bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biphasic Patterns of Peripheral Insulin and Glucose Levels After Lunch in Normal Subjects
Authors: Robbins David C , Jaspan Jonathan , Vasquez Barbara , Cauter Eve Van 
Published: March 2007

The dynamic relationship of glucose concentrations and insulin secretion during the postabsorptive state is complex and has been associated with a variety of cyclic rhythms. To study the pattern of insulin and glucose response immediately after a mixed meal, we collected blood every 15 min from 0730 to 1645 h from eight normal resting men (age 24.9 ± 2 . 1 yr). They took identically constituted mixed meals at 0800 and 1145 h. Concentrations of glucose and insulin were measured in samples taken throughout the study, whereas levels of C-peptide, glucagon, and a-NH2 were determined in samples taken after 1130 h only. Computer-assisted analysis was used to identify significant increments and declines in concentrations and to quantify the coincidence of peaks of glucose, C-peptide, glucagon, and α-NH2 with peaks of insulin. Coefficients of correlation between data points were calculated for each individual.
The patterns of blood insulin and glucose after breakfast and lunch were different. After breakfast, a single simultaneous peak in insulin and glucose occurred ∼60 min after starting the meal. In contrast, the pattern after lunch in seven of the eight subjects was clearly biphasic. There were secondary, significant coincident peaks in serum insulin, glucose, and C-peptide occurring 1.75—2.25 h after the meal was served. The secondary peak appeared unrelated to the late absorption of protein because it was not associated with consistent changes in serum a-NH2 concentration. Erratic variations characterized the postlunch pattern of glucagon levels, excluding a role for this counterregulatory hormone in the control of the biphasic insulin and glucose response. Of the measured substances, only glucose, insulin, and C-peptide demonstrated significant cross-correlations. These data indicate that in this well-defined group of healthy volunteers, the response of plasma glucose, serum insulin, and C-peptide to lunch is biphasic.
Single-Void Urine Samples Can Be Used To Estimate Quantitative Microalbuminuria
Authors: Nathan David M , Rosenbaum Carol , Protasowicki V Daniel 
Published: March 2007

The excretion of small quantities of urinary albumin (microalbuminuria) may predict renal failure in diabetes. The measurement of microalbuminuria with radioimmunoassays has been based on 24-h, overnight, and 3- to 4-h collections. To determine whether single-void urine samples can be used to estimate 24-h excretion, we compared the results of 24-h outpatient urine collections with single-void samples corrected for creatinine from diabetic and nondiabetic subjects.
The overall correlation of single-void sample results expressed as microgram albumin per milligram creatinine with 24-h excretion (mg/24 h) was excellent (r = .82, P &lt; .001). More important, in the diabetic patients the sensitivity and specificity of detecting 24-h microalbuminuria in the abnormal range were at least 94 and 96%, respectively. Single-void urine specimens adjusted for creatinine discriminate between normal and abnormal levels of microalbuminuria, as determined in 24-h urine collection, with high specificity and sensitivity.
Racial Differences in Metabolic Control of Children and Adolescents With Type I Diabetes Mellitus
Authors: Delamater Alan M , Albrecht Dawn R , Postellon Daniel C , Gutai James P 
Published: March 2007

Objective
This study evaluated racial differences in the metabolic control of children and adolescents with insulin-dependent (type I) diabetes mellitus and examined the interactive effects of race with age and sex.

Research Design and Methods
Data on several demographic and clinical variables were obtained for 102 black and 108 white children, including the percentage of total HbA1, age, age at diagnosis, duration of diabetes, pubertal status, insulin dose (U · kg−1 · day−1), body mass index, number of clinic visits kept and missed, number of hospitalizations for diabetic ketoacidosis (DKA) for the year, and socioeconomic status (SES).

Results
Black children had higher insulin dosages (P &lt; 0.05) and lower SESs (P &lt; 0.001) than white children. HbA1 was higher in black than white children (P &lt; 0.01) after statistically adjusting for the effects of insulin dose, diabetes duration, and SES. With HbA1-based criteria, more black than white children were in poor and fewer in good metabolic control (P &lt; 0.001). Older children (≥ to 13 yr) had higher HbA1 levels than younger (&lt; 13 yr) children (P &lt; 0.002), but there were no differences in HbA1 between males and females nor were there interactive effects of race, sex, and age-group. Black children were hospitalized for DKA more frequently than white children (P &lt; 0.04). More black than white children missed clinic visits (P &lt; 0.01), but they did not differ in number of visits kept.

Conclusions
Black youths with type I diabetes mellitus are in poorer metabolic control than white youths.
Demonstration of Insulin Transformation Products in Insulin Vials by High-Performance Liquid Chromatography
Authors: Gregory Robert , Edwards Susan , Yateman Nigel A 
Published: March 2007

Objective
To assess the importance of temperature, light, agitation, and regular withdrawal of insulin on the rates of appearance of three groups of insulin transformation products (ITPs) in vials of human and beef soluble insulin.

Research Design And Methods
Twelve insulin-treated patients (6 receiving human soluble insulin, 6 receiving beef soluble insulin) participated in the study. Reverse-phase high-performance liquid chromatography was used to measure ITP in serial samples from vials stored in various laboratory environments or issued to patients. Vials in the laboratory were analyzed on nine occasions over 26 wk; those issued to patients were analyzed weekly.

Results
Results were expressed as rates of change (% total protein/wk). Except for human insulin stored at 4°C, sampling did not accelerate transformation. Storage at higher temperatures caused more rapid transformation to all ITP groups, and human insulin was more susceptible than beef insulin. Exposure to light accelerated transformation mainly to group 3 ITP. Fibrillation occurred in beef but not human insulin carried in a shirt pocket. Results from patients' vials were consistent with reported storage conditions.

Conclusions
All three ITP groups form in human and beef soluble insulin. Their rate of production is a function of temperature and light exposure. Differences between the two insulins were probably due to differences in formulation. Patients should be discouraged from hoarding vials and storing insulin in direct sunlight. One or more ITPs could contribute to the residual immunogenicity of modern insulin preparations.
International Evaluation of Cause-Specific Mortality and IDDM
Authors:   Diabetes Epidemiology Research International Mortality Study Group
Published: March 2007

Objective
A cross-cultural study was completed to evaluate differences in mortality patterns in four population cohorts in Japan; Israel; Allegheny County, Pennsylvania; and Finland.

Research Design and Methods
Cases were diagnosed between 1 January 1965 and 31 December 1979. Mortality was determined as of 1 January 1985. There were 147 deaths occurring in the 8212 insulin-dependent diabetes mellitus (IDDM) patients in the four countries. A standardized protocol for assessing causes of death (cause-specific mortality) was developed; in this article, we report the causes.

Results
Major overall mortality differences by country appeared, with IDDM subjects in Japan much more likely to die than in the other countries. In Japan, the elevated mortality was the result of acute diabetes-related complications and kidney disease. For all countries, mortality from acute diabetes-related complications accounted for a surprisingly high percentage of deaths (&gt; 25% in each country). A larger percentage of cases in Finland died as a result of suicide than for the other three countries.

Conclusions
The results suggest that there are major cross-country differences in cause-specific mortality and that much of the premature mortality associated with diabetes is potentially preventable.
Serum Levels of Tumor Necrosis Factor and IL-1α and IL-1β in Diabetic Patients
Authors: Mooradian Arshag D , Reed Richard L , Meredith Keith E , Scuderi Philip 
Published: March 2007

Objective
To determine whether chronic hyperglycemia causes increased levels of serum tumor necrosis factor (TNF) and interleukin 1 α (IL-1 α) and IL-1 β.

Research Design and Methods
Sera were obtained from 59 diabetic patients, 44 chronically ill nondiabetic patients, and 34 age-matched healthy control subjects. Mononuclear cells were isolated from a subgroup of diabetic patients and healthy control subjects.

Results
Except for a modest increase in the prevalence of detectable serum TNF levels in diabetic patients, the serum cytokines measured in this study did not appear to be altered in diabetes. In vitro TNF production by mononuclear cells was not altered in diabetic patients. However, in vitro IL-1 β secretion, in response to lipopolysaccharides, was reduced.

Conclusions
Diabetes mellitus is not associated with significant changes in serum levels of TNF, IL-1 α, or IL-1 β. In vitro secretion of IL-1 β in response to lipopolysaccharides may be reduced in diabetes.
Smoking and Diabetes Mellitus: Findings From 1988 Behavioral Risk Factor Surveillance System
Authors: Ford Earl S , Newman Jeffrey 
Published: March 2007

Objective
To examine the association between smoking and self-reported diabetes mellitus.

Research Design and Methods
The study was comprised of 3006 people ≥18 yr of age with diabetes and 52,750 without diabetes.

Results
Twenty-six percent (SE 1.8) of the diabetic population were current smokers, 25.9% (SE 1.4) were former smokers, and 48.1% (SE 2) had never smoked. Similar percentages were found among the nondiabetic population. Compared to respondents without diabetes, the prevalence of current smoking was notably higher among respondents with diabetes who were between the ages of 18 and 34 yr (36.1%, SE 4.1), who had not graduated from high school (44.9%, SE 3.7), and who were men of African-American origin (54.8%, SE 5.8).

Conclusions
Despite the excess risks, the overall prevalence of smoking in the diabetic population is comparable to that of the general population. Our finding of a higher prevalence of smoking among young people, people who had not graduated from high school, and African-American men with diabetes suggests that additional educational efforts should be targeted at these groups.
Hand Skin Blood Flow in Diabetic Patients With Autonomic Neuropathy and Microangiopathy
Authors: Hauer Joao L , Boland Oliver M , Ewing David J , Clarke B F 
Published: March 2007

Objective
To determine whether changes in hand skin blood flow in diabetic men could be demonstrated with liquid crystal contact thermography and to assess the relative effects of autonomic neuropathy and microangiopathy on these changes.

Research Design and Methods
Thirty-four diabetic and 12 age-matched nondiabetic men comprised the study. The diabetic men were categorized according to standard cardiovascular autonomic function tests and the presence or absence of background or proliferative retinopathy and/or proteinuria. Bilateral hand thermograms were measured at rest and after immersion of the right hand in ice-cold water.

Results
Diabetic men with definite or severe autonomic neuropathy (n = 13) had a high frequency of anisothermal baseline thermograms (77 vs. 25% in nondiabetic subjects, P &lt; 0.05). After ice-cold water immersion, right-hand recovery was abnormally slow (514 ± 157 arbitrary U, area under the curve) compared with nondiabetic men (685 ± 135 arbitrary U, P &lt; 0.01). Diabetic men with proliferative retinopathy (n = 8) all had definite or severe autonomic neuropathy and showed the same abnormalities. Diabetic men with nor or early autonomic changes showed normal thermographic patterns.

Conclusions
These results are consistent with increased palmar arteriovenous shunt blood flow or capillary closure in the hands of diabetic patients with definite or severe autonomic neuropathy. They indicate that thermoregulatory reflex changes in hand skin blood flow are controlled by the autonomic nervous system. It is possible, however, that diabetic microangiopathy, associated with the presence of proliferative retinopathy, also independently affects hand skin blood flow.
Topical Phenytoin in Diabetic Foot Ulcers
Authors: Muthukumarasamy M Govindraj , Sivakumar Gurumurthy , Manoharan Govindan 
Published: March 2007

Objective
The efficacy of topical phenytoin in the treatment of diabetic foot ulcers was evaluated in a controlled inpatient study.

Research Design and Methods
Fifty patients were treated with topical phenytoin, and 50 patients matched for age, sex, and ulcer areas, depth, chronicity, and infection were dressed with dry sterile occlusive dressing.

Results
Both groups improved, but the ulcers treated with topical phenytoin healed more rapidly. Mean time to complete healing was 21 days with phenytoin and 45 days with control. The differences seen were statistically significant (P &lt; 0.05) via the chi 2 test.

Conclusions
Phenytoin appears to be useful as a topical agent in promoting the healing of diabetic foot ulcers.
Contact Thermography of Painful Diabetic Neuropathic Foot
Authors: Chan Ah Wah , MacFarlane Ian A , Bowsher David R 
Published: March 2007

Objective
To investigate regional differences in skin blood flow (measured by contact thermography) in the diabetic neuropathic foot and to examine the effect of foot temperature on the severity of neuropathic pain.

Research Design and Methods
Thirty-five diabetic patients with painful polyneuropathy (PPN) and 33 healthy age- and sex-matched control subjects comprised the study. Mean foot temperature (MFT) in PPN (mean ± SE 28.3 ± 0.3 ° C) was significantly higher (P &lt; 0.001) than in the control subjects (25.9 ± 0.5 ° C), with the highest temperatures over the metatarsal areas and heel. Visual analogue scale pain score (mean ± SD 5.3 ± 1.9 cm) did not correlate with MFT (r = −0.14, P = 0.52). In 10 patients with PPN followed for 2–8 mo (mean 4.6), MFT fell by 1.6 ° C (P = 0.05), but pain scores did not alter.

Conclusions
Neuropathic pain is unaffected by alterations in skin temperature. Elevated skin temperatures at recognized sites of weight bearing (metatarsal heads and heels) are common in the diabetic neuropathic foot and may indicate tissue injury or inflammation induced by pressure trauma or increased arteriovenous shunting. Follow-up studies will determine whether thermographic hot spots are more susceptible to ulceration.
Effect of Puberty on Insulinlike Growth Factor I and HbA1 in Type I Diabetes
Authors: Rogers Douglas G , Sherman Lori D , Gabbay Kenneth H 
Published: March 2007

Objective
To assess the effect of puberty on the relationship between glycemic control and insulinlike growth factor I (IGF-I) levels in children with insulin-dependent (type I) diabetes mellitus.

Research Design and Methods
Simultaneous HbA1 and plasma IGF-I levels were determined in 71 prepubertal (Tanner stage I) and 112 pubertal (Tanner stages II-V) subjects aged 2.7–17.8 yr.

Results
Overall, IGF-I levels were positively correlated with both age (r = 0.31, P &lt; 0.001) and Tanner stage (r = 0.32, P &lt; 0.001) but only weakly associated with HbA1 values (r = −0.16, P = 0.025). A strong negative association existed between IGF-I and HbA1 levels (r = −0.45, P &lt; 0.001) in the pubertal subjects, but no such association was apparent in the prepubertal subjects. Multiple regression analyses disclosed a significant independent negative association between IGF-I and HbA1 levels in the pubertal group (P &lt; 0.001) but not in the prepubertal group.

Conclusions
Glycemic control appears to strongly influence IGF-I levels only after the onset of puberty.
Copper, Zinc, Manganese, and Magnesium Status and Complications of Diabetes Mellitus
Authors: Walter Rober M , Uriu-Hare Janet Y , Olin Katherine Lewis , Oster Michelle H , Anawalt Bradley D , Critchfield James W , Keen Carl L 
Published: March 2007

Objective
To evaluate copper, zinc, manganese, magnesium, and other indices of peroxidative status in diabetic and nondiabetic human subjects.

Research Design and Methods
Convenience sample of 57 insulin-dependent or non-insulin-dependent diabetic subjects recruited from the diabetes clinic of the University of California, Davis, Medical Center and 28 nondiabetic subjects recruited from the staffs of the Departments of Internal Medicine and Nutrition. Individuals conducting laboratory analyses were blind to subject group. A fasting blood sample was collected from all subjects and appropriately processed for future analyses. A 24-h urine collection was obtained in a subset of subjects.

Results
Hyperzincuria and hypermagnesuria were evident in diabetic subjects compared with control subjects. There were no differences in plasma magnesium or whole-blood manganese between groups. Plasma copper was higher and plasma zinc was lower in diabetic than in control subjects. When data were viewed with respect to specific diabetes-associated complications, diabetic subjects with retinopathy, hypertension, or microvascular disease had higher plasma copper concentrations compared with both diabetic subjects without complications and with control subjects. There were no significant differences between control and diabetic subjects in erythrocyte copper-zinc superoxide dismutase activity or whole-blood glutathione peroxidase or glutathione reductase activities. Plasma peroxide concentrations were higher in diabetic than control subjects.

Conclusions
Diabetes can alter copper, zinc, magnesium, and lipid peroxidation status. Perturbations in mineral metabolism are more pronounced in diabetic populations with specific complications. It is not known whether differences in trace element status are a consequence of diabetes, or alternatively, whether they contribute to the expression of the disease.
Receiver Operating Characteristic Analysis on Fasting Plasma Glucose, HbA1c, and Fructosamine on Diabetes Screening
Authors: Tsuji Ichiro , Nakamoto Kazuya , Hasegawa Toshihiko , Hisashige Akinori , Inawashiro Hiroshi , Fukao Akira , Hisamichi Shigeru 
Published: March 2007

Objective
To determine the efficacy of HbA1c and fructosamine as alternatives to fasting plasma glucose (FPG) for diabetes screening.

Research Design and Methods
Receiver operating characteristic (ROC) analysis was conducted on the above tests. Comparison among tests was based on the area under ROC curve of a test. World Health Organization criteria for classifying glucose tolerance status of the subjects was used. The study consisted of subjects (n = 583) who visited the clinic from September to October 1989 and all diabetic cases (n = 36) from November 1989 to March 1990, after excluding those &lt; 40 yr of age or with hypoglycemic therapies (469 were normal, 88 with impaired glucose tolerance [IGT], and 62 with diabetes).

Results
Area under ROC curve of HbA1c was not different from that of FPG. Area under curve of fructosamine was significantly smaller than that of FPG. For all tests, overall efficacy of a test to detect IGT and diabetes was considerably diminished compared with detection of diabetes alone.

Conclusions
The discriminating ability of HbA1c is almost the same as that of FPG, therefore HbA1c is a good alternative to FPG. Fructosamine is not suitable for diabetes screening.
Altering Triglyceride Concentrations Changes Insulin-Glucose Relationships in Hypertriglyceridemic Patients: Double-Blind Study With Gemfibrozil With Implications for Atherosclerosis
Authors: Steiner George 
Published: March 2007

Objective
To determine whether reducing triglyceride concentrations in humans reduces serum insulin levels and consider the implications of this for the insulin resistance of hypertriglyceridemia.

Research Design and Methods
Insulin and glucose levels were determined during an oral glucose tolerance test (OGTT) in 14 volunteers who had a range of basal triglyceride levels. A double-blind crossover design was used to study active and placebo gemfibrozil and relate triglyceride changes to insulin and glucose levels. Diet and weight were kept constant.

Results
Glucose concentrations during OGTT were the same in both treatment periods. Insulin concentrations were reduced in proportion to reductions in triglyceride.

Conclusions
Triglyceride reduction in hypertriglyceridemic patients is associated with a decrease in serum insulin. This does not appear to be a direct effect of gemfibrozil, because it does not occur without a sufficient fall in triglyceride levels. Because glucose concentration remains the same despite the reduced insulin, the triglyceride reduction may result in greater sensitivity to insulin. Treatment of hypertriglyceridemia may break a vicious and potentially atherogenic cycle of hypertriglyceridemia and hyperinsulinemia.
Inverse Association Between Fish Intake and Risk of Glucose Intolerance in Normoglycemic Elderly Men and Women
Authors: Feskens Edith JM , Bowles Carel H , Kromhout Daan 
Published: March 2007

Objective
To examine the association of fish intake with the subsequent risk of impaired glucose tolerance and diabetes mellitus (glucose intolerance).

Research Design and Methods
In 1971, information about food intake was obtained by the cross-check dietary history method on 175 men and women aged 64-87 yr who were normoglycemic and free of clinical diabetes. During the follow-up period from 1972 to 1975, an oral glucose tolerance test was performed annually, and in 59 of 175 elderly people a diagnosis of glucose intolerance was made at least once.

Results
In 1971, ~ 60% of the subjects usually ate fish, with a mean daily intake of 24.2 g. In fish eaters, the incidence of glucose intolerance was significantly lower compared with nonfish eaters (odds ratio [OR] 0.40, 95% confidence interval [CI] 0.21-0.77). With logistic regression analysis, this inverse association could not be explained by taking into account age and sex or possible confounding baseline characteristics, such as the prevalence of myocardial infarction, body mass index, energy intake per kilogram body weight, or intake of carbohydrates (OR 0.47, 95% CI 0.23-0.93). Baseline characteristics of the oral glucose tolerance test and serum triglyceride levels could also not account for this result.

Conclusions
These results suggest that, in an elderly population, the habitual consumption of a small amount of fish may protect against the development of impaired glucose tolerance and diabetes mellitus.