bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the Effect of Plasma Glucose Concentrations on Microvascular Disease Between Pima Indian Youths and Adults
Authors: Krakoff Jonathan , Hanson Robert L. , Kobes Sayuko , Knowler William C. 
Published: March 2007

OBJECTIVE—To examine whether the current adult guidelines for diagnosis of diabetes are applicable to youth (age &lt;20 years).
RESEARCH DESIGN AND METHODS—We analyzed fasting plasma glucose (FPG) and 2-h plasma glucose (PG) in two groups of Pima Indians, youths aged 5–19 years and adults aged 20–34 years, in relation to the incidence of microvascular disease when subjects were reexamined at ages 25–39 (youths) and 40–54 (adults). Microvascular disease was defined as retinopathy or a urine protein-to-creatinine ratio ≥0.5 g.
RESULTS—An increase in the incidence of microvascular disease occurred at nearly the same level of glycemia in both groups. For youths, this increase occurred at FPG ∼7.3 mmol/l and 2-h PG ∼10.0 mmol/l; for adults, this increase occurred at FPG ∼7.5 mmol/l and 2-h PG ∼10.3 mmol/l. Sensitivity of the adult diagnostic guidelines of FPG ≥7.0 mmol/l and 2-h PG ≥11.1 mmol/l for the detection of microvascular disease was much lower (with higher specificity) in youths than in adults. Receiver operating characteristics (ROC) curve areas were lower for FPG and 2-h PG for youths, suggesting that microvascular disease was less strongly predicted by baseline glucose.
CONCLUSION—The current adult guidelines for diagnosis of diabetes are applicable to youth, as they identify a population at high risk of microvascular complications.
Autoantibodies to a 38-kDa Glycosylated Islet Cell Membrane–Associated Antigen in (Pre)type 1 Diabetes
Authors: Winnock Frederic , Christie Michael R. , Batstra Manou R. , Aanstoot Henk-Jan , Weets Ilse , Decochez Katelijn , Jopart Philippe , Nicolaij Dany , Gorus Frans K. ,   The Belgian Diabetes Registry
Published: March 2007

OBJECTIVE—To study the association of autoantibodies against a 38-kDa glycated islet cell membrane–associated (GLIMA) protein with (pre)type 1 diabetes, patient characteristics, and other immune and genetic markers of the disease and to evaluate the possible added value of GLIMA antibody determinations for disease prediction and classification.
RESEARCH DESIGN AND METHODS—Recent-onset type 1 diabetic patients (n = 100), prediabetic siblings (n = 23), and nondiabetic control subjects (n = 100) were consecutively recruited by the Belgian Diabetes Registry. GLIMA antibodies were determined by immunoprecipitation of radiolabeled islet cell proteins; islet cell antibodies (ICAs) were determined by indirect immunofluorescence; and insulin autoantibodies (IAAs), insulinoma-associated protein-2 antibodies (IA-2As), and GAD antibodies (GADAs) were determined by radioligand assays.
RESULTS— GLIMA antibodies were detected in 38% of type 1 diabetic patients and 35% of prediabetic siblings (during follow-up) vs. 0% in control subjects (P &lt; 0.001). Their prevalence was lower than that of other antibodies and was significantly associated with high levels of IA-2A and ICA (P &lt; 0.0001). In (pre)diabetes, GLIMA antibodies could only be demonstrated in sera positive for ≥1 other autoantibody.
CONCLUSIONS— GLIMA antibodies are strongly associated with type 1 diabetes and antibody markers of rapid progression to clinical onset but have a lower diagnostic sensitivity for the disease than IAA, ICA, IA-2A, or GADA. In its present form, the GLIMA antibody assay does not provide much additional information for prediction or classification of diabetes, compared with that obtained from the measurement of IA-2As alone or in combination with IAAs, ICAs, and GADAs.
Risk of Type 1 Diabetes Development in Children With Incidental Hyperglycemia
Authors: Lorini Renata , Alibrandi A. , Vitali L. , Klersy C. , Martinetti M. , Betterle C. , d’Annunzio G. , Bonifacio E. ,   Pediatric Italian Study Group of Prediabetes
Published: March 2007

OBJECTIVE—The aim of our study was to determine whether children with incidental hyperglycemia are at an increased risk of developing type 1 diabetes.
RESEARCH DESIGN AND METHODS—A total of 748 subjects, 1–18 years of age (9.04 ± 3.62, mean ± SD), without family history of type 1 diabetes, without obesity, and not receiving drugs were studied and found to have incidental elevated glycemia defined as fasting plasma glucose &gt;5.6 mmol/l confirmed on two occasions. Subjects were tested for immunological, metabolic, and immunogenetic markers.
RESULTS—Islet cell antibodies &gt;5 Juvenile Diabetes Foundation units were found in 10% of subjects, elevated insulin autoantibody levels in 4.6%, GAD antibody in 4.9%, and anti-tyrosine phosphatase-like protein autoantibodies in 3.9%. First-phase insulin response (FPIR) was &lt;1st centile in 25.6% of subjects. The HLA-DR3/DR3 and HLA-DR4/other alleles were more frequent in hyperglycemic children than in normal control subjects (P = 0.012 and P = 0.005, respectively), and the HLA-DR other/other allele was less frequent than in normal control subjects (P = 0.000027). After a median follow-up of 42 months (range 1 month to 7 years), 16 (2.1%) subjects (11 males and 5 females), 4.1–13.9 years of age, became insulin dependent. All had one or more islet autoantibodies, and the majority had impaired insulin response and genetic susceptibility to type 1 diabetes. Diabetes symptoms were recorded in 11 patients and ketonuria only in 4 patients. The cumulative risk of type 1 diabetes was similar in males and females, and it was also similar in subjects under or over 10 years, whereas the cumulative risk of type 1 diabetes was increased in subjects with one or more autoantibodies and in those with FPIR &lt;1st centile.
CONCLUSIONS—Children with incidental hyperglycemia have a higher-than-normal frequency of immunological, metabolic, or genetic markers for type 1 diabetes and have an increased risk of developing type 1 diabetes.
Serum Type IV Collagen in Diabetic Patients at Risk for Nephropathy
Authors: Cohen Margo P. , Shearman Clyde W. , Lautenslager Gregory T. 
Published: March 2007

OBJECTIVE—Whereas increased urinary excretion of type IV collagen, which is believed to reflect renal overproduction of this extracellular matrix protein in early diabetic nephropathy, has been confirmed in several studies, examination of serum concentrations of this analyte has yielded conflicting results. We sought to clarify the relationship between early renal dysfunction in diabetes and circulating type IV collagen concentrations.
RESEARCH DESIGN AND METHODS—We measured serum (human) collagen IV concentrations by immunoassay in 109 patients with type 1 or type 2 diabetes and various amounts of albuminuria extending from the normo- to the macroalbuminuric range, and we examined its relationship to albumin excretion and to serum creatinine levels.
RESULTS—Serum collagen IV concentrations (mean ± SEM) were not significantly different in normoalbuminuric (219 ± 10 ng/ml), microalbuminuric (209 ± 6 ng/ml), or macroalbuminuric (206 ± 7 ng/ml) diabetic subjects or in nondiabetic normal volunteers (206 ± 10 ng/ml). Collagen IV concentrations showed no significant correlation (P &gt; 0.25) with albumin excretion (r = −0.001), HbA1c (r = 0.030), or serum creatinine (r = −0.161) and were unrelated to urinary excretion of collagen IV in the subset of subjects in whom these data were available.
CONCLUSIONS—The results of this cross-sectional analysis discount the utility of measurement of the serum concentration of collagen IV as an indicator of early renal dysfunction in diabetes. Increased urine excretion of collagen IV without a significant change in the serum concentration is consistent with a renal origin of this analyte in early diabetic nephropathy.
The Effect of Aggressive Versus Standard Lipid Lowering by Atorvastatin on Diabetic Dyslipidemia
Authors:   The Diabetes Atorvastatin Lipid Intervention (DALI) Study Group
Published: March 2007

OBJECTIVE—In patients with type 2 diabetes, intensive glucose regulation, although effective for microangiopathy, has not been shown to have unambiguous preventive effects on the occurrence of cardiovascular disease. Patients with diabetes show a characteristic dyslipidemia (high triglyceride level, low HDL cholesterol level). Aggressive reduction of triglycerides might be an effective method to reduce the cardiovascular risk in these patients.
RESEARCH DESIGN AND METHODS—A double-blind, placebo-controlled, randomized study to assess the effect of 30 weeks of administration of atorvastatin 10 and 80 mg on plasma triglyceride levels in 217 patients with type 2 diabetes and fasting triglyceride levels between 1.5 and 6.0 mmol/l.
RESULTS—Administration of atorvastatin 10 and 80 mg resulted in significant reductions (25 and 35%, respectively) of plasma triglyceride levels (both P &lt; 0.001). The difference between 10 and 80 mg was not statistically significant (P &gt; 0.5). Atorvastatin 10 mg provided significant reductions from baseline in total cholesterol (−30%, P &lt; 0.001), LDL cholesterol (−40%, P &lt; 0.001), and apolipoprotein B (−31%, P &lt; 0.001), and significantly increased HDL cholesterol from baseline by 6% (P &lt; 0.005). Atorvastatin 80 mg had a similar effect on HDL cholesterol (+5.2%, P &lt; 0.005) but significantly decreased total cholesterol (−40%, P &lt; 0.001), LDL cholesterol (−52%, P &lt; 0.001), and apolipoprotein B (−40%, P &lt; 0.001) more than atorvastatin 10 mg (P &lt; 0.005). The side effects of atorvastatin 10 and 80 mg were similar and did not differ from the patients receiving placebo.
CONCLUSIONS—Administration of 10- and 80-mg doses of atorvastatin provides similar, significant reductions from baseline in triglyceride levels in patients with type 2 diabetes. A higher dose of atorvastatin improves cholesterol-related parameters. Both doses were well tolerated in this patient population.
The Effect of Day Care Exposure on the Risk of Developing Type 1 Diabetes
Authors: Kaila Brinderjit , Taback Shayne P. 
Published: March 2007

OBJECTIVE—Exposure to infections in infancy or childhood may be important in the pathogenesis of type 1 diabetes, but a protective role has also been suggested. We tested the hypothesis that increased early contact with infectious agents, measured by day care exposure, would decrease the risk of type 1 diabetes in childhood.
RESEARCH DESIGN AND METHODS—We conducted a systematic review of case-control studies. Meta-analysis was performed to combine results, assess for heterogeneity, and explore variation in study design.
RESULTS—Several generally well-designed case-control studies show a statistically significant protective effect of day care on type 1 diabetes. However, meta-analysis revealed too much heterogeneity to accept the overall synthesis results and none of the studies used prerecorded data. Day care does seem to have a protective effect in the subgroup of children who will be diagnosed with type 1 diabetes before the age of 5 years (odds ratio = 0.6, 95% CI 0.5–0.8); however, this result is based on only two studies.
CONCLUSIONS—Recall bias is one alternate explanation for these data; confirmation using prerecorded data is required. Such data could be prospectively measured in cohort studies of children at risk. We also suggest that information about day care attendance be measured in randomized trials of agents for the prevention of type 1 diabetes, as day care exposure could potentially modify the effect of the preventive agent.
High Prevalence of Type 2 Diabetes in All Ethnic Groups, Including Europeans, in a British Inner City
Authors: Riste Lisa , Khan Farida , Cruickshank Kennedy 
Published: March 2007

OBJECTIVE—To compare the prevalence of type 2 diabetes in white Europeans and individuals of African-Caribbean and Pakistani descent.
RESEARCH DESIGN AND METHODS—Random sampling of population-based registers in inner-city Manchester, Britain’s third most impoverished area. A total of 1,318 people (25–79 years of age) were screened (minimum response 67%); 533 individuals without known diabetes underwent 2-h glucose tolerance testing, classified by 1999 World Health Organization criteria.
RESULTS—More than 60% of individuals reported household annual income &lt;£10,000 ($15,000) per year. Energetic physical activity was rare and obesity was common. Age-standardized (35–79 years) prevalence (mean 95% CI) of known and newly detected diabetes was 20% (17–24%) in Europeans, 22% (18–26%) in African-Caribbeans, and 33% (25–41%) in Pakistanis. Minimum prevalence (assuming all individuals not tested were normoglycemic) was 11% (8–14%), 19% (15–23%), and 32% (24–40%), respectively. Marked changes in prevalence represent only small shifts in glucose distributions. Regression models showed that greater waist girth, lower height, and older age were independently related to plasma glucose levels, as was physical activity. Substituting BMI and waist-to-hip ratio revealed their powerful contribution.
CONCLUSIONS—A surprisingly high prevalence of diabetes, despite expected increases with new lower criteria, was found in Europeans, as previously established in Caribbeans and Pakistanis. Lower height eliminated ethnic differences in regression models. History and relative poverty, which cosegregate with obesity and physical inactivity, are likely contributors. Whatever the causes, the implications for health services are alarming, although substantial preventive opportunities through small reversals of glucose distributions are the challenge.
Postchallenge Hyperglycemia and Mortality in a National Sample of U.S. Adults
Authors: Saydah Sharon H. , Miret Montserrat , Sung Jennifer , Varas Cristina , Gause Douglas , Brancati Frederick L. 
Published: March 2007

OBJECTIVE—Although postchallenge hyperglycemia is a well-established feature of type 2 diabetes, its association with risk of mortality is uncertain. Therefore, the aim of this study was to assess the independent association of fasting and 2-h glucose levels with all-cause and cardiovascular disease (CVD) mortality.
RESEARCH DESIGN AND METHODS—We analyzed data from the Second National Health and Nutrition Examination Survey (NHANES II) Mortality Study, a prospective cohort study of U.S. adults examined in the NHANES II, and focused on the 3,092 adults aged 30–74 years who underwent an oral glucose tolerance test at baseline (1976–1980). Deaths were identified from U.S. national mortality files from 1976 to 1992. To account for the complex survey design, we used SUDAAN statistical software for weighted analysis.
RESULTS—Compared with their normoglycemic counterparts (fasting glucose [FG] &lt;7.0 and 2-h glucose &lt;7.8 mmol/l), adults with fasting and postchallenge hyperglycemia (FG ≥7.0 and 2-h glucose ≥11.1 mmol/l) had a twofold higher risk of death after 16 years of follow-up (age- and sex-adjusted relative hazard [RH] 2.1, 95% CI 1.4–3.2). However, adults with isolated postchallenge hyperglycemia (FG &lt;7.0 and 2-h glucose ≥11.1 mmol/l) were also at higher risk of death (1.6, 1.0–2.6). In proportional hazards analysis, FG (fully adjusted RH 1.10 per 1 SD; 95% CI 1.01, 1.22) and 2-h glucose (1.14, 1.00–1.29) showed nearly identical predictive value for mortality. Similar trends were observed for CVD mortality.
CONCLUSIONS—These results suggest that postchallenge hyperglycemia is associated with increased risk of all-cause and CVD mortality independently of other CVD risk factors.
Peripheral Arterial Disease in Diabetic and Nondiabetic Patients
Authors: Jude Edward B. , Oyibo Samson O. , Chalmers Nicholas , Boulton Andrew J.M. 
Published: March 2007

OBJECTIVE—The aim of this study was to quantify the distribution of peripheral arterial disease in the diabetic and nondiabetic population attending for angiography and to compare severity and outcome between both groups of patients.
RESEARCH DESIGN AND METHODS—Randomly selected lower-extremity angiograms were examined according to the Bollinger system. Patient demographics and medical history were recorded and case notes were examined to determine which patients later underwent a revascularization procedure or amputation and which patients had died.
RESULTS—A total of 136 arteriograms obtained between 1992 and 1996 were analyzed. The age (mean ± SD) of the patients was 64.7 ± 10.8 years. Diabetic patients (43%) and nondiabetic patients were of similar age (63.9 ± 10.4 vs. 65.3 ± 11.1 years, P = 0.43), with a similar history of smoking (81.0 vs. 76.9%, P = 0.26), ischemic heart disease (41.4 vs. 37.2%, P = 0.54), and hypercholesterolemia (24.4 vs. 30.8%, P = 0.48). However, there were a greater proportion of hypertensive patients in the diabetic group (63.8 vs. 39.7%, P = 0.006). Diabetic patients had greater severity of arterial disease in the profunda femoris and all arterial segments below the knee (P = 0.02). A greater number of amputations occurred in the diabetic group: diabetic patients were five times more likely to have an amputation (41.4 vs. 11.5%, odds ratio [OR] 5.4, P &lt; 0.0001). Mortality was higher in the diabetic group (51.7 vs. 25.6%, OR 3.1, P = 0.002), and diabetic patients who died were younger at presentation than nondiabetic patients (64.7 ± 11.4 vs. 71.1 ± 8.7 years, P = 0.04).
CONCLUSIONS—In patients with peripheral arterial disease, diabetic patients have worse arterial disease and a poorer outcome than nondiabetic patients.
Diabetes and Incidence of Functional Disability in Older Women
Authors: Gregg Edward W. , Mangione Carol M. , Cauley Jane A. , Thompson Theodore J. , Schwartz Ann V. , Ensrud Kristine E. , Nevitt Michael C. ,   for the Study of Osteoporotic Fractures Research Group
Published: March 2007

OBJECTIVE—To examine the relationship between diabetes and the incidence of functional disability and to determine the predictors of functional disability among older women with diabetes.
RESEARCH DESIGN AND METHODS—We analyzed data from 8,344 women enrolled in the Study of Osteoporotic Fractures, a prospective cohort of women aged ≥65 years. Diabetes (n = 527, 6.3% prevalence) and comorbidities (coronary heart disease, stroke, arthritis, depression, and visual impairment) were assessed by questionnaire and physical examination. Incident disability, defined as onset of inability to do one or more major functional tasks (walking 0.25 mile, climbing 10 steps, performing household chores, shopping, and cooking meals), was assessed by questionnaire over 12 years.
RESULTS—The yearly incidence of any functional disability was 9.8% among women with diabetes and 4.8% among women without diabetes. The age-adjusted hazard rate ratio (HRR) of disability for specific tasks associated with diabetes ranged from 2.12 (1.82–2.48) for doing housework to 2.50 (2.05–3.04) for walking two to three blocks. After adjustment for potential confounders at baseline (BMI, physical activity, estrogen use, baseline functional status, visual impairment, and marital status) and comorbidities (heart disease, stroke, depression, and arthritis), diabetes remained associated with a 42% increased risk of any incident disability and a 53–98% increased risk of disability for specific tasks. Among women with diabetes, older age, higher BMI, coronary heart disease, arthritis, physical inactivity, and severe visual impairment at baseline were each independently associated with disability.
CONCLUSIONS—Diabetes is associated with an increased incidence of functional disability, which is likely to further erode health status and quality of life.
The Impact of Outpatient Diabetes Management on Serum Lipids in Urban African-Americans With Type 2 Diabetes
Authors: Erdman Diane M. , Cook Curtiss B. , Greenlund Kurt J. , Giles Wayne H. , El-Kebbi Imad , Ryan Gina J. , Gallina Daniel L. , Ziemer David C. , Dunbar Virginia G. , Phillips Lawrence S. 
Published: March 2007

OBJECTIVE—Treating dyslipidemia in diabetic patients is essential, particularly among minority populations with increased risk of complications. Because little is known about the impact of outpatient diabetes management on lipid outcomes, we examined changes in lipid profiles in urban African-Americans who attended a structured diabetes care program.
RESEARCH DESIGN AND METHODS—A retrospective analysis of initial and 1-year follow-up lipid values was conducted among patients selected from a computerized registry of an urban outpatient diabetes clinic. The independent effects of lipid-specific medications, glycemic control, and weight loss on serum total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels were evaluated by analysis of covariance and multiple linear regression.
RESULTS—In 345 patients (91% African-American and 95% with type 2 diabetes), HbA1c decreased from 9.3% at the initial visit to 8.2% at 1 year (P &lt; 0.001); total and LDL cholesterol and triglyceride levels were significantly lower, and HDL cholesterol was higher. After stratifying based on use of lipid-specific therapy, different outcomes were observed. In 243 patients not taking dyslipidemia medications, average total cholesterol, LDL cholesterol, and triglyceride concentrations at 1 year were similar to initial values, whereas in 102 patients receiving pharmacotherapy, these lipid levels were all lower at 1 year relative to baseline (P &lt; 0.001). Mean HDL cholesterol increased regardless of lipid treatment status (P &lt; 0.001). After adjusting for other variables, changes in LDL cholesterol concentration were associated only with use of lipid-specific agents (P = 0.003), whereas improved HbA1c and weight loss had no independent effect. Lipid therapy, improved glycemic control, and weight loss were not independently related to changes in HDL cholesterol and therefore could not account for the positive changes observed. Use of lipid-directed medications, improvement in glycemic control, and weight loss all resulted in significant declines in triglyceride levels but only improved HbA1c and weight loss had an independent effect.
CONCLUSIONS—Among urban African-Americans, diabetes management led to favorable changes in HDL cholesterol and triglyceride levels, but improved glycemic control and weight loss had no independent effect on LDL cholesterol concentration. Initiation of pharmacologic therapy to treat high LDL cholesterol levels should be considered early in the course of diabetes management to reach recommended targets and reduce the risk of cardiovascular complications in this patient population.
Hormone Replacement Therapy and Its Relationship to Lipid and Glucose Metabolism in Diabetic and Nondiabetic Postmenopausal Women
Authors: Crespo Carlos J. , Smit Ellen , Snelling Anastacia , Sempos Christopher T. , Andersen Ross E. 
Published: March 2007

OBJECTIVE—Among postmenopausal women, those with diabetes experience more cardiovascular diseases than those without diabetes. We examine the relationship of hormone replacement therapy (HRT) with indicators of lipid and glucose metabolism using a national sample of diabetic and nondiabetic postmenopausal women.
RESEARCH DESIGN AND METHODS—We used data from the Third National Health and Nutrition Examination Survey, conducted from 1988 to 1994. A total of 2,786 postmenopausal women aged 40–74 years participated in an oral glucose tolerance test, had blood drawn for lipid assessment, and responded to HRT questions.
RESULTS—Our results show that postmenopausal women with diabetes had increased dyslipidemia compared with nondiabetic women. Among diabetic women, current users of HRT had significant different lipid and glucose control levels than never users of HRT for the following variables: total cholesterol (225 vs. 241 mg/dl), non-HDL (169 vs. 188 mg/dl), apoA (171 vs. 147 mg/dl), fibrinogen (306 vs. 342 mg/dl), glucose (112 vs. 154 mg/dl), insulin (16.81 vs. 22.6 uU/ml), and GHb (6.03 vs. 7.13 mg/dl).
CONCLUSIONS—Diabetic and nondiabetic postmenopausal women currently taking HRT had better lipoprotein profile than never or previous users of HRT. Diabetic women currently taking HRT had better glycemic control than never or previous users of HRT.