bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insulinoma in a Patient With NIDDM
Authors: Kane L A , Grant C S , Nippoldt T B , Service F J 
Published: March 2007

Objective— To confirm insulinoma as the cause of hypoglycemia in a patient with NIDDM and determine the frequency of the co-occurrence of these two conditions.
Research Design and Methods— The patient underwent an in-hospital prolonged fast (≤72 h), according to standard protocol, and an ultrasound examination of the pancreas. All cases of histologically confirmed insulinoma at this institution over the period of 1927–1992 were reviewed to determine the prevalence of pre-existent diabetes mellitus.
Results— After 10 h of fasting, plasma glucose was low (1.89 mM); plasma insulin (258 pM) and C-peptide (1.39 nM) were elevated in the absence of sulfonylurea in the plasma. An insulinoma detected by ultrasonography was removed surgically with subsequent reoccurrence of insulin-requiring diabetes. Among 313 cases of insulinoma confirmed at this institution, this patient is the only one with pre-existent diabetes mellitus.
Conclusions— Insulinoma occurs extraordinarily rarely in patients with pre-existing NIDDM.
Metabolic Effects of Dietary Sucrose in Type II Diabetic Subjects
Authors: Bantle John P , Swanson Joyce E , Thomas William , Laine Dawn C 
Published: March 2007

Objective— To assess in diabetic subjects the effects of dietary sucrose on glycemia and lipemia.
Research Design and Methods— Twelve type II diabetic subjects consumed, in random order, two isocaloric, 55% carbohydrate study diets for 28 days. In one diet, 19% of energy was derived from sucrose. In the other diet, &lt;3% of energy was derived from sucrose, and carbohydrate energy came primarily from starch. Both study diets were composed of common foods. All meals were prepared in a metabolic kitchen where foods were weighed during meal preparation.
Results— No significant differences were noted between the study diets at any time point in mean plasma glucose. At day 28, mean plasma glucose values for the sucrose diet were 9.6 ± 0.5 mM and for the starch diet were 9.4 ± 0.6 mM (P = 0.63). Also, no significant differences were observed between the study diets in urine glucose, fasting serum total, HDL, or LDL cholesterol; fasting serum TG; or peak postprandial serum TG.
Conclusions— A high sucrose diet did not adversely affect glycemia or lipemia in type II diabetic subjects.
South African Indians Show a High Prevalence of NIDDM and Bimodality in Plasma Glucose Distribution Patterns
Authors: Omar Mahomed A K , Seedat Mahomed A , Dyer Robin B , Motala Ayesha A , Knight Lucinda T , Becker Peter J 
Published: March 2007

OBJECTIVE
To determine the prevalence of diabetes mellitus and impaired glucose tolerance (IGT) and to test for bimodality in the plasma glucose distribution in South African Indians.

RESEARCH DESIGN AND METHODS
Subjects were selected by systematic cluster sampling in various areas of Durban. They underwent a modified glucose tolerance test whereby fasting and 2-h postglucose (75 g) plasma glucose levels were measured. The program MIX was used to test for bimodality in the plasma glucose distribution.

RESULTS
We tested 2,479 subjects (1,441 women and 1,038 men). Based on the revised World Health Organization criteria, the crude prevalence of diabetes mellitus was 9.8%, and the crude prevalence of IGT was 5.8%; the age- and sex-adjusted prevalence was 13.0 and 6.9%, respectively. IGT was significantly more common in men (7.6%) than in women (4.4%). Obesity was a feature of both diabetes mellitus and IGT, particularly in women. Both fasting and 2-h plasma glucose values did not conform to a single normal distribution pattern in any age-group, whereas unequivocal evidence of bimodality was seen in the 55- to 74-year age-group of both sexes for fasting and 2-h glucose and also in the 2-h levels of men in the 25- to 34-year age-group.

CONCLUSIONS
This study has highlighted a high prevalence of non-insulindependent diabetes mellitus in South African Indians and bimodality in the plasma glucose distribution.
Community Diabetes Care: A 10-year Perspective
Authors: Hiss Roland G , Anderson Robert M , Hess George E , Stepien Cathie J , Davis Wayne K 
Published: March 2007

OBJECTIVE
To compare diabetes care and education at the community level in 1981 and 1991 in order to record progress achieved in the decade of the 1980s, determine if there is a gap that must be closed to reach diabetes-related objectives for 2000, and establish a baseline to which changes stimulated by the Diabetes Control and Complications Trial can be compared.

RESEARCH DESIGN AND METHODS
In eight Michigan communities, representative primary-care physicians (61 in 1981; 68 in 1991) and their diabetic patients (428 and 440) were identified. Communities, physicians, and patients were randomly selected. Participating patients were interviewed and examined in their community or home to assess the kind and extent of diabetes care they had been receiving; their metabolic, nutritional, educational, and psychosocial status; their diabetic history and current status; and other related factors. The diabetic status, care, and education of the 1981 community patients were compared with those of patients studied in 1991.

RESULTS
Positive changes in diabetes care and education at the community level from 1981 to 1991 were seen in the areas of patient glucose monitoring, insulin administration practices, hypertension control, exercise recommendations in diabetic management; and smoking rates. Negative changes occurred in the percentage of non-insulin-dependent diabetes mellitus (NIDDM) patients receiving diabetes education and frequency of office visits to the patient's primary-care physician. Changes of indeterminate value included a sharp decline in primary diabetes admissions to the hospital and a decrease in the proportion of NIDDM patients managed with insulin. Many other hoped-for changes from 1981 status, such as screening for retinopathy, foot-care practices, and overall metabolic control of diabetes, did not occur.

CONCLUSIONS
The decade of the 1980s produced modest, but not impressive, improvements in diabetes care and education at the community level. Progress must be accelerated if the diabetes-related objectives included in the national targets for health promotion and disease prevention for 2000 are to be met.
Improved Visual Evoked Potential Latencies In Poorly Controlled Diabetic Patients After Short-Term Strict Metabolic Control
Authors: Ziegler Olivier , Guerci Bruno , Algan Michel , Lonchamp Philippe , Weber Michel , Drouin Pierre 
Published: March 2007

OBJECTIVE
To determine whether short-term strict control of blood glucose can improve abnormal visual evoked potentials (VEPs) in poorly controlled diabetic patients with no overt diabetic complications.

RESEARCH DESIGN AND METHODS
VEPs (P100 wave latencies) were recorded in 12 poorly controlled diabetic patients (7 with insulin-dependent diabetes mellitus and 5 with non-insulin-dependent diabetes mellitus) before and after at least 3 days of near normoglycemia obtained by continuous subcutaneous insulin infusion (CSII). Exclusion criteria were overt diabetic neuropathy or retinopathy. The control subjects were 12 healthy subjects matched for age and sex. Fifty-two other subjects formed a reference control population. The intra-individual coefficient of variation for P100 latency was &lt; 3%.

RESULTS
The P100 latencies were longer in diabetic patients than in control subjects (means of both eyes ± SD: 116.8 ± 10.1 vs. 106.2 ± 4.5 ms, P &lt; 0.01), and 4 of the 12 diabetic patients had abnormal VEPs. After 3 days of close blood glucose control (mean blood glucose profile fell from 13.7 ± 2.2 mmol/l to 6.8 ± 1.2 mmol/l, P &lt; 0.01), the mean P100 latencies were significantly shorter (112.5 ± 7.6 ms, P &lt; 0.01) but were still significantly longer than control values. The longer the initial P100 latency, the greater the decrease after CSII. There was no correlation between the fall in blood glucose and improvement in VEPs.

CONCLUSIONS
Short-term blood glucose normalization is associated with improved P100 wave latency in uncomplicated diabetic patients. These data suggest that abnormal VEPs are partly reversible and include functional disturbances related to glucose metabolism.
Perinatal Determinants Among Children Who Later Develop IDDM
Authors: Bock Troels , Pedersen Charlotte R , Vølund Aage , Pallesen Camilla S , Buschard Karsten 
Published: March 2007

OBJECTIVE
The aim of this study was to investigate whether children who develop insulin-dependent diabetes mellitus (IDDM) differ in some aspects from a matched control group at the time of birth.

RESEARCH DESIGN AND METHODS
We studied all children who were born in Denmark during the period 1973–1977 and admitted to a Danish hospital with a diagnosis of IDDM during 1978–1989. The study was conducted by combining two nationwide registries, The National Patient Registry and The Birth Registry.

RESULTS
The criteria were fulfilled by 837 children. Data regarding the age of the parents, the number of previous pregnancies of the mother, the month of birth, and the birth weight and length of the children who developed IDDM were compared with the data of an age- and sex-matched control group of 837 children without IDDM. We did not detect any significant differences between the two groups with respect to the parameters studied.

CONCLUSIONS
No differences in perinatal determinants could be demonstrated among Danish children who develop IDDM compared with children without diabetes.
Differences in Peripheral and Autonomic Nerve Function Measurements in Painful and Painless Neuropathy: A clinical study
Authors: Veves Aristidis , Young Matthew J , Manes Christos , Boulton Andrew J M 
Published: March 2007

OBJECTIVE
To examine the differences in peripheral and autonomic nerve function measurements between diabetic patients without neuropathy (group 1, n = 38, mean age 50.9, range 29–71 years), with painless neuropathy (group 2, n = 32, mean age 49.2, range 30–71 years), and with painful neuropathy (group 3, n = 52, mean age 51.5, range 28–73 years).

RESEARCH DESIGN AND METHODS
The evaluation of neuropathy was based on clinical symptoms, signs, and quantitative sensory testing, including current perception threshold (CPT) with a neurometer and electrophysiology.

RESULTS
The Neuropathy Symptom Score and the Neuropathy Disability Score were higher in patients with painful neuropathy compared with patients with painless neuropathy (6.8 ± 2.7 vs. 0.5 ± 0.8 [mean ± SD], P &lt; 0.0001, and 12.5 ± 6.2 vs. 8.6 ± 6.8, P &lt; 0.01, respectively). In contrast, no differences were found in the quantitative sensory testing, including CPT measurements, the electrophysiological measurements, and the autonomic nerve system function tests in the two groups. Significant differences were found in all the above measurements when groups 2 and 3 were compared with diabetic patients without neuropathy (group 1). When all diabetic patients were considered as one group, significant correlations were found between CPT and the other peripheral nerve function assessments. In particular, peroneal nerve motor conduction velocity correlated with CPT at 2 kHz (r = −0.48, P &lt; 0.001) and vibration perception threshold (r = −0.50, P &lt; 0.001).

CONCLUSIONS
We conclude that no difference could be found in the function of small and large nerve fibers between painful and painless diabetic neuropathy using conventional tests currently used. The CPT evaluation failed to quantify painful symptoms, but it compared favorably with other quantitative sensory tests in quantifying peripheral neuropathy.
Prevalence of Arterial Hypertension in Diabetic Patients Before and After the JNC-V
Authors: Tarnow Lise , Rossing Peter , Gall Mari-Anne , Nielsen Flemming S , Parving Hans-Henrik 
Published: March 2007

OBJECTIVE
To compare the prevalence of arterial hypertension in patients with insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) according to blood pressure (BP) criteria from the World Health Organization (WHO) and The Fifth Report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure (JNC-V).

RESEARCH DESIGN AND METHODS
Two cohorts of Caucasian patients attending the outpatient clinic at Hvidöre Hospital were identified: 1) 957 patients with IDDM; 53% men, 40 (18–75) years of age (mean [range]); and 2) 549 patients with NIDDM; 53% men, 60 (20–76) years of age. BP was measured at least yearly, while patients rested in a sitting position, with a standard clinical sphygmomanometer. Patients were classified as hyper- or normotensive based on average BP during a 3-year follow-up period. Patients receiving antihypertensive treatment were classified as hypertensives.

RESULTS
In IDDM patients, the prevalence of arterial hypertension rose from 15 to 42% in the normoalbuminuric group, from 26 to 52% in the microalbuminuric group, and from 61 to 79% in the macroalbuminuric group when WHO and JNC-V criteria were compared. The corresponding rises in NIDDM patients were from 51 to 71% (normo-), from 73 to 90% (micro-), and from 82 to 93% (macroalbuminuria). Of the untreated hypertensive patients, 78% of IDDM patients and 50% of NIDDM patients had stage 1 (140–159/90–99 mmHg) hypertension; 20% of IDDM patients and 37% of NIDDM patients had stage 2 (160–179/100–109 mmHg) hypertension. Two out of three untreated hypertensive patients had isolated systolic hypertension.

CONCLUSIONS
The new JNC-V criteria approved by the American Diabetes Association leads to a considerable increase in the prevalence of arterial hypertension in a population of IDDM and NIDDM patients. Isolated systolic hypertension contributes importantly.
Comparison of World Health Organization and National Diabetes Data Group Procedures to Detect Abnormalities of Glucose Tolerance During Pregnancy
Authors: Pettitt David J. , Bennett Peter H. , Hanson Robert L. , Narayan K. M. Venkat , Knowler William C. 
Published: March 2007

OBJECTIVE
To compare the one-step procedure proposed by the World Health Organization (WHO) with the two-step procedure proposed by the National Diabetes Data Group (NDDG) for the identification of abnormalities of glucose tolerance during pregnancy.

RESEARCH DESIGN AND METHODS
One hundred twenty-seven non-diabetic Pima Indian women had a 75-g 2-h glucose tolerance test (WHO criteria). Those with an elevated 1-h glucose concentration (≥ 7.8 mmol/l) were referred for a 100-g 3-h glucose tolerance test (National Diabetes Data Group criteria). The effectiveness of the two test procedures was determined by comparing the frequency of macrosomia and cesarean section as outcomes of pregnancy.

RESULTS
Of 42 women with 1-h plasma glucose concentrations ≥ 7.8 mmol/l, 13 had no 100-g test, 27 had a normal test, and 2 had an abnormal test. Both women (100%) with abnormal two-step 100-g tests also had abnormal one-step 75-g tests, but only 2 of the 11 women (18%) with an abnormal one-step test had an abnormal two-step test. Sixteen of the 127 women delivered babies weighing ≥ 4,000 g. Six of these women (38%) were correctly identified as abnormal using the one-step test and one (6%) using the two-step test. Of seven women delivering by cesarean section, four (57%) had abnormal one-step tests, but none had an abnormal two-step test.

CONCLUSIONS
The one-step WHO test for glucose tolerance during pregnancy was abnormal in a greater percentage of women with adverse outcomes than the more cumbersome two-step NDDG test. The one-step test has the added advantage of being directly comparable to the standard glucose tolerance test used in nonpregnant women.
Comparison of Pharmacokinetics and Pharmacodynamics of Short- and Long-Term Glyburide Therapy in NIDDM
Authors: Jaber Linda A , Antal Edward J , Slaughter Richard L , Welshman Ian R 
Published: March 2007

OBJECTIVE
To examine the pharmacokinetics and pharmacodynamics of glyburide after single- and multiple-dose administration in patients with type II diabetes.

RESEARCH DESIGN AND METHODS
Twenty patients with type II diabetes between 40 and 70 years of age participated in the study. A 24-h pharmacokinetic evaluation including a 4-h Sustacal tolerance test was conducted before instituting glyburide therapy (baseline), after the first 2.5-mg test dose of glyburide and at weeks 6 and 12 of chronic glyburide therapy. Glyburide doses were titrated with a target goal of achieving a fasting plasma glucose of ≤ 7.8 mmol/l or to reach maximum daily doses of 20 mg.

RESULTS
A significant prolongation in the elimination half-life (t1/2: week 0, 4.0 ± 1.9 h; week 6, 13.7 ± 10.5 h; and week 12, 12.1 ± 8.2 h) and an increased volume of distribution of glyburide was observed during chronic dosing. These results strongly suggest possible drug accumulation. No differences in pharmacokinetic parameters were noted between evaluations at week 6 or week 12. Changes in pharmacodynamic response of glucose, insulin, and C-peptide to chronic glyburide therapy were observed. Glyburide therapy significantly reduced plasma glucose levels at weeks 6 and 12 (percent changes in AUC0→4. glucose from baseline: week 0, −3 ± 11%; week 6, − 29 ± 13%; and week 12, −26 ± 19%). Pancreatic insulin secretion was acutely enhanced and maintained during long-term therapy. Responsiveness to therapy as assessed by the ratio of AUC0→4.glucose:AUC0→4.C-peptide was significantly improved at all weeks compared with baseline. No pharmacodynamic response differences were observed between the week 6 and the week 12 evaluations.

CONCLUSIONS
This study demonstrates that significant differences in glyburide pharmacokinetics and pharmacodynamics exist between single-dose and steady-state conditions. These differences support the need for careful dosage titration of glyburide to achieve a desired therapeutic response in patients with type II diabetes.
Hyperproinsulinemia of Type II Diabetes Is Not Present Before the Development of Hyperglycemia
Authors: Birkeland Kåre I , Torjesen Peter A , Eriksson Johan , Vaaler Stein , Groop Leif 
Published: March 2007

OBJECTIVE
To examine proinsulin and insulin levels in first-degree relatives of patients with non-insulin-dependent diabetes mellitus (NIDDM).

RESEARCH DESIGN AND METHODS
Comparison of insulin and proinsulin responses to an oral glucose tolerance test in four groups of individuals: 1) 31 patients with newly diagnosed NIDDM treated with diet alone, 2) 34 first-degree relatives of NIDDM patients with impaired glucose tolerance (IGT), 3) 26 relatives with normal glucose tolerance (NGT), and 4) 30 subjects without a family history of diabetes.

RESULTS
Both fasting and post-glucose levels of proinsulin were elevated in patients with diabetes, but not in the relatives with IGT or NGT. Levels of true insulin were highest in the diabetic group, followed by the subjects with IGT, and were lowest among relatives with NGT. Proinsulin levels correlated with glucose levels, suggesting that hyperglycemia is the main stimulus for increased proinsulin secretion.

CONCLUSIONS
First-degree relatives of NIDDM patients, who have a high risk of developing diabetes, do not exhibit elevated levels of fasting or glucose-stimulated proinsulin as long as their fasting glucose levels remain normal.
Impaired Glucose Tolerance and NIDDM: Does a Lifestyle Intervention Program Have an Effect?
Authors: Bourn Diane M , Mann Jim I , McSkimming Barbara J , Waldron Margaret A , Wishart Janet D 
Published: March 2007

OBJECTIVE
To determine whether a 2-year lifestyle intervention program improves glucose tolerance and lipid levels in people with persistent impaired glucose tolerance (IGT) or non-insulin-dependent diabetes mellitus (NIDDM).

RESEARCH DESIGN AND METHODS
Screening for IGT and NIDDM was carried out in 1,752 people. Subjects with persistent IGT or NIDDM completed three 2-h oral glucose tolerance tests (OGTTs) before the start of the study and after 2 years. A single OGTT was carried out every 3 months. A 4-day food diary and a 7-day exercise diary were completed, and weight, blood pressure, glycated hemoglobin (HbA1), plasma lipids, and fasting and 2-h serum insulin were measured at baseline and every 3 months. Subjects were encouraged to make dietary changes and increase exercise.

RESULTS
Thirty-two subjects with persistent IGT and 20 subjects with NIDDM were recruited. Women reported significant decreases in total and saturated fat and an increase in carbohydrate, but few subjects reached the recommended intakes. Men achieved smaller dietary changes. There were significant decreases in body mass index, fasting and 2-h plasma glucose, HbA1, total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels in both the IGT and NIDDM groups during the study.

CONCLUSIONS
Results suggest that a diet and exercise program can result in significant improvements in a range of clinical and metabolic variables in some people with IGT or NIDDM, although the absence of a control group precludes firm conclusions. Screening for IGT in those at high risk for developing NIDDM and offering those with persistent IGT a lifestyle intervention program could help reduce the progression of IGT to NIDDM.
Prevalence of Adult-Onset IDDM in the U.S. Population
Authors: Harris Maureen I , Robbins David C 
Published: March 2007

OBJECTIVE
To investigate the prevalence of adult-onset insulin-dependent diabetes mellitus (IDDM) in a nationally representative sample of adults 30–74 years of age. Although it is a widely held belief that onset of IDDM in adults is rare, there are few objective data to support this. Adult-onset IDDM may represent a disease that is biologically distinct from youth-onset IDDM, and it would be important to distinguish these two entities.

RESEARCH DESIGN AND METHODS
The Second National Health and Nutrition Examination Survey (NHANES II) contained a national probability sample of 12,102 subjects 30–74 years of age in the U.S. population. All subjects with diabetes diagnosed by a physician before the survey were identified. Cases of IDDM defined by age at diagnosis ≥ 30 years, continuous or nearly continuous insulin treatment since diagnosis of diabetes, and relative body weight ≤ 125 were classified as adult-onset IDDM.

RESULTS
Subjects with adult-onset IDDM represented 0.30% of the U.S. population 30–74 years of age and 7.4% of all diabetic patients diagnosed at 30–74 years of age.

CONCLUSIONS
These data indicate that onset of IDDM in adults is uncommon. Given the limitations of the survey instrument, subclinical or slowly progressive IDDM (as distinguished from non-insulin-dependent diabetes mellitus with progressive loss of β-cell function) would not have been detected, and these would constitute additional cases of adult-onset IDDM. However, the data suggest that a very large population base would be required to identify sufficient numbers of adult-onset IDDM cases for study of the etiology and pathogenesis of this disease.