bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac Autonomic Nervous Dysfunction in Diabetic Patients With a Mitochondrial DNA Mutation
Authors: Momiyama Yukihiko , Suzuki Yoshihiko , Ohtomo Masako , Atsumi Yoshihito , Matsuoka Kempei , Ohsuzu Fumitaka , Kimura Mitsuru 
Published: March 2007

OBJECTIVE—To elucidate the degree and characteristics of cardiac autonomic nervous dysfunction in diabetic patients associated with a mitochondrial DNA mutation at base pair 3243.
RESEARCH DESIGN AND METHODS—We investigated heart rate variability using 24-h Holter monitoring in 10 diabetic patients with the mutation compared with 55 ordinary diabetic patients and 45 nondiabetic control subjects.
RESULTS—Age and sex were similar in the three groups. Between patients with the mutation and ordinary diabetic patients, the duration of diabetes and blood glycemic levels were not different. In the time domain analysis of heart rate variability, patients with the mutation and ordinary diabetic patients had significantly smaller SDNN index and pNN50 than control subjects. Compared with ordinary diabetic patients, patients with the mutation had smaller SDNN index (P &lt; 0.02), but rMSSD and pNN50 were not different. In the frequency domain analysis, total, low frequency (LF), and high frequency (HF) spectra were significantly smaller in patients with the mutation and ordinary diabetic patients than in control subjects. Compared with ordinary diabetic patients, patients with the mutation had smaller total and LF spectra (P &lt; 0.02). However, HF spectra were not significantly different. Notably, the LF/HF spectra ratio was lower in patients with the mutation than in ordinary diabetic patients and control subjects (P &lt; 0.05), but this ratio was similar in ordinary diabetic patients and control subjects.
CONCLUSIONS—Our results suggest that diabetic patients with the mitochondrial DNA mutation have more severely impaired cardiac autonomic nervous function with sympathovagal imbalance, as compared with ordinary diabetic patients.
Mortality in Concurrent Type 1 Diabetes and Anorexia Nervosa
Authors: Nielsen Søren , Emborg Charlotte , Mølbak Anne-Grethe 
Published: March 2007

OBJECTIVE—Previous studies in this field report early occurrence of diabetic complications, but excess mortality, though expectable, has not been reported. We combined information from earlier studies to estimate the mortality for this group of patients.
RESEARCH DESIGN AND METHODS—The observed mortality is analyzed using crude mortality rate (a percentage), standardized mortality ratio (SMR), incidence rate ratio, risk difference, and survival analysis.
RESULTS—After ∼10 years of follow-up, 13 of 510 females with type 1 diabetes, 43 of 658 females with anorexia nervosa (AN), and 8 of 23 concurrent case subjects had died. Mortality rate was 2.2 (per 1,000 person-years) for type 1 diabetes, 7.3 for AN cases, and 34.6 for concurrent cases. Crude mortality rates were 2.5, 6.5, and 34.8%, respectively. SMR was 4.06 in type 1 diabetes, 8.86 in AN, and 14.5 in concurrent cases. Survival analysis indicated between-group differences in mortality.
CONCLUSIONS—Concurrent type 1 diabetes and AN is a rare but serious condition in females. All indexes of mortality evidence excess mortality in this preliminary study. Vigorous and well-directed treatment efforts seem vital for this subpopulation. Collaboration between diabetologists and eating disorder specialists is warranted. The implications of other eating disorders and subclinical eating disorders in diabetic populations need to be analyzed, especially because these conditions are more frequent than clinical eating disorders.
Parent Report of Mealtime Behavior and Parenting Stress in Young Children With Type 1 Diabetes and in Healthy Control Subjects
Authors: Powers Scott W. , Byars Kelly C. , Mitchell Monica J. , Patton Susana R. , Standiford Debbie A. , Dolan Lawrence M. 
Published: March 2007

OBJECTIVE—This study assessed parent report of mealtime behavior and parenting stress in preschoolers with type 1 diabetes. It was hypothesized that children with type 1 diabetes would be seen as exhibiting more mealtime behavior problems and that their parents would evidence greater parenting stress when compared with healthy subjects. It was also hypothesized that report of mealtime behavior problems would be positively correlated with parenting stress.
RESEARCH DESIGN AND METHODS—A total of 40 children (aged 1–6 years) with type 1 diabetes were recruited from a pediatric hospital. Another 40 children matched for age, sex, marital status, and socioeconomic status were used as control subjects. Reliable and valid parent report measures, such as the Behavioral Pediatrics Feeding Assessment Scale and the Parenting Stress Index, were used for data collection.
RESULTS—Parents of children with type 1 diabetes reported more behavioral feeding problems than parents of healthy control subjects. Additionally, parents of children with type 1 diabetes reported higher frequencies of parenting behaviors associated with poor nutritional intake and a greater number of parenting problems concerning mealtimes when compared with parents of healthy control subjects. Parents of children with type 1 diabetes also reported higher stress levels than parents of control subjects. A moderate relationship between mealtime behavior problems and general parenting stress was observed for families coping with type 1 diabetes.
CONCLUSIONS—Mealtime problems reported in preschool children with type 1 diabetes are appropriate targets for behavioral intervention. Behavioral observation techniques and training in child behavior management skills should be used in future research aimed at assessing and treating barriers to effective nutrition management in young children with type 1 diabetes.
Effect of a High-Protein, High–Monounsaturated Fat Weight Loss Diet on Glycemic Control and Lipid Levels in Type 2 Diabetes
Authors: Parker Barbara , Noakes Manny , Luscombe Natalie , Clifton Peter 
Published: March 2007

OBJECTIVE—To determine the effect of a high-protein (HP) weight loss diet compared with a lower-protein (LP) diet on fat and lean tissue and fasting and postprandial glucose and insulin concentrations.
RESEARCH DESIGN AND METHODS—Replacing dietary protein for carbohydrate (CHO) during energy restriction and weight loss has been effective in sparing lean mass and improving insulin sensitivity in obese subjects but has not been tested in subjects with type 2 diabetes. We compared an HP diet (28% protein, 42% CHO, 28% fat [8% saturated fatty acids, 12% monounsaturated fatty acids, 5% polyunsaturated fatty acids]) with an LP diet (16% protein, 55% CHO, 26% fat [8% saturated fatty acids, 11% monounsaturated fatty acids, 5% polyunsaturated fatty acids]) in 54 obese men and women with type 2 diabetes during 8 weeks of energy restriction (1,600 kcal) and 4 weeks of energy balance. Body composition was determined by dual-energy X-ray absorptiometry at weeks 0 and 12.
RESULTS—Overall, weight loss of 5.2 ±1.8 kg was achieved independently of diet composition. However, women on the HP diet lost significantly more total (5.3 vs. 2.8 kg, P=0.009) and abdominal (1.3 vs. 0.7 kg, P=0.006) fat compared with the women on the LP diet, whereas, in men, there was no difference in fat loss between diets (3.9 vs. 5.1 kg). Total lean mass decreased in all subjects independently of diet composition. LDL cholesterol reduction was significantly greater on the HP diet (5.7%) than on the LP diet (2.7%) (P &lt; 0.01).
CONCLUSIONS—Both dietary patterns resulted in improvements in the cardiovascular disease (CVD) risk profile as a consequence of weight loss. However, the greater reductions in total and abdominal fat mass in women and greater LDL cholesterol reduction observed in both sexes on the HP diet suggest that it is a valid diet choice for reducing CVD risk in type 2 diabetes.
Comorbid Depression is Associated With Increased Health Care Use and Expenditures in Individuals With Diabetes
Authors: Egede Leonard E. , Zheng Deyi , Simpson Kit 
Published: March 2007

OBJECTIVE—This study ascertained the odds of diagnosed depression in individuals with diabetes and the relation between depression and health care use and expenditures.RESEARCH DESIGN AND METHODS—First, we compared data from 825 adults with diabetes with that from 20,688 adults without diabetes using the 1996 Medical Expenditure Panel Survey (MEPS). Second, in patients with diabetes, we compared depressed and nondepressed individuals to identify differences in health care use and expenditures. Third, we adjusted use and expenditure estimates for differences in age, sex, race/ethnicity, health insurance, and comorbidity with analysis of covariance. Finally, we used the Consumer Price Index to adjust expenditures for inflation and used SAS and SUDAAN software for statistical analyses.RESULTS—Individuals with diabetes were twice as likely as a comparable sample from the general U.S. population to have diagnosed depression (odds ratio 1.9, 95% CI 1.5–2.5). Younger adults (&lt;65 years), women, and unmarried individuals with diabetes were more likely to have depression. Patients with diabetes and depression had higher ambulatory care use (12 vs. 7, P &lt; 0.0001) and filled more prescriptions (43 vs. 21, P &lt; 0.0001) than their counterparts without depression. Finally, among individuals with diabetes, total health care expenditures for individuals with depression was 4.5 times higher than that for individuals without depression ($247,000,000 vs. $55,000,000, P &lt; 0.0001).CONCLUSIONS—The odds of depression are higher in individuals with diabetes than in those without diabetes. Depression in individuals with diabetes is associated with increased health care use and expenditures, even after adjusting for differences in age, sex, race/ethnicity, health insurance, and comorbidity.
Type 2 Diabetes and Metabolic Syndrome in Filipina-American Women
Authors: Araneta Maria Rosario G. , Wingard Deborah L. , Barrett-Connor Elizabeth 
Published: March 2007

OBJECTIVE—To compare the prevalence of type 2 diabetes and features of the metabolic syndrome among Filipina and Caucasian women in San Diego County, California.
RESEARCH DESIGN AND METHODS—Data on several chronic diseases were collected between 1992 and 1999 from community-dwelling Filipina (n=294) and Caucasian (n=379) women aged 50–69 years.
RESULTS—Filipina and Caucasian women did not differ in mean age (59.7 vs. 60 years, respectively), BMI (25.6 vs. 25.4 kg/m2), percentage of body fat (33.5 vs. 34.2%), or waist-to-hip ratio (0.84 vs. 0.83), although Filipinas had larger waist circumferences and higher percentages of truncal fat. Compared with Caucasians, Filipinas were less likely to be obese (BMI ≥ 30 kg/m2, 8.8 vs. 14%, P=0.04) and less likely to smoke, consume alcohol, or take postmenopausal estrogen; Filipinas also had lower levels of HDL cholesterol. Compared with Caucasians, Filipinas had higher prevalence of type 2 diabetes by oral glucose tolerance test criteria (36 vs. 9%) and the metabolic syndrome (34 vs. 13%). These differences persisted after adjusting for age, body size, fat distribution, percentage of body fat, smoking, alcohol consumption, exercise, and estrogen therapy.
CONCLUSIONS—A total of 10% of Filipinas with diabetes were obese, compared with one third of Caucasians with diabetes. The finding of a high prevalence of diabetes in an unstudied nonobese ethnic group reinforces the importance of expanding the study of diabetes to diverse populations. The high prevalence of diabetes in populations who are not of Northern European ancestry may be missed when they are not obese by Western standards.
Posttransplantation Diabetes
Authors: Montori Victor M. , Basu Ananda , Erwin Patricia J. , Velosa Jorge A. , Gabriel Sherine E. , Kudva Yogish C. 
Published: March 2007

OBJECTIVES— To systematically review the incidence of posttransplantation diabetes (PTD), risk factors for its development, prognostic implications, and optimal management.RESEARCH DESIGN AND METHODS— We searched databases (MEDLINE, EMBASE, the Cochrane Library, and others) from inception to September 2000, reviewed bibliographies in reports retrieved, contacted transplantation experts, and reviewed specialty journals. Two reviewers independently determined report inclusion (original studies, in all languages, of PTD in adults with no history of diabetes before transplantation), assessed study methods, and extracted data using a standardized form. Meta-regression was used to explain between-study differences in incidence.RESULTS— Nineteen studies with 3,611 patients were included. The 12-month cumulative incidence of PTD is lower (&lt;10% in most studies) than it was 3 decades ago. The type of immunosuppression explained 74% of the variability in incidence (P = 0.0004). Risk factors were patient age, nonwhite ethnicity, glucocorticoid treatment for rejection, and immunosuppression with high-dose cyclosporine and tacrolimus. PTD was associated with decreased graft and patient survival in earlier studies; later studies showed improved outcomes. Randomized trials of treatment regimens have not been conducted.CONCLUSIONS— Physicians should consider modification of immunosuppressive regimens to decrease the risk of PTD in high-risk transplant recipients. Randomized trials are needed to evaluate the use of oral glucose-lowering agents in transplant recipients, paying particular attention to interactions with immunosuppressive drugs.
Prevalence of Q-T Interval Dispersion in Type 1 Diabetes and Its Relation With Cardiac Ischemia
Authors: Veglio Massimo , Giunti Sara , Stevens Linda K. , Fuller John H. , Perin Paolo Cavallo ,   The EURODIAB IDDM Complications Study Group
Published: March 2007

OBJECTIVE—The interlead variation in duration of the Q-T interval on the surface electrocardiogram (Q-T interval dispersion [QTd]) has been shown to predict mortality in type 2 diabetic patients. We evaluated the prevalence of QTd prolongation in the EURODIAB population and its relation to corrected Q-T interval (QTc), sex, age, duration of diabetes, blood glucose control, and complications.
RESEARCH DESIGN AND METHODS—A total of 3,042 type 1 diabetic patients were studied. QTc was calculated according to the Bazett’s formula; QTc &gt; 0.44 s was considered abnormally prolonged. QTd was calculated using the difference between the maximum and the minimum QTc in any thoracic lead. QTd &gt;0.080 s was considered abnormally prolonged.
RESULTS—The prevalence of an increased QTd was 7%. A significant relation was observed between QTd prolongation and diastolic blood pressure (P &lt; 0.05). A higher prevalence of QTd prolongation was observed in patients with ischemic heart disease (P = 0.004), whereas no relationship was observed with retinopathy, albumin excretion rate, or measures of somatic and autonomic neuropathy. QTc and QTd were significantly related (P = 0.001); however, a proportion of patients with normal QTd showed a prolonged QTc (&gt;0.44 s).
CONCLUSIONS—In patients with type 1 diabetes, QTd is associated with ischemic heart disease and diastolic blood pressure but not neuropathy. Although QTd is statistically related to duration of QTc, increased QTd and increased QTc identify different patients, and their predictive value deserves prospective evaluation.
The Incidence of Type 1 Diabetes in the Age Group 0–39 Years Has Not Increased in Antwerp (Belgium) Between 1989 and 2000
Authors: Weets Ilse , De Leeuw Ivo H. , Du Caju Marc V.L. , Rooman Raoul , Keymeulen Bart , Mathieu Chantal , Rottiers Raoul , Daubresse Jean-Claude , Rocour-Brumioul Danielle , Pipeleers Daniel G. , Gorus Frans K. ,   The Belgian Diabetes Registry
Published: March 2007

OBJECTIVE—A worldwide increase in the incidence of childhood type 1 diabetes has been observed. Because in various countries the majority of new type 1 diabetic patients are diagnosed in adulthood, we investigated whether the rising incidence of this disorder in children reflects a global increase in the incidence of diabetes or a shift toward earlier clinical presentation.
RESEARCH DESIGN AND METHODS—The incidence of type 1 diabetes presenting before age 40 years was prospectively measured in the Antwerp district over a 12-year period (1989–2000). The completeness of ascertainment was evaluated by the capture-recapture method. Trends in incidence during the study period were analyzed by Poisson regression.
RESULTS—The incidence of type 1 diabetes diagnosed before age 40 years remained constant over the 12-year period, averaging 9.9 cases per 100,000 individuals per year. The incidence was similar in both sexes under age 15 years, but a marked male excess was noted for adult-onset disease, in particular after age 20 years, resulting in a male-to-female ratio of 0.9 under age 15 years vs. 1.6 thereafter (P = 0.001). During the 12-year observation period, there was a significant tendency toward increasing incidence under age 15 years at the expense of a decreasing incidence between ages 15 and 40 years (P = 0.025). The annual increase in incidence averaged 1.8% under age 15 years and 5.0% under age 5 years (P = 0.06).
CONCLUSIONS—Our results indicate that in Belgium, the increasing incidence of childhood type 1 diabetes—especially for children under age 5 years—is not attributable to a global increase in disease incidence, but rather to earlier clinical manifestation. The results suggest that an environmental factor may preferentially accelerate the subclinical disease process in young diabetes-prone subjects.
Advanced Glycation End Products and Endothelial Dysfunction in Type 2 Diabetes
Authors: Tan Kathryn C.B. , Chow Wing-Sun , Ai Victor H.G. , Metz Christine , Bucala Richard , Lam Karen S.L. 
Published: March 2007

OBJECTIVE—Data from experimental studies have suggested that the increased formation of advanced glycation end products (AGEs) is one of the causes of endothelial dysfunction in diabetes. This study was performed to investigate whether changes in endothelium-dependent vasodilation, a marker of endothelial function, were related to serum AGEs concentrations in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—For this study, 170 patients with type 2 diabetes and 83 healthy nondiabetic control subjects of similar age were recruited. Serum AGEs were assayed by competitive enzyme-linked immunosorbent assay. Endothelium-dependent and -independent vasodilation of the brachial artery was measured by high-resolution vascular ultrasound.
RESULTS—Serum AGEs were increased in diabetic patients compared with control subjects (4.6 ± 0.7 vs. 3.1 ± 0.8 unit/ml; P &lt; 0.01), and both endothelium-dependent (5.1 ± 2.5 vs. 9.1 ± 4.1%; P &lt; 0.01) and endothelium-independent vasodilation (13.2 ± 4.6 vs. 16.4 ± 5.5%; P &lt; 0.01) were impaired. On univariate analysis of all subjects, serum AGEs correlated with endothelium-dependent vasodilation (r = −0.51, P &lt; 0.01); a weaker association was found with endothelium-independent vasodilation (r = −0.24, P &lt; 0.01). On multiple regression analyses including age, sex, smoking status, and plasma lipids, only serum AGEs remained a significant independent determinant of endothelium-dependent vasodilation (r2 = 0.34, P &lt; 0.01).
CONCLUSIONS—Increased serum concentrations of AGEs in patients with type 2 diabetes is associated with endothelial dysfunction, independent of other cardiovascular risk factors. Further studies to determine whether treatment targeting AGEs will lead to an amelioration of endothelial dysfunction are warranted.
HOMA-Estimated Insulin Resistance Is an Independent Predictor of Cardiovascular Disease in Type 2 Diabetic Subjects
Authors: Bonora Enzo , Formentini Gianni , Calcaterra Francesco , Lombardi Simonetta , Marini Franco , Zenari Luciano , Saggiani Francesca , Poli Maurizio , Perbellini Sandro , Raffaelli Andrea , Cacciatori Vittorio , Santi Lorenza , Targher Giovanni , Bonadonna Riccardo , Muggeo Michele 
Published: March 2007

OBJECTIVE—To evaluate whether homeostasis model assessment-estimated insulin resistance (HOMA-IR) is an independent predictor of cardiovascular disease (CVD) in type 2 diabetes.
RESEARCH DESIGN AND METHODS—Conventional CVD risk factors (sex, age, smoking, plasma lipids, blood pressure, and metabolic control) and insulin resistance (estimated by HOMA) were evaluated at baseline in 1,326 patients with type 2 diabetes examined within the Verona Diabetes Complications Study. At baseline and after a mean follow-up of 4.5 years, CVD was assessed by medical history, physical examination, electrocardiography, and echo-Doppler of carotid and lower limb arteries. Death certificates and medical records of subjects who died during the follow-up were carefully scrutinized to identify cardiovascular deaths. In statistical analyses, CVD was an aggregate end point including both fatal and nonfatal coronary, cerebrovascular, and peripheral vascular disease as well as ischemic electrocardiographic abnormalities and vascular lesions identified by echo-Doppler.
RESULTS—At baseline, 441 subjects were coded positive for CVD (prevalent cases). Incident cases numbered 126. Multiple logistic regression analyses showed that, along with sex, age, smoking, HDL/total cholesterol ratio, and hypertension, HOMA-IR was an independent predictor of both prevalent and incident CVD. A 1-unit increase in (log)HOMA-IR value was associated with an odds ratio for prevalent CVD at baseline of 1.31 (95% CI 1.10–1.56, P = 0.002) and for incident CVD during follow-up of 1.56 (95% CI 1.14–2.12, P &lt; 0.001).
CONCLUSIONS—HOMA-IR is an independent predictor of CVD in type 2 diabetes. The improvement of insulin resistance might have beneficial effects not only on glucose control but also on CVD in patients with type 2 diabetes.
Homeostasis Model Assessment of Insulin Resistance in Relation to the Incidence of Cardiovascular Disease
Authors: Hanley Anthony J.G. , Williams Ken , Stern Michael P. , Haffner Steven M. 
Published: March 2007

OBJECTIVE—The prospective association between insulin levels and risk of cardiovascular disease (CVD) is controversial. The objective of the present study was to investigate the relationship of the homeostasis model assessment of insulin resistance (HOMA-IR), as well as insulin levels, with risk of nonfatal and fatal CVD over the 8-year follow-up of the San Antonio Heart Study.
RESEARCH DESIGN AND METHODS—Between 1984 and 1988, randomly selected Mexican-American and non-Hispanic white residents of San Antonio participated in baseline examinations that included fasting blood samples for glucose, insulin, and lipids, a glucose tolerance test, anthropometric measurements, and a lifestyle questionnaire. Between 1991 and 1996, 2,569 subjects who were free of diabetes at baseline were reexamined using the same protocol.
RESULTS—Over the follow-up period, 187 subjects experienced an incident cardiovascular event (heart attack, stroke, heart surgery, angina, or CVD death). Logistic regression analysis indicated that risk of a CVD event increased across quintiles of HOMA-IR after adjustment for age, sex, and ethnicity (P for trend &lt;0.0001; quintile 5 vs. quintile 1, odds ratio [OR] 2.52, 95% CI 1.46–4.36). Additional adjustment for LDL, triglyceride, HDL, systolic blood pressure, smoking, alcohol consumption, exercise, and waist circumference only modestly reduced the magnitude of these associations (P for trend 0.02; quintile 5 vs. quintile 1, OR 1.94, 95% CI 1.05–3.59). Furthermore, there were no significant interactions between HOMA-IR and ethnicity, sex, hypertension, dyslipidemia, glucose tolerance (impaired glucose tolerance versus normal glucose tolerance), or obesity. The magnitude and direction of the relationship between insulin concentration and incident CVD were similar.
CONCLUSIONS—We found a significant association between HOMA-IR and risk of CVD after adjustment for multiple covariates. The topic remains controversial, however, and additional studies are required, particularly among women and minority populations.