bluuebunny/crossref_metadata_2025_split huggingface dataset:
Environmental Correlates of Physical Activity Among Individuals With Diabetes in the Rural Midwest
Authors: Deshpande Anjali D. , Baker Elizabeth A. , Lovegreen Sarah L. , Brownson Ross C. 
Published: March 2007

OBJECTIVE—To determine the relationship between physical and social environment attributes and levels of physical activity in a population-based sample of diabetic individuals living in rural areas.
RESEARCH DESIGN AND METHODS—Cross-sectional telephone survey data from rural communities of southeastern Missouri, Tennessee, and Arkansas were used. Logistic regression was used to calculate crude and adjusted prevalence odds ratios (PORs) and 95% CIs.
RESULTS—A total of 278 (11%) individuals with diabetes were identified. Almost 37% of this group reported no leisure-time physical activity. Individuals with diabetes who reported regular physical activity were more likely to report better general health status, normal BMI, and no physical impairment. After adjustment, regular activity was positively associated with use of three or more facilities (POR 14.3, 95% CI 3.0–67.3) in the past 30 days, the availability of many nearby places to walk (2.3, 1.1–4.8), the availability of shoulders on streets (2.4, 1.3–4.5), often walking to nearby places (4.1, 2.0–8.3), and rating the community for physical activity as generally pleasant (2.3, 1.1–4.8). Additionally, the regular activity group was more likely to report their physician had helped make a plan to increase physical activity (2.8, 1.3–5.8) and followed up on their plan (2.2, 1.1–4.4). Social environment variables were not associated with physical activity after adjustment.
CONCLUSIONS—Physical inactivity is a significant problem in rural diabetic populations. We have identified aspects of the social and physical environment that are positively associated with physical activity. Understanding the role of the environment may result in increased physical activity for individuals with diabetes.
History of Depression Increases Risk of Type 2 Diabetes in Younger Adults
Authors: Brown Lauren C. , Majumdar Sumit R. , Newman Stephen C. , Johnson Jeffrey A. 
Published: March 2007

OBJECTIVE—The purpose of this study was to assess the history of previous depression in people with incident diabetes compared with people without diabetes.RESEARCH DESIGN AND METHODS—We conducted a population-based nested case-control study using the administrative databases of Saskatchewan Health to assess the study objective. We identified cases of type 2 diabetes based on diagnostics codes and prescription records for individuals over the age of 20 years. For each case subject, two control subjects were randomly selected from the nondiabetic population during the same index year. History of depression, based on diagnostic codes and antidepressant prescription, was ascertained up to 3 years before index date. Simple and multivariate logistic regression analysis was used to estimate the odds ratio (OR) and 95% CIs, after adjusting for age, sex, and frequency of physician visits.RESULTS—Individuals with newly diagnosed diabetes (1,622 of 33,257; 4.9%) were 30% more likely to have had a previous history of depression compared with people without diabetes (2,279 of 59,420; 3.8%). This increased risk remained after controlling for sex and number of physician visits but was limited to subjects 20–50 years of age (adjusted OR 1.23 [95% CI 1.10–1.37]) and not in those aged ≥51 years (0.92 [0.84–1.00]).CONCLUSIONS—Depression appears to increase the risk of developing diabetes by ∼23% in younger adults. This provides information regarding the temporality of the relationship between diabetes and depression.
Effects of Oral Insulin in Relatives of Patients With Type 1 Diabetes
Authors:   The Diabetes Prevention Trial-Type 1 Study Group
Published: March 2007

OBJECTIVE—This randomized, double-masked, placebo-controlled clinical trial tested whether oral insulin administration could delay or prevent type 1 diabetes in nondiabetic relatives at risk for diabetes.
RESEARCH DESIGN AND METHODS—We screened 103,391 first- and second-degree relatives of patients with type 1 diabetes and analyzed 97,273 samples for islet cell antibodies. A total of 3,483 were antibody positive; 2,523 underwent genetic, immunological, and metabolic staging to quantify risk of developing diabetes; 388 had a 5-year risk projection of 26–50%; and 372 (median age 10.25 years) were randomly assigned to oral insulin (7.5 mg/day) or placebo. Oral glucose tolerance tests were performed every 6 months. The median follow-up was 4.3 years, and the primary end point was diagnosis of diabetes.
RESULTS—Diabetes was diagnosed in 44 oral insulin and 53 placebo subjects. Annualized rate of diabetes was similar in both groups: 6.4% with oral insulin and 8.2% with placebo (hazard ratio 0.764, P = 0.189). In a hypothesis-generating analysis of a subgroup with insulin autoantibody (IAA) levels confirmed (on two occasions) ≥80 nU/ml (n = 263), there was the suggestion of benefit: annualized diabetes rate 6.2% with oral insulin and 10.4% with placebo (0.566, P = 0.015).
CONCLUSIONS—It is possible to identify individuals at high risk for type 1 diabetes and to enroll them in a large, multisite, randomized, controlled clinical trial. However, oral insulin did not delay or prevent type 1 diabetes. Further studies are needed to explore the potential role of oral insulin in delaying diabetes in relatives similar to those in the subgroup with higher IAA levels.
Time-Action Profile of Inhaled Insulin in Comparison With Subcutaneously Injected Insulin Lispro and Regular Human Insulin
Authors: Rave Klaus , Bott Susanne , Heinemann Lutz , Sha Sue , Becker Reinhard H.A. , Willavize Susan A. , Heise Tim 
Published: March 2007

OBJECTIVE—This study compares the time-action profile of inhaled insulin (INH; Exubera) with that of subcutaneously injected insulin lispro (ILP) or regular human insulin (RHI) in healthy volunteers.
RESEARCH DESIGN AND METHODS—In this open-label, randomized, three-way, crossover study, 17 healthy male volunteers were given each of the following treatments in random order: INH (6 mg), ILP (18 units), or RHI (18 units). Glucose infusion rates and serum insulin concentrations were monitored over 10 h.
RESULTS—INH had a faster onset of action than both RHI and ILP, as indicated by shorter time to early half-maximal effect (32 vs. 48 and 41 min, respectively; P &lt; 0.001 for IHN vs. RHI and P &lt; 0.05 for IHN vs. ILP). Time to maximal effect was comparable between INH and ILP (143 vs. 137 min; NS) but was shorter for INH than RHI (193 min; P &lt; 0.01). The maximal metabolic effect of INH was comparable with RHI but lower than ILP (8.7 vs. 9.8 vs. 11.2 mg · kg–1 · min–1, respectively; P &lt; 0.01 for INH vs. ILP). The duration of action of INH, indicated by time to late half-maximal effect (387 min), was longer than ILP (313 min; P &lt; 0.01) and comparable to RHI (415 min; NS). Total glucodynamic effect after inhalation of INH was comparable to both ILP and RHI (NS). Relative bioefficacy of INH was 10% versus RHI and 11% versus ILP. No drug-related adverse events were observed.
CONCLUSIONS—INH had a faster onset of action than RHI or ILP and a duration of action longer than ILP and comparable to RHI. These characteristics suggest that inhaled insulin is suitable for prandial insulin supplementation in patients with diabetes.
A Double-Blind, Randomized, Dose-Response Study Investigating the Pharmacodynamic and Pharmacokinetic Properties of the Long-Acting Insulin Analog Detemir
Authors: Plank Johannes , Bodenlenz Manfred , Sinner Frank , Magnes Christoph , Görzer Evelyn , Regittnig Werner , Endahl Lars A. , Draeger Eberhard , Zdravkovic Milan , Pieber Thomas R. 
Published: March 2007

OBJECTIVE—To investigate the pharmacodynamic profile and duration of action for five subcutaneous doses of insulin detemir (0.1, 0.2, 0.4, 0.8, and 1.6 units/kg; 1 unit = 24 nmol) and one subcutaneous dose of NPH insulin (0.3 IU/kg; 1 IU = 6 nmol).
RESEARCH DESIGN AND METHODS—This single-center, randomized, double-blind, six-period, crossover study was carried out as a 24-h isoglycemic clamp (7.2 mmol/l) in 12 type 1 diabetic patients.
RESULTS—Duration of action for insulin detemir was dose dependent and varied from 5.7, to 12.1, to 19.9, to 22.7, to 23.2 h for 0.1, 0.2, 0.4, 0.8, and 1.6 units/kg, respectively. Interpolation of the dose-response relationships for AUCGIR (area under the glucose infusion rate curve) revealed that a detemir dose of 0.29 units/kg would provide the same effect as 0.3 IU/kg NPH but has a longer duration of action (16.9 vs. 12.7 h, respectively). Lower between-subject variability was observed for insulin detemir on duration of action (0.4 units/kg insulin detemir vs. 0.3 IU/kg NPH, P &lt; 0.05) and GIRmax (maximal glucose infusion rate) (0.2 and 0.4 units/kg insulin detemir vs. 0.3 IU/kg NPH, both P &lt; 0.05). Assessment of endogenous glucose production (EGP) and peripheral glucose uptake (PGU) resulted in an AOCEGP (area over the EGP curve) of 636 mg/kg (95% CI 279–879) vs. 584 (323–846) and an AUCPGU (area under the PGU curve) of 173 (47–316) vs. 328 (39–617) for 0.29 units/kg detemir vs. 0.3 IU/kg NPH, respectively.
CONCLUSIONS—This study shows that insulin detemir provides a flat and protracted pharmacodynamic profile.
Elevated Pregnancy Losses at High and Low Extremes of Maternal Glucose in Early Normal and Diabetic Pregnancy
Authors: Jovanovic Lois , Knopp Robert H. , Kim Haesook , Cefalu William T. , Zhu Xiao-Dong , Lee Young Jack , Simpson Joe Leigh , Mills James L. ,   for the Diabetes in Early Pregnancy Study Group
Published: March 2007

OBJECTIVE—Early pregnancy losses increase with marked hyperglycemia in diabetic pregnancy. However, mean loss rates do not differ from those of nondiabetic pregnancy. This observation might be explained by increased fetal losses at the extremes of glycemia in diabetic and nondiabetic pregnancy. To test this hypothesis, we examined relationships of proximate measures of prior glycemia, glycated protein and fructosamine, to pregnancy loss.
RESEARCH DESIGN AND METHODS—A total of 389 diabetic and 429 nondiabetic pregnant subjects participated in the Diabetes In Early Pregnancy study. Glycated protein and fructosamine measurements were standardized as multiples of control values for each center (Z score). The logarithm of odds of pregnancy loss were plotted against Z scores and tested by logistic models.
RESULTS—Mean pregnancy loss rates were 12% in diabetic and 13% in normal pregnancies. However, over six intervals of glycated protein in diabetic pregnancy, fetal loss rates at the upper and lower extremes (24 and 33%, respectively) were approximately threefold higher than the four intervening rates (8–14%). The odds ratio of pregnancy loss for these extreme intervals to the intervening intervals is 3.0 (P = 0.01). Nondiabetic losses showed a similar pattern. In confirmation, logit pregnancy losses were increased in a J-shaped curve at the glycemic extremes in normal (P &lt; 0.019) and diabetic (P &lt; 0.015) pregnancy. The upper glycemic extreme in diabetic pregnancy was two- to fivefold higher than in control pregnancy.
CONCLUSIONS—Pregnancy losses are increased at the extremes of glycemia in both normal and diabetic pregnancy but at higher levels in diabetic pregnancy. The data suggest defensive adaptations against hyperglycemia in diabetic pregnancy.
β-Cell Function in Mild Type 2 Diabetic Patients
Authors: Mari Andrea , Gastaldelli Amalia , Foley James E. , Pratley Richard E. , Ferrannini Ele 
Published: March 2007

OBJECTIVE—We studied the effects of the oral insulin secretagogue nateglinide on insulin secretion using a modeling approach to obtain β-cell function parameters from a meal test and examined the impact of the β-cell improvement on glucose tolerance.RESEARCH DESIGN AND METHODS—Mild type 2 diabetic men and women (n = 108; fasting glucose 7.0–8.3 mmol/l) on diet treatment alone randomly received 30, 60, or 120 mg nateglinide or placebo for 24 weeks. β-Cell function parameters were derived by modeling (based on C-peptide deconvolution) from a standardized meal test at baseline and after 24 weeks of treatment.RESULTS—The baseline demographic and metabolic characteristics of the four groups were similar. Nateglinide treatment resulted in dose-dependent reductions in the mean postprandial glucose response and at the 120-mg dose in fasting glucose. Fasting or total insulin secretion during the meal were not different. In contrast, we found differences in the model parameters. Rate sensitivity (expressing early insulin secretion when glucose is rising) was significantly enhanced at 24 weeks with the lowest nateglinide dose, with no further stimulation at higher doses. Early potentiation (expressing an initial insulin secretion enhancement), glucose sensitivity (the slope of the glucose–insulin secretion relationship), and insulin secretion at a fixed- reference 7-mmol/l glucose concentration all showed a trend toward increasing, with increasing nateglinide dose, and were significantly greater than placebo at the 120-mg dose. In multiple regression analyses, changes in rate sensitivity, glucose sensitivity, and potentiation all contributed to the observed glucose changes.CONCLUSIONS—The model-derived parameters are sensitive measures of β-cell function, showing improvements after nateglinide treatment and predicting changes in glucose tolerance.
Familial Aggregation of Severity of Diabetic Retinopathy in Mexican Americans From Starr County, Texas
Authors: Hallman D. Michael , Huber J. Charles , Gonzalez Victor H. , Klein Barbara E.K. , Klein Ronald , Hanis Craig L. 
Published: March 2007

OBJECTIVE—Diabetic retinopathy is a major cause of blindness. To determine whether retinopathy itself or only its severity aggregates in families, we examined the occurrence and severity of diabetic retinopathy in Mexican-American siblings with type 2 diabetes.
RESEARCH DESIGN AND METHODS—Using stereoscopic fundus photography of seven standard fields, we measured retinopathy in 656 type 2 diabetic patients from 282 Mexican-American families from Starr County, Texas. Retinopathy severity was scored using the Early Treatment of Diabetic Retinopathy Study system and classified as no retinopathy, early nonproliferative diabetic retinopathy (NPDR-E), moderate-to-severe nonproliferative diabetic retinopathy (NPDR-S), or proliferative diabetic retinopathy (PDR).
RESULTS—Of 249 siblings of randomly selected probands with retinopathy, 169 (67.9%) had retinopathy, compared with 95 of 125 siblings of unaffected probands (76.0%; P = 0.11). Proband retinopathy class was associated (P = 0.03) with sibling retinopathy class, with significant odds ratios (ORs) for NPDR-E versus no retinopathy (OR 0.57 [95% CI 0.35–0.93]) and PDR versus NPDR-E (2.02 [1.13–3.63]); the contrast of NPDR-S versus NPDR-E approached significance (1.78 [0.99–3.20]). With the more severe classes (PDR and NPDR-S) combined in one group and the less severe ones (none and NPDR-E) in another, more severe proband retinopathy was associated with more severe sibling retinopathy (1.72 [1.03–2.88]).
CONCLUSIONS—More severe diabetic retinopathy showed evidence of familial aggregation, but the occurrence of diabetic retinopathy per se did not. The factors involved in the onset of diabetic retinopathy may differ from those involved in its progression to more severe forms.
Magnesium Deficiency Is Associated With Insulin Resistance in Obese Children
Authors: Huerta Milagros G. , Roemmich James N. , Kington Marit L. , Bovbjerg Viktor E. , Weltman Arthur L. , Holmes Viola F. , Patrie James T. , Rogol Alan D. , Nadler Jerry L. 
Published: March 2007

OBJECTIVE—Magnesium deficiency has been associated with insulin resistance (IR) and increased risk for type 2 diabetes in adults. This study was designed to determine whether obese children exhibit serum or dietary magnesium deficiency and its potential association with IR.
RESEARCH DESIGN AND METHODS—We studied 24 obese nondiabetic children (BMI ≥85th percentile) and 24 sex- and puberty-matched lean control subjects (BMI &lt;85th percentile). We measured serum magnesium, indexes of insulin sensitivity, dietary magnesium intake (using a food frequency questionnaire), and body composition (by air displacement plethysmography).
RESULTS—Serum magnesium was significantly lower in obese children (0.748 ± 0.015 mmol/l, means ± SE) compared with lean children (0.801 ± 0.012 mmol/l) (P = 0.009). Serum magnesium was inversely correlated with fasting insulin (rs = −0.36 [95% CI −0.59 to −0.08]; P = 0.011) and positively correlated with quantitative insulin sensitivity check index (QUICKI) (0.35 [0.06–0.58]; P = 0.015). Dietary magnesium intake was significantly lower in obese children (obese: 0.12 ± 0.004 vs. lean: 0.14 ± 0.004 mg/kcal; P = 0.003). Dietary magnesium intake was inversely associated with fasting insulin (−0.43 [−0.64 to −0.16]; P = 0.002) and directly correlated with QUICKI (0.43 [0.16–0.64]; P = 0.002).
CONCLUSIONS—The association between magnesium deficiency and IR is present during childhood. Serum magnesium deficiency in obese children may be secondary to decreased dietary magnesium intake. Magnesium supplementation or increased intake of magnesium-rich foods may be an important tool in the prevention of type 2 diabetes in obese children.
Two-Year Outcome of a Combination of Weight Loss Therapies for Type 2 Diabetes
Authors: Redmon J. Bruce , Reck Kristell P. , Raatz Susan K. , Swanson Joyce E. , Kwong Christine A. , Ji Hong , Thomas William , Bantle John P. 
Published: March 2007

OBJECTIVE—To evaluate the effects over 2 years of a weight loss program combining several weight loss strategies on weight loss and diabetes control in overweight subjects with type 2 diabetes.
RESEARCH DESIGN AND METHODS—A total of 59 overweight or obese individuals with type 2 diabetes were randomly assigned to either a combination therapy weight loss program for 2 years (C therapy) or a standard therapy weight loss program for 1 year followed by a combination therapy weight loss program in the 2nd year (S/C therapy). C therapy combined the use of meal replacement products, repetitive intermittent low-calorie-diet weeks, and pharmacologic therapy with sibutramine. Outcome measures included changes in weight, glycemic control, plasma lipids, blood pressure, and body composition over 2 years.
RESULTS—A total of 48 participants (23 in the C therapy group and 25 in the S/C therapy group) completed 2 years of study. After 2 years, the C therapy group had weight loss of 4.6 ± 1.2 kg (P &lt; 0.001) and a decrease in HbA1c of 0.5 ± 0.3% (P = 0.08) from baseline. At 2 years, the C therapy group had significant reductions in BMI, fat mass, lean body mass, and systolic blood pressure. The S/C therapy group showed changes in weight and HbA1c in year 2 of the study that were similar to those demonstrated by the C therapy group in year 1.
CONCLUSIONS—This combination weight loss program resulted in significant weight loss and improved diabetes control over a 2-year period in overweight subjects with type 2 diabetes.
Diabetic Retinopathy Is Associated With Mortality and Cardiovascular Disease Incidence
Authors: van Hecke Manon V. , Dekker Jacqueline M. , Stehouwer Coen D.A. , Polak Bettine C.P. , Fuller John H. , Sjolie Anne Katrin , Kofinis Athanasios , Rottiers Raoul , Porta Massimo , Chaturvedi Nish 
Published: March 2007

OBJECTIVE—To study the relationship of nonproliferative and proliferative retinopathy with all-cause mortality and cardiovascular disease (CVD) incidence in type 1 diabetic patients and, additionally, the role of cardiovascular risk factors in these associations.
RESEARCH DESIGN AND METHODS—This prospective study included 2,237 type 1 diabetic patients from 31 centers in 16 European countries at baseline, aged 15–60 years, who were examined for retinopathy by taking two-field 45° fundus photographs, which were centrally graded. Mortality and cardiovascular morbidity follow-up was assessed 6–8 years after baseline examination according to a standardized protocol.
RESULTS—After 7.9 years of follow-up, 64 patients had died and 128 patients had incident CVD. The age- and sex-adjusted hazard ratios (HRs) of all-cause mortality were 1.45 (95% CI 0.71–2.96) and 4.16 (1.96–8.84) in patients with nonproliferative and proliferative retinopathy at baseline, respectively. Adjustments for cardiovascular risk factors completely obliterated the association with nonproliferative retinopathy, whereas the association with proliferative retinopathy remained twofold increased, although nonsignificant. The age- and sex-adjusted HRs of incident CVD were 1.73 (1.15–2.60) and 2.05 (1.22–3.45) in patients with nonproliferative and proliferative retinopathy, respectively. After adjustments for cardiovascular risk factors, both associations were attenuated and lost statistical significance.
CONCLUSIONS—This study shows that type 1 diabetic patients with nonproliferative or proliferative retinopathy have an increased risk for all-cause mortality and incident CVD. The presence of cardiovascular risk factors explained the associations to a large extent, except for the associations with proliferative retinopathy, which suggests that other shared mechanisms may be involved.
Serum Adiponectin Is Increased in Type 1 Diabetic Patients With Nephropathy
Authors: Saraheimo Markku , Forsblom Carol , Fagerudd Johan , Teppo Anna-Maija , Pettersson-Fernholm Kim , Frystyk Jan , Flyvbjerg Allan , Groop Per-Henrik ,   on behalf of the FinnDiane Study Group
Published: March 2007

OBJECTIVE—To elucidate whether serum adiponectin is associated with renal function, low-grade inflammatory markers, metabolic control, and insulin resistance in type 1 diabetic patients with and without nephropathy.
RESEARCH DESIGN AND METHODS—A total of 189 type 1 diabetic patients from the Finnish Diabetic Nephropathy Study were divided into three groups based on their urinary albumin excretion rate (AER): patients with normal AER (n = 66) had no antihypertensive medication, while patients with microalbuminuria (n = 63) or macroalbuminuria (n = 60) were all treated with an ACE inhibitor. Renal function was estimated with the Cockcroft-Gault formula. Adiponectin was measured by an in-house time-resolved immunofluorometric assay.
RESULTS—Adiponectin concentrations were higher in women than in men, but since there was no significant difference in sex distribution between the groups, data were pooled. Adiponectin concentrations were higher in patients with macroalbuminuria (19.8 ± 12.0 mg/l) than in patients with microalbuminuria (13.1 ± 4.8 mg/l) or normoalbuminuria (11.8 ± 4.2 mg/l). In a univariate analysis, adiponectin was positively associated with creatinine (r = 0.41; P &lt; 0.0001), AER (r = 0.33; P &lt; 0.0001), interleukin-6 (r = 0.22; P = 0.002), systolic blood pressure (r = 0.22; P = 0.004), HbA1c (r = 0.17; P = 0.02), total cholesterol (r = 0.16; P = 0.03), and HDL cholesterol (r = 0.16; P = 0.03) and negatively with estimated glomerular filtration rate (GFR; r = −0.52; P &lt; 0.0001) and waist-to-hip ratio (WHR; r = −0.16; P = 0.03). In a multiple linear regression analysis including the above variables, estimated GFR, AER, and WHR were independently associated with adiponectin levels (r2 = 0.32).
CONCLUSIONS—Serum adiponectin concentrations are increased in type 1 diabetic patients with nephropathy, and levels are further associated with renal insufficiency.