bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insulin Antibody Responses After Long-Term Intraperitoneal Insulin Administration via Impiantatile Programmable Insulin Delivery Systems
Authors: Olsen Craig L , Chan Eve , Turner Dee S , Iravani Mohamed , Nagy Maria , Selam Jean-Louis , Wong Nathan D , Waxman Ken , Charles M Arthur 
Published: March 2007

OBJECTIVE
To determine whether insulin antibodies are generated in diabetic patients after short- and long-term intraperitoneal insulin use and, if so, whether they are of potential clinical interest. Insulin antibodies commonly develop in diabetic patients who use subcutaneous human insulin, although their clinical significance remains controversial. Few data are available regarding insulin antibody responses to intraperitoneal insulin.

RESEARCH DESIGN AND METHODS
We studied insulin antibody levels and clinical diabetes control in 25 type 1 diabetic patients treated for 3-6 years with intraperitoneal surfactant-stabilized porcine modified human insulin delivered by implantable programmable insulin delivery systems.

RESULTS
All patients had preimplantation insulin antibody levels &lt;20 μU/ml, with a mean value of 2 ± 2 μU/ml (1 SD). Mean antibody levels increased throughout the study period to a mean maximum of 197 ± 326 μU/ml (P &lt; 0.02) with 11 of 25 (44%) patients' levels exceeding 20 μU/ml (insulin responders). The mean time to significant antibody development was 21.8 ± 4.4 months. Of the 11 responder patients, 4 had clinical syndromes that consisted of increasing daily insulin requirements and/or nocturnal hypoglycemia despite minimal nighttime basal insulin infusion rates associated with peak antibody levels &gt;200 μU/ml. None of the nonresponder patients (antibody levels &lt;20 (μU/ml) had these clinical findings.

CONCLUSIONS
Our results indicate that insulin antibody levels observed during intraperitoneal administration of human insulin are 1) similar to those reported during subcutaneous administration; although the rise in antibody level may be delayed compared with subcutaneous human insulin, 2) associated with a patient subset who are insulin antibody responders after switching from subcutaneous to intraperitoneal human insulin, 3) associated with a decrease in levels among responder patients regardless of whether they discontinue or continue pump use, and 4) associated with increased insulin needs and/or nocturnal hypoglycemia despite minimal basal rate insulin infusion at nighttime when antibody levels exceed 200 μU/ml.
Incipient and Overt Diabetic Nephropathy in African Americans With NIDDM
Authors: Dasmahapatra Amita , Bale Asha , Raghuwanshi Maya P , Reddi Alluru , Byrne William , Suarez Sarah , Nash Fred , Varagiannis Evelyn , Skurnick Joan H 
Published: March 2007

OBJECTIVE
To determine the prevalence of incipient and overt nephropathy in African- American subjects with non-insulin-dependent diabetes mellitus(NIDDM) attending a hospital clinic. Contributory factors, such as blood pressure (BP), duration and age at onset of diabetes, hyperglycemia, hyperlipidemia, and body mass index (BM1) also were evaluated.

RESEARCH DESIGN AND METHODS
We recruited 116 African-American subjects with NIDDM for this cross-sectional, descriptive, and analytical study. BP, BMI, 24-h urine albumin excretion, creatinine clearance, serum creatinine, lipids, and GHb levels were measured. Albumin excretion rate (AER) was calculated, and subjects were divided into three groups: no nephropathy (AER &lt;20 μg/min), incipient nephropathy (AER 20–200 μg/min), and overt nephropathy (AER &gt;200 μg/min). Frequency of hypertension and nephropathy was analyzed by x2 testing, group means were comparedusing analysis of variance, and linear correlations were performed between AER and other variables. Multiple regression analysis was used to examine theassociation of these variables while controlling for the effects of other variables.

RESULTS
Increased AER was present in 50% of our subjects; 31% had incipient and 19% had overt nephropathy. Hypertension was present in 72.4%; nephropathy, particularly overt nephropathy, was significantly more prevalent in the hypertensive group. Mean BP and diastolic blood pressure (dBP) were higher in the groups with incipient and overt nephropathy, and systolic blood pressure (sBP) was increased in overt nephropathy. Men with either form of nephropathy had higher sBP, dBP, and mean BP, whereas only women with overt nephropathy had increased sBP and mean BP. Subjects with incipient or overt nephropathy had a longer duration of diabetes, and those with overt nephropathyhad a younger age at onset of diabetes. By multiple regression analysis, AER correlated with younger age at diabetes onset, but not with diabetes duration. No correlation with age, lipid levels, or GHb was noted. BMI correlated with AER.

CONCLUSIONS
Incipient and overt nephropathy were observed frequently inthese African-American subjects with NIDDM. Albuminuria correlated with BP, younger age at diabetes onset, and BMI. Association of albuminuria and increased cardiovascular mortality may place 50% of inner-city African-American patients with NIDDM at risk for developing cardiovascular complications.
Hyperosmolar Nonketotic Diabetic Syndrome Following Treatment of Human Immunodeficiency Virus Infection With Didanosine
Authors: Munshi Medha N , Martin Rebecca E , Fonseca Vivian A 
Published: March 2007

OBJECTIVE
To determine whether didanosine (DDI), one of the drugs commonly used to treat infection with human immunodeficiency virus (HIV), contributes to the development of diabetes and hyperosmolar nonketotic diabetic syndrome (HNKDS).

CASE SUMMARY
One female patient was treated with DDI for infection with HIV during pregnancy. Soon after starting DDI treatment, she developed diabetes, which progressed to HNKDS.

CONCLUSIONS
Although not reported in the literature, hyperglycemia following treatment with DDI has been noted in 82 patients and is usually associated with pancreatitis. DDI should be recognized as one of the drugs known to potentially cause diabetes and HNKDS. With the increasing use of DDI and other drugs that cause hyperglycemia, such as pentamidine and dapsone, blood glucose should be monitored frequently in the HIV-infected patients.
Weight Loss in Severely Obese Subjects Prevents the Progression of Impaired Glucose Tolerance to Type II Diabetes: A longitudinal interventional study
Authors: Long Stuart D , O'brien Kevin , Macdonald Kenneth G , Leggett-Frazier Nancy , Swanson Melvin S , Pories Walter J , Caro José F 
Published: March 2007

OBJECTIVE
To determine if weight loss may prevent conversion of impaired glucose tolerance (IGT) to diabetes, because weight loss reduces insulin resistance. The prevalence of IGT in the U. S. population is estimated at 11.2%, more than twice that of diabetes. Furthermore, because an oral glucose tolerance test is needed for its detection, most of these patients are undiagnosed. Screening for IGT would be meaningful if progression to diabetes could be delayed or prevented.

RESEARCH DESIGN AND METHODS
For an average of 5.8 years (range 2–10 years), 136 individuals with IGT and clinically severe obesity (&gt;45 kg excess body weight) were followed. The experimental group included 109 patients with IGT who underwent bariatric surgery for weight loss. The control group was made up of 27 subjects with IGT who did not have bariatric surgery. The criteria of the World Health Organization was used to detect IGT and diabetes in this population. The main outcome measure of this nonrandomized control trial is the incidence density, or number of events (development of diabetes) divided by the time of exposure to risk.

RESULTS
Of the 27 subjects in the control group, 6 developed diabetes during an average of 4.8 ± 2.5 years of postdiagnosis follow-up, yielding a rate of conversion to diabetes of 4.72 cases per 100 person-years. The 109 individuals of the experimental group were followed for an average of 6.2 ± 2.5 years postbariatric surgery. Based on the 95% confidence interval of the comparison group, we would expect to find that between 22 and 36 subjects in the experimental group developed diabetes over the follow-up period. Only 1 of the 109 experimental-group patients developed diabetes, resulting in a conversion rate of the experimental group of only 0.15 cases per 100 person-years, which is significantly lower (P &lt; 0.0001) than the control group.

CONCLUSIONS
Weight loss in patients with clinically severe obesity prevents the progression of IGT to diabetes by &gt;30-fold.
Effects of Long-Term Enalapril Treatment on Persistent Microalbuminuria in Well-Controlled Hypertensive and Normotensive NIDDM Patients
Authors: Sano Takahisa , Kawamura Takahiko , Matsumae Hiromi , Sasaki Hiromitsu , Nakayama Motohiro , Hara Tomohiro , Matsuo Seiichi , Hotta Nigishi , Sakamoto Nobuo 
Published: March 2007

OBJECTIVE
To determine whether long-term treatment with an angiotensinconverting enzyme (ACE) inhibitor has a beneficial effect on the urinary microalbumin excretion and renal function in non-insulin-dependent diabetes mellitus (NIDDM) patients, enalapril (5 mg/day) was administered for 48 months.

RESEARCH DESIGN AND METHODS
Fifty-two patients with NIDDM who had persistent microalbuminuria in the range of 20–300 mg/24 h, serum creatinine &lt; 106.1 μM 1.2 mg/dl), supine systolic blood pressure (BP) &lt;150 mmHg, supine diastolic BP &lt;90 mmHg, and HbA1c &lt;10% were divided into four groups. Twenty-six patients with normotension were divided at random into two groups; one group received enalapril (5 mg/day) (NE group), the other did not receive enalapril (NC group). In the same way, 26 other patients who were already well-controlled with nifedipine (30 mg/day) over a long-term period (4–6 years) were divided at random into two groups; one received enalapril (5 mg/day) (HE group), the other did not receive enalapril (HC group).

RESULTS
After 48 months, urinary albumin excretion (UAE) was markedly reduced in group NE from 102.4 ×/÷ 1.3 to 55.5 ×/÷ 1.3 mg/24 h (P &lt; 0.005), whereas no significant change occurred in group NC. In the well-controlled hypertensive groups, a significant reduction in UAE occurred in group HE (P &lt; 0.05), whereas no significant change occurred in group HC. No changes in creatinine clearance, BP, or blood glucose control were seen during the study.

CONCLUSIONS
Treatment with enalapril for 48 months may have a beneficial effect on the decline of microalbumin excretion in NIDDM patients.
Improvement of Basal Hepatic Glucose Production ana Fasting Hyperglycemia of Type I Diabetic Patients Treated With Human Recombinant Ultralente Insulin
Authors: Riccio Antonio , Avogaro Angelo , Valerio Anna , Zappella Anna , Tiengo Antonio , Prato Stefano Del 
Published: March 2007

OBJECTIVE
To test whether a suppertime injection of human ultralente insulin in patients with type I diabetes would result in a larger inhibition of basal hepatic glucose production (HGP) and improvement in fasting and mean daily plasma glucose levels.

RESEARCH DESIGN AND METHODS
We studied 16 type I diabetic patients (41 ± 4 years of age; body mass index [BMI] = 23.3 ± 0.3 kg/m2; diabetes duration &gt;3 years) with a crossover protocol of therapy with an intermediate and ultralente insulin. All patients were already treated with three injections per day of regular insulin in addition to intermediate-acting (NPH) insulin at suppertime. After a 14-day run-in period, patients were randomly assigned to treatment with equivalent doses (10.8 ± 0.8 U, at 1900) of intermediate (Humulin 1) or ultralente (Humulin U) insulin. After 1 month of treatment, patients were crossed over. No change of the insulin dosage was performed during the study period. Basal HGP was measured by β-glucose infusion. Plasma glucose concentration was measured in the fasting state and monitored during the day.

RESULTS
Before starting the study period, fasting plasma glucose was 13.4 ±1.1 mM and plasma free-insulin was 48.0 ± 4.8 pM. Daily plasma glucose concentration averaged 10.3 ± 0.3 mM and the area under the curve (AUC) was 1.41 ± 0.05 mol/14 h. NPH insulin, given at suppertime for a month, did not induce significant changes in fasting plasma insulin (40.2 ± 4.8 pM), glucose concentration (14.0 ± 0.9 mM) or HGP (20.2 ± 2.2 jamol · kg–1 · min–1). Accordingly, no change occurred in the average daily plasma glucose (10.3 ± 0.3 mM) or AUC (1.41 ± 0.9 mol/14 h). Glycated hemoglobin also was not affected (8.2 ± 0.4 vs. 8.2 ± 0.3%). On the contrary, a 4-week treatment with ultralente insulin, also given at suppertime, was associated with a decline in the basal HGP (16.0 ±1.3 /Ltmol · kg–1 · min–1), fasting (11.3 ± 0.9 mM) and average daily (9.4 ± 0.3 mM) plasma glucose concentrations, and AUC (1.29 ± 0.07 mol/14 h) of plasma glucose level (all P &lt; 0.05). Glycated hemoglobin was reduced (7.9 ± 0.4%). In each condition, fasting plasma glucose concentration was correlated with the average daily plasma glucose level (basal = 0.78; intermediate = 0.89; ultralente = 0.62; all P &lt; 0.05), which suggests that ultralente insulin likely induces the improvements of metabolic control through reducing fasting plasma glucose.

CONCLUSIONS
Our results suggest that treating type I diabetic patients with ultralente insulin at suppertime provides a better modulation of basal HGP so that lower fasting plasma glucose levels are ensured. The reduction of fasting hyperglycemia is likely to affect positively aily plasma glucose control.
National Diabetes Programs: Application of capture-recapture to count diabetes?
Authors: Bruno Graziella , Laporte Ronald E , Merletti Franco , Biggeri Annibale , McCarty Daniel , Pagano Gianfranco 
Published: March 2007

OBJECTIVE
To evaluate the utility of capture-recapture methods using multiple, routinely collected, computerized data sources to estimate the numbers and prevalence of diabetes. Methods employed for regional and national monitoring of diabetes have been too inaccurate or too expensive.

RESEARCH DESIGN AND METHODS
A survey was undertaken that used four sources of ascertainment to identify prevalent cases of known diabetes in a community of Northern Italy: diabetic clinic and family physicians, hospital discharges, prescriptions, and reagent strips and insulin syringes. Capture-recapture methods were employed to estimate the number of missing cases and to adjust for undercount to accurately estimate the number of people who had diabetes.

RESULTS
We identified 2,069 unique prevalent cases of known diabetes with the intensive case-finding procedure. The diabetic clinic and family physicians data source identified the largest number of cases. The evaluation of the two sample capture-recapture estimates showed that they were all biased downward because of dependencies between sources. Log-linear modeling was employed to take into account the dependence among all data sources and the heterogeneity of diabetic patients. This method estimated that 2,586 cases existed, resulting in an ascertainment-adjusted prevalence of 2.77% (95% confidence interval, 2.44–3.10). Thus, despite the active case identification, ∼20% could not be identified. However, the number of cases and rates could easily be adjusted using capture-recapture.

CONCLUSIONS
The study shows that a two-sample capture-recapture estimate could be very biased if the investigator is not assured that the sources are independent. However, if at least three data sources are employed, log-linear models allow estimation of the number and prevalence rate adjusted for the degree of undercount (in spite of both the dependence of data sources and the heterogeneity of the diabetic population). The critical factor, however, is that the application of multiple sources with capture-recapture methods could be applied across broad geographical areas and across time to have cost-effective monitoring of diabetes at local and national level.
The Prediction of Diabetic Neuropathic Foot Ulceration Using Vibration Perception Thresholds: A prospective study
Authors: Young Matthew J , Breddy John L , Veves Aristidis , Boulton Andrew J M 
Published: March 2007

OBJECTIVE
To assess the ability of vibration perception threshold (VPT) to predict the development of diabetic foot ulceration.

RESEARCH DESIGN AND METHODS
A prospective follow-up study of consecutive patients with vibration perception measured by biothesiometry from April 1988 to March 1989. Patients were stratified in various risk groups.

RESULTS
Patients with a VPT &lt;15 V had a cumulative incidence of foot ulceration of 2.9% compared with 19.8% in patients with a VPT &gt;25 V, odds ratio (OR) 7.99 (3.65–17.5, 95% confidence intervals), P &lt; 0.01. The incidence of ulceration increased with duration of diabetes, but even with this effect removed, the excess of ulceration persisted, OR 6.82 (2.75–16.92), P &lt; 0.01.

CONCLUSIONS
VPT is an effective predictor of the risk of foot ulceration in diabetes and therefore could be used to target foot-care education to those patients most likely to benefit and, thereby, possibly improve its effectiveness.
Prevalence of Isthmic Lumbar Spondylolisthesis in Nondiabetic Subjects and NIDDM Patients
Authors: Virta Lauri , Rönnemaa Tapani , Laakso Markku 
Published: March 2007

OBJECTIVE
To compare the prevalence of lumbar spondylolytic spondylolisthesis (LSS) in nondiabetic and diabetic subjects.

RESEARCH DESIGN AND METHODS
A cross sectional study of 1,147 randomly selected nondiabetic subjects and 892 non-insulin-dependent diabetes mellitus (NIDDM) patients, 45–64 years of age. LSS was diagnosed radiographically using a lateral view of the lumbosacral spine.

RESULTS
No significant difference was seen in the prevalence of LSS between nondiabetic (6.0%) and diabetic (5.7%) subjects. LSS was more frequent in nondiabetic men (7.7%) than in nondiabetic women (4.6%; P = 0.026), whereas diabetic patients showed no significant sex difference in the prevalence of LSS (men 5.6% and women 5.9%).

CONCLUSIONS
NIDDM does not predispose one to lumbar spondylolisthesis. However, diabetes seems to abolish the sex difference in the prevalence of LSS observed in nondiabetic populations.
Hyperinsulinemia and Macrosomia in the Fetus of the Diabetic Mother
Authors: Schwartz Robert , Gruppuso Philip A , Petzold Kathleen , Brambilla Donald , Hiilesmaa Vilho , Teramo Kari A 
Published: March 2007

OBJECTIVE
To determine 1) whether macrosomia in the fetus of the diabetic mother is related to fetal hyperinsulinemia and 2) whether hyperinsulinemia and macrosomia are related to maternal metabolic control.

RESEARCH DESIGN AND METHODS
Normal pregnant women (n = 95) were compared with insulin-treated pregnant women (n = 155), who were subdivided according to White's class, hypertension, and mode of delivery. All women were treated to achieve optimal metabolic control. HbA1c was determined at each visit. At delivery, umbilical plasma was analyzed for glucose, insulin antibodies, total insulin, free insulin, C-peptide, proinsulin components, and total and individual amino acids.

RESULTS
Macrosomia, defined as &lt;2 standard deviation units (97.75%), was found in 10–27% of the diabetic groups. It was not related to maternal mass or size, but was significantly correlated with umbilical total insulin, free insulin, and C-peptide. Proinsulin components were not different among groups. Amino acids also were not different. Glycosylated hemoglobin was a weak predictor of birth weight and fetal hyperinsulinism.

CONCLUSIONS
Macrosomia in the fetus of the diabetic mother remains inadequately explained. In a large population of pregnant women with strict metabolic control, macrosomia was mainly independent of glycosylated hemoglobin. Nevertheless, fetal hyperinsulinism remains the driving force for excessive fetal growth. The stimulus for fetal insulin excess in humans remains to be defined.
Diabetes Mellitus and Cigarette Smoking: Findings from the 1989 National Health Interview Survey
Authors: Ford Earl S , Malarcher Ann M , Herman William H , Aubert Ron E 
Published: March 2007

OBJECTIVE
To compare the prevalence of current smoking in the U. S. diabetic population with that of the nondiabetic population.

RESEARCH DESIGN AND METHODS
Using data from the 1989 National Health Interview Survey—a nationally representative sample—we calculated the prevalence of current smoking for 2,405 people with self-reported diabetes and 20,131 people without this condition.

RESULTS
Overall, the age-adjusted prevalence of smoking was 27.3% among people with diabetes and 25.9% among people without diabetes. The prevalence of smoking did not differ significantly between participants with and without diabetes when they were stratified by age, sex, race, or education. Black and Hispanic men with diabetes had a higher prevalence of smoking than did white men with diabetes and black and Hispanic men without diabetes, but none of these differences were statistically significant. Among people with diabetes, age, race, sex, and educational status were independent predictors of current smoking in a multiple-logistic regression model. Duration of diabetes was not related to smoking.

CONCLUSIONS
These data again emphasize the need to prevent and reduce smoking in the diabetic population. Smoking cessation programs should particularly target people with diabetes who are ≤44 years of age. Black and Hispanic men are also prime targets for intervention efforts.
Mechanism of Glomerular Hyperfiltration After a Protein Meal in Humans: Role of hormones and amino acids
Authors: Sreekumaran Nair K , Pabico Rufino C , Truglia Joseph A , McKenna Barbara A , Statt Marcia , Lockwood Dean H 
Published: March 2007

OBJECTIVES
Previous studies demonstrated that protein meals and amino acid (AA) infusions increase glomerular nitration rate (GFR) and renal plasma flow (RPF) and that somatostatin (SRIH) infusion inhibits these increments. We tested whether a single AA such as alanine could increase GFR and RPF and whether the changes in GFR and RPF could be explained on the basis of changes in glucagon, growth hormone (GH), and insulin.

RESEARCH DESIGN AND METHODS
In the first experiment, alanine was infused with or without SRIH in five normal subjects. In the second experiment, five other subjects were infused with SRIH on three separate occasions. In a control study, insulin, glucagon, and GH were given at replacement doses; in a hyperglucagonemia study, glucagon was given at a rate of 0.2 μ · kg−1 · h−1 (hypoglucagonemia); and in a high GH study, GH was given at a rate of 2 /μg · kg−1· h−1. GFR and RPF were measured using inulin and para-aminohippurate, respectively.

RESULTS
Alanine increased GFR and RPF, whereas SRIH inhibited these changes (P &lt; 0.05). Hyperglucagonemia or high GH with or without insulin failed to increase RPF or GFR.

CONCLUSIONS
A single AA such as alanine increases GFR and RPF, and this increase is dependent on a factor inhibited by SRIH. Although GH, glucagon, and insulin are factors inhibited by SRIH, none of these factors explains the changes in RPF and GFR in our acute studies.
A Treatable Cause of Recurrent Severe Hypoglycemia
Authors: Hardy Kevin J , Burge Mark R , Boyle Patrick J , Scarpello John H B 
Published: March 2007

OBJECTIVE
To see if glucocorticoid deficiency might explain increased insulin sensitivity causing severe brittle diabetes in two type 1 diabetic patients.

CASES
We describe two patients who developed brittle diabetes characterized by recurrent severe hypoglycemia on small daily insulin doses with severe hyperglycemia on further insulin dose reduction. In both patients, insulin requirements had fallen markedly.

RESULTS
Both patients were found to have glucocorticoid deficiency. In one patient, this was a result of hypopituitarism, in which hypoglycemia was aggravated by growth hormone deficiency. In the other patient, glucocorticoid deficiency was the result of primary adrenal failure. Resolution of brittle diabetes and restoration of normal insulin doses followed steroid replacement therapy in both patients.

CONCLUSIONS
These patients emphasize the importance of seeking an organic cause for recurrent severe hypoglycemia. Increasing insulin sensitivity in type I diabetic patients should alert clinicians to the possibility of glucocorticoid deficiency.