bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low Prevalence of Islet Autoantibodies in Patients With Gestational Diabetes Mellitus
Authors: Dozio Nicoletta , Beretta Angelo , Belloni Cristina , Castiglioni Mariateresa , Rosa Susanna , Bosi Emanuele , Bonifacio Ezio 
Published: March 2007

OBJECTIVE
To determine the proportion of patients with gestational diabetes mellitus (GDM) who have serological characteristics typical of IDDM.

RESEARCH DESIGN AND METHODS
Islet cell antibodies (ICAs), insulin autoantibodies (IAAs), GAD65, and IA-2 antibodies were measured in 145 pregnant women with GDM, 33 with impaired glucose tolerance (IGT), and in 73 with normal glucose tolerance (NGT). ICAs were measured by indirect immunofluorescence; GAD65 and IA-2 antibodies, by a radio-ligand immunoassay incorporating 35S-labeled recombinant antigen; and IAAs, by a liquid-phase radiobinding assay.

RESULTS
The prevalences of islet autoantibodies were low and not significantly different between groups. ICAs were detected at levels ranging from 5 to 45 Juvenile Diabetes Foundation U in 14 (10%) women with GDM, 2 (6%) women with (GT, and in 4 (5%) women with NGT. IAAs were detected at levels between 3 and 4 SD above the mean in 4 (3%) women with GDM, 0 women with IGT, and in 1 (1%) woman with NGT. None had both ICAs and IAAs. Neither GAD65 nor IA-2 antibodies, which have been detected in the majority of pre-IDDM and IDDM patients, were found in NGT, IGT, or GDM patients.

CONCLUSIONS
Low-titer ICAs and IAAs are not infrequent in pregnant women, but multiple islet autoantibodies and antibodies to GAD65 or IA-2 were not found in GDM. These findings suggest that the serological characteristics of IDDM are rare in GDM.
Efficacy and Safety of Mexiletine in the Treatment of Painful Diabetic Neuropathy. The Mexiletine Study Group
Authors: Oskarsson Per , Ljunggren Jan-Gustaf , Lins Per-Eric 
Published: March 2007

OBJECTIVE
To investigate the efficacy and safety of mexiletine in the treatment of painful diabetic neuropathy.

RESEARCH DESIGN AND METHODS
A total of 216 insulin-treated diabetes patients with painful diabetic neuropathy were randomly allocated to three dosages of mexiletine or placebo. The Visual Analog Scale (VAS) for pain/discomfort was scored each day during daytime and nighttime, and sleeping disturbances were also recorded by the patients. Plasma levels of mexiletine and 24-h electrocardiogram (ECG) mapping were assessed before and during the 3-week study period.

RESULTS
A significant reduction in sleep disturbances and pain during nighttime was observed in the group of patients taking the highest dosages (675 mg/day) of mexiletine compared with the other groups. No significant correlation was found between plasma concentration of mexiletine and the therapeutic effect or adverse events. No serious adverse events were seen. The 24-h ECG mapping did not disclose onset of significant arrhythmias in any patient.

CONCLUSIONS
Mexiletine in a dosage of 675 mg daily can reduce pain caused by diabetic neuropathy, and the effect of this drug appears to have a rapid onset.
No Effect of Unfractioned or Low Molecular Weight Heparin Treatment on Markers of Vascular Wall and Hemostatic Function in Incipient Diabetic Nephropathy
Authors: Myrup Bjarne , Jensen Tonny , Gram Jørgen , Kluft Cornelis , Jespersen Jørgen , Deckert Torsten 
Published: March 2007

OBJECTIVE
The high risk for cardiovascular disease in IDDM patients with nephropathy may be mediated by abnormal function of the vascular wall. We investigated whether heparin was able to modulate markers of vascular wall and hemostatic function in patients with incipient nephropathy.

RESEARCH DESIGN AND METHODS
Thirty-five IDDM patients with incipient nephropathy were randomized to treatment with placebo, unfractioned heparin, or low molecular weight heparin in a double-blind trial. The treatment was given as 1 h of conventional intravenous high-dose treatment and in a conventional subcutaneous low-dose regime for 3 months. Transcapillary escape rate of albumin and plasma levels of von Willebrand factor, fibrinogen, prothrombin fragment 1 + 2, thrombin-antithrombin III complexes, tissue type plasminogen activator, tissue plasminogen activator inhibitor type 1, total cholesterol, HDL cholesterol, and triglycerides were measured before and after treatment. Of the patients, 31 completed the study.

RESULTS
We found no significant effect of heparin on markers of vascular wall and hemostatic function by any of the treatments.

CONCLUSIONS
Treatment with high- or low-dose heparin induced no modulation of markers of vascular wall or hemostatic function in IDDM patients with incipient diabetic nephropathy.
Hyperinsulinemia and the Development of ST-T Electrocardiographic Abnormalities: An 11-year follow-up study
Authors: Adachi Hisashi , Hashimoto Ryuichi , Tsuruta Makoto , Jacobs David R , Crow Richard S , Imaizumi Tsutomu 
Published: March 2007

OBJECTIVE
It has been suggested that insulin resistance and consequent hyperinsulinemia promote atherosclerosis, but few prospective studies have reported the relationships between hyperinsulinemia and the development of ST-T abnormalities in the 12-lead resting electrocardiogram (ECG) in populations in which atherosclerosis is rare.

RESEARCH DESIGN AND METHODS
A total of 304 Japanese men and women, aged 20–69 years, selected for having high blood glucose or more than a trace-positive urine glucose from a population-based health examination in 1981, were followed for 11 years. Of these, 33 died, 1 from myocardial infarction, while 260/271 living were reexamined in 1992. The 237 subjects with a normal ECG at the baseline examination were analyzed.

RESULTS
Incident ST-T abnormalities occurred in 13/237 people. Insulin concentrations were positively associated with the development of ST-T abnormalities (relative risk approximately 8, comparing those in the highest versus lowest quartile of insulin values). Adjustment for age, sex, and systolic blood pressure or other risk factors had little effect on this relationship.

CONCLUSIONS
Hyperinsulinemia was related to the development of ST-T abnormalities in ECGs in the absence of the development of clinical signs of atherosclerosis, independent of blood pressure and other risk factors in men and women with mild glucose intolerance.
Exercise Responses in Patients With IDDM
Authors: Nugent Anne-Marie , Steele Ian C , Al-Modaris Firas , Vallely Stephen , Moore Ann , Campbell Norman P S , Bell Patrick M , Buchanan Keith D , Trimble Elisabeth R , Nicholls D Paul 
Published: March 2007

OBJECTIVE
The hemodynamic, respiratory, and metabolic responses to exercise were studied in IDDM patients and control subjects to detect diabetic cardiomyopathy.

RESEARCH DESIGN AND METHODS
Eight subjects aged 25–40 years with diabetes of at least 10 years' duration were compared with eight control subjects aged 21–46 years. All subjects underwent a progressive incremental bicycle exercise test with measurement of gas exchange, blood glucose, lactate, fat metabolite, and catecholamine levels and two steady-state exercise tests with measurement of cardiac output by a CO2 rebreathing method. A new first-pass radionuclide method was used to measure cardiac ejection fractions (EFs) at rest, peak exercise, and steady-state exercise.

RESULTS
The peak achieved oxygen consumption was similar in the diabetic and control subjects (29.9 [25.1–34.6] and 31.4 [26.9–35.9] ml . min−1 . kg−1, respectively; mean [95% CI]). There were no significant differences in heart rate, double product, ventilation, respiratory exchange ratio, or ventilatory equivalents for oxygen and CO2 during the incremental test. Glucose levels were higher in the diabetic subjects, but there were no significant differences in levels of lactate, catecholamines, free fatty acids, glycerol, or β-hydroxybutyrate. Left ventricular EF fell from rest to peak exercise within the diabetic group (66.0% [59.6–72.4] at rest; 53.6% [45.6–61.6] at peak; P &lt; 0.05) but this did not differ significantly from the control group (58.7% [52.3–65.1] at rest; 60.3% [48.9–71.7] at peak). Right ventricular EFs were similar in each group, and there was no reduction in peak filling rate to suggest diastolic dysfunction. The cardiac output responses to exercise were also similar in the two groups.

CONCLUSIONS
There is no evidence of impairment of the exercise response in subjects with long-standing diabetes, and the apparent fall in left ventricular EF at peak exercise could be related to hemodynamic adaptation.
IDDM Accompanied by a Growth Hormone-Producing Pituitary Adenoma: A case report
Authors: Otsuka Fumio , Ogura Toshio , Yamauchi Takayoshi , Shikata Kenichi , Kageyama Jingo , Makino Hirofumi 
Published: March 2007

CASE HISTORY
A 30-year-old Japanese man who presented with recurrent ketoacidosis caused by IDDM was found to have increased secretion of growth hormone (GH). On initial cranial magnetic resonance imaging (MRI), no pituitary lesion was detected; however, a pituitary microadenoma was found 2 years later during a repeat MRI. In spite of the hypersecretion of GH, serum IGF-I was dramatically suppressed. Transsphenoidal surgery was performed to resect the pituitary tumor that was histologically an acidophilic pituitary adenoma. Although the GH excess rapidly improved postoperatively, the IGF-I level remained low. Subsequent insulin therapy initiated 1 year after the operation elevated the serum IGF-I level to within the normal range.

DISCUSSION
The first case of coexistent IDDM and a GH-producing pituitary adenoma suggests that patients with uncontrolled IDDM may develop GH hypersecretion. Furthermore, the low IGF-I levels may be closely associated with the GH excess and with the development or progression of GH-secreting pituitary adenomas.
Effect of a Bicultural Community Health Worker on Completion of Diabetes Education in a Hispanic Population
Authors: Corkery Eileen , Palmer Carmen , Foley Mary E , Schechter Clyde B , Frisher Leah , Roman Sheila H 
Published: March 2007

OBJECTIVE
To determine the effect of a bicultural community health worker (CHW) on completion of diabetes education in an inner-city Hispanic patient population and to evaluate the impact of completion of the education program on patient knowledge, self-care behaviors, and glycemic control.

RESEARCH DESIGN AND METHODS
Patients were randomized into CHW intervention and non-CHW intervention groups. All patients received individualized, comprehensive diabetes education from a certified diabetes nurse educator after baseline demographic information, diabetes knowledge, diabetes self-care practices, and glycohemoglobin levels were assessed. Rates of education program completion were determined. Diabetes knowledge, self-care practices, and glycohemoglobin levels were reassessed at program completion and at a later postprogram follow-up medical appointment and compared to baseline. Logistic regression analysis and the Mantel-Haenszel χ2 statistic were used to determine the effect of the CHW assignment on program completion. Analyses of covariance were performed with end-of-treatment behavior scores, knowledge scores, and glycohemoglobin levels as outcome variables, controlling for baseline values and testing for the effect of CHW assignment.

RESULTS
Of 64 patients enrolled in the study, 40 (63%) completed and 24 (37%) dropped out before completing the diabetes education program. Of the patients having CHW intervention, 80% completed the education program, compared with 47% of patients without CHW intervention (P = 0.01). “Dropouts” were younger (age 47.5 ± 12.5 years [mean ± SD]) compared with patients who completed the program (55.9 ± 9.9 years) (P = 0.004). Dropout status showed no significant relationship to educational level achieved or literacy level. For the program “completers,” knowledge levels and selected self-care practices significantly improved, and glycohemoglobin levels improved from a baseline level of 11.7% to 9.9% at program completion (P = 0.004) and 9.5% at the postprogram follow-up (P &lt; 0.001). The effect of the CHW assignment on program completion, controlling for financial status and language spoken, was extremely robust (P = 0.007). The effect of the CHW on knowledge, self-care behavior, or glycohemoglobin outcome variables was not statistically significant.

CONCLUSIONS
These findings suggest that intervention with a bicultural CHW improved rates of completion of a diabetes education program in an inner-city Hispanic patient population irrespective of literacy or educational levels attained. Our data further suggests that completion of individualized diabetes educational strategies leads to improved patient knowledge, self-care behaviors, and glycemic control.
Carotid Intima-Media Thickness in Hyperlipidemic Type I and Type II Diabetic Patients
Authors: Kanters Suzan D J M , Algra Ale , Banga Jan-Dirk 
Published: March 2007

OBJECTIVE
Ultrasonographic measurements of the combined thickness of the carotid intima and media can be used to examine early vessel wall changes in atherosclerosis. Premature atherosclerosis is common in diabetes, especially when other risk factors are present. Intima-media thickness was quantified in hyperlipidemic type I and type II diabetic patients, and relationships between various risk factors and intima-media thickness were investigated.

RESEARCH DESIGN AND METHODS
Thirty-one patients with type I diabetes and 56 with type II diabetes were examined, with an LDL cholesterol of &gt; 2.6 mmol/l and/or triglycerides of &gt; 1.7 mmol/l and/or HDL cholesterol of &lt; 0.9 mmol/l for men or &lt; 1.1 mmol/l for women. Intima-media thickness was measured on-line, over a length of 1 cm in the common carotid artery. Later, the mean and the maximum of six measurements was calculated (left and right side, both in three directions).

RESULTS
Mean intima-media thickness was 0.63 ± 0.18 (±SD) mm for type I diabetes and 0.80 ± 0.31 mm for type II diabetes. Adjusted for age, the difference was 0.06 mm, with a 95% CI of −0.08 to 0.20 mm. In multivariate regression analysis, age over 50 years and higher HbA1c were independently associated with an increase in mean intima-media thickness in type I diabetes. In type II diabetes, none of the variables reached a significance level of ≤ 0.10. Results for maximum intima-media thickness were essentially the same.

CONCLUSIONS
In general, intima-media thickness is larger in type II diabetes than in type I diabetes. The effect of age is absent in type II diabetes, whereas in type I diabetes, age and blood glucose control have an important effect on intima-media thickness.
High Incidence of IDDM Over 6 Years in Edmonton, Alberta, Canada
Authors: Toth Ellen L , Lee Kwok-Choy , Couch Robert M , Martin Laurence F 
Published: March 2007

OBJECTIVE
To determine the incidence of IDDM among children 0–14 years of age in Edmonton, Alberta, between 1990 and 1995 by means of a population-based registry.

RESEARCH DESIGN AND METHODS
Children &lt;15 years of age diagnosed with IDDM between January 1990 and December 1995 were registered according to criteria of the World Health Organization (WHO) Multinational Project for Childhood Diabetes. The primary source of case ascertainment consisted of office records of pediatricians and endocrinologists. The secondary source consisted of inpatient records from the main city hospitals.

RESULTS
Between 1990 and 1995, 211 IDDM patients &lt;15 years of age were detected by the two sources. All but 15 of them were of European ancestry. The ascertainment-corrected incidence rates of this ethnic group (constituting 77% of the population) for the 6 years were 38.6, 23.5, 23.3, 24.2, 22.0, and 24.3 per 100,000, respectively, with case ascertainment rates of 75–95%. The age-adjusted rate over the 6-year period was 25.7 per 100,000 with a case ascertainment rate of 84.3%. No sex difference was observed. The highest incidence occurred in the 10- to 14-year-old age-group, and more cases were detected between January and March than at other periods in the year.

CONCLUSIONS
The incidence of IDDM among the European-derived population in Edmonton between 1990 and 1995 is the highest rate over a 6-year period to be reported in North America, comparable to that in Prince Edward Island, Canada, and to the highest rates in the world.
Diabetes Complications and Mortality Among Alaska Natives: 8 Years of Observation
Authors: Schraer Cynthia D , Adler Amanda I , Mayer Ann Marie , Halderson Karen R , Trimble Brian A 
Published: March 2007

OBJECTIVE
To determine the prevalence and incidence of diabetes in Alaska Natives and the incidence of cerebrovascular accidents (stroke), myocardial infarction (MI), end-stage renal disease (ESRD), lower-extremity amputations (LEA), and mortality over a 6- to 8-year period.

RESEARCH DESIGN AND METHODS
The data derive from a registry of diagnosed diabetes (World Health Organization [WHO] criteria) of the Alaska Area Native Health Service (AANHS), from medical records, and from the Alaska Bureau of Vital Statistics.

RESULTS
From 1986 to 1993, the prevalence of diabetes in Alaska Natives increased by 22% from 15.7 to 19.2 per 1,000 people. Of these cases, nearly all were diagnosed with type II diabetes. During the same period, 614 new cases were diagnosed. The incidence was 1.5 per 1,000 Alaska Natives per year. The incidence of confirmed MI was 8.0 per 1,000 person-years of diabetes. Aleuts had the highest rate, followed by Indians and Eskimos. The incidence of confirmed stroke was 10.6 per 1,000 person-years of diabetes. Eskimos had a significantly higher rate than Indians (P = 0.002), and women had a higher rate than men. The incidence of LEA was 5.0 per 1,000 person-years of diabetes. The incidence rate dropped significantly after instituting a foot care program. The incidence for ESRD was 3.3 per 1,000 and also showed a decline with time. The all-cause mortality rate of 43.2 per 1,000 person-years of diabetes was nearly equal between men and women. Among Alaska Natives with diabetes, cardiovascular disease (CVD) was the most common cause of death, followed by cancer and diabetes, per se.

CONCLUSIONS
We conclude that diabetes is increasing in Alaska Natives, who are experiencing both the microvascular and macrovascular complications of diabetes. The incidence of LEA and ESRD show some evidence of a decrease after intervention efforts.
Plasma Endothelin in Normal and Diabetic Pregnancy
Authors: Wolff Kerstin , Carlström Kjell , Fyhrquist Frej , Hemsén Anette , Lunell Nils-Olov , Nisell Henry 
Published: March 2007

OBJECTIVE
To examine endothelin-1 (ET-1) concentrations longitudinally throughout pregnancy in healthy and insulin-dependent diabetic women and to evaluate the relationship between ET-1 and big ET-1 in normal pregnancy.

RESEARCH DESIGN AND METHODS
Venous blood samples were obtained consecutively in gestational weeks 18, 28, and 38 from 40 healthy women with uneventful pregnancies and 24 pregnant women with IDDM. By radioimmunoassay, plasma ET-1 and big ET-1 were analyzed in the healthy women and plasma ET-1 in the diabetic women.

RESULTS
In the diabetic pregnant women, plasma ET-1 levels were significantly higher than in healthy pregnant women during the entire observation period (P &lt; 0.001), but did not change with advancing gestational age. Five of the diabetic, but none of the healthy pregnant women, developed preeclampsia. ET-1 levels did not differ between the diabetic women who developed preeclampsia and those who did not. Plasma ET-1 levels in healthy pregnant women were within the range of those in healthy nonpregnant women and did not change during pregnancy. The big ET-1 levels increased and the ET-1/big ET-1 ratio decreased significantly during the observation period.

CONCLUSIONS
Plasma ET-1 levels do not change with advancing gestational length. During normal pregnancy, the ET-1/big ET-1 ratio decrease, indicating a suppressed converting enzyme activity or altered clearance of ET-1. Pregnant women with IDDM have markedly elevated ET-1 levels. Although diabetic women with and without preeclampsia did not differ with respect to endothelial dysfunction, as reflected by elevated ET-1 concentration, we cannot exclude that altered endothelial function may be of importance for the increased frequency of preeclampsia in pregnant IDDM patients.
Moderate-to-Severe Diabetic Retinopathy Is More Prevalent in Mexico City Than in San Antonio, Texas
Authors: Villalpando Maria Elena González , Villalpando Clicerio González , Pérez Beatriz Arredondo , Díaz Sandra Virginia Martínez , Mitchell Braxton , Martínez David Rivera , Klein Ronald , Haffner Steven M , Stern Michael P 
Published: March 2007

OBJECTIVE
To compare the prevalence of diabetic retinopathy (DR) between low-income Mexicans from Mexico City and Mexican-Americans from San Antonio, Texas.

RESEARCH DESIGN AND METHODS
We designed a cross-sectional population-based study in low-income neighborhoods of Mexico City and San Antonio. The men and non-pregnant women included in the study had NIDDM and were between 35 and 64 years of age. Ophthalmologic evaluation was performed in 414 patients, 204 in San Antonio and 210 in Mexico City. Seven field standard stereophotographs of each eye were obtained, adapting the Early Treatment Diabetic Retinopathy Study protocol, and graded at the Fundus Photograph Reading Center of the University of Wisconsin.

RESULTS
Early nonproliferative DR occurred in 37 (17.6%) and 39 (19.1%) patients in Mexico City and San Antonio, respectively. Moderate-to-severe nonproliferative DR occurred in 55 (26.2%) and 37 (18.1%) patients in Mexico City and San Antonio, respectively, and proliferative DR occurred in 12 (5.7%) and 7 (3.4%) patients in Mexico City and San Antonio, respectively. Using univariate and multivariate logistic regression analysis with DR as the dependent variable, age, duration of disease, and fasting glucose concentration were positively and significantly associated with retinopathy, whereas city, systolic blood pressure, and other selected metabolic variables were not. We defined moderate-to-severe DR to include the categories of moderate-to-severe nonproliferative and proliferative DR. For this combined category, Mexico City patients with diabetes had a significantly higher prevalence (P &lt; 0.01) than those from San Antonio when analyzed by multiple logistic regression analysis (odds ratio for Mexico City/San Antonio, 1.72; 95% CI 1.10–2.70).

CONCLUSIONS
Overall prevalence of DR is similar in both cities. However, moderate-to-severe DR is significantly higher in Mexico City.