bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Exercise on the Absorption of Inhaled Human Insulin via the AERx Insulin Diabetes Management System in People With Type 1 Diabetes
Authors: Petersen Astrid H. , Köhler Gerd , Korsatko Stefan , Wutte Andrea , Wonisch Manfred , Jeppesen Ole K. , Sparre Thomas , Clauson Per , Laursen Torben , Wollmer Per , Pieber Thomas R. 
Published: September 2007

OBJECTIVE—This study investigated the effect of moderate exercise on the absorption of inhaled insulin via the AERx insulin diabetes management system (iDMS).RESEARCH DESIGN AND METHODS—In this randomized, open-label, four-period, crossover, glucose clamp study 23 nonsmoking subjects with type 1 diabetes received a dose of 0.19 units/kg inhaled human insulin followed in random order by either 1) no exercise (NOEX group) or 30 min exercise starting, 2) 30 min after dosing (EX30), 3) 120 min after dosing (EX120), or 4) 240 min after dosing (EX240).RESULTS—Exercise changed the shape of the free plasma insulin curves, but compared with the NOEX group the area under the curve for free plasma insulin (AUCins) for the first 2 h after the start of exercise was unchanged for EX30 and EX240, while it was 15% decreased for EX120 (P &lt; 0.01). The overall insulin absorption during 6 and 10 h after dosing was 13% decreased for EX30 (P &lt; 0.005), 11% decreased for EX120 (P &lt; 0.01), and unchanged for EX240. Exercise did not influence the maximum insulin concentration (Cmax), while the time to Cmax was 22 min earlier for EX30 (P = 0.04). The AUC for the glucose infusion rate (AUCGIR) for 2 h after the start of exercise increased by 58% for EX30, 45% for EX120, and 71% for EX240 (all P &lt; 0.02) compared with the NOEX group.CONCLUSIONS—Thirty minutes of moderate exercise led to unchanged or decreased absorption of inhaled insulin via AERx iDMS and faster Cmax for early exercise. Thus, patients using AERx iDMS can adjust insulin dose as usual independent of time of exercise, but they should be aware of the faster effect if exercising early after dosing.
Cost-Effectiveness of the Interventions in the Primary Prevention of Diabetes Among Asian Indians
Authors: Ramachandran Ambady , Snehalatha Chamukuttan , Yamuna Annasami , Mary Simon , Ping Zhang 
Published: September 2007

OBJECTIVE—In the Indian Diabetes Prevention Programme (IDPP), a 3-year randomized, controlled trial, lifestyle modification (LSM) and metformin helped to prevent type 2 diabetes in subjects with impaired glucose tolerance (IGT). The direct medical costs and cost-effectiveness of the interventions relative to the control group are reported here.
RESEARCH DESIGN AND METHODS—Relative effectiveness and costs of interventions (LSM, metformin, and LSM and metformin) in the IDPP were estimated from the health care system perspective. Costs of intervention considered were only the direct medical costs. Direct nonmedical, indirect, and research costs were excluded. The cost-effectiveness of interventions was measured as the amount spent to prevent one case of diabetes within the 3-year trial period.
RESULTS—The direct medical cost to identify one subject with IGT was Indian rupees (INR) 5,278 ($117). Direct medical costs of interventions over the 3-year trial period were INR 2,739 ($61) per subject in the control group, INR 10,136 ($225) with LSM, INR 9,881 ($220) with metformin, and INR 12,144 ($270) with LSM and metformin. The number of individuals needed to treat to prevent a case of diabetes was 6.4 with LSM, 6.9 with metformin, and 6.5 with LSM and metformin. Cost-effectiveness to prevent one case of diabetes with LSM was INR 47,341 ($1,052), with metformin INR 49,280 ($1,095), and with LSM and metformin INR 61,133 ($1,359).
CONCLUSIONS—Both LSM and metformin were cost-effective interventions for preventing diabetes among high risk-individuals in India and perhaps may be useful in other developing countries as well. The long-term cost-effectiveness of the interventions needs to be assessed.
Type 2 Diabetes Prevention in the “Real World”
Authors: Absetz Pilvikki , Valve Raisa , Oldenburg Brian , Heinonen Heikki , Nissinen Aulikki , Fogelholm Mikael , Ilvesmäki Vesa , Talja Martti , Uutela Antti 
Published: September 2007

OBJECTIVE—“Real-world” implementation of lifestyle interventions is a challenge. The Good Ageing in Lahti Region (GOAL) Lifestyle Implementation Trial was designed for the primary health care setting, with lifestyle and risk reduction objectives derived from the major diabetes prevention efficacy trials. We report on the program's effectiveness as well as findings related to the program's reach, adoption, and implementation.
RESEARCH DESIGN AND METHODS—A total of 352 middle-aged participants with elevated type 2 diabetes risk were recruited from the health care centers in Päijät-Häme Province in Finland. The intervention included six group counseling sessions, delivered by trained public health nurses. Measurement was conducted at baseline and 12 months. Clinical risk factors were measured by study nurses, and lifestyle outcomes were analyzed from self-reports. Lifestyle outcomes were compared with the outcomes achieved in relevant efficacy trials, and within-subject changes were tested for risk reduction.
RESULTS—At baseline, mean BMI was &gt;32 kg/m2, and 25% of the participants had impaired glucose tolerance. At 12 months, 20% of participants achieved at least four of five key lifestyle outcomes, with these results being comparable with the reference trials. However, physical activity and weight loss goals were achieved significantly less frequently (65 vs. 86% and 12 vs. 43%, respectively). Several clinical risk factors decreased, more so among men than women.
CONCLUSIONS—This trial demonstrates that lifestyle counseling can be effective and is feasible in real-world settings for individuals with elevated risk of type 2 diabetes. To increase program impact, program exposure and treatment intensity need to be increased.
Pelvic Floor Disorders, Diabetes, and Obesity in Women
Authors: Lawrence Jean M. , Lukacz Emily S. , Liu In-Lu Amy , Nager Charles W. , Luber Karl M. 
Published: September 2007

OBJECTIVE—We examined associations between obesity and diabetes and female pelvic floor disorders (PFDs), stress urinary incontinence (SUI), overactive bladder (OAB), and anal incontinence (AI) in community-dwelling women.
RESEARCH DESIGN AND METHODS—Women were screened for PFD using a validated mailed survey. Diabetes status, glycemic control, and diabetes treatment were extracted from clinical databases, while other risk factors for PFDs were obtained through self-report. Women were categorized hierarchically as nonobese/nondiabetic (reference), nonobese/diabetic, obese/nondiabetic, and obese/diabetic.
RESULTS—Of 3,962 women, 393 (10%) had diabetes. In unadjusted analyses, women with diabetes and women who were obese had greater odds of having PFDs. Among women with diabetes, being obese was associated with SUI and OAB. After adjusting for confounders, we found that obese/diabetic women were at the highest likelihood of having SUI (odds ratio 3.67 [95% CI 2.48–5.43]) and AI (2.09 [1.48–2.97]). The odds of having OAB among obese women was the same for obese/diabetic women (2.97 [2.08–4.36]) and obese/nondiabetic women (2.93 [2.33–3.68]). Nonobese/diabetic women had higher odds of SUI (1.90 [1.15–3.11]) but did not differ significantly in their OAB (1.45 [0.88–2.38]) and AI (1.33 [0.89–2.00]) prevalence from nonobese/nondiabetic women.
CONCLUSIONS—Given the impaired quality of life experienced by women with PFDs, health care providers should counsel women that obesity and diabetes may be independent modifiable risk factors for PFDs.
Serum Levels of Adipokine Retinol-Binding Protein-4 in Relation to Renal Function
Authors: Ziegelmeier Michaela , Bachmann Anette , Seeger Jeannette , Lossner Ulrike , Kratzsch Jürgen , Blüher Matthias , Stumvoll Michael , Fasshauer Mathias 
Published: September 2007

OBJECTIVE—Retinol-binding protein (RBP)-4 was recently identified as an adipokine that induces insulin resistance. In the current study, we investigated RBP-4 serum levels in diabetic and nondiabetic patients on chronic hemodialysis (CD) compared with control subjects with a glomerular filtration rate &gt;50 ml/min. The majority of the diabetic subjects used oral hypoglycemic agents or insulin.
RESEARCH DESIGN AND METHODS—RBP-4 was determined by enzyme-linked immunosorbent assay in control subjects (n = 59) and CD patients (n = 58) and correlated with clinical and biochemical measures of renal function, glucose and lipid metabolism, and inflammation in both groups.
RESULTS—Mean serum RBP-4 levels were almost fourfold higher in CD patients (102 ± 30 mg/l) compared with control subjects (28 ± 8 mg/l). Furthermore, serum creatinine independently predicted RBP-4 concentrations in multiple regression analyses in both control subjects and CD patients. In addition, C-reactive protein and systolic blood pressure independently and negatively correlated with RBP-4 serum concentrations in CD patients but not control subjects. In contrast, markers of glucose and lipid metabolism were not independently related to serum RBP-4 in control subjects or CD patients.
CONCLUSIONS—We show that markers of renal function are independently related to serum RBP-4 levels.
Risk of Type 2 Diabetes Attributable to C-Reactive Protein and Other Risk Factors
Authors: Dehghan Abbas , van Hoek Mandy , Sijbrands Eric J.G. , Stijnen Theo , Hofman Albert , Witteman Jacqueline C.M. 
Published: September 2007

OBJECTIVE— To calculate the population-attributable risk (PAR) of C-reactive protein (CRP) and other risk factors for type 2 diabetes.
RESEARCH DESIGN AND METHODS— The Rotterdam Study is a population-based, prospective follow-up study among 7,983 participants aged ≥55 years. Risk factors including serum CRP were determined at baseline. Participants with diabetes at baseline were excluded, and the cohort was followed for a mean of 10.8 years. The hazard ratio (HR) and PAR for diabetes were computed for all studied risk factors.
RESULTS— Serum CRP &gt;1 mg/l (HR 1.67, PAR 0.33), BMI &gt;25 kg/m2 (HR 2.51, PAR 0.51), waist circumference &gt;102 for men and &gt;88 cm for women (HR 1.36, PAR 0.14), current smoking (HR 1.16, PAR 0.03), age &gt;65 years (HR 1.35, PAR 0.15), and family history of diabetes (HR 1.87, PAR 0.16) were related to diabetes and contributed to the risk of the disease. Serum CRP was a greater contributor to the risk of diabetes in women than in men (PAR values of 0.37 vs. 0.28, respectively). Age and current smoking PARs were not statistically significantly contributing to the risk of diabetes in women. Combined PAR was 0.80 (95% CI 0.74–0.85) for all six studied risk factors and 0.71 (0.64–0.78) for modifiable risk factors (serum CRP, BMI, waist circumference, and current smoking).
CONCLUSIONS— High CRP is one of the major contributors to the risk of type 2 diabetes. The contribution of modifiable risk factors to the risk of diabetes is considerable.
Serum Adipocyte Fatty Acid–Binding Protein as a New Biomarker Predicting the Development of Type 2 Diabetes
Authors: Tso Annette W.K. , Xu Aimin , Sham Pak C. , Wat Nelson M.S. , Wang Yu , Fong Carol H.Y. , Cheung Bernard M.Y. , Janus Edward D. , Lam Karen S.L. 
Published: September 2007

OBJECTIVE— Adipocyte fatty acid–binding protein (A-FABP) is abundantly expressed in adipocytes and plays a role in glucose homeostasis in experimental animals. We have previously shown that circulating A-FABP levels are associated with the metabolic syndrome, which confers an increased risk of type 2 diabetes. Here we investigated whether serum A-FABP levels could predict the development of diabetes in a 10-year prospective study.
RESEARCH DESIGN AND METHODS— Baseline serum A-FABP levels were measured with an enzyme-linked immunosorbent assay in 544 nondiabetic subjects, recruited from the Hong Kong Cardiovascular Risk Factor Prevalence Study cohort, who were followed prospectively to assess the development of type 2 diabetes. The role of A-FABP in predicting the development of type 2 diabetes over 10 years was investigated using Cox regression analysis.
RESULTS— At baseline, serum sex-adjusted A-FABP levels were higher in subjects with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) (P &lt; 0.00001 versus normal glucose tolerance) and correlated positively with adverse cardiometabolic risk factors. Over 10 years, 96 subjects had developed type 2 diabetes. High baseline A-FABP was predictive of type 2 diabetes, independent of obesity, insulin resistance, or glycemic indexes (relative risk [RR] 2.25 [95% CI 1.40–3.65]; P = 0.001; above versus below sex-specific median). High A-FABP levels remained an independent predictor of type 2 diabetes in the high-risk IGT/IFG subgroup (adjusted RR 1.87 [1.12–3.15]; P = 0.018).
CONCLUSIONS— Serum A-FABP was associated with glucose dysregulation and predicted the development of type 2 diabetes in a Chinese cohort.
Family History and Prevalence of Diabetes in the U.S. Population
Authors: Valdez Rodolfo , Yoon Paula W. , Liu Tiebin , Khoury Muin J. 
Published: September 2007

OBJECTIVE—We sought to test the association between stratified levels of familial risk of diabetes and the prevalence of the disease in the U.S. population.
RESEARCH DESIGN AND METHODS—This study includes 16,388 adults interviewed for the National Health and Nutrition Examination Survey between 1999 and 2004. Fasting glucose was available for a subsample of 6,004 participants. Familial risk of diabetes was classified as average, moderate, or high. The prevalence and the odds of having diabetes were estimated for each risk class after accounting for other risk factors.
RESULTS—Overall, 69.8% of the U.S. adults were in the average, 22.7% in the moderate, and 7.5% in the high familial risk for diabetes. The crude prevalence of diabetes for each risk class was 5.9, 14.8, and 30%, respectively. The graded association between familial risk and prevalence of diabetes remained even after accounting for sex, race/ethnicity, age, BMI, hypertension, income, and education. Versus people in the average risk class, independently of other risk factors considered, the odds of having diabetes for people in the moderate and high familial risk categories were, respectively, 2.3 and 5.5 times higher.
CONCLUSIONS—In the U.S. population, family history of diabetes has a significant, independent, and graded association with the prevalence of diabetes. This association not only highlights the importance of shared genes and environment in diabetes but also opens the possibility of formally adding family history to public health strategies aimed at detecting and preventing the disease.
Association of Oxidative Stress, Insulin Resistance, and Diabetes Risk Phenotypes
Authors: Meigs James B. , Larson Martin G. , Fox Caroline S. , Keaney John F. , Vasan Ramachandran S. , Benjamin Emelia J. 
Published: September 2007

OBJECTIVE—Systemic oxidative stress causes insulin resistance in rodents. We tested the hypothesis that oxidative stress and insulin resistance are associated in humans.
RESEARCH DESIGN AND METHODS—We used cross-sectional data from 2,002 nondiabetic subjects of the community-based Framingham Offspring Study. We measured insulin resistance with the homeostasis model and defined categorical insulin resistance as homeostasis model assessment of insulin resistance (HOMA-IR) &gt;75th percentile. We measured oxidative stress using the ratio of urine 8-epi-prostaglandin F2α (8-epi-PGF2α) to creatinine and used age- and sex-adjusted regression models to test the association of oxidative stress with insulin resistance in individuals without diabetes and among subgroups at elevated risk of diabetes.
RESULTS—Across 8-epi-PGF2α/creatinine tertiles, the prevalence of insulin resistance increased (18.0, 27.5, and 29.4% for the first, second, and third tertiles, respectively; P &lt; 0.0001), as did mean levels of HOMA-IR (3.28, 3.83, and 4.06 units; P &lt; 0.0001). The insulin resistance–oxidative stress association was attenuated by additional adjustment for BMI (P = 0.06 across tertiles for insulin resistance prevalence; P = 0.004 for mean HOMA-IR). Twenty-six percent of participants were obese (BMI ≥30 kg/m2), 39% had metabolic syndrome (according to the Adult Treatment Panel III definition), and 37% had impaired fasting glucose (IFG) (fasting glucose 5.6–6.9 mmol/l). Among 528 obese participants, respectively, insulin resistance prevalence was 41.3, 60.6, and 54.2% across 8-epi-PGF2α/creatinine tertiles (P = 0.005); among 781 subjects with metabolic syndrome, insulin resistance prevalence was 41.3, 56.7, and 51.7% (P = 0.0025); and among 749 subjects with IFG, insulin resistance prevalence was 39.6, 47.2, and 51.6% (P = 0.04).
CONCLUSIONS—Systemic oxidative stress is associated with insulin resistance in individuals at average or elevated risk of diabetes even after accounting for BMI.
Carotid Intima-Media Thickness in Pediatric Type 1 Diabetic Patients
Authors: Rodriguez Rocio Rabago , Gómez-Díaz Rita A. , Haj Janet Tanus , Garnica Francisco Jose Avelar , Soriano Eleazar Ramirez , Meguro Elisa Nishimura , Aguilar-Salinas Carlos A. , Wacher Niels H. 
Published: September 2007

OBJECTIVE—To compare the carotid artery intima-media thickness in Hispanic pediatric type 1 diabetic patients against that in healthy control subjects matched for age, sex, height, and BMI.
RESEARCH DESIGN AND METHODS—The evaluation consisted of anthropometric measurements, biochemical parameters, and a carotid Doppler and real-time ultrasound, in which carotid artery intima-media thickness (cIMT), peak systolic velocity, and end diastolic velocity were measured using standardized procedures.
RESULTS—A total of 52 diabetic patients and 47 control subjects were included. No significant differences existed in the characteristics between case and control subjects (mean age 11.8 ± 3.1 vs. 11.8 ± 2.8 years, weight 42.2 ± 15.3 vs. 44.2 ± 14.4 kg, height 1.45 ± 0.15 vs. 1.47 ± 0.15 m, BMI 19.3 ± 3.2 vs. 19.9 ± 4.4 kg/m2, systolic blood pressure 99.1 ± 9.9 vs. 99.6 ± 9 mmHg, and diastolic blood pressure 63 ± 6.4 vs. 62.0 ± 5.7 mmHg, respectively). The mean duration of diabetes was 4.8 ± 3.2 years (range 6–144 months), and the mean A1C was 8.6 ± 1.6%. A significantly higher cIMT was found in the patients with type 1 diabetes (0.463 ± 0.04 vs. 0.441 ± 0.04 mm; P = 0.001). In contrast, both peak systolic velocity (107.1 ± 22.8 vs. 119.3 ± 19.2, P &lt; 0.005) and end diastolic velocity (28.4 ± 6.0 vs. 33.0 ± 7.0, P &lt; 0.001) were higher in the control subjects.
CONCLUSIONS—Type 1 diabetes is associated with higher cIMT and decreased flow velocities in a Hispanic pediatric population.
Toughening of unsaturated polyester resins with core–shell rubbers
Authors: Huang Yan‐Jyi , Wu Jia‐Horng , Liang Jiing‐Guan , Hsu Mann‐Wen , Ma Jiun‐Kwei 
Published: September 2007

AbstractThe effects of core–shell rubbers (CSRs) as tougheners on the fracture properties of unsaturated polyester (UP) resins during curing at 110°C are investigated. CSRs were synthesized by two‐stage soapless emulsion polymerizations; the soft core was made from rubbery poly(n‐butyl acrylate), whereas the hard shell was made from methyl methacrylate, ethylene glycol dimethacrylate, and various concentrations of glycidyl methacrylate. Depending on the content of glycidyl methacrylate in the CSR shell and the amount of CSR added to the UP, the fracture properties of the CSR‐toughened UP resins varied. The experimental results are explained by an integrated approach of measurements of the static phase characteristics of a styrene/UP/CSR system, the reaction kinetics, the cured sample morphology, the glass‐transition temperatures, and the fracture toughness with differential scanning calorimetry, scanning electron microscopy, transmission electron microscopy, and dynamic mechanical analysis. Finally, the toughening mechanism for the CSR‐toughened UP resins is also explored. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci, 2008
Engineering properties of poly(vinyl chloride)–poly(butyl methacrylate) semi‐1 and semi‐2 interpenetrating polymer networks
Authors: Chakrabarti Rupa , Chakraborty Debabrata 
Published: September 2007

AbstractSemi‐1 and semi‐2 interpenetrating polymer networks (IPNs) of poly(vinyl chloride) (PVC) and in situ formed poly(butyl methacrylate) (PBMA) have been synthesized using diallyl phthalate and ethylene glycol dimethacrylate as the crosslinkers of PVC and PBMA, respectively. These were then characterized with reference to their mechanical, thermal, and morphological properties. The mechanical and thermal characteristics revealed modification over the unmodified polymeric systems in relation to their phase morphologies. The semi‐1 IPNs displayed a decrease in their mechanical parameters of modulus and UTS while semi‐2 IPNs exhibited a marginal increase in these two values. The semi‐1 IPNs, however, also revealed a decrease in the elongation and toughness values away from the normal behavior. The thermomechanical behavior of both the systems is in conformity with their mechanicals in displaying the softening characteristics of the system and stabilization over unmodified PVC. The DSC thermograms are also correlated to these observations along with the heterogeneous phase morphology which is displayed by both the systems especially at higher concentration of PBMA incorporation. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci, 2008
The preparation and characterization of chitosan wound dressings with different degrees of acetylation
Authors: Qin Yimin 
Published: September 2007

AbstractChitosan fibers have in recent years found applications in various fields such as antimicrobial textiles and wound dressings. In this study, chitosan fibers with different degrees of acetylation were prepared by controlling the ratio between the amount of acetic anhydride and the weight of the fibers during the acetylation process. The absorption and antimicrobial properties, as well as the dry and wet strength of nonwoven chitosan wound dressings with different degrees of acetylation were studied. Results showed that the partially acetylated chitosan wound dressing had a much higher absorption capacity than the original untreated chitosan samples, while there was a reduction in the wet strength and antimicrobial property for the partially acetylated chitosan nonwoven dressing. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci, 2008