bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Metabolic Syndrome in the West Bank Population
Authors: Abdul-Rahim Hanan F. , Husseini Abdullatif , Bjertness Espen , Giacaman Rita , Gordon Nahida H. , Jervell Jak 
Published: March 2007

OBJECTIVE— To compare the prevalence of components of the metabolic syndrome, including hypertension, abnormal glucose metabolism,dyslipidemia, central obesity, and overall obesity, between a rural and an urban Palestinian West Bank community.RESEARCH DESIGN AND METHODS— A total of 500 rural and 492 urban men and women aged 30-65 years participated in a community-based cross-sectional survey. Diabetes and impaired glucose tolerance were diagnosed using the oral glucose tolerance test. BMI, waist-to-hip ratio, and blood pressure were measured, and blood samples were taken from each subject. Sociodemographic characteristics were investigated using a questionnaire.RESULTS— Hypertriglyceridemia, low HDL cholesterol, overall obesity, and smoking were significantly more prevalent in the urban population, whereas central obesity was more prevalent in the rural population. Prevalence of hypertension was not significantly different between the rural and urban populations (25.4 and 21.5%, respectively; P =0.15). The age-adjusted prevalences of diabetes were high: 11.3% (8.5-14.1 95%CI) and 13.9% (10.8-17.0) in the rural and urban populations, respectively,but not significantly different. In each community, the age-adjusted prevalence of the metabolic syndrome as defined by the World Health Organization was 17%.CONCLUSIONS— Although no significant differences were found in the prevalences of hypertension and diabetes between the two populations,other components of the metabolic syndrome, namely elevated triglycerides, low HDL cholesterol, and overall obesity, were more prevalent in the urban population. Given the rapid urbanization of the Palestinian population, the implications for a rise in noncommunicable diseases should be a major public health concern.
The High Prevalence of Autoantibodies to Tissue Transglutaminase in First-Degree Relatives of Patients With Type 1 Diabetes Is Not Associated With Islet Autoimmunity
Authors: Williams Alistair J. K. , Norcross Alastair J. , Lock Robert J. , Unsworth David J. , Gale Edwin A. M. , Bingley Polly J. 
Published: March 2007

OBJECTIVE—To determine the extent of celiac autoimmunity in type 1 diabetic patients and the overlap between islet and celiac autoimmunity in their nondiabetic relatives.
RESEARCH DESIGN AND METHODS—IgA antibodies to tissue transglutaminase were determined in serum taken from 433 type 1 diabetic patients and 1,442 nondiabetic first-degree relatives. Samples with transglutaminase antibodies above the 97.5th percentile of 347 schoolchildren were also assayed for IgA anti-endomysial antibodies (EMAs). Markers of islet autoimmunity (islet cell antibodies and autoantibodies to insulin, glutamate decarboxylase, and protein tyrosine phosphatase IA-2) had previously been measured in all relatives.
RESULTS—In the absence of known celiac disease, the prevalence of transglutaminase antibody levels above the 97.5th percentile of the schoolchildren was 13.4% in diabetic patients and 7.0% in nondiabetic relatives. EMAs were found in addition to transglutaminase antibodies in 2.6% of probands and in 1.9% of first-degree relatives, but none of the schoolchildren. Transglutaminase antibodies were found to persist in 10 of 30 patients and in 30 of 59 relatives with follow-up samples taken at least 2 years after the initial sample. Of 186 nondiabetic relatives with islet autoantibodies, only 10 also had transglutaminase antibodies.
CONCLUSIONS—We found a high prevalence of celiac autoimmunity in patients and first-degree relatives of children with type 1 diabetes, but we found limited overlap between islet and celiac autoimmunity in nondiabetic relatives. The high prevalence of celiac autoimmunity may be explained by shared genetic susceptibility and identifies a population within which screening for the disease may be justified.
Prevalence and Significance of Retinopathy in Subjects With Type 1 Diabetes of Less Than 5 Years’ Duration Screened for the Diabetes Control and Complications Trial
Authors: Malone John I. , Morrison Anthony D. , Pavan Peter R. , Cuthbertson David D. 
Published: March 2007

OBJECTIVE—The Diabetes Control and Complications Trial (DCCT) demonstrated the powerful impact of glycemic control on the progression of diabetic retinopathy. A large number of individuals (2,771) underwent stereoscopic color photography and fluorescein angiography as part of screening for participation in the DCCT. A subgroup of those individuals screened participated in the DCCT and underwent evaluation of their retinal vasculature semiannually for 4–9 years. These data were evaluated to determine how the 2000 American Diabetes Association position statement would apply to the DCCT experience. Specifically, the position statement indicates that the first dilated eye examination should be performed after 3–5 years’ duration of diabetes because vision-threatening retinopathy virtually never develops in patients with type 1 diabetes during that interval.
RESEARCH DESIGN AND METHODS—We examined the experience of the DCCT in evaluating retinal photographs in 1,613 patients with type 1 diabetes of &lt;5 years’ duration and follow-up photographs every 6 months for 4–9 years in 855 members of that group.
RESULTS—Of 1,613 subjects with type 1 diabetes of &lt;5 years’ duration screened for the DCCT, 716 (44.4%) had stereo-color photographic evidence of diabetic retinopathy, and 6 had preproliferative or worse pathology. Fluorescein angiography revealed retinopathy in 158 of 713 subjects with no evidence of retinopathy on color photographs. Thus, 874 (54.2%) of the original 1,613 subjects had retinopathy at baseline. DCCT follow-up identified 341 additional individuals in whom retinopathy was developing before 5 years; 1,083 of 1,613 (67.1%) individuals screened for the DCCT had retinopathy before 5 years’ duration of diabetes. Those with retinopathy before 5 years had more rapid three-step progression of vascular pathology than those with no retinopathy.
CONCLUSIONS—Dilated eye examinations and retinal photography should be included in the routine management of type 1 diabetes during the first 5 years to identify the individuals at greatest risk for vision-threatening problems.
Cardiovascular Drug Use and Hospitalizations Attributable to Type 2 Diabetes
Authors: Erkens Joëlle A. , Klungel Olaf H. , Stolk Ronald P. , Spoelstra José A. , Grobbee Diederick E. , Leufkens Hubert G.M. 
Published: March 2007

OBJECTIVE—To investigate cardiovascular drug use and hospitalizations attributable to type 2 diabetes from 1 year before until 6 years after the start of oral antidiabetic therapy.
RESEARCH DESIGN AND METHODS—In this cohort study, 2,584 patients with type 2 diabetes were selected from the PHARMO Record Linkage System, comprising pharmacy records and hospitalizations for all 320,000 residents of six Dutch cities. Patients with type 2 diabetes were identified as incident oral antidiabetic drug users between 1992 and 1997. Nondiabetic subjects were 1:1–matched for age, sex, pharmacy, and index date and received no insulin, oral antidiabetic drugs, or glucose-testing supplies.
RESULTS—Patients with type 2 diabetes were more likely to use cardiovascular drugs (RR 1.28 [95% CI 1.23–1.34]) and to be hospitalized because of cardiovascular diseases (1.54 [1.33–1.78]) after the start of oral antidiabetic therapy than nondiabetic subjects. Differences between patients with type 2 diabetes and nondiabetic subjects lessened from 1 year before until 6 years after the start of oral antidiabetic therapy, reflected by decreasing attributable risks for diuretics, β-blockers, calcium channel blockers, and cardiac and antithrombotic drugs. The difference in use of angiotensin-converting enzyme inhibitors and lipid-lowering drugs increased. Cardiovascular hospitalizations attributable to type 2 diabetes were ∼50% in the years close to the start of oral antidiabetic treatment and decreased to ∼33% in the following years.
CONCLUSIONS—Although cardiovascular drug use and hospitalizations remained increased in patients with type 2 diabetes after the start of oral antidiabetic therapy, cardiovascular drug use attributable to type 2 diabetes decreased after the start of oral antidiabetic therapy, especially β-blockers, whereas cardiovascular hospitalizations first decreased and then stabilized.
Dietary Fat and Incidence of Type 2 Diabetes in Older Iowa Women
Authors: Meyer Katie A. , Kushi Lawrence H. , Jacobs David R. , Folsom Aaron R. 
Published: March 2007

OBJECTIVE—To examine the associations between reported intakes of dietary fat and incident type 2 diabetes.
RESEARCH DESIGN AND METHODS—We studied the relation between dietary fatty acids and diabetes in a prospective cohort study of 35,988 older women who initially did not have diabetes. Diet was assessed with a food frequency questionnaire at baseline, and 1,890 incident cases of diabetes occurred during 11 years of follow-up.
RESULTS—After adjusting for age, smoking, alcohol consumption, BMI, waist-to-hip ratio, physical activity, demographic factors, and dietary magnesium and cereal fiber, diabetes incidence was negatively associated with dietary polyunsaturated fatty acids, vegetable fat, and trans fatty acids and positively associated with ω-3 fatty acids, cholesterol, and the Keys score. After simultaneous adjustment for other dietary fat, only vegetable fat remained clearly related to diabetes risk. Relative risks across quintiles of vegetable fat intake were 1.00, 0.90, 0.87, 0.84, and 0.82 (P = 0.02). Diabetes risk was also inversely related to substituting polyunsaturated fatty acids for saturated fatty acids and positively correlated to the Keys dietary score.
CONCLUSIONS—These data support an inverse relation between incident type 2 diabetes and vegetable fat and substituting polyunsaturated fatty acids for saturated fatty acids and cholesterol.
Genotype Arg/Arg, but not Trp/Arg, of the Trp64Arg Polymorphism of the β3-Adrenergic Receptor Is Associated With Type 2 Diabetes and Obesity in a Large Japanese Sample
Authors: Oizumi Toshihide , Daimon Makoto , Saitoh Tamotsu , Kameda Wataru , Yamaguchi Hiroshi , Ohnuma Hiroshi , Igarashi Masahiko , Eguchi Hideyuki , Manaka Hideo , Tominaga Makoto , Kato Takeo 
Published: March 2007

OBJECTIVE—Despite a large number of studies, no association of the Trp64Arg polymorphism of the β3-adrenergic receptor gene with obesity and type 2 diabetes has yet to be clearly elucidated. We examined the associations in a large population-based sample.
RESEARCH DESIGN AND METHODS—A total of 1,685 subjects (935 women and 750 men, aged 58.7 ± 12.4 years) from a cohort population (n = 3,706) of the Funagata Diabetes Study were divided into three groups according to genotypes: Trp/Trp (n = 1,155), Trp/Arg (n = 486), and Arg/Arg (n = 44). Glucose tolerance was diagnosed according to the 1985 World Health Organization criteria. Subjects who had a BMI ≥30 kg/m2 were considered obese. Associations with the traits related to obesity, diabetes, hypertension, and dyslipidemia were also examined. The χ2 test and analysis of variance were used for the association studies and to assess the differences in the traits’ values, respectively.
RESULTS—More subjects with genotype Arg/Arg were obese and had diabetes (13.6% for each) than those with genotype Trp/Trp (3.29%, P &lt; 0.001; and 4.16%, P = 0.007, respectively) or genotype Trp/Arg (2.06%, P &lt; 0.001; and 5.97%, P = 0.051, respectively). No significant differences in the frequencies of occurrence of these conditions were observed between genotypes Trp/Arg and Trp/Trp. Traits related to obesity, such as percent body fat (28.82 ± 7.95 vs. 25.93 ± 7.21, P = 0.038) and BMI (25.07 ± 3.84 vs. 23.63 ± 3.18, P = 0.018), were higher in the genotype Arg/Arg than in the genotype Trp/Trp groups.
CONCLUSIONS—Genotype Arg/Arg, but not Trp/Arg, of the β3-adrenergic receptor was associated with both obesity and type 2 diabetes in a large Japanese sample.
Stress Echocardiography for Risk Stratification of Diabetic Patients With Known or Suspected Coronary Artery Disease
Authors: Bigi Riccardo , Desideri Alessandro , Cortigiani Lauro , Bax Jeroen J. , Celegon Leopoldo , Fiorentini Cesare 
Published: March 2007

OBJECTIVE—Coronary artery disease (CAD) is a leading cause of mortality and morbidity in diabetic patients; therefore, their risk stratification is a relevant issue. Because exercise tolerance is frequently impaired in these patients, pharmacological stress echocardiography (SE) has been suggested as a valuable alternative. Our aim was to evaluate the prognostic value of this technique in diabetic patients with known or suspected CAD.
RESEARCH DESIGN AND METHODS—A total of 259 consecutive diabetic patients underwent pharmacological SE (dobutamine in 108 patients and dipyridamole in 151 patients) and follow-up for 24 ± 22 months. A comparison between the prognostic value of SE and exercise electrocardiography (ECG) was made in a subgroup of 120 subjects.
RESULTS—A total of 13 cardiac deaths and 13 nonfatal infarctions occurred during follow-up, and 58 patients were revascularized. Univariate predictors of outcome were known CAD, positive SE, rest and peak wall motion score index (WMSI), and peak/rest WMSI variation. Peak WMSI was the only significant and independent prognostic indicator (odds ratio 11; 95% CI 4–29, P &lt; 0.0001) on multivariate Cox’s analysis. After adjustment for the most predictive clinical and exercise ECG variables, SE provided 43% additional prognostic information (gain in X2 = 7, P &lt; 0.01). Moreover, positive SE was associated with a significantly lower event-free survival.
CONCLUSIONS—SE effectively predicts cardiac events in diabetic patients with known or suspected CAD and adds additional prognostic information as compared with exercise ECG.
Hormone Replacement Therapy, Insulin Sensitivity, and Abdominal Obesity in Postmenopausal Women
Authors: Ryan Alice S. , Nicklas Barbara J. , Berman Dora M. 
Published: March 2007

OBJECTIVE—The purpose of this study was to determine whether insulin sensitivity differs between postmenopausal women taking estradiol, women on estrogen plus progesterone hormone replacement therapy (HRT), and women not on HRT and whether differences are explained by the differences in total and/or abdominal adiposity and fat deposition in the muscle.RESEARCH DESIGN AND METHODS—We studied 28 obese, sedentary postmenopausal Caucasian women. Women taking oral estrogen (n = 6) were matched for age (57 ± 3 vs. 58 ± 2 years), weight (87.9 ± 6.0 vs. 83.0 ± 3.9 kg), and BMI (33.9 ± 1.7 vs. 33.9 ± 1.9 kg/m2) with women not on HRT (n = 6). Eight women taking oral estrogen plus progesterone were matched with eight different women not on HRT for age (59 ± 2 vs. 60 ± 2 years), weight (82.8 ± 3.7 vs. 83.7 ± 4.1 kg), and BMI (30.7 ± 1.0 vs. 29.9 ± 1.3 kg/m2).RESULTS—Vo2max (maximal aerobic capacity), percentage of fat, total body fat mass, and fat-free mass (FFM) were similar between groups. Visceral fat, subcutaneous abdominal fat, sagittal diameter, and mid-thigh low-density lean tissue (intramuscular fat) did not differ by hormone status. Basal carbohydrate and fat utilization was not different among groups. Fasting plasma glucose and insulin did not differ by hormone use. Glucose utilization (M) was measured during the last 30 min of a 3-h hyperinsulinemic-euglycemic clamp (40 mU · m2 · min−1). Postmenopausal women taking oral estrogen had a 31% lower M than women not on HRT (42.7 ± 4.0 vs. 61.7 ± 4.7 μmol · kgFFM · min−1, P &lt; 0.05). M was 26% lower in women taking estrogen plus progesterone (44.0 ± 3.5 vs. 59.7 ± 6.2 μmol · kgFFM · min−1, P &lt; 0.05) than women not on HRT. M/I, the amount of glucose metabolized per unit of plasma insulin (I), an index of insulin sensitivity, was 36% lower in women taking estrogen compared with matched women not on HRT (P &lt; 0.05) and 28% lower in women taking estrogen plus progesterone compared with matched women not on HRT (P &lt; 0.05).CONCLUSIONS—Postmenopausal women taking oral estrogen or those taking a combination of estrogen and HRT are more insulin-resistant than women not on HRT, even when women are of comparable total and abdominal adiposity.
High-Intensity Resistance Training Improves Glycemic Control in Older Patients With Type 2 Diabetes
Authors: Dunstan David W. , Daly Robin M. , Owen Neville , Jolley Damien , de Courten Maximilian , Shaw Jonathan , Zimmet Paul 
Published: March 2007

OBJECTIVE—To examine the effect of high-intensity progressive resistance training combined with moderate weight loss on glycemic control and body composition in older patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—Sedentary, overweight men and women with type 2 diabetes, aged 60–80 years (n = 36), were randomized to high-intensity progressive resistance training plus moderate weight loss (RT & WL group) or moderate weight loss plus a control program (WL group). Clinical and laboratory measurements were assessed at 0, 3, and 6 months.
RESULTS—HbA1c fell significantly more in RT & WL than WL at 3 months (0.6 ± 0.7 vs. 0.07 ± 0.8%, P &lt; 0.05) and 6 months (1.2 ± 1.0 vs. 0.4 ± 0.8%, P &lt; 0.05). Similar reductions in body weight (RT & WL 2.5 ± 2.9 vs. WL 3.1 ± 2.1 kg) and fat mass (RT & WL 2.4 ± 2.7 vs. WL 2.7 ± 2.5 kg) were observed after 6 months. In contrast, lean body mass (LBM) increased in the RT & WL group (0.5 ± 1.1 kg) and decreased in the WL group (0.4 ± 1.0) after 6 months (P &lt; 0.05). There were no between-group differences for fasting glucose, insulin, serum lipids and lipoproteins, or resting blood pressure.
CONCLUSIONS—High-intensity progressive resistance training, in combination with moderate weight loss, was effective in improving glycemic control in older patients with type 2 diabetes. Additional benefits of improved muscular strength and LBM identify high-intensity resistance training as a feasible and effective component in the management program for older patients with type 2 diabetes.
Barriers to Blood Glucose Monitoring in a Multiethnic Community
Authors: Zgibor Janice C. , Simmons David 
Published: March 2007

OBJECTIVE—We studied a multiethnic community to determine factors associated with blood glucose monitoring (BGM) and to determine the independent association between barriers to diabetes care and BGM.
RESEARCH DESIGN AND METHODS—A total of 323 participants (35.6% European, 32.2% Maori, and 32.2% Pacific Islander) from the South Auckland Diabetes Project (free of major complications by self-report) completed a qualitative survey to determine barriers to diabetes care. Five barriers to diabetes care categories were generated including internal psychological (self efficacy/health beliefs), external psychological (psychosocial environment), internal physical (comorbidities/side effects of treatment), external physical (finance/access to care), and educational (knowledge of diabetes/services) barriers.
RESULTS—Characteristics associated with BGM greater than or equal to twice weekly were female sex, HbA1c &gt;8%, higher diabetes knowledge scores, and insulin use. Multivariate analyses demonstrated that those reporting external physical barriers (OR 0.47, 95% CI 0.26–0.84), external psychological barriers (0.55, 0.30–1.0), and internal psychological barriers (0.56, 0.32–1.0) were less likely to perform BGM independent of ethnicity, insulin use, age, sex, diabetes knowledge, and glycemic control. Further multivariate analyses demonstrated that those reporting external physical barriers, particularly related to personal finance, were less likely to perform BGM.
CONCLUSIONS—These data demonstrate that patient-reported barriers to diabetes care are associated with BGM, particularly in relation to financial, psychosocial, and self-efficacy issues. Understanding these barriers and overcoming them within the context of the patient’s ethnic environment may lead to increased participation in self-care.
A Comparison of the Effects of Rosiglitazone and Glyburide on Cardiovascular Function and Glycemic Control in Patients With Type 2 Diabetes
Authors: St. John Sutton Martin , Rendell Marc , Dandona Paresh , Dole Jo F. , Murphy Karen , Patwardhan Rita , Patel Jai , Freed Martin ,   For the Rosiglitazone Clinical Trials Study Group
Published: March 2007

OBJECTIVE—This open-label, active-controlled study investigated the cardiac safety and antihyperglycemic effect of rosiglitazone (RSG) in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—Of the 203 patients randomly assigned to RSG (4 mg b.i.d.) or glyburide (GLB) (titrated to achieve optimal glycemic control for the first 8 weeks only to limit the risk of hypoglycemia; mean 10.5 mg/day), 118 had an echocardiogram performed at week 52. Left ventricular (LV) mass index, ejection fraction, and left ventricular end-diastolic volume were assessed by M-mode echocardiography at baseline and weeks 12, 28, and 52; 24-h ambulatory blood pressure was assessed at baseline and at weeks 28 and 52. Glycemic control was assessed by measuring fasting plasma glucose (FPG) and HbA1c.
RESULTS—Neither treatment produced an increase in LV mass index that exceeded 1 SD. Ejection fraction did not change in either group. Both groups had clinically insignificant increases in LV end-diastolic volume. RSG, but not GLB, caused a statistically significant reduction in ambulatory diastolic blood pressure. Both treatments reduced HbA1c and FPG.
CONCLUSIONS—A total of 52 weeks of therapy with RSG (4 mg b.i.d.) did not adversely affect cardiac structure or function in patients with type 2 diabetes and produced significant and sustained reductions in hyperglycemia. Decreases in ambulatory diastolic blood pressure with RSG were superior to those with GLB.
Adherence to American Diabetes Association Standards of Care by Rural Health Care Providers
Authors: Coon Patricia , Zulkowski Karen 
Published: March 2007

OBJECTIVE—To determine whether rural health care providers are compliant with American Diabetes Association (ADA) clinical practice guidelines for glycemic, blood pressure, lipid management, and preventative services.
RESEARCH DESIGN AND METHODS—This study was performed using a retrospective chart review of 399 patients 45 years of age and older, with a definitive diagnosis of diabetes seen for primary diabetes care at four rural health facilities in Montana between 1 January 1999 and 1 August 2000.
RESULTS—Glycemic testing was adequate (85%), and glycemic control (HbA1c 7.43 ± 1.7%) was above the national average. Comorbid conditions of hypertension and dyslipidemia were not as well managed. Mean systolic blood pressure (SBP) was 139 ± 18.8 mmHg and LDL was 119 ± 33 mg/dl. Of 399 patients, 11 were considered as needing no additional treatment based on ADA guidelines of an HbA1c level &lt;7%, a BP &lt;130/85 mmHg, and a LDL level &lt;100 mg/dl. Monofilament testing and dilated eye examinations were poorly documented, as were immunizations. There were few referrals for diabetic education.
CONCLUSIONS—Rural health care practitioners are not adequately following the ADA standards for comprehensive management of their patients with diabetes. Glycemic testing is being ordered, but HbA1c values indicate that patients do not have their diabetes under optimal control. The comorbid conditions of hypertension and dyslipidemia are not optimally managed according to the ADA guidelines.