bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex Differences in the Impact of Coexistent Diabetes on Survival in Patients With Coronary Heart Disease
Authors: Liao Youlian , Cooper Richard S , Ghali Jalal K , Lansky David , Cao Guichan , Lee John 
Published: March 2007

OBJECTIVE
To evaluate the sex difference in the impact of diabetes on survival in patients with coronary heart disease.

RESEARCH DESIGN AND METHODS
Cohort study based on a sample from a hospital registry in Chicago, IL. A total of 974 consecutive patients (585 men and 389 women) with angiographically confirmed coronary artery disease were followed for 4.6 yr.

RESULTS
At baseline, 160 men and 155 women had diabetes. The age-adjusted relative risk of death from all causes for patients with diabetes versus patients without diabetes was 0.93 (95% confidence interval 0.65–1.34) in men and 1.99 (95% CI 1.30–3.05) in women. For cardiac death, the corresponding relative risk was 1.00 (95% CI 0.64–1.56) and 1.96 (95% CI 1.19–3.24) in men and women, respectively. Baseline differences in age, hypertension, body mass index, number of diseased vessels, and ejection fraction did not fully explain the excess mortality risk in diabetic women. Excess risk was apparent in both cardiac and noncardiovascular categories. Among nondiabetic patients, the risk of death was significantly lower in women compared with men (multivariate-adjusted relative risk = 0.61, 95% CI 0.41–0.89). However, the mortality risk of diabetic women became similar to men as a whole (relative risk =1.13, 95% CI 0.80–1.60).

CONCLUSIONS
Diabetes confers a substantially higher risk of mortality in women than in men when it occurs in the presence of coronary heart disease.
Lipoprotein(a) in Diabetic Patients and Normoglycemic Relatives in Familial NIDDM
Authors: Velho Gilberto , Erlich Danielle , Turpin Elisabeth , Néel Dominique , Cohen Daniel , Froguel Philippe , Passa Philippe 
Published: March 2007

OBJECTIVE
To compare lipoprotein(a) levels in diabetic patients and normoglycemic relatives in familial NIDDM and to assess whether Lp(a) is a risk factor for myocardial infarction in this population.

RESEARCH DESIGN AND METHODS
We compared 577 patients and 261 normoglycemic relatives from 189 NIDDM multiplex families with 49 unrelated healthy individuals. of the 577, 23 patients with previously documented myocardial infarction were further analyzed as a separate group.

RESULTS
Lp(a) concentrations in diabetic patients, normoglycemic relatives, and the control group were not significantly different. Variance of Lp(a) in a given individual could not be accounted for by any clinical or biological parameter, but was strongly related to the mean Lp(a) value in his or her family. Diabetic patients with previous myocardial infarction (and their relatives) had significantly higher levels of Lp(a) than patients without coronary heart disease complaints.

CONCLUSIONS
Lp(a) concentration in familial NIDDM was not related to the degree of glucose intolerance, but presented a strong familial aggregation. High Lp(a) levels seem to be an independent risk factor for myocardial infarction in this NIDDM cohort.
Autonomic Neuropathy Predicts Deterioration in Glomerular Filtration Rate in Patients With IDDM
Authors: Sundkvist Göran , Lilja Bo 
Published: March 2007

OBJECTIVE
To evaluate whether autonomic neuropathy predicts deterioration in glomerular filtration rate in IDDM patients.

RESEARCH DESIGN AND METHODS
A prospective study in which 35 IDDM patients have been followed for 10–11 yr. Autonomic nerve function tests included heart-rate reactions to deep breathing (expiration-to-inspiration ratio) and to tilt (acceleration and brake indexes). GFR was evaluated by the 51Cr-EDTA plasma clearance method.

RESULTS
At entry to the study, no significant differences were noted in age (39 ± 2 [mean ± SE] vs. 42 ± 4 yr), duration of diabetes (20 ± 3 vs. 23 ± 4 yr), supine blood pressures (120/79 ± 3/2 mmHg vs. 121/78 ± 6/3 mmHg), and GFR (113 ± 6 vs. 107 ± 3 ml·min−1·1.73 m−2) between 20 patients with and 15 without autonomic neuropathy (age-corrected criteria). After 10–11 yr, GFR had decreased significantly (22 ± 4 ml·min−1·1.73 m−2 P &lt; 0.001) in patients with autonomic neuropathy but not (8 ± 5 ml·min−1·1.73 m−2, NS) in patients without. In keeping with this, GFR decreased more than expected (difference in GFR/ expected decrease in GFR) in patients with autonomic neuropathy, compared with those without (4.46 ± 0.98 vs. 0.48 ± 0.73, P &lt; 0.005).

CONCLUSIONS
Autonomic neuropathy predicts future deterioration in GFR in IDDM patients.
Factors Involved in Catheter Obstruction During Long-Term Peritoneal Insulin Infusion
Authors: Bousquet-Rouaud Regine , Castex Françoise , Costalat Guy , Bastide Madeleine , Hedon Bernard , Bouanani Majida , Jouvert Sylvie , Mirouze Jacques 
Published: March 2007

OBJECTIVE
To analyze the efficacy of ECPII and the factors responsible for technical problems often encountered. This treatment has been in use with IDDM patients since 1980.

RESEARCH DESIGN AND METHODS
Forty-four IDDM treated by ECPII for 42–78 mo (mean, 53 mo). patients were

RESULTS
Glycemic equilibrium was improved during treatment (mean plasma glucose level, 7.6 mM; mean GHb level, 8%). Catheter blockage was the main reason for ECPII failure (74%). Mean catheter survival of each catheter, determined by actuarial analysis, was 11.7 mo and significantly decreased with subsequent implantation. SEM of the catheter tips showed deposits composed of fibrin and cells occluding the inner lumen. Factors such as age, sex, local infection, and low insulin basal rate were not found to have any incidence on the catheter survival. Placement of the catheter in the upper part of the peritoneum, however, increased catheter survival. Anti-insulin antibodies did not seem to be directly involved in blockage.

CONCLUSIONS
We conclude from this long-term experience that during ECPII, catheter blockage remains the major recurring complication, probably involving a local immune-inflammatory response in the peritoneum.
Effect of War on Glycemic Control in Type II Diabetic Patients
Authors: Roglic Gojka , Metelko Zeljko 
Published: March 2007

OBJECTIVE
To determine the effect of war-related, protracted stress on glycemic control in type II diabetic patients.

RESEARCH DESIGN AND METHODS
We examined 35 patients with type II diabetes as part of their routine control in October 1990. We reexamined them in October 1991, 3 mo after the war in Croatia began. We also administered a questionnaire to assess the patients' exposure to stress and changes in diet and exercise.

RESULTS
The patients were exposed to considerable stressors. The wartime diet differed from the prewar diet. We found significant changes in total serum cholesterol and TG values (P &lt; 0.01), but we observed no significant changes in body weight, FBG, postprandial blood glucose, and HbA1c values. Insulin and glibenclamide dosages did not change.

CONCLUSIONS
We detected no significant impact of stress on glycemic control, probably because of differences in individual stress responsiveness. Changes in the lipid status probably were attributable to changes in dietary habits caused by specific circumstances.
Alternative Approaches to Public Health Surveillance of IDDM
Authors: Newman Jeffrey M , Herman William H , Vinicor Frank 
Published: March 2007

OBJECTIVE
To assess the appropriateness of national surveillance of IDDM.

RESEARCH DESIGN AND METHODS
We reviewed the structure and function of national disease surveillance, the diverse goals of IDDM surveillance, and prior experience with IDDM as a reportable disease.

RESULTS
Surveillance is the systematic and ongoing collection, analysis, interpretation,and dissemination of data linked to public health action. The potential goals of surveillance of IDDM are to understand the etiology and trends in incidence of IDDM, to measure the burden of IDDM and its complications, and to assess mortality. Problems associated with surveillance of IDDM include underreporting, delayed reporting, and lack of funding.

CONCLUSIONS
To make IDDM a nationally reportable disease is neither warranted nor feasible at this time. Although surveillance is needed to understand diabetes better and for diabetes control, proposed initiatives, such as major expansions of IDDM reporting, should be developed to address specific questions, problems, and needs— stillrecognizing real-world issues of competing priorities and limited resources.
Association Between Fish Intake and Coronary Heart Disease Mortality: Differences in normoglycemic and glucose intolerant elderly subjects
Authors: Feskens Edith J M , Bowles Carel H , Kromhout Daan 
Published: March 2007

Objective— To compare the association of habitual fish intake with 17-yr mortality of coronary heart disease between normoglycemic and glucose intolerant elderly subjects.
Research Design and Methods— In 1971, 272 men and women, 64-87 yr of age, were examined in a general practice in the town of Rotterdam, The Netherlands. Glucose intolerance (impaired glucose tolerance or diabetes mellitus) was observed in 83 subjects, and 189 subjects were found to be normoglycemic and free of clinically diagnosed diabetes mellitus. Information on usual dietary intake was obtained using the cross-check dietary history method.
Results—Fish consumption was found in 58.7% of the normoglycemic population and in 62.4% of the glucose intolerant population. Among normoglycemic subjects, the age- and sex-adjusted 17-yr mortality for coronary heart disease was 10.9/1000 person-yr for those who ate fish and 25.1/1000 person-yr for those who did not. For the glucose intolerant population, the rates were 20.6/1000 and 31.2/1000 person-yr, respectively. Adjusted for age, sex, body mass index, smoking, alcohol use, intake of energy, polyunsaturated fat, and carbohydrates, the risk ratio for normoglycemic population was 0.34 (95% confidence interval: 0.16-0.72). For glucose intolerant subjects, an adjusted risk ratio of 0.80 (95% confidence interval: 0.31–2.05) was observed.
Conclusions— These results suggest that in a glucose intolerant population the possible protective effect of fish intake on coronary heart disease may be smaller than in normoglycemic subjects.
Metabolic and Hemodynamic Effects of Metformin and Glibenclamide in Normotensive NIDDM Patients
Authors: Chan Juliana C N , Tomlinson Brian , Critchley Julian A J H , Cockram Clive S , Walden Richard J 
Published: March 2007

Objective— To compare the metabolic and hemodynamic effects of metformin and glibenclamide in normotensive NIDDM patients.
Research Design and Methods— After a 2-wk run-in period on dietary treatment alone, 12 Chinese normotensive patients with uncomplicated NIDDM were randomized to receive either metformin, or glibenclamide for 4 wk before being crossed-over to the alternative treatment for an additional 4 wk. Metabolic and hemodynamic index, including cardiac output estimation by impedance cardiography, were measured at baseline and at the end of each treatment period.
Results— Body mass index was reduced more with metformin than with glibenclamide, although glycemic control was similar with both drugs. Plasma total cholesterol concentration fell more with metformin (mean difference −0.65 mM, 95% confidence interval −0.96 to −0.32) than glibenclamide (mean difference −0.20 mM, 95% confidence interval −0.54–0.12) (P &lt; 0.05). Compared with baseline values, erect diastolic blood pressure was reduced more by metformin (12.9% [95% confidence interval −21.5 to −4.4%]) than glibenclamide (−6.8% [95% confidence interval −14.9 to 1.2%]) (P &lt; 0.001). The relative changes in the systemic vascular resistance index also differed between the two treatments (glibenclamide, 6.2 [−4.3 to 16.6%]; metformin, −1.2 [95% confidence interval −8.8−6.4%]) (P &lt; 0.05)].
Conclusions— In normotensive NIDDM patients, treatment with metformin was associated with greater reductions in body weight, plasma total cholesterol concentration, and erect diastolic blood pressure, whereas the systemic vascular resistance index increased after treatment with glibenclamide. These findings merit long-term investigation.
Acute Insulin Response to Glucose and Glucagon in Subjects at Risk of Developing Type I Diabetes
Authors: Vialettes Bernard , Zevaco-Mattei Catherine , Thirion Xavier , Lassmann-Vague Véronique , Pieron Henri , Mercier Pierre , Vague Philippe 
Published: March 2007

Objective— To determine if knowledge of characteristics of insulin response to various secretagogues during the preclinical phase of type I diabetes may facilitate the diagnosis of subjects at risk.
Research Design and Methods— A test consisting of sequential intravenous challenge with glucose (0.3 g/kg) and glucagon (1 mg, 10 min after the end of glucose injection) was performed on 171 ICA− relatives of type I diabetic patients, 18 ICA+ relatives of type I diabetic patients, and 5 transiently hyperglycemic subjects. Acute response to glucose was expressed as the sum of plasma insulin at 2 and 5 min and response to glucagon as the increase in plasma insulin after 10 min.
Results— Responses below the lower 95% confidence interval in the ICA− population (40 and 43 μU/ml for glucose and glucagon, respectively) were considered abnormal. The two values were correlated (r = 0.62). Abnormalities coexisted in 2.3% of the ICA− group, 11% of the ICA+ group, and 100% of the transiently hyperglycemic group. All the relatives who subsequently developed diabetes or hyperglycemic subjects who required insulin exhibited combined abnormalities. Some ICA− and ICA+ relatives were tested repeatedly over a follow-up period of 1.5–4 yr. Although the intraindividual coefficient of variation for the two responses was high (28 and 30%), values tended to run parallel in both ICA+ and ICA− relatives. In 2 patients monitored for 2 and 4 yr before diabetes developed, both responses declined at the same rate. In terms of prediction of diabetes, sensitivity of combined abnormalities was high (100%). But compared with the intravenous glucose tolerance test, improvement of specificity by the double challenge was not statistically significant.
Conclusions— Both insulin responses to glucose and glucagon are related. They depend on the secretory capacity of β-cells and simultaneously become abnormal in the prediabetic phase.
Stability Over Time of Modern Diagnostic Criteria for Type II Diabetes
Authors: Stern Michael P , Valdez Rodolfo A , Haffner Steven M , Mitchell Braxton D , Hazuda Helen P 
Published: March 2007

Objective— To examine the long-term stability of the World Health Organization criteria for diabetes in the 8-yr follow-up of the San Antonio Heart Study. A problem with older criteria for diagnosing diabetes was that many individuals classified as having borderline or chemical diabetes reverted to nondiabetic status on follow-up. Few studies have addressed this issue among diabetic patients who meet the more stringent, modern National Diabetes Data Group or World Health Organization criteria.
Research Design and Methods— We studied 98 Mexican-American and 44 non-Hispanic white type II diabetic patients 8 yr after they were diagnosed according to World Health Organization criteria in a population-based epidemiological survey. Patients were classified as follows: whether they were on pharmacological treatment for diabetes at baseline, or, if not, whether they had a prior diagnosis of diabetes at the time of their baseline survey visit or were newly diagnosed.
Results— Of the 142 patients who met the study criteria for type II diabetes at baseline and whose status at follow-up was known, 20 (14.1%; 95% confidence interval 9.0–20.5%) no longer met criteria at follow-up 8 yr later. All but 2 of those who reverted to nondiabetic status were from the newly diagnosed group. Two of 20 had lost more than 5.0 kg over the 8 yr and an additional 5 had lost 2.5–5.0 kg. The 20 patients who reverted to nondiabetic status lacked many of the associated anthropometric, physiological, and metabolic findings of diabetes such as obesity, unfavorable body fat distribution, and dyslipidemia. Moreover, only one had proteinuria, and none had any grade of diabetic retinopathy at baseline.
Conclusions— Epidemiological surveys that rely on a single oral glucose tolerance test to determine the prevalence of type II diabetes may overestimate prevalence by as much as 16% (95% confidence interval 10.5–23.6%) (142/122 = 1.16). The actual overestimate could well be less because some patients who truly have diabetes at baseline may be in remission at follow-up as a result of significant weight loss. Despite these difficulties, the modern National Diabetes Data Group and World Health Organization criteria are more stable than earlier criteria.
A Prospective Population-Based Study of Microalbuminuria as a Predictor of Mortality in NIDDM
Authors: Neil Andrew , Hawkins Michael , Potok Michael , Thorogood Margaret , Cohen David , Mann Jim 
Published: March 2007

Objective— To assess prospectively the relationship between microalbuminuria and mortality in a geographically defined population of NIDDM patients and to determine the relative importance of microalbuminuria as a risk factor for mortality.
Research Design and Methods–A survey of known diabetes undertaken in 1982 identified a cohort of 249 NIDDM patients. Follow-up information was available for 246 patients who contributed 1498 person-yr exposure and were followed up for a mean period of 6.1 yr. The median age of the cohort at entry was 68 yr (range 28–89 yr), and the median duration of diabetes was 7 yr (range 1–41 yr). At baseline, a clinical examination was performed and a random daytime urine specimen was obtained for measurement of urinary albumin concentration.
Results— UAC results were available for 236 patients: 45 (19%) patients had a UAC &gt; 15- &lt; 40 mg/L; 36 (15%) had a UAC 40–200 mg/L; 10 (4%) had a UAC &gt; 200 mg/L; and 145 (61%) had a normal UAC &lt; or = 15 mg/L. During the follow-up period, 93 patients died. All-causes mortality, expressed as standardized mortality ratio (SMR = 149) and coronary heart disease mortality (CHD SMR = 166) were significantly increased. This excess mortality was significant in women (all-causes SMR = 194, CHD SMR = 234) but not in men (all-causes SMR = 118, CHD SMR = 128). On univariate analysis, systolic blood pressure was the only significant association with albumin concentration (P = 0.0002). An age-stratified log-rank test was conducted to determine the effect of potential explanatory variables on survival. Survival distributions were significantly different for known duration of diabetes (P = 0.045), intermittent claudication (P = 0.012), severity of retinopathy, lens opacity (P &lt; 0.001) and UAC (P = 0.013) and diastolic blood pressure approached significance (P = 0.051). After adjusting for the effects of these potentially confounding variables identified by the log-rank analysis, significant predictors of early mortality on multivariate survival analysis were age, UAC of 40–200 mg/L (relative risk = 2.2, 95% confidence interval 1.3–3.7), more severe retinopathy (relative risk = 3.4, 95% confidence interval 1.9–6.0), and lens opacity (relative risk = 2.4, 95% confidence interval 1.6–3.8).
Conclusions— The findings from this population-based cohort confirm the predictive power of microalbuminuria as a risk factor for mortality in NIDDM. In contrast to prospective studies of conventional cardiovascular risk factors in NIDDM, consistent evidence indicates that microalbuminuria is an independent predictor of excess mortality regardless of the collection procedure used.
Psychosocial Adjustment to Advanced Proliferative Diabetic Retinopathy
Authors: Wulsin Lawson R , Jacobson Alan M , Rand Lawrence I 
Published: March 2007

OBJECTIVE
To identify the major problems with adjustment to the advanced stages of proliferative diabetic retinopathy and to examine the relationship between adjustment and visual acuity.

RESEARCH DESIGN AND METHODS
A cross-sectional descriptive cohort study was conducted at the referral-based eye unit at Joslin Diabetes Center in Boston, Massachusetts. We studied 47 adults with IDDM and advanced proliferative diabetic retinopathy. Thirty reported recent visual loss, and 17 had more stable vision.

RESULTS
Psychosocial Adjustment to Illness Scale scores were significantly elevated relative to a normative diabetic sample (t = 2.94, P &lt; 0.01). Our proliferative diabetic retinopathy sample reported the most difficulties in the domain of health-care orientation. No significant differences were observed in adjustment scores between those with recent partial visual loss and those with more stable vision. However, visual acuity in the best eye correlated significantly with the proliferative diabetic retinopathy sample's total adjustment score (r = −0.34, P = 0.02) and with 4 of 7 adjustment subscales.

CONCLUSIONS
These results suggest that advanced proliferative diabetic retinopathy may be associated with particular difficulties in adjustment that are more related to best visual acuity than to recent visual loss. Relatively mild visual impairment may have significant psychosocial impact.
Calculated Low-Density Lipoprotein Cholesterol Should Not Be Used for Management of Lipoprotein Abnormalities in Patients With Diabetes Mellitus
Authors: Rubiés-Prat Juan , Reverter Jordi L , Sentí Mariano , Pedro-Botet Juan , Salinas Isabel , Lucas Anna , Nogués Xavier , Sanmartí Anna 
Published: March 2007

OBJECTIVE
To assess the validity of calculated low-density lipoprotein cholesterol by the Friedewald formula for management of lipoprotein abnormalities in patients with diabetes mellitus.

RESEARCH DESIGN AND METHODS
Calculated LDL cholesterol by the Friedewald formula was compared with measured LDL cholesterol after separation by ultracentrifugation in 61 patients with type I diabetes, 50 patients with type II diabetes, and 116 healthy control subjects.

RESULTS
Calculated LDL cholesterol coincided with measured LDL cholesterol, with &lt; 10% error, in 54 (49%) patients with diabetes mellitus, and 85 (73%) control subjects. Calculated LDL cholesterol was overestimated, with an error of &gt; or = 10% of measured LDL cholesterol in 39% of patients and 26% of control subjects, and underestimated in 13 and 1%, respectively. Despite a good correlation between calculated and measured LDL cholesterol, the intraclass correlation coefficients demonstrated a poor concordance between calculated and measured LDL cholesterol, both in patients and control subjects. When comparing the mean differences of calculated and measured LDL cholesterol for diabetic subjects versus control subjects, significantly greater differences in type II (but not type I) diabetic subjects were seen.

CONCLUSIONS
Calculation of LDL cholesterol by the Friedewald formula may be inaccurate for assessment of cardiovascular risk in patients with type II diabetes and may not be appropriate for management of lipoprotein abnormalities in those diabetic patients.