bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptoms and Well-Being in Relation to Glycemic Control in Type II Diabetes
Authors: Van der Does Ferdinand E E , De Neeling J Nico D , Snoek Frank J , Kostense Pieter J , Grootenhuis Peter A , Bouter Lex M , Heine Robert J 
Published: March 2007

OBJECTIVE
To describe the cross-sectional relation between glycemic control and physical symptoms, emotional well-being, and general well-being in patients with type II diabetes.

RESEARCH DESIGN AND METHODS
The study population consisted of 188 patients with type II diabetes between 40 and 75 years of age. Patients were treated with blood glucose-lowering agents or had either a fasting venous plasma glucose level ≥7.8 mmol/l or an HbA1c level &gt; 6.1%. Multiple regression analyses were performed. Dependent variables were scores on the Type II Diabetes Symptom Checklist, the Profile of Mood States, the Affect Balance Scale, and questions regarding general well-being. The primary determinant under study was HbA1c. In addition, age, sex, neuroticism (indicating a general tendency to complain), insulin use, and comorbidity were included as determinants in all analyses. Other potential determinants taken into consideration were hypoglycemic complaints, marital status, diabetes duration, cardiovascular history, blood pressure, BMI, waist-to-hip ratio, perceived burden of treatment, and smoking. None of these potential determinants had to be included to correct confounding of the relation between HbA1c and well-being scores.

RESULTS
Higher HbA1c levels were significantly associated with higher symptom scores (total score, hyperglycemic score, and neuropathic score), with worse mood (total score, displeasure score, depression, tension, fatigue), and with worse general well-being. The relative risks varied between 1.02 and 1.36 for each percentage difference in HbA1c. The relation between HbA1c and some mood states was modified by neuroticism: in the less neurotic patient (i.e., one who is less inclined to complain), the relation was more evident.

CONCLUSIONS
These data suggest that better glycemic control in type II diabetes is associated with fewer physical symptoms, better mood, and better well-being, in a nonhypoglycemic HbA1c range.
Reduction in Severe Hypoglycemia With Long-Term Continuous Subcutaneous Insulin Infusion in Type I Diabetes
Authors: Bode Bruce W , Steed R Dennis , Davidson Paul C 
Published: March 2007

OBJECTIVE
To compare the incidence of severe hypoglycemia in patients crossed over from multiple daily injections (MDIs) of insulin to continuous subcutaneous insulin infusion (CSII).

RESEARCH DESIGN AND METHODS
From a population of 255 patients using CSII, all patients who met the following selection criteria were included in the present study: 1) a minimum of 12 months on intensive therapy with MDIs before switching to CSII, and 2) a minimum of 12 months on CSII after crossover. Glycemic control and adverse event rates for the 1-year MDI control period were compared with those for the CSII therapy period.

RESULTS
The incidence of severe hypoglycemia during MDI therapy declined from 138 to 22 events per 100 patient-years during the 1st year of CSII (P &lt; 0.0001) and remained significantly lower in years 2, 3, and 4 on CSII (26, 39, and 36, respectively). HbA1c levels did not change significantly between the MDI phase and any year on CSII. However, in the subgroup of patients who had pre-CSII HbA1c levels of ≥8.0%, the change to CSII was associated with a significant reduction in HbA1c from baseline to year 1 (8.9 ± 0.8 vs. 8.1 ± 1.0%, P = 0.0004). The difference in diabetic ketoacidosis rates between the MDI year (14.6 events per 100 patientyears) and the CSII period (7.2 events per 100 patient-years) was not statistically significant.

CONCLUSIONS
CSII therapy was associated with a marked and sustained reduction in the rate of severe hypoglycemia without adversely affecting the level of glycemic control attained during MDI therapy. The more reproducible and flexible insulin delivery afforded by CSII was considered to be the major factor contributing to the improvement in severe hypoglycemia rates.
A Metabolic Syndrome in Whites and African-Americans: The Atherosclerosis Risk in Communities baseline study
Authors: Schmidt Maria Inês , Duncan Bruce B , Watson Robert L , Sharrett A Richey , Brancati Frederick L , Heiss Gerardo ,   The Atherosclerosis Risk in Communities Study Investigators
Published: March 2007

OBJECTIVE
To describe clustering of hypertriglyceridemia, low HDL cholesterol, hypertension, diabetes, and hyperuricemia and its association with fasting insulin, waist-to-hip ratio (WHR), and BMI for African-American and white men and women.

RESEARCH DESIGN AND METHODS
Observed frequencies of clusters were compared with those expected in 14,481 participants, 45-64 years of age, of the Atherosclerosis Risk in Communities (ARIC) baseline survey, 1987–1989. Associations of clusters with insulin, central adiposity, and overall obesity, as well as with abnormalities, were analyzed through multiple logistic regression.

RESULTS
Clustering beyond chance was observed in all four sex/ethnic groups (P &lt; 0.001), with 7% of the sample presenting 30% of the abnormalities in large clusters (≥ 3 abnormalities per individual). The odds ratio (OR) for the association of each abnormality with clustering of the remaining four ranged from 1.6 to 8.8 (P &lt; 0.01). These odds of clustering were notably large in white women. Of the abnormalities, hypertriglyceridemia demonstrated the highest OR (5.0–8.8) and diabetes had the lower OR in African-American subjects than in white subjects (P &lt; 0.001). Insulin, WHR, and BMI were statistically associated with clustering in all groups (P &lt; 0.001, except for BMI in African-Americans.

CONCLUSIONS
Clustering of abnormalities consistent with the concept of a metabolic syndrome is present in both white and African-American subjects.
Trends in Hospital Admissions Among Children Aged 0–19 Years with Type I Diabetes in The Netherlands
Authors: Hirasing Remy A , Reeser H Maarten , de Groot Regina R M , Ruwaard Dirk , Van Buuren Stef , Verloove-Vanhorick S Pauline 
Published: March 2007

OBJECTIVE
To determine the number and duration of hospital admissions due to diabetes in children aged 0–19 years between 1980–1991.

RESEARCH DESIGN AND METHODS
Secondary analysis of data collected by the SIG Health Care Information was based on the 9th revision of the International Classification of Diseases. The subjects were all children in The Netherlands, aged 0–19 years. The main outcome measures were number and duration of hospital admissions due to type I diabetes (ICD 9 code 250.0–250.9).

RESULTS
The hospital admission rate due to diabetes decreased &gt; 30%. This decrease was statistically significant in all age subgroups. The total number of days in hospital due to diabetes decreased dramatically: from 24,961 in 1980 to 11,305 in 1991. The average duration of hospital stay length due to diabetes decreased as well from 14.5 days in 1980 to 11.9 days in 1991.

CONCLUSIONS
The hospital admission rate and the length of hospital stay for diabetes in children aged 0–19 years have decreased, in spite of an increasing incidence. The hospital admission rate may decrease still further if more children with newly diagnosed diabetes can be adequately managed by team management at home in the initial phase.
GHb Is a Better Predictor of Cardiovascular Disease Than Fasting or Postchallenge Plasma Glucose in Women Without Diabetes: The Rancho Bernardo Study
Authors: Park Sue , Barrett-Connor Elizabeth , Wingard Deborah L , Shan Jun , Edelstein Sharon 
Published: March 2007

OBJECTIVE
To examine the relation between GHb, fasting plasma glucose (FPG), postchallenge plasma glucose (PCPG), and mortality from cardiovascular disease (CVD) and ischemic heart disease (IHD) in older adults.

RESEARCH DESIGN AND METHODS
A community-based study of 1,239 nondiabetic older adults followed for an average of 8 years, from baseline (1984–1987) to 1993.

RESULTS
GHb, but not FPG or PCPG, was significantly related to CVD and IHD mortality in women but not men. The age-adjusted relative hazard for those in the highest quintile of GHb (≥ 6.7%) compared with women with lower levels was 2.37 for fatal CVD (95% CI = 1.30−4.31, P = 0.005) and 2.43 for IHD (95% CI = 1.12−5.25, P = 0.024). This association persisted after adjustment for all covariates (age, systolic blood pressure, BMI, LDL, HDL, triglycerides, cigarette smoking, antihypertensive medication use, and estrogen use). GHb was significantly associated with LDL and HDL levels in women, but the association between GHb and CVD or IHD persisted after adjustment for these lipoproteins.

CONCLUSIONS
We concluded that GHb is a better predictor of CVD and IHD mortality than FPG or PCPG in women without diabetes; no single measure of glycemia was predictive in men. The reason for the sex difference is unexplained.
A Family History of NIDDM Is Associated With Decreased Aortic Distensibility in Normal Healthy Young Adult Subjects
Authors: Hopkins Kathileen D , Lehmann Eldon D , Jones Robin L , Turay Ramina C , Gosling Ray G 
Published: March 2007

OBJECTIVE
NIDDM is associated with stiffer arteries and an increased incidence of macrovascular disease. NIDDM has strong familial inheritance. We studied the associations of a family history of NIDDM with blood pressure-corrected aortic distensibility (Cp).

RESEARCH DESIGN AND METHODS
Because age is a strong determinant of arterial distensibility, we studied an age-select cohort of 67 healthy normotensive normoglycemic young adults along with fasting measurements of glucose and insulin concentrations. Cp was calculated from noninvasive Doppler ultrasound measurements of pulse wave velocity along the descending thoracoabdominal aorta.

RESULTS
The mean age of the subjects was 20.6 ± 0.7 (mean ± SD) years. A total of 22 subjects gave a positive family history of NIDDM in a parent or grandparent. Subjects with a positive family history of NIDDM had significantly less distensible (i.e., stiffer) aortas than their age- and sex-matched counterparts who gave no family history of NIDDM (Cp [dimensionless]: 0.22 ± 0.04 vs. 0.25 ± 0.04, P = 0.02). Subjects with a positive family history of NIDDM also had significantly higher fasting glucose (5.1 ± 0.4 vs. 4.9 ± 0.4 mmol/l, P = 0.009) and insulin (7.5 ± 5.5 vs. 4.2 ± 2.0 mU/l, P = 0.02) levels and BMIs (23.2 ± 2.3 vs 21.1 ± 2.5 kg/m2, P = 0.002). On multivariate regression analysis, family history of NIDDM (P = 0.03) was the only significant independent predictor of Cp.

CONCLUSIONS
A positive family history of NIDDM is associated with decreased aortic distensibility in early adult life. The relevance of these observations to future cardiovascular events merits further investigation.
Does Suppression of Postprandial Blood Glucose Excursions by the α-Glucosidase Inhibitor Miglitol Improve Insulin Sensitivity in Diet-Treated Type II Diabetic Patients?
Authors: Johnson Andrew B , Taylor Roy 
Published: March 2007

OBJECTIVE
Insulin sensitivity is impaired in patients with type II diabetes and is exacerbated by high mean blood glucose (BG). Potentially, large postprandial swings in BG could result in further decrements of insulin sensitivity. Because alpha-glucosidase inhibitors cause a marked reduction in the amplitude of BG changes, the aim of this study was to determine if such a BG-smoothing effect improves insulin sensitivity in well-controlled type II diabetic subjects treated with diet alone.

RESEARCH DESIGN AND METHODS
Patients received either miglitol (BAY m 1099) (50 mg three times daily) or placebo for 8 weeks in a randomized double-blind parallel study. The miglitol (9 men, 2 women) and placebo (7 men, 3 women) groups were well matched (mean ± SD) for age, weight, and blood glucose control (fasting BG, 6.4 ± 1.0 vs. 6.9 ± 1.6 mmol/l; HbA1, 7.7 ± 1.0 vs. 7.9 ± 0.4%; fructosamine, 0.99 ± 0.08 vs. 1.07 ± 0.17 mmol/l). The glucose metabolic clearance rate was calculated during the last 30 min of a 150 min glucose/insulin sensitivity test (glucose, 6 mg · kg−1 · min−1; insulin, 0.5 U · kg−1 · min−1).

RESULTS
There was no significant improvement in metabolic clearance rate (0.21 ± 0.27 vs. 0.16 ± 0.35 l · kg−1 · min−1) for the miglitol- and placebo-treated groups, respectively. There were no statistically significant differences between miglitol and placebo for changes from baseline in BG (0.1 ± 0.1 vs. -0.1 ± 0.2 mmol/l), HbA1 (0.1 ± 0.1 vs. 0.3 ± 0.1%), and fructosamine (−0.06 ± 0.02 vs. −0.03 ± 0.02 mmol/l).

CONCLUSIONS
α-glucosidase-induced improvement in postprandial hyperglycemia does not result in increased insulin sensitivity.
Increased Resting and Exercise-Induced Oxidative Stress in Young IDDM Men
Authors: Laaksonen David E , Atalay Mustafa , Niskanen Leo , Uusitupa Matti , Hänninen Osmo , Sen Chandan K 
Published: March 2007

OBJECTIVE
To assess the effect of acute physical exercise on oxidative stress and glutathione redox status and the relation to physical fitness in otherwise healthy young men with IDDM.

RESEARCH DESIGN AND METHODS
Nine men with IDDM (HbA1c 7.3 ± 1.7%), ages 21–30 years, and 13 matched control subjects exercised on a bicycle ergometer for 40 min at 60% of their maximal oxygen consumption (VO2max). Oxidative stress was assessed with plasma thiobarbituric acid reactive substance (TBARS) levels (an index of lipid peroxidation) and, in response to exercise, also glutathione redox status. For glutathione redox status, blood total glutathione (TGSH) and oxidized glutathione (GSSG) were determined. Blood samples were drawn immediately before and after exercise.

RESULTS
Resting plasma TBARS levels were markedly elevated in diabetic patients (2.2 ± 0.7 vs. 0.9 ± 0.4 μumol/l; P = 0.0002). Mean blood TGSH was higher in diabetic subjects (1,203 ± 221 vs. 936 ± 156 mmol/l; P = 0.002), with no significant difference in GSSG or GSSG/TGSH values. Exercise increased plasma TBARS and blood GSSG by ∼50% in both groups. Resting plasma TBARS had a strong inverse correlation (r = −0.82; P = 0.006), and the exercise-induced percentage increase in TBARS had a strong positive correlation (r = 0.81, P = 0.008) with VO2max in diabetic subjects only.

CONCLUSIONS
Glutathione redox status appears to be adequate in healthy young moderately active diabetic men. On the other hand, they demonstrated increased resting and postexercise oxidative stress as indicated by plasma TBARS. Although exercise acutely induces oxidative stress, in patients with diabetes, physical fitness may have a protective effect against oxidative stress.
Glycemic Responses to Exercise in IDDM After Simple and Complex Carbohydrate Supplementation
Authors: Soo Karen , Furler Stuart M , Samaras Katherine , Jenkins Arthur B , Campbell Lesley V , Chisholm Donald J 
Published: March 2007

OBJECTIVE
Subjects with IDDM should take carbohydrate before exercise to avoid hypoglycemia. However, there is little information on the glycemic effect of recommended supplementation. This study is aimed to determine the glycemic effects of oral glucose or bread (30 g carbohydrate) before 45 min of moderate exercise.

RESEARCH DESIGN AND METHODS
Nine subjects with uncomplicated IDDM did 45 min of bicycle ergometer exercise at 60% VO2max in the morning before insulin injection on three occasions: 1) with no carbohydrate supplement, 2) with 30 g glucose in water at −5 min, and 3) with 30 g carbohydrate as white bread with water at −20 min. The glycemic responses were determined. The glycemic responses to glucose and bread were also determined without exercise in six subjects.

RESULTS
Without carbohydrate, exercise caused a small fall (−1.2 ± 0.6 mmol/l, mean ± SE) in plasma glucose (PG). With either glucose or bread, PG rose (the change in plasma glucose relative to basal [Δ PG] = 5.1 ± 0.8 and 2.6 ± 0.8, respectively). The rise was greater (P &lt; 0.01) without exercise (Δ PG = 6.9 ± 0.7 and 4.5 ± 0.7, respectively). During exercise, glucose increased PG levels more than bread increased glucose levels P &lt; 0.05).

CONCLUSIONS
Before morning insulin injection, the fall in PG during moderate exercise in IDDM subjects is generally small or absent. The glycemic effects of complex carbohydrate are slightly &lt; glucose before exercise. Under these circumstances, the usually recommended amount of carbohydrate tends to cause an unwanted elevation of PG; thus, IDDM subjects should anticipate reducing or even omitting carbohydrate supplementation after monitoring their individual glycemic response.
Risk Factors Predicting Lower Extremity Amputations in Patients With NIDDM
Authors: Lehto Seppo , Rönnemaa Tapani , Pyörälä Kalevi , Laakso Markku 
Published: March 2007

OBJECTIVE
To examine the predictors of lower extremity amputation in patients with NIDDM.

RESEARCH DESIGN AND METHODS
At baseline, risk factors for amputation were determined in 1,044 NIDDM patients (571 men, 473 women) aged 45 to 64 years. These patients were followed up to 7 years with respect to amputation.

RESULTS
The incidence of amputation was 5.6% in men and 5.3% in women. High fasting plasma glucose at baseline examination and the duration of diabetes were associated with a twofold risk for amputation. Similarly, glycemic control measured at baseline by HbA1 was an important predictor of amputation. There was a dose-response relationship between plasma glucose or HbA1 and the risk for amputation. The effect of hyperglycemia on the risk of amputation was seen clearly even after the adjustment for other cardiovascular risk factors. Signs of peripheral neuropathy and bilateral absence of Achilles tendon reflexes and vibration sense were important predictors for amputation. Furthermore, absent peripheral artery pulses and femoral artery bruit on auscultation predicted amputation.

CONCLUSIONS
Our 7-year follow-up study gives strong evidence that poor glycemic control is an important predictor of amputation in patients with NIDDM in addition to clinically detectable peripheral arterial disease and peripheral neuropathy.
Diabetes and Nontraumatic Lower Extremity Amputations: Incidence, risk factors, and prevention—a 12-year follow-up study in Nauru
Authors: Humphrey A R G , Dowse G K , Thoma K , Zimmet P Z 
Published: March 2007

OBJECTIVE
To measure the 12-year incidence (1982–1994) of nontraumatic lower extremity amputations (LEAs) in Nauruans, a population at high risk for NIDDM, and to determine the risk factors for amputation in Nauruans with diabetes.

RESEARCH DESIGN AND METHODS
Amputation data were abstracted from operating theater records in Nauru, hospital databases in Australia, and Nauru government records. Baseline characteristics of a cohort of 1,564 Nauruans aged ≥ 20 years examined during a population-based survey in 1982 were used to determine risk factors for first LEAs.

RESULTS
Over this 12-year period, 46 first LEAs were performed on people with NIDDM, of whom 30 were members of the 1982 study cohort. The incidence of first LEAs in Nauruans aged ≥ 25 years with NIDDM was 8.1 per 1,000 person-years in the study cohort and an estimated 7.6 per 1,000 person-years nationally. Amputations were associated significantly with lower BMI, lower blood pressure, higher fasting plasma glucose (FPG) level, and longer mean duration of diabetes at baseline, but levels of other risk factors, including cigarette smoking, plasma triglycerides, and plasma cholesterol, were also elevated in amputees. There were no amputations among individuals with baseline FPG levels &lt; 7.8 mmol/l, irrespective of diabetes duration. FPG, baseline diabetes duration, and male sex were independent risk factors for first amputation using the Cox proportional hazards model. There was a decrease in the incidence of amputations after the commencement of a national foot care health education and prevention campaign in June 1992.

CONCLUSIONS
The incidence of LEAs in diabetic Nauruans was higher than in other populations after adjusting for age and duration. Given the apparent success of the Nauruan footcare program in reducing amputation rates, other populations with high rates of NIDDM and LEAs should consider population-wide prevention strategies.
The Natural Progression of Autonomic Neuropathy and Autonomic Function Tests in a Cohort of People With IDDM
Authors: Levitt Naomi S , Stansberry Kevin B , Wynchank Sinclair , Vinik Aaron I 
Published: March 2007

OBJECTIVE
To test the natural progression of symptoms of autonomic neuropathy (AN) and function tests in subjects with IDDM.

RESEARCH DESIGN AND METHODS
Seventy-six subjects with IDDM of &lt; 10 years duration had cardiovascular autonomic reflex tests and were evaluated for signs and symptoms of AN.

RESULTS
Fifty-seven subjects (66%) were available for restudy 9 years later (15 had died, 4 could not be located). Of the symptoms of AN, only gastroparesis increased in prevalence (P &lt; 0.01). Of the five cardiovascular AN measures, only the R-R response to the Valsalva maneuver deteriorated (F[1,44] = 10.61, P &lt; 0.01).

CONCLUSIONS
The progression of AN in IDDM is monitored best longitudinally by the Valsalva maneuver because of the small variance ratio in repeated measures. Prevalence rates can be monitored by expiration-to-inspiration R-R or Valsalva ratios. Most clinical signs and symptoms of AN do not progress, underscoring the need for objective and quantitative autonomic function tests to identify people at risk for premature death.
Glycemic Effect of a Single High Oral Dose of the Novel Sweetener Sucralose in Patients With Diabetes
Authors: Mezitis Nicholas H E , Maggio Carol A , Koch Pamela , Quddoos Arshad , Allison David B , Pi-Sunyer F Xavier 
Published: March 2007

OBJECTIVE
To examine the effect of a single high oral dose of the novel noncaloric sweetener sucralose on short-term glucose homeostasis in patients with IDDM or NIDDM.

RESEARCH DESIGN AND METHODS
A total of 13 IDDM and 13 NIDDM patients with glycosylated hemoglobin levels &lt; 10% completed this double-blind cross-over study. After an overnight fast, patients were administered opaque capsules containing either 1,000 mg sucralose or cellulose placebo, followed by a standardized 360-kcal liquid breakfast. Plasma glucose and serum C-peptide levels were measured over the next 4 h.

RESULTS
Regardless of the type of diabetes, areas under the curves for changes of plasma glucose and serum C-peptide levels after sucralose administration were not significantly different from those after placebo. During test meals with sucralose, one episode of symptomatic hypoglycemia occurred in each of three IDDM patients, but these episodes were not considered the result of sucralose administration.

CONCLUSIONS
The present results support the conclusion that sucralose consumption does not adversely affect short-term blood glucose control in patients with diabetes.