bluuebunny/crossref_metadata_2025_split huggingface dataset:
Skin Surface pH in Intertriginous Areas in NIDDM Patients: Possible Correlation to Candidal intertrigo
Authors: Yosipovitch Gil , Tur Ethel , Cohen Ohad , Rusecki Yael 
Published: March 2007

OBJECTIVE
To compare skin surface pH and moisture in intertriginous areas in diabetic patients and healthy control subjects and to study the relationship between these parameters and candidal infection.

RESEARCH DESIGN AND METHODS
We measured the skin surface pH and moisture in the axillary, inframammary, inguinal, and forearm skin with a pH meter with a flat-glass electrode and skin corneometer. The subjects were 50 NIDDM patients from the diabetic outpatient clinic at Beilinson Medical Center, Petah Tiqva, Israel, and 40 healthy control subjects from hospital personnel. The main outcome measures were skin surface pH, skin moisture, and skin culture for Candida.

RESULTS
Skin pH in the inguinal and axillary regions was significantly higher in diabetic patients compared with healthy control subjects (P &lt; 0.0001), whereas no difference was noted in the forearm. In the inframammary region, diabetic women had significantly higher pH than nondiabetic women (P &lt; 0.01). No difference was noted in men in this region. Six patients (12%) had candidal infection in intertriginous areas.

CONCLUSIONS
Our study indicates that in intertriginous regions, skin surface pH of diabetic patients is significantly higher than in normal control subjects and implies the significance of skin pH as a possible factor promoting host susceptibility to skin candidal infection.
Development of Impaired Glucose Tolerance With or Without Weight Gain
Authors: Charles Marie A , Pettitt David J , Saad Mohammed F , Nelson Robert G , Bennett Peter H , Knowler William C 
Published: March 2007

OBJECTIVE
To evaluate whether risk factors and changes in insulin concentrations differ in subjects who develop impaired glucose tolerance with or without weight gain. Hyperinsulinemia is a risk factor for impaired glucose tolerance, and insulin concentrations increase further with the development of impaired glucose tolerance. Its development, however, often is accompanied by weight gain, which, by itself, is associated with high insulin concentrations.

RESEARCH DESIGN AND METHODS
Participants for this study were adult Pima Indians involved in an ongoing epidemiological study. Initially, all had normal glucose tolerance. During follow-up, 80 of 387 who did not gain weight developed impaired glucose tolerance, as did 295 of 1026 who gained weight. Risk factors for impaired glucose tolerance and the relationships between changes in weight and glucose and changes in insulin were evaluated by multivariate analyses.

RESULTS
High baseline fasting insulin predicted impaired glucose tolerance regardless of weight after adjustment for age, sex, body mass index, and glucose. The development of impaired glucose tolerance was accompanied by a further increase in fasting and 2-h insulin, whether or not subjects gained weight. In both weight-change groups, impaired glucose tolerance was associated with more centralized fat distribution.

CONCLUSIONS
Fasting hyperinsulinemia, a reflection of insulin resistance, is associated with the risk of developing impaired glucose tolerance whether or not weight is gained. Impaired glucose tolerance occurs when insulin resistance increases further. Weight gain is the most common precipitating factor. Aging and physical inactivity are other possible precipitating factors.
Renal Function Changes in Microalbuminuric Normotensive Type II Diabetic Patients Treated With Angiotensin-Converting Enzyme Inhibitors
Authors: Romero Ramon , Salinas Isabel , Lucas Anna , Abad Elena , Reverter Jordi L , Johnston Susan , Sanmarti Anna 
Published: March 2007

OBJECTIVE
To determine the effects of captopril on microalbuminuria and renal function in normotensive type II diabetic patients.

RESEARCH DESIGN AND METHODS
A total of 26 patients were randomized in two homogeneous groups for clinical and analytical data in a 6-mo follow-up study. Group A received captopril (initial dose: 12.5 mg daily, increased according to tolerance); group B was untreated.

RESULTS
Microalbuminuria decreased only in the treated group at 6 mo (P = 0.044) and a significant (P = 0.027) mean percentage change on microalbuminuria excretion between the groups was observed. Filtration fraction decreased in group A (baseline: 0.23 ± 0.03; 6 mo: 0.22 ± 0.04) and increased in group B (baseline: 0.22 ± 0.04; 6 mo: 0.25 ± 0.04) with a significant mean percentage change between the groups at 6 mo (P = 0.032). The mean percentage change in microalbuminuria was significantly correlated with a mean percentage change in diastolic blood pressure throughout the trial. Neither metabolic control nor sodium or protein intake changed in either group during the trial.

CONCLUSIONS
These results suggest that captopril can help arrest microalbuminuria in normotensive type II diabetic patients, with a decrease in diastolic blood pressure and filtration fraction after a 6-mo treatment.
Effects of Metformin on Insulin Resistance, Risk Factors for Cardiovascular Disease, and Plasminogen Activator Inhibitor in NIDDM Subjects: A study of two ethnic groups
Authors: Nagi Dinesh K , Yudkin John S 
Published: March 2007

OBJECTIVE
To investigate the effects of metformin on glycemic control, insulin resistance, and risk factors for cardiovascular disease in NIDDM subjects from two ethnic groups (Caucasian and Asian) with different risks of cardiovascular disease.

RESEARCH DESIGN AND METHODS
A total of 27 subjects with NIDDM (17 Caucasian, 10 Asian) were given metformin and placebo each for a 12-wk period in a randomized, double-blind, placebo-controlled crossover study, and the dose was increased after 1 and 6 wk, up to a maximum of 850 mg three times a day. Insulin resistance, glycemic control, and cardiovascular risk factors were assessed before and after each treatment phase. The end of 12 wk of metformin treatment was compared with the end of 12 wk of placebo treatment.

RESULTS
Metformin treatment was associated with significant improvement in FPG at 6 and 12 wk (mean difference at 12 wk, −3.08 mM, 95% CI −4.12 to −2.04 mM, P &lt; 0.0001) and MCR of glucose (median difference 0.40 ml · kg−1 · min−1, interquartile range −0.10 to 1.30 ml · kg−1 · min−1, P = 0.036). β-cell function calculated by HOMA also improved significantly (median difference 14%, interquartile range 7 to 23%, P &lt; 0.001). Total triglyceride (median difference −0.2 mM, interquartile range −0.6 to 0.1 mM, P = 0.034), total cholesterol (mean difference −0.52 mM, 95% CI −0.83 to −0.22 mM, P = 0.002), and LDL cholesterol (mean difference −0.40 mM, 95% CI −0.64 to −0.16 mM, P = 0.002) fell significantly on metformin treatment, whereas no significant changes were observed in HDL cholesterol. PAI-1 activity fell significantly (mean difference −5.3 AU/ml, 95% CI −8.2 to −2.4 AU/ml, P = 0.001), but plasma fibrinogen concentrations and platelet function, spontaneous or agonist induced, were unaffected. UAE was lower on metformin treatment (median difference −2.4 μg/min, interquartile range −4.4 to −0.2 μg/min, P = 0.004), but metformin had no significant effect on BP. The effects of metformin on glycemic control and cardiovascular risk factors were generally similar in the two ethnic groups.

CONCLUSIONS
These findings indicate that metformin treatment improves glycemic control, and lowers insulin resistance and risk factors for cardiovascular disease, including PAI-1, and may therefore be useful in the long-term management of NIDDM subjects who have a high risk of cardiovascular disease.
Glucose Concentration in Subcutaneous Extracellular Space
Authors: Schmidt Frans J , Sluiter Willem J , Schoonen Adelbert JM 
Published: March 2007

OBJECTIVE
To compare the subcutaneous glucose sensor measurements with two reference methods. Previous studies provide conflicting findings about the real glucose concentrations in subcutaneous tissue. Some suggest substantially lower concentration, whereas others measure proportionally higher glucose concentrations compared with the blood compartment. Before these results can be taken seriously as an expression of the real glucose concentration in the extracellular space, the measurements must be validated by an independent method.

RESEARCH DESIGN AND METHODS
We applied a microdialysis-based enzyme sensor to measure glucose concentration in subcutaneous tissue. We also developed two reference methods: subcutaneous filtrate collection and an equilibration method using ultrafiltration membranes to support the earlier findings. We provided an anatomical model to explain the results.

RESULTS
The mean overall intercellular filtrate glucose concentration, sampled with the filtrate collector and taken after a 6-h stabilization time, including the values during the glucose clamp period, was 46 ± 9%. The mean subcutaneous glucose concentration measured with the glucose sensor, calibrated in vitro, was 44 ± 8% of the mean venous blood glucose concentration. Mean overall intercellular equilibrate glucose concentration, i.e., the mean glucose concentration in the subcutaneous extracellular space, taken after a 4-h stabilization time, was 46 ± 15% of the mean venous blood glucose concentration.

CONCLUSIONS
The close agreement between the mean values of subcutaneous glucose concentrations, obtained with three independent methods— filtration, equilibration, and dialysis (sensor)— shows the real glucose concentration in subcutaneous interstitial fluid is — 50% the blood glucose value in normal humans. Our results clarify some of the conflicting evidence presented in previous studies.
Provider-Patient Communication and Metabolic Control
Authors: Street Richard L , Piziak Veronica K , Carpentier Wllma S , Herzog Jean , Hejl Joyce , Skinner Gladys , McLellan Lynn 
Published: March 2007

OBJECTIVE
To determine whether nurses' and NIDDM patients' communicationstyles during consultations are related to subsequent metabolic control and to examine factors influencing patterns of communication in these consultations.

RESEARCH DESIGN AND METHODS
A total of 47 NIDDM patients participated in the study and completed the following procedures: 1) assessment of baseline HbA1 2) attended 3.5 days of diabetes education, 3) returned in 1 mo fora follow-up consultation with a nurse, and (4) returned in 9–12 wk for a follow-up HbA1 assessment. The communication variables coded from the consultations were the frequency with which nurses produced controlling, informative, and patientcentered utterances and the frequency with which patients sought information, engaged in decision making, and expressed negative affect.

RESULTS
The results were as follows: 1) patients experienced poorer metabolic control after interacting with nurses who were more controlling and directive in their communication with patients (r = 0.39, P &lt; 0.01); 2) the nurses' use of patientcentered responses was directly related to the degree to which patients expressed feelings (r = 0.34, P &lt; 0.01) and exhibited decision-making behavior (r = 0.62, P &lt; 0.01); and 3) several of the nurses' and patients' communicative behaviors were related to patient characteristics such as age, sex, education, and baseline HbA1 levels.

CONCLUSIONS
The results suggest that providers' attempts to exert considerable control during consultations with NIDDM patients may be counterproductive and contribute to poorer outcomes. The findings also indicate that patient-centered behaviors (e.g., encouraging the patient's involvement, respecting the patient's opinion, and offering support) facilitate the patient's ability to be an active participant in the consultation.
Plasma Norepinephrine in Sensory Diabetic Polyneuropathy
Authors: Tsigos Constantine , Reed Paul , Weinkove Cyril , White Anne , Young Robert J 
Published: March 2007

OBJECTIVE
To examine whether changes in circulating norepinephrine are associated with the sensory disturbances of diabetic polyneuropathy. Experimental studies have indicated that NE can excite sprouts from injured nerves, producing pain.

RESEARCH DESIGN AND METHODS
We measured supine and erect plasma NE in 13 normal, nondiabetic control subjects and three groups of diabetic patients: 20 without clinical neuropathy, 20 with chronic painful neuropathy, and 15 with painless neuropathy and foot ulceration. Neuropathy was characterized bysymptom and deficit scores, sensory thresholds, electrophysiology, and cardiovascular autonomic function tests. Neuropathic pain was scored by the patients on a linear analogue scale.

RESULTS
In painless neuropathy, NE levels were greatly reduced (supine, 1.3 nM; erect, 2.2 nM) compared with control subjects (supine, 2.4 nM; erect, 4.0 nM; P &lt; 0.001) and were combined with grossly abnormal autonomic reflexes. NE also was reduced in the diabetic group without neuropathy (supine, 1.7 nM; erect, 2.7 nM; P &lt; 0.01 vs. control subjects). By contrast, in painful neuropathy NE levels (supine, 2.2 nM; erect, 3.6 nM) were similar to control subjects and significantly higher than in painless neuropathy (P &lt; 0.01). Furthermore, NE correlated with the severity of neuropathic pain (r = 0.46, P = 0.02). To assess whether pain, acting as a stressor, could account for the observed differences in NE, we also measured the stress hormones epinephrine and cortisol. They did not differ among the diabetic groups.

CONCLUSIONS
Circulating NE is higher in painful than painless diabetic neuropathy. We suggest that painful neuropathy is associated with a relatively higher number of functioning sympathetic fibers that may contribute to pain.
Effects of Age and Body Fat Insulin Resistance in Healthy Men
Authors: Boden Guenther , Chen Xinhua , DeSantis Richard A , Kendrick Zebulon 
Published: March 2007

OBJECTIVE
Aging is known to be associated with increasing insulin resistance and declining glucose tolerance. The cause for the insulin resistance, however, remains uncertain. In this study, we examined the hypothesis that at least part of the insulin resistance may be attributable to age-related changes in body composition and muscle blood flow rather than age itself.

RESEARCH DESIGN AND METHODS
We studied 6 healthy, elderly (66.2 ± 1.7 yr) and 6 younger, healthy men (31.8 ± 3.0 yr) matched for height and weight by determination of their body composition (by underwater weighing), leg blood flow (by mercury strain-gauge plethysmography), rates of glucose uptake (by stable isotope dilution analysis with 6,6 D2-glucose), and carbohydrate oxidation (by indirect calorimetry) during euglycemic hyperinsulinemic clamping.

RESULTS
Body fat (kg fat mass or in percentage of body weight), rates of insulin-stimulated leg blood flow, glucose uptake, oxidation, and storage were all similar in elderly and younger men. Body fat (in percentage of body weight) of both elderly and younger men correlated closely and negatively with glucose uptake (r = −0.73, P &lt; 0.01), glucose oxidation (r = −0.67, P &lt; 0.05), and with glucose storage (r = −0.65, P &lt; 0.05). In contrast, age did not correlate significantly with any parameter of glucose metabolism.

CONCLUSIONS
Our data suggested that insulin sensitivity in men until around 60–70 yr of age appears to be determined more by body fat than by age.
Low Levels of Intraplatelet cGMP in IDDM
Authors: Amado Jose A , Salas Eduardo , Botana Manuel A , Poveda Juan J , Berrazueta Jose R 
Published: March 2007

OBJECTIVE
To determine the levels of intraplatelet cGMP, an index of activity of the antiaggregatory nitric oxide pathway, in IDDM patients.

RESEARCH DESIGN AND METHODS
We measured intraplatelet and plasmatic cGMP levels in 22 IDDM patients and 22 age- and sex-matched control subjects.

RESULTS
Intraplatelet cGMP levels decreased in the IDDM patients (0.32 ±; 0.16 pmol/109 platelets) when compared with the control group (0.52 ±; 0.32 pmol/109 platelets), P = 0.032. Plasmatic cGMP levels were not significantly different between groups. Intraplatelet cGMP levels correlated negatively with the duration of the disease (r = −0.43, P &lt; 0.05).

CONCLUSIONS
IDDM patients have lower levels of intraplatelet cGMP, which may be responsible in part for their platelet hyperactivity.
Nephropathy in NIDDM is Associated With Cellular Markers for Hypertension
Authors: Herman William H , Prior Donna E , Yassine May D , Weder Alan B 
Published: March 2007

OBJECTIVE
To determine if nephropathy in NIDDM is associated with cellular markers for hypertension.

RESEARCH DESIGN AND METHODS
We compared 11 patients with clinical diabetic nephropathy with 15 control subjects with no diabetic nephropathy. The patients were white and had had NIDDM for &gt; 9 yr and serum creatinine levels &lt; 177 M (2.0 mg/dl).

RESULTS
Patients with nephropathy were more obese and had higher blood pressures and triglyceride levels, and lower high-density lipoprotein cholesterol levels than control subjects. Erythrocyte sodium lithium countertransport activity, erythrocyte sodium content, and platelet sodium-proton exchange were higher in patients with nephropathy than in control subjects.

CONCLUSIONS
The results of this small study suggest that in white patients with long-standing NIDDM, diabetic nephropathy is associated with cellular markers for hypertension. Measurement of cellular markers for hypertension may be useful to identify patients who are at risk for developing nephropathy.
Screening for Diabetic Retinopathy: The wide-angle retinal camera
Authors: Pugh Jacqueline A , Jacobson James M , Van Heuven W A J , Watters John A , Tuley Michael R , Lairson David R , Lorimor Ronald J , Kapadia Asha S , Velez Ramon 
Published: March 2007

OBJECTIVE— To define the test characteristics of four methods of screening for diabetic retinopathy.
RESEARCH DESIGN AND METHODS— Four screening methods (an exam by an ophthalmologist through dilated pupils using direct and indirect ophthalmoscopy, an exam by a physician's assistant through dilated pupils using direct ophthalmoscopy, a single 45° retinal photograph without pharmacological dilation, and a set of three dilated 45° retinal photographs) were compared with a reference standard of stereoscopic 30° retinal photographs of seven standard fields read by a central reading center. Sensitivity, specificity, and positive and negative likelihood ratios were calculated after dichotomizing the retinopathy levels into none and mild nonproliferative versus moderate to severe nonproliferative and proliferative. Two sites were used. All patients with diabetes in a VA hospital outpatient clinic between June 1988 and May 1989 were asked to participate. Patients with diabetes identified from a laboratory list of elevated serum glucose values were recruited from a DOD medical center.
RESULTS— The subjects (352) had complete exams excluding the exam by the physician's assistant that was added later. The sensitivities, specificities, and positive and negative likelihood ratios are as follows: ophthalmologist 0.33, 0.99, 72, 0.67; photographs without pharmacological dilation 0.61, 0.85, 4.1, 0.46; dilated photographs 0.81, 0.97, 24, 0.19; and physician's assistant 0.14, 0.99, 12, 0.87.
CONCLUSIONS— Fundus photographs taken by the 45° camera through pharmacologically dilated pupils and read by trained readers perform as well as ophthalmologists for detecting diabetic retinopathy. Physician extenders can effectively perform the photography with minimal training but would require more training to perform adequate eye exams. In this older population, many patients did not obtain adequate nonpharmacological dilation for use of the 45° camera.
β-Cell Function in Relation to Islet Cell Antibodies During the First 3 Yr After Clinical Diagnosis of Diabetes in Type II Diabetic Patients
Authors: Gottsäter Anders , Landin-Olsson Mona , Fernlund Per , Lernmark Åke , Sundkvist Göran 
Published: March 2007

OBJECTIVE— To determine the effects of islet cell antibodies on β-cell function during the first 3 yr after diagnosis in type II diabetic patients.
RESEARCH DESIGN AND METHODS— β-cell function in type II diabetic patients with (n = 11, 50 ± 5 yr of age) and without (n = 10, 52 ± 4 yr of age) ICA was followed prospectively and compared with β-cell function in type I adult diabetic patients (n = 17, 37 ± 5 yr of age) and in healthy control subjects (n = 34, age 45 ± 3 yr). β-cell function was evaluated as fasting C-peptide, 1 + 3 min C-peptide after intravenous glucose, and ∆ C-peptide after glucagon.
RESULTS— Fasting C-peptide was equal in type II diabetic patients with ICA (0.30 ± 0.03 nM) and type I diabetic patients (0.24 ± 0.03 nM) at diagnosis, and decreased (P &lt; 0.05) during 3 yr in these groups but not in type II diabetic patients without ICA. At diagnosis, type II diabetic patients with ICA showed a 1 + 3 min C-peptide (0.92 ± 0.17 nM) lower (P &lt; 0.001) than control subjects but higher (P &lt; 0.05) than type I diabetic patients (0.53 ± 0.11 nM). After 1 yr, 1 + 3 min C-peptide in type II diabetic patients with ICA had decreased (P &lt; 0.05) to 0.18 ± 0.11 nM and was equal to type I diabetic patients (0.38 ± 0.10 nM). ∆ C-peptide after glucagon was equally impaired in type II diabetic patients with ICA (0.38 ± 0.06 nM) and type I diabetic patients (0.35 ± 0.11 nM) at diagnosis. After 3 yr, type II diabetic patients with ICA had fasting C-peptide of 0.09 ± 0.04 nM, 1 + 3 min C-peptide of 0.18 ± 0.10 nM, and ∆ C-peptide after glucagon of 0.20 ± 0.09 nM, values equal to type I diabetic patients but lower (P &lt; 0.01) than in type II diabetic patients without ICA, whose values remained unchanged; fasting C-peptide of 0.97 ± 0.17 nM, 1 + 3 min C-peptide of 2.31 ± 0.50 nM, and ∆ C-peptide after glucagon of 1.76 ± 0.28 nM.
CONCLUSIONS— In patients considered type II diabetic with ICA, β-cell function progressively decreased after diagnosis, and after 3 yr was similar to type I diabetic patients, whereas β-cell function in type II diabetic patients without ICA was unchanged.
Fibrocalculous Pancreatic Diabetes in Pune, India: Clinical features and follow-up for 7 yr
Authors: Yajnik Chittaranjan S , Shelgikar Kishore M 
Published: March 2007

OBJECTIVE— To study clinical features of fibrocalculous pancreatic diabetes from this clinic, to compare these with the published criteria of malnutrition-related diabetes mellitus, and to conduct serial follow-up of these patients to study difficulties in their treatment.
RESEARCH DESIGN AND METHODS— Details of presenting symptoms, anthropometry, diabetic tissue damage, treatment, and follow-up of 55 patients with fibrocalculous pancreatic diabetes (pancreatic calculi demonstrated on X-ray and sonography) treated during the last 7 yr were studied.
RESULTS— Many patients did not fit the accepted criteria of malnutrition-related diabetes. Thus, 17 (31%) were diagnosed after 30 yr of age and 23 (42%) had a body mass index &gt; 18 kg/m2, and the daily dose of insulin in these patients (mean 0.8 U/kg) was similar to that in the IDDM patients (mean 1.0 U/kg). The two pathognomonic complaints (pancreatic pain and steatorrhea) were not always present. Many patients took very irregular treatment, but none suffered diabetic ketoacidosis despite stopping insulin for long periods of time; 33% of patients had some diabetic tissue damage when first seen. Fourteen patients were lost to follow-up, and 11 died during the follow-up.
CONCLUSIONS— Clinical features of these fibrocalculous pancreatic diabetes patients were somewhat different than the classic descriptions. A need exists to reconsider classification of FCPD under malnutrition-related diabetes mellitus. Many patients receive irregular treatment, and a substantial proportion die within a few years of diagnosis, many as a result of preventable causes.