bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-Intensity Laser Therapy for Painful Symptoms of Diabetic Sensorimotor Polyneuropathy
Authors: Zinman Lorne H. , Ngo Mylan , Ng Eduardo T. , Nwe Khin T. , Gogov Sven , Bril Vera 
Published: March 2007

OBJECTIVE—Low-intensity laser therapy (LILT) has been advocated for treatment of chronic pain disorders. Although the mechanism of pain relief is uncertain, this therapy has been suggested for relief of painful symptoms of diabetic sensorimotor polyneuropathy (DSP). The objective of this study was to determine whether LILT relieves the pain of DSP.
RESEARCH DESIGN AND METHODS—We conducted a randomized, double-masked, sham therapy-controlled clinical trial in 50 patients with painful DSP diagnosed with the Toronto Clinical Neuropathy Score. All patients received sham therapy over a 2-week baseline period and were then randomized to receive biweekly sessions of either sham or LILT for 4 weeks. The primary efficacy parameter was the difference in the weekly mean pain scores on a visual analog scale (VAS).
RESULTS—The patients had similar baseline characteristics for pain intensity, HbA1c, and duration of DSP. Both groups noted a decrease in weekly mean pain scores during sham treatment. After the 4-week intervention, the LILT group had an additional reduction in weekly mean pain scores of −1.0 ± 0.4 compared with −0.0 ± 0.4 for the sham group (P = 0.07). LILT had no effect on the Toronto Clinical Neuropathy Score, nerve conduction studies, sympathetic skin response, or quantitative sensory testing.
CONCLUSIONS—Although an encouraging trend was observed with LILT, the study results do not provide sufficient evidence to recommend this treatment for painful symptoms of DSP.
Type 2 Diabetes and Intravenous Thrombolysis Outcome in the Setting of ST Elevation Myocardial Infarction
Authors: Zairis Michael N. , Lyras Anastassios G. , Makrygiannis Stamatis S. , Psarogianni Paraskevi K. , Adamopoulou Evdokia N. , Handanis Stelios M. , Papantonakos Apostolos , Argyrakis Spyros K. , Prekates Athanasios A. , Foussas Stefanos G. 
Published: March 2007

OBJECTIVE—There are conflicting results regarding the impact of type 2 diabetes on intravenous thrombolysis effectiveness during ST elevation myocardial infarction (STEMI). The present study, using a continuous 12-lead electrocardiogram, examined the possible association of type 2 diabetes with both acute intravenous thrombolysis effectiveness and long-term prognosis in this setting.
RESEARCH DESIGN AND METHODS—The study included 726 consecutive subjects (214 type 2 diabetic subjects) with STEMI who received intravenous thrombolysis in the first 6 h from index pain and were followed up for 3.5 years.
RESULTS—Type 2 diabetic subjects had significantly lower incidence of sustained ≥50% ST recovery than nondiabetic subjects (P = 0.03). Additionally, the former required a significantly greater time interval through the achievement of this criterion than the latter (P &lt; 0.001). In both type 2 diabetic (P &lt; 0.001) and nondiabetic subjects (P &lt; 0.001), those who had not attained ≥50% ST recovery were at significantly higher risk of cardiac death than subjects who had reached this criterion. The subjects who attained the above electrocardiographic criterion in ≥60 min after thrombolysis initiation were at significantly higher risk compared with those who achieved this criterion in &lt;60 min (P = 0.02). However, this association was true only for type 2 diabetic subjects (P = 0.01) and not for nondiabetic subjects (P = 0.9).
CONCLUSIONS—The present study suggests that type 2 diabetes is a strong predictor of acute intravenous thrombolysis failure during STEMI. This finding may significantly contribute to the worse prognosis for type 2 diabetic subjects compared with nondiabetic ones in this setting.
Critical Evaluation of Adult Treatment Panel III Criteria in Identifying Insulin Resistance With Dyslipidemia
Authors: Liao Youlian , Kwon Soonho , Shaughnessy Sara , Wallace Penny , Hutto Amy , Jenkins Alicia J. , Klein Richard L. , Garvey W. Timothy 
Published: March 2007

OBJECTIVE—The goal of this study was to evaluate the efficacy of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) in identifying insulin resistance.
RESEARCH DESIGN AND METHODS—This study included 74 nondiabetic Caucasians who were evaluated for insulin resistance and risk factors associated with the metabolic syndrome. Glucose disposal rate (GDR) was measured by hyperinsulinemic-euglycemic clamp and was used to quantify insulin resistance. Sensitivity and specificity of ATP III criteria in detecting insulin resistance were calculated for various cutoffs of GDR.
RESULTS—Insulin resistance was associated with increased waist circumference, fasting glucose, blood pressure, triglycerides, and decreased levels of HDL cholesterol. Only 12.2% of study subjects met ATP III criteria for metabolic syndrome, and ATP III criteria exhibited low sensitivity for detecting insulin resistance. Although high in specificities (&gt;90%), the sensitivities of ATP III criteria ranged only between 20 and 50% when insulin resistance was defined as various GDR cutoff values below 10 to 12 mg · kg−1 · min−1. The larger number of subjects who were insulin resistant but did not meet ATP III criteria were found to have an adverse cardiovascular disease risk profile, including higher BMI, waist circumference, fasting glucose, triglycerides, and an unfavorable lipoprotein subclass profile determined by nuclear magnetic resonance compared with insulin-sensitive individuals (i.e., increased large VLDL, increased small LDL, and decreased large HDL particle concentrations).
CONCLUSIONS—ATP III criteria have low sensitivity for identifying insulin resistance with dyslipidemia in nondiabetic individuals who are at increased risk for cardiovascular disease and diabetes. More sensitive criteria should be developed for clinical assessment of metabolic and cardiovascular disease risk relevant to the metabolic syndrome.
Testosterone and Sex Hormone–Binding Globulin Predict the Metabolic Syndrome and Diabetes in Middle-Aged Men
Authors: Laaksonen David E. , Niskanen Leo , Punnonen Kari , Nyyssönen Kristiina , Tuomainen Tomi-Pekka , Valkonen Veli-Pekka , Salonen Riitta , Salonen Jukka T. 
Published: March 2007

OBJECTIVE—In men, hypoandrogenism is associated with features of the metabolic syndrome, but the role of sex hormones in the pathogenesis of the metabolic syndrome and diabetes is not well understood. We assessed the association of low levels of testosterone and sex hormone–binding globulin (SHBG) with the development of the metabolic syndrome and diabetes in men.
RESEARCH DESIGN AND METHODS—Concentrations of SHBG and total and calculated free testosterone and factors related to insulin resistance were determined at baseline in 702 middle-aged Finnish men participating in a population-based cohort study. These men had neither diabetes nor the metabolic syndrome.
RESULTS—After 11 years of follow-up, 147 men had developed the metabolic syndrome (National Cholesterol Education Program criteria) and 57 men diabetes. Men with total testosterone, calculated free testosterone, and SHBG levels in the lower fourth had a severalfold increased risk of developing the metabolic syndrome (odds ratio [OR] 2.3, 95% CI 1.5–3.4; 1.7, 1.2–2.5; and 2.8, 1.9–4.1, respectively) and diabetes (2.3, 1.3–4.1; 1.7, 0.9–3.0; and 4.3, 2.4–7.7, respectively) after adjustment for age. Adjustment for potential confounders such as cardiovascular disease, smoking, alcohol intake, and socioeconomic status did not alter the associations. Factors related to insulin resistance attenuated the associations, but they remained significant, except for free testosterone.
CONCLUSIONS—Low total testosterone and SHBG levels independently predict development of the metabolic syndrome and diabetes in middle-aged men. Thus, hypoandrogenism is an early marker for disturbances in insulin and glucose metabolism that may progress to the metabolic syndrome or frank diabetes and may contribute to their pathogenesis.
Reduction in Diabetes-Related Lower-Extremity Amputations in the Netherlands: 1991–2000
Authors: van Houtum William H. , Rauwerda Jan A. , Ruwaard Dirk , Schaper Nicolaas C. , Bakker Karel 
Published: March 2007

OBJECTIVE—Lower-extremity amputation is a common complication among patients with diabetes throughout the world. However, few data exist on the actual impact of the recent moves to improve the management of diabetic foot ulcers to reduce the incidence of lower-extremity amputations. The aim was to determine the incidence of lower-extremity amputations among diabetic patients from 1991 to 2000 in the Netherlands.
RESEARCH DESIGN AND METHODS—A secondary database containing information regarding all hospital admissions in which a lower-extremity amputation occurred for the years 1991–2000 was obtained from the Dutch National Medical Register. Because a patient-unique identifier was included, multiple amputations and hospitalizations for a single individual could be identified. Furthermore, age- and sex-specific diabetes prevalence rates were calculated using a 3-year average for every year, calculating the total diabetic population in the Netherlands at risk for every year.
RESULTS—In 1991, a total of 1,687 patients with diabetes had been admitted 1,865 times for 2,409 amputations. In 2000, a total of 1,673 patients with diabetes were admitted 1,932 times for 2,448 amputations. The overall incidence rates of the number of patients who underwent lower-extremity amputation decreased over the years from 55.0 to 36.3 per 10,000 patients with diabetes (P &lt; 0.05). Both in men (71.8 vs. 46.1, P &lt; 0.05) and women (45.0 vs. 28.0, P &lt; 0.05) with diabetes, a significant decrease could be observed. Mean duration of hospitalization decreased from 45.0 days (SD 44.4) in 1991 to 36.2 days (SD 38.4) in 2000; decreases were observed for both men and women.
CONCLUSIONS—Over the years observed in this study, the incidence rates of diabetes-related lower-extremity amputation in the Netherlands was found to decrease in both men (36%) and women (38%) with diabetes. Furthermore, the duration of hospitalization decreased over time.
Treatment of Diabetic Gastroparesis by High-Frequency Gastric Electrical Stimulation
Authors: Lin Zhiyue , Forster Jameson , Sarosiek Irene , McCallum Richard W. 
Published: March 2007

OBJECTIVE—To investigate the long-term efficacy of high-frequency gastric electrical stimulation (GES) for treating diabetic gastroparesis.
RESEARCH DESIGN AND METHODS—This is a retrospective review of 48 adult diabetic patients with refractory gastroparesis who had a GES system implanted surgically and had follow-up evaluations at 6 and 12 months. The outcome measures were total symptom score (TSS), derived from six upper gastrointestinal (GI) symptom subscores; health-related quality of life (HQOL), including physical composite score (PCS) and mental composite score (MCS) assessed by SF-36 questionnaire, radionuclide gastric emptying test, nutritional status, HbA1c, and adverse events.
RESULTS—In comparison with baseline, TSS, all six upper GI symptom subscores, PCS, and MCS were significantly improved at 6 months, with the improvement sustained at 12 months. Of 13 patients receiving nutritional support at baseline by tube feeding, only 5 required supplemental enteral feeding at 12 months, and none of the 9 on total parenteral nutrition continued this support. The mean number of hospitalization days during the year after GES was significantly reduced by 52 days compared with the prior year. HbA1c levels were significantly reduced at 12 months. Gastric emptying was only minimally and not significantly faster. Because of infections at the pulse generator pocket site, four patients had their GES systems removed 3–17 months postsurgery.
CONCLUSIONS—In diabetic patients with refractory gastroparesis, high-frequency GES by a permanently implanted system significantly improved upper GI symptoms, HQOL, nutritional status, glucose control, and hospitalizations with an acceptably low complication rate.
Sural Nerve Sorbitol in Patients With Diabetic Sensorimotor Polyneuropathy
Authors: Bril Vera , Ono Yoshiyuki , Buchanan Robert A. 
Published: March 2007

OBJECTIVE—Nerve sorbitol levels have been measured in sural nerve biopsy samples from patients with diabetic sensorimotor polyneuropathy in several studies using different methods and measurement units. In this study, we compared the results of sorbitol assays to determine the required sensitivity of analytical methods for nerve sorbitol measurements.
RESEARCH DESIGN AND METHODS—We performed a literature search using PaperChase for reports of nerve sorbitol in diabetic patients and selected those with nerve conduction studies to delineate the severity of nerve damage.
RESULTS—In patients who had undergone a nerve conduction study, the standardized nerve sorbitol levels were 0.034–0.300 nmol/mg wet nerve.
CONCLUSIONS—Our results showed the level of sensitivity required in laboratory methodology to perform this assay in the target population and aid in the planning of clinical research trials of aldose reductase inhibitor agents.
Increasing Incidence of Diabetes After Gestational Diabetes
Authors: Lauenborg Jeannet , Hansen Torben , Jensen Dorte Møller , Vestergaard Henrik , Mølsted-Pedersen Lars , Hornnes Peter , Locht Henning , Pedersen Oluf , Damm Peter 
Published: March 2007

OBJECTIVE—To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes.
RESEARCH DESIGN AND METHODS—Women with diet-treated GDM during 1978–1985 (old cohort, n = 241, also followed up around 1990) or 1987–1996 (new cohort, n = 512) were examined in 2000–2002. Women were classified by a 2-h, 75-g oral glucose tolerance test according to the World Health Organization criteria or an intravenous glucagon test supplemented by measurement of GAD antibodies. Historical data from index-pregnancy and anthropometrical measurements were collected.
RESULTS—A total of 481 (63.9%) women were examined (median 9.8 years [interquartile range 6.4–17.2]) after index pregnancy. Diabetes and impaired glucose tolerance (IGT)/impaired fasting glucose were present in 40.0 and 27.0% of women, respectively. In the new cohort, 40.9% had diabetes compared with 18.3% in the old cohort at the 1990 follow-up (P &lt; 0.0005). Prepregnancy BMI was significantly higher in the new compared with the old cohort (26.0 [22.5–30.8] vs. 22.9 kg/m2 [20.2–28.0], P &lt; 0.0005). Among others, new-cohort membership, prepregnancy overweight (BMI ≥25 kg/m2), and IGT postpartum were identified as independent predictors of diabetes by multiple logistic regression analyses.
CONCLUSIONS—The incidence of diabetes among Danish women with previous diet-treated GDM was very high and had more than doubled over a 10-year period. This seems to be due to a substantial increase in BMI in women with GDM.
High-Fiber Cereal Reduces Postprandial Insulin Responses in Hyperinsulinemic but not Normoinsulinemic Subjects
Authors: Wolever Thomas M.S. , Campbell Janice E. , Geleva Daniela , Anderson G. Harvey 
Published: March 2007

OBJECTIVE—The objective of this study was to compare the plasma glucose and insulin responses elicited by two ready-to-eat breakfast cereals (one being high and the other being low in cereal fiber) and to see if the differences in response depended on subjects’ fasting plasma insulin.
RESEARCH DESIGN AND METHODS—Nondiabetic men (n = 77) were studied on two occasions after 10- to 14-h overnight fasts. They consumed 25 g of available carbohydrate from high- or low-fiber breakfast cereals in random order with blood taken at intervals for 2 h. Data from the 42 men with high fasting plasma insulin (FPI) on screening (&gt;40 pmol/l) were compared with those from the 35 men with normal FPI (≤40 pmol/l).
RESULTS—Hyperinsulinemic men had significantly higher waist circumference and BMI, lower HDL cholesterol, and a trend toward higher triglycerides (P = 0.07) than control subjects. In all 77 subjects, the incremental area under the glucose response curve (AUC) after high-fiber cereal was 11.8 ± 5.5% (P = 0.036) less than after low-fiber cereal with the reductions being equivalent in the hyperinsulinemic (12.6 ± 8.3%) and control (10.9 ± 9.1%) groups. However, insulin peak rise was reduced by the high-fiber cereal only in hyperinsulinemic men (351 ± 29 vs. 485 ± 55 pmol/l) but not in control subjects (211 ± 20 vs. 220 ± 20 pmol/l; cereal × group interaction P = 0.044). Insulin AUC after the high-fiber cereal, expressed as a percentage of that after low-fiber cereal, was negatively related to FPI (P = 0.009) but not to age, BMI, or waist circumference.
CONCLUSIONS—The high-fiber cereal reduced glucose responses to the same extent in normal and hyperinsulinemic men, but reduced insulin responses only in hyperinsulinemic subjects.
Ragaglitazar Improves Glycemic Control and Lipid Profile in Type 2 Diabetic Subjects
Authors: Saad Mohammed F. , Greco Susan , Osei Kwame , Lewin Andrew J. , Edwards Christopher , Nunez Margarita , Reinhardt Rickey R. ,   for the Ragaglitazar Dose-Ranging Study Group
Published: March 2007

OBJECTIVE—Ragaglitazar is a novel insulin sensitizer with dual peroxisome proliferator-activated receptor (PPAR)-γ and PPAR-α stimulating activities that improve plasma glucose and lipid profiles. The aim of the present dose-ranging study was to assess the efficacy and safety of ragaglitazar in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—This study included 177 hypertriglyceridemic type 2 diabetic subjects who participated in a 12-week, double-blind, parallel, randomized, placebo-controlled dose-ranging study (open pioglitazone arm). Subjects received ragaglitazar (0.1, 1, 4, or 10 mg), placebo, or pioglitazone (45 mg). Efficacy parameters included fasting plasma levels of triglycerides and glucose (FPG) along with other lipid levels, A1C, and insulin.
RESULTS—Ragaglitazar in doses of 1, 4, and 10 mg resulted in a significant decrease from baseline as compared with placebo in FPG (−48, −74, −77 mg/dl) and triglycerides (−40, −62, −51%), free fatty acids (−36, −54, −62%), apolipoprotein B (−13, −29, −25%), LDL cholesterol (−14 and −19% for 4- and 10-mg groups), and total cholesterol (−16 and −15% for 4 and 10 mg) and a significant increase in HDL cholesterol (20 and 31% for 1- and 4-mg groups, respectively). Changes in triglycerides and FPG for pioglitazone treatment were similar to 1 mg ragaglitazar. Mean A1C values of the 1-, 4-, and 10-mg ragaglitazar and pioglitazone groups were significantly reduced compared with placebo (−0.5, −1.3, −1.1, and −0.3%, respectively). Common adverse events were edema, weight increase, leukopenia, and anemia.
CONCLUSIONS—Ragaglitazar provided glycemic control that was comparable with that of pioglitazone and, compared with placebo, provided significant improvement in the lipid profile.
Vascular Effects of Improving Metabolic Control With Metformin or Rosiglitazone in Type 2 Diabetes
Authors: Natali Andrea , Baldeweg Stephanie , Toschi Elena , Capaldo Brunella , Barbaro Daniele , Gastaldelli Amalia , Yudkin John S. , Ferrannini Ele 
Published: March 2007

OBJECTIVE—The aim of this study was to test whether vascular reactivity is modified by improving metabolic control and peripheral insulin resistance in type 2 diabetes.
RESEARCH DESIGN AND METHODS—In a randomized, double-blind design, we assigned 74 type 2 diabetic patients to rosiglitazone (8 mg/day), metformin (1,500 mg/day), or placebo treatment for 16 weeks and measured insulin sensitivity (euglycemic insulin clamp), ambulatory blood pressure, and forearm blood flow response to 1) intra-arterial acetylcholine (ACh), 2) intra-arterial nitroprusside, 3) the clamp, and 4) blockade of nitric oxide (NO) synthase.
RESULTS—Compared with 25 nondiabetic subjects, patients had reduced insulin sensitivity (30 ± 1 vs. 41 ± 3 μmol · min−1 · kg fat-free mass−1; P &lt; 0.001) and reduced maximal response to ACh (586 ± 42 vs. 883 ± 81%; P &lt; 0.001). Relative to placebo, 16 weeks of rosiglitazone and metformin similarly reduced fasting glucose (−2.3 ± 0.5 and −2.3 ± 0.5 mmol/l) and HbA1c (−1.2 ± 0.3 and −1.6 ± 0.3%). Insulin sensitivity increased with rosiglitazone (+6 ± 3 μmol · min−1 · kg fat-free mass−1; P &lt; 0.01) but not with metformin or placebo. Ambulatory diastolic blood pressure fell consistently (−2 ± 1 mmHg; P &lt; 0.05) only in the rosiglitazone group. Nitroprusside dose response, clamp-induced vasodilatation, and NO blockade were not affected by either treatment. In contrast, the slope of the ACh dose response improved with rosiglitazone (+40% versus baseline, P &lt; 0.05, +70% versus placebo, P &lt; 0.005) but did not change with either metformin or placebo. This improvement in endothelium-dependent vasodilatation was accompanied by decrements in circulating levels of free fatty acids and tumor necrosis factor-α.
CONCLUSIONS—At equivalent glycemic control, rosiglitazone, but not metformin, improves endothelium dependent vasodilatation and insulin sensitivity in type 2 diabetes.
The Arg972 Variant in Insulin Receptor Substrate-1 Is Associated With an Increased Risk of Secondary Failure to Sulfonylurea in Patients With Type 2 Diabetes
Authors: Sesti Giorgio , Marini Maria Alelaide , Cardellini Marina , Sciacqua Angela , Frontoni Simona , Andreozzi Francesco , Irace Concetta , Lauro Davide , Gnasso Agostino , Federici Massimo , Perticone Francesco , Lauro Renato 
Published: March 2007

OBJECTIVE—The aim of this study was to investigate whether diabetic patients carrying the Arg972 insulin receptor substrate-1 (IRS-1) variant are at increased risk for secondary failure to sulfonylurea.
RESEARCH DESIGN AND METHODS—A total of 477 unrelated Caucasian type 2 diabetic patients were recruited according to the following criteria: onset of diabetes after age 35 years, absence of ketonuria at diagnosis, and anti-GAD− antibody. Type 2 diabetes was diagnosed according to the American Diabetes Association criteria. Patients with secondary sulfonylurea failure were defined as those requiring insulin due to uncontrolled hyperglycemia (fasting plasma glucose &gt;300 mg/dl) despite sulfonylurea-metformin combined therapy, appropriate diet, and absence of any conditions causing hyperglycemia.
RESULTS—Of the total patients, 53 (11.1%) were heterozygous for the Arg972 IRS-1 variant, 1 (0.2%) was homozygous, and the remainder (88.7%) were homozygous for the wild-type allele. The genotype frequency of the Arg972 IRS-1 variant was 8.7% among diabetic patients well controlled with oral therapy and 16.7% among patients with secondary failure to sulfonylurea (odds ratio 2.1 [95% CI 1.18–3.70], P = 0.01). Adjustment for age, sex, BMI, metabolic control, age at diagnosis, duration of diabetes, and Pro12Ala polymorphism of peroxisome proliferator–activated receptor-γ2 gene in a logistic regression analysis with secondary failure to sulfonylurea as a dependent variable did not change this association (2.0 [1.38–3.86], P = 0.038).
CONCLUSIONS—These data demonstrate that the Arg972 IRS-1 variant is associated with increased risk for secondary failure to sulfonylurea, thus representing a potential example of pharmacogenetics in type 2 diabetes.