bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Prevalence of Diabetes in Rio de Janeiro, Brazil
Authors: Oliveira Jose Egídio P , Milech Adolpho , Franco Laercio J ,   The Cooperative Group for the Study of Diabetes Prevalence in Rio De Janeiro
Published: March 2007

OBJECTIVE
To assess the prevalence of diabetes and impaired glucose tolerance (IGT) in the adult population of Rio de Janeiro, a two-stage cross-sectional survey was carried out in a random sample of 2,051 individuals aged 30–69 years from Rio de Janeiro city in Brazil.

RESEARCH DESIGN AND METHODS
Subjects were first screened by fasting capillary glycemia (FCG). All individuals who screened positive (FCG &gt; 5.6 mmol/l) and every sixth consecutive person who screened negative (FCG &lt; 5.6 mmol/l) were subjected to a 75-g glucose load. Diagnoses of diabetes and IGT were based on World Health Organization criteria.

RESULTS
Results from every sixth individual who screened negative were extrapolated to all individuals who screened negative after adjustment for some potential bias in the subsample. Age-adjusted prevalence rates for diabetes and IGT were 7.1 and 9.0%, respectively. The rates were higher (P &lt; 0.01) among women than among men (8.7 vs. 5.2% for diabetes and 11.7 vs. 5.8% for IGT), among obese individuals than among nonobese individuals (7.9 vs. 6.2% for diabetes and 11.4 vs. 7.3% for IGT), and among those with family history of diabetes than among those without family history of diabetes (12.4 vs. 4.8% for diabetes and 13.8 vs. 6.7% for IGT). The rates for diabetes and IGT increased with age, being 1.7 and 4.5%, respectively, for the age-group of 30–39 years, 3.9 and 8.5% for the age-group of 40–49 years, 13.6 and 13% for the age-group of 50–59 years, and 17.3 and 15.3% for the age-group of 60–69 years (P &lt; 0.01). The prevalence of diabetes was higher among individuals with low educational levels than among those with high educational levels (7.3 vs 4.2%). For IGT, the rates increased from the group with intermediate level of education (8.3%) to the low- (11.3%) and high-education group (12.6%). Differences in the rates for whites and non-whites (6.9 vs. 7.1% for diabetes and 8.8 vs. 9.6% for IGT) were not statistically significant. Among those with confirmed diabetes in the survey, 27.6% did not know of their diabetic condition. Among previously diagnosed diabetes (self-reported diabetes), 19.5% were not being treated, 31.8% were on diet only, 40.7% were on oral hypoglycemic drugs, and 8.0% were on insulin. Self-reported prevalence of diabetes was 0.1% for the population &lt; 30 years of age, 4.3% for the 30–69 year old age-group, and 16.6% for those &gt; 70 years of age.

CONCLUSIONS
The numbers found for Rio de Janeiro are similar to those for more developed countries and lead us to conclude that the impact of diabetes on public health is the same as in those countries where this disease is considered an important health problem.
A Prevalence Survey of Diabetes in Mauritania
Authors: Ducorps Michel , Baleynaud Serge , Mayaudon Herve , Castagne Christian , Bauduceau Bernard 
Published: March 2007

OBJECTIVE
To perform an epidemiological study of the prevalence of diabetes in Mauritania, West Africa, with little data available on diabetes in West Africa.

RESEARCH DESIGN AND METHODS
The study was performed with a representative sample of the Mauritanian population. A random selection of the study population (n = 744) was drawn by a cluster sampling method. Screening for diabetes was made by capillary blood glucose (CBG) measurement, using strips analyzed by reflectance meter. Criteria for the diagnosis of diabetes were those of the World Health Organization (WHO).

RESULTS
The survey performed a screening of 744 subjects whose sex distribution was 307 men and 437 women. Their mean age was 34.6 ± 15.2 years, and their mean BMI was 22.7 ± 5.1 kg/m2, with a significant difference for BMI between men (20.0 ± 2.9 kg/m2) and women (24.3 ± 5.5 kg/m2). According to the study criteria, we found 14 diabetic patients (4 men, 10 women). The crude prevalence of diabetes was 1.88% (95% CI 0.90–2.86). The difference in prevalence by sex was 1.30% (95% CI 0.00–2.60) for men and 2.29% (95% CI 0.89–3.43) for women. For the truncated 30- to 64-year-old age-group, the crude prevalence was 2.84%; the age-adjusted prevalence for the same 30- to 64-year-old age-group, using the standardized age distribution of Segi (10), was 2.61%.

CONCLUSIONS
With a crude prevalence of diabetes of 1.88% and an age-adjusted prevalence of 2.61%, Mauritania may be classified among the countries with a low prevalence of diabetes, a finding which is not surprising, considering the low level of development of this region of Africa.
Potential Therapeutic Levels of Glucagon-Like Peptide I Achieved in Humans by a Buccal Tablet
Authors: Gutniak Mark K , Larsson Hillevi , Heiber Sonia J , Juneskans Olof T , Holst Jens J , Ahrén Bo 
Published: March 2007

OBJECTIVE
Glucagon-like peptide I(7–36) (GLP-I) amide, an endogenous incretin, has been identified as a potential adjunct to the treatment of NIDDM and has been studied following intravenous and subcutaneous injection. A mucoadhesive buccal GLP-I tablet containing 119 nmol has been developed to provide transmucosal absorption as a possible alternative to injection treatment.

RESEARCH DESIGN AND METHODS
Eight healthy volunteers received a single tablet under fasting conditions in this randomized double-blind placebo-controlled study. A total GLP-I immunoreactivity was measured using COOH-terminal radioimmunoassay (RIA) (total peptide activity) and NH2-terminal RIA (active, nondegraded peptide).

RESULTS
The mean (± SE) peak GLP-I concentration was 117 ± 19 pmol/l and occurred 30 ± 4 min after application. The mean placebo-adjusted area under curve was 8,145 ± 873 pmol · min−1 · l−1, consistent with a relative bioavailability of 7% versus intravenous injection and 47% versus subcutaneous injection. The levels of active peptide increased in parallel with total GLP-I. Half-life of peptide activity after buccal administration was 27 and 24 min measured with COOH-terminal and NH2-terminal RIA, respectively. Placebo adjusted insulin concentrations increased to a peak of 252 ± 57 pmol/l, glucose decreased 1.4 ± 0.2 mmo/l, and glucagon decreased 17 ± 3 ng/l, consistent with the increase in plasma GLP-I concentrations.

CONCLUSIONS
Therapeutic plasma levels of GLP-I in humans were achieved after a single buccal tablet. No increased degradation of GLP-I was found in the buccal mucosa compared to subcutaneous tissue. This alternative treatment form may be feasible in in the future for NIDDM.
How Have Patients Reacted to the Implications of the DCCT?
Authors: Thompson Chris J , Cummings J Fraser , Chalmers John , Gould Craig , Newton Ray W 
Published: March 2007

OBJECTIVES
To assess the reactions of people with insulin-treated diabetes (ITD) to the results of the Diabetes Control and Complications Trial (DCCT).

RESEARCH DESIGN AND METHODS
A leaflet documenting the purpose and results of the DCCT was circulated to all 771 patients ages 15–60 years with ITD attending our clinic. Patients were invited to complete and return a questionnaire on their responses.

RESULTS
Of 550 respondents, 330 felt encouraged to improve glycemic control. Female respondents (P = 0.003) and younger age-groups (15–25 years, P = 0.001) were most likely to want to improve control. Patients with long duration of diabetes (&gt; 20 years, P = 0.00001), hypoglycemia unawareness (P = 0.0001), or previous severe hypoglycemia (P = 0.001) were less likely to want to improve their control. Fear of hypoglycemia concerned all age-groups, whereas female respondents were most likely to be worried about the potential for weight gain (P = 0.00006).

CONCLUSIONS
Knowledge of the results of the DCCT encourages significant numbers of patients to want to improve glycemic control. Fear of hypoglycemia and, in women, weight gain may prove significant impediments to the clinical implementation of the results of the DCCT.
Long-Term Therapy of IDDM With an Implantable Insulin Pump
Authors: Dunn Fredrick L , Nathan David M , Scavini Marina , Selam Jean-Louis L , Wingrove Theresa G ,   The Implantable Insulin Pump Trial Study Group
Published: March 2007

OBJECTIVE
To examine the long-term benefits and risks of treatment of IDDM with an implantable programmable insulin pump.

RESEARCH DESIGN AND METHODS
Seventy-six patients with IDDM were studied at nine clinical centers. After 3–4 months of intensive subcutaneous therapy, the Infusaid Model 1000 pump was implanted, and insulin was delivered either intraperitoneally or intravenously for an average of 39.6 ± 10 months (251 patient-years). Data was collected for glycemic control, lipid levels, weight gain, insulin requirements, adverse events, and quality of life. Sixty-three patients were also followed for 8.5 ± 6.3 months (45 patient-years) after pump therapy was discontinued.

RESULTS
Mean quarterly HbA1c fell with subcutaneous intensive therapy and remained stable on implantable pump therapy between 6.9 and 7.5%. Severe hypoglycemia was relatively rare, with only 4 episodes/100 patient-years of implantable pump therapy. This rate was significantly less than with subcutaneous intensive therapy before implantable pump initiation (33 episodes/100 patient-years) or after discontinuation of implantable pump therapy (36/100 patient-years) (P &lt; 0.003). Weight did not increase significantly in the 1st year of therapy, but increased by 2.0 ± 4.3 kg after 3 years of therapy. There were no significant differences in metabolic control or adverse events between intraperitoneal and intravenous insulin therapy except for minor differences in lipid levels and the more frequent development of catheter obstruction with intravenous delivery. Most pump slow-downs and catheter occlusions were corrected noninvasively. Quality of life, as measured by the Diabetes Control and Complications Trial instrument, showed high satisfaction and improved impact scores.

CONCLUSIONS
Long-term implantable pump therapy maintained HbA1c in a range similar to intensive subcutaneous therapy, but with fewer episodes of severe hypoglycemia. Although pump and catheter occlusions remain a limitation, patient satisfaction with implantable pump therapy remains high.
The PATHWAYS Church-Based Weight Loss Program for Urban African-American Women at Risk for Diabetes
Authors: McNabb Wylie , Quinn Michael , Kerver Jean , Cook Sandy , Karrison Theodore 
Published: March 2007

OBJECTIVE
This study was carried out to test the effectiveness of PATHWAYS, a weight loss program designed specifically for urban African-American women, when administered in urban churches by trained lay facilitators.

RESEARCH DESIGN AND METHODS
Thirty-nine obese women were recruited from three urban African-American churches. After randomization and the collection of baseline data on weight and lifestyle practices, subjects in the experimental group (n = 19) were assigned to receive a 14-week weight loss program (PATHWAYS) conducted by trained lay volunteers; control group subjects (n = 20) were put on a waiting list to receive the program at the conclusion of the study period.

RESULTS
Of the 39 women enrolled, 15 experimental group subjects and 18 control group subjects were available for posttreatment data collection. After completing the program, PATHWAYS participants lost an average of 10.0 lb, and the control group subjects gained an average of 1.9 lb. Posttreatment difference in weight loss between the groups was statistically significant (P &lt; 0.0001). Waist circumference among PATHWAYS participants decreased 2.5 inches, while waist circumference among control group subjects remained relatively the same. This difference between the groups was statistically significant (P &lt; 0.05).

CONCLUSIONS
A weight loss program administered by trained lay volunteers was effective in producing significant and clinically meaningful weight loss among African-American women who often do not benefit from typical weight loss programs. Ongoing research is focusing on whether the weight loss can be maintained or enhanced through monthly reinforcement sessions.
Disparity in Glycemic Control and Adherence Between African-American and Caucasian Youths With Diabetes: Family and community contexts
Authors: Auslander Wendy F , Thompson Sanna , Dreitzer Daniele , White Neil H , Santiago Julio V 
Published: March 2007

OBJECTIVE
To describe sociodemographic, family, and community factors that contribute to the glycemic control of African-American and Caucasian youths with diabetes, we investigated two questions: 1) Is there a disparity in glycemic control between African-American and Caucasian youths with diabetes, and if so, what sociodemographic, family, and community factors explain the disparity? and 2) Is there a difference in the adherence to treatment between African-American and Caucasian youths with diabetes, and if so, what sociodemographic, family, and community factors explain the difference?

RESEARCH DESIGN AND METHODS
This cross-sectional study included 146 youths with diabetes (95 Caucasians and 51 African-Americans) and their mothers. The youths were invited to participate if they had been diagnosed with diabetes at least 1 year before the study, did not have another chronic illness, and were &lt; 18 years of age.

RESULTS
The findings indicate that African-American youths with diabetes are in significantly poorer metabolic control than their Caucasian counterparts (1.5% difference in HbA1c levels). Single-parent household status and lower levels of adherence partially account for the poorer glycemic control. Examination of the adherence subscales indicates that African-Americans report significantly lower adherence to diet and glucose testing than Caucasian youths.

CONCLUSIONS
This study suggests that African-American youths with diabetes may be at greater risk for poor glycemic control due to the higher prevalence of single parenting and lower levels of adherence found in this population.
Factors Related to Glycemic Control in IDDM and Insulin-Treated NIDDM Patients in Current Practice: A comparison of care policies
Authors: Garancini Maria Paola , Gallus Giuseppe , Cucinotta Domenico , Rossi Andrea , Riccardi Gabriele ,   Siemtic Group
Published: March 2007

OBJECTIVE
To evaluate, under routine conditions, the relation between different diabetes care policies and glycemic control through a by-center analysis procedure aimed at reducing some drawbacks of cross-sectional data.

RESEARCH DESIGN AND METHODS
A survey on insulin-treated diabetes care management (IDDM and NIDDM) involved 16 Italian randomly selected diabetes outpatient clinics. A total of 2,142 representative patients were investigated. The standardized HbA1c average value of each center was related, by regression models, to some indicators of center care policy (average number of injections, average BMI, proportion of cases with recent fundus oculi examinations, or frequent visits) as well as to patients' average social levels (employment type). Homogeneity in patient admission criteria is assumed among the investigated centers as a basic condition for the procedure validity. Some known imbalance were controlled for both design and analysis.

RESULTS
HbA1c showed a univariate inverse relation with daily number of injections in IDDM (P = 0.0009, r2 = 0.56) but not in NIDDM (P = 0.33). It was inversely related to both fundus examination (IDDM P = 0.04; NIDDM P = 0.099) and qualified employment (IDDM P = 0.06; NIDDM P = 0.026). A stepwise regression analysis left in the model insulin injections (P = 0.0002) in IDDM (total r2 = 0.68) and qualified employment (P = 0.016) and fundus examination (P = 0.14) in NIDDM (total r2 = 0.53), after controlling for age, sex, disease duration, insulin therapy starting delay, and insulin dose per kilogram.

CONCLUSIONS
These results suggest that the confirmed benefits of a multiple-injection regimen in IDDM cannot be simply extrapolated to NIDDM, where patients' awareness and medical attention to complications proved to be the most important factors in current practice.
Reducing Plantar Pressure in the Neuropathic Foot: A comparison of footwear
Authors: Lavery Lawrence A , Vela Steven A , Fleischli John G , Armstrong David G , Lavery David C 
Published: March 2007

OBJECTIVE
To compare the effectiveness of therapeutic, comfort, and athletic shoes with and without viscoelastic insoles.

RESEARCH DESIGN AND METHODS
We compared pressure reduction at ulcer sites under the hallux (n = 10), first metatarsal (n = 10), and lesser metatarsals (n = 12), using extra-depth, athletic, and comfort shoes with and without viscoelastic insoles. A rubber-soled canvas oxford was used to establish baseline pressure values.

RESULTS
When used in conjunction with a viscoelastic insole, all shoe types reduced mean peak plantar pressure better than their non-insoled counterparts (P &lt; 0.05). Consistently, comfort shoes reduced pressure significantly better than both the cross trainers and extra-depth shoes for ulcers under the first and lesser metatarsals (P &lt; 0.05). For each shoe type, the addition of the viscoelastic insole provided a significant reduction in mean peak pressure (P &lt; 0.05). Compared with stock insoles, viscoelastic insoles reduced pressures an additional 5.4-20.1% at ulcer sites. The same trend was also observed at regions of the foot not associated with an ulceration.

CONCLUSIONS
When used in conjunction with a viscoelastic insole, both the comfort and athletic cross-trainer shoes studied were as, if not more, effective than commonly prescribed therapeutic shoes in reducing mean peak first and lesser metatarsal pressures. Furthermore, comfort shoes were as effective as therapeutic shoes in reducing pressure under the great toe. Both of these shoe types may be viable options to prevent the development or recurrence of foot ulcers.
A Prospective Study of Oral Contraceptives and NIDDM Among U.S. Women
Authors: Chasan-Taber Lisa , Willett Walter C , Stampfer Meir J , Hunter David J , Colditz Graham A , Spiegelman Donna , Manson Joann E 
Published: March 2007

OBJECTIVE
To examine prospectively the association between modern oral contraceptives with low doses of estrogen and progestin and subsequent incidence of NIDDM.

RESEARCH DESIGN AND METHODS
In a prospective cohort study, 98,590 U.S. female nurses aged 25 to 42 and free of diagnosed diabetes, coronary heart disease, stroke, and cancer at baseline in 1989 were followed for 4 years. Endpoint was incidence of confirmed NIDDM. Oral contraceptive use was reported on mailed questionnaires.

RESULTS
During 352,067 person-years follow-up, we confirmed 185 incident cases of NIDDM. After adjusting for age, BMI, cigarette smoking, family history of diabetes, parity, physical activity, alcohol intake, ethnicity, history of diagnosis of infertility, elevated cholesterol, and hypertension, women currently using oral contraceptives had a relative risk (RR) of 1.6 (95% CI, 0.9–3.1). For past users, the multivariate RR was 1.2 (95% CI, 0.8–1.8). This association was attenuated after restricting the analysis to symptomatic cases of NIDDM. For current users, RR = 1.3 (95% CI, 0.6–2.8), and for past users, RR = 0.9 (95% CI, 0.6–1.4), suggesting that increased surveillance may explain at least part of any excess risk.

CONCLUSIONS
In this large prospective study, we found no appreciable increase in the 4-year risk of NIDDM among current users of oral contraceptives. There was no apparent increase in risk among past users. The small number of cases reflect the low absolute risk of NIDDM in this population of young women.
Effects of Electrical Stimulation on Wound Healing in Patients With Diabetic Ulcers
Authors: Baker Lucinda L , Chambers Richard , DeMuth Sharon K , Villar Fernando 
Published: March 2007

OBJECTIVE
To evaluate the effects of two stimulation waveforms on healing rates in patients with diabetes and open ulcers. The hypothesis was that stimulus waveforms with minimal polar characteristics would provide significant healing for this patient sample.

RESEARCH DESIGN AND METHODS
This was a prospective study that enrolled 80 patients with open ulcers. Patients received stimulation with either an asymmetric biphasic (A) or symmetric biphasic (B) square-wave pulse. Amplitudes were set to activate intact peripheral nerves in the skin. Two other groups received either very low levels of stimulation current (MC), or no electrical stimulation (C). When combined these groups were referred to as the control group. Treatment was carried out daily until the wound healed, the patient withdrew from the study, or the physician changed the overall wound management program. Average healing rates were calculated from weekly measures of the wound perimeter and were used for statistical comparison through a one-way analysis of variance.

RESULTS
Stimulation with the A protocol significantly increased the healing rate, enhancing healing by nearly 60% over the control rate of healing. Stimulation with the B protocol did not increase the healing rate when compared with control subjects.

CONCLUSIONS
Electrical stimulation, given daily with a short pulsed, asymmetric biphasic waveform, was effective for enhancement of healing rates for patients with diabetes and open ulcers.
A Double-Masked Placebo-Controlled Trial Assessing Effects of Various Doses of BTS 67,582, a Novel Insulinotropic Agent, on Fasting Hyperglycemia in NIDDM Patients
Authors: Skillman Carmela A , Raskin Philip 
Published: March 2007

OBJECTIVE
To determine the effect over a 4-week period of varying doses of BTS 67,582, a novel nonsulfonylurea insulinotropic agent, on fasting plasma glucose (FPG) levels in sulfonylurea-responsive NIDDM patients.

RESEARCH DESIGN AND METHODS
This was a 12-week multicenter, double-masked, placebo-controlled trial. Patients entered a 4-week stabilization period during which they received their previously prescribed sulfonylurea. Qualified patients (FPG ≤ 10 mmol/l) then entered a 4-week sulfonylurea withdrawal single-masked placebo run-in period. Qualified patients (FPG 8.9–16.7 mmol/l) were randomized to either placebo (n = 14), 50 mg b.i.d. BTS 67,582 (n = 18), 250 mg b.i.d. BTS 67,582 (n = 18), 500 mg b.i.d. BTS 67,582 (n = 15), 100 mg q.d. BTS 67,582 (n = 17), or 500 mg q.d. BTS 67,582 (n = 16). The primary efficacy variables were mean changes from baseline in FPG and fructosamine (FRUC). Additional variables included mean changes from baseline in HbA1c, fasting serum insulin (FSI), and fasting serum C-peptide.

RESULTS
After 4 weeks of treatment, all BTS 67,582 dose groups showed a decrease from baseline in FPG and FRUC compared with the placebo group. The treatment groups of 250 mg b.i.d. (−3.1 ± 0.7 mmol/l), 500 mg b.i.d. (−2.3 ± 0.6 mmol/l), and 500 mg q.d. (−1.2 ± 0.7 mmol/l) had statistically significant (P &lt; 0.05) decreases in FPG compared with placebo (0.7 ± 0.6 mmol/l). Similarly, there were statistically significant (P &lt; 0.05) decreases from baseline in FRUC for the 250 mg b.i.d (−55 ± 10 μumol/l), 500 mg b.i.d. (−40 ± 12 μumol/l), and 500 mg q.d. (−13 ± 9 μumol/l) treatment groups compared with placebo (15 ± 11 μumol/l). Although the treatment period was only 4 weeks in duration, there were also significant differences (P &lt; 0.05) in the HbA1c changes from baseline for the 250 mg b.i.d. (0.0 ± 0.1%) and 500 mg b.i.d. (−0.2 ± 0.1%) treatment groups compared with placebo (0.6 ± 0.2%). There were no significant differences among the treatment groups in the changes from baseline for FSI or C-peptide levels. The most frequently reported side effects were headache, asthenia, infection, and thirst, and the incidence of these events as well as the incidence of study drug discontinuation was comparable in all treatment groups including placebo.

CONCLUSIONS
Four weeks of treatment with BTS 67,582 at doses of 250 mg b.i.d. and 500 mg b.i.d. in NIDDM patients was effective in reducing FPG and FRUC, with significant results also seen for HbA1c. The drug was well tolerated with an incidence of discontinuations and laboratory side-effect safety profiles comparable to placebo. BTS 67,582 is a safe and effective oral treatment for NIDDM patients.