bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Progression of Diabetic Retinopathy in Koreans With NIDDM
Authors: Kim Hong-Kyu , Kim Chul-Hee , Kim Sang-Wook , Park Joong-Yeol , Hong Sung-Kwan , Yoon Young-Hee , Lee Ki-Up 
Published: March 2007

OBJECTIVE
To determine the incidence and risk factors for the development and progression of diabetic retinopathy in Korean patients with NIDDM.

RESEARCH DESIGN AND METHODS
A total of 186 patients with NIDDM who did not have proliferative diabetic retinopathy (PDR) at baseline were prospectively studied for 5.3 ± 1.0 years in an outpatient clinic of a university hospital. The incidence and progression of diabetic retinopathy was determined by annual funduscopic examination by an ophthalmologist.

RESULTS
Of the 130 patients who were free of diabetic retinopathy at baseline, 30 developed it, giving an incidence of 44.4/1,000 person-years. Age and known duration of diabetes, mean fasting plasma glucose, and HbA1 levels during the follow-up period were higher in the patients who developed diabetic retinopathy. Of the 56 patients who had nonproliferative diabetic retinopathy at baseline, 11 developed PDR, giving an incidence of 37.5/1,000 person-years. The patients who progressed to PDR during follow-up (progressors) had a higher change of BMI and urinary albumin excretion rate at baseline and a higher mean HbA1 during the follow-up period than the nonprogressors. Cox proportional hazards analysis revealed that mean HbA1 was the only independent risk factor for both the development and progression of diabetic retinopathy.

CONCLUSIONS
The incidence of PDR in Korean NIDDM patients is comparable to that reported in other populations. Poor glycemic control is the most important risk factor for both the development and progression of diabetic retinopathy in NIDDM patients.
UKPDS 28: A Randomized Trial of Efficacy of Early Addition of Metformin in Sulfonylurea-Treated Type 2 Diabetes
Authors:   U.K. Prospective Diabetes Study Group
Published: March 2007

OBJECTIVE
To assess the efficacy over 3 years of the addition of metformin to maximum sulfonylurea therapy in type 2 diabetes.

RESEARCH DESIGN AND METHODS
This multicenter randomized open-controlled trial was conducted in outpatient diabetes clinics in 15 U.K. hospitals. A total of 591 subjects who had already been randomly allocated to sulfonylurea therapy were taking maximum doses with suboptimal glycemic control, i.e., raised fasting plasma glucose (FPG) concentrations of 6−15 mmol/l but no significant hyperglycemic symptoms. The main outcome measures included FPG, glycated hemoglobin, protocol-defined marked hyperglycemia, body weight, blood pressure, fasting plasma lipids, compliance, and hypoglycemia and other side effects.

RESULTS
After the addition of metformin, FPG concentrations decreased by mean (95% CI) −0.47 (−0.82 to −0.13) mmol/l over 3 years compared with an increase of 0.44 (0.07−0.81) mmol/l in subjects on sulfonylurea alone (P &lt; 0.00001). Median FPG concentrations at 3 years were 8.6 vs. 9.9 mmol/l, respectively (P &lt; 0.00001), and HbA1c values were 7.5 and 8.1%, respectively (P = 0.006). Adjustment for baseline BMI or FPG concentration did not affect response to therapy. Only 7% of those allocated to sulfonylurea plus metformin developed protocol-defined marked hyperglycemia compared with 36% of those allocated to sulfonylurea alone (P &lt; 0.0001). Fasting plasma lipids, body weight, and blood pressure did not change significantly. The incidence of hypoglycemic episodes did not differ between groups: 4% on sulfonylurea plus metformin and 2% on sulfonylurea alone (NS).

CONCLUSIONS
Early addition of metformin improved glycemic control in patients with suboptimal glycemic control while taking maximum sulfonylurea therapy, irrespective of obesity or baseline FPG concentrations.
Carotid Artery Stiffness is Increased in Microalbuminuric IDDM Patients
Authors: Lambert Jan , Smulders Ronald A , Aarsen Mieke , Donker Ab J M , Stehouwer Coen D A 
Published: March 2007

OBJECTIVE
In IDDM, the development of microalbuminuria, which is associated with an elevation in blood pressure within the normal range, is a risk factor for future cardiovascular disease. Vascular stiffness might be one of the factors involved because it increases systolic blood pressure and the workload of the heart.

RESEARCH DESIGN AND METHODS
We investigated carotid artery stiffness with a noninvasive ultrasound method in 24 microalbuminuric and 53 normoalbuminuric IDDM patients and in 54 healthy control subjects.

RESULTS
The distensibility coefficient, a measure of intrinsic vascular wall elasticity, was decreased in microalbuminuric IDDM (21.6 × 10−3/kPa) as compared with normoalbuminuric IDDM (24.8 × 10−3/kPa) and control subjects (25.9 × 10−3/kPa; P = 0.02). This result was based on a higher blood pressure in microalbuminuric patients. After correction for the difference in blood pressure, the distensibility coefficients were similar in the three groups. In the two diabetic patient groups taken together, age, blood pressure, female sex, diabetes duration, and cigarette smoking were determinants of a decreased distensibility.

CONCLUSIONS
Blood pressure is a major determinant of increased arterial stiffness in microalbuminuric IDDM patients. Increased arterial stiffness may contribute to the accelerated progression of complications if concomitant hypertension exists.
Descriptive Epidemiology of IDDM in Hokkaido, Japan: The Childhood IDDM Hokkaido Registry
Authors: Matsuura Nobuo , Fukuda Katsuhiro , Okuno Akimasa , Harada Shohei , Fukushima Naoki , Koike Akemi , Ito Yoshiya , Hotsubo Tomoyuki 
Published: March 2007

OBJECTIVE
To identify the incidence of IDDM with regard to sex, age, family history of diabetes, season, and 5-year period of childhood IDDM among children ages 0–14 years from a population-based epidemiological study in Hokkaido, Japan, from 1973 to 1992.

RESEARCH DESIGN AND METHODS
Registration of all new IDDM cases in Hokkaido was conducted by the Childhood IDDM Hokkaido Registry Study Group from 1973 to 1992. The cases were selected from among 1) patients who were admitted to the member hospitals of the study group, 2) patients who answered a questionnaire distributed to hospitals and diabetic clinics throughout Hokkaido, and 3) patients whose cases were recorded in free-treatment medical records of urban and rural districts. The case ascertainment rate was estimated to be 100%. Differences in incidence with regard to sex, age, family history of diabetes, season, and year period were analyzed by the Poisson regression analysis by GENMOD.

RESULTS
During the 20-year period studied, 396 cases (181 boys, 215 girls) of abruptonset IDDM were registered. Statistically significant differences in annual incidence were found according to sex (female), age (8–14 years), history (having no diabetes in family), season (spring), and 5-year period.

CONCLUSIONS
This is the first population-based, long-term epidemiological study of childhood IDDM from Japan. We observed a significantly higher annual incidence (per 100,000/year) of IDDM in female subjects (1.81), older age-groups (2.25 for 8–14 years), subjects with no family history of diabetes (1.26), diabetes onset in the spring (2.20), and an increased trend over the 20 years. In addition, the heterogeneity of IDDM among Japanese children needs to be elucidated.
Lactic Acidosis Rates in Type 2 Diabetes
Authors: Brown Jonathan B , Pedula Kathryn , Barzilay Joshua , Herson Michael K , Latare Peggy 
Published: March 2007

OBJECTIVE
To provide a context for the interpretation of lactic acidosis risk among patients using metformin, we measured rates of lactic acidosis in patients with type 2 diabetes before metformin was approved for use in the U.S.

RESEARCH DESIGN AND METHODS
Using electronic databases of hospital discharge diagnoses and laboratory results maintained by a large, nonprofit health maintenance organization (HMO), we identified possible lactic acidosis events in three geographically and racially diverse populations with type 2 diabetes. We then reviewed hard-copy clinical records to confirm and describe each event and determine its likely cause(s).

RESULTS
From &lt;41,000 person-years of experience, we found four confirmed, three possible, and three borderline cases of lactic acidosis. In each case, we identified at least one severe medical condition that could have caused the acidosis. The annual confirmed event rate is similar to published rates of metformin-associated lactic acidosis.

CONCLUSIONS
Lactic acidosis occurs regularly, although infrequently, among persons with type 2 diabetes, at rates similar to its occurrence among metformin users. The medical conditions with which both metformin-associated and naturally occurring lactic acidosis cooccur are also its potential causes. The observed association between metformin and lactic acidosis may be coincidental rather than causal. This possibility merits further study.
Effect of Bacille Calmette-Guérin Vaccination on C-Peptide Secretion in Children Newly Diagnosed With IDDM
Authors: Elliott John F , Marlin Karen L , Couch Robert 
Published: March 2007

OBJECTIVE
To determine whether administration of bacille Calmette-Guerin (BCG) vaccination to newly diagnosed IDDM patients can help preserve C-peptide secretion over the subsequent 18 months.

RESEARCH DESIGN AND METHODS
Twenty-six IDDM patients, all of whom had been diagnosed within the previous year, had basal C-peptide levels &gt;0.06 nmol/1, and had negative reactions to Mantoux's test, were randomized pairwise as they presented and were given either 0.1 ml (100 μg) BCG vaccine or 0.1 ml saline intradermally. Both the patients and the investigators were blinded to the treatment. Fasting and glucagon-induced C-peptide levels and HbA1c were measured in all patients at enrollment and at 1, 3, 6, 9, 12, and 18 months after vaccination, and insulin dose was recorded at each visit.

RESULTS
At enrollment, there was no significant difference in age, duration of diabetes, insulin dose, HbA1c, or fasting C-peptide levels between the BCG-vaccinated and control groups. The mean basal and stimulated C-peptide levels in the BCG-treated group did not differ significantly from those in the control group at any time during the 18 months of followup, and there was no difference in insulin dose or HbA1c at any time between the groups.

CONCLUSIONS
BCG vaccination in children who have been recently diagnosed with IDDM does not affect the progressive decline in C-peptide levels or alter the clinical course of the disease.
Optimal Provision of Daytime NPH Insulin in Patients Using the Insulin Analog Lispro
Authors: Ahmed Abu Baker , Home Philip D 
Published: March 2007

OBJECTIVE
Insulin lispro improves early postprandial blood glucose control but can result in late interprandial hyperglycemia. As an approach to resolving this problem, we performed a randomized, crossover study with four treatment arms, comparing the daytime metabolic profile after either premeal lispro alone or premeal lispro with optimal daytime NPH insulin and with standard human regular insulin.

RESEARCH DESIGN AND METHODS
Twelve C-peptide negative type 1 diabetic patients were studied on four separate study days, at least 7 days apart. On each study day, patients received one of the four study insulin treatments, in random order, with identical meals and snacks. The four treatments were 1) premeal human regular insulin before lunch and supper at unchanged dose; 2) premeal lispro (unchanged dose) at lunchtime and dinner; 3) prelunch reduced-dose lispro (70%) before lunch and supper with supplemental lunchtime NPH and with a 6-h interval until dinner; and 4) pre-lunch reduced-dose lispro (70%) before lunch and supper with supplemental lunchtime NPH and with a 8-h interval until dinner. All patients were using their usual premeal plus basal insulin regimen during the period of the study, with human regular insulin before meals and NPH insulin at bedtime.

RESULTS
Postprandial blood glucose concentrations (1230–1500) were lower after reduced or usual lispro dose compared with human regular insulin (5.5 ± 0.2 and 5.6 ± 0.2 vs. 8.2 ± 0.5 mmol/l, P &lt; 0.001), with no difference between the lispro doses. However, preprandial (1800) blood glucose levels deteriorated to higher levels after usual-dose lispro alone compared with either human regular insulin (P &lt; 0.05) or reduced-dose lispro plus NPH (P &lt; 0.05) (8.9 ± 0.3 vs. 7.1 ± 0.8 and 6.4 ± 0.4 mmol/l), with no difference between human regular insulin and reduced-dose lispro plus NPH. During the 2 h between the usual and delayed mealtime, blood glucose concentrations remained controlled on lispro plus NPH (2000: 6.5 ± 0.4 mmol/l).

CONCLUSIONS
Reduced-dose lunchtime lispro plus NPH maintained the improvement in postprandial blood glucose control with no deterioration in interprandial blood glucose control, even up to a late meal.
Increased Nitrotyrosine in the Diabetic Placenta: Evidence for oxidative stress
Authors: Lyall Fiona , Gibson Janice L , Greer Ian A , Brockman Diane E , Eis Annie L , Myatt Laslie 
Published: March 2007

OBJECTIVE
To evaluate the presence of nitrotyrosine (NT) residues in placental villous tissue of diabetic pregnancies as an index of vascular damage linked to oxidative stress.

RESEARCH DESIGN AND METHODS
Villous tissue was collected and Hash frozen after delivery from 10 class C and D IDDM patients (37.9 ± 3.2 weeks) and 10 normotensive pregnant individuals (37.5 ± 3.8 weeks). Serial sections of tissue were immunostained with specific antibodies to NT, endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS), and manganese superoxide dismutase (MnSOD). Sections were scored for intensity of immunostaining (0–3) by three observers blinded to the identity of tissue.

RESULTS
All tissues demonstrated immunostaining for eNOS in both syncytiotrophoblast and stem villous vascular endothelium with no apparent differences between groups. Immunostaining for iNOS was seen in the villous stroma, but again was not different between the two groups. Significantly more intense NT staining was apparent in vascular endothelium and villous stroma (both P &lt; 0.02) of diabetic placentas. The endothelium of large villous vessels of diabetic tissues also showed more intense immunostaining for MnSOD (P &lt; 0.01).

CONCLUSIONS
In these diabetic pregnancies, we were unable to show increased eNOS, unlike previous findings in preeclamptic pregnancies. The presence of NT may indicate vascular damage in the diabetic placenta due to peroxynitrite action formed from increased synthesis/interaction of nitric oxide and superoxide. The apparently paradoxical increase in MnSOD expression may be an adaptive response to increased superoxide generation.
Use of the 1997 American Diabetes Association Diagnostic Criteria for Diabetes in a Hong Kong Chinese Population
Authors: Ko Gary T C , Chan Juliana C N , Woo Jean , Cockram Clive S 
Published: March 2007

OBJECTIVE
Recently, the American Diabetes Association (ADA) has proposed revised diagnostic criteria for diabetes. Lowering of the fasting plasma glucose (FPG) cutoff value is intended to reduce the discrepancy with the 2-h plasma glucose (PG) cutoff value and to encourage the use of FPG. We have applied these new criteria to data collected from a population-based prevalence survey in Hong Kong Chinese subjects of working age.

RESEARCH DESIGN AND METHODS
The results of 1,513 oral glucose tolerance tests (OGTTs) from a previously published prevalence survey of glucose intolerance and cardiovascular risk factors in a Hong Kong Chinese working population were reexamined using the new criteria. Of the 1,513 subjects, 27 had a known history of diabetes. Of the remaining 1,486 subjects, 228 were also selected randomly for a second OGTT without prior knowledge of the result of the first test

RESULTS
After exclusion of the 27 subjects with a known history of diabetes, the crude prevalence of diabetes was 2.83% (n=42) when the World Health Organization's (WHO) criteria were applied. When the criterion of FPG ≥7.0 mmol/l was used, as recommended by the ADA, the prevalence of diabetes was 1.41% (n = 21). Twenty-nine subjects (1.95%) with FPG &lt;7.0 mmol/l had a 2-h PG ≥11.1 mmol/l. Eight subjects (0.53%), previously without a diagnosis of diabetes according to the WHO criteria (FPG &lt;7.8 mmol/l and 2-h PG &lt;11.1 mmol/l), had FPG between 7.0 and 7.8 mmol/l and were classified as having diabetes by the ADA criteria. This classification gave a net change of −1.42% in the prevalence of diabetes between the use of FPG 5:7.0 mmol/l alone and the use of WHO criteria. Among the 1,486 subjects with no known history of diabetes, those classified as having diabetes according to the ADA FPG criterion alone had higher HbAlc and fructosamine levels than diabetic subjects defined by the WHO criteria. Of the 228 subjects for whom two FPG measurements were available, those who had consistent definitions (diabetes, impaired fasting glucose, normal fasting glucose) on both occasions were considered to have reproducible tests, giving an overall reproducibility of 90.8% (207 of 228).

CONCLUSIONS
Compared with the WHO criteria, the use of FPG to diagnose diabetes, as recommended by the ADA, was a more reproducible test and identified those subjects who had a greater degree of hyperglycemia. Although lowering of the cutoff value from 7.8 to 7.0 mmol/l increased the number of diagnoses among subjects with low FPG, the omission of the 2-h PG would lead to fewer subjects having their diabetes diagnosed.
Isradipine in Prediabetic Hypertensive Subjects
Authors: Byington Robert P , Furberg Curt D , Craven Timothy E , Pahor Marco , Sowers James R 
Published: March 2007

OBJECTIVE
Investigators from the Multicenter Isradipine Diuretic Atherosclerosis Study (MIDAS) previously reported that the isradipine group had a higher incidence of cardiovascular disease (CVD) events than the diuretic group. The ultimate objective of the analyses presented here was to assess how indices of glycemia (specifically, serum glucose, serum insulin, and HbAlc)might have influenced the effects of the two agents on blood pressure control and CVD events.

RESEARCH DESIGN AND METHODS
Inclusion criteria included men and women ≥40 years of age with ultrasonographically confirmed carotid atherosclerosis and a diastolic blood pressure of &gt;90 mmHg. Although insulin-dependent diabetic patients were excluded, the three glycemia indices had wide enough ranges to include patients who may be classified as prediabetic. A total of 883 patients were randomized either to the dihydropyridine calcium antagonist (CA) isradipine (2.5–5 mg twice a day) or to the diuretic hydrochlorothiazide (12.5–25 mg twice a day) and followed in double-blind fashion for 3 years.

RESULTS
Both treatment groups had achieved comparable control of diastolic blood pressure, and there were no statistically significant differences in any of the glycemia indices, either at baseline or during follow-up. However, the excess isradipine events were noted to be clustered among those patients with elevated baseline levels of HbA1c who also experienced greater blood pressure reductions during follow-up.

CONCLUSIONS
The increased cardiovascular risk associated with dihydropyridine CAs in prediabetic patients may be an explanation for the overall CA debate.
Impaired Endothelium-Dependent Vasodilatation in Women With Previous Gestational Diabetes
Authors: Anastasiou Eleni , Lekakis John P , Alevizaki Maria , Papamichael Christos M , Megas John , Souvatzoglou Athanasios , Stamatelopoulos Stamatios F 
Published: March 2007

OBJECTIVE
To assess whether otherwise healthy women with a history of gestational diabetes mellitus (GDM) may have abnormalities in endothelial function at a very early stage, before glucose intolerance occurs.

RESEARCH DESIGN AND METHODS
A total of 33 women with previous GDM (17 nonobese [BMI &lt;27] and 16 obese [BMI ≥27]) and 19 healthy nonobese women were examined. A 75-g oral glucose tolerance test was performed, and insulin levels and biochemical parameters were also measured. Using high-resolution ultrasound, we measured vasodilatory responses of the brachial artery during reactive hyperemia (endothelium-dependent vasodilatation), and after nitroglycerin administration, an endothelium-independent vasodilator.

RESULTS
Flow-mediated dilatation (FMD) was significantly and equally decreased in both groups of women with previous GDM, compared with control subjects (1.6 ± 3.7% in the nonobese GDM group and 1.6 ± 2.5% in the obese GDM group vs. 10.3 ± 4.4% in control subjects, P &lt;0.001). FMD correlated inversely with serum uric acid levels, BMI, serum total cholesterol, and basal insulin resistance (homeostasis model assessment). Nitrate-induced dilatation was significantly decreased only in the obeseGDM group compared with control subjects (21.4 ± 5.1 vs. 27.9 ± 9.5, P &lt; 0.05).

CONCLUSIONS
Endothelial dysfunction, which is considered as a very early index of atherogenesis, is alreadypresent in both obese and nonobese women with a history of GDM, even when they have normal glucose tolerance.
Variation of Postprandial Plasma Glucose, Palatability, and Symptoms Associated With a Standardized Mixed Test Meal Versus 75 g Oral Glucose
Authors: Wolever Thomas M S , Chiasson Jean-Louis , Csima Adele , Hunt John A , Palmason Carol , Ross Stuart A , Ryan Edmond A 
Published: March 2007

OBJECTIVE
To compare within-subject variability of plasma glucose measured 2 h after a glucose tolerance test (GTT) with that of plasma glucose measured 2 h after administration of a standardized test meal (diabetes screening product [DSP], Ceapro, Edmonton, Alberta, Canada) and to determine the relationship between the two sets of plasma glucose measurements.

RESEARCH DESIGN AND METHODS
Plasma glucose and insulin responses of 36 overnight-fasted subjects (10 lean normal, 9 obese normal, 9 with impaired glucose tolerance [IGT], and 8 with mild diabetes) were studied on eight different mornings after they consumed 75 g oral glucose or 50 g carbohydrate from the DSP. Each test meal was repeated four times by each subject. Within-subject coefficients of variation (CVs) (CV = 100 × SD/mean) of plasma glucose concentrations 2 h after administration of the GTT and DSP were compared by repeated measures ANOVA and linear regression analysis.

RESULTS
Mean plasma glucose 2 h after administration of the DSP (D) was linearly related to that 2 h after the GTT (G): G = 1.5 × D − 1.6 (r = 0.97, P &lt; 0.0001). The CV of 2-h plasma glucose was significantly lower after administration of the DSP, 10.5 ± 1.0%, than after the GTT, 12.7 ± 1.18% (P = 0.025). The effect of test meal on CV differed in different groups of subjects (P = 0.018), with the largest difference found in IGT subjects, in whom the CV after DSP administration was 47% &lt; after the GTT (P = 0.0005). The DSP was significantly more palatable and produced fewer adverse symptoms than the GTT.

CONCLUSIONS
Plasma glucose concentrations measured 2 h after DSP administration are closely related to those measured 2 h after the GTT but are more consistent than the 2-h post-GTT concentrations within the critical IGT range. This finding suggests that measurement of plasma glucose 2 h after administration of the DSP may allow more precise discrimination among normal glucose levels, IGT, and diabetes than measurement of plasma glucose 2 h after the GTT.