bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyperinsulinemia in Macrosomic Infants of Nondiabetic Mothers
Authors: Hoegsberg Bente , Gruppuso Philip A , Coustan Donald R 
Published: March 2007

Objective— We tested the hypothesis that macrosomic infants of nondiabetic mothers are more likely to have hyperinsulinemia and increased subcutaneous fat.
Research Design and Methods— Plasma insulin concentrations were measured in cord blood from 50 macrosomic infants and 32 normal-sized (control), term infants. All mothers had had a normal 50-g 1-h GCT. Skin-fold measurements of the triceps and subscapular area were done on 44 macrosomic infants with a Halpern caliper.
Results— No difference was observed in GCT between mothers of macrosomic (5.8 ± 1.0 mM) and normal (5.7 mM) infants. The insulin level in macrosomic infants (18.75 ± 19.08 μU/ml) was significantly higher than in control infants (8.67 ± 6.64 μU/ml). Macrosomia was a predictor of hyperinsulinemia and vice versa (R2 = 0.26). Maternal height, prepregnancy weight, and weight gain were predictors for macrosomia (R2 = 0.26). No differences were noted in anthropometric measurements between hyperinsulinemic and normoinsulinemic infants.
Conclusions— A subset of macrosomic infants have hyperinsulinemia. Maternal anthropometric factors as well as hyperinsulinemia are correlated with macrosomia. The macrosomia may be causally related to the high insulin levels.
Renal Disease Among the Eastern Band of Cherokee Indians
Authors: Quiggins Patricia A , Farrell Mary Anne 
Published: March 2007

OBJECTIVE— To ascertain the incidence and prevalence of ESRD in the Eastern Band of Cherokee in the IHS user population from 1978 to 1988 and to determine what proportion of ESRD and chronic renal failure is attributable to diabetes.
RESEARCH DESIGN AND METHODS— Cases were identified from three IHS data sources and from death records obtained from the North Carolina Bureau of Health Statistics. Chronic renal insufficiency was defined as an individual having a serum creatinine of ≥ or = 176.8 μM that remained at that level for a sustained period. An ESRD case was defined as one in which dialysis was required to sustain life, regardless of whether treatment was actually implemented. Data were obtained from chart review and included date of diagnosis, maximum serum creatine level attained, diabetes status, and certain demographic data.
RESULTS— Twenty-two (88%) cases of ESRD were attributable to diabetes. The average annual incidence of ESRD during the study period was much higher than that in the U.S. white population and that of Native Americans. The incidence of ESRD caused by diabetes was 2.5 times higher than that reported in the U.S. Native American population affected by diabetes. Degree of Indian inheritance did not appear to be related to prevalence of diabetic renal disease in individuals having diagnosed diabetes.
CONCLUSIONS— The proportion of ESRD attributable to diabetes indicates that primary prevention of diabetes may be the best method of preventing ESRD in this population.
Diabetic Complications Among American Indians of Washington, Oregon, and Idaho: Prevalence of retinopathy, end-stage renal disease, and amputations
Authors: Freeman William L , Hosey Gwendolyn M 
Published: March 2007

OBJECTIVE— To estimate the prevalence of severe diabetic complications.
RESEARCH DESIGN AND METHODS— We surveyed the data systems of the IHS and local care providers to identify all AI/AN people with any of three diabetic complications: retinopathy needing one or more laser treatments, ESRD needing dialysis, and one or more LEAs. We calculated prevalence rates that were sex-age adjusted to the U.S. population for total sample, each community, gender, and culture area.
RESULTS–Of the population-based complete sample with diabetes, 1.7% had retinopathy, 1% ESRD, and 4% LEA. Complication rates among the culture areas were not statistically different. The LEA rate among diabetic men (5.8%) was higher than that among women (2.3%). The odds ratio was 2.2 (95% CI 1.2-4.2). One community had an extraordinarily high LEA rate of 16%.
CONCLUSIONS— This study showed that IHS can use its data systems to estimate prevalence of diabetic complications and identify population groups with higher prevalence rates. The data led the IHS clinic with the high LEA rate to start a program to prevent amputations. We suggest quality assurance activities based on the methods of this study.
Elevated Serum Sialic Acid Concentration in NIDDM and Its Relationship to Blood Pressure and Retinopathy
Authors: Crook Martin A , Tutt Peter , Pickup John C 
Published: March 2007

Objective— In view of the possible link between serum sialic acid and cardiovascular disease in the general population, we investigated whether serum total and lipid-associated sialic concentrations are elevated in NIDDM patients compared with normal subjects. We also investigated how sialic acid levels relate to glycemic control, blood pressure, microalbuminuria, retinopathy, and serum lipid levels.
Research Design and Methods— We selected 20 NIDDM patients at random and matched them for age and sex with 20 normal subjects. The patients also had a similar BMI as the control subjects. A first morning blood sample was taken for sialic acid, glucose, fructosamine, and lipid analysis, as was a first morning urine sample for assessment of microalbuminuria. Retinopathy was assessed by fundoscopy.
Results— Both total and lipid-associated sialic acid levels were elevated in the NIDDM patients compared with control subjects (mean ± SD, total: 0.74 ± 0.11 vs. 0.60 ± 0.22 g/L, P &lt; 0.02; lipid-associated: 0.18 ± 0.04 vs 0.12 ± 0.04 g/L, P &lt; 0.001). Total serum sialic acid was correlated with systolic blood pressure (r = 0.58, P &lt; 0.01) and diastolic blood pressure (r = 0.58, P &lt; 0.02). There was no significant relationship of total sialic acid with age, duration of diabetes, BMI, microalbuminuria, serum triglyceride, blood glucose, or serum fructosamine. A relationship of lipid-associated sialic acid levels and systolic blood pressure did not reach significance (P = 0.09). In 9 patients with background retinopathy with or without maculopathy, the total serum sialic acid concentration was higher than in those without retinopathy (0.81 ± 0.09 vs. 0.69 ± 0.10 g/L, P &lt; 0.008). Lipid-associated sialic acid levels were similar in those with and without retinopathy. (The conversion factor for standard units to SI units is 1 gL = 3.2 mM.)
Conclusions— Total serum sialic acid levels were significantly elevated in a relatively small group of NIDDM patients and were correlated with hypertension and retinopathy. A larger study of circulating sialic acid concentrations as a risk factor for the development or marker of diabetic angiopathy is therefore justified.
C-Peptide in NIDDM: Follow-up for 4-6 yr
Authors: Lev-Ran Arye , Hwang David L 
Published: March 2007

Objective— To study whether fasting and 1-h postbreakfast C-peptide levels in NIDDM stabilize with time in individual patients.
Research Design and Methods— Within the period of 4–6 yr, 49 NIDDM patients had repeated tests of fasting and 1-h postprandial levels of plasma glucose and C-peptide with the aim of determining their individual qualitative patterns. Throughout the follow-up period, 13 patients were treated with insulin, 21 with oral sulfonylureas, and 15 were switched from oral drugs to insulin, with the tests done in both treatment periods.
Results— The group as a whole demonstrated no changes in mean fasting or postprandial C-peptide within 4–6 yr of observation, irrespective of the mode of therapy or its changes. Glycemic and C-peptide response to breakfast was qualitatively typical for each patient with the correlation between plasma glucose and C-peptide. However, the response was vastly different from patient to patient, and the cross-sectional data showed no correlation between postprandial changes in glycemia and C-peptide, nor between glycemic response to breakfast and fasting plasma glucose or C-peptide. In spite of high fasting glycemia, 25% of the patients showed remarkable tolerance to breakfast with only small increases in plasma glucose. In many other patients, however, in spite of similar increase in C-peptide, plasma glucose rose sharply after the meal.
Conclusions— In our group, no deterioration of the insulin secretory function was observed within 4–6 yr of follow-up. Qualitative patterns of the glycemic and C-peptide responses to breakfast were typical for each patient but vastly different between patients. We see in NIDDM a syndrome with few common characteristics and recommend further work for its subclassification into forms with different pathogenesis.
Familial Hyperproinsulinemia Associated With NIDDM: A case study
Authors: Oohashi Hiroshi , Ohgawara Hisako , Nanjo Kishio , Tasaka Yoshimasa , Cao Qiu-Ping , Chan Shu Jin , Rubenstein Arthur H , Steiner Donald F , Omori Yasue 
Published: March 2007

OBJECTIVE
To report studies on an elderly patient with moderate NIDDM associated with marked fasting hyperinsulinemia.

RESEARCH DESIGN AND METHODS
The propositus and several family members were studied by a combination of clinical, biochemical, and molecular genetic approaches to define the underlying genetic defect.

RESULTS
Fasting levels of contrainsulin hormones were normal, and resistance to exogenous insulin was absent. Gel filtration and reverse-phase high-performance liquid chromatography revealed elevated amounts of a structurally abnormal proinsulin intermediate (AC proinsulin). A study of the family of the propositus showed rhe same abnormality in 4 of 5 members in 3 successive generations. Genetic analysis revealed a point mutation affecting residue 65 of human proinsulin (Arg→His) in one allele of the insulin gene in the propositus, a defect similar to that described previously in 3 other apparently unrelated lineages.

CONCLUSIONS
This family exhibits a clear-cut relationship between increasing age and metabolic decompensation in all the hyperproinsulinemic members, suggesting that (inherited) metabolic stress and age both contribute to development of diabetes mellitus.
Improved Insulin Action and Glycemic Control After Long Term Angiotensin-Converting Enzyme Inhibition in Subjects with Arterial Hypertension and Type II Diabetes
Authors: Torlone Elisabetta , Britta Mariella , Rambotti Anna Maria , Perriello Gabriele , Santeusanio Fausto , Brunetti Paolo , Bolli Geremia B 
Published: March 2007

OBJECTIVE
To determine the long-term effects of the angiotensin-converting enzyme inhibitor captopril on insulin sensitivity in subjects with type II diabetes and arterial hypertension. The chronic effects of angiotensin-converting enzyme inhibition on insulin-sensitive individuals are presently controversial.

RESEARCH DESIGN AND METHODS
Sixteen subjects, with type II diabetes (on diet and/or diet plus oral hypoglycemic agents) and arterial hypertension, were studied. During a 1-mo run-in period no antihypertensive drugs were administered, but oral hypoglycemic agents were continued in subjects already in therapy. The subjects were then randomly assigned to two 3-mo treatment periods, with either captopril or placebo (single blind, cross-over design). At the end of each treatment period, insulin sensitivity was assessed by means of a euglycemic-hyperinsulinemic clamp (2 sequential steps, 2-h each, insulin infusion 0.25 and 1 mU ·kg−1 ·min−1, steps 1 and 2, respectively), combined with infusion of [3-3H]glucose (for calculation of hepatic glucose output and peripheral glucose utilization, rates of glucose disappearance), and indirect calorimetry (for calculation of glucose oxidation, nonoxidative glucose metabolism, and lipid oxidation). The percentage of HbAlc was measured to assess long-term glycemic control.

RESULTS
Comparing data at the end of placebo and captopril treatment, captopril resulted in: lower blood pressure (systolic 154 ± 2 vs. 163 ± 3 mmHg and diastolic 93 ± 2 vs. 101 ± 2 mmHg); greater insulin sensitivity in hyperglycemic conditions (total amount of insulin infused and time of insulin infusion required to reach euglycemia, 1.73 ± 0.54 vs. 2.08 ± 0.60 U and 58 ± 8 vs. 70 ± 11 min, captopril and placebo, respectively, P &lt; 0.05); greater insulin sensitivity in euglycemic conditions at liver level (hepatic glucose output 4.11 ± 0.55 vs. 5.2 ± 0.4 μmol · kg−1 · min−1, step 1 of the clamp), muscle level (rates of glucose disappearance 26.1 ± 2.3 vs. 23.8 ± 2.1 μmol · kg−1 · min−1, step 2 of the clamp), primarily attributable to ∼29% increase in nonoxidative glucose metabolism, and adipose tissue level (plasma free fatty acid 0.185 ± 0.03 vs. 0.24 ± 0.02 mM and lipid oxidation 1.9 ± 0.3 vs. 2.21 ± 0.04 μmol · kg−1 · min−1 in step 1); and lower HbA1c (6.7 ± 0.2 vs. 7.3 ± 0.2%, P &lt; 0.05).

CONCLUSIONS
Long-term captopril administration in type II diabetic subjects improves insulin sensitivity in the postprandial state, not in the fasting state, and improves glycemic control.
Does Familial Hypertriglyceridemia Predispose to NIDDM?
Authors: Sane Timo , Taskinen Marja-Riitta 
Published: March 2007

OBJECTIVE
To determine the 10 -yr incidence of impaired glucose tolerance and NIDDM in families with a clustering of endogenous hypertriglyceridemia.

RESEARCH DESIGN AND METHODS
The prospective population study, where the oral glucose tolerance test and the measurement of serum lipids and lipoproteins were performed at the baseline examination and after the 10-yr followup, was conducted on 56 subjects (17–60 yr of age at the baseline). The subjects were from six pedigrees with a clustering of endogenous hypertriglyceridemia, and 47 of these subjects attended the follow-up 10 yr later.

RESULTS
In the study families, the prevalence of glucose intolerance and NIDDM increased from 15 to 49% (P &lt; 0.001) and from 2 to 21% (P &lt; 0.001), respectively, over the 10-yr period. When grouped according to the baseline serum triglyceride tertiles, 76% (P &lt; 0.01) of the family members with highest serum triglycerides were glucose intolerant (29% impaired glucose tolerance, 47% NIDDM) at follow-up compared with 20% of those with lowest serum triglycerides. In discriminant analysis, including age, body mass index, treatment with thiazides and β-blocking agents, and 2-h serum insulin concentration, the baseline serum triglycerides still remained as an independent predictor of development of impaired glucose tolerance and NIDDM.

CONCLUSIONS
Families with a clustering of hypertriglyceridemia are at increased risk of NIDDM, and in these families elevation of serum triglycerides serves as a risk marker of glucose intolerance and NIDDM.
Survey of Physician Practice Behaviors Related to Diabetes Mellitus in the U.S.: Physician adherence to consensus recommendations
Authors: Kenny Susan J , Smith Philip J , Goldschmid Merilyn G , Newman Jeffrey M , Herman William H 
Published: March 2007

OBJECTIVE
To summarize the frequency of physician adherence to consensus recommendations for prevention of diabetic complications.

RESEARCH DESIGN AND METHODS
Survey data from a nationwide stratified probability sample of primary-care physicians were analyzed. Adherence to recommendations were reported by physician specialty, age-group, and type of diabetes treated.

RESULTS
Adherence was high for eye exams, blood pressure measurements, neurological and circulatory exams, and laboratory procedures using blood. Adherence was low for examination of the teeth and gums, examination of the feet, and laboratory procedures involving the collection of urine. Internists generally had the highest adherence rates and pediatricians the lowest. Reported adherence decreased with physician age. Adherence was higher for the management of individuals with IDDM than for those with NIDDM.

CONCLUSIONS
Recommendations for the care of diabetic individuals need to be more widely implemented. Recommendations targeted specifically to pediatricians may be necessary.
Prior feeding Alters the Response to the 50-g Glucose Challenge Test in Pregnancy: The Staub-Traugott Effect revisited
Authors: Lewis Gary F , McNally Colleen , Blackman John D , Polonsky Kenneth S , Barron William M 
Published: March 2007

OBJECTIVE
To examine the effect of prior meal ingestion on the glucose, insulin, and C-peptide response to a 50-g glucose challenge test in the third trimester of pregnancy.

RESEARCH DESIGN AND METHODS
Ten pregnant women with gestational diabetes mellitus and 12 nondiabetic pregnant control subjects matched for age and weight underwent a 50-g glucose challenge test on three occasions within a 2-wk period, in random order. On one occasion the test was administered in the fasting state (fasting glucose challenge test), on a second occasion the test was administered 1 h after ingestion of a standard mixed meal (1-h postprandial study), and on a third occasion the test was administered 2 h after ingestion of a standard mixed meal (2-h postprandial study).

RESULTS
In the control subjects, the plasma glucose level 1 h after ingestion of 50 g of glucose was higher in the fasting study (7.8 ±0.4 mM, 7 of 12 subjects with glucose ≥7.8 mM) than in the 1-h postprandial study (6.7 ± 0.3 mM, 3 of 12 subjects with glucose ≥7.8 mM) and the 2-h postprandial study (6.3 ± 0.4 mM, 3 of 12 with glucose ≥7.8 mM) (P &lt; 0.01). In the postprandial studies of control subjects, insulin and C-peptide levels were higher at the time of ingestion of the 50 g of glucose, but the early (1 h) insulin secretory response was less than in the fasting study. In the diabetic patients, glucose levels 1 h after 50-g glucose ingestion were similar in the fasting study (10.5 ± 0.4 mM, no subjects with glucose value &lt;7.8 mM) and the 1-h postprandial study (11.0 ± 0.6 mM, 1 subject with glucose &lt;7.8 mM), but was lower in the 2-h postprandial study (9.3 ± 0.3 mM, 1 subject with glucose &lt;7.8 mM) (P &lt; 0.03). In contrast to the control subjects, the insulin secretory response to 50 g of oral glucose was greater in the two postprandial studies than in the fasting study.

CONCLUSIONS
We have reached the following conclusions. 1) In nondiabetic gravidas, plasma glucose concentrations 1 h after ingestion of a 50-g oral glucose load are higher if administered in the fasting state compared with the postprandial state. 2) During normal pregnancy the Staub-Traugott Effect, i.e., improved glucose disposal after successive glucose load administrations, occurs and appears to be caused by mechanisms other than enhanced insulin secretion with successive glucose loads. 3) The effect of the prandial state on plasma glucose response to the 50-g glucose challenge test used to screen for gestational diabetes mellitus may be of sufficient magnitude to significantly alter the operating characteristics, i.e., sensitivity and specificity, of this test.
IDDM Is a Risk Factor for Adolescent Psychiatric Disorders
Authors: Blanz Bernd J , Rensch-Riemann Beatrice S , Fritz-Sigmund Doris I , Schmidt Martin H 
Published: March 2007

OBJECTIVE
To determine whether the rate of psychiatric disorders increases in children and adolescents with IDDM.

RESEARCH DESIGN AND METHODS
The rate of psychiatric disorders was assessed by highly structured interviews in a group of 93 IDDM adolescents 17–19 yr of age and compared with a healthy (nondiabetic) age-, sex-, and socioeconomic status-matched control group.

RESULTS
The rate of psychiatric disorders was 33.3% in the diabetic group, more than threefold higher than in the control group (9.7%). With regard to the ratepsychiatric disorders, no sex-specific differences between the two groups were found. The diabetic adolescents suffered from significantly more introversive symptoms than their healthy counterparts, especially somatic symptoms, sleeping disturbances, compulsions, and depressive moods. In spite of the elevated rate of psychiatric disorders, the rates of life events and familial adversities did not increase in the diabetic group.

CONCLUSIONS
The results support the notion that IDDM adolescents should be seen as a high-risk group for psychiatric disorders.
Cerebral and Ophthalmic Artery Hemodynamic Responses in Diabetes Mellitus
Authors: Albert Stewart G , Gomez Camilo R , Russell Stephen , Chaitman Bernard R , Bernbaum Marla , Kong Barbara A 
Published: March 2007

OBJECTIVE
To address whether hemodynamic responses in the cerebral arteries and OAs may be altered in patients with diabetic retinopathy. We used TCD to evaluate the effects of changes in BP, posture, and exercise on MCA and OA blood flow velocities.

RESEARCH DESIGN AND METHODS
We evaluated 13 patients with BDR, 19 with PDR, and 11 control subjects. Each was tested while supine, breathing 100% oxygen, sitting, and during exercise.

RESULTS
Control subjects exhibited linear increases in velocity in the MCA and OA with increases in BP. Those with BDR had higher baseline sBP than control subjects. The MCA velocity response to BP in the BDR group was parallel to, but differed significantly from, the response in control subjects in compensation for the level of BP (ANCOVA F1,53 = 10.1, P = 0.003). The OA velocity response to BP was indistinguishable between the control subjects and the group with BDR. The group with PDR had more elevated BP than control subjects, and those with BDR had more advanced autonomic neuropathy. The PDR group had heterogenous velocity responses in the MCA and OA with respect to BP. None of the control subjects and 3 of 13 of the BDR group had abnormal autoregulatory velocity responses in the MCA or OA to 100% oxygen breathing, whereas 12 of 19 PDR patients were abnormal (P &lt; 0.01). Of those with PDR, 4 had elevated MCA and 3 had elevated OA velocities while supine at rest.

CONCLUSIONS
Patients with PDR demonstrated abnormal hemodynamic responses of the cerebral and ophthalmic circulation both at rest and with exercise.
Patients' Attitudes Toward Screening for Gestational Diabetes Mellitus in the Illawarra Area, Australia
Authors: Griffiths Rhonda D , Rodgers Dianne V , Moses Robert G 
Published: March 2007

OBJECTIVE
To examine the attitudes toward screening of a group of women who have had GDM compared with a group who were screened but did not have GDM.

RESEARCH DESIGN AND METHODS
We surveyed 90 women with GDM and 100 control women with a postal questionnaire. They were asked to mark on a six-point Likert scale their responses to statements about certain aspects of screening for diabetes in pregnancy.

RESULTS
No significant differences were found in mean responses between the two groups. The method of screening was found to be convenient (GDM group, 5.02; control group, 4.77). A strong belief that all women should be screened in pregnancy (GDM group, 5.76; control group, 5.66) and a personal desire for screening in any future pregnancy (GDM group, 5.73; control group, 5.62) were expressed.

CONCLUSIONS
Both groups of women surveyed in this study were extremely positive about the convenience of the screening method used, the need for all women to be screened in pregnancy, and their desire for screening in future pregnancies.