bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Increase of Oxidative Stress and Reduced Antioxidant Defenses in Patients With Uncomplicated Type 1 Diabetes
Authors: Marra Giampiero , Cotroneo Patrizia , Pitocco Dario , Manto Andrea , Di Leo Mauro A.S. , Ruotolo Valeria , Caputo Salvatore , Giardina Bruno , Ghirlanda Giovanni , Santini Stefano A. 
Published: March 2007

OBJECTIVE—Diabetes increases the risk of coronary heart disease (CHD) to a greater extent in women than in men. We investigated whether type 1 diabetic patients with short duration of disease and without complications have an altered oxidative status and whether there are differences between men and women.
RESEARCH DESIGN AND METHODS—We investigated oxidative status in 29 control subjects and 37 patients with uncomplicated type 1 diabetes with duration of 6 ± 3 years.
RESULTS—Compared with control subjects, type 1 diabetic patients had lower total plasma antioxidant capacity (TRAP) (720.3 ± 111.2 vs. 972.5 ± 97.7 μmol/l in men, P &lt; 0.001; 579.8 ± 95.4 vs. 930.1 ± 84.2 in women, P &lt; 0.001), higher lipid hydroperoxide (ROOH) levels (6.4 ± 2.2 vs. 2.0 ± 0.7 μmol/l in men, P &lt; 0.001; 8.1 ± 1.9 vs. 2.2 ± 0.6 in women, P &lt; 0.001), higher total conjugated diene (CD) levels (0.037 ± 0.003 vs. 0.033 ± 0.002 A.U. in men, P &lt; 0.001), lower 246-nm CD levels (0.0032.± 0.0010 vs. 0.0070 ± 0.0012 A.U. in men, P &lt; 0.001; 0.0022 ± 0.0011 vs. 0.0072 ± 0.0014 A.U. in women, P &lt; 0.001), and higher 232-nm CD levels (0.0348 ± 0.0041 vs. 0.0257 ± 0.0022 A.U. in men, P &lt; 0.001; 0.0346 ± 0.0031 vs. 0.0246 ± 0.0074 A.U. in women, P &lt; 0.001). Compared with diabetic men, diabetic women had lower TRAP (P &lt; 0.01), higher ROOH levels (P &lt; 0.01), and lower 246-nm CD levels (P &lt; 0.05). Plasma concentration of uric acid was significantly lower in patients with type 1 diabetes than in control subjects (3.3 ± 0.3 vs. 4.3 ± 0.2 mg/dl; P = 0.009) with a significant difference between women and men with type 1 diabetes (2.6 ± 0.3 vs. 3.9 ± 0.3, respectively; P = 0.009).
CONCLUSIONS—Our findings suggest that reduced antioxidant activity and increased oxidative stress occur early after the diagnosis of type 1 diabetes, especially in women, and this might explain, at least in part, the increased susceptibility of diabetic women to cardiovascular complications.
Basal and Postglucagon C-Peptide Levels in Ethiopians with Diabetes
Authors: Siraj Elias S , Reddy S. Sethu K , Scherbaum Werner A , Abdulkadir Jemal , Hammel Jeffrey P , Faiman Charles 
Published: March 2007

OBJECTIVE—To study basal C-peptide (BCP) and postglucagon C-peptide (PGCP) levels in Ethiopians with diabetes.
RESEARCH DESIGN AND METHODS—A total of 56 subjects with type 1 diabetes, 97 subjects with type 2 diabetes, and 50 control subjects were recruited from a hospital in Ethiopia. BCP was determined in all subjects and PGCP in 86 subjects.
RESULTS—Mean (±SEM) BCP, PGCP, and the increment after glucagon in type 1 diabetic subjects (0.14 ±0.04, 0.22 ±0.11, and 0.08 ±0.05 nmol/l, respectively) were lower (P &lt; 0.001) than those in type 2 diabetic subjects (0.66 ±0.04, 1.25 ±0.10, and 0.56 ±0.06 nmol/l, respectively) or control subjects (0.54 ±0.04, 1.52 ±0.26, and 1.11 ±0.24 nmol/l, respectively). The mean BCP level was higher in type 2 diabetic subjects than control subjects (P=0.015), whereas the mean increment was lower (P=0.005). Insulin-treated type 2 diabetic subjects, compared with non-insulin-treated type 2 diabetic subjects, had lower mean BCP (0.55 ±0.08 nmol/l [n=37] vs. 0.73 ±0.04 [n=60], P=0.001), lower PGCP (0.97 ±0.20 nmol/l [n=18] vs. 1.40 ±0.11 [n=35], P=0.010), and a lower C-peptide increment (0.34 ±0.06 [n=18] vs. 0.67 ±0.07 nmol/l [n=35], P=0.003). In both the type 1 and type 2 diabetic groups, those with BCP levels &lt;0.2 nmol/l had lower BMI than those with higher BCP levels (P=0.023 and P &lt; 0.001, respectively).
CONCLUSIONS—Combined with clinical criteria, C-peptide levels are good discriminators between type 1 and type 2 diabetes in Ethiopians and may also be useful in identifying subjects with type 2 diabetes who require insulin therapy. There is a subgroup of type 2 diabetic subjects with features of type 1 diabetes.
The Impact of Cardiovascular Disease on Medical Care Costs in Subjects With and Without Type 2 Diabetes
Authors: Nichols Gregory A. , Brown Jonathan B. 
Published: March 2007

OBJECTIVE—We examined whether cardiovascular disease (CVD) affects medical care costs differently in subjects with and without diabetes and explored the impact of CVD on costs across the dimensions of age and diabetes duration.
RESEARCH DESIGN AND METHODS—We compared the prevalence of CVD and medical care costs for subjects with and without CVD in all 16,180 full-year health maintenance organization members in 1999 who had been diagnosed with type 2 diabetes and in control members matched by year of birth and sex. We ascertained diagnoses from the Kaiser Permanente Northwest Region’s electronic ambulatory medical record and from hospital discharge datafiles. Utilization from these and other data systems were multiplied by unit costs.
RESULTS—CVD was 76% more prevalent in subjects with diabetes, but the risk ratios of more severe forms of CVD were even greater. Risk ratios for CVD were greatest in younger subjects. Cost profiles for subjects with both CVD and diabetes differed markedly from those with diabetes but without CVD. In the latter group, costs grew steadily with age, whereas in the former group, costs peaked in the 55- to 64-year age group before declining with age.
CONCLUSIONS—The types of CVD present in diabetic patients are more likely to be more severe and therefore more costly than in similar subjects without diabetes. CVD also disproportionately affects younger diabetic subjects. Finally, when CVD is present in diabetes, more costs occur earlier in life as well as earlier in the course of diabetes.
Plasma F2 Isoprostanes
Authors: Sampson Michael J. , Gopaul Nitin , Davies Isabel R. , Hughes David A. , Carrier Martin J. 
Published: March 2007

OBJECTIVES—Acute hyperglycemia in type 2 diabetes increases the generation of plasma 8-epi-prostaglandin F2 (8-epi-PGF2α) isoprostane, a sensitive direct marker of in vivo free radical oxidative damage to membrane phospholipids.
RESEARCH DESIGN AND METHODS—A total of 21 patients with type 2 diabetes underwent an oral 75-g glucose tolerance test. Plasma 8-epi-PGF2α isoprostane concentrations (by gas chromatography [GC]/mass spectrometry [MS]), intralymphocyte reduced-to-oxidized glutathione ratios, and plasma total antioxidant capacity were measured at baseline and 90 min after glucose loading.
RESULTS—Plasma 8-epi-PGF2α isoprostane concentrations rose significantly (P=0. 010) from 0.241± 0.1 to 0.326± 0.17 ng/l after 90 min. Intracellular oxidative balance and plasma antioxidant capacity did not change in either group.
CONCLUSIONS—Plasma concentrations of 8-epi-PGF2α isoprostane increase during acute hyperglycemia in type 2 diabetes, providing direct evidence of free radical–mediated oxidative damage and demonstrating a pathway for an association between acute rather than fasting hyperglycemia and macrovascular risk in type 2 diabetes.
Risk Indicators Predictive for Severe Hypoglycemia During the First Trimester of Type 1 Diabetic Pregnancy
Authors: Evers Inge M. , ter Braak Edith W.M.T. , de Valk Harold W. , van der Schoot Bertine , Janssen Nancy , Visser Gerard H.A. 
Published: March 2007

OBJECTIVES—To investigate the frequency of severe hypoglycemia (SH) and hypoglycemic coma during the first trimester of type 1 diabetic pregnancy and in the 4 months before gestation and to identify risk indicators predicting first trimester SH in a nonselected nationwide cohort of pregnant women with type 1 diabetes.
RESEARCH DESIGN AND METHODS—We conducted a longitudinal cohort survey in 278 pregnant type 1 diabetic women using questionnaires at inclusion and at 17 weeks of gestation, addressing the frequencies of SH (i.e., external help required) and hypoglycemic coma, general characteristics, hypoglycemia awareness, blood glucose symptom threshold, and the Hypoglycemia Fear Survey.
RESULTS—The occurrence of SH (including hypoglycemic coma) rose from 0.9 ±2.4 episodes per 4 months before gestation to 2.6 ±6.3 episodes during the first trimester (P &lt; 0.001), including an increase in episodes of coma from 0.3 ±1.3 to 0.7 ±3.7 (P=0.03). The proportion of women affected by SH rose from 25 to 41% (P &lt; 0.001). First-trimester SH was independently related to a history of SH before gestation (odds ratio [95%CI]: 9.2 [3.9ndash;21.7]), a 10 years’ longer diabetes duration (1.6 [1.0ndash;2.4]), an HbA1c level ≤6.5% (2.5 [1.3ndash;5.0]), and a 0.1 unit/kg higher daily insulin dose (5.4 [1.5ndash;18.9]), adjusted for a decreased symptom threshold.
CONCLUSIONS—In type 1 diabetic pregnancy, the risk of SH is increased already before pregnancy and rises further during the first trimester. A history of SH before gestation, longer duration of diabetes, an HbA1c level ≤6.5%, and a higher total daily insulin dose were risk indicators predictive for SH during the first trimester. Further research should aim to elucidate how the benefits of strict glycemic control balance with the markedly increased risk of SH early in pregnancy.
Carpal Tunnel Syndrome in Patients With Diabetic Polyneuropathy
Authors: Perkins Bruce A. , Olaleye David , Bril Vera 
Published: March 2007

OBJECTIVE—Carpal tunnel syndrome (CTS) and diabetic polyneuropathy (DPN) are common conditions in patients with diabetes and therefore frequently occur concomitantly. Diagnosis of CTS in patients with DPN is important, as therapeutic interventions directed toward relief of CTS may be effective irrespective of diffuse neuropathy. The prevalence of clinical CTS and the most efficient electrodiagnostic discriminators of CTS from diffuse neuropathy are uncertain.
RESEARCH DESIGN AND METHODS—A total of 478 subjects, including reference subjects (without diabetes and without neuropathy), nonneuropathic subjects with diabetes, and diabetic subjects with mild, moderate, and severe neuropathy, were evaluated in a cross-sectional design for clinical features of CTS. In the ascertainment of the cohort, a clinical stratification method was used to ensure a broad spectrum of neuropathy severity. All subjects underwent nerve conduction study determinations of median, ulnar, and sural nerve parameters.
RESULTS—The prevalence of clinical CTS was 2% in the reference population, 14% in diabetic subjects without DPN, and 30% in those with DPN. Multiple linear regression analysis revealed that mean electrodiagnostic parameters are not significant predictors of clinical CTS in patients with diabetes. Generally, the parameters worsened with severity of neuropathy, but none reliably distinguished diabetic patients with and without CTS.
CONCLUSIONS—Given the high prevalence of CTS in patients with DPN and that electrodiagnostic criteria cannot distinguish those with clinical CTS, it is recommended that therapeutic decisions for CTS be made independently of electrodiagnostic findings.
Effects of Dietary Treatment Alone or Diet With Voglibose or Glyburide on Abdominal Adipose Tissue and Metabolic Abnormalities in Patients With Newly Diagnosed Type 2 Diabetes
Authors: Takami Kazuhisa , Takeda Noriyuki , Nakashima Kazuya , Takami Rieko , Hayashi Makoto , Ozeki Shigehiko , Yamada Akiko , Kokubo Yoshiaki , Sato Mayumi , Kawachi Shin-ichi , Sasaki Akihiko , Yasuda Keigo 
Published: March 2007

OBJECTIVE—To examine the effects of diet and diet with voglibose or glyburide on abdominal adiposity and metabolic abnormalities in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—A total of 36 Japanese patients with newly diagnosed type 2 diabetes (50.8 ± 8.6 years of age, BMI 24.5 ± 3.5 kg/m2) and 273 normal control subjects were studied. The patients were treated for 3 months with diet alone (30 kcal/kg per day) (n = 15), diet with voglibose (n = 12), or diet with glyburide (n = 9). They underwent 75-g oral glucose tolerance testing, assessment of insulin sensitivity (SI), and acute insulin response (AIR) with intravenous glucose tolerance testing based on the minimal model, and measurement of abdominal visceral adipose tissue area (VAT) and subcutaneous adipose tissue area (SAT) by computed tomography before and after treatment.
RESULTS—The diabetic patients had comparable SAT but larger VAT than the control subjects. With a mean weight loss of 2–3 kg, VAT and SAT were decreased similarly in all treatment groups. The VAT-to-SAT ratio was decreased only in the voglibose group. Glycemic control and serum lipid profiles were improved in all groups. Changes in glycemic control after diet were closely correlated with changes in VAT but not with changes in SAT. SI and AIR were unchanged in the diet group but were improved in the voglibose and glyburide groups.
CONCLUSIONS—In Japanese patients with newly diagnosed type 2 diabetes who were relatively lean but had excess VAT, diet with or without voglibose or glyburide effectively reduced VAT. Decrease in VAT was closely associated with improvement of glycemic control with diet. Additional use of voglibose or low-dose glyburide had no detrimental effects on abdominal adiposity and had beneficial effects on SI and AIR.
Sexual Dysfunction in Women With Type 1 Diabetes
Authors: Enzlin Paul , Mathieu Chantal , Van den Bruel Annick , Bosteels Jan , Vanderschueren Dirk , Demyttenaere Koen 
Published: March 2007

OBJECTIVE—This study aimed to 1) examine the prevalence of sexual problems in women with type 1 diabetes, 2) compare this prevalence rate with that of an age-matched control group, 3) study the influence of diabetes-related somatic factors on female sexuality, and 4) study the influence of psychological variables on the sexual functioning of both groups.RESEARCH DESIGN AND METHODS—A total of 120 women with diabetes visiting the outpatient diabetes clinic completed questionnaires evaluating psychological adjustment to diabetes, marital satisfaction, depression, and sexual functioning. Medical records were used to obtain data on HbA1c, use of medication, BMI, and early-onset microvascular complications. An age-matched control group of 180 healthy women attending an outpatient gynecological clinic for preventive routine gynecological assessment also completed the non–diabetes-related questionnaires.RESULTS—More women with diabetes than control subjects reported sexual dysfunction (27 vs. 15%; P = 0.04), but a significant difference was found only for decreased lubrication. No association was found between sexual dysfunction and age, BMI, duration of diabetes, HbA1c, use of medication, menopausal status, or complications. Women with more complications, however, reported significantly more sexual dysfunctions, and the presence of complications altered treatment satisfaction. Both diabetic and control women with sexual dysfunction mentioned lower overall quality of the marital relation and more depressive symptoms than their respective counterparts without sexual problems. Depression was a significant predictor for sexual dysfunction in both women with diabetes and control subjects.CONCLUSIONS—Sexual problems are frequent in women with diabetes. They affect the overall quality of life and deserve more attention in clinical practice and research.
Additional Lunchtime Basal Insulin During Insulin Lispro Intensive Therapy in a Randomized, Multicenter, Crossover Study in Adults
Authors: Stades Aline M.E. , Hoekstra Joost B.L. , van den Tweel Ingeborg , Erkelens D. Willem , Holleman Frits ,   STABILITY Study Group
Published: March 2007

OBJECTIVE—This study was performed to evaluate whether an additional dose of NPH insulin at lunchtime might overcome the deleterious effects of waning basal insulinemia on pre-dinner and evening glucose values during insulin lispro intensive therapy with once daily basal insulin at night.
RESEARCH DESIGN AND METHODS—The study was a 10-month multicenter, randomized, crossover trial. After a 2-month run-in period, subjects injected NPH insulin once (1 × NPH) or twice (2 × NPH) daily for 4 months in a randomized order. Adult patients were included if they had HbA1c levels &lt;8.5%. Efficacy measures were HbA1c levels, 8-point glucose profiles, and the frequency of hypoglycemia. The statistical analysis included a within-patient comparison for crossover trials.
RESULTS—In all, 104 patients completed the trial. The mean HbA1c level before randomization was 7.1 ± 0.85%. The HbA1c levels did not change significantly within patients (t test, mean difference = 0.06%; 95% confidence interval [CI] −0.073 to 0.20). The pre-dinner blood glucose values were significantly lower during the 2 × NPH daily protocol, with a mean difference of 0.76 mmol/l (t test, P = 0.004; CI 0.25 to 1.3). In the evening, the frequency of hypoglycemia increased significantly during the 2 × NPH daily protocol with a median difference of 0.56 mild episodes/30 days (P = 0.001) and 6.9 severe episodes/patient year (P = 0.007), respectively.
CONCLUSIONS—Equal HbA1c levels and increasing frequencies of hypoglycemia in the evening overshadow the slight improvement of the evening glucose profiles during a regimen with 2 × NPH daily insulin. Therefore, generalized use of a second injection of NPH insulin at lunchtime cannot be recommended to all adult patients with type 1 diabetes using intensive insulin lispro therapy.
The Rising Prevalence of Diabetes and Impaired Glucose Tolerance
Authors: Dunstan David W. , Zimmet Paul Z. , Welborn Timothy A. , de Courten Maximilian P. , Cameron Adrian J. , Sicree Richard A. , Dwyer Terry , Colagiuri Stephen , Jolley Damien , Knuiman Matthew , Atkins Robert , Shaw Jonathan E. ,   On Behalf of the AusDiab Steering Committee
Published: March 2007

OBJECTIVE—To determine the population-based prevalence of diabetes and other categories of glucose intolerance (impaired glucose tolerance [IGT] and impaired fasting glucose [IFG]) in Australia and to compare the prevalence with previous Australian data.
RESEARCH DESIGN AND METHODS—A national sample involving 11,247 participants aged ≥25 years living in 42 randomly selected areas from the six states and the Northern Territory were examined in a cross-sectional survey using the 75-g oral glucose tolerance test to assess fasting and 2-h plasma glucose concentrations. The World Health Organization diagnostic criteria were used to determine the prevalence of abnormal glucose tolerance.
RESULTS—The prevalence of diabetes in Australia was 8.0% in men and 6.8% in women, and an additional 17.4% of men and 15.4% of women had IGT or IFG. Even in the youngest age group (25–34 years), 5.7% of subjects had abnormal glucose tolerance. The overall diabetes prevalence in Australia was 7.4%, and an additional 16.4% had IGT or IFG. Diabetes prevalence has more than doubled since 1981, and this is only partially explained by changes in age profile and obesity.
CONCLUSIONS—Australia has a rapidly rising prevalence of diabetes and other categories of abnormal glucose tolerance. The prevalence of abnormal glucose tolerance in Australia is one of the highest yet reported from a developed nation with a predominantly Europid background.
Do Sensor Glucose Levels Accurately Predict Plasma Glucose Concentrations During Hypoglycemia and Hyperinsulinemia?
Authors: Monsod Teresa P. , Flanagan Daniel E. , Rife Fran , Saenz Rebecca , Caprio Sonia , Sherwin Robert S. , Tamborlane William V. 
Published: March 2007

OBJECTIVE—The MiniMed Continuous Glucose Monitoring System (CGMS) measures subcutaneous interstitial glucose levels that are calibrated against three or more fingerstick glucose levels daily. The objective of the present study was to examine whether the relationship between plasma and interstitial fluid glucose is altered by changes in plasma glucose and insulin levels and how such alterations might influence CGMS performance.
RESEARCH DESIGN AND METHODS—Arterialized plasma glucose, sensor glucose, and interstitial fluid glucose were measured by microdialysis in 11 healthy subjects during a 1.0 mU · kg−1 · min−1 stepped euglycemic-hypoglycemic-hyperglycemic (plasma glucose ∼5, 3.1, and 8.6 mmol/l, respectively) insulin clamp that raised plasma insulin to ∼360–390 pmol/l.
RESULTS—When the CGMS was calibrated versus plasma glucose levels before insulin infusion, basal sensor and plasma glucose were similar (5.0 ± 0.3 vs. 5.2 ± 0.3 mmol/l, respectively); dialysate glucose was 3.3 ± 0.9 mmol/l. During the hyperinsulinemic-euglycemia study (plasma glucose 4.9 ± 0.3 mmol/l), dialysate glucose fell by 30–35%, accompanied by a significant reduction in sensor glucose (to 3.7 ± 0.6 mmol/l; P &lt; 0.001 vs. plasma). Subsequently, sensor levels remained lower than plasma values during mild hypoglycemia (2.5 ± 0.6 vs. 3.1 ± 0.3 mmol/l; P &lt; 0.01) and during recovery from hypoglycemia (7.3 ± 1.2 vs. 8.6 ± 0.6; P &lt; 0.01). However, when the CGMS was calibrated against plasma glucose levels before and during each step of the clamp, sensor glucose levels increased throughout the study and did not differ from plasma glucose values during hypoglycemia.
CONCLUSIONS—Although hyperinsulinemia may contribute to modest discrepancies between plasma and sensor glucose levels, the CGMS is able to accurately track acute changes in plasma glucose when calibrated across a range of plasma glucose and insulin levels.