bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of a Chicken-Based Diet on Renal Function and Lipid Profile in Patients With Type 2 Diabetes
Authors: Gross Jorge L. , Zelmanovitz Themis , Moulin Cileide C. , De Mello Vanessa , Perassolo Magda , Leitão Cristiane , Hoefel Alice , Paggi Alexandre , Azevedo Mirela J. 
Published: March 2007

OBJECTIVE—To assess the effect of replacing red meat with chicken in the usual diet and the effect of a low-protein diet on glomerular filtration rate (GFR), urinary albumin excretion rate (UAER), and lipid levels in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—A randomized, crossover, controlled trial was conducted with 28 patients with type 2 diabetes (seven women; mean age 58.1 years): 15 patients were normoalbuminuric (UAER &lt;20 μg/min), and 13 patients were microalbuminuric (UAER 20–200 μg/min). A chicken-based diet (red meat replaced with chicken) and a low-protein diet were compared with the patients’ usual diet. Patients followed each diet for 4 weeks with a 4-week washout period between. GFR (51Cr-EDTA single-injection technique), 24-h UAER (immunoturbidimetry), apolipoprotein B, total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides were measured after each diet.
RESULTS—Normoalbuminuric and microalbuminuric patients with diabetes were analyzed separately. In normoalbuminuric patients, GFR after the chicken (101.3 ± 22.9 ml · min−1 · 1.73 m−2) and low-protein diets (93.8 ± 20.5 ml · min−1 · m−2) was lower than after the usual diet (113.4 ± 31.4 ml · min−1 · 1.73 m−2; P &lt; 0.05). In microalbuminuric patients, apolipoprotein B levels were lower after the chicken (113.5 ± 36.0 mg/dl) and low-protein diets (103.5 ± 40.1 mg/dl) than after the usual diet (134.3 ± 30.7 mg/dl; P &lt; 0.05). Only the chicken diet reduced UAER (median 34.3 μg/min) compared with the low-protein (median 52.3 μg/min) and usual (median 63.8 μg/min) diets (P &lt; 0.05). Glycemic control and blood pressure did not change after the diets.
CONCLUSIONS—A normoproteic diet with chicken as the only source of meat may represent an alternative strategy for treatment of patients with type 2 diabetes and microalbuminuria.
Detection of Symptoms by Adolescents and Young Adults With Type 1 Diabetes During Experimental Induction of Mild Hypoglycemia
Authors: Ryan Christopher M. , Dulay Daisy , Suprasongsin Chittiwat , Becker Dorothy J. 
Published: March 2007

OBJECTIVE—To identify hormonal, psychological, and demographic predictors of symptom detection and accuracy of blood glucose estimation during mild hypoglycemia in adolescents and young adults with type 1 diabetes.
RESEARCH DESIGN AND METHODS—During an insulin-glucose clamp study, 53 adolescents and 19 young adults estimated blood glucose levels and reported symptoms at euglycemia and after 30 min of mild hypoglycemia (3.3 mmol/l). Epinephrine and pancreatic polypeptide were measured, and both change in anxiety level during hypoglycemia and baseline level of anxiety were measured with the Spielberger Anxiety Inventory. Elevated levels of anxiety during euglycemia were used as an indicator of the psychological trait “negative affectivity.” Previous studies have suggested that individuals with higher negative affectivity are more internally focused and, therefore, more likely to report somatic and visceral changes.
RESULTS—During mild hypoglycemia, 42% of the sample subjects reported an increase in autonomic symptoms; 29% reported an increase in neuroglycopenic symptoms, and 28% estimated blood glucose levels accurately (within 10% of actual). Hormonal excursions did not predict any outcome, but higher anxiety levels during the euglycemic baseline were associated with better detection of hypoglycemic symptoms and more accurate estimation of blood glucose values after controlling for change in anxiety level during hypoglycemia.
CONCLUSIONS—Psychological factors such as elevated anxiety levels (“negative affectivity”) can influence blood glucose estimation and symptom detection in adolescents and young adults and may explain why some individuals are more adept than others at reducing their risk of severe hypoglycemia after participation in a formal blood glucose awareness training program.
ACE Gene Insertion/Deletion Polymorphism Associated With 1998 World Health Organization Definition of Metabolic Syndrome in Chinese Type 2 Diabetic Patients
Authors: Lee Yau-Jiunn , Tsai Jack C.R. 
Published: March 2007

OBJECTIVE—Because ACE insertion/deletion (I/D) polymorphism has been shown to be associated with diabetes, hypertension, coronary artery diseases, and diabetic nephropathy, and because plasma ACE concentration has been found to be associated with plasma triglyceride and total cholesterol levels in patients with type 2 diabetes, the goal of this study was to investigate whether ACE gene I/D polymorphism is associated with metabolic syndrome in Chinese subjects with type 2 diabetes.
RESEARCH DESIGN AND METHODS—A total of 711 patients with type 2 diabetes and 750 control subjects were studied. The ACE I/D polymorphism was determined by PCR. The definition and criteria of metabolic syndrome used in this study matched those proposed in the 1998 World Health Organization classification.
RESULTS—Of 711 patients with type 2 diabetes, 534 (75.1%) fulfilled the criteria for metabolic syndrome. The prevalence of metabolic syndrome in control subjects with II, ID, and DD genotype was 9.4, 11.5, and 15.4%, respectively, and in patients with type 2 diabetes, it was 68.6, 79.2, and 86.1%, respectively. The ACE I/D polymorphism was significantly associated with the syndrome in patients with type 2 diabetes (P = 0.001). When pooling the control subjects with diabetic patients, the prevalence of metabolic syndrome in the whole study group with II, ID, and DD genotype was 37.9, 44.5, and 51.0%, respectively, and ACE I/D polymorphism was still significantly associated with metabolic syndrome (P = 0.003). Diabetic patients with DD genotype were also found to have a higher prevalence of dyslipidemia (II/ID/DD = 43.1/53.1/65.8%, P &lt; 0.001) and albuminuria (36.0/44.6/50.6%, P = 0.018) and to have higher serum triglyceride levels (II, ID, and DD = 155 ± 114, 170 ± 140, and 199 ± 132 mg/dl, respectively, P &lt; 0.05). Control subjects with DD genotype were also found to have a higher prevalence of albuminuria or more advanced nephropathy (II/ID/DD = 5.7/14.0/15.4%, P = 0.001), whereas the prevalence of dyslipidemia was not found to be statistically different in the control group. When pooling control with diabetic subjects, ACE genotype could still be significantly associated with dyslipidemia (II/ID/DD = 34.7/41.3/52.2%, P &lt; 0.001) and albuminuria or more advanced nephropathy (20.3/28.9/33.1%, P &lt; 0.001). Diabetic patients with metabolic syndrome were found to have higher serum uric acid levels than those without metabolic syndrome (6.4 ± 1.8 vs. 5.3 ± 1.4 mg/dl, P &lt; 0.01).
CONCLUSIONS—The ACE I/D polymorphism was found to be associated with metabolic syndrome in Chinese patients with type 2 diabetes. This finding may provide genetic evidence to explain the clustering of metabolic syndrome and suggests that the renin-angiotensin system is involved in the pathophysiology of metabolic derangement in patients with type 2 diabetes.
The Forefoot-to-Rearfoot Plantar Pressure Ratio Is Increased in Severe Diabetic Neuropathy and Can Predict Foot Ulceration
Authors: Caselli Antonella , Pham Hau , Giurini John M. , Armstrong David G. , Veves Aristidis 
Published: March 2007

OBJECTIVE—We have previously demonstrated that high plantar pressures can predict foot ulceration in diabetic patients. The aim of the present study was to evaluate both the relationship between forefoot and rearfoot plantar pressure in diabetic patients with different degrees of peripheral neuropathy and their role in ulcer development.
RESEARCH DESIGN AND METHODS—Diabetic patients of a 30-month prospective study were classified according to the neuropathy disability score: scores of 0, 1–5, 6–16, and 17–28 are defined as absent (n = 20), mild (n = 66), moderate (n = 95), and severe (n = 57) neuropathy, respectively. The F-Scan mat system was used to measure dynamic plantar pressures. The peak pressures under the forefoot and the rearfoot were selectively measured for each foot, and the forefoot-to-rearfoot ratio (F/R ratio) was calculated.
RESULTS—Foot ulcers developed in 73 (19%) feet. The peak pressures were increased in the forefoot of the severe and moderate neuropathic groups compared with the mild neuropathic and nonneuropathic groups (6.2 ± 4.5 and 3.8 ± 2.7 vs. 3.0 ± 2.1 and 3.3 ± 2.1 kg/cm2 [mean ± SD], respectively; P &lt; 0.0001). The rearfoot pressures were also higher in the severe and moderate neuropathic groups compared with the mild neuropathic and nonneuropathic groups (3.2 ± 2.0 and 3.2 ± 1.9 vs. 2.5 ± 1.3 and 2.3 ± 1.0, respectively; P &lt; 0.0001). The F/R ratio was increased only in the severe group compared with the moderate and mild neuropathic and nonneuropathic groups (2.3 ± 2.4 vs. 1.5 ± 1.2, 1.3 ± 0.9, and 1.6 ± 1.0, respectively; P &lt; 0.0001). In a logistic regression analysis, both forefoot pressure (odds ratio 1.19 [95% CI 1.11–1.28], P &lt; 0.0001) and the F/R ratio (1.37 [1.16–1.61], P &lt; 0.0001) were related to risk of foot ulceration, whereas rearfoot pressure was not.
CONCLUSIONS—Both the rearfoot and forefoot pressures are increased in the diabetic neuropathic foot, whereas the F/R ratio is increased only in severe diabetic neuropathy, indicating an imbalance in pressure distribution with increasing degrees of neuropathy. This may lend further evidence toward the concept that equinus develops in the latest stages of peripheral neuropathy and may play an important role in the etiology of diabetic foot ulceration.
The American Diabetes Association and World Health Organization Classifications for Diabetes
Authors: Rodriguez Beatriz L. , Abbott Robert D. , Fujimoto Wilfred , Waitzfelder Beth , Chen Randi , Masaki Kamal , Schatz Irwin , Petrovitch Helen , Ross Webster , Yano Katsuhiko , Blanchette Patricia L. , Curb J. David 
Published: March 2007

OBJECTIVE—To compare the prevalence of diabetes according to the American Diabetes Association (ADA) and World Health Organization (WHO) classifications in a sample of elderly Japanese-American men; to examine the association with total and cardiovascular mortality by diabetes status using both classifications; and to determine whether the fasting or 2-h glucose measurement is a stronger predictor of adverse outcomes.
RESEARCH DESIGN AND METHODS—Examinations given from 1991 to 1993 in the Honolulu Heart Program were used as baseline for these analyses. Subjects were 71–93 years of age at that time and were followed for total and cardiovascular disease mortality for up to 7 years.
RESULTS—A total of ∼66% of individuals who had diabetes by WHO criteria were missed when the ADA definition was used. The relative risks of total and cardiovascular mortality for those with versus those without diabetes were similar for both definitions; however, when fasting and postload glucose measures were analyzed as continuous variables, the 2-h measurement was a superior predictor and was independent of fasting glucose. In contrast, fasting glucose was not an independent predictor of these outcomes in the presence of the 2-h measurement.
CONCLUSIONS—The prevalence of glucose metabolism abnormalities was very high among elderly Japanese-American men. The WHO classification was superior to the ADA classification in identification of subjects at high risk for adverse outcomes. Therefore, we conclude that the 2-h glucose measurement is valuable and should be retained in epidemiologic studies.
Comparison of the Effects of Three Insulinotropic Drugs on Plasma Insulin Levels After a Standard Meal
Authors: Cozma Lawrence S. , Luzio Stephen D. , Dunseath Gareth J. , Langendorg Kirsten W. , Pieber Thomas , Owens David R. 
Published: March 2007

OBJECTIVE—To compare the effects of repaglinide, glipizide, and glibenclamide on insulin secretion and postprandial glucose after a single standard 500-kcal test meal.RESEARCH DESIGN AND METHODS—A total of 12 type 2 diabetic patients with early diabetes (mean HbA1c of 6.1%) and 12 matched control subjects were enrolled in this randomized, double-blind, crossover trial. Subjects received placebo, 2 mg repaglinide, 5 mg glipizide, and 5 mg glibenclamide in a random fashion during the trial. Administration of each drug was followed by a single standard 500-kcal test meal. A washout period of 7–12 days existed between the four study visits.RESULTS—All three drugs were equally effective on the total prandial insulin secretion (area under the curve [AUC] −15 to 240 min). However, clear differences were noted in the early insulin secretion (AUC −15 to 30 min); both repaglinide and glipizide increased secretion in nondiabetic subjects by ∼61 and 34%, respectively, compared with placebo. In the diabetic patients, the difference versus placebo was 37 and 47%, respectively. The difference between glipizide and glibenclamide reached significance in both groups of subjects, whereas repaglinide was more effective than glibenclamide only in the healthy nondiabetic subject group. All three drugs were effective in decreasing total glucose AUC in the nondiabetic and diabetic population. In the nondiabetic subjects, however, repaglinide was significantly more effective than glibenclamide. The differences disappeared in the diabetic subjects, probably as a result of increased prevalence of insulin resistance in this group.CONCLUSIONS—Repaglinide and glipizide but not glibenclamide significantly enhanced the early insulin secretion in both nondiabetic and diabetic subjects with preserved β-cell function after a single standard meal.
Animal Versus Plant Protein Meals in Individuals With Type 2 Diabetes and Microalbuminuria
Authors: Wheeler Madelyn L. , Fineberg S. Edwin , Fineberg Naomi S. , Gibson Reid G. , Hackward Laurie L. 
Published: March 2007

OBJECTIVE—To determine, for individuals with type 2 diabetes and microalbuminuria, the effects of 6 weeks of meals containing plant-based protein (PP) versus meals with predominantly animal-based protein (AP) on renal function and secondarily on glycemia, lipid levels, and blood pressure.
RESEARCH DESIGN AND METHODS—In a randomized crossover trial, we compared 6 weeks of meals containing only PP with meals containing primarily AP (60% animal, 40% plant) in 17 subjects with type 2 diabetes and microalbuminuria treated with diet and/or oral antidiabetic agents. Protein content was equivalent to the average American diet, and calories provided weight maintenance. Nutrients were equivalent between the two diets. Meals were prepared and packaged by a metabolic kitchen staff and were sent home weekly. At the beginning and end of each 6-week period, subjects were studied for 36 h on a metabolic unit.
RESULTS—There were no significant differences between diets for glomerular filtration rate, renal plasma flow, albumin excretion rate, total cholesterol, HDL cholesterol, triglyceride area under the curve (AUC), glucose and insulin AUC, HbA1c, blood pressure, or serum amino acids. For both diets, at the end of the treatment periods as compared with baseline, total cholesterol was significantly lower (PP and AP: from 4.75 to 4.34 mmol/l, P &lt; 0.01), HbA1c had significantly improved (PP: from 8.1 to 7.5%, P &lt; 0.01; AP: from 7.9 to 7.4%, P &lt; 0.01), and diastolic blood pressure was significantly lower (PP: from 83 to 80 mmHg, P &lt; 0.02; AP: from 82 to 78, P &lt; 0.02).
CONCLUSIONS—There is no clear advantage for the recommendation of diets containing only PP rather than diets containing protein that is primarily animal-based for individuals with type 2 diabetes and microalbuminuria. There are, however, potential lipid, glycemic, and blood pressure benefits for following a carefully constructed, weight-maintaining, healthy diet, regardless of protein source.
Tissue Factor Pathway Inhibitor and Other Endothelium-Dependent Hemostatic Factors in Elderly Individuals With Normal or Impaired Glucose Tolerance and Type 2 Diabetes
Authors: Leurs Paul B. , Stolk Ronald P. , Hamulyak Karly , van Oerle René , Grobbee Diederick E. , Wolffenbuttel Bruce H. R. 
Published: March 2007

OBJECTIVE—Impaired glucose tolerance (IGT) is believed to be a prediabetic phase that precedes the development of type 2 diabetes. In elderly subjects, IGT and diabetes are both independently associated with the occurrence of cardiovascular disease. Endothelial damage precedes atherosclerotic changes of the vascular wall. Therefore, several markers of endothelial dysfunction were examined in elderly subjects with IGT and elderly patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—Von Willebrand factor (vWF), tissue plasminogen activator (t-PA), plasminogen activator inhibitor type-1 (PAI-1), and thrombomodulin were studied as markers of endothelial dysfunction in a population-based study of elderly subjects with normal glucose tolerance (NGT) or IGT and type 2 diabetes. In addition to these endothelium-dependent factors, we also investigated tissue factor pathway inhibitor (TFPI) activity in relation to metabolic parameters and cardiovascular risk factors.
RESULTS—All data were adjusted for age. Increased levels of vWF antigen, t-PA antigen, and PAI-1 activity were seen in the IGT and diabetic group compared with the NGT group. TFPI activity and thrombomodulin levels were increased in all elderly subjects, and no differences were seen between the groups. There was a positive association between HbA1c and TFPI activity and vWF antigen. Fasting blood glucose levels correlated with vWF antigen, t-PA antigen, and PAI-1 activity, whereas urine albumin excretion correlated with TFPI activity, vWF antigen, and PAI-1 activity. Serum insulin levels correlated strongly not only with vWF antigen and t-PA antigen but also with PAI-1 activity. This correlation did not change after further adjustment for serum glucose and HbA1c, which may suggest that in the elderly subjects, impaired fibrinolysis is probably associated with insulin resistance. There were no associations between the endothelium-dependent hemostatic factors and lipids, except for a negative correlation between HDL cholesterol and thrombomodulin.
CONCLUSIONS—In elderly subjects with IGT, several endothelium-dependent hemostatic factors are already consistently increased, indicating endothelial damage in this stage.
Acidic Drinking Water and Risk of Childhood-Onset Type 1 Diabetes
Authors: Stene Lars C. , Hongve Dag , Magnus Per , Rønningen Kjersti S. , Joner Geir 
Published: March 2007

OBJECTIVE—To estimate the associations of acidity and concentration of selected minerals in household tap water with the risk of type 1 diabetes.
RESEARCH DESIGN AND METHODS—We designed a population-based case-control study with 64 cases of type 1 diabetes and 250 randomly selected control subjects. Acidity, color, and mineral content were measured in tap water from each participant’s household.
RESULTS—Tap water pH 6.2–6.9 was associated with a fourfold higher risk of type 1 diabetes compared with pH ≥7.7 (OR 3.73, 95% CI 1.52–9.15). This result was similar after exclusion of individuals with the highly protective HLA-DQB1*0602 allele, but adjustment for maternal education, urban/rural residence, sex, and age tended to strengthen the estimated association. Higher tap water concentration of zinc was associated with lower risk of type 1 diabetes after adjustment for pH and other possible confounders, but the overall association was strictly not significant.
CONCLUSIONS—These results suggest the possibility that quality of drinking water influences the risk of type 1 diabetes. The possible mechanisms by which water acidity or mineral content may be involved in the etiology of type 1 diabetes remain unknown, but the mechanisms are most likely indirect and may involve an influence on survival of microorganisms in the water.
Prevalence and Concomitants of Glucose Intolerance in European Obese Children and Adolescents
Authors: Invitti Cecilia , Guzzaloni Gabriele , Gilardini Luisa , Morabito Francesco , Viberti Giancarlo 
Published: March 2007

OBJECTIVE—The worldwide increase in the prevalence of childhood obesity is reaching epidemic proportions and is associated with a dramatic rise in cases of type 2 diabetes. The prevalence of glucose intolerance and its determinants and the relation of cardiovascular risk factors with levels of glycemia and degree of obesity were studied in grossly obese children of European origin.
RESEARCH DESIGN AND METHODS—A total of 710 grossly obese Italian children (SD score [SDS] of BMI 3.8 ± 0.7) aged 6–18 years, including 345 male subjects, underwent an oral glucose tolerance test. Insulin resistance and insulin secretion were estimated using the homeostasis model assessment for insulin resistance and the insulinogenic index, respectively. Fibrinogen, C-reactive protein, lipids, and uric acid were measured. The 2-h postload glucose and degree of obesity, calculated as the SDS of weight/height2, were used as dependent variables.
RESULTS—The prevalence of glucose intolerance was 4.5%. Insulin resistance (P &lt; 0.0001), impaired insulin secretion (P &lt; 0.0001), and diastolic blood pressure (BP) (P &lt; 0.05) were significantly and independently related to 2-h postload glucose values. The degree of obesity did not relate to insulin resistance but was independently correlated with inflammatory proteins, uric acid, and systolic BP, variables that were often abnormal in this population.
CONCLUSIONS—In these grossly obese children, both insulin resistance and impaired insulin secretion contribute to the elevation of glycemia, and the degree of obesity is related to cardiovascular risk factors independently of insulin resistance.
Discordance Between HbA1c and Fructosamine
Authors: Cohen Robert M. , Holmes Yancey R. , Chenier Thomas C. , Joiner Clinton H. 
Published: March 2007

OBJECTIVE—Discordances between HbA1c and other measures of glycemic control are common in clinical practice and remain unexplained. We developed a measure of discordance between HbA1c and fructosamine (FA) (glycosylated serum proteins) to conduct a systematic evaluation. We termed this the glycosylation gap (GG) and sought to determine its relationship to diabetic nephropathy.
RESEARCH DESIGN AND METHODS—Measurements of HbA1c and FA on the same sample in 153 people were used to calculate GG, defined as the difference between measured HbA1c and HbA1c predicted from FA based on the population regression of HbA1c on FA.
RESULTS—GG had a broad distribution (range, −3.2% to 5.5%); 40% of samples had values indicating major differences in prediction of complications risk by the measured versus predicted HbA1c. GG was highly correlated (r = 0.81) between measurements repeated in 65 patients 23 ± 2 weeks apart, indicating that the discordances are reliable and not explained by differences in turnover of underlying proteins. In 40 patients with type 1 diabetes of ≥15 years’ duration, an increase in GG by 1% was associated with a 2.9-fold greater frequency of increasing nephropathy stage (P = 0.0014). GG was −0.8 ± 0.2% in subjects with no nephropathy, −0.3 ± 0.2% with microalbuminuria/hypertension, and 0.7 ± 0.3% in subjects with proteinuria or renal dysfunction (P &lt; 0.05). GG correlated better with nephropathy than did either HbA1c or FA alone in this population.
CONCLUSIONS—The glycosylation gap may be a useful clinical research tool for evaluating physiologic sources of variation in diabetic complications beyond glycemic control.