bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Population-Based Study of the Prevalence of Diabetes and Impaired Glucose Tolerance in Adults in Northern Sudan
Authors: Elbagir Murtada N , Eltom Mohammed A , Elmahadi Elmahadi MA , Kadam Ibrahim MS , Berne Christian 
Published: March 2007

OBJECTIVE
To study the prevalence of glucose intolerance in adult urban and rural populations in the northern parts of Sudan.

RESEARCH DESIGN AND METHODS
A sample of 1,284 subjects aged ≥25 years was selected using a multistage cluster method and underwent a 75-g oral glucose tolerance test.

RESULTS
The crude prevalence was 3.4% (men, 3.5%; women, 3.4%) for diabetes and 2.9% (men, 2.2%; women, 3.3%) for impaired glucose tolerance (IGT). The highest crude prevalence was in the northern parts of Sudan (5.5%) and the lowest in the western desert-like parts (0.9%). Diabetes and IGT rates were not different between the urban and rural populations. New cases (2.2%) were almost twice as prevalent as previously known cases (1.3%). Family history of diabetes, obesity, and advanced age were associated with higher rates of diabetes.

CONCLUSION
The results showed a high prevalence of diabetes in the adult population of Sudan, with a wide difference among the different areas. The high ratio of newly discovered to previously known diabetic cases may reflect poor public awareness and medical services. These findings will certainly have far-reaching implications for diabetes care delivery in this country.
Smoking Is Independently Associated With High Plasma Insulin Levels in Nondiabetic Men
Authors: Rönnemaa Tapani , Rönnemaa Elina M , Puukka Pauli , Pyörälä Kalevi , Laakso Markku 
Published: March 2007

OBJECTIVE
Studies using the euglycemic clamp technique or the insulin suppression test in relatively small numbers of subjects have suggested that smoking may cause insulin resistance. Our aim was to study the association between smoking status and fasting plasma insulin in a large nondiabetic male population.

RESEARCH DESIGN AND METHODS
A total of 616 nondiabetic men aged 45–64 years were taken from a population register. Fasting plasma insulin and blood pressure were measured, and smoking history and medication were evaluated by interview.

RESULTS
Age- and BMI-adjusted insulin levels were significantly higher in smokers and ex-smokers than in nonsmokers (92.4, 86.4, and 78.6 pmol/l, respectively; P = 0.009). In every BMI-tertile, smokers and ex-smokers had higher plasma insulin than nonsmokers. After adjustment for factors potentially affecting insulin sensitivity (hypertension, systolic or diastolic blood pressure, use of β-blockers and/or diuretics, use of vasodilating antihypertensive drugs, physical exercise, alcohol use, parental history of NIDDM, coronary heart disease, and previous myocardial infarction), insulin concentrations were still highest in smokers (91.2 pmol/l), intermediate in ex-smokers (86.8 pmol/l), and lowest in nonsmokers (78.9 pmol/l, P = 0.008 between groups).

CONCLUSIONS
Our results show that chronic smoking is associated with high age- and BMI-adjusted plasma insulin levels, independent of other factors known to influence insulin sensitivity. The effect of smoking may be partially reversible after quitting.
Increase in Circulating Products of Lipid Peroxidation in Smokers With IDDM
Authors: Zoppini Giacomo , Targher Giovanni , Monauni Tiziano , Faccini Giovanni , Pasqualini Elena , Martinelli Carlo , Zenari Maria L , Muggeo Michele 
Published: March 2007

OBJECTIVE
To measure plasma malondialdehyde (MDA) concentration, a product of lipid peroxidation, both in IDDM patients and in healthy control subjects and to examine whether smoking has a negative impact on the plasma MDA levels in diabetic patients.

RESEARCH DESIGN AND METHODS
Plasma total MDA concentration (as a thiobarbituric acid adduct by high-performance liquid chromatography) was measured in 56 young IDDM patients and in a group of 32 age-, sex-, BMI-, and smoking habit-matched healthy subjects.

RESULTS
Plasma MDA concentration in IDDM patients was significantly higher than that in healthy control subjects (mean ± SE: 0.95 ± 0.03 vs. 0.54 ± 0.03 μmol/l; P &lt; 0.0001). After stratification by smoking status, it was seen that diabetic smokers had values of age, BMI, serum lipids, blood pressure, metabolic control, and diabetes duration and its chronic complications superimposable on those of their nonsmoking counterparts. Nevertheless, plasma MDA concentration was significantly higher in IDDM patients who smoked than in IDDM patients who didn't smoke (1.03 ± 0.4 vs. 0.87 ± 0.03 μmol/l; P = 0.002), without any sex difference with regard to MDA levels.

CONCLUSIONS
These data show an increase in circulating products of lipid peroxidation in young diabetic smokers, thus further supporting the clinical importance of discouraging the initiation of smoking as well as promoting its cessation in people with IDDM.
Reduced Decrease of Peripheral Vascular Resistance During Exercise in Young Type I Diabetic Patients
Authors: Matthys Dirk , Craen Margaretha , De Wolf Daniel , Walle Johan Vande , Verhaaren Henri 
Published: March 2007

OBJECTIVE
In normal subjects, peripheral vascular resistance decreases during dynamic exercise. We studied blood pressure and peripheral vascular resistance responses to dynamic exercise in young normotensive type I diabetic patients.

RESEARCH DESIGN AND METHODS
Thirty adolescent diabetic patients (9–19 years of age) underwent a maximal exercise test on a cycle ergometer. In a subset of 14 patients, cardiac output was measured by a CO2 rebreathing method and peripheral vascular resistance was calculated. Twenty-four normal individuals, age and sex matched, served as control subjects.

RESULTS
Diastolic blood pressure was significantly higher in diabetic patients at intermediate workload (77 ± 2 vs. 71 ± 1 mmHg) and peak exercise (86 ± 2 vs. 73 ± 2 mmHg). Peripheral vascular resistance was significantly higher in diabetic patients at intermediate workload (17.0 ± 1.1 vs. 12.6 ± 0.5 mmHg·l−1 · min−1 · m−2) and peak exercise (16.3 ± 1.3 vs. 11.4 ± 0.5 mmHg ·l−1 · min−1 · m−2). There were no significant correlations with the patient's age, diabetes duration, or diabetes control.

CONCLUSIONS
We observed the decrease of vasodilator response during dynamic exercise in normotensive young type I diabetic patients.
A Twofold Excess Mortality Among Black Compared With White IDDM Patients in Allegheny County, Pennsylvania
Authors: Tull Eugene S , Barinas Emma ,   The Pittsburgh Deri Mortality Study Group
Published: March 2007

OBJECTIVE
To examine the long-term mortality experience of blacks who develop IDDM in childhood.

RESEARCH DESIGN AND METHODS
The 11–25-year mortality status of individuals with IDDM who participated in the Diabetes Epidemiology Research International (DERI) Mortality Study was verified as of 1 January 1990 for 1,008 (94%) of the 1,076 individuals in the study. Life-table analysis was performed, and race-specific rates were determined for the final sample.

RESULTS
Among black patients, 14.9% died compared with 6.6% of the white patients after a maximum of 25 years of follow-up. African-Americans experienced an age-adjusted mortality rate that was over twice that of whites for the entire period (9.4 vs. 3.8 per 1,000 person-years, respectively; P &lt; 0.05) and at each 5-year interval of follow-up. Among blacks, the mortality rate for females (15.9/1,000 person-years) was 8.4 times (P &lt; 0.05) that of males (1.9/1,000 person-years). In contrast, this sex difference was not seen among whites. Acute complications of diabetes accounted for 40% of the mortality in the black patients, while only 23% of the white patients died from acute causes.

CONCLUSIONS
The data suggest that some of the excess mortality in black IDDM patients may be preventable.
Costs of diabetes in Texas, 1992
Authors: Warner David C , McCandless Roy R , De Nino Louis A , Cornell John E , Pugh Jacqueline A , Marsh Genevieve M 
Published: March 2007

OBJECTIVE
To estimate direct and indirect costs of diabetes in Texas in 1992.

RESEARCH DESIGN AND METHODS
For most direct medical costs, we relied on third party and provider billing databases, including Medicare, Medicaid, VA facilities, public hospitals, and others. The researchers identified people with diabetes in the respective databases, located all records of their care, and sorted records as clearly, probably, or probably not attributable to diabetes on the basis of principal diagnoses. In most cases, costs were valued as allowable or paid charges. Some medical costs, such as private insurance, were estimated from national data and state surveys. Indirect costs included current short- and long-term disability costs and the discounted present value of future costs of mortality. Disability estimates relied on National Health Interview Survey (NHIS) data and U.S. Department of Labor wage data applied to Texas. Mortality estimates were based on death certificates.

RESULTS
Total costs clearly or probably attributable to diabetes among Texans in 1992 were estimated at $4.0 billion. Direct medical costs were ∼ $1.6 billion. Indirect costs were estimated at $2.4 billion. the largest direct costs were paid by Medicare. Most indirect costs were from long-term disability.

CONCLUSIONS
This study demonstrates methods for conducting cost of illness studies at the state level. In a state like Texas, with a large and growing Mexican-American population, estimation of current and future economic costs of diabetes is vital for development of strategies to minimize social and economic consequences of diabetes.
Mitochondrial Aldehyde Dehydrogenase in Diabetes Associated With Mitochondrial tRNALeu(UUR) Mutation at Position 3243
Authors: Suzuki Yoshihiko , Muramatsu Taro , Taniyama Matsuo , Atsumi Yoshihito , Suematsu Makoto , Kawaguchi Ryuji , Higuchi Susumu , Asahina Takayuki , Murata Chisato , Handa Michiko , Matsuoka Kempei 
Published: March 2007

OBJECTIVE
To ascertain why alcohol is prone to manifest unpleasant effects in diabetes associated with mitochondrial tRNALeu(UUR) mutation at position 3243 (DM-Mt3243), we investigated the genotype of aldehyde dehydrogenase (ALDH) 2 and alcohol dehydrogenase 2 (ADH2) in DM-Mt3243.

RESEARCH DESIGN AND METHODS
Nineteen unrelated patients with DM-Mt3243 were included in the study (12 men and 7 women). They were recruited from ∼700 diabetic patients at three different institutes, without prior information of alcohol habit. ALDH2, ADH2, and 3243 mutation were genotyped by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) methods. There were 461 unrelated Japanese individuals and 170 non-3243 mutant NIDDM patients enrolled as control subjects.

RESULTS
In the DM-Mt3243 group, 15 (79%) patients had inactive ALDH2 and 18 (95%) had atypical ADH2. The frequency of the inactive ALDH2 genotype was higher than that in the normal control subjects (P &lt; 0.002) and that in the NIDDM control subjects (P &lt; 0.003). However, the frequencies of ADH2 genotype in the DM-Mt3243 group, the normal control subjects, and the NIDDM control subjects were not different.

CONCLUSIONS
Inactive ALDH2 genotype was frequently observed in DM-Mt3243. It suggests that DM-Mt3243 is associated with ALDH2 inactivity. We speculate the trait of acetaldehyde accumulation on ALDH2 inactivity may favor mitochondrial DNA abnormalities, thereby worsening ATP production and impairing insulin secretion. In addition, the interaction of ALDH1 and ALDH2 may alter the retinoid metabolism in the pancreas, thereby influencing insulin secretion and precipitating diabetes. Thus, this association of ALDH2 genotype with DM-Mt3243 provides insight into the etiology of diabetes in the mitochondrial diseases.
Raised Serum Sialic Acid Concentration in NIDDM Patients With and Without Diabetic Nephropathy
Authors: Chen Jian-Wen , Gall Mari-Anne , Yokoyama Hiroki , Jensen Jan S , Deckert Marja , Parving Hans-Henrik 
Published: March 2007

OBJECTIVE
Raised serum sialic acid concentration is a strong predictor of cardiovascular mortality in the general white population. A progressive increase in cardiovascular morbidity and mortality takes place in relation to increasing albuminuria in NIDDM patients. Therefore, we investigated the potential association between serum sialic acid and micro- and macroangiopathy in NIDDM patients.

RESEARCH DESIGN AND METHODS
We studied a prevalence cohort of all white NIDDM patients &lt; 76 years of age attending a diabetic clinic during 1 year. Of the patients, 319 had normoalbuminuria, 148 had microalbuminuria, and 75 had macroalbuminuria (diabetic nephropathy was in 47 of 75 patients); 66 nondiabetic age- and sex-matched subjects acted as a control group. Blood samples were taken for measurements of sialic acid, lipids, creatinine, and HbA1c. Retinopathy was assessed by funduscopy. The prevalence of cardiovascular disease was based on Minnesota-coded electrocardiograms and the World Health Organization cardiovascular questionnaire.

RESULTS
A progressive raise in serum sialic acid was demonstrated with an increasing urinary albumin excretion rate: [median (range)] 2.02 (1.55–2.63); 2.42 (1.47–6.48); 2.67 (1.57–5.86), and 2.95 (1.52–7.86) mmol/l in nondiabetic subjects, NIDDM patients with normoalbuminuria, microalbuminuria, and diabetic nephropathy, respectively (P &lt; 0.05 or less for differences between groups). Multiple linear regression analysis showed that serum cholesterol concentration, serum HDL cholesterol concentration, BMI, albuminuria, smoking, and cardiovascular disease correlate independently with logarithmic (10) serum sialic acid concentration.

CONCLUSIONS
Our study revealed a progressive raise in serum sialic acid with increasing urinary albumin excretion rate in NIDDM patients. Furthermore, several modifiable cardiovascular risk factors were associated with serum sialic acid.
The Effect of Metformin on Adipose Tissue Metabolism and Peripheral Blood Flow in Subjects With NIDDM
Authors: Jansson Per-Anders E , Gudbjörnsdóttir H Soffia , Andersson Ove K , Lönnroth Peter N 
Published: March 2007

OBJECTIVE
To examine the effect of metformin on net lactate and glycerol release in NIDDM subjects, we used abdominal subcutaneous microdialysis combined with 133Xe clearance. Skeletal muscle blood flow (MBF) was assessed simultaneously both before and after metformin treatment.

RESEARCH DESIGN AND METHODS
Nine male patients with NIDDM (age 53 ± 2 years [mean ± SE]; BMI 30.2 ± 1.4 kg/m2; body fat 23.0 ± 2.6 kg; diabetes duration 4.6 ± 1.5 years; six of nine receiving sulfonylurea treatment) were recruited into an open study. They were studied after an overnight fast, both before and after 1 week of additional treatment with 500 mg metformin three times daily. Nine weight- and age-matched nondiabetic subjects served as a control group.

RESULTS
Postabsorptive net subcutaneous lactate release increased (149 ± 50 vs. 475 ± 127 nmol · 100 g1 · min−1, P &lt; 0.05) whereas plasma lactate was unchanged after metformin treatment in the NIDDM patients. The net decrease of glycerol release 90 min after an oral glucose tolerance test was more pronounced (110 ± 30 vs. 199 ± 20 nmol · 100 g−1 · min−1, P &lt; 0.05) after metformin treatment. Both adipose tissue blood flow (ATBF) (1.5 ± 0.1 vs. 2.3 ± 0.2 ml · 100 g−1 · min−1, P &lt; 0.01) and MBF (3.2 ± 0.4 vs. 4.2 ± 0.5 ml · 100 ml−1 · min−1, P &lt; 0.05) increased after metformin treatment.

CONCLUSIONS
In this open study, postabsorptive net lactate release in abdominal subcutaneous adipose tissue was clearly increased in NIDDM patients after metformin treatment. Basal ATBF as well as MBF was improved after metformin treatment. Whether this reflects enhanced metabolic control or is a drug-specific effect remains to be established.
The Low Prevalence of Immunogenetic Markers in Korean Adult-Onset IDDM Patients
Authors: Park Yongsoo , Lee Hongkyu , Koh Chang-Soon , Min Hunki , Rowley Merrill , Mackay Ian R , Zimmet Paul , McCarthy Bridget , McCanlies Erin , Dorman Janice , Trucco Massimo 
Published: March 2007

OBJECTIVE
IDDM is an autoimmune disease that occurs among genetically susceptible individuals. In Asian populations, it is not uncommon for adult patients with NIDDM to eventually lose β-cell function and develop IDDM. These individuals may be characterized by autoantibodies to GAD and high-risk HLA-DQ alleles, which are unlikely to be prevalent among patients with true NIDDM or in the general population. The objective of the present study was to evaluate and compare the prevalence of these immunogenetic markers in NIDDM patients and healthy nondiabetic individuals from Korea.

RESEARCH DESIGN AND METHODS
The prevalences of anti-GAD antibodies and HLA-DQA1 and DQB1 alleles among 121 patients with newly diagnosed NIDDM identified from a population-based study in Yonchon, Korea, and 100 matched healthy control subjects were evaluated and compared.

RESULTS
The overall prevalence of anti-GAD antibodies was 1.7% (2 of 121) in patients with previously undiagnosed NIDDM, whereas 1 of 100 control subjects had a positive test for antibodies. Among those who tested positive, titers of antibodies to GAD were not high. No statistically significant differences in the distributions of either mean levels of anti-GAD antibodies or DQA1 and DQB1 alleles were found comparing NIDDM patients with control subjects. Interestingly, the frequency of DQB1*non-Asp-57 and DQA1*Arg-52 alleles in the Korean adult control population was similar to that in the U.S. white population (DQB1*non-Asp-57: 0.431 vs. 0.475; DQA1*Arg-52: 0.492 vs. 0.463).

CONCLUSIONS
The low prevalence of anti-GAD antibodies and HLA-DQA1 and DQB1 susceptibility alleles among recent-onset NIDDM patients, which was similar to observations in control subjects, suggests that diabetes in Korean adults is unlikely to have an autoimmune component to its pathogenesis.
A Comparison of Acarbose Versus Metformin as an Adjuvant Therapy in Sulfonylurea-Treated NIDDM Patients
Authors: Bayraktar Miyase , Van Thiel David H , Adalar Nezaket 
Published: March 2007

OBJECTIVE
To compare the effects of acarbose or metformin treatment used as an adjunct with a sulfonylurea agent in the treatment of NIDDM not adequately controlled with the use of a sulfonylurea agent alone.

RESEARCH DESIGN AND METHODS
Of the poorly controlled female NIDDM patients on sulfonylurea treatment, 18 were randomly selected from the outpatient diabetic clinic for study. For 8 weeks, they received either acarbose (300 mg/daily) or metformin (1,500 mg/daily) in addition to sulfonylurea in a crossover design using a 3-week washout period between treatments. The efficacy of each drug regimen was assessed by measuring the levels of glycosylated hemoglobin, fasting and 2-h postprandial blood glucose (PPBG) levels, cholesterol, triglyceride, and fibrinogen levels before and after 8 weeks of therapy.

RESULTS
The metabolic parameters measured before initiation of either treatment regimen were similar. Mean fasting and 2-h postprandial glucose levels were reduced moderately at the end of 8 weeks of both combination treatments (P &lt; 0.05). Although the fasting and 2-h postprandial plasma insulin and C-peptide and fibrinogen levels at the end of the 8-week treatment periods were lower than those obtained at the beginning of the study, the differences between these values were not statistically significant. Cholesterol levels remained unchanged. Only the 2-h PPBG level in the group using acarbose plus a sulfonylurea was lower than the level achieved by the group using metformin plus a sulfonylurea (8.1 ± 0.8 vs. 9.8 ± 1.0 mmol/l, respectively, P &lt; 0.05). The difference between pre- and posttreatment levels of the 2-h PPBG level in both arms of the study were statistically significant (Δ-acarbose, 5.3 ± 0.4 vs. ff-metformin, 2.9 ± 0.3) (P &lt; 0.05). Specific drug-associated side effects were observed in 12 patients on acarbose and 3 patients on metformin.

CONCLUSIONS
Acarbose or metformin can be used as effective adjuvant therapies with a sulfonylurea agent in NIDDM patients who are poorly controlled with the sulfonylurea agent alone.
Excess Mortality and Its Relation toHypertension and Proteinuria in Diabetic Patients
Authors: Wang Shu-Li , Head Jenny , Stevens Clynda , Fuller John H ,   World Health Organization,   Multinational Study Group
Published: March 2007

OBJECTIVE
To determine the extent that mortality in IDDM and NIDDM patients is inexcess of that of the general population and examine its relation to hypertension and proteinuriain diabetic patients.

RESEARCH DESIGN AND METHODS
A stratified random sample of 4,714 diabetic patients aged 35–55 years participating in the World Health Organization MultinationalStudy of Vascular Disease in Diabetes has been followed up from 1975 to 1987. Excess mortality,compared with the background population, was assessed in terms of standardized mortalityratios (SMRs) for each of the 10 international cohorts. The relationship between excess mortalityand proteinuria/hypertension was examined by diabetes type and sex.

RESULTS
SMRs were in general higher in patients with IDDM (ranging from 188 to 686 formen and from 336 to 790 for women) than with NIDDM (from 138 to 370 for men and from 126to 435 for women). For both diabetes types and in both sexes, SMRs decreased with increasingage and increased with increasing diabetes duration. Patients with both hypertension and proteinuria experienced a strikingly high mortality risk: 11-fold for men with IDDM and 18-fold forwomen with IDDM and 5-fold for men with NIDDM and 8-fold for women with NIDDM. Evenin the absence of proteinuria and hypertension, SMRs were significantly increased in both IDDM(284 men and 360 women) and NIDDM (192 men and 236 women) patients.

CONCLUSIONS
Considerable international differences were found not only in mortalityrates for the two types of diabetes but also in the extent of excess mortality among centers. IDDM patients had a high excess mortality in comparison with the general population. The significantexcess mortality was demonstrated even in patients without proteinuria and without hypertension for both sexes and diabetes types.
Effectiveness of a Behavioral Weight Control Program for Blacks and Whites With NIDDM
Authors: Wing Rena R , Anglin Kimberly 
Published: March 2007

OBJECTIVE
To compare the weight losses of black and white patients with NIDDM treated in a year-long behavioral weight loss program.

RESEARCH DESIGN AND METHODS
Subjects were randomly assigned to a behavioral program that either used a low-calorie diet throughout or included two 12-week periods of a very-low calorie diet (VLCD). Weight, dietary intake, and exercise were measured at 0, 6, and 12 months of treatment, and attendance and self-monitoring records were assessed weekly throughout the year.

RESULTS
Blacks had smaller weight losses than whites regardless of treatment condition. Overall weight losses (baseline to 1 year) were 7.1 kg in blacks vs 13.9 kg in whites. The differences in overall outcome resulted primarily from greater weight regain in blacks during months 6-12 than in whites. There was a trend for blacks to have poorer attendance than whites during the latter half of the program and for blacks to report smaller changes in calorie intake from baseline to 6 months.

CONCLUSIONS
The results confirm prior studies with nondiabetic patients showing smaller weight losses in blacks than in whites and suggest that these differences may result primarily from faster weight regain in blacks. Further research is needed to more carefully examine the variables that may explain this difference and to develop more effective programs for blacks with NIDDM.