bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Sample Temperature on Reflectance Photometry and Electrochemical Glucometer Measurements
Authors: Fazel Ali , Koutoubi Zaher , Sorg Timothy B , Mehrotra Bhoomi 
Published: March 2007

OBJECTIVE
A study was conducted to determine the influence of sample temperature on manual reflectance photometers, automatic reflectance photometers, and electrochemical glucometers.

RESEARCH DESIGN AND METHODS
Aqueous and blood-based control solutions were tested at temperatures ranging from 25 to 44°C. With the Accu-Chek 3, One Touch, and Satellite G glucometers, multiple glucose determinations were performed on each sample.

RESULTS
The results indicate that the manual reflectance photometry glucometer is prominently influenced by variation in sample temperature. The effect of sample temperature is greatest at high glucose levels.

CONCLUSIONS
Caution may be required in the interpretation of manual reflectance photometry glucometer measurements in febrile or hypothermic diabetic patients.
Insulin Underdelivery From Implanted Pumps Using Peritoneal Route: Determinant role of insulin pump compatibility
Authors: Renard Eric , Bouteleau Serge , Jacques-Apostol Dominique , Lauton Dominique , Gibert-Boulet Françoise , Costalat Guy , Bringer Jacques , Jaffiol Claude 
Published: March 2007

OBJECTIVE
To evaluate the incidence and investigate determinants of insulin underdelivery events occurring with implanted pumps using peritoneal route from a 103 patient-year experiment.

RESEARCH DESIGN AND METHODS
Of the MiniMed (MIP 2001) pumps implanted in 47 type I diabetic patients, 70 were refilled quarterly with four successive batches (A, B, C, D) of U400 Hoechst 21 PH neutral insulin during a 3-year study period. Any reduction of insulin flow rate &gt;15% was considered as abnormal insulin delivery. Diagnosis of the cause of underdelivery was established according to the response to the following steps: 1) 0.01 mol/l NaOH rinse of pump circuits to solubilize insulin aggregates, 2) surgical examination and replacement of blocked catheters, and 3) postsurgical 0.01 mol/l NaOH rinse of pump. Step 2 was selected first if the increase of insulin requirements or reduction of flow rate were &gt; 50%. Relative contributions of insulin and the implanted system to underdelivery events were analyzed.

RESULTS
There were 76 episodes of insulin underdelivery that occurred during the study, resulting in an incidence of 74 events per 100 patient-years. Of 52 NaOH pump rinses, 30 restored normal flow rate. Surgery, performed after rinse failure (n = 22) or as the first step (n = 24), disclosed catheter blockages due to tip obstructions in 28 cases and omental encapsulations in 18 other cases. Five combined severe reductions of pump flow rate requiring pump replacements were diagnosed during surgery, and additional NaOH rinses had to be performed after catheter change in 12 other cases. Analysis of the incidence of underdelivery events indicated that both pump- and catheter-related problems were significantly increased while implanted systems infused batches B, C, and D versus batch A (P &lt; 0.01), whereas the duration of pump implantation had no significant influence.

CONCLUSIONS
Underdelivery events constitute serious limiting obstacles to prolonged peritoneal insulin infusion from implanted pumps. Progress in insulin pump compatibility is expected to reduce their occurrence and, thus, to improve the feasibility of this treatment.
Reducing Dynamic Foot Pressures in High-Risk Diabetic Subjects With Foot Ulcerations: A comparison of treatments
Authors: Lavery Lawrence A , Vela Steven A , Lavery David C , Quebedeaux Terri L 
Published: March 2007

OBJECTIVE
To compare the effectiveness of total contact casts, commercially available therapeutic shoes, and removable walking casts to reduce mean peak plantar foot pressures at the site of neuropathic ulcerations in diabetic subjects.

RESEARCH DESIGN AND METHODS
We compared the reduction in peak plantar pressures at ulcer sites under the great toe (n = 5), first metatarsal (n = 10), and second through fifth metatarsals (n = 10) using six treatments: total contact casts (TCCs), DH Pressure Relief Walkers (DH), Aircast Pneumatic Walkers, Three D Dura-Steppers (3D), CAM Walkers, and P.W. Minor Xtra Depth shoes. A rubber sole canvas oxford was used to establish baseline pressure values. The canvas oxford could be viewed as a worse-case scenario for this patient population. With the EMED Pedar in-shoe pressure measurement system, data for 40 steps were collected for each treatment. We used Tukey's Studentized Range Test for simultaneous multiple comparisons to compare treatments.

RESULTS
DH Pressure Relief Walkers reduced plantar pressures significantly better than other commercially available treatments for ulcers under the first metatarsal, second through fifth metatarsals, and great toe (P &lt; 0.05). There was not a significant difference in mean peak plantar pressures between TCCs and DHs at any of the forefoot ulcer sites.

CONCLUSIONS
DH Pressure Relief Walkers were as effective as total contact casts to reduce foot pressures at ulcer sites and may be an effective practical addition in the treatment of foot ulcers.
Glucagon-Like Peptide I Enhances the Insulinotropic Effect of Glibenclamide in NIDDM Patients and in the Perfused Rat Pancreas
Authors: Gutniak Mark K , Juntti-Berggren Lisa , Hellström Per M , Guenifi Amel , Holst Jens J , Efendic Suad 
Published: March 2007

OBJECTIVE
To investigate the acute effects of glibenclamide and glucagon-like peptide I (GLP-I) and their combination in perfused isolated rat pancreas and in patients with secondary failure to sulfonylureas.

RESEARCH DESIGN AND METHODS
Rat islets were perfused with 10 nmol/l GLP-I in combination with 2 μumol/l glibenclamide. In human experiments, GLP-I (0.75 pmol. kg−1 · min−1) was given as a continuous infusion during 240 min, while glibenclamide (3.5 mg) was administered orally. Eight patients participated in the study (age 57.6 ± 2.7 years, BMI 28.7 ± 1.5 kg/m2, mean ± SE). In all subjects, blood glucose was first normalized by insulin infusion administered by an artificial pancreas (Biostator).

RESULTS
GLP-I increased the insulinotropic effect of glibenclamide fourfold in the perfused rat pancreas. In human experiments, treatment with GLP-I alone and in combination with glibenclamide significantly decreased basal glucose levels (5.1 ± 0.4 and 4.5 ± 0.1 vs. 6.0 ± 0.3 mmol/l, P &lt; 0.01), while with only glibenclamide, glucose concentrations remained unchanged. GLP-I markedly decreased total integrated glucose response to the meal (353 ± 60 vs. 724 ± 91 mmol μ l−1 · min−1, area under the curve [AUC] [–30–180 min], P &lt; 0.02), whereas glibenclamide had no effect (598 ± 101 mmol · l−1 · min−1, AUC [–30–180 min], NS). The combined treatment further enhanced the glucose lowering effect of GLP-I (138 ± 24 mmol · l−1 · min, AUC [–30–180 min], P &lt; 0.001). GLP-I, glibenclamide, and combined treat-stimulated meal-induced insulin release as reflected by insulinogenic indexes (control 1.44 ± 0.4; GLP-I 6.3 ± 1.6, P &lt; 0.01; glibenclamide 6.8 ± 2.1, P &lt; 0.01; combination 20.7 ± 5.0, P &lt; 0.001). GLP-I inhibited basal but not postprandial glucagon responses. Using paracetamol as a marker for gastric emptying rate of the test meal, treatment with GLP-I decreased gastric emptying at 180 min by ∼50% compared with the control subjects (P &lt; 0.01).

CONCLUSIONS
In acute experiments on overweight patients with NIDDM, GLP-I exerted a marked antidiabetogenic action on the basal and postprandial state. The peptide stimulated insulin, suppressed basal glucagon release, and prolonged gastric emptying. The glucose-lowering effect of GLP-I was further enhanced by glibenclamide. This action may be at least partially accounted for by a synergistic effect of these two compounds on insulin release. Glibenclamide per se enhanced postprandial but not basal insulin release and exerted a less pronounced antidiabetogenic effect compared with GLP-I.
Evidence of a Relationship Between Childhood-Onset Type I Diabetes and Low Groundwater Concentration of Zinc
Authors: Haglund Bengt , Ryckenberg Katarina , Selinus Olle , Dahlquist Gisela 
Published: March 2007

OBJECTIVE
Zinc deficiency has shown to increase the risk for diabetes in diabetes-prone experimental animals. Low concentrations of zinc have also been shown in serum of recent onset cases with IDDM. The present study examines the hypothesis that exposure to a low concentration of zinc in drinking water could increase the risk for future onset of IDDM.

RESEARCH DESIGN AND METHODS
Using the Swedish childhood diabetes registry and data on residence 3 years before the onset of disease, a case-control study was designed comparing cases and control subjects with estimates of groundwater contents of zinc obtained in biogeochemical samples from areas of residence.

RESULTS
A high groundwater concentration of zinc was associated with a significant decrease in risk (odds ration [OR] = 0.8; 95% CI = 0.7–0.9). The same OR was obtained when the model included information of other metals that might act as possible confounders (chromium, vanadium, cobalt selenium, cadmium, lead, and mercury). In small rural areas, in which drinking water is taken from local wells and thus is closely associated with the groundwater content within the area, an even stronger association between zinc and diabetes (OR = 0.6; 95% CI = 0.4–0.9) was found.

CONCLUSIONS
It is concluded that this study for the first time provides evidence that a low groundwater content of zinc, which may reflect long-term exposure through drinking water, is associated with later development of childhood onset diabetes.
The Effect of Glipizide Gastrointestinal Therapeutic System on Islet Cell Hormonal Responses to a Test Meal in NIDDM
Authors: Mooradian Arshag D , Albert Stewart G , Bernbaum Marla , Plummer Sharon 
Published: March 2007

OBJECTIVE
To determine whether the abnormal glucagon and amylin secretions in NIDDM are secondary to hyperglycemia and relative hypoinsulinemia.

RESEARCH DESIGN AND METHODS
A total of 13 patients with NIDDM were studied before and after treatment with glipizide gastrointestinal therapeutic system (GITS) in a randomized double-blind placebo-controlled fashion. Of the 13 subjects, 9 were randomized to the glipizide GITS arm and 4 were randomized to the placebo arm of the study. Serum glucose, insulin, C-peptide, plasma glucagon, and plasma amylin concentrations were measured under fasting and postprandial (post-Sustacal ingestion) conditions. The Sustacal challenge was performed at baseline and after 12 weeks of treatment with either glipizide GITS or placebo.

RESULTS
Glipizide GITS treatment resulted in a significant reduction in hyperglycemia and increases in insulin and C-peptide secretion. Hyperglucagonemia was not ameliorated, and amylin secretion was not altered after glipizide GITS treatment. Placebo-treated patients did not show significant changes in any of the parameters measured.

CONCLUSIONS
Glipizide GITS treatment failed to ameliorate the hyperglucagonemia of NIDDM and did not alter amylin secretion even though it increased insulin secretion and significantly ameliorated the hyperglycemia. These observations suggest that NIDDM related abnormalities in some of the islet cell hormonal responses are the result of changes inherent in the islet cells and may be independent of hyperglycemia and relative hypoinsulinemia.
Incidence of Lower Limb Amputations and Diabetes
Authors: Trautner Christoph , Haastert Burkhard , Giani Guido , Berger Michael 
Published: March 2007

OBJECTIVE
We collected data on the incidence rates of amputations and their relative risk in diabetic subjects compared with the nondiabetic population.

RESEARCH DESIGN AND METHODS
From all three hospitals in a city of ∼ 160,000 inhabitants, we obtained complete lists of nontraumatic lower limb amputations. From each patient record, diabetic status was determined. We estimated age-specific and standardized incidence rates of amputations in the diabetic and nondiabetic populations and in the entire population, as well as the relative and attributable risks due to diabetes.

RESULTS
Nontraumatic lower limb amputations were performed on 106 residents of Leverkusen (Germany) in 1990 and 1991. Of them, 82 (77.4%) had diabetes. Mean age was 72.0 years. In the case of multiple amputations, only the highest level was counted for the analysis. The following results were standardized to the German population. Incidence rates (100,000−1 · year−1) were determined to be as follows: for all amputations per total population, 33.8; for amputations in diabetic individuals per diabetic population, 209.2; for amputations in nondiabetic individuals per nondiabetic population, 9.4. Relative risk was 22.2; attributable risk among exposed, 0.96; population attributable risk, 0.72. When the study is repeated to monitor the St. Vincent targets (50% reduction), a reduction in the amputation rate in the diabetic population by 46% will be detected with 90% power.

CONCLUSIONS
We found incidence rates similar to those in the non-Indian population of the U.S. Great relative and population-attributable risks indicate that improving foot care in diabetic individuals appears to be the main target for the reduction of amputations in the general population.
The Effect of Metformin on the Metabolic Abnormalities Associated With Upper-Body Fat Distribution. BIGPRO Study Group
Authors: Fontbonne Annick , Charles M Aline , Juhan-Vague Irene , Bard Jean Marie , André Philippe , Isnard Françoise , Cohen Jean Marie , Grandmottet Pierre , Vague Philippe , Safar Michel E , Eschwège Eveline 
Published: March 2007

OBJECTIVE
The constellation of anomalies associated with insulin resistance is a plausible additional cause of ischemic cardiovascular disease and of NIDDM. To test this hypothesis in a primary prevention trial, the effects of metformin as a potential candidate for intervention in the insulin resistance syndrome (IRS) were evaluated in 324 middle-aged subjects with upper-body obesity.

RESEARCH DESIGN AND METHODS
Trial patients were selected on the basis of a high waist-to-hip ratio. They were randomly allocated to receive either metformin or placebo, following a double-blind procedure. After 1 year of treatment, the main clinical and biological parameters of the IRS were assessed and their evolution compared between treatment groups.

RESULTS
Compared with placebo, metformin induced a significant weight loss, a better maintenance of fasting blood glucose, total and LDL cholesterol levels, and a greater decrease of fasting plasma insulin concentration. Moreover, tissue-type plasminogen activator antigen, a marker of fibrinolytic impairment, showed a significant decrease under metformin. By contrast, metformin treatment had no significant effect on blood pressure or serum triglyceride and HDL cholesterol concentrations. The main side effect of metformin was diarrhea.

CONCLUSIONS
The BIGuanides and Prevention of Risks in Obesity (BIGPRO1) results suggest that metformin would be a suitable candidate for long-term intervention for the prevention of diabetes but that its use in a trial of primary prevention of cardiovascular diseases requires either a reevaluation of its properties toward the most potentially atherogenic anomalies of the IRS or a better definition of the target population.
A Comprehensive Assessment of the Avoidability of Long-Term Complications of Diabetes. A case-control study. SID-AMD Italian Study Group for the Implementation of the St. Vincent Declaration
Authors: Nicolucci Antonio , Cavaliere Donatella , Scorpiglione Nicola , Carinci Fabrizio , Capani Fabio , Tognoni Gianni , Benedetti Massimo Massi 
Published: March 2007

OBJECTIVE
To identify and quantify risk factors for the development of long-term diabetic complications (i.e., critical limb ischemia, amputation, chronic renal failure [creatinine &gt; 3 mg/dl], dialysis treatment, proliferative retinopathy, blindness), with particular emphasis on those variables that, being related to quality of care, can be considered avoidable.

RESEARCH DESIGN AND METHODS
We designed a case-control study that enrolled 886 patients with long-term diabetic complications and 1,888 control subjects without complications from 35 diabetic outpatient clinics and 49 general practitioners' offices during a 6-month period. Selected socioeconomic, pathophysiologic, self-care, health care, and lifestyle information were collected for all patients.

RESULTS
A logistic regression analysis showed that several factors are related to the development of major diabetic complications. Among patient characteristics, male sex (odds ratio [OR] = 1.8, 95% CI 1.4–2.3) and age (OR = 1.7, 95% CI 1.2–2.4 for patients between 50 and 69 years of age as opposed to those younger than 50 years of age) were associated with an increased risk of complication. Among clinical variables, the type and the duration of diabetes were the most important predictors of diabetic complications. The presence of hypertension was also associated with the development of diabetic complications, particularly when it was poorly controlled by treatment (OR = 3.1, 95% CI 2.3–4.3). Patients who needed help to reach a health care facility and those who did not regularly attend such a facility were at higher risk of developing complications (OR = 1.5, 95% CI 1.2–1.9; OR = 1.7, 95% CI 1.3–2.2, respectively). Educational aspects were also related to the outcome: patients who did not receive any kind of educational intervention had an increased risk of developing complications (OR = 4.1, 95% CI 1.7–9.7), while self-management of insulin therapy had a protective effect (OR = 0.6, 95% CI 0.5–0.8). The summary attributable risk related to avoidable risk factors (i.e., uncontrolled hypertension, poor compliance with visit scheduling, inadequate diabetes education, no self-management of insulin treatment) was 0.39.

CONCLUSIONS
Our data suggest that, by removing avoidable risk factors, the number of diabetic complications considered could be reduced by more than one-third. The case-control methodology represents an efficient way of monitoring clinical practice and relating it to important outcomes. It can be of help for policy makers in identifying the more effective strategies and in tailoring specific interventions aimed at improving the quality of the care delivered to diabetic patients.
Insulin Antibodies Do Not Preclude Optimization of Metabolic Control in Women With IDDM During Pregnancy
Authors: Dozio Nicoletta , Beretta Angelo , Castiglioni Mariatersa , Rosa Susanna , Scavini Marina , Belloni Cristina , Poloniato Antonella 
Published: March 2007

OBJECTIVE
To evaluate whether the presence of insulin antibodies (IAs) may preclude the optimization of metabolic control during pregnancy and affect outcome in women with IDDM.

RESEARCH DESIGN AND METHODS
IAs were measured by radiobinding assay in 44 women with IDDM referred to the Diabetes and Pregnancy Outpatients' Clinic during 46 pregnancies. Age, duration of IDDM, metabolic control (HbA1c, mean pre- and postprandial capillary blood glucose, frequency of hypo- or hyperglycemia), insulin requirement at 1st and 3rd trimester of pregnancy, BM1, and weight gain were recorded. Neonatal variables such as gestational age, weight, length, and the presence at birth of either hypoglycemia, hypocalcemia, or jaundice requiring phototherapy were also considered.

RESULTS
IAs correlated positively with insulin requirement (P &lt; 0.05) and negatively with HbA1c at term (P &lt; 0.01). Patients with IA levels ≥ 40% insulin binding (8 of 46) had a higher insulin requirement and lower preprandial capillary blood glucose at the beginning of pregnancy but not at term (P &lt; 0.005), whereas they had lower HbA1c at term than did patients with low IA levels (P &lt; 0.01). IA levels decreased slightly at term (P = 0.007). IA levels ≥ 40% were not associated with a higher rate of hypo- or hyperglycemic episodes or with diabetic complications or thyreopathy. No correlation was found between LA levels and any of the neonatal variables considered.

CONCLUSIONS
The presence of IAs does not preclude optimization of metabolic control during pregnancy and is compatible with a favourable outcome.
Hypoglycemia: Incidence and Clinical Predictors in a Large Population-Based Sample of Children and Adolescents with IDDM
Authors: Davis E A , Keating B , Byrne G C , Russell M , Jones T W 
Published: March 2007

OBJECTIVE
To determine the frequency of moderate and severe hypoglycemia and to identify clinical predictors associated with its occurrence in a large population-based sample of children and adolescents with IDDM.

RESEARCH DESIGN AND METHODS
A total of 657 patients (age: 12.1 ± 4.4 years, mean ± SD) were included in the study, yielding 1,449 patient-years of data. A prospective assessment of severe hypoglycemia (an event resulting in a seizure or coma) and moderate hypoglycemia (an event requiring assistance of another, excluding severe episodes) was made over a 3-year period. Patients and caregivers detailed episodes of significant hypoglycemia (moderate and severe events) and these were recorded at each 3-month clinic visit along with HbA1c. Data were analyzed using generalized estimating equation models fitted with the exchange correlation structure.

RESULTS
The overall incidence of severe events was 4.8/100 patient-years and of moderate events was 13.1/100 patient-years. Over 3 years, severe events occurred in 8.5% of children and moderate events occurred in 26.9%. Significant hypoglycemia was rare in the first 12 months after diagnosis. Rates of hypoglycemia were increased in children &lt; 6 years of age versus &gt; 6 years of age (40.9 vs. 16.6/100 patient-years, age ≤6 years vs. age &gt; 6 years, P &lt; 0.001). Rates of hypoglycemia doubled when HbA1c fell below 8%, and children with HbA1c &lt; 7% had a threefold increase in both moderate and severe hypoglycemia (e.g., severe episodes 14.9 vs. 4.1/100 patient-years, HbA1c ≤ 7% vs. HbA1c &gt; 7%, P &lt; 0.001). Most severe events were seizures, and 75% of them occurred at night. The majority of events were related to missed meals or increased activity. However, in 38% no predisposing factor was evident.

CONCLUSIONS
Newly diagnosed children appear to be protected from severe hypoglycemia. Rates increase with lower glycated hemoglobin, especially when mean HbA1c is &lt; 8.0%. Younger children, who may be more susceptible to the adverse effects of neuroglycopenia, are at a particular risk of significant hypoglycemia.