bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Capillary Collection System for HbA1c Specimens
Authors: Voss Ellen M , Cembrowski George S , Clasen Becky L , Spencer Martha L , Ainslie Michael B , Haig Broatch 
Published: March 2007

Objective
We evaluated the accuracy and stability of a capillary HbA1c collection system for use with a high-performance liquid chromatography analyzer.

Research Design and Methods
The collection system requires that 5 ul blood is drawn into a calibrated capillary tube, which is then placed into a vial of stabilizing solution and sent for analysis. The study was conducted on simultaneously drawn capillary and venous blood specimens from 47 pediatric diabetes patients. Accuracy was determined by comparing the capillary to the venous HbA1c values. Stability was measured by analyzing 17 capillary specimens over 3 wk.

Results
There was excellent agreement between the capillary and venous HbA1c values (capillary 0.959, venous +0.494, R2 = 98.7%). The capillary HbA1c values were 0.2% higher than the venous HbA1c values and decreased gradually over time (0.1% HbA1c/week) when stored at room temperature.

Conclusions
The Bio-Rad (Richmond, CA) collection system is accurate, stable, and simple to use.
Immunological and Metabolic Responses of Patients with History of Antibody-Induced Beef Insulin Resistance to Treatment With Beef, Pork, Human, and Sulfated Beef Insulin
Authors: Davidson John K , Fineberg S Edwin , Meyts Pierre De , Fineberg Naomi S , Galloway John A 
Published: March 2007

Objective
We evaluated immunological and metabolic responses during therapy with beef (B), pork (P), human (H, rDNA), and sulfated beef (SB) insulins in patients with insulin-antibody-mediated insulin resistance.

Research Design and Methods
A randomized double-blind sequential crossover study was performed with each insulin administered for 56 days unless dose reached 200 U/day or allergy developed. Participants were 26 individuals with history of B-P insulin dosage ≥200 U/day and insulin binding capacities &gt;0.216 nM (30 mU/ml serum). Twenty-one participants completed the study. Insulin dosage/day, fasting plasma glucose, percentage HbA1, insulin antibody binding capacity (IABC), bound insulin (BI), percentage binding of 125I-labeled B, P, and H insulins, and receptor inhibition factor (RIF) were assessed.

Results
Mean insulin dosage (U/day) was significantly greater on B (88.9) than on P (29.2), H (29.4), or SB (29.6). On B, dosage increased in 12 individuals and reached 200 U/day in 6 individuals. Mean fasting plasma glucose (12.1 mM) and HbA1 (11%) were significantly higher on B than on P, H, and SB. Mean IABC, bound insulin, RIF, and percentage of B, P, and H bound were significantly higher on B than on P, H, and SB. Prolonged treatment with SB before entry into the study (&gt;5 wk) resulted in a blunted anamnestic response to B insulin.

Conclusions
Rechallenge with B results in anamnestic immunological response and deterioration of metabolic control. SB, H, and P insulins have equivalent effects in patients with insulin antibody-mediated immunologic resistance.
Use of Health Maintenance Organization Data Bases to Study Pharmacy Resource Usage in Diabetes Mellitus
Authors: Glauber Harry S , Brown Jonathan B 
Published: March 2007

Objective
To evaluate use of medications by patients with diabetes.

Research Design and Methods
We analyzed the computerized pharmacy data base of a large health maintenance organization to evaluate cost impact and patterns of usage for all pharmacy products by a defined population of diabetic patients.

Results
Diabetic patients received 31.2 dispenses/yr compared with 11.5 for control patients. Total pharmacy costs were threefold higher for diabetic patients ($621 vs. 207/yr) and accounted for ∼ 17% of their total health-care costs. Products specifically for the care of diabetes averaged $175/yr or ∼ 4.5% of their total health-care costs: 57% received an oral hypoglycemic agent, 34% received insulin, and 6% received both. Cardiovascular drugs accounted for 29% of total costs. There was increased use of most classes of medication by patients with diabetes.

Conclusions
Health maintenance organization management data bases, particularly those storing pharmacy dispensing data, provide useful information on the impact of chronic disease. People with diabetes receive a greater number of most types of medication with a greater overall cost than do nondiabetic people. Previous studies have underestimated the contribution of pharmacy purchases to the costs of caring for a diabetic population.
Clinical Trial of Programmable Implantable Insulin Pump For Type I Diabetes
Authors: Selam Jean-Louis , Micossi Piero , Dunn Frederick L , Nathan David M ,   Implantable Insulin Pump Trial Study Group
Published: March 2007

Objective
The first step in the evolution of an artificial pancreas is the development of a reliable implantable pump for insulin delivery. Despite recent advances, significant issues remain, including small size of studies and frequent irreversible catheter obstructions. We report safety, feasibility, and efficacy results from 56 patients, representing 73 patient-yr of pump experience, entered into a multicenter trial with a new implantable programmable pump.

Research Design and Methods
All patients had insulin-dependent (type 1) diabetes, were 38 ± 8 yr old, and were not prone to severe hypoglycemia. The pump (Infusaid 1000) has a pulsatile mechanism powered by freon-vapor pressure. Its rate is regulated by battery-powered valves, operated via a hand-held programmer. The pump is refilled transcutaneously with 25 ml U100 insulin (Hoechst 21PH) on a monthly basis and has a second septum (side port) proximal to the catheter, which allows flushing the catheter or lavaging the pump unit. The pumps were implanted after 3 mo intensive subcutaneous insulin therapy and catheters were positioned either in the peritoneum (i.p., n = 38) or the superior vena cava (i.v., n = 18).

Results
All implanted pumps have functioned safely with no instance of overdelivery or stoppage. The most frequent complications were flow slow downs, presumably due to insulin precipitation within the pump, which occurred in 86% of pumps and were resolved in all but one case by lavaging the pump in situ with alkaline solution. Flow slow downs due to catheter obstruction occurred in 52% of the intravenous catheters but only 21% of the intraperitoneal catheters (P &lt; 0.05) and were resolved in all but two cases by diluent flushing through the sideport. Incidence of severe hypoglycemia decreased from 0.47 before implant to 0.05 episodes/patient-yr after pump implantation (P &lt; 0.001). Mean HbA1c fell from 7.4 ± 1.2% after intensive subcutaneous therapy to 7.1 ± 1.0% 12 mo after implantation. Only 2 patients withdrew from study after recurrent catheter problems, and quality-of-life questionnaires showed improvement in satisfaction with diabetes-specific quality of life when on implantable pump therapy.

Conclusions
Insulin therapy with implantable pumps is effective and safe for periods up to 1.7 yr with a decreased risk of severe hypoglycemia than with intensive subcutaneous insulin therapy.
Lipid and Lipoprotein Levels in Patients With IDDM: Diabetes Control and Complication Trial Experience
Authors:   The DCCT Research Group
Published: March 2007

Objective
To compare lipid and lipoprotein levels in patients with insulin-dependent diabetes mellitus (IDDM) with values in similarly aged nondiabetic subjects and analyze the effects of demographic variables, metabolic control, and other factors on the lipid and lipoprotein levels in the diabetic population.

Research Design and Methods
Fasting total cholesterol, triglyceride, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol levels measured during screening for the Diabetes Control and Complications Trial (DCCT) in 1569 generally healthy IDDM patients, between the ages of 13 and 40 yr and with 1–15 yr diabetes duration, were compared with values obtained with similar methods in the Lipid Research Clinics (LRC) prevalence study of nondiabetic individuals.

Results
When similarly aged groups of IDDM and nondiabetic subjects were compared, higher total and LDL cholesterol and lower HDL cholesterol lipid profiles were restricted to younger (13–24 yr) female diabetic subjects. In general, IDDM males and older IDDM females had similar or slightly less atherogenic profiles than similarly aged nondiabetic subjects. Metabolic control, measured by HbA1c, and body weight (% of ideal body wt) correlated positively with total cholesterol, LDL cholesterol, and triglyceride levels.

Conclusions
Lipid and lipoprotein levels in the generally healthy IDDM volunteers for the DCCT are similar to those in the nondiabetic population. More atherogenic profiles were present only in younger IDDM women compared with nondiabetic women. The differences between the DCCT data and older studies that demonstrated more profound abnormalities in lipid levels in IDDM populations may reflect patient selection and/or changes in dietary patterns (higher-carbohydrate and lower-fat content) and in glucose control that has occurred in recent years.
Association of Waist-Hip Ratio With Diabetes Mellitus: Strength and Possible Modifiers
Authors: Schmidt Maria Inês , Duncan Bruce B , Canani Luis Henrique , Karohl Cristina , Chambless Lloyd 
Published: March 2007

Objectives
To characterize the association between central obesity, as measured by the waist-hip ratio (WHR), and non-insulin-dependent diabetes mellitus (NIDDM), considering the effects of sex, age, overall obesity, and family history of diabetes.

Research Design and Methods
Case-control study nested within a community-based survey. We selected 151 subjects with NIDDM and 301 nondiabetic control subjects as a systematic sample of survey screening negative individuals.

Results
Odds ratios for NIDDM, comparing a high WHR (≥ 0.926 for men, ≥ 0.83 for women) to a low WHR were 4.72 with a 95% confidence interval of 2.39–9.34, and 2.17 with a 95% confidence interval of 1.03–4.58, for women and men, respectively, controlling for age, overall obesity, and a family history of diabetes. Women with high WHRs in the presence of these risk factors are notably at risk for diabetes.

Conclusions
Central obesity, as measured by the WHR, is importantly and independently associated with NIDDM.
MPO Activity and Generation of Active O2 Species in Leukocytes From Poorly Controlled Diabetic Patients
Authors: Sato Noriyuki , Shimizu Hiroyuki , Suwa Kunihiko , Shimomura Yohnosuke , Kobayashi Isao , Mori Masatomo 
Published: March 2007

OBJECTIVE
This study was undertaken to determine which part of ROI generation is reduced in the neutrophils from patients with NIDDM.

RESEARCH DESIGN AND METHODS
Superoxide anion (O2−) production, LDCL activity in response to opsonized zymosan, and MPO activity were measured in leukocytes of poorly controlled NIDDM patients (FBG &gt;8.89 mM, HbA1 &gt;10%).

RESULTS
In diabetic subjects, both O2− production and LDCL activity assessed with initial slope gradient and peak value were significantly reduced. MPO activity was also decreased in diabetic subjects, and there was a significant correlation between HbA1 levels and MPO activity of diabetic subjects.

CONCLUSIONS
This study demonstrated that every step in leukocyte ROI generation should be reduced in the leukocytes from poorly controlled diabetic patients.
Trends in Diabetes and Diabetic Complications, 1980–1987
Authors: Wetterhall Scott F , Olson David R , DeStefano Frank , Stevenson John M , Ford Earl S , German Robert R , Will Julie C , Newman Jeffrey M , Sepe Stephen J , Vinicor Frank 
Published: March 2007

OBJECTIVE
Although diabetes is a major source of morbidity and mortality in the United States, only recently has a unified national surveillance system begun to monitor trends in diabetes and diabetic complications.

RESEARCH DESIGN AND METHODS
We established a diabetes surveillance system using data for 1980–1987 from vital records, the National Health Interview Survey, the National Hospital Discharge Survey, and the Health Care Financing Administration's records to examine trends in the prevalence and incidence of diabetes, diabetes mortality, hospitalizations, and diabetic complications.

RESULTS
From 1980 through 1987, the number of individuals known to have diabetes increased by 1 million—to 6.82 million. Age-standardized prevalence for diabetes increased 9% during this period, from 25.4 to 27.6/1000 U.S. residents (P = 0.03). The incidence of diabetes increased among women (P = 0.003), particularly among those &gt; 65 yr old (P = 0.02). Age-standardized mortality rates (for diabetes as either an underlying or contributing cause) per 100,000 individuals with diabetes declined 12%, from 2350 to 2066. Annual mortality rates from stroke (as an underlying cause and diabetes as a contributing cause) and diabetic ketoacidosis declined 29% (P = 0.003) and 22% (P &lt; 0.001), respectively. During these 8 yr, hospitalization rates for major CVD and stroke (as the primary diagnoses and diabetes as a secondary diagnosis) increased 34% (P = 0.006) and 38% (P = 0.01), respectively. Also during this period, hospitalization rates increased 21% for diabetic ketoacidosis (P = 0.01) and 29% for lower-extremity amputations (P = 0.06). From 1982 through 1986, treatment for end-stage renal disease related to diabetes increased &gt; 10% each year (P &lt; 0.001). The prevalence of diagnosed diabetes was nearly twice as high in blacks as in whites (P = 0.04). Blacks also had increased rates of lower-extremity amputation (P = 0.02), diabetic ketoacidosis (P &lt; 0.001), and end-stage renal disease (P = 0.01).

CONCLUSIONS
Diabetes surveillance data will be useful in planning, targeting, and evaluating public health efforts designed to prevent and control diabetes and its complications.
Glycemic Control in Early IDDM
Authors: Allen Catherine , Zaccaro Daniel J , Palta Mari , Klein Ronald , Duck Stephen C , D'Alessio Donn J 
Published: March 2007

OBJECTIVE
A cohort (n = 277) was followed from diabetes diagnosis to evaluate longitudinal glycemic control, urinary C-peptide levels, and certain features of diabetes self-management.

RESEARCH DESIGN AND METHODS
Unselected cases with IDDM, who were &lt; 30 yr of age, were identified at diagnosis from a 28-county area in Wisconsin. Subjects were asked to submit blood every 4 mo for GHb testing, to report aspects of diabetes self-management every 6 mo, and to collect a 24-h urine specimen 4 mo after diagnosis.

RESULTS
In the 1st yr of diabetes, the rate of increase (0.23%/mo) in GHb was significant for the cohort (P &lt; 0.001) and for almost all age and sex subgroups. In the 2nd yr, there was no significant rate of increase for the cohort as a whole (P &gt; 0.10). Adolescent males (10–19 yr of age) had a mean GHb level for year 2 higher than males of other age-groups and higher than female adolescents (P &lt; 0.001). Adolescent males had a significant rate of increase in GHb for year 2 (P = 0.02), unlike all other age and sex subgroups. Adolescents had higher initial 24-h urine C-peptide levels than children &lt; 10 yr of age (P &lt; 0.01). During the 2nd yr of diabetes, the percentage of adolescent males reporting three or more insulin injections/day was lower than any other subgroup.

CONCLUSIONS
These data-suggest that glycemic control stabilizes during the 2nd yr of IDDM, except in adolescent males, and that this may be due partly to aspects of self-management.
Diabetic Nephropathy: Management of the end-stage patient
Authors: Markell Mariana S , Friedman Eli A 
Published: March 2007

Diabetic nephropathy is currently the leading cause of new patients requiring dialysis in the United States. Management of the diabetic patient with ESRD is complicated by the frequent coexistence of complications affecting other organ systems, including retinopathy, cardiovascular disease, peripheral neuropathy, or autonomic neuropathy, manifested as gastroparesis, diarrhea or obstipation, cystopathy, or orthostatic hypotension. Associated clinical syndromes must be followed and treated, if possible, while preparing the patient to receive renal replacement therapy. Both the clinical condition and the psychosocial environment are key factors in choice of ESRD therapy for an individual patient. Rehabilitation data are best for patients who undergo kidney transplantation, but these data are confounded by the fact that the healthiest patients are referred for this treatment modality. Living, related kidney transplant is the preferred initial choice for the diabetic patient with kidney disease. At most centers, both in the United States and abroad, the cadaveric transplant is the second choice for uremia therapy. At the appropriate institution, the patient with type I diabetes may also be considered for a simultaneous cadaveric pancreas transplant.
While awaiting cadaveric transplantation, or if contraindication to transplantation is present (chronic infection, recent malignancy, or severe cardiac disease), diabetic patients with severe impairment of the glomerular filtration rate (&lt; 10–15 ml/min) are referred for vascular access placement and/or insertion of a peritoneal catheter. The decision regarding the choice of CAPD vs. hemodialysis must be made on an individual basis. Rehabilitation and survival data for these therapies are similar, although technique survival rates for CAPD decline dramatically as time progresses because of infectious complications. In-center hemodialysis has the worst survival and rehabilitation profile, but the sickest, most debilitated patients with the highest number of comorbid conditions tend to be referred for that therapeutic modality. Most studies of rehabilitation were performed before use of recombinant human erythropoietin, and comparison between ESRD treatment modalities will have to be reevaluated now that the drug is routinely used.
Global Estimates for Prevalence of Diabetes Mellitus and Impaired Glucose Tolerance in Adults
Authors: King Hilary , Rewers Marian ,   Who Ad Hoc Diabetes Reporting Group
Published: March 2007

Objective— To assemble standardized estimates of abnormal glucose tolerance in adults in diverse communities worldwide and provide guidelines for the derivation of comparable estimates in future epidemiological studies.
Research Design and Methods— The project was limited to population-based investigations that had used current WHO criteria for diagnosis and classification of abnormal glucose tolerance. Raw data were obtained by WHO from surveys conducted during 1976–1991 of over 150,000 persons from 75 communities in 32 countries. Data within the truncated age range of 30–64 yr were adjusted to the standard world population of Segi. Age-specific prevalences also are reported for selected populations.
Results— Within the chosen age range, diabetes was absent or rare (&lt;3%) in some traditional communities in developing countries. In European populations, age-standardized prevalence varied from 3 to 10%. Some Arab, migrant Asian Indian, Chinese, and Hispanic American populations were at higher risk with prevalences of 14–20%. The highest prevalences were found in the Nauruans (41%) and the Pima/Papago Indians (50%). Age-standardized prevalence of IGT was low (&lt;3%) in some Chinese, traditional American Indian, and Pacific island populations. Moderate (3–10%) or high (11–20%) prevalences of IGT were observed in many populations worldwide. The highest estimates for prevalence of IGT were seen in female Muslim Asian Indians in Tanzania (32%) and in urban male Micronesians in Kiribati (28%). Prevalence of diabetes rose with age in all populations in which age-specific data were examined. This trend was most pronounced in those at moderate to high risk. The ratio of prevalence of diabetes in men versus women varied markedly between populations with little discernable trend, although IGT was generally more common in women. In most communities, at least 20% of diabetes cases were unknown before the survey, and in many communities, &gt;50% were previously undiagnosed. In both Chinese and Indian migrant populations, relative prevalence was high when compared with indigenous communities.
Conclusions— Diabetes in adults is now a global health problem, and populations of developing countries, minority groups, and disadvantaged communities in industrialized countries now face the greatest risk.
Diabetes Prevalence, Incidence, and Complications Among Alaska Natives, 1987
Authors: Schraer Cynthia D , Bulkow Lisa R , Murphy Neil J , Lanier Anne P 
Published: March 2007

Objective— To provide descriptive epidemiological data on diabetes mellitus among Alaska Natives, including incidence, updated prevalence, and incidence rates of ESRD, LEA, MI, and stroke in the diabetic population.
Research Design and Methods— In IHS and tribal contract hospitals and clinics throughout Alaska, Alaskan Indians, Eskimos, and Aleuts living in Alaska with documented diabetes mellitus were studied from 1986 to 1987.
Results— The number of diabetic patients increased from 610 to 708, and the prevalence changed from 15.7 to 17.4/1000 (not a statistically significant increase). Incidence rates per 10,000 diabetic person-yr for complications were 38 for ESRD, 69 for LEA, 92 for MI, and 92 for stroke.
Conclusions— The prevalence of diabetes mellitus increased during the period of observation, but not to a statistically significant degree. Incidence rates for diabetes are lower than for the U.S. general population, but complications rates are as high as those in other diabetic populations.
Diabetes in St. Regis Mohawk Indians
Authors: Martinez Charlene B , Strauss Karen 
Published: March 2007

Objective— To establish a registry of diabetes patients and to determine the point prevalence of diabetes in the St. Regis Mohawk New York community at the end of August 1989.
Research Design and Methods— Participants in this study consisted of residents of the St. Regis Mohawk reservation in New York state, who were registered for health care at the St. Regis Mohawk Clinic. This study was a survey of diabetes cases using the National Diabetes Data Group criteria for diagnosis with comparison with the U.S. rates determined from the 1987–1982 National Health Interview Survey and Canadian Mohawk Indian rates from other studies.
Results— The age-adjusted prevalence of 48.8/1000 Mohawk population was two times (95% CI 1.2–3.2) the U.S. rate. Although precise comparisons with Canadian studies are difficult because of differences in study design, rates for Quebec Mohawks aged 45–64 yr were similar.
Conclusions— A high prevalence (21%) among New York Mohawk Indians &lt;45 yr of age, compared with 17% of diabetic patients in that age-group in the U.S. population, means that complications resulting from diabetes will occur at a relatively young age, placing an increased burden on the health-care system with costs of patient care associated with diabetes increasing accordingly. The registry system is being used to gather information on the prevalence and incidence of diabetic complications and risk factors for developing diabetes. These data will be used to evaluate programs.