bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systolic Blood Pressure Relates to the Rate of Decline of Glomerular Filtration Rate in Type II Diabetes
Authors: Nielsen Søren , Schmitz Anita , Rehung Michael , Mogensen Carl Erik 
Published: March 2007

OBJECTIVE
To relate deterioration in kidney function to some potential cardiovascular risk factors in type II diabetic patients.

RESEARCH DESIGN AND METHODS
Twenty-four normoalbuminuric and 13 microalbuminuric patients completed a 3.4-yr prospective observational study. Glomerular nitration rate, urinary albumin excretion rate, blood pressure, glycemic control, and lipids were measured on entry and at the end of the study. Of the patients, 19 normoalbuminuric and 8 microalbuminuric (73%) patients had no history of antihypertensive treatment.

RESULTS
The glomerular filtration rate was significantly reduced during the follow-up period (−1.34 ± 0.54 ml · min−1 · 1.73 m−2 [mean ± SE], P &lt; 0.02). The rate of decline varied considerably in normoalbuminuric and microalbuminuric patients (from −13.5 to 4.3 and from −7.0 to 4.2 ml · min−1 · 1.73 m−2 per year, respectively) but was on average not accelerated in normoalbuminuric or microalbuminuric patients (−1.3 ± 0.7 and −1.5 ± 0.8 ml · min−1 · 1.73 m−2 per year, respectively). Significant correlations were observed between the glomerular filtration rate fall rate and initial systolic blood pressure (r = −0.47, P &lt; 0.01; patients without antihypertensive treatment: r = −0.42, P = 0.03) but not diastolic blood pressure. In a stepwise multiple linear regression analysis, baseline systolic blood pressure significantly determined the fall rate of the glomerular filtration rate (regression coefficient = −0.050, SE = 0.018, P = 0.011; patients without antihypertensive treatment: regression coefficient = −0.047, SE = 0.021, P = 0.030).

CONCLUSIONS
In these type II diabetic patients neither normoalbuminuria nor microalbuminuria are at an average associated with an accelerated decline in kidney function. Still, systolic blood pressure is a determining factor for the rate of decline in the glomerular filtration rate. A longer follow-up time with consecutive glomerular filtration rate measurements are needed to determine the long-term implications of normoalbuminuria and microalbuminuria on kidney function in type II diabetic patients.
A Prospective Study Identifying Risk Factors for Discontinuance of Insulin Pump Therapy
Authors: Floyd John C , Cornell Richard G , Jacober Scott J , Griffith Lauren E , Funnell Martha M , Wolf Leora L , Wolf Fredric M 
Published: March 2007

OBJECTIVE
To identify characteristics of adult patients at baseline associated with duration of subsequent, continuous, subcutaneous infusion of insulin treatment (pump therapy) of type I diabetes.

RESEARCH DESIGN AND METHODS
For 6 wk, patients followed a standardized conventional therapy and kept a record of insulin dosages, capillary blood glucose concentrations, and symptomatic hypoglycemia. They were then hospitalized. Additional baseline data were obtained and pump therapy was started. Survival analysis was used to determine the relationship between baseline independent variables or risk factors and duration of pump therapy, which is the dependent variable.

RESULTS
Of the 68 participants, 33 (49%) terminated pump therapy after an average of 9.9 mo of treatment. Two models (each P &lt; 0.00005) were developed that exhibited a high degree of consistency. Of the 6 variables, 5 were common to both models (HbA1 autonomic neuropathy, mean amplitude of glycemic excursions, frequency of symptoms of hypoglycemia when blood glucose was &lt; 70 mg/dl, and erythema at injection sites). The sixth variable in model 1 (insulin dosage) was replaced in model 2 by a variable, Adult Self-Efficacy for Diabetes, which was obtained on the 33 more recently enrolled patients; this variable related to patient perceptions of self-care behaviors.

CONCLUSIONS
We found that, at baseline, the presence of a high concentration of HbAx and a low estimation by the patient of their ability to treat the disease portend failure of insulin pump therapy as evidenced by its discontinuation. This effect is accentuated when clinical evidence of autonomic neuropathy is observed. These findings offer guidance in selecting patients with type I diabetes for insulin pump therapy.
Jet-Injected Insulin Is Associated With Decreased Antibody Production and Postprandial Glucose Variability When Compared With Needle-Injected Insulin in Gestational Diabetic Women
Authors: Jovanovic-Peterson Lois , Sparks Suzanne , Palmer Jerry P , Peterson Charles M 
Published: March 2007

OBJECTIVE
To elucidate the glycemic response and antibody formation in gestational diabetic women treated with insulin injected by a needle or a jet. The American Diabetes Association's position statement on jet injectors raised the concern that “insulin could be denatured as a result of forceful injection through a tiny port, which could lead to an increase in antibody formation” (Diabetes Care11:600, 1988). However, the pharmacokinetics of jet-injected insulin suggest that it might be useful in controlling postprandial glucose levels.

METHODS
We randomized 20 women with gestational diabetes mellitus (&lt;34 wk gestation) who required insulin to receive either jet-injected or needle-injected human NPH and regular insulin. Variables of interest were evaluated at the start of therapy, weekly until delivery, and 6-wk postpartum that included: 1) insulin antibodies in the mother and her infant, 2) HbA1c, 3) insulin dose, 4) fasting and postprandial glucose levels, and 5) subject acceptance and preference.

RESULTS
Of the 10 women in the needle group, 6 developed significant insulin antibodies compared with 1 of 10 in the jet group (P &lt; 0.001). HbA1c and insulin doses were the same in both groups. During the test meal, glucose levels in the jet group were significantly lower (P &lt; 0.01), yet none of the women in the jet group experienced blood glucose 70 mg/dl (3.89 mM) at 3–4 h after the meal, compared with 5 in the needle group (P &lt; 0.001). Jet injection was associated with less variability (P &lt; 0.001) in postprandial glucose values but slightly greater variability (P &lt; 0.05) in fasting glucose. Jet-injected insulin was more readily accepted by subjects than needle injections.

CONCLUSIONS
Jet injection is associated with a diminished antibody response and postprandial variability compared with needle-injected insulin. Thus, this warrants consideration as a therapeutic option for women with gestational diabetes mellitus and may also be applicable to nonpregnant, insulin-requiring diabetic patients.
Association of Lipoprotein Lipase Gene Variation with the Physiological Components of the Insulin-Resistance Syndrome in the Population of the San Luis Valley, Colorado
Authors: Ahn Young I , Ferrell Robert E , Hamman Richard F , Kamboh M Ilyas 
Published: March 2007

OBJECTIVE
To cross-sectionally evaluate the presence of clustering of the insulin-resistance syndrome components. Tests were conducted for association of the Hind III restriction site polymorphism at the lipoprotein lipase locus with clustering of the physiological components of the insulin resistance syndrome.

RESEARCH DESIGN AND METHODS
DNA samples of 370 normoglycemic Hispanics and 520 normoglycemic non-Hispanic whites from the San Luis Valley, Colorado, were amplified by the polymerase chain reaction. Lipids and glucose were determined by the standard procedures. Cross-tabulation and χ2 analysis were used.

RESULTS
The insulin-resistance syndrome components (elevated fasting insulin, reduced high-density lipoprotein cholesterol, and elevated triglycerides) appeared together in individuals of this population sample more often than expected by chance. Individuals in the population with the (+/+) lipoprotein lipase-HindIII restriction of fragment-length polymorphism genotype were more likely to have elevated fasting insulin and triglycerides and a reduced high-density lipoproteincholesterol level than subjects with the (+/−) genotype (odds ratio = 2.3, 95% confidence interval 1.38–3.98).

CONCLUSIONS
As expected from the physiological function of lipoprotein lipase, the primary association of lipoprotein lipase genotypes is with triglyceride and high-density lipoprotein-cholesterol levels. This appears to be the first reported genetic association with the insulin-resistance syndrome and may reflect genotype specific differences in the regulation of lipoprotein lipase by insulin.
Effect of Cold Remedies on Metabolic Control of NIDDM
Authors: LeMar Homer J , Georgitis William J 
Published: March 2007

OBJECTIVE
To compare the effects of two cough syrup formulations (one with sugar and alcohol and one without) on the metabolic control of NIDDM.

RESEARCH DESIGN AND METHODS
A prospective, blinded cross-over study was performed at the Endocrinology Clinic of a U.S. Army Medical Center on 20 volunteers with NIDDM, treated with diet alone or diet plus an oral hypoglycemic agent. After a 7-day lead-in period, patients took 3-day courses of each cough syrup (10 ml 4 times/day) with an intervening 4-day wash-out period. Fasting and postprandial blood glucose and lipids before and immediately after each course were compared.

RESULTS
No differences in pretherapy and posttherapy values were found with either formula. Values taken after the sugar- and alcohol-containing formula were not different from those taken after the alcohol- and sugar-free formula.

CONCLUSIONS
We conclude that patients with NIDDM can take standard daytime cough formulas, in short courses of standard doses, without adverse effect on blood glucose or lipids.
Plasma C3d Levels and Ischemic Heart Disease in Type II Diabetes
Authors: Figueredo A , Ibarra J L , Bagazgoitia J , Rodriguez A , Molino A M , Fernandez-Cruz A , Patino R 
Published: March 2007

OBJECTIVE
To test the hypothesis that the complement system may be activated in patients with type II diabetes and CAD.

RESEARCH DESIGN AND METHODS
The plasma C3d concentration was measured in 106 type II diabetic patients and 25 nondiabetic control subjects. The patient group was subdivided according to AER, and the groups were adjusted for age, sex, and known duration of diabetes. For the assignment to a given subgroup, normoalbuminuria was defined as AER &lt; 15 μm/min, microalbuminuria as AER 16–250 μg/min, and macroalbuminuria as AER &gt; 250 μg/min. The presence or absence of coronary disease was assessed through clinical examination, ECG, and coronary angiography. An RIA system was used for measurement of urinary albumin levels, and the plasma C3d concentrations were measured by ELISA.

RESULTS
Within each of the AER-defined subgroups, the plasma C3d levels were significantly higher in patients with IHD than in those without. Thus, in the normoalbuminuric group, plasma C3d levels were 16.3 AU/ml (95% CI 13.9–19) in patients with IHD vs. 11.6 AU/ml (95% CI 10.5–12.7) in those without (P &lt; 0.001). The corresponding data for the microalbuminuric and macroalbuminuric groups were 21.8 (95% CI 18.1–26.3) vs. 13.6 (95% CI 12.3–15.1) and 31.6 (95% CI 24.9–40) vs. 17.5 (13.6–22.6) AU/ml (P &lt; 0.01), respectively. Patients with IHD also had significantly higher plasma C3d levels than normal control subjects, regardless of AER subgroup. A multiple logistic regression analysis demonstrated an association between the plasma C3d concentration and IHD and AER.

CONCLUSIONS
Activation of the complement system may play a role in the development of macrovascular disease in type II diabetes.
The Impact of Preconception Counseling on Pregnancy Outcomes: The experience of the Maine Diabetes in Pregnancy Program
Authors: Willhoite M Beth , Bennert Harry W , Palomaki Glenn E , Zaremba Maryann M , Herman William H , Williams Josephine R , Spear Nona H 
Published: March 2007

OBJECTIVE
To determine if a noncentralized, statewide program could be established to educate health-care providers and women with pregestational diabetes on available strategies to prevent adverse outcomes in pregnancies complicated by diabetes. Characteristics of women who participated in the program and the outcomes of their pregnancies are evaluated.

RESEARCH DESIGN AND METHODS
A network of regional providers caring for pregnant women with diabetes was developed. Continuing education sessions were delivered to both providers and women with existing diabetes on the importance of preconception counseling.

RESULTS
Maine health-care providers collaborated on the development and adoption of three patient-care guidelines that address preconception counseling, prenatal care, and contraception for women with established diabetes. A total of 185 pregnancies among 160 women with pregestational diabetes reporting estimated delivery dates between 1 January 1987 and 31 December 1990 were identified. Of the total pregnancies, 62 (34%) occurred in women who received preconception counseling: among these 62 pregnancies were one major congenital defect (1.6%) and four fetal or neonatal deaths (6.4%). Among the 123 (66%) pregnancies occurring in women that had not received preconception counseling, 8 (6.5%) infants were born with congenital abnormalities, and 26 (21.1%) fetal or neonatal deaths were documented.

CONCLUSIONS
A program promoting preconception counseling can be implemented on a statewide basis by using various health-care providers to deliver the program. Participation in such a program appears to be related to improved pregnancy outcomes among women with pregestational diabetes.
Effects of Benfluorex on Insulin Resistance and Lipid Metabolism in Obese Type II Diabetic Patients
Authors: Bianchi Rutgert , Bongers Vivian , Bravenboer Bert , Erkelens D Willem 
Published: March 2007

OBJECTIVE
To evaluate the change in lipids and insulin sensitivity in 10 obese type II diabetic patients after treatment with benfluorex or placebo for 2 wk.

RESEARCH DESIGN AND METHODS
The study had a double-blind, cross-over design. Insulin sensitivity was measured with the euglycemic hyperinsulinemic glucose clamp technique at two different insulin infusion rates: 0.05 (clamp 1) and 0.10 U.kg−1 · h−1 (clamp 2).

RESULTS
Subanalysis of the glucose infusion rate under steady-state conditions in the last 30 min of clamp 2 yielded a glucose infusion rate of 5.36 and 3.87 mmol.kg−1.min−1 after benfluorex and placebo, respectively (P = 0.018).

CONCLUSIONS
Benfluorex increases insulin sensitivity in obese type II diabetic patients.
Apolipoprotein E Polymorphism Is Associated With Plasma Cholesterol Response in a 7-day Hospitalization Study for Metabolic and Dietary Control in NIDDM
Authors: Murakami Kaori , Shimizu Mizuo , Yamada Nobuhiro , Ishibashi Shun , Shimano Hitoshi , Yazaki Yoshio , Akanuma Yasuo 
Published: March 2007

OBJECTIVE
To investigate the effects of apolipoprotein E phenotype, which is an important genetic factor determining plasma cholesterol level, on plasma lipoprotein metabolism during a 7-day diet therapy of diabetes.

RESEARCH DESIGN AND METHODS
Diet therapy was performed in 242 subjects with NIDDM. Plasma lipid levels and apolipoprotein A-I, B, and E levels on hospital days 2 and 9 were compared in three phenotype groups, ε2 (E2/2, and E2/3), ε3 (E3/3), and ε4 (E3/4 and E4/4).

RESULTS
No differences were observed in fasting blood glucose level, body mass index, age, duration of NIDDM, or medication among the three phenotype groups. Before starting the treatment, total plasma cholesterol did not vary by apolipoprotein E phenotype, although the mean plasma low-density lipoprotein cholesterol level in epsilon 4 patients was higher than in either ε3 or ε2 patients (ε4, 145 ± 42; ε3, 131 ± 34; ε2, 128 ± 36 mg/dl; P &lt; 0.05). Changes in fasting blood glucose/body mass index after the 7-day treatment were not different among the apolipoprotein E phenotype groups, whereas the decrease in plasma cholesterol level after the treatment was significantly greater in ε2 patients than in either ε3 or ε4 patients (ε2, 10.3 ± 14.2; ε3, 6.1 ± 11.0; ε4, 3.8 ± 9.6%; P &lt; 0.05).

CONCLUSIONS
Total plasma cholesterol response to in-hospital diet therapy varies by apolipoprotein E phenotypes, with subjects with apolipoprotein E2 showing the greatest response, whereas those with apolipoprotein E4 show the least. We suggest that subjects with apolipoprotein E4 should be controlled more strictly than other subjects from a viewpoint of reducing plasma cholesterol levels.
Exaggerated Hyperglycemia After A Pizza Meal in Well-Controlled Diabetes
Authors: Ann Ahern Jo , Gatcomb Patricia M , Held NANcy A , Petit William A , Tamborlane William V 
Published: March 2007

OBJECTIVE
To examine whether the postprandial hyperglycemic effect of pizza in well-controlled IDDM patients is related to overeating or to unique properties of this popular food.

RESEARCH DESIGN AND METHODS
On two evenings, each patient (n = 8) consumed a meal that was similar in macronutrient composition except that one consisted of pizza and the other was a control meal that included high glycemic index foods. The insulin regimen was held constant.

RESULTS
Postprandial glucose levels were within the target range (&lt; or = 10 mM) after the control meal. Although the initial glucose increase was similar for the two meals, plasma glucose continued to rise and was significantly increased from 4 to 9 h after ingestion of pizza compared with the control meal (P &lt; 0.05). This increase occurred even though free insulin, glucagon, and free fatty acid levels did not differ significantly.

CONCLUSIONS
Our data suggest that pizza has properties that accentuate and sustain postprandial hyperglycemia.
Insulinemia in Children at Low and High Risk of NIDDM
Authors: Pettitt David J , Moll Patricia P , Knowler William C , Mott David M , Nelson Robert G , Saad Mohammed F , Bennett Peter H , Kottke Bruce A 
Published: March 2007

OBJECTIVE
Fasting hyperinsulinemia in the presence of normoglycemia usually indicates insulin resistance and is characteristic of populations at high risk for developing NIDDM. Hyperinsulinemia predicts the development of impaired glucose tolerance and NIDDM in Pima Indians, a population with a high incidence of NIDDM. Insulin concentrations in population-based samples of children who have different risks of developing NIDDM later in life have not been reported previously.

RESEARCH DESIGN AND METHODS
We compared fasting insulin concentrations in two populations of nondiabetic children, 6–19 yr of age: Pima Indians from southern Arizona and Caucasians from Minnesota.

RESULTS
Insulin concentration varied with age, sex, glucose concentration, and relative weight. Mean fasting insulin concentration was 140.3 pM in Pima Indian males, 94.4 pM in Caucasian males, 171.5 pM in Pima Indian females, and 107.1 pM in Caucasian females. For each sex, the mean fasting insulin concentration, controlled for age, glucose, and relative weight, was significantly higher in the Pima Indians than in the Caucasians (P &lt; 0.001).

CONCLUSIONS
From a young age, Pima Indian children have higher fasting insulin concentrations than Caucasian children. As hyperinsulinemia predicts subsequent NIDDM, these data suggest that the susceptibility to NIDDM is manifest at a young age as fasting hyperinsulinemia.
Pupillary Abnormalities in Type I Diabetes Occurring During Adolescence: Comparisons with cardiovascular reflexes
Authors: Schwingshandl Josef , Simpson Judy M , Donaghue Kim , Bonney Mary-Ann , Howard Neville J , Silink Martin 
Published: March 2007

OBJECTIVE
To evaluate computerized infrared pupillometry for the assessment of autonomic neuropathy in adolescents with type I diabetes.

RESEARCH DESIGN AND METHODS
We measured resting pupil diameters and pupillary light reflexes in 142 adolescents with type I diabetes (72 boys and 70 girls, 10.4–19.8 yr of age, duration of diabetes 0.7–18.3 yr) and in 75 nondiabetic control subjects (29 boys, 46 girls, 11.3–19.8 yr of age). All study participants were assessed using four standard cardiovascular tests: maximum – minimum heart rate during deep breathing (mean of three cycles); heart-rate change during a Valsalva maneuver (Valsalva ratio, mean of three maneuvers); lying-to-standing heart-rate change (30:15 ratio); and lying-to-standing BP change.

RESULTS
Mean resting pupil diameters were significantly smaller in the diabetic group: 6.28 ± 0.06 vs. 6.77 ± 0.11 mm, P &lt; 0.0001); and significantly smaller with greater duration of diabetes (r = −0.29, P = 0.0006) and higher levels of GHb (r = −0.24, P = 0.004). Patients with retinopathy grade 30 or more (Wisconsin 191 grading) had significantly smaller resting pupil diameters: 5.9 ± 0.16 vs. 6.4 ± 0.12 mm, P = 0.008). The phasic light reflex as determined by reflex amplitude and maximum constriction velocity was significantly reduced in the diabetic group: 2.27 ± 0.03 vs. 2.44 ± 0.04 mm, P = 0.0009; and 6.68 ± 0.12 vs. 7.24 ± 0.16 mm/s, P = 0.007). Reduced reflex amplitude was related to a longer postpubertal duration of diabetes (r = −0.18, P = 0.04). We found no association between pupillary and cardiovascular tests.

CONCLUSIONS
Infrared computerized pupillometry demonstrates subclinical diabetic autonomic neuropathy as early as adolescence. Its presence seems to be related to longer duration of diabetes and unfavorable metabolic control.
Effects of Low-Dose EPA-E on Glycemic Control, Lipid Profile, Lipoprotein(a), Platelet Aggregation, Viscosity, and Platelet and Vessel Wall Interaction in NIDDM
Authors: Westerveld H Tineke , de Graaf Jacques C , Van Breugel Hans HFI , Akkerman Jan Willem N , Sixma Jan J , Erkelens D Willem , Banga Jan Dirk 
Published: March 2007

OBJECTIVE
To assess the effects of low-dose eicosapentaenoic acid-ethyl-ester on diabetes regulation, lipid metabolism, blood rheology, and platelet reactivity.

RESEARCH DESIGN AND METHODS
In a double-blind, randomized, placebo-controlled study, 24 NIDDM subjects received 1800 mg of EPA-E, 900 mg of EPA-E, or a placebo (1656 mg olive oil) daily for 8 wk.

RESULTS
The EPA: arachidonic acid plasma ratio increased over an 8-wk period, then declined after a 4-wk wash-out period in the fish-oil groups in a dosedependent way. Platelet-activating factor-induced platelet aggregation decreased from 75 ± 7% at wk 0 to 35 ± 21% at wk 8 in the 900-mg group (P = 0.016) and from 72 ± 11 to 40 ± 30% in the 1800-mg group (P = 0.039), but did not change in the placebo group. No effects on A DP- or collagen-induced aggregation could be attributed to EPA-E. In the 1800-mg group low-density-lipoprotein cholesterol increased significantly, without concomitant rise in apolipoprotein B. Triglycerides, glycemic control, lipoprotein (a), blood and plasma viscosity, erythrocyte deformability, and platelet adhesion to and aggregate formation on extracellular endothelial cell matrix were not significantly influenced.

CONCLUSIONS
Purified EPA-E in doses of 900 and 1800 mg reduces Plateletactivating factor-induced platelet aggregation without negatively affecting glycemic control. Low-density-lipoprotein cholesterol was elevated in the 1800-mg group.