bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phenotypic Expression of Diabetes Secondary to a T14709C Mutation of Mitochondrial DNA: Comparison with MIDD syndrome (A3243G mutation): a case report
Authors: Vialettes B H , Paquis-Flucklinger V , Pelissier J F , Bendahan D , Narbonne H , Silvestre-Aillaud P , Montfort M F , Righini-Chossegros M , Pouget J , Cozzone P J , Desnuelle C 
Published: March 2007

OBJECTIVE
To analyze the clinical and biochemical features of a recently described point mutation of mitochondrial DNA associated with diabetes. This mutation, characterized by a T14709C transition of a highly conserved nucleotide in the region coding for the glutamic acid tRNA, is heteroplasmic.

RESEARCH DESIGN AND METHODS
The phenotypic expression in the insulin-requiring diabetic proband from the pedigree was compared to that of diabetic probands from three families with the classic A3243G mtDNA mutation (maternally inherited diabetes and deafness [MIDD] syndrome). The same investigations to evaluate pancreatic neurosensorial and muscle involvement were performed in all four patients.

RESULTS
The natural courses of the diabetes and the hearing defects were not different between the two mutations. The patient with the 14,709 mutation, however, exhibited a milder alteration of pigmentary epithelium of retina and a much more severe muscle involvement, as attested by the clinical expression and the concurrent anomalies of muscle energy production evidenced by 31P magnetic resonance spectroscopy, confirming the profound impairment of oxidative processes.

CONCLUSIONS
This novel mutation has to be added to the other known mtDNA anomalies in order to ascribe some diabetes suspected to arise from mitochondrial defects to this nosological framework.
Visceral Fat and Cardiovascular Risk Factors in Chinese NIDDM Patients
Authors: Anderson Patricia J , Chan Juliana C N , Chan Y L , Tomlinson Brian , Young Robert P , Lee Zoe S K , Lee Kenneth K C , Metreweli Constantine , Cockram Clive S , Critchley Julian A J H 
Published: March 2007

OBJECTIVE
The interrelations between obesity, glucose intolerance, hypertension, dyslipidemia, and insulin resistance are well recognized. These relationships are of particular interest in Hong Kong's Chinese population, in whom increasing affluence has coincided with a marked increase in the prevalence of NIDDM. We designed a pilot study to examine the relationships between visceral fat and cardiovascular risk factors in Chinese NIDDM patients.

RESEARCH DESIGN AND METHODS
We studied 21 Chinese NIDDM patients whose visceral fat was quantified by magnetic resonance imaging. Cardiovascular risk factors including plasma lipids and 24-h ambulatory blood pressure (BP) were measured. In addition, insulin resistance was determined by a short insulin tolerance test (SITT).

RESULTS
Increased visceral adiposity was significantly correlated with plasma triglycerides (r = 0.63, P = 0.004), the total cholesterol/HDL cholesterol ratio (r = 0.61, P = 0.008), the urinary albumin/creatinine ratio (r = 0.49, P = 0.04), and decreased insulin sensitivity as measured by the SITT (r = 0.47, P = 0.03). When the data were analyzed by tertiles, increasing visceral fat area was associated with higher plasma triglycerides, lower HDL cholesterol, and a smaller plasma glucose decrement during the SITT. In addition, the diurnal rhythm in BP and heart rate tended to be best preserved in those with the least visceral obesity.

CONCLUSIONS
This pilot study demonstrates that visceral fat accumulation is associated with dyslipidemia, hypertension, insulin resistance, and albuminuria in Chinese patients with NIDDM.
Nighttime Insulin Kinetics and Glycemic Control in Type 1 Diabetes Patients Following Administration of an Intermediate-Acting Lispro Preparation
Authors: Janssen Maureen M J , Casteleijn Sandrina , Devillé Walter , Popp-Snijders Corrie , Roach Paris , Heine Robert J 
Published: March 2007

OBJECTIVE
To determine insulin kinetics and overnight glycemic control after bedtime administration of a new intermediate-acting insulin preparation called neutral protamine lispro (NPL).

RESEARCH DESIGN AND METHODS
We studied 12 patients with well-controlled type 1 diabetes. The study had a double-blind, randomized, crossover design. After a lead-in period of 10–14 days two experiments were carried out with an interval of 2–7 days. During these experiments overnight insulin kinetics and fasting blood glucose levels were studied after evening administration of NPH insulin and NPL. Blood glucose levels &lt; 3.8 mmol/l were treated by means of a variable infusion of a 20% glucose solution.

RESULTS
A trend toward a shorter time to peak insulin concentration was observed after administration of NPL (P = 0.07). No differences between NPH and NPL were detected in the total area under the curve (AUC) for insulin, in insulin levels before breakfast, or in glucose levels before breakfast (P = 0.5, 0.6, and 0.4, respectively).

CONCLUSIONS
We detected no major differences between NPH and NPL in the total AUC for insulin, prebreakfast glucose levels, or prebreakfast insulin levels. Therefore, we conclude that NPH and NPL are equally effective in controlling overnight glycemia.
Cancer Arising After Pancreas and/or Kidney Transplantation in a Series of 99 Diabetic Patients
Authors: Martinenghi Sabina , Dell'Antonio Giacomo , Secchi Antonio , Carlo Valerio Di , Pozza Guido 
Published: March 2007

OBJECTIVE
Recipients of solid organ transplants have an increased risk of developing certain types of malignancies as compared with the general population. The majority of the literature has reported on neoplasms in kidney and heart transplant recipients.

RESEARCH DESIGN AND METHODS
We describe 9 neoplasms occurring in 7 out of 73 IDDM patients after simultaneous pancreas and kidney transplantation. No cases were recorded among 26 IDDM recipients of kidney transplantation.

RESULTS
Among the neoplasms found were 2 cases of posttransplant lymphoproliferative disorder (PTLD), malignant melanoma, basal-cell and squamous-cell carcinoma of the skin in the same patient, squamous-cell carcinoma in situ of the vulva, hepatocarcinoma, small-cell lung cancer, and ductal carcinoma of the breast. Four patients died. Among immunological risk factors, over-immunosuppression for steroid-resistant kidney rejection was administered only in the 2 cases of PTLD.

CONCLUSIONS
Increased dosage of immunosuppressive agents may be necessary in some patients of prevent or treat rejection in view of their reduced survival on hemodialysis.
IDDM and Early Infant Feeding: Sardinian case-control study
Authors: Meloni Tullio , Marinaro Anna Maria , Mannazzu Maria Chiara , Ogana Augusto , Vecchia Carlo La , Negri Eva , Colombo Carla 
Published: March 2007

OBJECTIVE
To further investigate the association between the type of feeding in infancy and the development of IDDM.

RESEARCH DESIGN AND METHODS
We have carried out a case-control study in the area of Sassari (northern Sardinia, Italy), which is characterized by an ethnically homogenous population at high risk of IDDM. The study subjects comprised 100 IDDM patients and 100 control subjects, matched for sex and age and selected from children admitted at the Department of Pediatrics of the University of Sassari. Diabetic children (53 boys, 47 girls) had been diagnosed between 1983 and 1994, and their age at diagnosis ranged between 1 and 15 years. Information on feeding patterns during the 1st year of life was collected through questionnaires administered to the mothers. The questionnaire was designed to evaluate the duration of complete or partial breast-feeding and the age at which dietary products containing cow's milk were introduced into the diet.

RESULTS
A larger proportion of the diabetic children rather than the control children had been breast-fed, and the risk of IDDM among children who had not been breast-fed was below unity (odds ratio [OR] 0.41; 95% CI 0.19–0.91). No clear difference was observed between diabetic and control subjects in the duration of breast-feeding (medians: 3 and 2 months, respectively), even if, overall, the data suggested a slight increase in the risk of IDDM with longer duration of breast-feeding (OR 1.10; 95% CI 0.99–1.22 per month). Although a larger proportion of control children rather than diabetic children had been given cow's milk–derived formula and solid food before the age of 3 months, there was no time-risk relationship.

CONCLUSIONS
Our data do not support the existence of a protective effect of breast-feeding on the risk of IDDM, nor do the data indicate that early exposure to cow's milk and dairy products has any influence on the development of IDDM in a high-risk population.
Performance of an NIDDM Screening Questionnaire Based on Symptoms and Risk Factors
Authors: Ruige Johannes B , Neeling J Nico D de , Kostense Pieter J , Bouter Lex M , Heine Robert J 
Published: March 2007

OBJECTIVE
To investigate to what extent a short questionnaire on symptoms and risk factors can be used to identify people at increased risk for undiagnosed NIDDM.

RESEARCH DESIGN AND METHODS
A general population sample of 2,364 Caucasian subjects, age 50–74 years, not known to have diabetes, completed a questionnaire on diabetes-related symptoms and risk factors. Subsequently, they underwent an oral glucose tolerance test. A backward stepwise multiple logistic regression was carried out with the absence or presence of newly detected diabetes as the dependent variable and the items from the questionnaire as the independent variables. The selected items were included in a new symptom risk questionnaire, which was evaluated in a different population sample of 786 subjects, age 45–74 years, not known to have diabetes and compared with existing questionnaires.

RESULTS
The newly developed symptom-risk questionnaire contains questions concerning the following items, which were independently and significantly (P &lt; 0.05) associated with the presence of previously undiagnosed diabetes: pain during walking with need to slow down, shortness of breath when walking with people of the same age, frequent thirst, age, sex, obesity, parent or sibling with diabetes, use of antihypertensive drugs, and reluctance to use a bicycle for transportation. The 1993 American Diabetes Association questionnaire, the 1995 Herman et aL (17) questionnaire, and the newly developed symptom-risk questionnaire had sensitivities of 59, 72, and 72%; specificities of 57, 55, and 56%; positive predictive values of 5.6, 6.4, and 6.5%; and negative predictive values of 97, 98, and 98%, respectively.

CONCLUSIONS
The newly developed symptom-risk questionnaire has good performance characteristics, and the advantage of a variable cutoff makes it a useful screening tool for NIDDM in general practice.
Clustering of Childhood IDDM: Links with age and place of residence
Authors: Law Graham R , McKinney Patricia A , Staines Anthony , Williams Rhys , Kelly Mike , Alexander Freda , Gilman Estelle , Bodansky H Jonathan 
Published: March 2007

OBJECTIVE
To improve understanding of the etiology of IDDM by analyzing spatial and space-time distribution of the incidence in children.

RESEARCH DESIGN AND METHODS
Statistical tests to detect clustering were applied to a population-based register of 1,490 children (aged 0–16 years) with IDDM in Yorkshire, northern England. The Knox test analyzed clustering in space and time, and the Potthoff-Whittinghill test quantified spatial differences in incidence between small-area census units (electoral wards). The Potthoff-Whittinghill test was conditioned for childhood population density and deprivation (Townsend index).

RESULTS
Both tests demonstrated clustering of IDDM in Yorkshire children. Space-time and spatial clustering is strongest in the younger children (0–4 and 5–9 years of age), even after conditioning for known associations. Clustering was more common in the county of Humberside during the years 1982–1985 and in wards of low population density (&lt; 0.26 0- to 16 year-old subjects per hectare).

CONCLUSIONS
The study revealed a nonrandom space-time distribution of IDDM in children not accounted for by known covarying demographic factors. The Potthoff-Whittinghill test has not previously been applied to childhood IDDM. The new finding of strong clustering in young children is consistent with early exposure, possibly in utero, to infectious agents or localized environmental sources.
Carotid Atherosclerosis and Serum Lipoprotein(a) Concentrations in Patients With NIDDM
Authors: Yamamoto Maki , Egusa Genshi , Yamakido Michio 
Published: March 2007

OBJECTIVE
To investigate the association of carotid atherosclerosis and serum lipoprotein(a) [Lp(a)] concentrations in subjects with NIDDM.

RESEARCH DESIGN AND METHODS
We measured carotid intima-media thickness (IMT) and Lp(a) concentrations in 117 NIDDM subjects. Subjects were divided into tertiles according to IMT values and number of plaques.

RESULTS
Serum Lp(a), but not lipid and apoprotein levels, increased significantly with increasing IMT (20.0 ± 2.3, 24.7 ± 3.3, and 39.8 ± 4.3 mg/dl [mean ± SE], respectively, P &lt; 0.001). Serum Lp(a) increased with increasing number of plaques (18.4 ± 2.5 mg/dl in 59 subjects with no plaques, 25.8 ± 2.5 mg/dl in 24 subjects with 1 plaque, and 38.7 ± 5.1 mg/dl in 34 subjects with more than 1 plaque; P &lt; 0.05). Furthermore, the mean IMT and Lp(a) levels in the subjects with cerebrovascular disease (CD) were significantly higher than in those without CD (1.25 ± 0.04 mm and 41.2 ± 4.7 mg/dl vs. 1.08 ± 0.03 mm and 22.2 ± 1.9 mg/dl; P &lt; 0.005). The mean IMT and Lp(a) levels were higher in subjects with ischemic heart disease (IHD) than in those without IHD, although statistical significance was not observed (1.21 ± 0.06 mm and 31.7 ± 4.7 mg/dl vs. 1.10 ± 0.03 mm and 27.0 ± 2.4 mg/dl, respectively).

CONCLUSIONS
Elevated serum Lp(a) concentrations are associated with carotid atherosclerosis in NIDDM subjects.
Validity of Screening for Individuals at Risk for Type I Diabetes by Combined Analysis of Antibodies to Recombinant Proteins
Authors: Christie Michael R , Roll Ursula , Payton Mark A , Hatfield Emma CI , Ziegler Anette-G 
Published: March 2007

OBJECTIVE
To determine whether screening for the presence of multiple antibody markers for IDDM is effective at identifying individuals with high risk for disease development.

RESEARCH DESIGN AND METHODS
Antibodies to GAD and the tyrosine phosphatase-like protein IA-2 were determined in sequential serum samples from 44 first-degree relatives of IDDM patients, identified as possessing islet cell antibody (ICA) and/or insulin autoantibody (IAA), who were followed prospectively for IDDM development, ICA, IAA, and antibodies to GAD and IA-2 were also determined in 93 cases of new-onset nonfamilial IDDM.

RESULTS
The presence of two or more antibodies in addition to ICA or IAA conferred high risk (61%) for development of IDDM within 5 years of entry into the study and identified 89% of those who have developed IDDM on current follow-up. None of the relatives positive for ICA or IAA alone, in the absence of other antibody markers, have developed IDDM. Antibodies to islet antigens could both appear and disappear in follow-up samples obtained after entry into the study. The majority (60%) of young (&lt; 16 years), sporadic cases of IDDM had multiple antibodies to islet antigens, but this proportion was lower in older patients (37%).

CONCLUSIONS
A screening strategy based on the analysis of antibodies to multiple islet antigens can predict IDDM at high sensitivity and specificity in families, and such a strategy may also be applicable to identify young individuals in the general population with high disease risk. Since appearance of antibodies to different antigens occurs sequentially rather than simultaneously, accurate assessment of diabetes risk based on the presence of multiple antibodies will require follow-up over a number of years after the first evidence of islet autoimmunity.
Determinants of Growth in Diabetic Pubertal Subjects
Authors: Zachrisson I , Brismar K , Hall K , Wallensteen M , Dahlqvist G 
Published: March 2007

OBJECTIVE
To analyze the relationship among metabolic control, IGF-I, and growth in pubertal diabetic subjects.

RESEARCH DESIGN AND METHODS
In 72 diabetic children, we have studied the pattern of change of IGF-I, IGF-I SD score, IGF binding protein (BP)-1, and growth rate in different pubertal stages and have analyzed their relation to age sex, weight/length index, HbA1c, insulin concentration, insulin dose, and dehydroepiandrosteronesulfate (DHEAS).

RESULTS
The serum IGF-I values increased up to Tanner stage 4 and thereafter decreased, whereas IGFBP-1 showed the inverse pattern. When transforming the IGF-I values into SD scores, correcting for age, sex, and pubertal stage, it was shown that the deviation from normal values increased with increasing pubertal stage in boys, but was equal in stages 3–5 in girls. Using multiple regression analysis, HbA1c, insulin dose, and DHEAS were significantly correlated to IGF-I SD score (R2 = 0.253, P = 0.001). IGFBP-I levels in the afternoon were within normal range. LogIGFBP-1 showed an inverse correlation, to insulin concentration in single correlation (r = −0.26, P = 0.02). In single correlation, growth rate correlated significantly to insulin dose (r = 0.25, P = 0.03). In a multiple regression analysis, only DHEAS and IGF-I SD score were found to be significantly correlated to growth rate (R2 = 0.370, P &lt; 0.001). The 18 adolescents who had reached their final height did not deviate from their target final height, according to their recorded growth since birth.

CONCLUSIONS
In a group of fairly well-controlled diabetic children, the normal increase in IGF-I during puberty is blunted. Despite decreased IGF-I levels, target final height was attained, probably because of adequate insulin compensation leading to normal IGFBP-l, thus adequate bioavailability of IGF-I. Our results point out the importance of sufficient exogenous insulin in the period of rapid linear growth.
Long-Term Follow-Up of Diabetes in Two Patients With Thiamine-Responsive Megaloblastic Anemia Syndrome
Authors: Valerio Giuliana , Franzese Adriana , Poggi Vincenzo , Tenore Alfred 
Published: March 2007

OBJECTIVE
To describe a 15-year follow-up of diabetes and to present data regarding pancreatic β-cell function in two adolescents affected by the thiamine-responsive megaloblastic anemia (TRMA) syndrome.

CASE REPORTS
The first patient (PMR) is a 17.5-year-old Italian girl who presented megaloblastic anemia at 7.5 months of age. At age 2.5 years, because of the presence of diabetes and sensorineural deafness, she was diagnosed with TRMA syndrome and started treatment with thiamine-HCl, followed very early by benzoyloxymethyl-thiamine (BOM-T). The second patient (PF) is a 16.8-year-old Italian boy born to consanguineous parents. Sensorineural deafness was diagnosed at age 1.5 years, while diabetes with ketoacidosis and megaloblastic anemia were diagnosed at age 3 years. Treatment with thiamine HCl was started immediately after diagnosis and changed to BOM-T 2 months later. Subsequent to the initiation of the vitamin, the two patients did not require insulin for ∼ 7 and 10 years, respectively. Puberty was determinant in deteriorating the metabolic control in these patients, leading to treatment with an oral hypoglycemic agent and finally to a reinstitution of insulin therapy.

CONCLUSIONS
The hormonal assessment in our patients (normal insulin response to oral glucose in childhood, preserved C-peptide secretion in case 2) and the good response to an oral hypoglycemic agent would indicate that the pancreatic disease may initiate as type 2 diabetes and may progress after several years to an insulin-requiring diabetes, as indicated by the exhaustion of the insulin secretory capacity.
Comparison of GAD and ICA512/IA-2 Antibodies at and After the Onset of IDDM
Authors: Yokota Ichiro , Matsuda Junko , Naito Etsuo , Ito Michinori , Shima Kenji , Kuroda Yasuhiro 
Published: March 2007

OBJECTIVE
Longitudinal changes in GAD antibody (Ab) and ICA512/IA-2 (ICA512) Ab were examined in relation to age at the onset of diabetes and autoimmunity against the thyroid gland.

RESEARCH DESIGN AND METHODS
GADAb, ICA512Ab, and antithyroid autoantibody were examined at onset in 40 juvenile-onset IDDM patients (17 males, 23 females, age at onset 9.4 ± 4.1 years, range 1.7−20). To assess the changes in antibody levels, 29 patients were followed up with sequential serum samples for up to 5 years.

RESULTS
At onset, GADAb, ICA512Ab, and antithyroid autoantibody (thyroglobulinAb or thyroid peroxidaseAb) were found in 70, 58, and 25% of the 40 patients, respectively. Prepubertal patients (n = 21) had a significantly higher prevalence and index of ICA512Ab compared with pubertal patients (n = 19) (76 vs. 37%, P = 0.012, and 2.43 ± 2.36 vs. 0.66 ± 1.23, P = 0.011), while GADAb was more prevalent in pubertal patients (57 vs. 84%, P = 0.09). A longitudinal analysis of GADAb and ICA512Ab showed that GADAb levels declined more slowly than those of ICA512Ab (P = 0.008). Patients with continuous extremely high levels of GADAb also had high levels of antithyroid autoantibody.

CONCLUSIONS
The measurement of ICA512Ab is useful in prepubertal patients, who often show rapid progression of the disease. The presence of autoimmunity against thyroid gland seems to influence the GADAb level but not the ICA512Ab level.
Counterregulatory Hormone Responses After Long-Term Continuous Subcutaneous Insulin Infusion With Lispro Insulin
Authors: Tsui Elaine Y L , Chiasson Jean-Louis , Tildesley Hugh , Barnie Annette , Simkins Sari , Strack Thomas , Zinman Bernard 
Published: March 2007

OBJECTIVE
To determine whether the long-term use of insulin lispro (LP) affects the counterregulatory hormone response to hypoglycemia.

RESEARCH DESIGN AND METHODS
Ten patients (age range 26-51 years; ratio of men to women 9:1; BMI 24.9 ± 0.48; mean HbA1c 7.84 ± 0.25%) with IDDM, treated with continuous subcutaneous insulin infusion (CSII; Disetronic H-TRON V100) were studied using a double-blind, crossover design. Patients were randomized to LP or human regular insulin (HR) for 3 months and then crossed over to the other insulin for an additional 3 months. All meal boluses were given 0-5 min before breakfast, lunch, and dinner. Counterregulatory hormone responses to a stepped hypoglycemic clamp (consecutive glucose levels in mmol/l: 4.2; 3.5; 2.8, each for 1 h) were evaluated at the end of each treatment period.

RESULTS
HbA1c was significantly lower with LP versus HR (7.47 ± 0.28% vs. 7.9 ± 0.26%, P = 0.04). The incidence of hypoglycemia per 30 days (capillary blood glucose &lt; 3.0 mmol/l and/or symptoms) during the last month of the study was significantly lower with LP versus HR (8.7 ± 2.9 vs. 11.8 ± 2.9, P = 0.03). The total daily insulin dosage was not different in the two treatment periods. There was no episode of severe hypoglycemia or diabetic ketoacidosis. The peak growth hormone, cortisol, glucagon, and epinephrine responses during the same period of hypoglycemia were not different for each treatment period.

CONCLUSIONS
The use of LP in CSII results in improved glycemic control and a decrease in the frequency of hypoglycemia without adversely affecting counterregulatory hormone response to hypoglycemia.