bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ethnic Differences in Insulin Sensitivity and β-Cell Function in Premenopausal or Early Perimenopausal Women Without Diabetes
Authors: Torréns Javier I. , Skurnick Joan , Davidow Amy L. , Korenman Stanley G. , Santoro Nanette , Soto-Greene Maria , Lasser Norman , Weiss Gerson 
Published: March 2007

OBJECTIVE—To assess differences in insulin sensitivity and β-cell function between nondiabetic premenopausal or early perimenopausal non-Hispanic white women and African American, Chinese American, Japanese American, and non–Mexican-American Latino women.
RESEARCH DESIGN AND METHODS—Homeostasis model assessments (HOMAs) of insulin sensitivity (HOMA%S) and β-cell function (HOMA%β) were used. Stepwise multivariable ethnic-specific ANCOVA models were used to compare HOMA%S and HOMA%β between non-Hispanic whites and each of the four ethnic groups.
RESULTS—HOMA%S was lower in African Americans, Chinese Americans, and Japanese Americans when compared with non-Hispanic white women after correcting for waist circumference, presence of impaired fasting glucose, and site. Significant differences persisted only between African Americans and non-Hispanic whites after inclusion of triglycerides in the model. Triglycerides indirectly corrected for the differences in HOMA%S in the other two groups. There were no differences in HOMA%S between the non–Mexican-American Latinos and the non-Hispanic whites. Japanese Americans and Chinese Americans had lower HOMA%β than non-Hispanic whites, whereas African Americans had higher HOMA%β than non-Hispanic whites after correcting for confounders. HOMA%β was similar between non–Mexican-American Latinos and non-Hispanic whites.
CONCLUSIONS—These data suggest that type 2 diabetes prevention strategies for African-American women should initially target decreased insulin sensitivity, whereas strategies for Japanese-American and Chinese-American women may initially need to target both decreased insulin sensitivity and β-cell function. Previous studies of Mexican-American populations may not apply to non–Mexican-American Latino women.
Cardiac Abnormalities in Diabetic Patients With Neuropathy
Authors: Johnson Brian F. , Nesto Richard W. , Pfeifer Michael A. , Slater William R. , Vinik Aaron I. , Chyun Deborah A. , Law Gordon , Wackers Frans J.Th. , Young Lawrence H. 
Published: March 2007

OBJECTIVE—The goal of this study was to determine whether treatment with an aldose reductase inhibitor (ARI) has beneficial effects on asymptomatic cardiac abnormalities in diabetic patients with neuropathy.
RESEARCH DESIGN AND METHODS—Diabetic subjects with neuropathy (n = 81) with either a low diastolic peak filling rate or impaired augmentation of left ventricular (LV) ejection fraction (LVEF) during maximal bicycle exercise were identified by gated radionuclide ventriculography. Coronary artery disease, left ventricular hypertrophy, and valvular heart disease were excluded by clinical evaluation, myocardial perfusion imaging, and echocardiography. Subjects were randomized to receive blinded treatment with either the placebo or the ARI zopolrestat 500 or 1,000 mg daily for 1 year.
RESULTS—After 1 year of ARI treatment, there were increases in resting LVEF (P &lt; 0.02), cardiac output (P &lt; 0.03), LV stroke volume (P &lt; 0.004), and exercise LVEF (P &lt; 0.001). In placebo-treated subjects, there were decreases in exercise cardiac output (P &lt; 0.03), stroke volume (P &lt; 0.02), and end diastolic volume (P &lt; 0.04). Exercise LVEF increased with ARI treatment independent of blood pressure, insulin use, or the presence of baseline abnormal heart rate variability. There was no change in resting diastolic filling rates in either group.
CONCLUSIONS—Diabetic patients with neuropathy have LV abnormalities that can be stabilized and partially reversed by ARI treatment.
Nondipping and Its Relation to Glomerulopathy and Hyperfiltration in Adolescents With Type 1 Diabetes
Authors: Torbjörnsdotter Torun B. , Jaremko Georg A. , Berg Ulla B. 
Published: March 2007

OBJECTIVE—To determine whether there is a relation between dipping/nondipping status and end-organ damage (measured as renal glomerulopathy) and long-term renal function in order to predict the development of nephropathy in normoalbuminuric patients with type 1 diabetes.
RESEARCH DESIGN AND METHODS—Analysis of renal biopsy and ambulatory blood pressure measurements was done in relation to renal function tests performed during a 10-year period. Forty unselected patients (16 girls), with a mean age of 17.7 years and a mean duration of 10.7 years, were studied. The renal biopsies were examined by electron microscopy. Ambulatory blood pressure was monitored (Space Labs 90 207). Systolic nondippers were defined as a &lt;7%, diastolic nondippers as a &lt;14%, and mean arterial blood pressure (MAP) nondippers as a &lt;12% fall in blood pressure during the night. Renal function was evaluated every other year by clearances of inulin (glomerular filtration rate [GFR]) and para-amino hippurate (effective renal plasma flow [ERPF]), and filtration fraction (GFR/ERPF) was calculated. Overnight urinary albumin excretion rate and long-term mean HbA1c were measured.
RESULTS—MAP (27% of the patients) and diastolic nondippers (12%) had a significantly thicker basement membrane; larger mesangial matrix volume fraction; and higher long-term GFR, nighttime heart rate, and mean HbA1c than dippers.
CONCLUSIONS—Nondipping status was related to more renal morphological changes and long-term hyperfiltration in normoalbuminuric adolescents and young adults, despite a short duration of type 1 diabetes. Nondipping status may be an early predictor of later nephropathy.
Predictors of the Incident Metabolic Syndrome in Adults
Authors: Palaniappan Latha , Carnethon Mercedes R. , Wang Yun , Hanley Anthony J.G. , Fortmann Stephen P. , Haffner Stephen M. , Wagenknecht Lynne 
Published: March 2007

OBJECTIVE—To prospectively investigate predictors of the incident metabolic syndrome in nondiabetic adults.
RESEARCH DESIGN AND METHODS—This analysis included 714 white, black, and Hispanic participants in the Insulin Resistance Atherosclerosis Study (IRAS) who were free of the metabolic syndrome at baseline; 139 of these developed the metabolic syndrome in the subsequent 5 years. We examined measures of glucose (fasting and 2 h), insulin (fasting and 2 h, acute insulin response, insulin sensitivity [Si], and proinsulin), lipids (HDL and triglycerides), blood pressure (systolic and diastolic), waist circumference, and baseline physical activity (total energy expenditure) as predictors of the metabolic syndrome. Logistic regression models were adjusted for age, sex, study site, ethnicity, and impaired glucose tolerance. Signal detection analysis was used to identify the characteristics of the highest risk group.
RESULTS—The best predictors of incident metabolic syndrome were waist circumference (odds ratio [OR] 1.7 [1.3–2.0] per 11 cm), HDL cholesterol (0.6 [0.4–0.7] per 15 mg/dl), and proinsulin (1.7 [1.4–2.0] per 3.3 pmol/l). Signal detection analysis identified waist circumference (&gt;89 cm in women, &gt;102 cm in men) as the optimal predictor.
CONCLUSIONS—These findings suggest that obesity may precede the development of other metabolic syndrome components. Interventions that address obesity and reduce waist circumference may reduce the incidence of the metabolic syndrome in nondiabetic adults.
Preclinical Atherosclerosis and Inflammation in 61-Year-Old Men With Newly Diagnosed Diabetes and Established Diabetes
Authors: Sigurdardottir Vilborg , Fagerberg Björn , Hulthe Johannes 
Published: March 2007

OBJECTIVE—The aim of this study was to investigate the occurrence of subclinical atherosclerosis and underlying mechanisms in men with newly diagnosed diabetes and established diabetes compared with healthy control subjects.
RESEARCH DESIGN AND METHODS—In a population-based study of 61-year-old Caucasian men (n = 271) with established diabetes (n = 50) and newly diagnosed diabetes (n = 24) and healthy control subjects (n = 197), standard risk factors and highly sensitive (hs) C-reactive protein (CRP) were measured. Ultrasound measurements of intima-media thickness (IMT) were performed bilaterally in the common carotid artery, and a composite measure was calculated from common carotid and carotid bulb IMT (composite IMT). The plaque status was assessed.
RESULTS—Composite IMT and carotid plaque size increased gradually among the healthy control subjects, newly diagnosed diabetic patients, and established diabetic patients (P for trend ≤0.001, respectively). CRP was higher in newly and established diabetes (NS between diabetes groups) compared with healthy control subjects (P &lt; 0.001). Total cholesterol levels were lower in newly diagnosed diabetes (5.51 ± 1.13 mmol/l, P &lt; 0.05) and established diabetes (5.45 ± 1.15 mmol/l, P &lt; 0.01) compared with those of healthy control subjects (5.77 ± 1.03 mmol/l). In men with diabetes (n = 74), diabetes onset status (newly diagnosed versus established), waist-to-hip ratio (WHR), and serum triglycerides, but not CRP, explained 16% of the variance in composite IMT.
CONCLUSIONS—This is the first study to show increased preclinical atherosclerotic changes (IMT and plaque size) and increased inflammation (hs-CRP) in men with newly diagnosed diabetes as well as in patients with established diabetes compared with healthy control subjects. WHR, diabetes onset status (newly diagnosed versus established), and triglycerides, but not CRP, were independent correlates of carotid artery IMT in men with diabetes.
Role of Simvastatin as an Immunomodulator in Type 2 Diabetes
Authors: Lopes-Virella Maria F. , Mironova Marina , Stephan Elias , Durazo-Arvizu Ramon , Virella Gabriel 
Published: March 2007

OBJECTIVE—To test the hypothesis that simvastatin reduces the levels of circulating immune complexes (ICs) containing modified lipoproteins (mLDLs; mLDL-ICs), which may represent an additional mechanism for the reduced incidence of cardiovascular events in patients treated with simvastatin.
RESEARCH DESIGN AND METHODS—A total of 26 patients with type 2 diabetes and triglyceride levels &lt;400 mg/dl who were not receiving lipid-lowering medications or CYP 3A4 inhibitors were enrolled in the study. After 2 weeks on a lipid-lowering diet and exercise, the patients were started on simvastatin 20 mg/day. The dose of simvastatin was adjusted until the levels of LDL cholesterol were ≤100 mg/dl. Blood was collected at baseline, 3 and 6 months after LDL cholesterol levels reached target, and 3 months after stopping simvastatin to measure advanced glycation end product LDL and oxidized LDL antibodies, mLDL-IC, intracellular adhesion molecule-1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1), E-selectin, metalloproteinase-1 (MMP-1), lipid profile, liver function tests, creatinine kinase, glucose, and HbA1c.
RESULTS—Twenty-one patients completed the study. Their HbA1c remained within 1% of baseline levels. There was a highly significant decrease in mLDL-IC levels after 3 and 6 months of treatment with simvastatin, with a return to near baseline levels after discontinuation.
CONCLUSIONS—Simvastatin significantly reduced the concentration of mLDL-IC, probably as a consequence of both a decrease in the formation of mLDL and to a reduction in the titers of mLDL antibodies. This effect is likely to have a beneficial impact in the inflammatory reaction associated with atherosclerosis.
Telecare for Patients With Type 1 Diabetes and Inadequate Glycemic Control
Authors: Montori Victor M. , Helgemoe Pamela K. , Guyatt Gordon H. , Dean Diana S. , Leung Teresa W. , Smith Steven A. , Kudva Yogish C. 
Published: March 2007

OBJECTIVE—To determine the efficacy of telecare (modem transmission of glucometer data and clinician feedback) to support intensive insulin therapy in patients with type 1 diabetes and inadequate glycemic control.
RESEARCH DESIGN AND METHODS—Thirty-one patients with type 1 diabetes on intensive insulin therapy and with HbA1c &gt;7.8% were randomized to telecare (glucometer transmission with feedback) or control (glucometer transmission without feedback) for 6 months. The primary end point was 6-month HbA1c. To place our findings in context, we pooled HbA1c change from baseline reported in randomized trials of telecare identified in a systematic review of the literature.
RESULTS—Compared with the control group, telecare patients had a significantly lower 6-month HbA1c (8.2 vs. 7.8%, P = 0.03, after accounting for HbA1c at baseline) and a nonsignificant fourfold greater chance of achieving 6-month HbA1c ≤7% (29 vs. 7%; risk difference 21.9%, 95% CI −4.7 to 50.5). Nurses spent 50 more min/patient giving feedback on the phone with telecare patients than with control patients. Meta-analysis of seven randomized trials of adult patients with type 1 diabetes found a 0.4% difference (95% CI 0–0.8) in HbA1c mean change from baseline between the telecare and control groups.
CONCLUSIONS—Telecare is associated with small effects on glycemic control in patients with type 1 diabetes on intensive insulin therapy but with inadequate glycemic control.
Contrasting Diabetes Phenotypes Associated With Hepatocyte Nuclear Factor-1α and -1β Mutations
Authors: Pearson Ewan R. , Badman Michael K. , Lockwood Christopher R. , Clark Penelope M. , Ellard Sian , Bingham Coralie , Hattersley Andrew T. 
Published: March 2007

OBJECTIVE—Mutations in the highly homologous transcription factors hepatocyte nuclear factor (HNF)-1α and -1β cause maturity-onset diabetes of the young types 3 and 5, respectively. Diabetes due to HNF-1α mutations is well characterized. However, physiological assessment of the HNF-1β phenotype is limited. We aimed to test the hypothesis that the diabetes phenotype due to HNF-1β mutations is similar to that in HNF-1α.
RESEARCH DESIGN AND METHODS—Fasting biochemistry and a tolbutamide-modified intravenous glucose tolerance test (IVGTT) were compared in matched HNF-1β, HNF-1α, type 2 diabetic, and control subjects. Homeostasis model assessment indexes were determined from fasting insulin and glucose. The peak measures for the insulin increment after tolbutamide and for the insulin increment after glucose were determined from the IVGTT.
RESULTS—The HNF-1β patients showed a 2.4-fold reduction in insulin sensitivity compared with the HNF-1α patients (P = 0.001) with fasting insulin concentrations 2.7-fold higher (P = 0.004). HNF-1β patients had lower HDL cholesterol (1.17 vs. 1.46 mmol/l; P = 0.009) and higher triglyceride (2.2 vs. 1.35 mmol/l; P = 0.015) levels than HNF-1α patients. The HNF-1β patients had similar β-cell responses to tolbutamide and glucose as the type 2 diabetic patients, but in the HNF-1α patients, the tolbutamide response was considerably increased relative to the response to glucose (P = 0.002).
CONCLUSIONS—HNF-1β patients have a different diabetes phenotype than HNF-1α patients. Those with HNF-1β mutations have hyperinsulinemia and associated dyslipidemia consistent with insulin resistance and may have a different β-cell defect. This suggests that despite considerable homology and a shared binding site, HNF-1α and HNF-1β have a different role in maintaining normal glucose homeostasis. This result suggests a new etiological pathway for insulin resistance involving HNF-1β.
Influence of Caffeine on Heart Rate Variability in Patients With Long-Standing Type 1 Diabetes
Authors: Richardson Tristan , Rozkovec Adrian , Thomas Peter , Ryder Jacqueline , Meckes Candy , Kerr David 
Published: March 2007

OBJECTIVE—The effect of caffeine on cardiovascular health remains controversial. Patients with long-standing type 1 diabetes are at risk of autonomic failure and sudden cardiac death. We investigated the effects of caffeine on autonomic dysfunction (as assessed by heart rate variability [HRV]) in this high-risk group and in a control population.RESEARCH DESIGN AND METHODS—Using a randomized blinded, placebo-controlled, crossover design trial, we examined 2 weeks of caffeine consumption (250 mg twice daily) on HRV in 20 type 1 diabetic patients and 10 matched healthy volunteers.RESULTS—Baseline HRV was blunted in the diabetic patients (P &lt; 0.0005 vs. control subjects) and markedly increased by caffeine in both groups (+103% in the group with diabetes [P = 0.009] and +38% in control subjects [P = 0.002]). The caffeine-associated increase in HRV was not statistically different between the control and the type 1 diabetes groups (P = 0.16).CONCLUSIONS—Modest amounts of caffeine improved autonomic function in diabetic patients and healthy volunteers. For individuals with abnormal HRV, regular caffeine use may have the potential to reduce the risk of cardiovascular events.
Risk of Community-Acquired Pneumococcal Bacteremia in Patients With Diabetes
Authors: Wernich Thomsen Reimar , Holmager Hundborg Heidi , Lervang Hans-Henrik , Paaske Johnsen Søren , Schønheyder Henrik Carl , Toft Sørensen Henrik 
Published: March 2007

OBJECTIVE—We conducted this population-based case-control study to examine whether diabetes is associated with an increased risk of community-acquired pneumococcal bacteremia.
RESEARCH DESIGN AND METHODS—We included 598 cases in the North Jutland County Bacteremia Registry, Denmark, with residence in the county and a first hospitalization for community-acquired pneumococcal bacteremia from 1992 through 2001. Ten sex- and age-matched population control subjects per case were selected, using a unique personal identifier. Diabetes was determined by record linkage with the County Prescription Database (for prescriptions for antidiabetic drugs) and the Hospital Discharge Registry (for previous hospitalizations with diabetes or diabetic complications). We performed conditional logistic regression to estimate odds ratios (ORs) for pneumococcal bacteremia among diabetic and nondiabetic persons, with adjustment for a range of comorbid diseases considered to be risk factors for pneumococcal infection.
RESULTS—The crude OR for pneumococcal bacteremia in persons with diabetes was 1.9 (95% CI 1.4–2.6). After adjustment for comorbidity, the OR decreased to 1.5 (95% CI 1.1–2.0). The impact of diabetes on the risk for pneumococcal bacteremia was most pronounced in adults aged 40 years and younger (adjusted OR 4.2, 95% CI 1.1–16.7) and in persons without any other coexisting morbidity (adjusted OR 2.3, 95% CI 1.3–3.9). Under the assumptions that the association was causal and that there is a 5% overall prevalence of diabetes in our study population, 24 of 1,000 admissions with incident pneumococcal bacteremia may be attributed to diabetes.
CONCLUSIONS—Diabetes seems to be a risk factor for community-acquired pneumococcal bacteremia.
Insulin Sensitivity in the Offspring of Women With Type 1 and Type 2 Diabetes
Authors: Hunter Wendy A. , Cundy Tim , Rabone Diana , Hofman Paul L. , Harris Mark , Regan Fiona , Robinson Elizabeth , Cutfield Wayne S. 
Published: March 2007

OBJECTIVE—To determine if insulin sensitivity is altered in prepubertal offspring exposed to a diabetic intrauterine environment.
RESEARCH DESIGN AND METHODS—Fifteen control children, 17 offspring of type 1 diabetic women, and 10 offspring of type 2 diabetic women, aged between 5 and 10 years, underwent a frequently sampled intravenous glucose tolerance test (FSIGTT). Weight and height were measured, and body composition was calculated using bioelectrical impedance. Bergman’s minimal model was applied to the glucose and insulin measurements to obtain values for insulin sensitivity (Si), acute insulin response (AIR), and glucose effectiveness (Sg).
RESULTS—Si was lowest in the offspring of type 2 diabetic mothers, and AIR was highest in this group, although neither of these changes reached significance (Si, P = 0.2, and AIR, P = 0.3). Offspring of type 2 diabetic mothers had higher BMI SD scores (P = 0.004) and percentage fat mass (P = 0.002) than the children in the other two groups. The BMI SD score and percentage fat mass in the subjects, as well as maternal insulin dose, were negatively correlated with offspring insulin sensitivity.
CONCLUSIONS—Intrauterine exposure to hyperglycemia by itself was not associated with alterations in glucose regulation in prepubertal offspring. Children of mothers with type 2 diabetes, however, were overweight, and they had a tendency for a reduced Si. The combined effect of genetic and postnatal environmental factors, rather than prenatal exposure to hyperglycemia, may place this group at risk for developing impaired glucose tolerance in later life.
Younger Age at Onset and Sex Predict Celiac Disease in Children and Adolescents With Type 1 Diabetes
Authors: Cerutti Franco , Bruno Graziella , Chiarelli Francesco , Lorini Renata , Meschi Franco , Sacchetti Carla ,   the Diabetes Study Group of Italian Society of Pediatric Endocrinology and Diabetology
Published: March 2007

OBJECTIVE—To estimate the prevalence of biopsy-confirmed celiac disease in Italian children and adolescents with type 1 diabetes and to assess whether age at onset of type 1 diabetes is independently associated with diagnosis of celiac disease.
RESEARCH DESIGN AND METHODS—The study group was a clinic-based cohort of children and adolescents with type 1 diabetes cared for in 25 Italian centers for childhood diabetes. Yearly screening for celiac disease was performed using IgA/IgG anti-gliadin and IgA anti-endomysium antibodies.
RESULTS—Of the 4,322 children and adolescents (age 11.8 ± 4.2 years) identified with type 1 diabetes, biopsy-confirmed celiac disease was diagnosed in 292 (prevalence 6.8%, 95% confidence interval [CI] 6.0–7.6), with a higher risk seen in girls than in boys (odds ratio [OR] 1.93, 1.51–2.47). In 89% of these, diabetes was diagnosed before celiac disease. In logistic regression analyses, being younger at onset of diabetes, being female, and having a diagnosis of a thyroid disorder were independently associated with the risk of having diabetes and celiac disease. In comparison with subjects who were older than 9 years at onset of diabetes, subjects who were younger than 4 years at onset had an OR of 3.27 (2.20–4.85).
CONCLUSIONS—We have provided evidence that 1) the prevalence of biopsy-confirmed celiac disease in children and adolescents with type 1 diabetes is high (6.8%); 2) the risk of having both diseases is threefold higher in children diagnosed with type 1 diabetes at age &lt;4 years than in those age &gt;9 years; and 3) girls have a higher risk of having both diseases than boys.