bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Blood Glucose Monitoring Communication Questionnaire
Authors: Hood Korey K. , Butler Deborah A. , Volkening Lisa K. , Anderson Barbara J. , Laffel Lori M.B. 
Published: March 2007

OBJECTIVE—The aim of this study was to present the psychometric properties of a new tool for evaluating affective response to blood glucose monitoring (BGM) in youths with type 1 diabetes and their parents.
RESEARCH DESIGN AND METHODS—Study participants included 153 youths with type 1 diabetes and their parents. Each youth and parent completed the Blood Glucose Monitoring Communication (BGMC) questionnaire, Diabetes Family Conflict Scale, and Pediatric Quality of Life Inventory. Statistical analyses evaluated the psychometric properties of the BGMC questionnaires and their association with glycemic outcomes.
RESULTS—Youth and parent BGMC questionnaires had acceptable internal consistency (youth, α = 0.77; parent, α = 0.82) and 1-year test-retest reliability (youth, r = 0.60; parent, r = 0.80). Higher BGMC questionnaire scores (indicating more negative affect) showed a strong association with higher levels of diabetes-specific family conflict (youth, r = 0.33; parent, r = 0.44) and poorer health-related psychosocial quality of life (youth, r = −0.50; parent, r = −0.42). Higher BGMC questionnaire scores were also associated with poorer glycemic control (youth, r = 0.28; parent, r = 0.20), even when the effects of diabetes-specific family conflict and psychosocial quality of life were controlled. Youths with BGMC questionnaire scores in the upper quartile had A1c values 1 percentage point higher (9.1%) than youths with scores in the lowest quartile (8.0%).
CONCLUSIONS—The BGMC questionnaires have strong psychometric properties and are convenient measures of affect specific to BGM. Further, BGM affect is associated with glycemic outcomes and may provide a unique contribution to factors associated with glycemic control in youths.
Diet, Growth, and the Risk for Type 1 Diabetes in Childhood
Authors: Pundziūtė-Lyckå Austė , Persson Lars-Åke , Cedermark Gunilla , Jansson-Roth Agneta , Nilsson Ulla , Westin Vera , Dahlquist Gisela 
Published: March 2007

OBJECTIVE— To study the association between type 1 diabetes risk and previous intake of energy, accounting for body size and previous intake of nutrients and foods, accounting for the energy intake.
RESEARCH DESIGN AND METHODS—We conducted an incident population-based case-referent study in Stockholm, Sweden, including 99 of 100 eligible 7- to 14-year-old diabetic children and 180 of 200 age-, sex-, and area-matched referent children identified through the Swedish population register. Average daily energy and nutrient intake 1 year before diabetes diagnosis/interview was estimated using the food frequency questionnaire with assessment of consumed food amounts. Mean SD scores of growth measurements taken during the last 4 years before the diagnosis were used. Odds ratios (ORs) were calculated by conditional logistic regression.
RESULTS—Average intake of energy, carbohydrate, fat, and protein was significantly higher among the case subjects as well as mean weight-for-age SD score. Higher energy intake and weight-for-age were both associated with increased diabetes risk after adjustment for each other: OR (95% CI) for medium and high levels of energy intake were 1.33 (0.52–3.42) and 5.23 (1.67–16.38), respectively, and for weight-for-age were 3.20 (1.30–7.88) and 3.09 (1.16–8.22), respectively. High intake of carbohydrates, especially disaccharides and sucrose, increased diabetes risk.
CONCLUSIONS— Higher energy intake and larger body size were independently associated with increased diabetes risk. Of the different nutrients, higher intake of carbohydrates, particularly disaccharides and sucrose, increased the risk. Lifestyle habits leading to higher energy intake and more rapid growth in childhood may contribute to the increase of childhood-onset type 1 diabetes by different mechanisms.
Serum 25-Hydroxyvitamin D, Diabetes, and Ethnicity in the Third National Health and Nutrition Examination Survey
Authors: Scragg Robert , Sowers MaryFran , Bell Colin 
Published: March 2007

OBJECTIVE—To determine the association between serum 25-hydroxyvitamin D (25OHD) and diabetes risk and whether it varies by ethnicity.RESEARCH DESIGN AND METHODS—We performed an analysis of data from participants who attended the morning examination of the Third National Health and Nutrition Examination Survey (1988–1994), a cross-sectional survey of a nationally representative sample of the U.S. population. Serum levels of 25OHD, which reflect vitamin D status, were available from 6,228 people (2,766 non-Hispanic whites, 1,736 non-Hispanic blacks, and 1,726 Mexican Americans) aged ≥20 years with fasting and/or 2-h plasma glucose and serum insulin measurements.RESULTS—Adjusting for sex, age, BMI, leisure activity, and quarter of year, ethnicity-specific odds ratios (ORs) for diabetes (fasting glucose ≥7.0 mmol/l) varied inversely across quartiles of 25OHD in a dose-dependent pattern (OR 0.25 [95% CI 0.11–0.60] for non-Hispanic whites and 0.17 [0.08–0.37] for Mexican Americans) in the highest vitamin D quartile (25OHD ≥81.0 nmol/l) compared with the lowest 25OHD (≤43.9 nmol/l). This inverse association was not observed in non-Hispanic blacks. Homeostasis model assessment of insulin resistance (loge) was inversely associated with serum 25OHD in Mexican Americans (P = 0.0024) and non-Hispanic whites (P = 0.058) but not non-Hispanic blacks (P = 0.93), adjusting for confounders.CONCLUSIONS—These results show an inverse association between vitamin D status and diabetes, possibly involving insulin resistance, in non-Hispanic whites and Mexican Americans. The lack of an inverse association in non-Hispanic blacks may reflect decreased sensitivity to vitamin D and/or related hormones such as the parathyroid hormone.
Gender Difference in the Impact of Type 2 Diabetes on Coronary Heart Disease Risk
Authors: Juutilainen Auni , Kortelainen Saara , Lehto Seppo , Rönnemaa Tapani , Pyörälä Kalevi , Laakso Markku 
Published: March 2007

OBJECTIVE—To explain the stronger effect of type 2 diabetes on the risk of coronary heart disease (CHD) in women compared with men.
RESEARCH DESIGN AND METHODS—The study population consisted of 1,296 nondiabetic subjects and 835 type 2 diabetic subjects aged 45–64 years without cardiovascular disease. The end points were CHD death and a major CHD event (CHD death or nonfatal myocardial infarction). The follow-up time was 13 years.
RESULTS—Major CHD event rate per 1,000 person-years was 11.6 in nondiabetic men, 1.8 in nondiabetic women, 36.3 in diabetic men, and 31.6 in diabetic women. The diabetes-related hazard ratio for a major CHD event from the Cox model, adjusted for age and area of residence, was 2.9 (95% CI 2.2–3.9) in men and 14.4 (8.4–24.5) in women, and after further adjustment for cardiovascular risk factors, 2.8 (2.0–3.7) and 9.5 (5.5–16.9), respectively. The burden of conventional risk factors in the presence of diabetes was greater in women than in men at baseline. Prospectively, elevated blood pressure, low HDL cholesterol, and high triglycerides contributed to diabetes-related CHD risk more in women than in men. However, after adjusting for conventional risk factors, a substantial proportion of diabetes-related CHD risk remained unexplained in both genders.
CONCLUSIONS—The stronger effect of type 2 diabetes on the risk of CHD in women compared with men was in part explained by a heavier risk factor burden and a greater effect of blood pressure and atherogenic dyslipidemia in diabetic women.
A Randomized Trial Evaluating a Predominately Fetal Growth–Based Strategy to Guide Management of Gestational Diabetes in Caucasian Women
Authors: Schaefer-Graf Ute M. , Kjos Siri L. , Fauzan Ostary H. , Bühling Kai J. , Siebert Gerda , Bührer Christoph , Ladendorf Barbara , Dudenhausen Joachim W. , Vetter Klaus 
Published: March 2007

OBJECTIVE—To compare the management of Caucasian women with gestational diabetes (GDM) based predominantly on monthly fetal growth ultrasound examinations with an approach based solely on maternal glycemia.
RESEARCH DESIGN AND METHODS—Women with GDM who attained fasting capillary glucose (FCG) &lt;120 mg/dl and 2-h postprandial capillary glucose (2h-CG) &lt;200 mg/dl after 1 week of diet were randomized to management based on maternal glycemia alone (standard) or glycemia plus ultrasound. In the standard group, insulin was initiated if FCG was repeatedly &gt;90 mg/dl or 2h-CG was &gt;120 mg/dl. In the ultrasound group, thresholds were 120 and 200 mg/dl, respectively, or a fetal abdominal circumference &gt;75th percentile (AC&gt;p75). Outcome criteria were rates of C-section, small-for-gestational-age (SGA) or large-for-gestational-age (LGA) infants, neonatal hypoglycemia (&lt;40 mg/dl), and neonatal care admission.
RESULTS—Maternal characteristics and fetal AC&gt;p75 (36.0 vs. 38.4%) at entry did not differ between the standard (n = 100) and ultrasound groups (n = 99). Assignment to (30.0 vs. 40.4%) and mean duration of insulin treatment (8.3 vs. 8.1 weeks) did not differ between groups. In the ultrasound group, AC&gt;p75 was the sole indication for insulin. The ultrasound-based strategy, as compared with the maternal glycemia-only strategy, resulted in a different treatment assignment in 34% of women. Rates of C-section (19.0 vs. 18.2%), LGA (10.0 vs. 12.1%), SGA (13.0 vs. 12.1%), hypoglycemia (16.0 vs. 17.0%), and admission (15.0 vs. 14.1%) did not differ significantly.
CONCLUSIONS—GDM management based on fetal growth combined with high glycemic criteria provides outcomes equivalent to management based on strict glycemic criteria alone. Inclusion of fetal growth might provide the opportunity to reduce glucose testing in low-risk pregnancies.
Trunk Fat and Leg Fat Have Independent and Opposite Associations With Fasting and Postload Glucose Levels
Authors: Snijder Marieke B. , Dekker Jacqueline M. , Visser Marjolein , Bouter Lex M. , Stehouwer Coen D.A. , Yudkin John S. , Heine Robert J. , Nijpels Giel , Seidell Jacob C. 
Published: March 2007

OBJECTIVE—Waist and hip circumferences have been shown to have independent and opposite associations with glucose levels. Waist circumference is positively associated with glucose levels, whereas hip circumference is negatively associated. It is unclear which tissues are involved in the pathophysiological mechanism causing these associations. The main goal was to determine which tissue in the trunk and legs, fat or lean tissue, is associated with measures of glucose metabolism.
RESEARCH DESIGN AND METHODS—In 623 participants of the third examination of the Hoorn Study, whole-body dual-energy X-ray absorptiometry was performed to determine fat and lean soft-tissue mass in the trunk and legs. Fasting and 2-h postload glucose levels after 75-g oral glucose tolerance test (OGTT) were determined. After exclusion of known diabetic patients, cross-sectional analyses were performed in 275 men aged 60–87 years (140 with normal glucose metabolism, 92 with impaired glucose metabolism; and 43 with diabetes) and in 281 women (148 with normal glucose metabolism, 90 with impaired glucose metabolism, and 43 with diabetes).
RESULTS—Greater trunk fat mass was associated with higher glucose levels after adjustment for age, trunk lean mass, leg lean mass, and leg fat mass. Standardized β (95% CI) in men were 0.44 (0.25–0.64) for fasting and 0.41 (0.22–0.60) for postload glucose. For women, these values were 0.49 (0.35–0.63) and 0.47 (0.33–0.61), respectively. In contrast, in the same regression models, a larger leg fat mass was associated with lower glucose levels. Standardized β in men were −0.24 (−0.43 to −0.05) and −0.12 (−0.31 to 0.07) and in women −0.24 (−0.37 to −0.10) and −0.27 (−0.40 to −0.13) for fasting and postload glucose, respectively. In these models, larger leg lean mass was also associated with lower glucose levels but was only statistically significant in men.
CONCLUSIONS—If trunk fat is taken into account, accumulation of fat in the legs seems to be protective against a disturbed glucose metabolism, particularly in women. Further research is needed to unravel underlying pathophysiological mechanisms.
Metabolic Control in Adolescent Girls
Authors: Maharaj Sherry , Daneman Denis , Olmsted Marion , Rodin Gary 
Published: March 2007

OBJECTIVE—This study investigated whether intimacy and autonomy in mother-daughter interactions and relational aspects of the self are associated with metabolic control in adolescent girls with type 1 diabetes.
RESEARCH DESIGN AND METHODS—This cross-sectional study included 88 girls with diabetes (mean age 14.9 ± 2.2 years, diabetes duration 7.1 ± 3.9 years, and HbA1c 8.9 ± 1.6%) from the Diabetes Clinic at the Hospital for Sick Children in Toronto and their mothers. Teens completed a self-report measure assessing self-concept in eight domain-specific areas. Mothers and daughters engaged in a 7-min, videotaped, problem-solving task involving a diabetes-related conflict issue. Interactions were rated using a macroanalytic rating system to assess intimacy and autonomy in parent-teen relationships. Metabolic control was measured using HbA1c.
RESULTS—Self-concept in domains of perceived behavioral conduct (P = 0.003), social acceptance (P = 0.03), romantic appeal (P = 0.03), and close friendships (P = 0.04) independently predicted HbA1c levels, together accounting for 30% of the variance. Also, the experience of emotional closeness (i.e., intimacy) rather than separateness (i.e., autonomy) in mother-daughter relationships was associated with lower HbA1c (P = 0.03).
CONCLUSIONS—Relational aspects of the self and the experience of emotional closeness in relationships are associated with metabolic control in adolescent girls. Efforts to improve metabolic control in girls should include enhancing the self-concept and the experience of relatedness in familial, peer, and patient-caregiver relationships.
Adiponectin Is Associated With Vascular Function Independent of Insulin Sensitivity
Authors: Fernández-Real José-Manuel , Castro Antoni , Vázquez Gabriel , Casamitjana Roser , López-Bermejo Abel , Peñarroja Georgina , Ricart Wifredo 
Published: March 2007

OBJECTIVE—Adiponectin has been proposed to play important roles in the regulation of energy homeostasis and insulin sensitivity. In experimental studies, adiponectin has also been found to inhibit vascular smooth muscle cell proliferation. Decreased adiponectin levels have been described in patients with coronary artery disease, and circulating adiponectin predicts cardiovascular death in patients with renal failure. Because adiponectin appears to influence both insulin sensitivity and vessel wall physiology, we examined insulin sensitivity and vascular function in relation with circulating adiponectin.
RESEARCH DESIGN AND METHODS—We studied brachial artery vascular reactivity (high-resolution external ultrasound) and insulin sensitivity (minimal model) in 68 healthy subjects. Brachial artery vascular reactivity was also determined in 52 patients with altered glucose tolerance: 30 subjects with impaired fasting glucose (IFG) or glucose intolerance (GIT) and 22 patients with type 2 diabetes.
RESULTS—Circulating adiponectin concentration was significantly associated with insulin sensitivity (r = 0.29, P = 0.02) and with fasting serum triglycerides (r = −0.29, P = 0.02) in healthy subjects. In the latter, adiponectin levels were positively associated with arterial vasodilation in response to nitroglycerin (endothelium-independent vasodilation [EIVD], r = 0.41, P = 0.002) but not with flux-induced, endothelium-dependent vasodilation (EDVD) (r = 0.007, P = NS). In contrast, EIVD was not significantly associated with adiponectin in subjects with IFG, GIT, or type 2 diabetes (r ≤ 0.10, P = NS). In a multiple linear regression analysis to predict EIVD in healthy subjects, age (P = 0.012), sex (P = 0.042), and adiponectin concentration (P = 0.045), but not BMI, insulin sensitivity, or fasting triglycerides, contributed to 39% of EIVD variance.
CONCLUSIONS—Serum adiponectin concentration appears to be significantly associated with vascular function in apparently healthy humans. This association seems to be independent of its link with insulin sensitivity.
Adult-Onset Atypical (Type 1) Diabetes
Authors: Aguilera Eva , Casamitjana Roser , Ercilla Guadalupe , Oriola Josep , Gomis Ramon , Conget Ignacio 
Published: March 2007

OBJECTIVE—In 1997, the American Diabetes Association proposed two subcategories for type 1 diabetes: type 1A or immunomediated diabetes and type 1B or idiopathic diabetes characterized by negative β-cell autoimmunity markers, lack of association with HLA, and fluctuating insulinopenia. The aim of this study was to examine clinical characteristics, β-cell function, HLA typing, and mutations in maturity-onset diabetes of the young (MODY) genes in patients with atypical type 1 diabetes (type 1 diabetes diagnosed at onset, without pancreatic autoantibodies and fluctuating insulinopenia).
RESEARCH DESIGN AND METHODS—Eight patients with atypical type 1 diabetes (all men, 30.7 ± 7.6 years) and 16 newly diagnosed age- and sex-matched patients with type 1A diabetes were studied retrospectively. Islet cell, GAD, tyrosine phosphatase and insulin antibodies, and basal and stimulated plasma C-peptide were measured at onset and after 1 year. HLA-DRB1-DQA1-DQB1 typing and screening for mutations in the HNF-1α and HNF-4α genes were performed from genomic DNA.
RESULTS—Atypical patients displayed significantly higher BMI and better β-cell function at onset and after 12 months. Three patients carried protective or neutral type 1 diabetes haplotypes, five patients displayed heterozygosity for susceptible and protective haplotypes, and seven patients showed Aspβ57. We found a nondescribed variant Pro436Ser in exon 10 of the HNF-4α gene in one atypical patient without susceptible haplotypes.
CONCLUSIONS—In our population, there are atypical forms of young adult-onset ketosis-prone diabetes initially diagnosed as type 1 diabetes, differing from type 1 diabetes in the absence of β-cell autoimmunity, persistent β-cell function capacity, fluctuating insulin requirements and ketosis-prone episodes, as well as clinical features of type 2 diabetes. Only one subgroup could be strictly classified as having type 1B diabetes. Additional information is still needed to improve our understanding of the mechanisms that finally lead to the disease.
Increasing Severity of Cardiovascular Risk Factors With Increasing Middle Cerebral Artery Stenotic Involvement in Type 2 Diabetic Chinese Patients With Asymptomatic Cerebrovascular Disease
Authors: Thomas G. Neil , Lin Jian Wen , Lam Wynnie W.M. , Tomlinson Brian , Yeung Vincent , Chan Juliana C.N. , Liu Roxanna , Wong Ka Sing 
Published: March 2007

OBJECTIVE—To identify determinants associated with increasing severity of middle cerebral artery (MCA) stenosis in asymptomatic Chinese type 2 diabetic patients with and without MCA stenosis determined using transcranial Doppler. Conventional risk factors contribute to the pathogenesis of ischemic stroke, and differences in the pattern of these may explain the heterogeneity of disease presentation in different populations. In Chinese patients, MCA stenosis is the most commonly identified intracranial vascular lesion.
RESEARCH DESIGN AND METHODS—Anthropometric and fasting biochemical parameters were compared between type 2 diabetic patients with MCA stenosis in one (n = 185) or both (n = 200) vessels and 1,492 type 2 diabetic patients without evidence of stenosis.
RESULTS—Increasing MCA stenotic vascular involvement was associated with significantly increasing age, duration of diabetes, systolic blood pressure, and LDL cholesterol, but with lower glucose levels. There was also an increased prevalence of hypertension, dyslipidemia, and use of blood pressure–and glucose-lowering agents in the patients with MCA stenosis. Concomitant significant increases in the prevalence of peripheral vascular disease and retinopathy were also observed in the patients with MCA stenosis.
CONCLUSIONS—Transcranial Doppler examination identified stenosis in one or both MCAs in over one-fifth of the Chinese type 2 diabetic subjects without symptoms of cerebrovascular disease. A number of conventional cardiovascular risk factors were closely associated with MCA stenosis. This technique may allow the identification of a particularly high-risk group, and further studies are required to determine whether asymptomatic MCA stenosis is predictive of primary cerebrovascular events and whether intensive treatment of risk factors would reduce the risk.
Impaired Insulin Sensitivity, Insulin Secretion, and Glucose Effectiveness Predict Future Development of Impaired Glucose Tolerance and Type 2 Diabetes in Pre-Diabetic African Americans
Authors: Osei Kwame , Rhinesmith Scott , Gaillard Trudy , Schuster Dara 
Published: March 2007

OBJECTIVE—We examined the determinants of impaired glucose tolerance (IGT) and type 2 diabetes in first-degree relatives of African-American type 2 diabetic patients over 5–8 years (median 6).
RESEARCH DESIGN AND METHODS—A total of 81 healthy subjects (age 41.5 ± 4.8 years; BMI 31.3 ± 3.6 kg/m2) participated in the study. Each subject underwent an oral glucose tolerance test (OGTT) and a frequently sampled intravenous glucose tolerance test at baseline. Insulin sensitivity index (Si) and glucose effectiveness index (Sg) were determined by the minimal model method. Homeostasis model assessment (HOMA) was used to estimate insulin resistance (HOMA-IR) and β-cell function (HOMA-%B). A total of 18 subjects progressed to either IGT or type 2 diabetes (progressors), whereas 19 subjects maintained normal glucose tolerance (nonprogressors).
RESULTS—Comparing the progressors and nonprogressors, mean fasting serum glucose levels (95 ± 8 vs. 80 ± 14 mg/dl, P &lt; 0.01) and 2-h serum glucose levels (149 ± 27 vs. 100 ± 60 mg/dl, P &lt; 0.01) as well as 2-h serum insulin levels (117 ± 81 vs. 72 ± 87 μU/ml, P &lt; 0.01) during OGTT were higher at baseline. Mean acute first-phase insulin secretion (205 ± 217 vs. 305 ± 230 μU/ml), HOMA-%B (148 ± 60 vs. 346 ± 372, P &lt; 01), Si (1.61 ± 1.13 vs. 2.48 ± 1.25 × 10−4 · min−1 [μU/ml]−1), and Sg (1.48 ± 0.61 vs. 2.30 ± 0.97 × 10−2 · min−1) were lower in the progressors than in the nonprogressors at baseline. Mean HOMA-IR (3.31 ± 1.64 vs. 2.36 ± 1.64) was significantly greater in the progressors than the nonprogressors. At the time of diagnosis of glucose intolerance (IGT + diabetes), HOMA-%B (101 ± 48 vs. 148 ± 60, P &lt; 0.001) and HOMA-IR (5.44 ± 2.55 vs. 3.31 ± 1.64, P &lt; 0.003) deteriorated in the progressors versus baseline.
CONCLUSIONS—We conclude that nondiabetic, first-degree relatives of African-American type 2 diabetic patients who progressed to IGT and type 2 diabetes manifest triple defects (decreased insulin secretion, insulin action, and glucose effectiveness) that antecede the disease.