bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptom Awareness Is Affected by the Subjects' Expectations During Insulin-Induced Hypoglycemia
Authors: Pohl Johannes , Frohnau Georg , Kerner Wolfgang , Fehm-Wolfsdorf Gabriele 
Published: March 2007

OBJECTIVE
To assess how expectations and symptom beliefs based on a previous episode of insulin-induced hypoglycemia influence symptom awareness after a second insulin injection in healthy subjects.

RESEARCH DESIGN AND METHODS
After a first episode of insulin-induced hypoglycemia in session 1, half of 40 healthy male subjects were told at the beginning of session 2 that they would receive human insulin (0.05 IU/kg), the other half saline. According to a 2 × 2 balanced placebo design, only half of each group received the announced substance, whereas the other half received the substance contrary to their expectations. Data collection at 10–15 min intervals included a symptom checklist, blood pressure, heart rate, plasma glucose, and counterregulatory hormone levels.

RESULTS
The expectation of a repeated hypoglycemia clearly influenced the subjects' psychophysiological responses. Without knowledge about the actual treatment, there was only an average maximum confidence of 65% of having received insulin. Expecting the insulin injection led to an increased sum score of neuroglycopenic symptoms but not of autonomic symptoms. Subjects expecting the insulin injection reported more weakness, blurred vision, and inner restlessness than those subjects expecting the saline injection. Those subjects correctly informed about receiving insulin experienced the most drowsiness, dizziness, and headaches. The expectations of the insulin injection increased the norepinephrine levels and the heart rate. The told insulin/given insulin group showed the highest glucagon levels.

CONCLUSIONS
The results support the hypothesis that the subjects' expectations influence their perceived symptoms.
Psychological Adjustment to IDDM: 10-Year Follow-Up of an Onset Cohort of Child and Adolescent Patients
Authors: Jacobson Alan M , Hauser Stuart T , Willett John B , Wolfsdorf Joseph I , Dvorak Ramona , Herman Leanna , Groot Mary De 
Published: March 2007

OBJECTIVE
To evaluate the psychological adjustment of young adults with IDDM in comparison with similarly aged individuals without chronic illness.

RESEARCH DESIGN AND METHODS
An onset cohort of young adults (n = 57), ages 19–26 years, who have been followed over a 10-year period since diagnosis, was compared with a similarly aged group of young adults identified at the time of a moderately severe, acute illness (n = 54) and followed over the same 10-year period. The groups were assessed at 10-year follow-up in terms of 1) sociodemographic indices (e.g., schooling, employment, delinquent activities, drug use), 2) psychiatric symptoms, and 3) perceived competence. In addition, IDDM patients were examined for longitudinal change in adjustment to diabetes.

RESULTS
The groups differed only minimally in terms of sociodemographic indices, with similar rates of high school graduation, post-high school education, employment, and drug use. The IDDM group reported fewer criminal convictions and fewer non-diabetes-related illness episodes than the comparison group. There were no differences in psychiatric symptoms. However, IDDM patients reported lower perceived competence, with specific differences found on the global self-worth, sociability, physical appearance, being an adequate provider, and humor subscales. The IDDM patients reported improving adjustment to their diabetes over the course of the 10-year follow-up.

CONCLUSIONS
Overall, the young adults with IDDM appeared to be as psychologically well adjusted as the young adults without a chronic illness. There were, however, indications of lower self-esteem in the IDDM patients that could either portend or predispose them to risk for future depression or other difficulties in adaptation.
Intake of a Diet High in Trans Monounsaturated Fatty Acids or Saturated Fatty Acids: Effects on postprandial insulinemia and glycemia in obese patients with NIDDM
Authors: Christiansen Erik , Schnider Sibylle , Palmvig Birthe , Tauber-Lassen E , Pedersen Oluf 
Published: March 2007

OBJECTIVE
High intake of trans fatty acids and saturated fatty acids (SFAs) is known to increase the risk of coronary heart disease. We studied the effects of diets enriched in various fatty acids on postprandial insulinemia and fasting serum levels of lipids and lipoproteins in obese patients with NIDDM.

RESEARCH DESIGN AND METHODS
Sixteen obese NIDDM patients were studied in a free-living outpatient regimen. After a run-in period, the patients received three different isocaloric diets for 6 weeks using a randomized crossover design. The patients were instructed to keep the energy intake from carbohydrate and protein constant at 50 and 20 E% (percent of energy intake), respectively, on all three diets. The fat composition of the diets differed: saturated fat (SAT) diet (20 E% SFAs, 5 E% polyunsaturated fatty acids [PUFAs], and 5 E% monounsaturated fatty acids [MUFAs]) versus cis monounsaturated fatty acid (CMUFA) diet (20 E% cis-MUFAs, 5 E% PUFAs, and 5 E% SFAs) versus trans monounsaturated fatty acid (TMUFA) diet (20 E% trans-MUFAs, 5 E% PUFAs, and 5 E% SFAs). Fasting serum levels of lipids and lipoproteins were measured at baseline and in the fasting state before meal tolerance tests at the end of each study period. Insulin secretion was assessed from incremental serum insulin and C-peptide responses during the meal tests.

RESULTS
BMI, waist-to-hip ratio, and glycemic control remained stable throughout the study. After meal stimulation, postprandial glycemic responses were similar on all diets; however, serum insulin and C-peptide responses were greater following the TMUFA and SAT diets than following the baseline or CMUFA diets (P &lt; 0.05). No statistical difference was found in fasting levels of serum lipids (total cholesterol, triglyceride, phospholipid, and nonesterified fatty acids) or lipoproteins of HDL cholesterol, VLDL cholesterol, LDL cholesterol, and apolipoprotein B between diets.

CONCLUSIONS
In the presence of unchanged glycemia, both dietary trans fatty acids and SFAs induce an increase in postprandial insulinemia in obese patients with NIDDM.
Increased Serum Levels of Advanced Glycation End Products (AGEs) in Children and Adolescents With IDDM
Authors: Berg Tore J , Dahl-Jørgensen Knut , Torjesen Peter A , Hanssen Kristian F 
Published: March 2007

OBJECTIVE
To investigate whether the serum levels of advanced glycation end products (AGEs) are increased in IDDM children and adolescents and to study the effect of puberty on serum levels of AGEs (S-AGEs).

RESEARCH DESIGN AND METHODS
A total of 68 children and adolescent IDDM patients (age, 13.3 ± 4.0 years; duration of diabetes, 5.0 ± 3.6 years; HbA1c, 8.2 ± 2.0%; Tanner stage [public hair], 1 vs. 2–5, 24/42) recruited from the pediatric outpatient clinic at Aker University Hospital were compared with 25 healthy nondiabetic control subjects. S-AGEs were measured by a fluoremetric immunoassay.

RESULTS
S-AGEs were significantly elevated in the diabetic group when compared with the control group (14.4 ± 3.5 vs. 11.7 ± 3.0 U/ml, P &lt; 0.002). A significant correlation (r = 0.26, P &lt; 0.04) was found between S-AGEs and HbA1c in the diabetic group but not in the control group. No significant correlation was found between S-AGEs and the duration of diabetes in the diabetic group or S-AGEs and blood glucose concentration or age in either group. We found no difference between S-AGEs in boys and girls and in prepubertal and pubertal diabetic or control subjects.

CONCLUSIONS
S-AGEs are increased in young patients with diabetes before puberty. Since AGEs are linked to the pathogenesis of vascular complications, this observation suggests that the pathological processes leading to diabetic late complications start even before puberty.
Transcapillary Escape Rate of Albumin in Type II Diabetic Patients: The relationship with microalbuminuria and hypertension
Authors: Nannipieri Monica , Penno Giuseppe , Rizzo Loredana , Pucci Laura , Bandinelli Simona , Mattei Paola , Taddei Stefano , Salvetti Antonio , Navalesi Renzo 
Published: March 2007

OBJECTIVE
To study why in type II diabetes, microalbuminuria, a marker of generalized vascular dysfunction, and hypertension have been linked with both renal and cardiovascular organ damage.

RESEARCH DESIGN AND METHODS
To investigate the effect of moderately elevated blood pressure on vascular damage, the transcapillary escape rate of albumin (TERalb) was measured by intravenous injection of purified 125I-human serum albumin in 9 healthy control subjects (group 1), 9 nondiabetic hypertensive subjects (group 2), and 73 nonobese type II diabetic patients stratified as follows: group 3: 17 normoalbuminuric-normotensive subjects; group 4: 22 normoalbuminuric-hypertensive subjects (systolic blood pressure [sBP] ≥ 140 mmHg or diastolic blood pressure [dBP] ≥ mmHg or both); group 5: 16 normotensive subjects with microalbuminuria (albumin excretion rate [AER]: 20–200 μg/min); and group 6: 18 microalbuminuric-hypertensive subjects.

RESULTS
Groups 3–6 had similar age, sex, duration of diabetes (group 3: 7.8 ± 5.5; group 4: 9.7 ± 8.7; group 5: 12.1 ± 8.1; and group 6: 10.7 ± 8.3 years), BMI, HbA1c (7.8 ± 1.1, 7.5 ± 1.5, 8.7 ± 1.5, and 7.7 ± 1.1%, respectively), blood glucose, and lipid profile. Systolic and diastolic blood pressure did not differ in the three hypertensive group (group 2: 154 ± 3/99 ± 6; group 4: 149 ± 13/95 ± 6; group 6: 154 ± 15/91 ± 9 mmHg) and were significantly lower (P &lt; 0.001) in group 3 (126 ± 12/76 ± 7), group 5 (128 ± 11/77 ± 5), and healthy control subjects (group 1: 133 ± 7/81 ± 4). TERalb was similar in control subjects (5.77 ± 1.06%/h) and in normoalbuminuric-normotensive subjects (5.81 ± 1.51%/h) but significantly higher (P &lt; 0.0001) in microalbuminuric subjects with or without hypertension (9.11 ± 1.65 and 8.60 ± 1.50%/h, respectively) as well as in normoalbuminuric diabetic patients with hypertension (8.10 ± 2.27%/h) and in essential hypertensive subjects (8.12 ± 1.68%/h).

CONCLUSIONS
By stepwise regression, TERalb was related (step 1) to log-AER (r = 0.30) or to the presence of microalbuminuria (r = 0.36) and (step 2) to dBP (multiple r = 0.40) or to the presence of hypertension (multiple r = 0.51) in the whole diabetic cohort (groups 3–6). TERalb was related to dBP (r = 0.47) or to the presence of hypertension (r = 0.56) only in normoalbuminuric diabetic patients (groups 3 and 4) and to log-AER (r = 0.56) or the presence of microalbuminuria (r = 0.68) only in normotensive patients (groups 3 and 5). In type II diabetic patients, TERalb was elevated in subjects with increased albuminuria, irrespective of blood pressure levels, but also was independently related to the presence of mild-to-moderate systemic hypertension.
The Independent and Combined Effects of Aerobic Exercise and Dietary Fish Intake on Serum Lipids and Glycemic Control in NIDDM: A randomized controlled study
Authors: Dunstan David W , Mori Trevor A , Puddey Ian B , Beilin Lawrie J , Burke Valerie , Morton Alan R , Stanton Kim G 
Published: March 2007

OBJECTIVE
The triglyceride-lowering effects of ω-3 fats and HDL cholesterol-raising effects of exercise may be appropriate management for dyslipidemia in NIDDM. However, fish oil may impair glycemic control in NIDDM. The present study examined the effects of moderate aerobic exercise and the incorporation of fish into a low-fat (30% total energy) diet on serum lipids and glycemic control in dyslipidemic NIDDM patients.

RESEARCH DESIGN AND METHODS
In a controlled, 8-week intervention, 55 sedentary NIDDM subjects with serum triglycerides &gt; 1.8 mmol/l and/or HDL cholesterol &lt; 1.0 mmol/l were randomly assigned to a low-fat diet (30% daily energy intake) with or without one fish meal daily (3.6 g ω-3/day) and further randomized to a moderate (55–65% VO2max) or light (heart rate &lt; 100 bpm) exercise program. An oral glucose tolerance test (75 g), fasting serum glucose, insulin, lipids, and GHb were measured before and after intervention. Self-monitoring of blood glucose was performed throughout.

RESULTS
In the 49 subjects who completed the study, moderate exercise improved aerobic fitness (VO2max) by 12% (from 1.87 to 2.07 l/min, P = 0.0001). Fish consumption reduced triglycerides (0.80 mmol/l, P = 0.03) and HDL3 cholesterol (0.05 mmol/l, P = 0.02) and increased HDL2 cholesterol (0.06 mmol/l, P = 0.01). After adjustment for age, sex, and changes in body weight, fish diets were associated with increases in GHb (0.50%, P = 0.05) and self-monitored glucose (0.57 mmol/l, P = 0.0002), which were prevented by moderate exercise.

CONCLUSIONS
A reduced fat diet incorporating one daily fish meal reduces serum triglycerides and increases HDL2 cholesterol in dyslipidemic NIDDM patients. Associated deterioration in glycemic control can be prevented by a concomitant program of moderate exercise.
Relationship Between Weight Change in Young Adulthood and the Risk of NIDDM: The Sotetsu Study
Authors: Sakurai Yutaka , Teruya Koji , Shimada Naoki , Wakabayashi Kazuo , Umeda Takashi , Honjo Satoshi , Todoroki Isao , Tanaka Hiroyuki , Muto Takashi , Sakurai Masaru , Nakamura Kou 
Published: March 2007

OBJECTIVE
To investigate the independent effect of weight change in young adulthood on the risk of prevalent NIDDM among middle-aged Japanese men.

RESEARCH DESIGN AND METHODS
A case-control study was carried out in 895 male employees aged ≥ 30 years of a railway company located in the vicinity of Tokyo. Adjusted odds ratios (ORs) were calculated for prevalent diabetes in each category of weight change (obtained from subjects' medical records) in young adulthood and adulthood. Adjustment for current age, initial BMI, and weight change in each age stratum was performed by the Mantel-Haenszel method or multiple logistic regression analysis.

RESULTS
Weight change between 20 years of age and the age at maximum weight was not associated with the risk of NIDDM. Weight gain between 20 and 25 years of age was significantly and positively associated with the risk of NIDDM (OR 3.87 for gains ≥ 10.0 kg, 2.53 for gains of 5.0–9.9%, and 3.73 for gains ≥ 10.0%). On the other hand, moderate weight gain after 30 years of age was significantly inversely associated with NIDDM (OR 0.44 for gains of 5.0–9.9 kg, 0.15 for gains of 10.0–19.9%, and 0.38 for gains of 20.0–29.9%).

CONCLUSIONS
Extreme weight gain between 20 and 25 years of age is a significant predictor of NIDDM, independent of current age, BMI at 20 years of age, and weight change within other age strata.
Diabetes Associated With a Novel 3264 Mitochondrial tRNALeu(UUR) mutation
Authors: Suzuki Yoshihiko , Suzuki Susumu , Hinokio Yoshinori , Chiba Masaki , Atsumi Yoshihito , Hosokawa Kazuhiro , Shimada Akira , Asahina Takayuki , Matsuoka Kempei 
Published: March 2007

OBJECTIVE
To present a novel mitochondrial DNA mutation in a diabetic family

RESEARCH DESIGN AND METHODS
The proband was a 64-year-old man. In the family, diabetes was maternally inherited. He had diabetes, cerebellar ataxia, cervical lipoma, hearing loss, olfactory dysfunction, ophthalmoplegia, and facial nerve bilateral palsy. On examination, early insulin secretion was blunted, and the M value on glucose clamp test was low. In muscle, ragged red fibers were not found. T-to-C mutation at position 3264 was detected in the proband (0.5% mutant DNAs in leukocyte and 30% in muscle), but was not detected in 201 normal individuals.

RESULTS
Heteroplasmy of mutation, maternal inheritance of diabetes, and symptoms related to mitochondrial dysfunction suggest the pathogenecity of this 3264 mutation. As for diabetes etiology, both impaired insulin secretion and decreased insulin sensitivity seem to be important. In phenotypic characteristics, the combination of cerebellar ataxia and lipoma is a symptom sometimes found in myoclonic epilepsy and ragged red fibers (MERRFs). Ophthamoplegia is a symptom of chronic progressive external ophthalmoplegia (CPEO). These suggest that our proband had phenotypic overlap with MERRF and CPEO. Conversely, facial nerve bilateral palsy is a rare finding. The pictures that focused on his cranial nerves were thus unique, suggesting the heterogeneity of mitochondrial DNA (mtDNA)-related diabetes.

CONCLUSIONS
A novel 3264 mitochondrial DNA mutation in diabetes gives new insight to the etiology of mitochondrial diabetes. Its pathogenecity supports the belief that the tRNA(Leu)(UUR) gene is an etiological hot spot of mitochondrial diseases.
Mortality of Childhood-Onset IDDM Patients: A cohort study in Havana City Province, Cuba
Authors: Collado-Mesa Fernando , Díaz-Díaz Oscar , Melián-Torres Ruber , Suárez-Pérez Rolando , Vera-González Manuel , Aldana-Padilla Deysi 
Published: March 2007

OBJECTIVE
To determine the survival pattern and the underlying cause of death in a cohort of childhood-onset IDDM subjects from Havana City Province, Cuba.

RESEARCH DESIGN AND METHODS
This was a descriptive study carried out on a historical cohort of IDDM subjects with disease onset before 15 years of age in Havana City Province, Cuba. The cohort was assembled from several sources. Subjects were diagnosed from 1965 to 1980, and their vital status was assessed at 31 December 1991. Cumulative survival rate was calculated by the Kaplan-Meier method, and a univariate analysis was performed. To test survival differences between groups, the Cox-Mantel test was used. To compare the cohort mortality with the general population, standardized mortality ratios by sex and age were calculated. Specific causes of death were determined by a committee examining death certificates, clinical records, and necropsy reports.

RESULTS
A total of 504 subjects were identified, and the mean follow-up time was 17.5 years. Of the subjects, 70 (13.9%) had died at 31 December 1991. Overall, the cohort had a 71% cumulative survival rate at 25 years of IDDM duration. There were no survival differences according to sex or calendar period of IDDM diagnosis. Statistically significant differences were found among age-at-diagnosis groups. The group with a peripubertal age at diagnosis showed the worst prognosis. The cohort experienced 8.5 times the all-causes death rate, compared with the general population. Renal disease accounted for almost half the deaths.

CONCLUSIONS
IDDM subjects from Havana City Province, Cuba, showed a better survival pattern than IDDM subjects from other developing countries. However, when compared with IDDM populations from developed countries, there is a survival reserve to be achieved by reducing mortality due to renal disease and infections.
Serum Insulin and Lipoprotein(a) Concentrations: The Jichi Medical School Cohort Study
Authors: Inoue Kazuo , Nago Naoki , Matsuo Hitoshi , Goto Tadao , Miyamoto Takeshi , Saegusa Tomohiro , Ishikawa Shizukiyo , Kario Kazuomi , Nakamura Yosikazu , Igarashi Masahiro 
Published: March 2007

OBJECTIVE
To examine the relationship between serum insulin and lipoprotein(a) [Lp(a)] concentrations in both sexes in a large population.

RESEARCH DESIGN AND METHODS
The authors conducted a cross-sectional investigation of fasting serum concentrations of insulin and Lp(a), other blood tests, blood pressures, anthropological measurements, physical activity index, smoking habit, alcohol consumption, and menopause. The subjects were 1,121 men and 1,480 women, ranging between 30 and 90 years of age, who were voluntary participants in the Jichi Medical Cohort Study and who resided in one of five rural communities in Japan.

RESULTS
In men, insulin, age, BMI, LDL cholesterol, triglycerides, glucose, and fibrinogen were significantly correlated with Lp(a). In women, insulin, age, LDL cholesterol, fibrinogen, and activated coagulation factor VII were significantly correlated with Lp(a). However, all correlations were weak in either sex. Insulin was inversely correlated with Lp(a) in both sexes. However, the coefficients were weak (r = −0.16 in mean and r = −0.06 in women). In the partial correlation analyses, Lp(a) was not significantly associated with insulin in either sex. The result was not influenced by selecting the subjects on the basis of detectable values of insulin and Lp(a) and stratifying them by serum glucose level.

CONCLUSIONS
There was no significant relationship found between serum insulin and Lp(a) concentrations in either sex of the cohort, which indicates that Lp(a) does not play a role in the increased risk of cardiovascular disease in hyperinsulinemic subjects.
Which Features of Smoking Determine Mortality Risk in Former Cigarette Smokers With Diabetes? The World Health Organization Multinational Study Group
Authors: Chaturvedi Nish , Stevens Lynda , Fuller John H ,   The World Health Organization Multinational Study Group
Published: March 2007

OBJECTIVE
The effects of quitting smoking on mortality risk in individuals with diabetes is unknown and may differ from the benefits observed in the general population. We therefore determined the mortality risks in ex-smokers with diabetes, compared with subjects who have never smoked, by the number of years since quitting, the number of cigarettes smoked, and the number of years of smoking.

RESEARCH DESIGN AND METHODS
An international cohort study of 4,427 individuals with diabetes was studied. Baseline examinations were performed in 1975–1977 when smoking habits were determined by questionnaire. Mortality follow-up continued until 1988.

RESULTS
All-cause mortality risks were higher for recent quitters (1–9 years; relative risk [RR], 1.53 [95% CI 1.19–1.97]; P = 0.001) than for those who quit earlier (≥ 10 years; RR, 1.25 [95% CI 1.03–1.52]; P = 0.02), compared with subjects who have never smoked. These risks were highest in those who had smoked the longest (≥ 30 years: RR, 1.66 [95% CI 1.22–2.26]; P = 0.001; vs. 1–9 years: RR, 1.17 [95% CI 0.85–1.60]; P = 0.3). Risks were also highest in those who had smoked the most and least number of cigarettes. Adjustment for key confounders, which included a previous history of heart disease, proteinuria, and blood pressure, did not materially affect these relationships.

CONCLUSIONS
Quitting smoking does reduce mortality risk in ex-smokers with diabetes, but risks remain high several years after quitting and are highly dependent on the duration of smoking. Thus, individuals with diabetes who smoke should be encouraged to quit as soon as possible in the course of disease.