bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glycated and Oxidized Protein Degradation Products Are Indicators of Fasting and Postprandial Hyperglycemia in Diabetes
Authors: Ahmed Naila , Babaei-Jadidi Roya , Howell Scott K. , Thornalley Paul J. , Beisswenger Paul J. 
Published: March 2007

OBJECTIVE—To assess the relative importance of fasting and postprandial hyperglycemia to vascular dysfunction in diabetes, we have measured indicators of glycation, oxidative and nitrosative stress in subjects with type 1 diabetes, and different postprandial glucose patterns.
RESEARCH DESIGN AND METHODS—Plasma and urinary levels of specific arginine- and lysine-derived advanced glycation end products, as well as oxidative and nitrosative products, were measured by liquid chromatography with triple quadrupole mass spectrometric detection (LC-MS/MS) after 2 months of treatment with insulin lispro or human regular insulin in 21 subjects participating in a cross-over study. Hb-bound early glycation (Amadori) products were also measured after each treatment period by high-performance liquid chromatography (fructosyl-valine Hb or HbA1c [A1C]:Diamat) and fructosyl-lysine Hb by LC-MS/MS (A1C:fructosyl-lysine).
RESULTS—In diabetic patients, the concentrations of protein glycation and oxidation-free adducts increased up to 10-fold, while urinary excretion increased up to 15-fold. Decreasing postprandial hyperglycemia with lispro gave 10–20% decreases of the major free glycation adducts, hydroimidazolones derived from methylglyoxal and 3-deoxyglucosone, and glyoxal-derived Nε-carboxymethyl-lysine. No differences were observed in A1C:Diamat or A1C:fructosyl-lysine with lispro or regular insulin therapy in spite of significant decreases in postprandial glycemia with lispro.
CONCLUSIONS—We conclude that the profound increases in proteolytic products of proteins modified by advanced glycation endproducts in diabetic patients are responsive to changes in mean hyperglycemia and also show responses to changes in postprandial hyperglycemia.
Dietary Glycemic Index and Glycemic Load, Carbohydrate and Fiber Intake, and Measures of Insulin Sensitivity, Secretion, and Adiposity in the Insulin Resistance Atherosclerosis Study
Authors: Liese Angela D. , Schulz Mandy , Fang Fang , Wolever Thomas M.S. , D’Agostino Ralph B. , Sparks Karen C. , Mayer-Davis Elizabeth J. 
Published: March 2007

OBJECTIVE—We studied the association of digestible carbohydrates, fiber intake, glycemic index, and glycemic load with insulin sensitivity (SI), fasting insulin, acute insulin response (AIR), disposition index, BMI, and waist circumference.
RESEARCH DESIGN AND METHODS—Data on 979 adults with normal (67%) and impaired (33%) glucose tolerance from the Insulin Resistance Atherosclerosis Study (1992–1994) were analyzed. Usual dietary intake was assessed via a 114-item interviewer-administered food frequency questionnaire from which nutrient intakes were estimated. Published glycemic index values were assigned to food items and average dietary glycemic index and glycemic load calculated per subject. SI and AIR were determined by frequently sampled intravenous glucose tolerance test. Disposition index was calculated by multiplying SI with AIR. Multiple linear regression modeling was employed.
RESULTS—No association was observed between glycemic index and SI, fasting insulin, AIR, disposition index, BMI, or waist circumference after adjustment for demographic characteristics or family history of diabetes, energy expenditure, and smoking. Associations observed for digestible carbohydrates and glycemic load, respectively, with SI, insulin secretion, and adiposity (adjusted for demographics and main confounders) were entirely explained by energy intake. In contrast, fiber was associated positively with SI and disposition index and inversely with fasting insulin, BMI, and waist circumference but not with AIR.
CONCLUSION—Carbohydrates as reflected in glycemic index and glycemic load may not be related to measures of insulin sensitivity, insulin secretion, and adiposity. Fiber intake may not only have beneficial effects on insulin sensitivity and adiposity, but also on pancreatic functionality.
Anthropometry, Glucose Tolerance, and Insulin Concentrations in Indian Children
Authors: Krishnaveni Ghattu V. , Hill Jacqueline C. , Leary Samantha D. , Veena Sargoor R. , Saperia Julia , Saroja Anandathirtha , Karat Samuel C. , Fall Caroline H.D. 
Published: March 2007

OBJECTIVE—The purpose of this study was to test the hypothesis that the environment experienced by fetuses of mothers with gestational diabetes mellitus (GDM) and mothers with higher glucose concentrations that are in the normal range causes increased adiposity and altered glucose/insulin metabolism in childhood.
RESEARCH DESIGN AND METHODS—Children (n = 630) whose mothers were tested for glucose tolerance during pregnancy had detailed anthropometry performed at birth and annually thereafter. At 5 years, plasma glucose and insulin concentrations were measured in the children (2-h oral glucose tolerance test) and their fathers (fasting samples only).
RESULTS—Newborns of diabetic mothers (n = 41) were larger in all body measurements than control newborns (babies with nondiabetic parents). At 1 year, these differences had diminished and were not statistically significant. At 5 years, female offspring of diabetic mothers had larger subscapular and triceps skinfold thicknesses (P = 0.01) and higher 30- and 120-min insulin concentrations (P &lt; 0.05) than control children. Offspring of diabetic fathers (n = 41) were lighter at birth than control children (P &lt; 0.001); they showed no differences in anthropometry at 5 years. In control children, skinfold thickness and 30-min insulin concentrations were positively related to maternal insulin area under the curve, and skinfold thicknesses were related to paternal fasting insulin concentrations independently of the parents’ skinfold thickness and socioeconomic status.
CONCLUSIONS—Maternal GDM is associated with adiposity and higher glucose and insulin concentrations in female offspring at 5 years. The absence of similar associations in offspring of diabetic fathers suggests a programming effect in the diabetic intrauterine environment. More research is needed to determine whether higher maternal glucose concentrations in the nondiabetic range have similar effects.
Psychological Stress May Induce Diabetes-Related Autoimmunity in Infancy
Authors: Sepa Anneli , Wahlberg Jeanette , Vaarala Outi , Frodi Ann , Ludvigsson Johnny 
Published: March 2007

OBJECTIVE— In retrospective studies, a number of disparate environmental factors (including experiences of serious life events) have been proposed as trigger mechanisms for type 1 diabetes or the autoimmune process behind the disease. Psychosocial stress in families may affect children negatively due to a link to hormonal levels and nervous signals that in turn influence both insulin sensitivity/insulin need and the immune system. Our aim was to investigate whether psychological stress, measured as psychosocial strain in families, is associated with diabetes-related autoimmunity during infancy.
RESEARCH DESIGN AND METHODS— The first 4,400 consecutive 1-year-old children from a large prospective population-based project participated in the study. Parents completed questionnaires at birth and at 1 year, including various measures of psychosocial stress (e.g., parenting stress) and sociodemographic background. Blood samples drawn from the children at 1 year were analyzed for type 1 diabetes–associated autoantibodies toward tyrosine phosphatase and GAD. Antibodies toward tetanus toxoid were used as non–diabetes-related control antibodies.
RESULTS— Psychosocial factors, i.e., high parenting stress (odds ratio 1.8 [95% CI 1.2–2.9], P &lt; 0.01), experiences of a serious life event (2.3 [1.3–4.0], P &lt; 0.01), foreign origin of the mother (2.1 [1.3–3.3], P &lt; 0.001), and low paternal education (1.6 [1.1–2.3], P &lt; 0.01) were associated with diabetes-related autoimmunity in the child, independent of family history of diabetes.
CONCLUSIONS— Psychological stress, measured as psychosocial strain in the family, seems to be involved in the induction, or progression, of diabetes-related autoimmunity in the child during the 1st year of life.
The Efficacy and Cost of Alternative Strategies for Systematic Screening for Type 2 Diabetes in the U.S. Population 45–74 Years of Age
Authors: Johnson Susan L. , Tabaei Bahman P. , Herman William H. 
Published: March 2007

OBJECTIVE—To simulate the outcomes of alternative strategies for screening the U.S. population 45–74 years of age for type 2 diabetes.
RESEARCH DESIGN AND METHODS—We simulated screening with random plasma glucose (RPG) and cut points of 100, 130, and 160 mg/dl and a multivariate equation including RPG and other variables. Over 15 years, we simulated screening at intervals of 1, 3, and 5 years. All positive screening tests were followed by a diagnostic fasting plasma glucose or an oral glucose tolerance test. Outcomes include the numbers of false-negative, true-positive, and false-positive screening tests and the direct and indirect costs.
RESULTS— At year 15, screening every 3 years with an RPG cut point of 100 mg/dl left 0.2 million false negatives, an RPG of 130 mg/dl or the equation left 1.3 million false negatives, and an RPG of 160 mg/dl left 2.8 million false negatives. Over 15 years, the absolute difference between the most sensitive and most specific screening strategy was 4.5 million true positives and 476 million false-positives. Strategies using RPG cut points of 130 mg/dl or the multivariate equation every 3 years identified 17.3 million true positives; however, the equation identified fewer false-positives. The total cost of the most sensitive screening strategy was $42.7 billion and that of the most specific strategy was $6.9 billion.
CONCLUSIONS— Screening for type 2 diabetes every 3 years with an RPG cut point of 130 mg/dl or the multivariate equation provides good yield and minimizes false-positive screening tests and costs.
Has Control of Hypercholesterolemia and Hypertension in Type 1 Diabetes Improved Over Time?
Authors: Zgibor Janice C. , Wilson Robb R. , Orchard Trevor J. 
Published: March 2007

OBJECTIVE—To determine the extent to which patients’ awareness, treatment, and control of hypertension and hypercholesterolemia have changed over time and to examine factors associated with awareness and treatment in a type 1 diabetes population.
RESEARCH DESIGN AND METHODS—Data from six examinations conducted over 10 years from the Pittsburgh Epidemiology of Diabetes Complications Study, a prospective study of subjects with childhood-onset (&lt;17 years of age) type 1 diabetes diagnosed between 1950 and 1980 and followed since 1986, were analyzed. Hypertension and hypercholesterolemia were defined according to the concurrent Joint National Committee and National Cholesterol Education Program Adult Treatment Panel criteria, respectively.
RESULTS—Results demonstrated that awareness of both conditions has improved; however, control is not optimal (e.g., only 32.1 and 28% of those with hypertension in 1986–1988 and 1996–1998 were controlled, while for hypercholesterolemia, the rates were 0 and 5.5%, respectively). Stratified by age-group (18–29, 30–39, and &gt;40 years), the youngest subjects with hypercholesterolemia were least likely to be treated and controlled to goal levels. Older age and physician contact were correlates of awareness and treatment of hypertension at baseline, while presence of renal or coronary complications was also associated with awareness and treatment of both hypertension and hypercholesterolemia at the 10-year follow-up.
CONCLUSIONS—There is a considerable treatment gap, particularly for hypercholesterolemia. Improved treatment of both hypertension and hypercholesterolemia are clearly needed, particularly hypercholesterolemia in younger age-groups who have not yet experienced long-term complications.
Evaluation of Removable and Irremovable Cast Walkers in the Healing of Diabetic Foot Wounds
Authors: Armstrong David G. , Lavery Lawrence A. , Wu Stephanie , Boulton Andrew J.M. 
Published: March 2007

OBJECTIVE—The purpose of this study was to evaluate the effectiveness of a removable cast walker (RCW) and an “instant” total contact cast (iTCC) in healing neuropathic diabetic foot ulcerations.
RESEARCH DESIGN AND METHODS—We randomly assigned 50 patients with University of Texas grade 1A diabetic foot ulcerations into one of two off-loading treatment groups: an RCW or the same RCW wrapped with a cohesive bandage (iTCC) so patients could not easily remove the device. Subjects were evaluated weekly for 12 weeks or until wound healing.
RESULTS—An intent-to-treat analysis showed that a higher proportion of patients had ulcers that were healed at 12 weeks in the iTCC group than in the RCW group (82.6 vs. 51.9%, P = 0.02, odds ratio 1.8 [95% CI 1.1−2.9]). Of the patients with ulcers that healed, those treated with an iTCC healed significantly sooner (41.6 ± 18.7 vs. 58.0 ± 15.2 days, P = 0.02).
CONCLUSIONS—Modification of a standard RCW to increase patient adherence to pressure off-loading may increase both the proportion of ulcers that heal and the rate of healing of diabetic neuropathic wounds.
Early Growth in Offspring of Diabetic Mothers
Authors: Touger Leslie , Looker Helen C. , Krakoff Jonathan , Lindsay Robert S. , Cook Valerie , Knowler William C. 
Published: March 2007

OBJECTIVE—By age 5 years, offspring of diabetic mothers (ODMs) are heavier and have altered glucose metabolism compared with offspring of mothers without diabetes (non-DMs). This study evaluates the growth pattern of ODMs before the age of 5 years.
RESEARCH DESIGN AND METHODS—Anthropometric measures (z scores) from birth, 1.5 years, and 7.7 years in Pima Indian children were compared by maternal diabetes status.
RESULTS—After adjustment for earlier gestational age at delivery (37.8 vs. 39.3 weeks, P &lt; 0.01), ODMs were heavier at birth (z score birth weight 0.49 vs. −0.04, P &lt; 0.01) than non-DMs. At age 1.5 years, ODMs were shorter than the non-DMs (z score = −0.24 vs. 0.12, P &lt; 0.01) but their weight and relative weight (RW; weight adjusted for age, sex, and length or height) were similar. From birth to 1.5 years, ODMs showed significant “catch down” of weight compared with non-DMs (change in weight z score from birth to 1.5 years of ODMs and non-DMs was −0.56 and 0.12, respectively, P &lt; 0.01). By age 7.7 years, ODMs were heavier (weight z score 0.89 vs. −0.07, P &lt; 0.01) but had similar height as non-DMs. Differences in glucose and insulin concentrations at age 7.7 years were dependent on RW.
CONCLUSIONS—ODMs had a dramatically different growth pattern from that of non-DMs. Gestational age–adjusted birth weight was higher. During the first 1.5 postnatal years, the change in weight z score and attained height were reduced. Subsequently, height caught up to that of non-DMs, while weight gain greatly exceeded that of non-DMs.
The Metabolic Syndrome in Older Individuals: Prevalence and Prediction of Cardiovascular Events
Authors: Scuteri Angelo , Najjar Samer S. , Morrell Christopher H. , Lakatta Edward G. 
Published: March 2007

OBJECTIVE—The prevalence of the metabolic syndrome, a potent risk factor for cardiovascular diseases (CVDs), has not been adequately explored in older individuals. Moreover, two sets of criteria have been proposed for the definition of metabolic syndrome, one by the World Health Organization (WHO) and one by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII). We therefore investigated the prevalence of this syndrome in a subgroup of older participants from the Cardiovascular Health Study (CHS) who were free of CVD at baseline. We also compared the prognostic significance of the two definitions of the metabolic syndrome.
RESEARCH DESIGN AND METHODS—A total of 2,175 subjects from the CHS who were free of CVD at baseline and not taking antihypertensive or lipid-lowering medications were studied. Prevalence of the metabolic syndrome was assessed with both the WHO and ATPIII criteria. The incidence of coronary or cerebrovascular disease was ascertained during a median follow-up time of 4.1 years.
RESULTS—Prevalence of the metabolic syndrome was 28.1% by ATPIII criteria and 21.0% by WHO criteria. The two sets of criteria provided concordant classification for 80.6% of participants. Multivariate Cox propotional hazard models showed that the metabolic syndrome defined with the ATPIII criteria, but not with the WHO criteria, was an independent predictor of coronary or cerebrovascular events and was associated with a 38% increased risk (hazard ratio 1.38 [95% CI 1.06–1.79], P &lt; 0.01).
CONCLUSIONS—Prevalence of the metabolic syndrome in older individuals is ∼21–28% (depending on the definition used). The two sets of criteria have 80% concordance in classifying subjects. As defined by the ATPIII criteria, the metabolic syndrome yields independent prognostic information, even after adjusting for traditional cardiovascular risk factors and the individual domains of the metabolic syndrome.
A Randomized Controlled Trial of Insulin Pump Therapy in Young Children With Type 1 Diabetes
Authors: Fox Larry A. , Buckloh Lisa M. , Smith Shiela D. , Wysocki Tim , Mauras Nelly 
Published: March 2007

OBJECTIVE—This study assesses the effects of insulin pump therapy on diabetes control and family life in children 1–6 years old with type 1 diabetes.
RESEARCH DESIGN AND METHODS—Twenty-six children with type 1 diabetes for ≥6 months were randomly assigned to current therapy (two or three shots per day using NPH insulin and rapid-acting analog) or continuous subcutaneous insulin infusion (CSII) for 6 months. After 6 months, current therapy subjects were offered CSII. Changes in HbA1c, mean blood glucose (MBG), hypoglycemia frequency, diabetes-related quality of life (QOL), and parental adjustment were recorded.
RESULTS—Eleven subjects from each group completed the trial (age 46.3 ± 3.2 months [means ± SE]). At baseline, there were no differences between groups in HbA1c, MBG, age, sex, diabetes duration, or parental QOL. Mean HbA1c, MBG, and parental QOL were similar between groups at 6 months. Mean HbA1c and MBG did not change from baseline to 6 months in either group. The frequency of severe hypoglycemia, ketoacidosis, or hospitalization was similar between groups at any time period. Subjects on CSII had more fasting and predinner mild/moderate hypoglycemia at 1 and 6 months. Diabetes-related QOL improved in CSII fathers from baseline to 6 months. Psychological distress increased in current therapy mothers from baseline to 6 months. All subjects continued CSII after study completion.
CONCLUSIONS—CSII is safe and well tolerated in young children with diabetes and may have positive effects on QOL. CSII did not improve diabetes control when compared with injections, despite more mild/moderate hypoglycemia. The benefits and realistic expectations of CSII should be thoroughly examined before starting this therapy in very young children.
Make Your Diabetic Patients Walk
Authors: Di Loreto Chiara , Fanelli Carmine , Lucidi Paola , Murdolo Giuseppe , De Cicco Arianna , Parlanti Natascia , Ranchelli Anna , Fatone Cristina , Taglioni Chiara , Santeusanio Fausto , De Feo Pierpaolo 
Published: March 2007

OBJECTIVE—To establish the impact of different amounts of increased energy expenditure on type 2 diabetes care.
RESEARCH DESIGN AND METHODS—Post hoc analysis of long-term effects of different amounts of increased energy expenditure (metabolic equivalents [METS] per hour per week) through voluntary aerobic physical activity was performed in 179 type 2 diabetic subjects (age 62 ± 1 years [mean ± SE]) randomized to a physical activity counseling intervention. Subjects were followed for 2 years and divided into six groups based on their increments in METs per hour per week: group 0 (no activity, n = 28), group 1–10 (6.8 ± 0.3, n = 27), group 11–20 (17.1 ± 0.4, n = 31), group 21–30 (27.0 ± 0.5, n = 27), group 31–40 (37.5 ± 0.5, n = 32), and group &gt;40 (58.3 ± 1.8, n = 34).
RESULTS—At baseline, the six groups did not differ for energy expenditure, age, sex, diabetes duration, and all parameters measured. After 2 years, in group 0 and in group 1–10, no parameter changed; in groups 11–20, 21–30, 31–40, and &gt;40, HbA1c, blood pressure, total serum cholesterol, triglycerides, and estimated percent of 10-year coronary heart disease risk improved (P &lt; 0.05). In group 21–30, 31–40, and &gt;40, body weight, waist circumference, heart rate, fasting plasma glucose, serum LDL and HDL cholesterol also improved (P &lt; 0.05). METs per hour per week correlated positively with changes of HDL cholesterol and negatively with those of other parameters (P &lt; 0.001). After 2 years, per capita yearly costs of medications increased (P = 0.008) by $393 in group 0, did not significantly change in group 1–10 ($206, P = 0.09), and decreased in group 11–20 (−$196, P = 0.01), group 21–30 (−$593, P = 0.009), group 31–40 (−$660, P = 0.003), and group &gt;40 (−$579, P = 0.001).
CONCLUSIONS—Energy expenditure &gt;10 METs · h−1 · week−1 obtained through aerobic leisure time physical activity is sufficient to achieve health and financial advantages, but full benefits are achieved with energy expenditure &gt;20 METs · h−1 · week−1.
Type 1 Diabetes Is Associated With Increased Cyclooxygenase- and Cytokine-Mediated Inflammation
Authors: Basu Samar , Larsson Anders , Vessby Johan , Vessby Bengt , Berne Christian 
Published: March 2007

OBJECTIVE—The extent of involvement of cyclooxygenase (COX)-mediated inflammation in type 1 diabetes is unknown, and the association between the COX- and cytokine-mediated inflammatory responses in type 1 diabetes is not fully understood.
RESEARCH DESIGN AND METHODS—Plasma high-sensitivity C-reactive protein (CRP), 24-h urinary and plasma 15-keto-dihydro-prostaglandin F2α (a metabolite of prostaglandin F2α [PGF2α] and an indicator of COX-mediated inflammation), serum amyloid protein A (SAA), and interleukin (IL)-6 (indicators of inflammation) were measured in 38 subjects with type 1 diabetes and 41 healthy age- and sex-matched control subjects.
RESULTS—The inflammatory indicators (urinary 15-keto-dihydro-PGF2α, P &lt; 0.01; IL-6, P &lt; 0.04) were increased in men with diabetes. CRP and SAA did not show any significant difference between the diabetic and the control subjects. Urinary levels of 15-keto-dihydro-PGF2α correlated with the degree of glycemic control, HbA1c (r = 0.42, P &lt; 0.0005). No correlation was found between the duration of diabetes and the inflammatory biomarkers or metabolic measurements.
CONCLUSIONS—These results suggest that an early low-grade inflammatory process reflected by elevated levels of PGF2α and IL-6 is involved in type 1 diabetes. Thus, both COX- and cytokine-mediated inflammatory pathways are significantly related to type 1 diabetes.