bluuebunny/crossref_metadata_2025_split huggingface dataset:
Slow Gastric Emptying in Type I Diabetes: Relation to Autonomic and Peripheral Neuropathy, Blood Glucose, and Glycemic Control
Authors: Merio René , Festa Andreas , Bergmann Helmar , Eder Thomas , Eibl Nicole , Stacher-Janotta Giselheld , Weber Ute , Budka Christine , Heckenberg Andrea , Bauer Peter , Francesconi Mario , Schernthaner Guntram , Stacher Georg 
Published: March 2007

OBJECTIVE
To investigate whether autonomic neuropathy or hyperglycemia plays a crucial etiological role in gastric retention of ingesta frequently found in type I diabetic patients.

RESEARCH DESIGN AND METHODS
We investigated the gastric emptying of a radiolabeled semisolid 1,168 kJ meal in 38 female and 45 male patients (age 18–75 years; illness duration 3–46 years). None took drugs affecting gastrointestinal motility. Fasted patients underwent tests of cardiovascular autonomic and peripheral nerve function. Blood glucose levels were determined before and after the scintigraphic recording of gastric emptying.

RESULTS
The percentage of meal remaining in the stomach at the end of the 50-min recording time was related significantly to the patients' degree of cardiovascular autonomic neuropathy [r (81) = 0.235, P &lt; 0.028] but not to their degree of peripheral neuropathy, preprandial blood glucose level, HbA1c indicative of glycemic control, diabetes duration, and age. The patients' mean residual percentage of meal was significantly &gt; that of 48 healthy subjects, that is, 71.1 ± 15.1 vs. 53.5 ± 13.1% [means ± SD; t (129) = 6.48, P &lt; 0.0001]. The healthy individuals' mean residual percentage + 2 SD was exceeded in 22 patients.

CONCLUSIONS
Slow gastric emptying in patients with type I diabetes seems related to the degree of autonomic neuropathy but not to peripheral neuropathy, actual blood glucose, and glycemic control.
Activated Protein C Resistance in Type I Diabetes
Authors: Gruden Gabriella , Olivetti Carla , Cavallo-Perin Paolo , Bazzan Mario , Stella Stefania , Tamponi Giacomo , Pagano Gianfranco 
Published: March 2007

OBJECTIVE
To compare activated protein C (aPC) sensitivity in 37 type I diabetic patients and 33 healthy control subjects.

RESEARCH DESIGN AND METHODS
In this study, 37 type I diabetic patients and 33 healthy control subjects without personal or familial history of venous thrombosis and coagulation disorders, infections, intercurrent conditions, serum lupus anticoagulant, clinical cardiovascular complications, or drugs were examined.

RESULTS
The aPC ratio (aPTT [activated partial thromboplastin time] with and without aPC) was significantly lower in the type I diabetic patients than in the control subjects (P = 0.005).

CONCLUSIONS
These results suggest that the final steps of the protein C/S inhibiting system could be abnormal in type I diabetes.
Elevated Ambulatory Blood Pressure in Microalbuminuric IDDM Patients Is Inversely Associated With Renal Plasma Flow: A compensatory mechanism?
Authors: Poulsen P L , Juhl B , Ebbehøj E , Klein F , Christiansen C , Mogensen C E 
Published: March 2007

OBJECTIVE
To evaluate the relationship between renal function, ambulatory blood pressure (AMBP), and glycemic control in microalbuminuric IDDM patients compared with normoalbuminuric patients.

RESEARCH DESIGN AND METHODS
Nineteen male patients (age 33 ± 6 years) with slight microalbuminuria (UAE 20–70 μg/min) were compared with 19 normoalbuminuric (UAE &lt; 15 μg/min) age-matched (33 ± 6 years) male patients. Through constant infusion technique, 125I-iothalamate marked the glomerular filtration rate (GFR), and 131I-hippuran marked effective renal plasma flow (RPF). AMBP was measured by oscillometric technique (Spacelabs 90202).

RESULTS
The microalbuminuric group had higher daytime systolic AMBP (132 ± 11 vs. 125 ± 7 mmHg, P &lt; 0.05) and a poorer glycemic control (HbA1c 9.5 ± 1.5 vs. 8.2 ± 1.3%, P &lt; 0.01). GFR (135 ± 22 and 135 ± 17 ml/min) and RPF (598 ± 112 and 542 ± 98 ml/min) were similar in the two groups. In the microalbuminuric group, daytime systolic AMBP was inversely correlated to both RPF (r = −0.77, P &lt; 0.005) and GFR (r = −0.53, P = 0.02). HbA1c and GFR correlated positively in the microalbuminuric group (r = 0.47, P &lt; 0.04). In contrast, the normoalbuminuric patients exhibited no such associations.

CONCLUSIONS
IDDM patients with moderate microalbuminuria have elevated AMBP and a strong negative association between AMBP and RPF. This leaves several possibilities of interpretation. Primary blood pressure increase (of unknown origin) may induce morphological changes leading to reduction in renal function. Alternatively, blood pressure increase early in the course of incipient nephropathy may represent a compensatory mechanism, initially aiming at preservation of renal function, but later becoming maladaptive.
Distinct Genetic and Immunological Features in Patients With Onset of IDDM Before and After Age 40
Authors: Lohmann Tobias , Sessler Jochen , Verlohren Hans-Joachim , Schröder Sabine , Rötger Julia , Dãhn Karsten , Morgenthaler Nils , Scherbaum Werner A 
Published: March 2007

OBJECTIVE
Young age at onset is a relevant parameter associated with a rapid progression of IDDM. Our major aim was to define differences between IDDM patients with age at diagnosis &gt; 40 years and adult IDDM with onset at a younger age.

RESEARCH DESIGN AND METHODS
The correlation between islet-related antibodies (islet cell antibodies [ICAs] and antibodies [Abs] to GAD and the tyrosine phosphatase IA2), T-cell responses to GAD peptides and HLA class II isotypes was investigated in 23 IDDM patients 12–38 years of age at onset (group 1), 24 patients with IDDM &gt; 40 years of age at onset (group 2), and 12 healthy control subjects. ICAs were measured by indirect immunofluorescence, and GAD-Ab and IA2-Ab were measured by immunoprecipitation tests. T-cell responses against GAD peptides, which had been identified as typical for IDDM, were tested by 5-day proliferation assays. HLA class II alleles were typed by polymerase chain reaction.

RESULTS
ICAs and GAD-Abs were more prevalent in IDDM patients than in control subjects (P &lt; 0.001), but only IDDM group 1 had IA2-Abs (P &lt; 0.001 compared with IDDM group 2 and control subjects). Moreover, antibody combinations differed between IDDM patients of groups 1 and 2. T-cell responses to GAD peptides were seen in 67% of IDDM group 1 and in 71% of IDDM group 2 (P &lt; 0.02 compared with control subjects). IDDM patients of group 1 were more frequently DR4+/DQ8+ and less frequently DR2+/DQ0602+ compared with IDDM patients of group 2 (P &lt; 0.05).

CONCLUSIONS
Our data provide strong evidence for humoral and cellular autoimmunity in adult IDDM patients with onset both before and after 40 years of age. However, late-onset differs from young-onset IDDM with respect to Ab profiles, especially a lack of IA2-Ab, and HLA class II types. These findings have consequences for the diagnostic strategy for identifying slow-onset IDDM in individuals after 40 years of age.
Diabetes Self-Management: Self-reported recommendations and patterns in a large population
Authors: Ruggiero Laurie , Glasgow Russell , Dryfoos Janet M , Rossi Joseph S , Prochaska James O , Orleans C Tracy , Prokhorov Alexander V , Rossi Susan R , Greene Geoffrey W , Reed Gabrielle R , Kelly Kim , Chobanian Lisa , Johnson Suzann 
Published: March 2007

OBJECTIVE
Diabetes self-management is the cornerstone of overall diabetes management. Yet many questions concerning self-management remain unanswered. The current study was designed to examine several questions about diabetes self-management: 1) What do individuals report being told to do? 2) What are their self-reported levels and patterns of self-care? 3) Are there differences on self-reported self-management recommendations and levels across various subgroups?

RESEARCH DESIGN AND METHODS
Mailed surveys were returned by 2,056 individuals (73.4% response rate). Of the total, 13.8% had IDDM and the remainder had NIDDM, with 65% of the NIDDM group using insulin.

RESULTS
The levels and patterns of self-management were consistent with those found in previous studies, i.e., individuals most regularly followed their prescribed medication regimen and least regularly followed recommendations for lifestyle changes of diet and exercise. There were significant differences on reported self-management recommendations across different subgroups. Comparisons on level of self-management across diabetes type revealed significant differences for diet and glucose testing. Differences were also found on self-management levels for a number of individual characteristics, including age, working status, and type of insurance, along with knowledge of the Diabetes Control and Complications Trial findings.

CONCLUSIONS
These findings provide important information on perceived self-management recommendations and the specific self-management levels and patterns in individuals with diabetes. The current findings may help health professionals better understand the levels and correlates of diabetes self-management and direct future research.
Health Insurance and the Financial Impact of IDDM in Families With a Child With IDDM
Authors: Songer Thomas J , LaPorte Ronald E , Lave Judith R , Dorman Janice S , Becker Dorothy J 
Published: March 2007

OBJECTIVE
To examine the health insurance experience and out-of-pocket health care costs of families with a child with IDDM.

RESEARCH DESIGN AND METHODS
A case-control study of 197 families with a child with IDDM and 142 control families with no diabetic children was conducted. IDDM-affected families were identified from the Allegheny County IDDM Registry. Brothers and sisters of the parents in the IDDM-affected families were asked to participate as control subjects. Health insurance coverage and the money that families spent on health care services and supplies not reimbursed by insurance (out-of-pocket costs) were assessed by questionnaire.

RESULTS
No difference was found between the IDDM-affected and control families in the percentages with or without insurance. Families with low household incomes ($10,000–$19,999) were at the greatest risk for having no insurance. While coverage provided by private plans was similar between the IDDM-affected and control families, many families had no reimbursement for insulin (10%), syringes (10%), or blood testing strips (30%). Out-of-pocket expenses were 56% higher in the IDDM-affected families than in the control families. Seventeen percent of the IDDM-affected families had expenses over 10% of their household income. This particularly affected families with low household incomes. Pre-existing illness clauses and insurance denial affected only a small proportion of the case families.

CONCLUSIONS
These data illustrate that most families with a child with IDDM have health insurance, yet still incur larger out-of-pocket health care costs than do families without the presence of diabetes. IDDM-affected families likely face a number of economic decisions regarding health insurance and the use of health care.
Model of Complications of NIDDM: I. Model construction and assumptions
Authors: Eastman Richard C , Javitt Jonathan C , Herman William H , Dasbach Erik J , Zbrozek Arthur S , Dong Fred , Manninen Diane , Garfield Sanford A , Copley-Merriman Catherine , Maier William , Eastman Jeffery F , Kotsanos James , Cowie Catherine C , Harris Maureen 
Published: March 2007

OBJECTIVE
To develop a model of NIDDM for analyzing prevention strategies for NIDDM.

RESEARCH DESIGN AND METHODS
A Markov type model with Monte Carlo techniques was used. Age, sex, and ethnicity of cohort was based on U.S. data. Incidence rates of complications were also based on community and population studies.

RESULTS
Nonproliferative retinopathy, proliferative retinopathy, and macular edema are predicted in 79, 19, and 52%, respectively, of people with NIDDM; 19% are predicted to develop legal blindness. Microalbuminuria, gross proteinuria, and end-stage renal disease related to diabetes are predicted in 53, 40, and 17%, respectively. Symptomatic sensorimotor neuropathy and lower-extremity amputation are predicted in 31 and 17%, respectively. Cardiovascular disease is predicted in 39%. Higher rates of complications (1.1−3.0×) are predicted in minority populations. Predicted average life expectancy is 17 years after diagnosis.

CONCLUSIONS
A probabilistic model of NIDDM predicts the vascular complications of NIDDM in a cohort representative of the incident cases of diabetes in the U.S. before age 75 years. Predictions of complications and mortality are consistent with the known epidemiology of NIDDM. The model is suitable for evaluating the effect of preventive interventions on the natural history of NIDDM.
Bacille Calmette-Guérin Vaccination and Incidence of IDDM in Montreal, Canada
Authors: Parent Marie-Élise , Siemiatycki Jack , Menzies Richard , Fritschi Lin , Colle Eleanor 
Published: March 2007

OBJECTIVE
To describe the association between Bacille Calmette-Guérin (BCG) vaccination and IDDM development in two different case-control series (A and B) in Montreal.

RESEARCH DESIGN AND METHODS
Case-control series A comprised 93 IDDM cases and 2,903 control subjects who participated in a community-based tuberculin reactivity survey and who belonged to the same birth cohorts and areas of residence as the IDDM cases, Case-control series B comprised 249 IDDM cases and 431 age- and sex-matched friends and neighborhood control subjects.

RESULTS
In series A, the BCG vaccination prevalence among cases and control subjects was 21.5% (95% CI 13.2–29.8%) and 22.3% (95% CI 20.8–23.8%), respectively. The odds ratio (OR) for IDDM associated with BCG vaccination was 1.09 (95% CI 0.62–1.91), after adjusting for the birth cohorts and areas of residence. The vaccination prevalence in series B was 17.7% (95% CI 13.0–22.4%) among cases and 15.1% (95% CI 11.7–18.5%) among control subjects. The OR for IDDM due to BCG vaccination was 1.26 (95% CI 0.79–2.02), taking into account the matched sets. Only one case (3.3%) from series B who had been vaccinated at birth was diagnosed by age 5, compared with 52 cases (24.5%) who had not been vaccinated (P &lt; 0.01).

CONCLUSIONS
The lower proportion of birth-vaccinated IDDM cases diagnosed at a very young age, compared with nonvaccinated cases, possibly reflects a temporary boost of the immune functions after vaccination. However, as a whole, results from these analyses fail to support a protective role of BCG vaccination against juvenile-onset IDDM.
Glycosaminoglycans Delay the Progression of Nephropathy in NIDDM
Authors: Solini Anna , Vergnani Luciana , Ricci Franco , Crepaldi Gaetano 
Published: March 2007

OBJECTIVE
To determine the effect of oral administration of glycosaminoglycans on metabolic control and albumin excretion rate (AER) in NIDDM patients with increased urinary albumin excretion.

RESEARCH DESIGN AND METHODS
Twelve NIDDM hypertensive patients (age 52 ± 3 years, HbA1c 7.7 ± 0.2%) on antihypertensive treatment were enrolled in a double-blind placebo-controlled study, assuming either placebo or sulodexide (100 mg/day) for 4 months; at the end of this period, a crossover was performed. We have evaluated routine biochemical parameters plus AER and coagulative function every 2 months.

RESULTS
Both plasma fibrinogen (from 4.15 ± 0.32 to 2.77 ± 0.47 mmol/l) and AER (from 128.3 ± 40.6 to 39.6 ± 11.9 μg/min) decreased significantly after treatment with glycosaminoglycans in respect to placebo; moreover, blood pressure control ameliorated, also in the absence of any variation of therapy.

CONCLUSIONS
Glycosaminoglycan therapy, likely in association with a satisfactory control of blood pressure values, seems to prevent the progression of diabetic nephropathy in NIDDM.
Cochlear Dysfunction in IDDM Patients With Subclinical Peripheral Neuropathy
Authors: Leo Mauro A S Di , Nardo Walter Di , Cercone Stefania , Ciervo Amedeo , Monaco Mauro Lo , Greco Aldo V , Paludetti Gaetano , Ghirlanda Giovanni 
Published: March 2007

OBJECTIVE
To investigate the function of the auditory pathway from the cochlea to the auditory cortex in subjects with IDDM.

RESEARCH DESIGN AND METHODS
Brain stem, middle-, and long-latency auditory-evoked responses and evoked otoacoustic emissions were measured in 48 normally hearing IDDM patients and in age- and sex-matched nondiabetic subjects. Peripheral neuropathy was diagnosed by nerve conduction velocity (NCV) at the peroneal and sural nerves. Auditory brain stem responses (ABRs) reflect auditory pathway function within the brain stem; middle-latency responses (MLRs) and long-latency responses (LLRs) originate from the auditory cortex; and evoked otoacoustic emissions (EOAEs) give objective information about preneural, mechanical elements of the cochlear function.

RESULTS
A subclinical peripheral neuropathy was found in 12 diabetic patients. We found higher latencies of waves I (t = 4.4, P &lt; 0.0001), III (t = 3.7, P = 0.0004), and V (t = 2.7, P = 0.008) of ABRs in diabetic patients (I: 1.7 ± 0.13 ms; III: 3.9 ± 0.17 ms; V: 5.7 ± 0.24 ms), compared with those of the control group (I: 1.6 ± 0.13 ms; III: 3.7 ± 0.18 ms; V: 5.6 ± 0.17 ms). However, neither central transmission time (i.e., the wave interpeak I-V) nor MLRs and LLRs were found to be significantly different in diabetic and control subjects. Mean EOAE amplitude was found to be significantly reduced (F = 4.2, P = 0.02) in diabetic patients with a reduced NCV (7.6 ± 3.9 dB; Scheffé test: P = 0.03), but not in those without neuropathy (9.1 ± 4.2 dB), compared with the control group (10.8 ± 3.1 dB). No correlations were found between duration of diabetes and EOAEs or between sural NCV and peroneal NCV and metabolic control. EOAEs were not correlated with peroneal and sural NCVs.

CONCLUSIONS
Our results indicate that the early preneural dysfunction of cochlear receptors causes a prolonged activation of the peripheral portion of the auditory pathway, while signal conduction along the central auditory pathway was shown to be normal in diabetes.
Incomplete Elimination of the ABBOS Epitope of Bovine Serum Albumin Under Simulated Gastrointestinal Conditions of Infants
Authors: Alting Arno C , Meijer Ron J G M , van Beresteijn Emerentia C H 
Published: March 2007

OBJECTIVE
Because the bovine serum albumin residues 126–144 (ABBOS) have been reported to be responsible for the autoimmune reaction directed against pancreatic islet cells, it was our aim to study the potential survival of the ABBOS epitope during digestion in the gastrointestinal tract.

RESEARCH DESIGN AND METHODS
Either nontreated (commercially available) or heat-treated bovine serum albumin (BSA) was hydrolyzed in vitro with pepsin at a pH of 2.0, 3.0, and 4.0 and subsequently with pancreatic enzymes at a pH of 7.5. Cross-reactivity between the ABBOS peptide and the BSA hydrolysates was determined by competitive enzyme-linked immunosorbent assay (ELISA) using a rabbit polyclonal antibody raised against the ABBOS peptide in BSA.

RESULTS
Biochemical findings clearly showed that the degradation of BSA during simulated physiological digestion depended on its conformation and on the pH of its pepsin-catalyzed hydrolysis. Raising the pH of the pepsin-catalyzed hydrolysis from 2.0 to 4.0 decreased the efficiency of the process, especially when BSA had first been denatured by heat treatment. As a consequence, a large proportion of the cross-reactive anti-ABBOS antibody-binding sites was still intact in the final hydrolysates.

CONCLUSIONS
The present results suggest that the ABBOS epitope of BSA will not be completely eliminated during digestion under conditions that prevail in the stomach of infants (pH 3–4).
Gestational Diabetes Is a Herald of NIDDM in Navajo Women: High rate of abnormal glucose tolerance after GDM
Authors: Steinhart Jonathan R , Sugarman Jonathan R , Connell Fred A 
Published: March 2007

OBJECTIVE
To estimate the rate of deterioration of glucose tolerance and evaluate risk factors for development of NIDDM in Navajo women with a history of gestational diabetes mellitus (GDM).

RESEARCH DESIGN AND METHODS
A retrospective analysis of 111 GDM deliveries over a 4-year period, 1983–1987, was conducted in 1994 to determine glucose tolerance status. Patients who had not developed NIDDM were recalled for a 2-h glucose tolerance test (GTT). Tested and non-tested patients were compared, as estimate of conversion to NIDDM was calculated, and risk factors for NIDDM were evaluated. A life-table analysis was developed to estimate the probability of NIDDM after GDM.

RESULTS
At the time of chart review, 32 patients (29%) had already been diagnosed with NIDDM. Of the patients, 79 were offered GTT testing, and 56 (71%) returned for follow-up; 15 were diagnosed with NIDDM and 17 with impaired glucose tolerance (IGT); 47 (42%) and 64 (58%) patients in the cohort had developed NIDDM or NIDDM/IGT at the conclusion of the study period. Patients who developed NIDDM had greater BMIs, parity, and infant weights. Fasting blood glucose &gt; 5.83 mmol/l, GTT &gt; 41.63 mmol/l, and recurrence of GDM were associated with later NIDDM. A life-table analysis estimated a 53% likelihood of having NIDDM at an 11-year follow-up; a second model, based only on patients with known NIDDM status, predicted a 70% rate of NIDDM at an 11-year follow-up.

CONCLUSIONS
A high proportion of Navajo women with GDM progressed to NIDDM. Postpartum counseling and periodic GTTs are recommended.
Health-Related Quality-of-Life Results From Multinational Clinical Trials of Insulin Lispro: Assessing benefits of a new diabetes therapy
Authors: Kotsanos James G , Vignati Louis , Huster William , Andrejasich Carol , Boggs Mary Beth , Jacobson Alan M , Marrero David , Mathias Susan D , Patrick Donald , Zalani Sunita , Anderson James 
Published: March 2007

OBJECTIVE
To compare health-related quality of life (HRQOL) in patients with diabetes receiving insulin lispro with patients receiving regular human insulin (Humulin R).

RESEARCH DESIGN AND METHODS
We performed two randomized comparative studies over a 6-month period (3 months per treatment). Primary analyses used crossover baseline to 3-month changes in HRQOL scores. Ninety-three principal investigators in Canada, France, Germany, and the U.S. participated in these studies. One HRQOL crossover study included 468 patients with type I diabetes; the other HRQOL crossover study included 474 patients with type II diabetes. In both studies, patients were taking insulin at least 2 months before enrollment. Primary outcomes included two generic HRQOL domains, energy/fatigue and health distress, and two diabetes-specific domains, treatment satisfaction and treatment flexibility. Thirty secondary outcomes included both generic and diabetes-specific measures. Secondary outcome domains were controlled for multiplicity in the analyses.

RESULTS
Primary analyses showed that treatment satisfaction scores (P &lt; 0.001) and treatment flexibility scores (P = 0.001) were higher for insulin lispro in type I diabetic patients. No other significant treatment differences were detected using the data from these 6-month crossover studies.

CONCLUSIONS
Treatment satisfaction and treatment flexibility were significantly improved in patients with type I diabetes using insulin lispro. Other HRQOL findings were comparable for insulin lispro and regular human insulin. Insulin lispro appears to have a measurable impact on lifestyle benefits in patients with type I diabetes, as demonstrated by increased treatment satisfaction and treatment flexibility.