bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychiatric Disorders in Youths With IDDM: Rates and Risk Factors
Authors: Kovacs Maria , Goldston David , Obrosky D Scott , Bonar Lisa K 
Published: March 2007

OBJECTIVE
To determine prevalence rates, associated features and risk factors for psychiatric disorders subsequent to the diagnosis of IDDM in youths.

RESEARCH DESIGN AND METHODS
Using a longitudinal, naturalistic design, 92 youths from 8 to 13 years old at onset of IDDM were followed from their initial diagnosis. They were repeatedly assessed by semistructured interview and diagnosed by operational criteria.

RESULTS
By the 10th year of IDDM and the mean age of 20 years, an estimated 47.6% of the sample developed psychiatric disorder. Major depressive, conduct, and generalized anxiety disorders were the most prevalent, and major depression had a significantly higher estimated rate (27.5%) than each other disorder. The highest incidence rates were during the 1st year of the medical condition. Initial maternal psychopathology increased the risk of psychiatric disorder in the subjects, and maternal depression was a specific risk factor for depression in the subjects. Earlier psychiatric disorder in the subjects also increased the risk of later disorder.

CONCLUSIONS
The results converge with findings from other studies, suggesting elevated psychiatric morbidity in contemporary samples of young people with IDDM. The morbidity partly reflects the high incidence of major depression in adolescence and generalized anxiety disorder in young adulthood. Monitoring the psychological status of young patients and their mothers may help to identify diabetic children at risk for psychiatric disorder and facilitate prevention or treatment efforts. Monitoring may be particularly beneficial during the 1st year of the IDDM.
Major Depressive Disorder in Youths With IDDM: A controlled prospective study of course and outcome
Authors: Kovacs Maria , Obrosky D Scott , Goldston David , Drash Allan 
Published: March 2007

OBJECTIVE
To determine whether IDDM affects the course of major depressive disorder (MDD) in youths.

RESEARCH DESIGN AND METHODS
The study samples include 24 youths with IDDM (of a group of 92) who developed MDD during a longitudinal follow-up of 10 years, on average, since onset of the medical condition, and 30 depressed psychiatric control subjects, matched on relevant variables. Both groups were repeatedly assessed by semistructured interviews and diagnosed by operational criteria.

RESULTS
In diabetic subjects, median time to recovery from the first episode of MDD was 6.4 months; by 12 months from onset, 69% of the youths will have recovered. Within 2 years of recovery, 32% were at risk for a new episode; by 6.5 years, altogether 47% are estimated to have a recurrence. Only 37.5% of diabetic subjects received treatment for the first episode of depression, and 50% received treatment for the second episode. Overall rates of recovery and recurrence were indistinguishable in the diabetic and psychiatric control groups. However, young women with diabetes were at nine times greater risk for recurrent depression than their male counterparts, and diabetic subjects eventually spent more time being depressed than the control subjects.

CONCLUSIONS
The course characteristics of MDD in young diabetic subjects and psychiatric control subjects appear to be similar in several regards. However, the eventual propensity of diabetic youths for more protracted depressions and the higher risk of recurrence among young diabetic women suggest that the mental health of patients with IDDM should be closely monitored. The findings confirm that depression is undertreated among patients in the primary health care sector.
The Effect of Prepubertal Diabetes Duration on Diabetes: Microvascular Complications in Early and Late Adolescence
Authors: Donaghue Kim C , Fung Amelia TW , Hing Stephen , Fairchild Jan , King Jennifer , Chan Albert , Howard Neville J , Silink Martin 
Published: March 2007

OBJECTIVE
To define the significance of prepubertal diabetes duration in the development of diabetic microvascular complications in adolescents.

RESEARCH DESIGN AND METHODS
Study A compares complications in 38 prepubertal (PreP) and 140 pubertal (Pub) subjects of the same age (10-14 years) and diabetes duration (3–12 years) to determine if the absence of puberty itself confers a lower risk of complications. Study B examines the importance of prepubertal and pubertal diabetes duration in 193 older adolescents (ages 15–22 years) with prepubertal onset of diabetes. Retinopathy status was assessed using stereoscopic fundus photography of seven fields per eye. Albumin excretion rate (AER) was assessed by three consecutive overnight urine collections, using a polyclonal radioimmunoassay.

RESULTS
In study A, there were no significant differences between the PreP and Pub groups for retinopathy (27 vs. 29%, P = 0.8) or differences in elevated AER (17 vs. 31%, P = 0.1). In study B, longer prepubertal diabetes duration improved the prediction for retinopathy over postpubertal duration alone (P &lt; 0.0005). No relationship with duration was found for elevated AER (&gt; 7.5, &gt; 15, and &gt; 30 micrograms/min).

CONCLUSIONS
Prepubertal subjects with diabetes did not have less retinopathy or elevated albumin excretion compared with pubertal subjects of the same age. Prepubertal diabetes duration is significantly related to the presence of retinopathy in adolescents.
Increased Urinary Albumin and Retinol-Binding Protein in Type I Diabetes: A study of identical twins
Authors: Dubrey Simon W , Beetham Robert , Miles Judith , Noble Mark IM , Rowe Rachel , Leslie R David G 
Published: March 2007

OBJECTIVE
Indexes of early renal glomerular and tubular dysfunction have been demonstrated in type I diabetes, but it remains uncertain whether such changes are genetically determined or are secondary to the disease process. We therefore undertook to study whether early markers of renal dysfunction are a consequence of type I diabetes or inherited.

RESEARCH DESIGN AND METHODS
We estimated both urinary albumin excretion (UAE) and urinary retinol-binding protein (RBP) in 51 identical twin pairs discordant for type I diabetes and in 51 matched control subjects.

RESULTS
UAE and RBP were significantly higher in the diabetic twins than in their nondiabetic co-twins (P &lt; 0.0001 and P &lt; 0.0002, respectively). Seven diabetic twins had elevated UAE, but none of the nondiabetic co-twins did. In a subgroup of 44 twins with normal UAE (albumin excretion rate &lt; 20 micrograms/min), diabetic twins had both a higher albumin excretion function (median [range]; 0.64 [0.18–2.74] mg/mmol creatinine) than their nondiabetic co-twins (0.48 [0.24–1.40], P &lt; 0.01) and higher levels of RBP excretion (10.4 [4.0–167.0] micrograms/mmol creatinine) than their nondiabetic co-twins (7.5 [0.97–23.0], P &lt; 0.05). Values between twins of a pair were significantly correlated for RBP (r = 0.36, P &lt; 0.05) but not for UAE (r = 0.13).

CONCLUSIONS
These results suggest that in type I diabetes, an index of renal tubular function (RBP), but not glomerular function (UAE), is influenced by shared genetic and nongenetic factors. Type I diabetes can affect renal tubular function even when glomerular function is normal. We conclude that neither the increased UAE nor urinary RBP found in type I diabetes is inherited independently of the diabetes process.
Impact of Dosage Frequency on Patient Compliance
Authors: Paes Arsenio H P , Bakker Albert , Soe-Agnie Carmen J 
Published: March 2007

OBJECTIVE
To evaluate the impact of dosage frequency on the compliance of patients who receive their medicines from community pharmacies.

RESEARCH DESIGN AND METHODS
Each month, patients received a supply of their medication in a Medication Event Monitoring Systems container, which registered each opening of the package. At the end of the study, the patients received a short questionnaire. The subjects were 91 diabetic patients using oral antidiabetic agents. Patients taking insulin and those who were unable to collect their medicines from the pharmacy were excluded from the study. Compliance was defined as the percentage of doses taken during the observation period. Another parameter used was compliance with the prescribed regimen, defined as the percentage of days in which the number of tablets were taken as prescribed. As a last parameter, compliance with the prescribed dose intervals was used.

RESULTS
Compliance is influenced by the frequency of doses. The compliance for this group of patients is 74.8%, with an average of 79% in the case of a dose once daily and 38% in the case of a dose three times daily. The predominant type of noncompliance in all groups was dose omissions. However, more than one-third of the patients used more doses than prescribed. Overconsumption is a frequently made mistake by patients on a one-dose daily schedule.

CONCLUSIONS
The reduction of dose frequency may decrease total noncompliance, but at the same time, it increases the risk of overconsumption. Reducing the frequency does not automatically result in a better therapeutic schedule. The choice of once or twice daily should depend on the therapeutic range of the drug.
Relationship Between Gastric Emptying and an α-Glucosidase Inhibitor Effect on Postprandial Hyperglycemia in NIDDM Patients
Authors: Kawagishi Takahiko , Nishizawa Yoshiki , Taniwaki Hiromichi , Tanaka Shinji , Okuno Yasuhisa , Inaba Masaaki , Ishimura Eiji , Emoto Masanori , Morii Hirotoshi 
Published: March 2007

OBJECTIVE
The purpose of the study was to examine the relationship between gastric emptying and the efficacy of an α-glucosidase inhibitor in NIDDM patients.

RESEARCH DESIGN AND METHODS
Sixteen NIDDM patients (4 patients treated with diet therapy alone and 12 receiving a sulfonylurea) were given 0.6 mg of voglibose daily for 4 weeks. The efficacy of voglibose was assessed by measurement of HbA1c, fasting plasma glucose, and 45- and 120-min postprandial plasma glucose (PPG) and serum insulin concentrations before and after the 4 weeks of voglibose therapy. Gastric emptying was evaluated using the proportional cumulative area under the absorption curve (% AUC) of plasma acetaminophen concentration at 60 min after ingestion of a liquid test meal containing 20 mg/kg of acetaminophen. These measurements were also taken before and after the therapy.

RESULTS
The change in the 45-min PPG levels from the fasting state correlated significantly with the % AUC of the plasma acetaminophen concentrations (r = 0.625, P = 0.0096) before the voglibose administrations. The mean 45-min and 2-h PPG levels were reduced significantly after 4 weeks of voglibose (P &lt; 0.05 and P &lt; 0.01, respectively). Two-hour postprandial serum insulin concentrations were also significantly reduced at the end of the treatment period (P &lt; 0.05). The changes in the PPG levels between pre- and posttreatment periods correlated significantly with the % AUC of the plasma acetaminophen concentrations before the treatment period (r = 0.499, P = 0.0490; r = 0.713, P = 0.0019, respectively). There was no significant difference in the plasma acetaminophen concentrations between pre- and posttreatment periods.

CONCLUSIONS
The rate of gastric emptying affects the efficacy of voglibose therapy in NIDDM patients. Voglibose did not however alter the rate of gastric emptying.
Modification of Postprandial Hyperglycemia With Insulin Lispro Improves Glucose Control in Patients With Type 2 Diabetes
Authors: Feinglos Mary N , Thacker Connie H , English Jennifer , Bethel M Angelyn , Lane James D 
Published: March 2007

OBJECTIVE
Insulin lispro is a rapid-acting analog of human insulin that can be used to target the postprandial rise in plasma glucose. We designed an open-label randomized crossover study of type 2 diabetic patients with secondary failure of sulfonylurea therapy to determine whether improvement of postprandial hyperglycemia would affect total daily glucose control.

RESEARCH DESIGN AND METHODS
Twenty-five type 2 diabetic patients who were poorly controlled on a maximum dose of sulfonylureas were studied in a university hospital clinical research center. In one arm of the study, patients continued therapy with maximum-dose sulfonylureas. In the other arm, patients used a combination therapy with insulin lispro before meals and sulfonylureas. After 4 months, patients were crossed over to the opposite arm. Fasting plasma glucose (FPG) and 1- and 2-h postprandial glucose (after a standardized meal), HbA1c, total, HDL, and LDL cholesterol, and triglyceride levels were measured at the end of each arm of the study.

RESULTS
Insulin lispro in combination with sulfonylurea therapy significantly reduced 2-h postprandial glucose concentrations compared with sulfonylureas alone, from 18.6 to 14.2 mmol/l (P &lt; 0.0001), and incremental postprandial glucose area from 617.8 to 472.9 mmol · min · 1−1 (P &lt; 0.0007). FPG levels were decreased from 10.9 to 8.5 mmol/l (P &lt; 0.0001), and HbA1c values were reduced form 9.0 to 7.1% (P &lt; 0.0001). Total cholesterol was significantly decreased in the lispro arm from 5.44 to 5.10 mmol/l (P &lt; 0.02). HDL cholesterol concentrations were increased in the lispro arm from 0.88 to 0.96 mmol/l (P &lt; 0.01). The patients weighed significantly more after lispro therapy than after sulfonylureas alone, but the difference was small in absolute terms (sulfonylurea therapy alone, 90.6 kg; lispro therapy, 93.8 kg; P &lt; 0.0001). Two episodes of hypoglycemia (glucose concentrations, &lt; 2.8 mmol/l) were reported by the patients while using lispro.

CONCLUSIONS
Previously, it has not been possible to address the effect of treatment of postprandial hyperglycemia specifically. We have now shown that the treatment of postprandial hyperglycemia with insulin lispro markedly improves overall glucose control and some lipid parameters in patients with type 2 diabetes.
Effects of an Intervention by a Diabetes Team in Hospitalized Patients With Diabetes
Authors: Koproski Jill , Pretto Zorayda , Poretsky Leonid 
Published: March 2007

OBJECTIVE
Hospitalized patients with diabetes have a prolonged length of stay in the hospital. We conducted a controlled prospective randomized feasibility study of the effects of a diabetes team (a diabetes nurse educator and an endocrinologist) on the length of stay and other outcomes of hospitalization in these patients.

RESEARCH DESIGN AND METHODS
A total of 179 hospitalized patients with diabetes were randomly assigned to receive usual care supplemented with (85 patients) or without (94 control patients) a diabetes team intervention. Outcome measures included the length of stay, blood glucose control, and rates of readmission.

RESULTS
For the primary diagnosis of diabetes, the median length of stay was 5.5 days (95% CI 4-8 days) for patients who received diabetes team intervention and 7.5 days (5–11 days) for the control patients (NS). For the secondary diagnosis of diabetes, the median length of stay was 10.0 days (8–13 days) in the intervention group and 10.5 days (8–13 days) in the control group (NS). One month after the team intervention was initiated, 75% of patients in the intervention group were in good glycemic control, compared with 46% in the control group. Readmissions at 3 months after discharge included 13 (15%) patients from the intervention group and 30 (32%) patients in the control group (P = 0.01).

CONCLUSIONS
Randomized controlled prospective trials of clinical interventions in hospitalized patients with diabetes are feasible. Diabetes team intervention appears to reduce the hospital length of stay and to improve glycemic control. Team intervention significantly reduces the rate of recurrent hospitalization.
Impact of Physical Activity on Cardiovascular Risk Factors in IDDM
Authors: Lehmann Roger , Kaplan Vladimir , Bingisser Roland , Bloch Konrad E , Spinas Giatgen A 
Published: March 2007

OBJECTIVE
To study the impact of physical activity on glycemic control and plasma lipids [HDL cholesterol (HDL-C), HDL-C subfractions, triglycerides, lipoprotein(a)], blood pressure, weight, and abdominal fat and to determine the necessary short-term adaptations in diabetes management during intensive endurance training in patients with IDDM.

RESEARCH DESIGN AND METHODS
Well-controlled subjects with IDDM (n = 20; HbA1c = 7.6%) engaged in a regular exercise program over a period of 3 months involving endurance sports such as biking, long-distance running, or hiking. Subjects were instructed to exercise at least 135 min per week. If baseline activity exceeded this level, subjects were to increase further their physical activity as much as possible and record the type and time of such activity.

RESULTS
During the 3-month intervention, physical activity increased from 195 ± 176 to 356 ± 164 min (mean ± SD) per week (P &lt; 0.001). Physical fitness as assessed by VO2max increased from 2,914 ± 924 to 3,092 ± 905 ml/min (P &lt; 0.001), and insulin sensitivity increased significantly (steady-state plasma glucose [SSPG] decreased from 10.5 ± 4.8 to 7.0 ± 3.3 mmol/l; P &lt; 0.01). Subsequently, LDL cholesterol decreased by 14% (P &lt; 0.05), and HDL and HDL3-C subfraction increased by 10 (P &lt; 0.05) and 16% (P &lt; 0.05), respectively. Systolic and diastolic blood pressure decreased significantly from 127 ± 9 to 124 ± 8 (P &lt; 0.05) and from 80 ± 5 to 77 ± 5 mmHg (P &lt; 0.01), respectively. Resting heart rate decreased from 63 ± 6 to 59 ± 7 bpm (P &lt; 0.01). Waist-to-hip circumference ratio decreased from 0.882 ± 0.055 to 0.858 ± 0.053 (P &lt; 0.001), body weight decreased from 70.7 ± 10.4 to 68.7 ± 10.2 kg (P = 0.003), with a consequent decrease in body fat from 21.9 ± 8.2 to 18.0 ± 6.3% (P &lt; 0.001) and an increase in lean body mass from 54.9 ± 12.2 to 56.8 ± 11.0 kg. These effects occurred independently of glycemic control. The overall frequency of severe hypoglycemic episodes was reduced from 0.14 to 0.10 per patient-year during the study period.

CONCLUSIONS
This study shows that increasing physical activity is safe and does not result in more hypoglycemic episodes and that there is a linear dose-response between increased physical activity and loss of abdominal fat and a decrease in blood pressure and lipid-related cardiovascular risk factors, with a preferential increase in the HDL3-C subfraction.
Effects of a Quick-Release Form of Bromocriptine (Ergoset) on Fasting and Postprandial Plasma Glucose, Insulin, Lipid, and Lipoprotein Concentrations in Obese Nondiabetic Hyperinsulinemic Women
Authors: Kamath Vinaya , Jones Claire N , Yip Jeannie C , Varasteh Ben B , Cincotta Anthony H , Reaven Gerald M , Chen Yii-Der I 
Published: March 2007

OBJECTIVE
To assess the effect on various aspects of carbohydrate and lipid metabolism of administering a quick-release formulation of bromocriptine (Ergoset) to obese, nondiabetic, hyperinsulinemic women.

RESEARCH DESIGN AND METHODS
Hourly concentrations of prolactin, glucose, insulin, free fatty acid (FFA), and triglyceride were measured for 24 h before and after approximately 8 weeks of treatment with Ergoset. In addition, fasting lipid and lipoprotein concentrations and the steady-state plasma glucose (SSPG) concentration in response to a continuous infusion of somatostatin, insulin, and glucose were determined before and after Ergoset administration.

RESULTS
Circulating prolactin concentrations were dramatically decreased (P &lt; 0.001) following treatment, associated with a significant fall (P &lt; 0.05) in 24-h-long plasma glucose, FFA, and triglyceride concentrations. Neither circulating plasma insulin concentrations nor the ability of insulin to mediate glucose disposal changed with treatment. Finally, fasting total cholesterol fell (P &lt; 0.05) and the ratio of total to HDL cholesterol decreased (P = 0.06) in association with Ergoset treatment.

CONCLUSIONS
The fact that significant metabolic improvement was seen in the obese nondiabetic hyperinsulinemic women studied suggests that Ergoset could be of therapeutic benefit in clinical conditions of hyperglycemia and/or dyslipidemia.
Comparison of a Carbohydrate-Rich Diet and Diets Rich in Stearic or Palmitic Acid in NIDDM Patients: Effects on lipids, glycemic control, and diurnal blood pressure
Authors: Storm Hanne , Thomsen Claus , Pedersen Eva , Rasmussen Ole , Christiansen Christian , Hermansen Kjeld 
Published: March 2007

OBJECTIVE
To compare the effects on lipid levels, glycemic control, and diurnal blood pressure of two diets rich in one of the two quantitatively most important saturated fatty acids, stearic and palmitic acid, with a carbohydrate-rich diet in NIDDM patients.

RESEARCH DESIGN AND METHODS
A total of 15 NIDDM patients participated in a randomized crossover study with three 3-week diet interventions separated by 2-week washout periods. Patients started with a diet rich in stearic acid (44 E% [percent of total energy] fat [13 E% stearic acid], 40 E% carbohydrate, 15 E% protein), palmitic acid (45 E% fat [16 E% palmitic acid], 40 E% carbohydrate, 15 E% protein), or carbohydrate (29 E% fat, 51 E% carbohydrate, and 18 E% protein), then were shifted to the other two diets in a randomized block design. At the start and end of each intervention period, fasting blood samples were drawn for analysis of lipids and blood glucose. In addition, diurnal blood pressure was measured.

RESULTS
At the end of the 3-week interventions, total cholesterol was significantly higher after the palmitic acid-rich diet than after the stearic acid-rich or carbohydrate-rich diets (5.3 ± 1.3 vs. 5.0 ± 1.2 and 4.9 ± 1.2 mmol/l, respectively; P = 0.03). No significant differences in triglyceride, LDL, or HDL cholesterol levels were seen after the three intervention diets. No difference in effects between the diet periods were seen for fructosamine, HbA1c, fasting blood glucose, or diurnal blood pressure.

CONCLUSIONS
For the first time, it has been demonstrated that a diet rich in palmitic acid was not as effective in lowering cholesterol levels as carbohydrate-rich and stearic acid-rich diets in NIDDM patients. No deleterious effects were seen on diurnal blood pressure, triglyceride levels, and glycemic control. Development of foods containing stearic acid rather than the more atherogenic saturated fatty acids may allow a wider choice of acceptable foods to NIDDM patients.
Reduced Frequency of Severe Hypoglycemia and Coma in Well-Controlled IDDM Patients Treated With Insulin Lispro
Authors: Holleman Frits , Schmitt Henry , Rottiers Raoul , Rees Alan , Symanowski Sharon , Anderson James H ,   The Benelux-UK Insulin Lispro Study Group
Published: March 2007

OBJECTIVE
Several studies have suggested that use of the short-acting insulin analog, insulin lispro, in multiple injection therapy may reduce the risk of hypoglycemia in comparison with regular insulin. This effect might be more pronounced in well-controlled patients, since intensive treatment of IDDM increases the rate of severe hypoglycemic events. This study evaluated the effects of insulin lispro on glycemic control and hypoglycemia rates in well-controlled IDDM patients.

RESEARCH DESIGN AND METHODS
This was an open, randomized, 6-month crossover study of 199 IDDM patients. Glycemic control was evaluated by HbA1c, home blood glucose measurements, and rate and timing of hypoglycemic events. At the end of the study, patients completed an evaluation form regarding therapy-related quality of life.

RESULTS
HbA1c remained constant at ∼ 7.3% throughout the study. Meal-related glucose excursions were significantly lower with insulin lispro compared with regular insulin (mean −0.8 ± 1.7 vs. 1.1 ± 1.6 mmol/l, P &lt; 0.001), as was the within-day variability (M value 27.7 ± 19.7 vs. 30.2 ± 23.1, P = 0.007). The incidence of severe hypoglycemic events (58 vs. 36, P = 0.037) including coma (16 vs. 3, P = 0.004) was significantly lower with insulin lispro than with regular insulin. Patients felt that insulin lispro increased flexibility and freedom of lifestyle.

CONCLUSIONS
In well-controlled IDDM patients, insulin lispro is associated with a lower risk of severe hypoglycemia and coma.