bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes, Major Depression, and Functional Disability Among U.S. Adults
Authors: Egede Leonard E. 
Published: March 2007

OBJECTIVE—The goal of this study was to determine prevalence and odds of functional disability in individuals with diabetes and comorbid major depression compared with individuals with either diabetes or major depression alone.
RESEARCH DESIGN AND METHODS—Data on 30,022 adults aged ≥18 years from the 1999 National Health Interview Survey (NHIS) were analyzed. Four disease categories were created: no diabetes and no major depression, major depression alone, diabetes alone, and diabetes and comorbid major depression. Prevalence of functional disability was calculated for each disease category. Multiple logistic regression was used to determine the odds and correlates of functional disability by disease category controlling for age, sex, race/ethnicity, education, income, census region, and disability-associated comorbidity. STATA was used for all analyses to account for the complex survey design of NHIS.
RESULTS—Prevalence of functional disability by disease category was as follows: no diabetes and no major depression (24.5%); major depression (51.3%); diabetes (58.1%); and diabetes and comorbid major depression (77.8%). With no diabetes and no major depression as reference and after adjusting for relevant covariates, the odds of functional disability was 3.00 (95% CI 2.62–3.42) for major depression, 2.42 (2.10–2.79) for diabetes, and 7.15 (4.53–11.28) for diabetes and comorbid major depression.
CONCLUSIONS—Individuals with diabetes and comorbid major depression have higher odds of functional disability compared with individuals with either diabetes or major depression alone. Additional studies are needed to establish a causal relationship.
Efficacy of Ipomoea batatas (Caiapo) on Diabetes Control in Type 2 Diabetic Subjects Treated With Diet
Authors: Ludvik Bernhard , Neuffer Beatrice , Pacini Giovanni 
Published: March 2007

OBJECTIVE—To investigate the tolerability, efficacy, and mode of action of Caiapo, an extract of white sweet potatoes, on metabolic control in type 2 diabetic patients.
RESEARCH DESIGN AND METHODS—A total of 61 type 2 diabetic patients treated by diet were given 4 g Caiapo (n = 30; mean age 55.2 ± 2.1 years; BMI 28.0 ± 0.4 kg/m2) or placebo (n = 31; mean age 55.6 ± 1.5 years; BMI 27.6 ± 0.3 kg/m2) once daily for 12 weeks. Each subject underwent a 75-g oral glucose tolerance test (OGTT) at baseline and after 1, 2, and 3 months to assess 2-h glucose levels. Additionally, fasting blood glucose, HbA1c, total cholesterol, and triglyceride levels were measured.
RESULTS—After treatment with Caiapo, HbA1c decreased significantly (P &lt; 0.001) from 7.21 ± 0.15 to 6.68 ± 0.14%, whereas it remained unchanged (P = 0.23) in subjects given placebo (7.04 ± 0.17 vs. 7.10 ± 0.19%). Fasting blood glucose levels decreased (P &lt; 0.001) in the Caiapo group (143.7 ± 1.9 vs. 128.5 ± 1.7 mg/dl) and did not change in the placebo group (144.3 ± 1.9 vs. 138.2 ± 2.1 mg/dl; P = 0.052). A decrease in body weight was observed in both the placebo group (P = 0.0027) and in the Caiapo group (P &lt; 0.0001), probably due to a better- controlled lifestyle. In the Caiapo group, body weight was related to the improvement in glucose control (r = 0.618; P &lt; 0.0002). Two-hour glucose levels were significantly (P &lt; 0.001) decreased in the Caiapo group (193.3 ± 10.4 vs. 162.8 ± 8.2 mg/dl) compared with the placebo group (191.7 ± 9.2 vs. 181.0 ± 7.1 mg/dl). Mean cholesterol at the end of the treatment was significantly lower in the Caiapo group (214.6 ± 11.2 mg/dl) than in the placebo group (248.7 ± 11.2 mg/dl; P &lt; 0.05). No significant changes in triglyceride levels or blood pressure were observed, and Caiapo was well tolerated without significant adverse effects.
CONCLUSIONS—This study confirms the beneficial effects of Caiapo on plasma glucose as well as cholesterol levels in patients with type 2 diabetes. For the first time, the long-term efficacy of Caiapo on glucose control was demonstrated by the observed decrease in HbA1c. Thus, the neutraceutical Caiapo seems to be a useful agent in the treatment of type 2 diabetes.
Anti-Inflammatory and Anticoagulant Effects of Pravastatin in Patients With Type 2 Diabetes
Authors: Sommeijer Dirkje W. , MacGillavry Melvin R. , Meijers Joost C.M. , Van Zanten Anton P. , Reitsma Pieter H. , Cate Hugo Ten 
Published: March 2007

OBJECTIVE—Type 2 diabetes is associated with increased plasma concentrations of coagulation and inflammation markers. Different studies have shown that treatment with hydroxymethylglutaryl-CoA reductase inhibitors (statins) is associated with antithrombotic and anti-inflammatory effects in addition to a cholesterol-lowering effect. Our objective was to evaluate the effect of pravastatin (40 mg/day) on coagulation and inflammation markers in type 2 diabetic patients.
RESEARCH DESIGN AND METHODS—This was an open, randomized, crossover study designed with an 8-week intervention period. The study group was comprised of 50 patients with type 2 diabetes (median HbA1c 7.1%) and serum total cholesterol of 5–10 mmol/l. We evaluated plasma levels of fibrinogen, F1 + 2, d-dimer, soluble tissue factor (sTF), von Willebrand Factor antigen (vWFag), and C-reactive protein (CRP) in blood samples drawn after fasting on day 1 and after 8 and 16 weeks.
RESULTS—Significant reductions of total cholesterol (−22%; P &lt; 0.001), LDL cholesterol (−32%; P &lt; 0.001), and triglycerides (−10%; P &lt; 0.05) were achieved after 8 weeks of treatment with pravastatin. In addition, significant reductions of plasma levels of F1 + 2 (−4.4%; P &lt; 0.05), vWFag (−5.3%; P &lt; 0.05), and sTF (−3.4%; P &lt; 0.05) were observed after treatment with pravastatin. Furthermore, plasma levels of CRP were also significantly reduced (−13%; P &lt; 0.05). Levels of fibrinogen and d-dimer did not decrease after treatment with pravastatin.
CONCLUSIONS—The results indicated that pravastatin reduces levels of coagulation and inflammation markers in type 2 diabetic patients. These antithrombotic and anti-inflammatory effects of treatment with statins could play a role in reducing cardiovascular complications in type 2 diabetic patients.
Establishment of Blood Glucose Monitoring System Using the Internet
Authors: Kwon Hyuk-Sang , Cho Jae-Hyoung , Kim Hee-Soo , Song Bok-Re , Ko Seung-Hyun , Lee Jung-Min , Kim Sung-Rae , Chang Sang-Ah , Kim Hee-Seung , Cha Bong-Yun , Lee Kwang-Woo , Son Ho-Young , Lee Jin-Hee , Lee Won-Chul , Yoon Kun-Ho 
Published: March 2007

OBJECTIVE—The Internet is used worldwide as a communication tool. To improve the quality of diabetes control, we investigated the effectiveness of an Internet-based blood glucose monitoring system (IBGMS) on controlling the changes in HbA1c levels.
RESEARCH DESIGN AND METHODS—We conducted a randomized clinical trial involving 110 patients who visited the outpatient clinic at the Kangnam St. Mary’s Hospital for 3 months. The study subjects were treated with IBGMS for 12 weeks, and the control group received the usual outpatient management over the same period. HbA1c and other laboratory tests were performed twice, once at the beginning of the study and again at the end of the study.
RESULTS—The test results from the beginning of the study established that there were no significant differences between the two groups with respect to age, sex, diabetes duration, BMI, blood pressure, HbA1c, and other laboratory data. On follow-up examination 12 weeks later, HbA1c levels were significantly decreased from 7.59 to 6.94% within the intervention group (P &lt; 0.001). At the end of the study, HbA1c levels in the intervention group were significantly lower than in the control group after adjusting the baseline HbA1c (6.94 vs. 7.62%; P &lt; 0.001, respectively). Among patients with baseline HbA1c &lt;7.0%, the patients in the intervention group had lower HbA1c than those in the control group (6.38 vs. 6.99%; P &lt; 0.05). Among the patients with a baseline HbA1c ≥7.0%, the difference between the two groups appeared more obvious: HbA1c levels at the end of the study were 8.12%.
CONCLUSIONS—This new IBGMS resulted in a significant reduction of HbA1c during the study period. We propose that this IBGMS be used as a method for improving diabetes control.
Adiponectin in Youth
Authors: Bacha Fida , Saad Rola , Gungor Neslihan , Arslanian Silva A. 
Published: March 2007

OBJECTIVE—Adiponectin is an adipose tissue protein that enhances insulin sensitivity and has antiatherogenic properties. The present study investigated the relationship of adiponectin levels in adolescents to 1) obesity and body fat distribution and 2) insulin sensitivity and the components of syndrome X.
RESEARCH DESIGN AND METHODS—Twenty-three normal-weight and 26 obese adolescents had fasting adiponectin, lipid profile, and proinsulin measurements performed. Hepatic and peripheral insulin sensitivity were assessed with constant-rate [6,6-2H2]glucose infusion and a 3-h hyperinsulinemic-euglycemic clamp, respectively. Body composition was evaluated by dual-energy X-ray absorptiometry, and visceral adipose tissue (VAT) and subcutaneous adipose tissue were measured by computed tomography scan at the L4-L5 level.
RESULTS—Obese adolescents had ∼50% lower adiponectin than normal-weight adolescents. Moreover, obese adolescents with high (111.8 ± 9.3 cm2) versus low (55.4 ± 2.1 cm2) VAT had lower adiponectin levels (6.2 ± 0.9 vs. 9.0 ± 1.0 μg/ml, P = 0.05). Plasma adiponectin correlated positively with peripheral and hepatic insulin sensitivity (r = 0.67, P &lt; 0.001 and r = 0.54, P &lt; 0.001, respectively) and HDL (r = 0.52, P &lt; 0.001) and negatively with fasting proinsulin and the proinsulin-to-insulin ratio (r = −0.64, P &lt; 0.001 and r = −0.43, P = 0.003, respectively). In a multiple regression analysis, adiponectin, independently and together with BMI, explained 73% (R2 = 0.73, P &lt; 0.001) of the variance in insulin sensitivity. Adiponectin, but not adiposity, was the significant independent determinant of the proinsulin-to-insulin ratio (R2 = 0.18, P = 0.008) and of HDL (R2 = 0.45, P &lt; 0.001).
CONCLUSIONS—In summary, hypoadiponectinemia in youth is a strong and independent correlate of insulin resistance, β-cell dysfunction, visceral adiposity, and syndrome X. The antidiabetogenic and antiatherogenic properties of adiponectin are evident early in life and compromised in youth-onset obesity.
Geographical Variation in Risk HLA-DQB1 Genotypes for Type 1 Diabetes and Signs of β-Cell Autoimmunity in a High-Incidence Country
Authors: Kukko Marika , Virtanen Suvi M. , Toivonen Anna , Simell Satu , Korhonen Sari , Ilonen Jorma , Simel Olli , Knip Mikael 
Published: March 2007

OBJECTIVE—To assess possible differences in the frequency of HLA-DQB1 risk genotypes and the emergence of signs of β-cell autoimmunity among three geographical regions in Finland.
RESEARCH DESIGN AND METHODS—The series comprised 4,642 children with increased HLA-DQB1–defined genetic risk of type 1 diabetes from the Diabetes Prediction and Prevention (DIPP) study: 1,793 (38.6%) born in Turku, 1,646 (35.5%) in Oulu, and 1,203 (25.9%) in Tampere. These children were examined frequently for the emergence of signs of β-cell autoimmunity, for the primary screening of which islet cell antibodies (ICA) were used. If the child developed ICA, all samples were also analyzed for insulin autoantibodies (IAA), GAD65 antibodies (GADA), and antibodies to the IA-2 molecule (IA-2A).
RESULTS—The high- and moderate-risk genotypes were unevenly distributed among the three areas (P &lt; 0.001); the high-risk genotype was less frequent in the Oulu region (20.4%) than in the Turku (28.4%; P &lt; 0.001) or Tampere regions (27.2%; P &lt; 0.001). This genotype was associated with an increased frequency of ICA seroconversion relative to the moderate risk genotypes (hazard ratio 1.89, 95% CI 1.36–2.62). Seroconversions to ICA positivity occurred less commonly in Tampere than in Turku (0.47, 0.28–0.75), whereas the seroconversion rate in Oulu did not differ from that in Turku (0.72, 0.51–1.03). The Tampere-Turku difference persisted after adjustment for risk genotypes, sex, and time of birth (before January 1998 versus later). Seroconversion for at least one additional autoantibody was also less frequent in Tampere than in Turku (0.39, 0.16–0.82).
CONCLUSIONS—These data show that in Finland, the country with the highest incidence of type 1 diabetes in the world, both the frequency of the high-risk HLA-DQB1 genotype and the risk of seroconversion to autoantibody positivity show geographical variation. The difference in seroconversion rate could not be explained by the difference in HLA-DQB1–defined disease susceptibility, implying that the impact of environmental triggers of diabetes-associated autoimmunity may differ between the three regions studied.
Adequacy of Glycemic, Lipid, and Blood Pressure Management for Patients With Diabetes in a Managed Care Setting
Authors: Beaton Sarah J. , Nag Soma S. , Gunter Margaret J. , Gleeson Jeremy M. , Sajjan Shiva S. , Alexander Charles M. 
Published: March 2007

OBJECTIVE—We conducted a retrospective study to evaluate the adequacy of glycemic, lipid, and blood pressure (BP) management for diabetic patients in a managed care organization (MCO).
RESEARCH DESIGN AND METHODS—Patients aged ≥18 years with diabetes (n = 7,114) were retrospectively identified over a 2-year period from the MCO’s administrative database based on the Health Plan Employer Data and Information Set 2000 selection criteria using pharmacy, laboratory, and encounter data. Analyses examined demographics and percentages of patients tested and meeting American Diabetes Association goals for HbA1c, lipids, and BP, both overall and for those receiving medication treatment versus no treatment.
RESULTS—Testing rates for A1C, LDL cholesterol, and BP were 77, 54, and 95%, respectively. The percentage of patients tested who were at goal were 37% for A1C, 23% for LDL cholesterol, and 41% for systolic BP. Of the patients in our sample, 72% were treated for glycemic control, 64% were treated for BP control, and only 28% were treated for lipid control. Of the patients who received medication treatment, less than one-third were at goal for A1C (29%) and LDL cholesterol (32%), whereas 40% were at goal for systolic BP.
CONCLUSIONS—We found that although a large percentage of diabetic patients were tested for A1C, LDL cholesterol, and systolic BP, a much smaller percentage had reached their respective goals. More aggressive glycemic, lipid, and BP management appears to be needed to improve care for these patients.
Heart Failure Prevalence, Incidence, and Mortality in the Elderly With Diabetes
Authors: Bertoni Alain G. , Hundley W. Gregory , Massing Mark W. , Bonds Denise E. , Burke Gregory L. , Goff David C. 
Published: March 2007

OBJECTIVE—The goal of this study was to determine heart failure prevalence and incidence rates, subsequent mortality, and risk factors for heart failure among older populations in Medicare with diabetes.
RESEARCH DESIGN AND METHODS—We used a national 5% sample of Medicare claims from 1994 to 1999 to perform a population-based, nonconcurrent cohort study in 151,738 beneficiaries with diabetes who were age ≥65 years, not in managed care, and were alive on 1 January 1995. Prevalent heart failure was defined as a diagnosis of heart failure in 1994; incident heart failure was defined as a new diagnosis in 1995–1999 among those without prevalent heart failure. Mortality was assessed through 31 December 1999.
RESULTS—Heart failure was prevalent in 22.3% in 1994. Among individuals without heart failure in 1994, the heart failure incidence rate was 12.6 per 100 person-years (95% CI 12.5–12.7 per 100 person-years). Incidence was similar by sex and race and increased significantly with age and diabetes-related comorbidities. The adjusted hazard of incident heart failure increased for individuals with the following: metabolic complications of diabetes (a proxy for poor control and/or severity) (hazards ratio 1.23, 95% CI 1.18–1.29), ischemic heart disease (1.74, 1.70–1.79), nephropathy (1.55, 1.45–1.67), and peripheral vascular disease (1.35, 1.31–1.39). Over 60 months, incident heart failure among older adults with diabetes was associated with high mortality—32.7 per 100 person-years compared with 3.7 per 100 person-years among those with diabetes who remained heart failure free.
CONCLUSIONS—These data demonstrate alarmingly high prevalence, incidence, and mortality for heart failure in individuals with diabetes. Prevention of heart failure should be a research and clinical priority.
Elevated Plasma Asymmetric Dimethylarginine as a Marker of Cardiovascular Morbidity in Early Diabetic Nephropathy in Type 1 Diabetes
Authors: Tarnow Lise , Hovind Peter , Teerlink Tom , Stehouwer Coen D.A. , Parving Hans-Henrik 
Published: March 2007

OBJECTIVE—Increased plasma concentration of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, has been associated with endothelial dysfunction, insulin resistance, and atherosclerosis in nondiabetic populations. In end-stage renal failure, circulating ADMA is elevated and a strong predictor of cardiovascular outcome. This study investigated the relation between ADMA and diabetic micro- and macrovascular complications in a large cohort of type 1 diabetic patients with and without early diabetic nephropathy.
RESEARCH DESIGN AND METHODS—ADMA concentrations in plasma were determined by a high-performance liquid chromatography method in 408 type 1 diabetic patients with overt diabetic nephropathy (252 men; mean age 42.7 years [SD 11.0], mean duration of diabetes 28 years [SD 9], median serum creatinine level 102 μmol/l [range 52–684]). A group of 192 patients with longstanding type 1 diabetes and persistent normoalbuminuria served as control subjects (118 men; mean age 42.6 years [SD 10.2], mean duration of diabetes 27 years [SD 9]).
RESULTS—In patients with diabetic nephropathy, mean ± SD plasma ADMA concentration was elevated 0.46 ± 0.08 vs. 0.40 ± 0.08 μmol/l in normoalbuminuric patients (P &lt; 0.001). An increase in plasma ADMA of 0.1 μmol/l increased the odds ratio of nephropathy to 2.77 (95% CI 1.89–4.05) (P &lt; 0.001). Circulating ADMA increased in nephropathy patients with declining kidney function, as indicated by elevated values in the lower quartiles of glomerular filtration rate (&lt;76 ml · min–1 · 1.73 m–2) (P &lt; 0.001 ANOVA). Mean ADMA levels were similar in patients with or without diabetic retinopathy (P &gt; 0.2). However, in 44 patients with nephropathy and history of myocardial infarction and/or stroke, ADMA was significantly elevated at 0.48 ± 0.08 μmol/l compared with 0.46 ± 0.08 μmol/l in patients without major cardiovascular events (P = 0.05).
CONCLUSIONS—Elevated circulating ADMA may contribute to the excess cardiovascular morbidity and mortality in early diabetic nephropathy.
Insulin Resistance and Cardiovascular Disease Risk Factors in Children of Parents With the Insulin Resistance (Metabolic) Syndrome
Authors: Pankow James S. , Jacobs David R. , Steinberger Julia , Moran Antoinette , Sinaiko Alan R. 
Published: March 2007

OBJECTIVE—To evaluate whether children of parents with the insulin resistance syndrome (IRS) themselves have greater insulin resistance and unfavorable patterns of cardiovascular disease (CVD) risk factors.
RESEARCH DESIGN AND METHODS—This cross-sectional study included 220 white and 36 black children aged 11–15 years identified through a school-based blood pressure screening program, along with 378 of their parents. Measures of insulin resistance (glucose disposal per minute per kilogram of lean body mass in a euglycemic-hyperinsulinemic clamp [Mlbm] and fasting insulin), adiposity, and other CVD risk factors were compared in children with and without a parental history of IRS, defined according to the National Cholesterol Education Program Adult Treatment Panel III consensus definition.
RESULTS—Compared with children in whom neither parent had IRS, children who had at least one parent with the syndrome had statistically significantly lower mean Mlbm (12.1 vs. 13.6 mg · kg–1 · min–1; P = 0.04) and higher fasting insulin (geometric means 99 vs. 76 pmol/l; P = 0.01) after adjustment for sex, race, age, and Tanner stage. Mean BMI, waist circumference, waist-to-hip ratio, triceps and subscapular skinfolds, and percentage of body fat were also significantly higher in children of an affected parent, but there were no significant differences in lipid or blood pressure levels between the two groups.
CONCLUSIONS—Insulin resistance and obesity may be the earliest manifestations of IRS in children with a parental history of the syndrome.
High Incidence of Childhood Type 1 Diabetes in the Avalon Peninsula, Newfoundland, Canada
Authors: Newhook Leigh A. , Curtis Joseph , Hagerty Donna , Grant Marie , Paterson Andrew D. , Crummel Cheryl , Bridger Tracey , Parfrey Patrick 
Published: March 2007

OBJECTIVE—The aim of this study was to determine the incidence of type 1 diabetes among children aged 0–14 years in the Avalon Peninsula in the Canadian Province of Newfoundland.
RESEARCH DESIGN AND METHODS—This was a prospective cohort study of the incidence of childhood type 1 diabetes in children aged 0–14 years who were diagnosed with type 1 diabetes from 1987 to 2002 on the Avalon Peninsula. Identified case subjects during this time period were ascertained from several sources and verified using the capture-recapture technique. Data were obtained from the only pediatric diabetes treatment center for children living on the Avalon Peninsula.
RESULTS—Over the study period, 294 children aged 0–14 years from the Avalon Peninsula were diagnosed with type 1 diabetes. The incidence of type 1 diabetes in this population over the period 1987–2002 inclusive was 35.93 with a 95% CI of 31.82–40.03. The incidence over this period increased linearly at the rate of 1.25 per 100,000 individuals per year.
CONCLUSIONS—The Avalon Peninsula of Newfoundland has one of the highest incidences of type 1 diabetes reported worldwide. The incidence increased over the 16-year study period.
Behavioral and Clinical Factors Associated With Depression Among Individuals With Diabetes
Authors: Katon Wayne , Von Korff Michael , Ciechanowski Paul , Russo Joan , Lin Elizabeth , Simon Gregory , Ludman Evette , Walker Edward , Bush Terry , Young Bessie 
Published: March 2007

OBJECTIVE—The goal of this study was to determine the behavioral and clinical characteristics of diabetes that are associated with depression after controlling for potentially confounding variables.
RESEARCH DESIGN AND METHODS—A population-based mail survey was sent to patients with diabetes from nine primary care clinics of a health maintenance organization. The Patient Health Questionnaire was used to diagnose depression, and automated diagnostic, pharmacy, and laboratory data were used to measure diabetes treatment intensity, HbA1c levels, and diabetes complications.
RESULTS—Independent factors that were associated with a significantly higher likelihood of meeting criteria for major depression included younger age, female sex, less education, being unmarried, BMI ≥30 kg/m2, smoking, higher nondiabetic medical comorbidity, higher numbers of diabetes complications in men, treatment with insulin, and higher HbA1c levels in patients &lt;65 years of age. Independent factors associated with a significantly higher likelihood of meeting criteria for minor depression included younger age, less education, non-Caucasian status, BMI ≥30 kg/m2, smoking, longer duration of diabetes, and a higher number of complications in older (≥65 years) patients.
CONCLUSIONS—Smoking and obesity were associated with a higher likelihood of meeting criteria for major and minor depression. Diabetes complications and elevated HbA1c were associated with major depression among demographic subgroups: complications among men and HbA1c among individuals &lt;65 years of age. Older patients with a higher number of complications had an increased likelihood of minor depression.