bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of IDDM in Southern Chinese Children in Hong Kong
Authors: Wong Gary W , Leung Sophie S , Oppenheimer Stephen J 
Published: March 2007

OBJECTIVE— To provide reliable data on the incidence of IDDM in southern Chinese children in Hong Kong.
RESEARCH DESIGN AND METHODS— A registry was established in 1991 to collect childhood IDDM cases retrospectively and prospectively from four districts in Hong Kong. The study included all newly diagnosed cases of IDDM with onset &lt; 15 yr of age from 1 January 1986 to 31 December 1990. Primary ascertainment was based on review of medical records at a regional hospital serving the four districts. An independent school survey validated registry data.
RESULTS— The completeness of ascertainment was 93.8%. The age-standardized incidence of IDDM was 2.0/100,000/yr with the 95% confidence interval of 1.2–3.0/100,000/yr for children &lt; 15 yr of age during the study period. The incidence rates/100,000/yr for the three age-groups were: &lt; or = 4 yr, 0.8; 5–9 yr, 2.2; 10–14 yr, 2.8. The incidence for males was 1.5/100,000/yr (95% confidence interval 0.7–2.9/100,000/yr) and for females, 2.4/100,000/yr (95% confidence interval 1.3–4.0/100,000/yr).
CONCLUSIONS— This study documents a very low incidence rate of childhood IDDM in southern Chinese in Hong Kong.
Prevalence of Cardiovascular and Renal Complications in Older Adults With Normal or Impaired Glucose Tolerance or NIDDM: A population-based study
Authors: Wingard Deborah L , Barrett-Connor Elizabeth L , Scheidt-Nave Christa , McPhillips Janice B 
Published: March 2007

Objective— To determine the prevalence of CVD and renal disease by glucose tolerance status in a population-based study.
Research Design and Methods— The study consisted of 991 men and 1243 women, aged 50-89 yr, living in the upper-middle class community of Rancho Bernardo, CA. All participants received a standard OGTT between 1984 and 1987.
Results— A total of 159 men and 158 women had NIDDM, whereas 237 men and 348 women had IGT. Age-adjusted prevalence of complications generally was highest in those who were previously diagnosed with NIDDM. A significant correlation was observed between increases in the prevalence of complications and increases in glucose intolerance for microproteinuria, macroproteinuria, and myocardial infarction (borderline), as well as for stroke and claudication in men and myocardial infarction and stroke in women. In men with IGT or NIDDM, the age-adjusted prevalence of proteinuria and CVD was highest when other complications were present whereas in women such a prevalence was highest when other complications were absent. In men with diabetes, microproteinuria was associated with duration of disease.
Conclusions— Prevalent CVD and renal disease were increased in adults with NIDDM and elevated in adults with IGT compared to those with normal glucose tolerance. The prevalence of complications in NIDDM subjects in this population-based study was substantially lower than that reported for clinic-based diabetic populations.
Lessening the Burden of Diabetes: Intervention Strategies
Authors: Eastman Richard C , Silverman Robert , Harris Maureen , Javitt Jonathan C , Chiang Yen Pin , Gorden Phillip 
Published: March 2007

OBJECTIVE
To evaluate the impact of primary and secondary interventions on the development of complications from diabetes, we modeled the effects of primary and secondary interventions for diabetes on a single well-studied complication, diabetic retinopathy.

RESEARCH DESIGN AND METHODS
A model was developed to predict cumulative incidence of retinopathy in IDDM and NIDDM. Risk functions are based on duration of diabetes. The effects of intervention strategies were simulated by altering the retinopathy risk. The effects of the simulations were assessed using cumulative incidence.

RESULTS
Simulations of delaying the onset of IDDM from 2 to 8 yr and decreasing the retinopathy rates by 20–80% were performed for each type of retinopathy. Simulating primary prevention shifted the cumulative incidence curves to the right, and simulating secondary intervention shifted the curves downward. Primary prevention was less effective than secondary prevention. This difference was more apparent for IDDM than for NIDDM, where disease duration and exposure to retinopathy risk were shorter. All interventions shifted the development of retinopathy to later in life.

CONCLUSIONS
The greatest effect on cumulative incidence of all forms of retinopathy occurs when primary and secondary interventions are combined.
A Highly Successful and Novel Model for Treatment of Chronic Painful Diabetic Peripheral Neuropathy
Authors: Pfeifer Michael A , Ross David R , Schrage Jon P , Gelber David A , Schumer Mary P , Crain Goldie M , Markwell Stephen J , Jung Sonya 
Published: March 2007

OBJECTIVE
To investigate why, in spite of a vast variety of treatment agents, the alleviation of pain in patients with diabetic neuropathy is difficult. Previous studies have not used a treatment algorithm based on anatomic site and neuropathophysiological source of the neuropathic pain.

RESEARCH DESIGN AND METHODS
A model that categorizes the types of pain into three groups (superficial, deep, and muscular) was applied in 75 diabetic patients with chronic (&gt; 12 mo) painful distal symmetrical polyneuropathy in a controlled case series. Twenty-two patients were untreated and 53 patients were treated with imipramine ± mexiletine for deep pain, capsaicin for superficial pain, and stretching exercises and metaxalone ± piroxican for muscular pain. Each type of pain was scored separately on a scale of 0 (none) to 19 (worst), and the total of all three types was used as an index of overall pain. Ability to sleep through the night was scored by a scale of 1 (never) to 5 (always).

RESULTS
No significant differences were observed in initial pain scores, sleep scores, demographics, biochemistries, or physical findings between the two groups. After 3 mo a significant improvement in scores was noted in the treated but not the untreated patients. In addition, a significant difference was found in the change of scores between the treated and untreated patients: total pain (−18 ± 2 vs. 0 ± 2), deep pain (−7 ± 1 vs. 0 ± 1), superficial pain (−5 ± 1 vs. 0 ± 1), muscular pain (−6 ± 1 vs. 0 ± 1), and sleep (1.2 ± 0.2 vs. 0.2 ± 0.2), all P &lt; 0.0001. In treated patients 21% became pain-free (total pain &lt; 2), 66% had improvement (decrease in total pain &gt; 5, but not total elimination of painful symptoms), and 13% were considered treatment failures (a decrease in total pain of &lt; or = 5). This compares with 0 (P &lt; 0.02), 10 (P &lt; 0.0001), and 90% (P &lt; 0.0001), respectively, in the untreated patients.

CONCLUSIONS
This study presents a new rationale and hypothesis for the successful treatment of chronic painful diabetic peripheral neuropathy. It uniquely bases the treatment algorithm on the types and sources of the pain.
Is the Corrected QT Interval a Reliable Indicator of the Severity of Diabetic Autonomic Neuropathy?
Authors: Bravenboer Bert , Hendriksen Peter-Henk , Oey Liam P , Gispen William-Hwndrik , Huffelen Alexander C Van , Erkelens D William 
Published: March 2007

Objective— We investigated whether the corrected QT interval correlated with two other tests for diagnosing autonomic dysfunction in 60 type I diabetic patients with proven peripheral neuropathy. The mean age ± SD was 48.3 ± 11.2 yr, the mean duration of diabetes was 24.9 ± 11.4 yr, and the mean HbA1 was 9.3 ± 2.4%.
Research Design and Methods— All patients underwent three autonomic function tests: 1) the standard five cardiovascular Ewing tests, each scored 0 (normal), 0.5 (borderline), or 1.0 (abnormal). We used the sum of the abnormal findings for the analysis, the cardiovascular autonomic score; 2) measurement of the corrected QT interval taken from a routine electrocardiogram recording; and 3) static and dynamic pupillometry: measurement of dark adapted pupil diameter as percentage of total iris diameter and of pupil constriction latency using an infrared light reflex technique.
Results— No significant correlation was found between age, duration of diabetes, or HbA1 and any of the autonomic function tests, except for one between age and cardiovascular autonomic score (r = 0.3202, P = 0.0126). Corrected QT interval did not correlate with cardiovascular autonomic score, pupil diameter, or constriction latency. A significant inverse correlation was found between cardiovascular autonomic score and pupil diameter (r = −0.4861, P &lt; 0.001) and constriction latency (r = 0.3783, P &lt; 0.001). Pupil diameter and constriction latency correlated well (r = −0.4276, P &lt; 0.001).
Conclusions— The corrected QT interval did not correlate with cardiovascular autonomic tests nor pupillometry results. The corrected QT interval therefore should not be used for the diagnosis of the severity of diabetic autonomic neuropathy.
Clinical Gallbladder Disease in NIDDM Subjects: Relationship to duration of diabetes and severity of glycemia
Authors: Haffner Steven M , Diehl Andrew K , Valdez Rodolfo , Mitchell Braxton D , Hazuda Helen P , Morales Philip , Stern Michael P 
Published: March 2007

Objective— To examine the relationship between the prevalence of gallbladder disease and severity of glycemia among diabetic individuals and to provide insight into whether the diabetes-gallstone association is a causal one, because NIDDM patients have an increased prevalence of clinical gallbladder disease.
Research Design and Methods— We examined 462 diabetic individuals identified during the San Antonio Heart Study, a population-based survey of diabetes and cardiovascular disease in Mexican Americans and non-Hispanic whites. Diabetes was diagnosed according to National Diabetes Data Group criteria.
Results— The prevalence of self-reported gallbladder disease was 34.2% in diabetic women and 7.2% in diabetic men. Although duration of diabetes was positively related to the prevalence of gallbladder disease (P &lt; 0.01), type of therapy was not associated, and fasting glucose concentration was inversely associated with gallbladder disease.
Conclusions— Factors other than hyperglycemia may account for the increased prevalence of gallbladder disease in diabetic subjects.
Factitious Diabetes Mellitus and Spontaneous Hypoglycemia: Consequences of unrecognized Munchausen syndrome by proxy
Authors: Kovacs Christopher S , Toth Ellen L 
Published: March 2007

Objective— To increase health-care professionals′ awareness and knowledge of factitious illness by proxy, or Munchausen syndrome by proxy, in relatives of diabetic patients.
Research Design and Methods— A case report is described of a 14-yr-old male who has a 6-yr history of diet-controlled diabetes mellitus, and a 6-mo history of reported spontaneous hypoglycemia.
Results— Neither diabetes nor spontaneous hypoglycemia was present in this child on objective testing. The child was subjected to inappropriate use of a strict diabetic diet and daily glucometer measurements for at least 8 yr. The father had convinced his son and health-care professionals of these diagnoses, in spite of evidence of the contrary.
Conclusions— When confronted with history and clinical findings that contradict laboratory findings, health-care professionals should have a high index of suspicion for factitious illness and should pursue it aggressively with the help of legal services.
Decreased Polymorphonuclear Leukocyte Deformability in NIDDM
Authors: Pécsvarády Zsolt , Fisher Timothy C , Darwin Christine H , Fabók Agnes , Maqueda Teresita S , Saad Mohammed F , Meiselman Herbert J 
Published: March 2007

OBJECTIVE
To determine the rheological properties of polymorphonuclear leukocytes (PMN) from non-insulin-dependent diabetes mellitus (NIDDM) patients.

RESEARCH DESIGN AND METHODS
The deformability of PMN from 33 NIDDM subjects, 13 with impaired glucose tolerance (IGT), and 22 with normal glucose tolerance (NGT) was studied. A Cell Transit Analyzer that measures the transit time of PMN through 8-(xm pores was used. Studies were performed under three different conditions: J) basal state; 2) after incubation with cytochalasin B (20 μM) to dissociate f-actin from the cytoskeleton; and 3) following activation with N-formyl-methionyl-leucyl-phenylalanine (fMLP, 1 nM).

RESULTS
PMN from diabetic patients were more rigid (i.e., had longer transit time) than those from subjects with NGT or IGT under basal conditions and after cytochalasin B, but not after stimulation with fMLP. The deformability of PMN from subjects with IGT was similar to those of the NGT group. In the pooled data, basal transit time correlated with age; systolic and diastolic blood pressure; HbA1c; and serum creatinine, cholesterol, and triglyceride concentrations (r = 0.29, 0.34, 0.37, 0.48, 0.25, 0.36, 0.29, respectively, P &lt; 0.05 for each). Hypertensive diabetic patients had less deformable PMN than normotensive ones. No relation was found between PMN deformability and the duration of diabetes, type of treatment, or the presence of retinopathy.

CONCLUSIONS
These data indicate increased rigidity of PMN in NIDDM that may contribute to development of microcirculatory disturbances and microangiopathy.
Normalization of Lipoprotein Composition by Intraperitoneal Insulin in IDDM: Role of increased hepatic lipase activity
Authors: Ruotolo Giacomo , Parlavecchia Mariella , Taskinen Marja-Riitta , Galimberti Gabriella , Zoppo Adele , Le Ngoc-Anh , Ragogna Francesca , Micossi Piero , Pozza Guido 
Published: March 2007

OBJECTIVE
To characterize the effects of intraperitoneal insulin pump therapy on lipoprotein composition and lipolytic enzyme activity in patients with insulin-dependent diabetes mellitus (IDDM).

RESEARCH DESIGN AND METHODS
Ten IDDM patients were studied 3 times: when receiving conventional subcutaneous insulin therapy and at 3 and 9 months from the initiation of intraperitoneal insulin regimen. Ten nondiabetic subjects matched for age, sex, and body weight were studied as controls. Levels of cholesterol, triglycerides, apolipoprotein A-I (apoA-I) and B (apoB) were measured in total plasma and lipoprotein fractions (very-low-density lipoprotein [VLDL], intermediate-density lipoprotein [IDL], low-density lipoprotein [LDL], and high-density lipoprotein [HDL]: HDL2 and HDL3). Postheparin plasma lipoprotein lipase and hepatic lipase activities were determined by an immunochemical method.

RESULTS
IDDM patients showed higher levels of HDL3 and lower levels of HDL2 particles during intraperitoneal insulin therapy in comparison with subcutaneous insulin therapy. Both cholesterol and apoA-I significantly increased in HDL3 and decreased in HDL2 during intraperitoneal treatment. Plasma total cholesterol significantly decreased in the diabetic patients at 3 months of intraperitoneal insulin therapy compared with both subcutaneous insulin regimen and control subjects. IDL triglyceride concentrations during intraperitoneal treatment were significantly lower than those seen with subcutaneous therapy. Furthermore, triglyceride:apoB ratio in VLDL and cholesterol:apoB ratio in LDL significantly decreased in IDDM patients treated by intraperitoneal insulin. A significant increase in the activity of hepatic lipase with intraperitoneal insulin therapy by 9 months compared with subcutaneous insulin therapy has been shown.

CONCLUSIONS
The increased activity of hepatic lipase after intraperitoneal insulin administration in IDDM patients appears to be one of the main determinants of lipoprotein changes observed, resulting in the normalization of lipoprotein composition during this mode of therapy. The normal inverse relationship between VLDL triglycerides and HDL cholesterol, which was not present in IDDM patients with subcutaneous therapy, was restored with intraperitoneal insulin regimen.
Long-Term Comparison of Three Dietary Prescriptions in the Treatment of NIDDM
Authors: Milne Robyn M , Mann Jim I , Chisholm Alex W , Williams Sheila M 
Published: March 2007

OBJECTIVE
To compare three sets of dietary guidelines for the treatment of non-insulin-dependent diabetes (NIDDM) in free-living individuals and to observe the effects on metabolic control over an 18-month period.

RESEARCH DESIGN AND METHODS
Seventy volunteer subjects with NIDDM were randomly assigned to one of three diets, a weight-management diet, a high-carbohydrate/fiber diet, or a modified-lipid diet and followed for 18 months. Nutrient intakes, weight, blood lipids, and glycemic control were measured.

RESULTS
In all diet groups, glycated hemoglobin (HbA1) fell significantly before diet intervention began, remaining lower throughout the study and at follow-up 9 months later. Low-density lipoprotein (LDL) cholesterol showed a sustained fall in all groups after diet intervention. Apart from transient changes in high-density lipoprotein (HDL) cholesterol and triglyceride (TG) in the diet groups with the higher carbohydrate intake, no lasting differences were found between the three diet groups.

CONCLUSIONS
In the long term, there were few differences in the outcome of the three dietary prescriptions. Even with intensive instruction, participants found it difficult to meet recommended nutrient intakes; however, specific dietary advice did result in an improvement in LDL cholesterol. Adverse changes in HDL cholesteroland TG because of diet intervention were transient. The significant improvement in glycemic control during the recruitment phase may have been the result of particpants' previous dietary knowledge and the increased attention that they received during the intervention.
A Comparison of Eating Behaviors in Newly Diagnosed NIDDM Patients and Case-Matched Control Subjects
Authors: Kenardy Justin , Mensch Melba , Bowen Kerry , Pearson Sallie-Anne 
Published: March 2007

OBJECTIVE
To determine whether disordered eating may be problematic in non-insulin-dependent diabetes mellitus (NIDDM).

RESEARCH DESIGN AND METHODS
We contrasted the eating behaviors and attitudes in 50 newly diagnosed NIDDM patients with 50 age-, sex-, and weight-matched control subjects.

RESULTS
Although 14% of diabetic subjects versus 4% of nondiabetic subjects reported episodes of binge eating (P &lt; 0.10), there was no difference between diabetic and nondiabetic subjects in the prevalence with which they met criteria for binge eating disorder. Diabetic patients with a history of binge eating were significantly heavier, had younger age at diagnosis, and had more problems with eating in response to situational and emotional cues than did diabetic patients who did not binge.

CONCLUSIONS
No support was found for greater prevalence of binge eating disorder in newly diagnosed NIDDM patients than in matched nondiabetic control subjects.
Impact of Obesity on Neuropathic Late Complications in NIDDM
Authors: Straub Rainer H , Thum Markus , Hollerbach Cathérine , Palitzsch Klaus-Dieter , Schölmerich Jürgen 
Published: March 2007

OBJECTIVE
This cross-sectional study was aimed to investigate the isolated influence of obesity on peripheral sensorimotor and autonomic neuropathy in patients with long-term non-insulin-dependent diabetes mellitus (NIDDM).

RESEARCH DESIGN AND METHODS
Ninety-one long-term NIDDM patients with a mean duration of 13.6 ± 1.0 years and a mean age of 60.4 ± 1.0 years were divided into two groups according to their body mass index (BMI) (lean with a BMI &lt; 26.5: n = 41, age = 58.6 ± 1.7 years, BMI = 23.7 ± 0.3 kg/m2; and obese with a BMI ≥ 26.5: n = 50, age = 61.9 ± 1.2 years, BMI = 30.5 ± 0.5 kg/m2). The two groups were not different in age, duration, gender, current parameters of glycemic control, number of smokers, cholesterol, triglycerides, and systolic and diastolic blood pressure. Neuropathic late complications were scrutinized by a standardized clinical examination that delivers a neuropathy score, pupillary autonomic neuropathy assessed by pupillometry, and cardiovascular autonomic neuropathy using a standardized test battery.

RESULTS
One-way analysis of variance revealed that obese patients had poor results in the clinical neuropathy test (overall score in obese vs. lean: 71.1 ± 2.9 vs. 80.6 ± 3.0 points, 2P = 0.0266; 100 points were absolutely normal). This was particularly true for the discrimination perception (obese vs. lean: 67.0 ± 4.0 vs. 81.7 ± 3.3 points, 2P = 0.0073) and the reflex status (obese vs. lean: 57.4 ± 4.0 vs. 71.8 ± 4.3 points, 2P = 0.0164). Furthermore, obese patients had a poor result in the respiratory sinus arrhythmia (RSA) test, one of six autonomic function tests (RSA: obese vs. lean in average RSA percentile: 36.9 ± 4.9 vs. 54.0 ± 5.9%, 2P = 0.0264).

CONCLUSIONS
Obesity influences sensorimotor and autonomic neuropathic late complications. The poor result in RSA in obesity may indicate an interrelation between pathogenesis of obesity and disorders of the respiratory and heart rhythm-generating control centers in the brain stem. Moreover, it could be due to intrathoracic fat deposits that alter lung mobility. Body mass control may be an important approach to reduce neuropathic complications. Beyond that, it seems necessary to control for body mass when comparing neuropathy in two groups of patients with NIDDM.
Rhinocerebral Mucormycosis in IDDM: Sequential magnetic resonance imaging of long-term survival with intensive therapy
Authors: Moll George W , Raila Frank A , Liu Gilbert C , Conerly A Wallace 
Published: March 2007

OBJECTIVE
To describe the clinical course and the utility of computerized tomography (CT) and magnetic resonance imaging (MRI) in the successful management of an often fatal fungal infection in a 12-year-old patient with insulin-dependent diabetes mellitus (IDDM).

CASE
The patient was admitted to The University of Mississippi Medical Center (UMC) for the purpose of diabetic ketoacidosis (DKA) management and subsequent intensive therapy for mucormycosis according to nationally accepted standards of care. Strict diabetic control was instituted with frequent monitoring of blood glucose levels and interval assessment of HbA1c. Sequential MRI studies were obtained according to approved patient standards; the clinical and MRI course of the infection was charted.

RESULTS
The patient's DKA resolved within 12 h on intravenous fluid repletion and insulin therapy. His sinusitis/rhinitis noted on admission did not respond to intravenous antibiotic therapy and progressed with obvious left orbital involvement and left cranial nerve palsies by 72 h of hospitalization. CT and MRI were invaluable aids to the early diagnosis and design of appropriate surgical and antifungal management of this patient, who survived with minimal left cranial nerve palsies.

CONCLUSIONS
Our patient is among the youngest of IDDM patients reported to have survived rhinocerebral mucormycosis. His survival is attributed to early recognition of possible mucormycosis with diagnostic support of CT and MRI, surgical debridement and antifungal therapy, and intensive blood glucose control. Sequential MRI is invaluable to the design of therapy for this type of patient and shows the nearly 3-year recovery from mucormycosis.