bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasonographic Manifestations of Carotid Atherosclerosis and Glucose Intolerance in Elderly Eastern Finnish Men
Authors: Tuomilehto Jaakko , Qiao Qing , Salonen Riitta , Nissinen Aulikki , Salonen Jukka T 
Published: March 2007

OBJECTIVE
To study the association of ultrasonographic manifestations of common carotid atherosclerosis with glucose intolerance in survivors of the cohort of men born in 1900–1919 in eastern Finland.

RESEARCH DESIGN AND METHODS
Carotid ultrasonography was carried out for 182 men in 1989. Glucose tolerance status classified based on an oral glucose tolerance test in 1984 and 1989 surveys was used in both prospective and cross-sectional analyses.

RESULTS
Carotid atherosclerosis was common in men aged 70–89 years. There was no significant difference in the maximal carotid intimal-medial thickness between diabetic and nondiabetic men and over different age-groups; it was 1.28, 1.33, and 1.36 mm in subjects with diabetes, impaired glucose tolerance, and normal glucose tolerance, respectively (P = 0.69). No association between the presence of a nonmineralized or a mineralized atherosclerotic lesion with diabetes was found. Fasting plasma insulin did not relate to ultrasonographically detectable atherosclerotic lesions.

CONCLUSIONS
Hyperglycemia and hyperinsulinemia may not be main contributors to atherosclerosis in elderly men, partly because smoking is less common and total and LDL cholesterol concentrations are lower in diabetic men than in men with normal glucose tolerance.
Resistance Training Improves Insulin Sensitivity in NIDDM Subjects Without Altering Maximal Oxygen Uptake
Authors: Ishii Tomofusa , Yamakita Tetsuya , Sato Toshihiko , Tanaka Shiro , Fujii Satoru 
Published: March 2007

OBJECTIVE
To examine the effect of resistance training on insulin sensitivity in nonobese NIDDM patients.

RESEARCH DESIGN AND METHODS
Previously sedentary nonobese NIDDM patients were enrolled in a resistance training group (RT; n = 9) or used as sedentary control subjects (SED; n = 8). SED subjects did not perform exercise training because of orthopedic disorders. The training program consisted of two sets of nine exercises with 10–20 repetitions. Subjects trained five times a week for 4–6 weeks. Insulin sensitivity, as assessed by the hyper-insulinemic-euglycemic clamp technique, HbAIc, and body composition, was measured before and after the training period. Maximal oxygen uptake (VO2max) and quadriceps strength were measured in the RT group.

RESULTS
The two groups did not differ significantly on any variables before participation in the program. The glucose disposal rate during the hyperinsulinemic-euglycemic clamp increased 48% in the RT group (6.85 ± 1.86 to 10.12 ± 3.15 mg · kg−1 lean body mass · min−1; P &lt; 0.05), but remained unchanged in the SED group (5.95 ± 1.63 to 6.36 ± 1.61 mg · kg−1 lean body mass · min−1). There was no significant change in body composition in either group. In the RT group, a 16% increase in quadriceps strength (191.1 ± 45.8 to 216.9 ± 42.8 Nm; P &lt; 0.05) but no significant change (27.6 ± 5.0 to 28.6 ± 6.5 ml · kg−1 · min−1) in VO2max was observed.

CONCLUSIONS
Moderate-intensity, high-volume resistance training improves insulin sensitivity in nonobese NIDDM without altering VO2max.
Population-Based Assessment of the Level of Care Among Adults With Diabetes in the U.S
Authors: Beckles Gloria LA , Engelgau Michael M , Narayan KM Venkat , Herman William H , Aubert Ronald E , Williamson David F 
Published: March 2007

OBJECTIVE
To estimate the levels of use of preventive care and to identify correlates of such care among people with diabetes in the U.S.

RESEARCH DESIGN AND METHODS
A cross-sectional study was conducted using a sample of 2,118 adults, age ≥18 years, with self-reported diabetes in 22 states that participated in the 1994 Behavioral Risk Factor Surveillance System. Most subjects were age ≥45 years (83%), women (51%), and white (75%) and were diagnosed at ages ≥30 years (83%), had type 2 diabetes (89%), and were not using insulin (66%).

RESULTS
Among all people with diabetes, 78% practiced self-monitoring of blood glucose, and 25% were aware of the term “glycosylated hemoglobin” or “hemoglobin A one C” (HbA1c). In the last year, 72% of the subjects visited a health care provider for diabetes care at least once, 61% had their feet inspected at least once, and 61% received a dilated eye examination. Controlled for age and sex, the odds ratios (ORs) for insulin use were for self-monitoring (OR [95% CI]; 4.0 [2.6–6.1]); having heard of HbA1c or receipt of a dilated eye examination (1.9 [1.4–2.5]); at least one visit to a provider (3.4 [1.9–7.2]); and feet inspected at least once (2.1 [1.5–2.9]). In addition, people &lt;45 years, those who did not complete high school, and those without insurance coverage were high-risk groups for underuse of preventive care. Only 3% of insulin users and 1% of nonusers met all five of the American Diabetes Association standards in the previous year.

CONCLUSIONS
Underuse of recommended preventive care practices is common among people with diabetes.
Sympathetic Function Test of Vasoconstrictor Changes in Foot Arteries in Diabetic Patients
Authors: Takahashi Tatsuji , Nishizawa Yoshiki , Emoto Masanori , Kawagishi Takahiko , Matsumoto Naoki , Ishimura Eiji , Inaba Masaaki , Okuno Yasuhisa , Shimada Hiroyuki , Morii Hirotoshi 
Published: March 2007

OBJECTIVE
We studied the relationship between vasoconstrictor changes in foot arteries (pedal, metatarsal, and digital arteries) and autonomic neuropathy in diabetic patients to estimate the degrees of sympathetic dysfunction.

RESEARCH DESIGN AND METHODS
Sixty-two patients and nineteen age-matched control subjects were studied. The resistance index (RI) and pulsatility index (PI) were measured as vascular hemodynamic parameters using Doppler sonography, and the increases in these hemodynamic parameters (%RI and %PI) from rest to a deep breath were measured as indexes of the degrees of sympathetic vasoconstrictor function. Cardiovascular autonomic function tests (AFTs) were performed and the score was compared to %RI and %PI values obtained.

RESULTS
Of the 62 diabetic patients, 51 had various degrees of autonomic neuropathy. Both %RI and %PI in the diabetic patients were significantly &lt; those in the control subjects for all foot arteries tested (all P &lt; 0.001). There were strongly inverse correlations between the %RI and %PI of foot arteries and the AFT score (r = −0.556 to −0.846, P &lt; 0.0001). The %RI of the digital artery was the most strongly correlated with AFT score (r = −0.846, P &lt; 0.0001) among foot arteries tested. The abnormality of sympathetic vasoconstriction was detectable in the majority of the diabetic patients with the early phase of autonomic neuropathy (%RI: 89.5%; %PI: 94.5%).

CONCLUSIONS
We conclude that the %RI of the digital artery is a useful and reliable sympathetic function test of early phase in diabetic patients.
Effect of Hypoglycemia on β-Adrenergic Sensitivity in Normal and Type 1 Diabetic Subjects
Authors: Fritsche Andreas , Stumvoll Michael , Grüb Matthias , Sieslack Sonja , Renn Walter , Schmülling Reinhold-Michael , Häring Hans-Ulrich , Gerich John E 
Published: March 2007

OBJECTIVE
The purpose of this study was to assess the potential role of reduced tissue sensitivity to catecholamines in the pathogenesis of hypoglycemia unawareness in patients with type 1 diabetes.

RESEARCH DESIGN AND METHODS
The effect of a single episode of hypoglycemia on β-adrenergic sensitivity was studied in 10 type 1 diabetic patients with apparently normal awareness of hypoglycemia (age 29 ± 5 years, diabetes duration 13 ± 8 years, HbA1c 7.3 ± 0.9%) and 10 age-matched healthy control subjects. β-adrenergic sensitivity was measured with the isoproterenol test after a hyperinsulinemic euglycemic clamp and after a hyperinsulinemic hypoglycemic clamp. β-adrenergic sensitivity was expressed as the dose of intravenous isoproterenol that increased the heart rate by 25 beats/min (IC25).

RESULTS
During hypoglycemia, diabetic subjects had an impaired plasma epinephrine response compared with that of the control subjects (16.7 ± 5.0 vs. 40.1 ± 6.8 ng/ml, P = 0.02). In control subjects, the IC25 was lower after hypoglycemia than after euglycemia (0.83 ± 0.22 vs. 1.13 ± 0.21 μg, P = 0.02) indicating an increase in β-adrenergic sensitivity. In diabetic subjects, on the other hand, the IC25 was greater after hypoglycemia than after euglycemia (1.00 ± 0.26 vs. 0.65 ± 0.14 μ, P = 0.04), indicating a decrease in β-adrenergic sensitivity.

CONCLUSIONS
In normal subjects, a single episode of hypoglycemia increases β-adrenergic sensitivity. In diabetic subjects, in contrast, hypoglycemia reduces β-adrenergic sensitivity. These results provide evidence that in type 1 diabetic patients, some maladaptation of tissue sensitivity to catecholamines contributes to the development of hypoglycemia unawareness. A unifying hypothesis is presented for the pathogenesis of hypoglycemia unawareness in type 1 diabetic patients incorporating the concepts of both a reduced catecholamine response and reduced adrenergic sensitivity.
Plasma Lipoprotein(a) Levels Are Not Influenced by Glycemic Control in Type 1 Diabetes
Authors: Pérez Antonio , Carreras Gemma , Caixàs Assumpta , Castellví Agustina , Caballero Agueda , Bonet Rosa , Ordóñez-Llanos Jordi , de Leiva Alberto 
Published: March 2007

OBJECTIVE
To determine the influence of glycemic control improvement with intensive therapy on lipoprotein(a) [Lp(a)] concentrations in type 1 diabetic patients.

RESEARCH DESIGN AND METHODS
A total of 105 poorly controlled type 1 diabetic patients (60 men, 45 women) without diabetic complications participated in a longitudinal study performed in a tertiary referral center, to compare lipid, lipoprotein, and Lp(a) levels before and after 3 months of intensive therapy with multiple insulin doses. Lp(a) levels were measured by the Terumo method. Differences between the two periods were assessed by the paired t test and Wilcoxon's test.

RESULTS
After 3 months of intensive therapy, all patients exhibited improved glycemic control. HbA1c decreased from 8.9 ± 2.4 to 6.5 ± 1.6% (P &lt; 0.0001), being ≤6% in 47% of patients. However, although a more favorable lipoprotein profile was obtained, no changes in Lp(a) concentrations were observed in the whole group of patients (16.7 ± 17.3 vs. 17.2 ± 17.7 mg/dl) or in patients with baseline Lp(a) levels above 30 mg/dl (47.1 ± 14.8 vs. 47.4 ± 18.9 mg/dl) or below 30 mg/dl (9.6 ± 7.3 vs. 10.2 ± 6.7 mg/dl). In addition, patients reaching HbA1c ≤6 or &gt;6% presented similar Lp(a) levels (19.7 ± 18.0 vs. 15.0 ± 17.4 mg/dl), and changes in Lp(a) did not correlate with those observed in HbA1c.

CONCLUSIONS
These data demonstrate that the improvement of glycemic control does not influence plasma Lp(a) concentrations in type 1 diabetic patients independently of baseline Lp(a) levels and the degree of glycemic control.
Hyperglycemia Is a Factor for an Increase in Serum Ceruloplasmin in Type 2 Diabetes
Authors: Daimon Makoto , Susa Susa , Yamatani Keiichi , Manaka Hideo , Hama Kiyoko , Kimura Mamoru , Ohnuma Hiroshi , Kato Takeo 
Published: March 2007

OBJECTIVE
To examine if there is a correlation between high blood glucose and serum ceruloplasmin (Cp) levels.

RESEARCH DESIGN AND METHODS
Serum Cp levels were measured in 637 patients with type 2 diabetes (all type 2 diabetes group). For the follow-up type 2 diabetes group, 161 patients who had not had any changes in their situation during the last year that are known to influence serum Cp levels were reexamined 1 year later. The control group was composed of 158 healthy individuals. Serum Cp and blood HbA1c levels were measured by radial immunodiffusion and high-performance liquid chromatography assays, respectively.

RESULTS
Serum Cp levels in the all type 2 diabetes group were significantly higher than those in the control group (P &lt; 0.0001), although the serum Cp levels did not correlate with the blood HbA1c levels in the all type 2 diabetes group (r = 0.055, P = 0.351). Then we evaluated those factors (Δ-log Cp and Δ-HbA1c) in the follow-up type 2 diabetes group to minimize changes from the genetic differences and to exclude any known factors influencing serum Cp levels. This indicated that the Δ-HbA1c had a positive correlation to the Δ-log Cp (r = 0.304, P &lt; 0.0001).

CONCLUSIONS
A persistent high blood glucose (namely HbA1c) is associated with an increase in serum Cp levels over 1 year.
Association of NIDDM and Hearing Loss
Authors: Dalton Dayna S , Cruickshanks Karen J , Klein Ronald , Klein Barbara EK , Wiley Terry L 
Published: March 2007

OBJECTIVE
To evaluate the association of NIDDM with hearing loss in a large population-based study.

RESEARCH DESIGN AND METHODS
Data from population-based longitudinal studies of aging conducted in Beaver Dam, Wisconsin, were used in these analyses. Hearing thresholds were determined by pure-tone air- and bone-conduction audiometry performed by trained technicians following American Speech-Language-Hearing Association specifications. Hearing loss was defined as the pure-tone average of the frequencies 500, 1,000, 2,000, and 4,000 Hz &gt; 25 decibels hearing level in the worse ear. Diabetes status was determined by self-report of physician-diagnosed diabetes or by elevated glucose or glycated hemoglobin levels at examination.

RESULTS
Of 3,571 study participants, 344 were classified as having NIDDM. Subjects with NIDDM were more likely to have a hearing loss than were subjects without diabetes (59 vs. 44%). After results were adjusted for age, this difference was not statistically significant. After individuals with hearing loss patterns inconsistent with presbycusis were excluded, there was an association between NIDDM and hearing loss when controlling for potential confounders (odds ratio [OR] 1.41, 95% CI 1.05–1.88). There was no association between duration of diabetes or glycemic control and hearing loss. Individuals with NIDDM and nephropathy were more likely to have a hearing loss than were those with NIDDM but no nephropathy (OR 2.28, 95% CI 1.04–5.00).

CONCLUSIONS
These data are suggestive of a weak association between NIDDM and hearing loss.
Increased Familial History of Arterial Hypertension, Coronary Heart Disease, and Renal Disease in Brazilian Type 2 Diabetic Patients With Diabetic Nephropathy
Authors: Canani Luís H , Gerchman Fernando , Gross Jorge L 
Published: March 2007

OBJECTIVE
To evaluate whether there is a familial association of arterial hypertension, coronary heart disease, renal disease, and stroke with diabetic nephropathy

RESEARCH DESIGN AND METHODS
There were 115 outpatients and 34 patients with end-stage renal disease treated by hemodialysis (61 men, age range 41–81 years) and having at least one sibling with type 2 diabetes studied. The positive or negative history of siblings (n = 765) was assessed by a standard questionnaire. The urinary albumin excretion rate (UAER) was measured by radioimmunoassay in 24-h sterile urine (three samples). The subjects were grouped as normoalbuminuric (UAER &lt;20 μg/min, n = 59), microalbuminuric (UAER 20-200 μg/min, n = 35), macroalbuminuric (UAER &gt;200 μg/min, n = 21), and end-stage renal disease (n = 34).

RESULTS
Patients with microalbuminuria, macroalbuminuria, or end-stage renal disease had an increased prevalence of sibling history of arterial hypertension (33.2, 37.3, and 33.8 vs. 23.4%, P &lt; 0.001) and coronary heart disease (15.2, 17.0, and 19.4 vs. 10.2%, P = 0.044) compared with the normoalbuminuric group. The renal disease history was increased only in the siblings of patients with macroalbuminuria or end-stage renal disease (12.8 and 15.6 vs. 7.6 and 6.1%, P = 0.005). The presence of sibling arterial hypertension strongly increases the prevalence of sibling renal and coronary heart disease independent of patient renal status.

CONCLUSIONS
There is an association of diabetic nephropathy and sibling history of arterial hypertension and renal and coronary heart disease in type 2 diabetic patients. These associations are not independent, and arterial hypertension may be their main determining factor.
Limited Joint Mobility in Type 1 Diabetic Patients
Authors: Frost Dietmar , Beischer Wolfgang 
Published: March 2007

OBJECTIVE— To study the relationship of limited joint mobility(LJM) in type 1 diabetic patients with microvascular complications,hypertension, and early atherosclerosis and to determine whether sex has an influence on possible associations.
RESEARCH DESIGN AND METHODS— A total of 335 consecutive unselected patients (191 women and 144 men), aged 14-40 years, were studied for LJM, retinopathy, nephropathy (stages III and IV), and hypertension. Standard laboratory tests were performed; the intima-media thickness (IMT) of the carotid arteries, which reflects the extent of early atherosclerosis, was measured by high-resolution ultrasound, and plaques were identified.
RESULTS— The frequency of LJM was 33.7% (29.8% in women and 38.9% in men). Subjects with LJM had a longer diabetes duration (P&lt; 0.001) than those without (women 16.7 ± 9.1 vs. 10.3 ± 6.0 years; men 15.0 ± 9.0 vs. 9.4 ± 6.3 years). Age,HbA1c, lipids, and systolic/diastolic blood pressure were not different between men and women with or without LJM. Men with LJM had a higher albumin excretion rate (37.1 vs. 13.1 μg/min, P &lt; 0.05) than those without LJM and showed a higher risk of proteinuria (odds ratio 1.8, 95%CI 1.2-2.7; P &lt; 0.05), retinopathy (2.4, 1.7-3.5; P &lt;0.001), and hypertension (1.7, 1.2-2.6; P &lt; 0.05). The occurrence of these complications was not different between women with and without LJM,but only women with LJM had a greater IMT (0.59 ± 0.13 vs. 0.55± 0.10 mm, P &lt; 0.05) and a higher risk of plaques (odds ratio 2.1, 95% CI 1.3-3.4; P &lt; 0.05) than women without LJM. In a multiple logistic regression analysis, adjusted for age and diabetes duration,male sex independently predicted the presence of LJM. Moreover, LJM proved to be an independent predictor of retinopathy in men only.
CONCLUSIONS— LJM is an indicator of microvascular disease in men, and LJM is associated with early macrovascular disease in women.
Influence of Intensive Diabetes Treatment on Body Weight and Composition of Adults With Type 1 Diabetes in the Diabetes Control and Complications Trial
Authors: Group The Diabetes Control and Complications Trial Research 
Published: March 2007

OBJECTIVE—To examine the differential effects of intensive and conventional diabetes therapy on weight gain and body composition in adults with type 1 diabetes.
RESEARCH DESIGN AND METHODS—Between 1982 and 1989, 1,246 adults (aged 18–39 years) in the Diabetes Control and Complications Trial were randomly assigned to either conventional therapy (1–2 injections of insulin per day) or intensive therapy (multiple daily injections or continuous subcutaneous infusion with frequent blood-glucose testing). Height and weight were measured at baseline and at annual visits for an average of 6 years (range 3–9). Body composition was assessed cross-sectionally with bioelectrical impedance analysis during 1992, at which time waist and hip circumferences were measured.
RESULTS—Intensively treated patients gained an average of 4.75 kg more than their conventionally treated counterparts (P &lt; 0.0001). This represented excess increases in BMI of 1.5 kg/m2 among men and 1.8 kg/m2 among women. Growth-curve analysis showed that weight gain was most rapid during the first year of therapy. Intensive therapy patients were also more likely to become overweight (BMI ≥27.8 kg/m2 for men, ≥27.3 kg/m2 for women) or experience major weight gain (BMI increased ≥5 kg/m2). Waist-to-hip ratios, however, did not differ between treatment groups. Major weight gain was associated with higher percentages of body fat and greater fat-free mass, but among patients without major weight gain, those receiving intensive therapy had greater fat-free mass with no difference in adiposity.
CONCLUSIONS—Intensive therapy for type 1 diabetes produces substantial excess weight gain compared with conventional therapy. However, the additional weight appears to include lean tissue as well as fat.
Contributors to Depression in Latino and European-American Patients With Type 2 Diabetes
Authors: Fisher Lawrence , Chesla Catherine A. , Mullan Joseph T. , Skaff Marilyn M. , Kanter Richard A. 
Published: March 2007

OBJECTIVE—To determine the independent and cumulative contributions of diabetes and other life stresses on depression and anxiety in Latino and European-American (EA) patients with diabetes.
RESEARCH DESIGN AND METHODS—A total of 75 Latino and 113 EA patients with type 2 diabetes, recruited from managed care settings, were assessed regarding three groups of potential stresses: demographics (age, sex, and education), disease status (functional impact, time since diagnosis, comorbidities, HbA1c, and BMI), and family stress (financial stress, spouse conflict resolution, and family closeness). Dependent variables were depression (Center for Epidemiological Studies–Depression scale [CES-D]) and anxiety (Symptom Checklist [SCL-90]). Multiple regression equations assessed the independent contribution of each predictor on depression and anxiety.
RESULTS—For both ethnic groups, education, functional impact, and financial stress significantly and independently predicted depression; poor spouse conflict resolution was a fourth significant predictor for EA patients only. The equations accounted for a high percentage of variance (43– 55%). Excluding education, the same variables predicted anxiety for both ethnic groups. The disease status and family stress variable groups significantly predicted outcomes independently. The relationships among these variables and depression and anxiety generally occurred for all patients, not only for those classified as likely depressed.
CONCLUSIONS—The findings suggest the utility of considering many life stresses, not just diabetes alone, that combine to affect depression and anxiety. We suggest that these effects are experienced cumulatively as general psychological distress for all patients with diabetes, not just those classified as likely depressed. Taken together, the findings emphasize a life-centered, patient-focused approach to the treatment of depression, rather than an exclusive disease-related perspective.
Limitations of Conventional Methods of Self-Monitoring of Blood Glucose
Authors: Boland Elizabeth , Monsod Teresa , Delucia Maria , Brandt Cynthia A. , Fernando Sanjay , Tamborlane William V. 
Published: March 2007

OBJECTIVE—Children with type 1 diabetes are usually asked to perform self-monitoring of blood glucose (SMBG) before meals and at bedtime, and it is assumed that if results are in target range, along with HbA1c measurements, then overall glycemic control is adequate. However, the brief glimpses in the 24-h glucose profile provided by SMBG may miss marked glycemic excursions. The MiniMed Continuous Glucose Monitoring System (CGMS) has provided a new method to obtain continuous glucose profiles and opportunities to examine limitations of conventional monitoring.
RESEARCH DESIGN AND METHODS—A total of 56 children with type 1 diabetes (age 2–18 years) wore the CGMS for 3 days. Patients entered four fingerstick blood samples into the monitor for calibration and kept records of food intake, exercise, and hypoglycemic symptoms. Data were downloaded, and glycemic patterns were identified.
RESULTS—Despite satisfactory HbA1c levels (7.7 ± 1.4%) and premeal glucose levels near the target range, the CGMS revealed profound postprandial hyperglycemia. Almost 90% of the peak postprandial glucose levels after every meal were &gt;180 mg/dl (above target), and almost 50% were &gt;300 mg/dl. Additionally, the CGMS revealed frequent and prolonged asymptomatic hypoglycemia (glucose &lt;60 mg/dl) in almost 70% of the children.
CONCLUSIONS—Despite excellent HbA1c levels and target preprandial glucose levels, children often experience nocturnal hypoglycemia and postprandial hyperglycemia that are not evident with routine monitoring. Repeated use of the CGMS may provide a means to optimize basal and bolus insulin replacement in patients with type 1 diabetes.