bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Bedtime NPH or Preprandial Regular Insulin Combined With Glibenclamide in Secondary Sulfonylurea Failure
Authors: Landstedt-Hallin Lena , Adamson Ulf , Arner Peter , Bolinder Jan , Lins Per-Eric 
Published: March 2007

OBJECTIVE
To compare the effect of bedtime NPH insulin or preprandial regular insulin combined with glibenclamide on metabolic control in non-insulin-dependent diabetes mellitus (NIDDM) patients with secondary failure to sulfonylurea therapy.

RESEARCH DESIGN AND METHODS
Eighty NIDDM patients were randomized to treatment with either three preprandial doses of regular insulin (daytime group D) or a bedtime dose of NPH insulin (nocturnal insulinization, group N), both regimens being combined with 10.5 mg of glibenclamide. Metabolic profiles were obtained at 0, 6, 16 weeks.

RESULTS
Glycemic control had improved significantly in both groups after 4 months. Fasting blood glucose was significantly lower compared with baseline in both groups. The mean change ± SD in group D was −2.8 ± 3.5 mmol/l and in group N −6.4 ± 3.0 mmol/L, the reduction being more pronounced in group N compared with group D (P &lt; 0.0001). HbA1c was lowered similarly, from 9.2 ± 1.4 to 7.1 ± 1.2% in group D (P &lt; 0.0001) and from 9.1 to 1.1 to 7.5 ± 1.5% in group N (P &lt; 0.0001). The total daily insulin doses were similar, 29 ± 11 U in group D and 26 ± 9 U in group N, and the circulating insulin levels during daytime were higher in group D than in group N. Total serum cholesterol and triglycerides were similarly and significantly lowered compared with baseline in both groups. Weight gain was more pronounced in group D (3.4 ± 0.3 kg) than in group N (1.9 ± 1.9 kg; D vs. N, P &lt; 0.002), and the change was inversely correlated with initial eight but not with the improvement in HbA1c.

CONCLUSIONS
The two insulin regimens exert similar effect on glucose metabolism and serum lipids in NIDDM patients on combination therapy. Weight gain is more pronounced in patients given insulin during the daytime when preprandial doses of short-acting insulin are used.
Demonstration, of Insulin Resistance in Coronary Artery Disease Documented With Angiography
Authors: Shinozaki Kazuya , Suzuki Masaaki , Ikebuchi Motoyoshi , Hara Yasushi , Harano Yutaka 
Published: March 2007

OBJECTIVE
To evaluate the relation between insulin resistance and coronary atherosclerosis, insulin sensitivity in lean nondiabetic, normotensive subjects with and without obstructive coronary artery disease (CAD). The correlation between insulin resistance and degree of coronary stenosis was also investigated.

RESEARCH DESIGN AND METHODS
Four groups were studied: 1) nine subjects with normal glucose tolerance(NGT) without CAD, 2) 10 subjects with NGT with CAD, 3) nine subjects withimpaired glucose tolerance (IGT) without CAD, and 4) 10 subjects with IGT with CAD. Insulin sensitivity was determined by the steady-state plasma glucose (SSPG) method using Sandostatin. Coronary angiography was performed in all study subjects, and the severity of coronary artery atherosclerosis wasquantified in a modified Gensini score.

RESULTS
The SSPG (millimoles per liter) levels were significantly higher in the patients with CAD compared with control subjects (control vs. patient group: 4.8 ±0.5 vs. 7.9 ± 0.9 with NGT, P &lt; 0.05; 5.6 ± 0.5 vs. 11.1 ± 0.8 with IGT, P &lt; 0.001), indicating the presence of insulin resistance in patients with CAD. The coronary atherosclerosis score (CAS) was significantly and positively correlated with SSPG (r = 0.74, P &lt; 0.05) and 2-h insulin area (r = 0.78, P &lt; 0.01) in NGT subjects with CAD. On the other hand, the percentage fall of plasma free fatty acid (0–30 min) during an insulin sensitivity test was significantly decreased in the subjects with CAD and was inversely correlated with the CAS (r = −0.43, P &lt; 0.05), especially in NGT subjects with CAD.

CONCLUSIONS
These data suggest that in patients with CAD, insulin-mediated glucose metabolism is significantly impaired, and a significant correlation was noted between insulin resistance and severity of CAD. Therefore, the hyperinsulinemia often observed in patients with CAD is attributable to the compensatory mechanism of the β-cell to the inadequate action of insulin for glucose metabolism. Hyperinsulinemia in the presence of insulin resistance aggravates dyslipidemia and may stimulate the atheromatous process by an as-yet-unknown mechanism.
Subcutaneous or Intramuscular Injections of Insulin in Children: Are we injecting where we think we are?
Authors: Polak Michel , Beregszaszi Marta , Belarbi Nadia , Benali Karim , Hassan Max , Czernichow Paul , Tubiana-Rufi Nadia 
Published: March 2007

OBJECTIVE
This study was designed to assess the insulin injection location in a group of children who had their injection according to their daily practice, thought to lead to subcutaneous injections.

RESEARCH DESIGN AND METHODS
The location of the insulin deposit at the injection site was visualized using an ultrasound device.

RESULTS
The exact insulin injection location could be localized, and 18 of 59 injections (30.5%) (one injection for each child) were in the intramuscular tissue. Of the children who had intramuscular injection, 15 of 18 were boys. The children who had an intramuscular injection had a significantly lower percentile of BMI (mean ± SE: 47 ± 8 vs. 72 ± 4, P = 0.004), lower distance from skin surface to muscle fascia without a skinfold (5.6 ± 0.6 vs. 11 ± 0.7 mm, P &lt; 0.0001), and a lower distance from skin surface to muscle fascia with a skinfold (8.1 ± 0.9 vs. 15.9 ± 0.8 mm, P &lt; 0.0001) than children who had a subcutaneous insulin injection.

CONCLUSIONS
We identified a group of children at risk for intramuscular insulin injections and that may deserve specific injection technique and advice.
Capillary Blood on Filter Paper for Determination of HbA1c by Ion Exchange Chromatography
Authors: Jeppsson Jan-Olof , Jerntorp Peter , Almër Lars-Olof , Persson Ruth , Ekberg Göran , Sundkvist Göran 
Published: March 2007

OBJECTIVE
To facilitate HbA1c determination, we evaluated an HbA1c filter paper system enabling capillary blood sampling at home by the patients.

RESEARCH DESIGN AND METHODS
Capillary blood (two drops) was applied to a filter paper (HbA1c Via Post) and sent to the laboratory where a small disc was punched out on the filter paper. Hemoglobin was eluted from the disc in a buffer containing cysteine to eliminate the interfering glutathione adduct (HbA3) formed during storage. Analysis was performed by ion-exchange chromatography (Mono S, high-performance liquid chromatography), and the eluate was compared with hemolysate of venous blood from 41 patients. The stability of blood impregnated on filter paper was checked at different temperatures over different periods of time.

RESULTS
There was an excellent agreement (r = 0.99) between HbA1c values from capillary blood on filter paper and HbA1c values from venous blood. HbA1c values were constant when stored on filter paper for 5–7 days at 20–21°C (room temperature) or at 4–6°C (refrigerator) for 10 days as well as at −70°C for several months after blood sampling. A new chromatographic-interfering hemoglobin fraction both from venous and capillary samples was identified as free alpha-chain of hemoglobin.

CONCLUSIONS
The HbA1c filter paper system enables capillary blood sampling at home, eliminates the need of vein puncture in children and adults, and provides the diabetologist with an HbA1c value when the patient visits the clinic without a need for a previsit phlebotomy.
Factors Associated With Glucose and Insulin Levels in Healthy Postmenopausal Women
Authors: Barrett-Connor Elizabeth , Schrott Helmut G , Greendale Gail , Kritz-Silverstein Donna , Espeland Mark A , Stern Michael P , Bush Trudy , Perlman Jeffrey A 
Published: March 2007

OBJECTIVE
Little is known about the covariates of hyperglycemia and hyperinsulinemia. We examined candidate factors in postmenopausal women.

RESEARCH DESIGN AND METHODS
We determined the cross-sectional associations of sociodemographic, body-size, lifestyle, reproductive, and menopausal factors with pretrial fasting and postchallenge glucose and insulin levels in 869 postmenopausal women aged 45-65 years. Women were participants in the Postmenopausal Estrogen/Progestin Interventions study who were not taking estrogen or insulin.

RESULTS
Plasma glucose levels increased significantly with age; serum insulin levels did not. BMI and waist-to-hip ratio (WHR) each showed graded positive and independent associations with glucose and insulin levels. Alcohol intake, cigarette smoking, physical activity, parity, education, and income were also associated with insulin or glucose in age-adjusted models. In multivariable models, BMI and WHR explained 18% of the variability in fasting glucose, 16% in postchallenge glucose, 28% in fasting insulin, and 17% in postchallenge insulin. Age and all other factors combined accounted for &lt;6% of the variance in glucose or insulin. In multiply adjusted models, African-American and Hispanic women had higher fasting and 2-h insulin levels than non-Hispanic white women.

CONCLUSIONS
Most of the variance in glycemia and insulin is unexplained. Measures of obesity and fat distribution account for nearly all the explained variance.
Raised Serum Sialic Acid Concentration Precedes Onset of Microalbuminuria in IDDM: A 10-year follow-up study
Authors: Yokoyama Hiroki , Jensen Jan Skov , Myrup Bjarne , Mathiesen Elisabeth R , Rønn Birgitte , Deckert Torsten 
Published: March 2007

OBJECTIVE
Elevated concentrations of serum sialic acid, a potent cardiovascular risk factor in the general population, have been found in patients with IDDM and microalbuminuria. We investigated whether a coincidence exists between the increase of sialic acid concentrations and albuminuria in the transition from normoalbuminuria to microalbuminuria. Furthermore, the predictability of increased sialic acid as well as von Willebrand factor (vWF) and total and HDL cholesterol concentrations in development of persistent microalbuminuria in IDDM was investigated.

RESEARCH DESIGN AND METHODS
This 10-year prospective study was carried out in a cohort of 209 IDDM patients with normoalbuminuria at baseline.

RESULTS
Of the cohort, 198 patients completed the follow-up period and 27 developed persistent microalbuminuria (urinary albumin excretion rate [UAER] ≥ 30 mg/24 h). A coincident increase of UAER and serum sialic acid concentration was seen before persistent microalbuminuria was diagnosed. Elevation of serum sialic acid concentrations in those who later developed microalbuminuria occurred 3 years before the diagnosis of persistent microalbuminuria. Baseline serum sialic acid concentrations were significantly higher in the group of patients who later developed microalbuminuria than in the group who remained normoalbuminuric (2.02 ± 0.41 vs. 1.85 ± 0.31 mmol/l [means ± SD], P &lt; 0.05). Baseline serum sialic acid concentration correlated significantly with HbA1c, UAER, blood pressure, total cholesterol, HDL cholesterol, and vWF and was significantly predictive for development of microalbuminuria (hazards ratio [95% CI], 3.1 [1.2–8.1]; P = 0.02) after adjustments for sex, duration of diabetes, smoking, blood pressure, vWF, total cholesterol, and HDL cholesterol. Adjustment for the effects of HbA1c and UAER, however, canceled out the predictive effect of serum sialic acid.

CONCLUSIONS
UAER and serum sialic acid concentration increase coincidentally before the onset of persistent microalbuminuria. An increased serum sialic acid concentration is predictive for the onset of microalbuminuria independent of age, sex, diabetes duration, smoking, blood pressure, vWF, and total HDL cholesterol.
Promoting Weight Loss in Type II Diabetes
Authors: Brown Sharon A , Upchurch Sandra , Anding Roberta , Winter Mary , Ramìrez Gilbert 
Published: March 2007

OBJECTIVE
To examine strategies—behavioral therapies, exercise, diet, anorectic drugs, surgery, or a combination of strategies—used for promoting weight loss in people with type II diabetes.

RESEARCH DESIGN AND METHODS
Meta-analysis was used to synthesize research of promoting weight loss in the population. Literature search strategies involved reviewing bibliographies, conducting computer searches and surveys of relevant master's degree programs, and contacting representatives of the Centers for Disease Control. The final sample consisted of 89 studies involving 1,800 subjects. Data were extracted on 80 variables characterizing the sample of studies/subjects and on 23 outcome variables, including weight, metabolic control, lipids, and other physiological parameters.

RESULTS
Diet alone had the largest statistically significant impact on weight loss (−20 lb) and metabolic control (−2.7% in glycosylated hemoglobin). All diets significantly improved fasting blood sugar. Behavioral programs alone had a statistically significant impact on weight loss (−6.4 lb) and metabolic control (−1.5%) but effects were &lt; for diet alone. Data from the few exercise studies indicated that weighted average effects for exercise on weight loss (−3.4 lb) and metabolic control (−0.8%) were &lt; diet alone. Behavioral therapy plus diet plus exercise was associated with statistically significant effect size estimates for weight loss (−8.5 lb) and metabolic control (−1.6%). Diet alone achieved better results. Effects of weight promotion strategies, in general, were smaller in experimental studies and for individuals over age 55.

CONCLUSIONS
Dietary strategies are most effective for promoting short-term weight loss in type II diabetes. A number of gaps exist in the extant literature—descriptions of subjects, interventions, or longitudinal outcomes beyond 12 months after intervention.
Comparisons of Studies on Diabetic Complications Hampered by Differences in GHb Measurements
Authors: Kullberg Carin E , Bergström Anders , Dinesen Bo , Larsson Lasse , Little Randie R , Goldstein David E , Arnqvist Hans J 
Published: March 2007

OBJECTIVE
To compare glycated hemoglobin (GHb) values of the relationship between glycemic control and complications of diabetes from laboratories involved in long-term studies (Steno, Oslo, Stockholm, Diabetes Control and Complications Trial, and Linköping.)

RESEARCH DESIGN AND METHODS
Blood samples were collected from 25 subjects selected to represent the clinically relevant measurement range. Fresh whole-blood samples were distributed and analyzed within 4 days of sample collection. Pretreatment of samples and analyses of GHb were performed according to the routine method of each study's central or reference laboratory. Results from each laboratory were compared with the group mean, i.e., the mean of all results for each sample.

RESULTS
Regression analyses with the group mean values as independent variables and results from each laboratory as dependent variables showed that Oslo's result had a slope significantly different from the group mean. Laboratories used by the DCCT, Oslo, and Steno studies gave, on average, 0.4, 0.4, and 0.7% higher HbA1c readings than the group mean, respectively, while HbA1c results from Linköping and Stockholm were, on average, 0.6 and 1.0% lower, respectively.

CONCLUSIONS
There were large differences in GHb values among laboratories participating in studies of diabetic complications. The present data offer a guide to the comparison of results from the studies and underscores the need for standardization of GHb measurements.
The Metabolic Syndrome in Hong Kong Chinese. The interrelationships among its components analyzed by structural equation modeling
Authors: Chan Juliana CN , Cheung Jacky CK , Lau Edith MC , Wooà Jean , Chan Albert YW , Swaminathan Ramasmyiyer , Cockrama Clive S 
Published: March 2007

OBJECTIVE
To examine the pattern of the metabolic syndrome in Chinese and the causal relationships among its components, including aging, obesity, hyperglycemia, hypertension, hypertriglyceridemia, and hyperinsulinemia in these subjects.

RESEARCH DESIGN AND METHODS
Based on a 75-g oral glucose tolerance test, the World Health Organization criteria were used for the diagnosis of glucose intolerance in a population-based study involving 1.513 Chinese subjects in two work sites. Demographic data including age, family history of diabetes, BMI, waist-to-hip ratio (WHR), and sitting blood pressure (BP) were documented. Fasting plasma glucose, triglyceride (TG) and insulin concentrations, and spot urinary albumin concentration (Ualb) were also measured. Structural equation modeling incorporating factor analysis and path analysis was performed to examine the causal relationships among these variables and their interactions.

RESULTS
Subjects who were treated with antidiabetic and/or antihypertensive drugs or who had a plasma creatinine level ≥ 150 μmol/l were excluded (n = 52). The prevalence of diabetes and impaired glucose tolerance (IGT) were 3.9% (n = 34) and 7.2% (n = 63) in men (n = 881) and 3.1% (n = 18) and 6.7% (n = 39) in women (n = 580), respectively. In both groups, glucose intolerance was associated with increasing age, higher BMI, WHR, BP, Ualb, serum TG, and insulin levels as well as higher prevalence rates of positive family history of diabetes. Structural equation modeling showed that age was a significant determinant for both BMI and WHR. Age and obesity accounted for most of the variance of BP, Ualb, plasma glucose, insulin and TG levels either directly or indirectly. Plasma glucose was determined by a positive family history of diabetes, age, and BMI while TG was dependent on BMI and WHR. Serum insulin was mainly determined by a positive family history of diabetes, obesity, plasma glucose, and TG levels. Apart from age and obesity, BP was also determined by serum insulin, both of which had causal effects on Ualb.

CONCLUSIONS
This model emphasizes the centrality of aging and obesity as well as a positive family history of diabetes as major determinants of the components of the metabolic syndrome. These components in turn had causal effects upon one another. Apart from a familial tendency, a central neurohormonal mechanism may account for these abnormalities mediated primarily through obesity and in close association with aging.
Cholesterol Absorption, Synthesis, and LDL Metabolism in NIDDM
Authors: Gylling Helena , Miettinen Tatu A 
Published: March 2007

OBJECTIVE
Cholesterol and lipoprotein metabolism was studied in mildly hypercholesterolemic nonobese men with NIDDM to find out which metabolic parameters regulate serum cholesterol level in these NIDDM subjects.

RESEARCH DESIGN AND METHODS
Nonobese NIDDM subjects (n = 13) and control subjects (n = 18) with serum cholesterol ≥ 6.0 and triglycerides ≤ 2.5 mmol/l were studied on a similar monoene-enriched diet. Cholesterol absorption was studied with peroral double isotopes and by measuring serum plant sterols with gas-liquid chromatography; cholesterol synthesis was studied by measuring sterol balance and by measuring serum cholesterol precursor sterols; and LDL kinetics was measured with 131I-labeled autologous apoprotein (apo) B.

RESULTS
Cholesterol absorption was significantly lower in NIDDM subjects than in the control subjects, as detected by low serum plant sterol levels and absorption percentage (23 vs. 29%, P &lt; 0.05). Cholesterol synthesis was significantly higher in NIDDM subjects than in the control subjects, as detected by precursor sterols or balance data (18 vs. 12 mg · kg−1 · day−1, P &lt; 0.01), cholesterol turnover (19 vs. 13 mg · kg−1 · day−1, P &lt; 0.01), and LDL apo B removal (0.343 vs. 0.267 pools/day, P &lt; 0.01). Serum total and LDL cholesterol levels were inversely correlated with cholesterol synthesis, which was positively related to the catabolism of LDL apo B and negatively related to cholesterol absorption efficiency.

CONCLUSIONS
In this small selected group of mildly hypercholesterolemic nonobese NIDDM subjects, the regulation of serum cholesterol levels was achieved by the homeostasis between cholesterol absorption, synthesis, and LDL fractional catabolism. Cholesterol turnover and removal of LDL apo B were high in NIDDM subjects, compared with the control subjects, whereas cholesterol absorption efficiency was abnormally low Because of the relatively small number of selected subjects, the present results are not directly applicable to the overall NIDDM population.
Total Plasma Antioxidant Capacity Predicts Thrombosis-Prone Status in NIDDM Patients
Authors: Ceriello Antonio , Bortolotti Nario , Pirisi Mario , Crescentini Adriana , Tonutti Laura , Motz Enrico , Russo Assunta , Giacomello Roberta , Stel Giuliana , Taboga Claudio 
Published: March 2007

OBJECTIVE
To explore the hypothesis that a relationship exists between free radical activity and abnormalities in hemostasis in NIDDM.

RESEARCH DESIGN AND METHODS
The use of the total radical-trapping antioxidant parameter (TRAP) has very recently been proposed to explore the antioxidant property of a plasma and their mutual cooperation. In the present study, TRAP, vitamin E, vitamin C, vitamin A, uric acid, protein-bound SH (thiol) groups, fibrinogen, prothrombin fragments F1 + 2, and D-dimer have been evaluated in 46 NIDDM patients and 47 healthy matched control subjects.

RESULTS
In NIDDM patients, TRAP, vitamin A, SH groups, and uric acid were significantly reduced, whereas the level of vitamin E was significantly increased. Vitamin C was similar in the two groups. Fibrinogen, prothrombin fragment 1 + 2, and D-dimer were increased in diabetic patients. TRAP, but no single other antioxidant, had a strong inverse association with fibrinogen, prothrombin fragment 1 + 2, and D-dimer.

CONCLUSIONS
These findings are consistent with the hypothesis that oxidative stress may condition coagulation activation in diabetics. However, the data suggest that it is the total antioxidant capacity rather than any single plasma antioxidant that is the most relevant parameter.
Insulin Aspart in a 30/70 Premixed Formulation: Pharmacodynamic properties of a rapid-acting insulin analog in stable mixture
Authors: Weyer Christian , Heise Tim , Heinemann Lutz 
Published: March 2007

OBJECTIVE
To study the pharmacodynamic properties of a 30/70 premixed formulation of the rapid-acting insulin analog insulin aspart (B28Asp) and its protamine-retarded preparation (30/70 IA) in comparison with a respective mixture of soluble human insulin and NPH insulin (30/70 HI).

RESEARCH DESIGN AND METHODS
In this single-center double-blind euglycemic glucose-clamp study, 24 healthy male volunteers (age, 26 ± 2 years; BMI, 23.7 ± 1.7 kg/m2) received single subcutaneous injections of 0.3 U/kg body wt of either 30/70 IA or 30/70 HI on 2 study days in randomized order. Glucose infusion rates (GIRs) were determined over a 24-h period after administration.

RESULTS
The injection of 30/70 IA resulted in an earlier onset and more pronounced peak of action (tmax, 127 ± 24 min; GIRmax 9.7 ± 2.3 mg · kg−1 · min−1) than 30/70 HI (tmax, 185 ± 52 min; GIRmax, 7.4 ± 1.7 mg · kg−1 · min−1_ (P &lt; 0.001). The metabolic activity of 30/70 IA (measured as the sum of the glucose infused) within the first 4 h after injection was 37% &gt; that of 30/70 HI (P &lt; 0.0001), while the total metabolic potencies over 24 h of both preparations were comparable.

CONCLUSIONS
The 30/70 premixed formulation of insulin aspart shows a significantly greater metabolic effect in the first 4 h after subcutaneous injection than the 30/70 mixture of human insulin. Insulin aspart retains its pharmacodynamic properties in a premixed 30/70 formulation.