The association between mental disorders, diabetes, and glycemic control should be evaluated carefully in terms of potentially confounding sociodemographic variables, sample characteristics, and definitions of the disorders.
Rapid Increase in the Use of Oral Antidiabetic Drugs in the United States, 1990–2001
Authors: Wysowski Diane K. , Armstrong George , Governale Laura 
Published: March 2007

OBJECTIVE—To describe the use of oral antidiabetic drugs for management of type 2 diabetes in the U.S. from 1990 through 2001.
RESEARCH DESIGN AND METHODS—Data on oral antidiabetic drugs were derived from two pharmaceutical marketing databases from IMS Health, the National Prescription Audit Plus and the National Disease and Therapeutic Index.
RESULTS—In 1990, 23.4 million outpatient prescriptions of oral antidiabetic agents were dispensed. By 2001, this number had increased 3.9-fold, to 91.8 million prescriptions. Glipizide and glyburide, two sulfonylurea medications, accounted for ∼77% of prescriptions of oral antidiabetic drugs in 1990 and 35.5% of prescriptions in 2001. By 2001, the biguanide metformin (approved in 1995) had captured ∼33% of prescriptions, and the thiazolidinedione insulin sensitizers (rosiglitazone and pioglitazone marketed beginning in 1999) accounted for ∼17% of market share. Compared with patients treated in 1990, those in 2001 were proportionately younger and they more often used oral antidiabetic drugs and insulin in combination. Internists and general and family practitioners were the primary prescribers of this class of drugs.
CONCLUSIONS—Consistent with the reported increase in the prevalence of type 2 diabetes, the number of dispensed outpatient prescriptions of oral antidiabetic drugs increased rapidly between 1990 and 2001. This period was marked by an increase in the treatment of younger people and the use of oral antidiabetic drugs in combination. With the approval in the last decade of several new types of oral antidiabetic medications with different mechanisms of action, options for management of type 2 diabetes have expanded.
Effects of the Early ACE Inhibition in Diabetic Nonthrombolyzed Patients With Anterior Acute Myocardial Infarction
Authors: Borghi Claudio , Bacchelli Stefano , Esposti Daniela Degli , Ambrosioni Ettore ,   on behalf of the SMILE Study Investigators
Published: March 2007

OBJECTIVE—The aim of the present study was to evaluate the clinical efficacy of the ACE inhibitor zofenopril in a cohort of diabetic patients with nonthrombolyzed anterior acute myocardial infarction who were enrolled in the Survival of Myocardial Infarction Long-Term Evaluation (SMILE) trial.
RESEARCH DESIGN AND METHODS—Among the overall population of 1,512 patients, 303 (20.0%) had diabetes. The primary end point of this study was the effect of treatment on the 6-week combined occurrence of death and severe congestive heart failure (CHF). Secondary end points included the evaluation of the 6-week rate of major cardiovascular events as well as the 1-year survival rate.
RESULTS—After 6 weeks of double-blind treatment, zofenopril significantly reduced both the incidence of the primary end point (8.6 vs. 18.3%; P = 0.019) and the 6-week incidence of severe CHF (0 vs. 7.3%; P = 0.001) in diabetic patients, and the effect was greater than that observed in nondiabetic patients. Conversely, 1-year mortality was significantly reduced among nondiabetic patients (9.1 vs. 13.8%; P = 0.010), whereas in the diabetic population, the decrease did not reach statistical significance (13.7 vs. 16.5%; P = 0.52).
CONCLUSIONS—The present data suggest that the clinical outcome of patients with diabetes and myocardial infarction can be significantly improved by early treatment with zofenopril. The lesser effect on 1-year mortality seems to suggest that long-term treatment is probably needed to maintain the benefits of the early ACE inhibition in patients with diabetes.
Relation Between Serum 3-Deoxyglucosone and Development of Diabetic Microangiopathy
Authors: Kusunoki Hitomi , Miyata Satoshi , Ohara Takeshi , Liu Bing-Fen , Uriuhara Atsuko , Kojima Hiroshi , Suzuki Kotaro , Miyazaki Hiroyuki , Yamashita Yumiko , Inaba Kayo , Kasuga Masato 
Published: March 2007

OBJECTIVE—3-Deoxyglucosone (3-DG), a highly reactive intermediate of the glycation reaction, has been suggested to contribute to the development of diabetes complications. To verify this hypothesis, we assessed the relation between serum 3-DG concentrations and the severity of diabetic microangiopathy in diabetic patients.
RESEARCH DESIGN AND METHODS—We conducted a high-performance liquid chromatography assay to determine the serum 3-DG concentrations of 110 diabetic patients with different degrees of severity of diabetic microangiopathy and 57 age-matched control subjects.
RESULTS—The fasting serum 3-DG level in diabetic patients was significantly (P &lt; 0.001) higher than that in control subjects (353 ± 110 vs. 199 ± 53 nmol/l). The 3-DG levels were significantly (P &lt; 0.001) elevated even in the diabetic patients showing normoalbuminuria (n = 62, 322 ± 79 nmol/l) compared with control subjects. The 3-DG levels were further elevated in the patients with microalbuminuria (n = 30, 383 ± 146 nmol/l) and overt proteinuria (n = 18, 410 ± 100 nmol/l) (P = 0.027 and P &lt; 0.001 vs. normoalbuminuria group, respectively). This phenomenon was basically reproduced in a category of retinopathy. Furthermore, the diabetic patients with low nerve conduction velocity showed a tendency to display higher 3-DG levels.
CONCLUSIONS—The present results show that the fasting serum 3-DG level is elevated in diabetic patients and that the patients with relatively higher 3-DG levels were prone to suffer from more severe complications, indicating a possible association of 3-DG with diabetic microangiopathy.
Left Ventricular Systolic and Diastolic Function in Normotensive Type 1 Diabetic Patients With or Without Autonomic Neuropathy
Authors: Didangelos Triantaffilos P. , Arsos Georgios A. , Karamitsos Dimitrios T. , Athyros Vasilios G. , Karatzas Nikolaos D. 
Published: March 2007

OBJECTIVE—To investigate the relation between diabetic autonomic neuropathy (DAN) and left ventricular (LV) function in type 1 diabetic patients.
RESEARCH DESIGN AND METHODS—A total of 57 type 1 diabetic patients free of coronary artery disease and arterial hypertension were studied. Diagnosis of DAN was established by autonomic nervous function (ANF) tests, and LV systolic and diastolic functions were assessed by radionuclide ventriculography at rest.
RESULTS—There were 24 patients who had definite DAN, established by the presence of two or more abnormal ANF tests, and 33 subjects were without DAN. DAN patients had impaired LV filling pattern, obvious by a reduced peak filling rate (3.1 ± 1.1 vs. 3.7 ± 0.7 end-diastolic volume [EDV]/s, P = 0.011) and first third filling fraction (35.3 ± 19.5 vs. 50.8 ± 16%, P = 0.002) as well as an increased time to peak filling (159.4 ± 45.1 vs. 134.2 ± 33.4 ms, P = 0.02) after correction for age and heart rate. There were no differences between the two groups with regard to ejection fraction, cardiac output, and cardiac index, whereas the peak emptying rate was greater in DAN patients (4.1 ± 0.8 vs. 3.6 ± 0.8 EDV/s, P = 0.019), suggesting LV hypercontractility. DAN patients had an increased heart rate (83.4 ± 11.9 vs. 72.7 ± 9.3 bpm, P = 0.001) and slightly higher systolic blood pressure. As a result, LV working load at rest was higher in DAN patients (11,109 vs. 9,096 bpm × mmHg, P &lt; 0.001). Moreover, a correlation was found between abnormal LV systolic and diastolic indexes and the number of abnormal ANF tests.
CONCLUSIONS—At rest, DAN patients have impaired LV filling pattern, slightly increased LV systolic function, and a higher LV working load, in comparison to non-DAN type 1 diabetic patients.
Carbohydrate-Induced Memory Impairment in Adults With Type 2 Diabetes
Authors: Greenwood Carol E. , Kaplan Randall J. , Hebblethwaite Stacey , Jenkins David J.A. 
Published: March 2007

OBJECTIVE—Memory impairment is observed in adults with type 2 diabetes. The focus of this study was to determine whether acute carbohydrate consumption contributes to or exacerbates memory dysfunction.
RESEARCH DESIGN AND METHODS—The impact of consuming 50 g of rapidly absorbed carbohydrate (one half bagel and white grape juice) at breakfast was examined in 19 adults with type 2 diabetes. Subjects (mean age 63 ± 9 years, mean BMI 26.1 ± 4.5 kg/m2) were tested, under fed and fasted conditions, on verbal declarative memory using both word list and paragraph recall tests (immediate and delayed [7-min] recall), Trails Test Part B as a measure of general brain function, and mood (subjectively monitoring global vigor and affect).
RESULTS—Under baseline (fasting) conditions, elevated blood HbA1c was negatively associated with immediate and delayed paragraph recall performance (R2 = 0.30; P = 0.024) and higher fasting blood glucose trended toward poorer word list recall (R2 = 0.09; P = 0.102). Carbohydrate ingestion influenced measures of delayed, but not immediate, recall in a time-dependent fashion (time × food) (word list, P = 0.046; paragraph, P = 0.044) such that delayed recall was improved at 15 min postingestion but was impaired at 30 min. Neither Trails Test scores (P = 0.17) nor mood (affect, P = 0.68 and vigor, P = 0.45) were influenced by food ingestion.
CONCLUSIONS—In adults with type 2 diabetes, poorer glycemic control is associated with lower performance on tests of declarative memory. Acute ingestion of high glycemic index carbohydrate foods further contributes to the underlying memory impairment.
Population Health Significance of Gestational Diabetes
Authors: Cheung N. Wah , Byth Karen 
Published: March 2007

OBJECTIVE—Women who have had gestational diabetes mellitus (GDM) have a high risk of subsequently developing diabetes. However, the contribution of GDM toward the total population of people with diabetes, or its population health impact, has not been examined. Therefore, the aim of this study is to determine the population health significance of GDM by estimating the proportion of cases of diabetes in women that would have been preceded by a pregnancy complicated by GDM.
RESEARCH DESIGN AND METHODS—A MEDLINE search was conducted to identify controlled follow-up studies of women with GDM. Meta-analysis of these studies, using the Mantel-Haenszel method for pooling relative risks (RRs), provided an overall RR for the development of diabetes in women with GDM versus control women who had been pregnant without GDM. Recent large studies examining the prevalence of GDM were also reviewed. This enabled the calculation of the population-attributable risk (PAR) for these populations. In this case, the PAR represents the proportion of cases of diabetes among parous women that were associated with previous GDM.
RESULTS—From six controlled follow-up studies, the overall RR for developing diabetes after GDM was calculated to be 6.0 (95% CI 4.1–8.8). Applying this to the studies of GDM prevalence, the PAR for GDM ranged from 0.10 to 0.31 (i.e., 10–31% of parous women with diabetes would have experienced a GDM pregnancy earlier).
CONCLUSIONS—In some populations, women who have had GDM comprise a substantial proportion of subjects who ultimately develop diabetes. Effective measures to prevent women with GDM from progressing to frank diabetes could therefore have a significant population health impact.
Characteristics of Patients With Type 2 Diabetes in México
Authors: Aguilar-Salinas Carlos A. , Monroy Oscar Velazquez , Gómez-Pérez Francisco J. , Chávez Antonio Gonzalez , Esqueda Agustin Lara , Cuevas Virginia Molina , Rull-Rodrigo Juan A. , Conyer Roberto Tapia ,   for the ENSA (Encuesta Nacional de Salud) 2000 Group
Published: March 2007

OBJECTIVE—To describe the clinical characteristics of the diabetic population that formed part of a population-based survey conducted in México.
RESEARCH DESIGN AND METHODS—In 2000, information was obtained from 42,886 subjects aged ≥20 years using a multistage sampling procedure. Standardized questionnaires were used. Anthropometric measurements, blood pressure, and capillary glucose concentrations were taken.
RESULTS—Type 2 diabetes was found in 3,597 subjects (age-adjusted prevalence 8.18%), of which 2,878 (80%) had previously been diagnosed. The average age of the diabetic participants was 55.2 ± 13.5 years; 13% were &lt;40 years of age. Nine percent had been diagnosed for &gt;10 years. The average BMI was 29.2 ± 5.7 kg/m2; three-quarters of the cases had BMI &gt;25 kg/m2. The average waist circumference was 102 ± 13.4 cm, and increased waist circumference was more common among women. Arterial hypertension was found in half of the cases and, of those on treatment, only one-third had a blood pressure &lt;140/90 mmHg. Smoking was reported in 34% of the diabetic group, a higher rate than in the nondiabetic subjects. There was at least one modifiable coronary risk factor in 67.6% of the cases. Very few followed an exercise or dietary regimen and a small percentage used insulin.
CONCLUSIONS—Diabetes affects a large proportion of Mexican adults (8.18%). This figure may be underestimated. The majority of the subjects had modifiable risk factors for the chronic complications of diabetes. Only a few achieved adequate blood pressure control and other treatment goals.
Evaluating Concordance to American Diabetes Association Standards of Care for Type 2 Diabetes Through Group Visits in an Uninsured or Inadequately Insured Patient Population
Authors: Clancy Dawn E. , Cope Dennis W. , Magruder Kathryn Marley , Huang Peng , Wolfman Tamara E. 
Published: March 2007

OBJECTIVE—To evaluate the effectiveness of a managed care approach to health care delivery, group visits, in the management of uninsured or inadequately insured patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—A total of 120 patients with uncontrolled type 2 diabetes were randomly assigned to receive their care in group visits or usual care for 6 months. After 6 months, concordance with 10 process-of-care indicators recommended by the American Diabetes Association (ADA) standards of care was evaluated through chart abstraction. The 10 items evaluated were up-to-date HbA1c levels and lipid profiles, urine for microalbumin, appropriate use of ACE inhibitor or angiotensin receptor blockers, use of lipid-lowering agents where indicated, daily aspirin use, annual foot examinations, annual referrals for retinal examinations, and immunizations against streptococcal pneumonia and influenza.
RESULTS—Patients who received care in group visits showed statistically significant improvement in concordance with these 10 process-of-care indicators (P &lt; 0.001). Of the patients, 76% who received care in group visits had at least 9 of these 10 items up to date, as compared with 23% of control patients; 86% of patients in group visits had at least 8 of the 10 indicators compared with 47% of control patients.
CONCLUSIONS—Group visits proved more effective in promoting concordance with ADA standards of care than usual care in the treatment of uninsured or inadequately insured patients with type 2 diabetes.
Long-Term Mortality in Nationwide Cohorts of Childhood-Onset Type 1 Diabetes in Japan and Finland
Authors: Asao Keiko , Sarti Cinzia , Forsen Tom , Hyttinen Valma , Nishimura Rimei , Matsushima Masato , Reunanen Antti , Tuomilehto Jaakko , Tajima Naoko ,   for the Diabetes Epidemiology Research International (DERI) Mortality Study Group
Published: March 2007

OBJECTIVE—This study compares mortality from type 1 diabetes in Japan and Finland and examines the effects of sex, age at diagnosis, and calendar time period of diagnosis on mortality.
RESEARCH DESIGN AND METHODS—Patients with type 1 diabetes from Japan (n = 1,408) and Finland (n = 5,126), diagnosed from 1965 through 1979, at age &lt;18 years, were followed until 1994. Mortality was estimated with and without adjustment for that of the general population to assess absolute and relative mortality using Cox proportional hazard models.
RESULTS—Overall mortality rates in Japan and Finland were 607 (95% CI 510–718) and 352 (315–393), respectively, per 100,000 person-years; standardized mortality ratios were 12.9 (10.8–15.3) and 3.7 (3.3–4.1), respectively. Absolute mortality was higher for men than for women in Finland, but relative mortality was higher for women than for men in both cohorts. Absolute mortality was higher in both cohorts among those whose diabetes was diagnosed during puberty, but relative mortality did not show any significant difference by age at diagnosis in either cohort. In Japan, both absolute and relative mortality were higher among those whose diagnosis was in the 1960s rather than the 1970s.
CONCLUSIONS—Mortality from type 1 diabetes was higher in Japan compared with Finland. The increased risk of death from type 1 diabetes seems to vary by sex, age at diagnosis, and calendar time period of diagnosis. Further investigation, especially on cause-specific mortality, is warranted in the two countries.