bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes and Impaired Glucose Tolerance Among the Inuit Population of Greenland
Authors: Jørgensen Marit E. , Bjeregaard Peter , Borch-Johnsen Knut , Backer Vibeke , Becker Ulrik , Jørgensen Torben , Mulvad Gert 
Published: March 2007

OBJECTIVE—To assess the prevalence of diabetes and impaired glucose tolerance (IGT) among the Inuit population of Greenland and to determine risk factors for developing glucose intolerance.
RESEARCH DESIGN AND METHODS—This cross-sectional study included 917 randomly selected adult Inuit subjects living in three areas of Greenland. Diabetes and IGT were diagnosed using the oral glucose tolerance test. BMI and waist-to-hip ratio were measured and blood samples were taken from each subject. Sociodemographic characteristics were investigated using a questionnaire.
RESULTS—The age-standardized prevalences of diabetes and IGT were 10.8 and 9.4% among men and 8.8 and 14.1% among women, respectively. Of those with diabetes, 70% had not been previously diagnosed. Significant risk factors for diabetes were family history of diabetes, age, BMI, and high alcohol consumption, whereas frequent intake of fresh fruit and seal meat were inversely associated with diabetic status. Age, BMI, family history of diabetes, sedentary lifestyle, and place of residence were significant predictors of IGT.
CONCLUSIONS—The prevalence of diabetes is high among the Inuit of Greenland. Heredity was a major factor, while obesity and diet were important environmental factors. The high proportion of unknown cases suggests a need for increased diabetes awareness in Greenland.
Diabetes and the Risk of Acute Urinary Tract Infection Among Postmenopausal Women
Authors: Boyko Edward J. , Fihn Stephan D. , Scholes Delia , Chen Chi-Ling , Normand Esther H. , Yarbro Patricia 
Published: March 2007

OBJECTIVE—To examine whether the presence of diabetes alters the risk of acute urinary tract infection (UTI) in postmenopausal women.
RESEARCH DESIGN AND METHODS—A case-control study of the Group Health Cooperative of Puget Sound (GHC), a staff-model nonprofit health maintenance organization in Washington State, was conducted. Subjects were women aged 55–75 years who had been members of GHC for at least 1 year and who had had an acute symptomatic UTI within the preceding month. Laboratory files were used to identify women with a urine culture that grew ≥105 colonies of a urinary pathogen. Medical records were reviewed to confirm the presence of acute, clinically symptomatic UTI. Control subjects were randomly selected from the GHC enrollment file, screened to remove women with recent UTI, and frequency matched to cases by age within 2 years. An interviewer ascertained self-reported clinician-diagnosed diabetes. Diagnosis of diabetes was confirmed by the GHC diabetes registry. A subsample of women underwent measurement of postvoid residual bladder volume (n = 748) and culture of vaginal flora (n = 454).
RESULTS—Of the 901 case and 913 control subjects, diabetes was reported in 13.1 and 6.8%, respectively. The health plan diabetes registry confirmed the diagnosis in 92% of women who self-reported the condition. The age-adjusted odds ratio (OR) for UTI in relation to self-reported clinician-diagnosed diabetes was 2.2 (95% CI 1.6–3.0). Adjustment for frequency of sexual intercourse and history of UTI had little effect on this estimate. Compared with nondiabetic women, higher UTI odds were seen in subjects who used oral hypoglycemic agents (OR 2.9 [95% CI 1.7–5.1]) and insulin (2.6 [1.5–4.6]) but not in subjects with untreated diabetes or diabetes treated by lifestyle changes (1.3 [0.7–2.3]). No significant difference was seen in the OR for UTI in diabetic women with disease of shorter duration (&lt;10 years, OR 1.9) or longer duration (≥10 years, OR 2.6) or in relation to HbA1c level. Similar microbiologic pathogens were seen in diabetic and nondiabetic women. No significant differences were seen by diabetes status in mean postvoid residual bladder volume or vaginal flora.
CONCLUSIONS—Diabetes under pharmacologic treatment is associated with increased risk of clinically apparent UTI in postmenopausal women.
Diabetic Neuropathic Foot Ulcers
Authors: Margolis David J. , Allen-Taylor Lynne , Hoffstad Ole , Berlin Jesse A. 
Published: March 2007

OBJECTIVE—The goal of this study was to evaluate whether simple risk factors can be identified that successfully characterize who will heal and who will not heal among patients who have received standard therapy for diabetic neuropathic foot ulcers.
RESEARCH DESIGN AND METHODS—For this cohort study, we evaluated &gt;31,000 individuals with a diabetic neuropathic foot ulcer seen in the Curative Health Services System. Using multivariate logistic regression, we evaluated the association between wound size, wound duration, wound grade, and other variables and their effect on whether a patient would heal by the 20th week of care.
RESULTS—We demonstrated that wound size, wound duration, and wound grade are all significantly associated with the likelihood of a wound healing by the 20th week of care. In addition, we noted that these associations were not significantly affected by the treating wound care center, whether the unit of analysis was one wound on a patient or all of their wounds, or current adjuvant therapies.
CONCLUSIONS—We have shown that three easy-to-measure risk factors are associated with a wound healing. These results should help clinicians understand the likelihood that a wound will heal and help those conducting clinical investigations to design better trials.
Small Bowel Motility Affects Glucose Absorption in a Healthy Man
Authors: Schwartz Matthijs P. , Samsom Melvin , Renooij Willem , van Steenderen Leo W. , Benninga Marc A. , van Geenen Erwin-Jan M. , van Herwaarden Margot A. , de Smet Martin B.M. , Smout André J.P.M. 
Published: March 2007

OBJECTIVE—To investigate the relationship between duodenojejunal motor activity and glucose absorption and to evaluate the effect of modification of duodenojejunal motility on glucose absorption by using the prokinetic drug cisapride.
RESEARCH DESIGN AND METHODS—We examined seven healthy males, mean age 22 years, who were treated with cisapride 10 mg t.i.d. and placebo during 3 days in a randomized order, with a 2-week time interval. Duodenojejunal manometry was performed after each treatment on the morning of day 3, using an 18-lumen catheter. A liquid nutrient (3 kcal/min) was administered intraduodenally for 30 min, followed by a bolus of the glucose analog 3-O-methylglucose (3-OMG). Plasma 3-OMG concentrations were measured to assess absorption kinetics.
RESULTS—The area under the 3-OMG concentration curve in the first 30 min after infusion was related to the number of antegrade propagated pressure waves (r = 0.49, P &lt; 0.05), but not to the peak concentration, time to peak, and absorption fraction. The mean amplitude of pressure waves was higher during cisapride than placebo (P &lt; 0.05), but the reoccurrence of interdigestive motility, numbers of pressure waves, and propagated pressure waves, as well as 3-OMG absorption characteristics, were not significantly different between the two treatments. During both treatments &gt;60% of antegrade propagated pressure waves were propagated over a very short distance (1.5 cm).
CONCLUSIONS—Glucose absorption in the human small intestine is related to short-traveling propagated intestinal contractile activity. Cisapride increases the amplitude of pressure waves, but does not affect the organization of pressure waves or the absorption of 3-OMG.
Effects of Vitamin E on Cardiovascular and Microvascular Outcomes in High-Risk Patients With Diabetes
Authors: Lonn Eva , Yusuf Salim , Hoogwerf Byrcon , Pogue Janice , Yi Qilong , Zinman Bernard , Bosch Jackie , Dagenais Gilles , Mann Johannes F.E. , Gerstein Hertzel C. ,   on behalf of the Heart Outcomes Prevention Evaluation (HOPE) Investigators
Published: March 2007

OBJECTIVES—Experimental and observational studies suggest that vitamin E may reduce the risk of cardiovascular (CV) events and of microvascular complications in people with diabetes. However, data from randomized clinical trials are limited. Therefore, we evaluated the effects of vitamin E supplementation on major CV outcomes and on the development of nephropathy in people with diabetes.
RESEARCH DESIGN AND METHODS—The Heart Outcomes Prevention Evaluation (HOPE) trial is a randomized clinical trial with a 2 × 2 factorial design, which evaluated the effects of vitamin E and of ramipril in patients at high risk for CV events. Patients were eligible for the study if they were 55 years or older and if they had CV disease or diabetes with at least one additional coronary risk factor. The study was designed to recruit a large number of people with diabetes, and the analyses of the effects of vitamin E in this group were preplanned. Patients were randomly allocated to daily treatment with 400 IU vitamin E and with 10 mg ramipril or their respective placebos and were followed for an average of 4.5 years. The primary study outcome was the composite of myocardial infarction, stroke, or CV death. Secondary outcomes included total mortality, hospitalizations for heart failure, hospitalizations for unstable angina, revascularizations, and overt nephropathy.
RESULTS—There were 3,654 people with diabetes. Vitamin E had a neutral effect on the primary study outcome (relative risk = 1.03, 95% CI 0.88–1.21; P = 0.70), on each component of the composite primary outcome, and on all predefined secondary outcomes.
CONCLUSIONS—The daily administration of 400 IU vitamin E for an average of 4.5 years to middle-aged and elderly people with diabetes and CV disease and/or additional coronary risk factor(s) has no effect on CV outcomes or nephropathy.
Acute Effect of Glimepiride on Insulin-Stimulated Glucose Metabolism in Glucose-Tolerant Insulin-Resistant Offspring of Patients With Type 2 Diabetes
Authors: Overkamp Dietrich , Volk Annette , Maerker Elke , Heide Peter E. , Wahl Hans G. , Rett Kristian , Häring Hans U. 
Published: March 2007

OBJECTIVE—This study addressed whether acute infusion of glimepiride influences glucose metabolism independent of its effect on insulin secretion.
RESEARCH DESIGN AND METHODS—Ten healthy, glucose-tolerant but insulin-resistant probands were subjected to a placebo-controlled, double-blind, cross-over study. Each individual received infusions of either 0.15 mol/l saline or glimepiride in randomized order on two separate occasions. A three-step hyperinsulinemic (0.5, 1.0, and 1.5 mU · kg−1 · min−1)-euglycemic glucose clamp was performed on both occasions to determine insulin sensitivity. Glimepiride-induced insulin secretion was inhibited by octreotide. Endogenous glucose production and glucose elimination were measured with the “hot” glucose infusion method using U-[13C]glucose as tracer. Glucose oxidation was determined from indirect calorimetry. Lipolysis was evaluated by measurements of nonesterified fatty acid (NEFA) and glycerol concentration and measurement of glycerol production.
RESULTS—Plasma glucose and insulin concentrations were not significantly different between glimepiride or saline infusions. There was a significant increase in the rate of glucose infusion necessary to maintain euglycemia during infusion of glimepiride during the low- (12.2 ± 1.1 vs. 16.1 ± 1.7 μmol · kg−1· min−1) and intermediate-dose insulin infusion (24.4 ± 1.7 vs. 30.0 ± 2.8 μmol · kg−1 · min−1). This was explained by an increased rate of glucose elimination and to a lesser degree by a decrease in glucose production. Glucose oxidation rate was not different. NEFA and glycerol concentration and glycerol production were equally suppressed.
CONCLUSIONS—Glimepiride improves peripheral glucose uptake and decreases endogenous glucose production independent of its insulin secretagogue action. The effects shown in this acute study are, however, too small to be considered therapeutically beneficial for the individual patient.
Bimodality in Blood Glucose Distribution
Authors: Lim Teck-Onn , Bakri Rugayah , Morad Zaki , Hamid Maimunah A. 
Published: March 2007

OBJECTIVE—Bimodality in blood glucose (BG) distribution has been demonstrated in several populations with a high prevalence of diabetes and obesity. However, other population studies had not found bimodality, thus casting doubt on its universality. We address this question in four ethnic populations—namely Malay, Chinese, Indian, and the indigenous people of Borneo.
RESEARCH DESIGN AND METHODS—A national health survey was conducted in Malaysia in 1996. A total of 18,397 subjects aged ≥30 years had post-challenge BG measurements taken. To test whether BG was consistent with a bimodal distribution, we fitted unimodal normal and skewed distribution as well a mixture of two normal distributions to the data by age and ethnic groups.
RESULTS—Age-specific prevalence of diabetes varied from 1.3 to 26.3%. In all ethnic/age groups, the bimodal model fitted the log BG data better (likelihood ratio tests, all P values &lt;0.001).
CONCLUSIONS—Bimodality in BG distribution is demonstrable even in populations with a very low prevalence of diabetes and obesity. Previous studies that found unimodality had failed to detect the second mode because of inadequate sample size, bias due to treatment of subjects with known diabetes, and inclusion of subjects with type 1 diabetes in the sample. Bimodality implies that diabetes is a distinct entity rather than an arbitrarily defined extreme end of a continuously distributed measurement.
Reduction of Blood Glucose Variability in Type 1 Diabetic Patients Treated By Pancreatic Islet Transplantation
Authors: Kessler Laurence , Passemard Raphael , Oberholzer Jose , Benhamou Pierre Yves , Bucher Pascal , Toso Christian , Meyer Pierre , Penfornis Alfred , Badet Lionel , Wolf Philippe , Colin Cyrille , Morel Philippe , Pinget Michel ,   on behalf of the GRAGIL Group
Published: March 2007

OBJECTIVE—To compare the glycemic profiles of patients with type 1 diabetes treated with either an implantable insulin pump or pancreas or islet transplantation by the means of the continuous glucose monitoring system (CGMS; Minimed, Sylmar, CA).RESEARCH DESIGN AND METHODS—The CGMS enabled recording of subcutaneous glucose concentrations (range 2.2–22 mmol/l) over 72 h (288 measurements per day). Over 3 days, 26 patients with type 1 diabetes were connected to a CGMS: 10 patients were treated with intraperitoneal insulin infusion through an implantable pump (IPII), 9 patients were treated with simultaneous pancreas-kidney transplantation (SPK), and 7 patients were treated with pancreatic islet transplantation after kidney grafting (IAK). All SPK patients and four IAK patients were insulin independent, whereas three IAK patients had partial graft function and reduced exogenous insulin needs. Glucose control was evaluated by the mean glucose concentration, glucose variability, and the number and duration of hypoglycemic events (&lt;3.3 mmol/l) over 3 days.RESULTS—The mean glucose concentration and the glucose variability in SPK and IAK patients were significantly lower than those observed in patients treated with IPII: 5.38 ± 1.12 and 5.83 ± 0.81 vs. 7.81 ± 1.55 mmol/l (P &lt; 0.001) and 1.40 ± 0.42 and 1.32 ± 0.53 vs. 3.47 ± 1.66 mmol/l (P &lt; 0.001), respectively. Furthermore, the mean glucose concentration and the glucose variability were comparable between SPK and IAK patients. Over 3 days, no hypoglycemic events were observed in SPK patients and insulin-independent IAK patients. A total of 4.12 ± 1.66 hypoglycemic events were detected in the IPII patient group, whereas only 0.66 ± 0.57 events were observed in IAK patients with partial graft function (P &lt; 0.001). The duration of the hypoglycemic events was significantly longer in IPII patients as compared with IAK patients: 64 ± 33 vs. 30 ± 15 min for the day period and 130 ± 62 vs. 30 ± 27 min for the night period (P &lt; 0.001).CONCLUSIONS—Use of subcutaneous CGMS confirms that islet transplantation can be as efficient as pancreas transplantation in restoring good metabolic control and reducing blood glucose variability. Metabolic improvement due to use of an implantable insulin pump requires insulin delivery by a closed loop.
Effects of Energy-Restricted Diets Containing Increased Protein on Weight Loss, Resting Energy Expenditure, and the Thermic Effect of Feeding in Type 2 Diabetes
Authors: Luscombe N.D. , Clifton P.M. , Noakes M. , Parker B. , Wittert G. 
Published: March 2007

OBJECTIVE—To determine the effect of a high-protein (HP) diet compared with a low-protein (LP) diet on weight loss, resting energy expenditure (REE), and the thermic effect of food (TEF) in subjects with type 2 diabetes during moderate energy restriction.RESEARCH DESIGN AND METHODS—In this study, 26 obese subjects with type 2 diabetes consumed a HP (28% protein, 42% carbohydrate) or LP diet (16% protein, 55% carbohydrate) during 8 weeks of energy restriction (1,600 kcal/day) and 4 weeks of energy balance. Body weight and composition and REE were measured, and the TEF in response to a HP or LP meal was determined for 2 h, at weeks 0 and 12.RESULTS—The mean weight loss was 4.6 ± 0.4 kg (P &lt; 0.001), of which 4.5 ± 0.4 kg was fat (P &lt; 0.001), with no effect of diet (P = 0.6). At both weeks 0 and 12, TEF was greater after the HP than after the LP meal (0.064 vs. 0.050 kcal · kcal−1 energy consumed · 2 h−1, respectively; overall diet effect, P = 0.003). REE and TEF were reduced similarly with each of the diets (time effects, P = 0.02 and P &lt; 0.001, respectively).CONCLUSIONS—In patients with type 2 diabetes, a low-fat diet with an increased protein-to-carbohydrate ratio does not significantly increase weight loss or blunt the fall in REE.
Morning Hyperglycemic Excursions
Authors: Monnier Louis , Colette Claude , Rabasa-Lhoret Rémy , Lapinski Hélène , Caubel Cécile , Avignon Antoine , Boniface Hélène 
Published: March 2007

OBJECTIVE—To determine whether, over daytime, one or several hyperglycemic excursions exist that can be general failures in the glycemic control of patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—In 200 non–insulin-using patients with type 2 diabetes, diurnal plasma glucose and insulin profiles were studied. Plasma glucose concentrations were measured after an overnight fast (at 8:00 a.m. immediately before breakfast), during the postprandial period (at 11:00 a.m. and 2:00 p.m.), and during the postabsorptive period (at 5:00 p.m., extended postlunch time).
RESULTS—In the population considered as a whole, prelunch glucose concentrations (12.0 mmol/l) were found to be significantly increased (P &lt; 0.0001) when compared with those observed at 8:00 a.m. (8.8 mmol/l), at 2:00 p.m. (10.5 mmol/l), and at 5:00 p.m. (8.6 mmol/l). Similar significant excursions (P &lt; 0.0001) in prelunch glucose were observed within subsets of patients selected from the following criteria: 1) body weight, 2) HbA1c, 3) categories of treatment, and 4) residual β-cell function. From the calculation of areas under the daytime glucose curves, the relative contributions of postprandial and fasting glucose to the total glucose increment were found to be similar.
CONCLUSIONS—High plasma glucose excursions over morning periods seem to be a permanent failure in non–insulin-using patients with type 2 diabetes, whatever the clinical (BMI), biological (HbA1c), therapeutic, and pathophysiological (residual β-cell function) status. Midmorning glucose testing should be recommended for detecting such abnormalities and for correcting them with appropriate therapies.
Immune Responses to Insulin Aspart and Biphasic Insulin Aspart in People With Type 1 and Type 2 Diabetes
Authors: Lindholm Anders , Jensen Lisbeth B. , Home Philip D. , Raskin Philip , Boehm Bernhard O. , Råstam Jacob ,   for the European and North American Study Groups on Insulin Aspart
Published: March 2007

OBJECTIVE—The antibody responses to a novel rapid-acting insulin analog, insulin aspart (IAsp), and their potential clinical correlates were studied with a specifically developed method in 2,420 people with diabetes treated for up to 1 year with preprandial subcutaneous injections of IAsp.
RESEARCH DESIGN AND METHODS—Circulating insulin antibodies were analyzed by radioimmunoassay with 125I insulin or IAsp tracers and polyethylene glycol precipitation. Four multinational, open, parallel group studies were conducted in Europe and North America, with a total of 1,534 people with diabetes exposed to IAsp and 886 people exposed to human insulin (HI) as meal-related insulin for 6–12 months.
RESULTS—Insulin antibodies specific to HI or IAsp were absent in a majority of patients throughout the 6- to 12-month study periods. A majority of the patients (64–68%) had antibodies cross-reacting between HI and IAsp when entering the studies, with baseline levels (means ± SD of percent bound/total) of 16.6 ± 16.3% in study 1 and 10.3 ± 14.0% in study 4. In all four studies, cross-reactive antibodies increased in patients exposed to IAsp, with a maximum at 3 months, and thereafter there was a decline toward baseline levels at 9–12 months (levels at 3 and 12 months: 22.3 ± 19.7 and 16.8 ± 16.5% in study 1 and 21.5 ± 21.9 and 16.9 ± 17.4% in study 4). Antibody levels showed similar changes in people with type 1 and type 2 diabetes, and there was no consistent relationship between antibody formation and glycemic control or between antibody formation and safety in terms of adverse events.
CONCLUSIONS—Treatment with IAsp is associated with an increase in cross-reactive insulin antibodies, with a subsequent fall toward baseline values, without any indication of clinical relevance because no effect on efficacy or safety could be identified.
Oral Contraceptive Use and Association With Glucose, Insulin, and Diabetes in Young Adult Women
Authors: Kim Catherine , Siscovick David S. , Sidney Stephen , Lewis Cora E. , Kiefe Catarina I. , Koepsell Thomas D. 
Published: March 2007

OBJECTIVE— We studied the associations between 1) current use of oral contraceptives (OCs) and 2) glucose levels, insulin levels, and diabetes in young women.
RESEARCH DESIGN AND METHODS—Subjects were women (n = 1,940) in the Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective observational study of African-Americans and whites aged 18–30 years at enrollment in 1985–1986. We analyzed the cross-sectional associations between 1) current use of OCs and 2) fasting glucose, fasting insulin, and presence of diabetes using generalized estimating equations to adjust for repeated measures. We also examined the effect of current use of OCs on incident diabetes at year 10 of the study.
RESULTS—In unadjusted analyses, current use was associated with lower fasting glucose levels [–3.1 mg/dl, 95% CI (−3.7, −2.5)] and reduction in the odds of diabetes [odds ratio 0.56 (0.32, 0.97)], but not lower fasting insulin levels [−0.01 μU/ml (−0.03, 0.02)], compared with nonuse in both African-American and white women. After adjustment for covariates, current use of OCs was still associated with lower fasting glucose levels [–1.8 mg/dl (−2.4, –1.3)] and lower odds of diabetes [odds ratio 0.56 (0.33, 0.95)], although the associations were attenuated. After adjustment, current use of OCs was associated with higher insulin levels [0.12 μU/ml (0.006, 0.23)]. No association existed between pattern of use of OCs and incident diabetes at year 10, although the total number of new persons with diabetes at year 10 was small (n = 17).
CONCLUSIONS—Current use of OCs is associated with lower glucose levels in young African-American and white women and may be associated with lower odds of diabetes.