bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes and Pregnancy: Factors associated with seeking pre-conception care
Authors: Janz Nancy K , Herman William H , Becker Mark P , Charron-Prochownik Denise , Shayna Viktoria L , Lesnick Timothy G , Jacober Scott J , Fachnie J David , Kruger Davida F , Sanfield Jeffrey A , Rosenblatt Solomon I , Lorenz Robert P 
Published: March 2007

OBJECTIVE
To define sociodemographic characteristics, medical factors, knowledge, attitudes, and health-related behaviors that distinguish women with established diabetes who seek pre-conception care from those who seek care only after conception.

RESEARCH DESIGN AND METHODS
A multicenter, case-control study of women with established diabetes making their first pre-conception visit (n = 57) or first prenatal visit without having received pre-conception care (n = 97).

RESULTS
Pre-conception subjects were significantly more likely to be married (93 vs. 51%), living with their partners (93 vs. 60%), and employed (78 vs. 41%); to have higher levels of education (73% beyond high school vs. 41%) and income (86% &gt; $20,000 vs. 60%); and to have insulin-dependent diabetes mellims (IDDM) (93 vs. 81%). Pre-conception subjects with IDDM were more likely to have discussed preconception care with their health care providers (98 vs. 51%) and to have been encouraged to get it (77 vs. 43%). In the prenatal group, only 24% of pregnancies were planned. Pre-conception patients were more knowledgeable about diabetes, perceived greater benefits of pre-conception care, and received more instrumental support.

CONCLUSIONS
Only about one-third of women with established diabetes receive pre-conception care. Interventions must address prevention of unintended pregnancy. Providers must regard every visit with a diabetic woman as a pre-conception visit. Contraception must be explicitly discussed, and pregnancies should be planned. In counseling, the benefits of pre-conception care should be stressed and the support of families and friends should be elicited.
Effects of Personality on Metabolic Control in IDDM Patients
Authors: Orlandini Alvise , Pastore Matteo R , Fossati Andrea , Clerici Stefano , Sergi Alessandro , Balini Annalisa , Parlangeli Maria A , Maffei Cesare , Secchi Antonio , Pozza Guido 
Published: March 2007

OBJECTIVE
The aim of this study was to evaluate the relationship between poor metabolic control and maladaptive personality traits (according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised) in an adult-onset insulin-dependent diabetes mellitus sample group (n = 77).

RESEARCH DESIGN AND METHODS
Metabolic control was evaluated through glycosylated hemoglobin (HbA1c). Personality traits were assessed with the Personality Diagnostic Questionnaire-Revised, a self-administered questionnaire. Residual pancreatic secretion (fasting serum C-peptide) was also evaluated.

RESULTS
Principal components analysis revealed three personality profiles: “withdrawn-suspicious” (P1), “dramatic-dependent” (P2), and “aggressive-irresponsible” (P3). Multiple linear regression analysis showed that C-peptide levels and P2 personality profiles were significant and independent predictors of HbA1c plasma levels: P2 predicted high HbA1c values and C-peptide predicted low HbA1c levels.

CONCLUSIONS
These data suggest that a P2 personality profile is a significant predictor of poor metabolic control.
Sex Differences in Insulin Levels in Older Adults and the Effect of Body Size, Estrogen Replacement Therapy, and Glucose Tolerance Status: The Rancho Bernardo Study, 1984–1987
Authors: Ferrara Assiamira , Barrett-Connor Elizabeth , Wingard Deborah L , Edelstein Sharon L 
Published: March 2007

OBJECTIVE
To determine if insulin levels vary with sex, independent of estrogen replacement therapy (ERT), differences in body mass index (BM1), waist-to-hip ratio (WHR), and glycernia.

RESEARCH DESIGN AND METHODS
In a population-based study of older adults, insulin levels were measured before and after a standardized oral glucose tolerance test in 673 men and 849 women, all free of known diabetes.

RESULTS
Age-adjusted fasting insulin levels were highest in men, intermediate in women not taking estrogen, and lowest in estrogen-treated women (P &lt; 0.01). Differences between men and women not taking estrogen disappeared after adjusting for age and BMI, but not glycemia; estrogen-treated women had significantly lower fasting insulin levels than did men (P &lt; 0.01) and women not taking estrogen (P &lt; 0.01). The association of estrogen use with lower fasting insulin levels persisted after adjusting for age and WHR (P &lt; 0.001) and was stronger among women with abnormal glucose tolerance. Age-adjusted postchallenge insulin levels were higher in women than in men (P &lt; 0.01). The sex difference persisted after adjusting for age and BMI or glycemia. Postchallenge insulin levels did not vary by ERT.

CONCLUSIONS
Men have higher fasting insulin levels than do women, whether or not the women are using ERT. Differences between men and untreated women are explained by differences in BMI, but estrogen users have lower fasting insulin levels independent of BMI. Postchallenge insulin levels are higher in women than men and are independent of ERT, BMI, and glycemia. Clinical trials in women are needed to determine whether ERT can improve insulin and glucose metabolism.
Circulating Endothelin-1 Levels Increase During Euglycemic, Hyperinsulinemic Clamp in Lean NIDDM Men
Authors: Ferri Claudio , Carlomagno Antonio , Coassin Simonetta , Baldoncini Roberta , Faldetta Maria R Cassone , Laurenti Oriana , Properzi Giuliana , Santucci Anna , Mattia Giancarlo De 
Published: March 2007

OBJECTIVE
To evaluate whether or not insulin stimulates endothelin (ET)-l secretion in vivo.

RESEARCH DESIGN AND METHODS
Plasma ET-1 levels were evaluated in 16 lean normotensive men with non-insulin-dependent diabetes mellitus (NIDDM) (mean age 50.3 ±4.1 years) during either a 2-h euglycemic hyperinsulinemic clamp (40 mU insulin · m−2 · min−1) or placebo infusion (50 ml isotonic saline) according to a single-blind randomized crossover protocol.

RESULTS
Circulating ET-1 levels increased during the euglycemic hyperinsulinemic clamp (from 0.88 ± 0.38 pg/ml at time 0 to 1.66 ± 0.22 pg/ml and 1.89 ± 0.99 pg/ml at 60 and 120 min, respectively [P &lt; 0.05 vs. time 0]) and returned to baseline levels after the discontinuation of insulin infusion (0.71 ± 0.22 pg/ml after a 30-min period of recovery [NS]). Compared with placebo, the euglycemic hyperinsulinemic clamp induced a significant increase in plasma ET-1 levels at 60 min (P &lt; 0.0001) and 120 min (P &lt; 0.0001). Changes in basal insulin levels and corresponding changes in circulating ET-1 levels after a 2-h euglycemic hyperinsulinemic clamp were significantly correlated (r = 0.771, P &lt; 0.0001). A possible unfavorable effect of ET-1 on the tissue sensitivity to insulin-stimulated glucose uptake was suggested by the presence of a negative correlation between total glucose uptake and baseline ET-1 levels (r = –0.498, P &lt; 0.05).

CONCLUSIONS
Our findings indicate that circulating ET-1 levels significantly increase during euglycemic hyperinsulinemic clamp in men with NIDDM. The negative correlation between total glucose uptake and circulating ET-1 levels suggests that the peptide might exert negative effects on the insulin sensitivity of target tissues. The consequent increase in insulin secretion as well as the insulin-related ET-1 release from endothelial cells could favor the development of diabetes-related vascular lesions.
Relation of Steroid Hormones to Glucose Tolerance and Plasma Insulin Levels in Men: Importance of visceral adipose tissue
Authors: Tchernof André , Després Jean-Pierre , Dupont André , Bélanger Alain , Nadeau André , Prud'homme Denis , Moorjani Sital , Lupien Paul J , Labrie Fernand 
Published: March 2007

OBJECTIVE
Low plasma testosterone levels are associated with hyperinsulinemia and glucose intolerance in men. However, it is unclear whether these abnormalities are related to the concomitant alteration in regional adipose tissue (AT) accumulation associated with reduced androgen levels.

RESEARCH DESIGN AND METHODS
We measured plasma steroid levels in a sample of 79 men, ranging from lean to obese (aged 29–42 years), for whom an oral glucose tolerance test (OGTT), anthropometrie and computed tomography (CT) measurements of body fatness, and AT distribution were performed. Sex hormone binding globulin (SHBG) and the following steroids were measured after extraction from plasma and chromatography: dehydro-epiandrosterone, androstenedione, androst–5–ene–3β,17β–diol, testosterone, estrone, and estradiol (E2).

RESULTS
Several significant negative correlations were found between adrenal C19 steroid precursors, testosterone, SHBG, and fasting insulin levels, as well as between plasma glucose and insulin concentrations measured during the OGTT (−0.25 ≤ r ≤ −0.35, 0.05 ≥ P ≥ 0.001). The best steroid correlate of plasma glucose and insulin homeostasis indexes was the E2: testosterone ratio (0.34 ≤ r ≤ 0.42,0.005 ≥ P ≥ 0.001). However, after correction of steroid levels for either fat mass, body mass index (BMI), or visceral AT area, as measured by CT, no significant residual associations were noted between testosterone, adrenal C19 steroid, SHBG, and estrogen levels and indexes of plasma glucose-insulin homeostasis, although the positive association between the E2:testosterone ratio and glucose area remained significant after adjustment for total body fat mass and BMI. Furthermore, 15 pairs of obese subjects, matched for visceral AT area, showing either low or high levels of the steroids studied, did not differ in fasting insulin and postglucose plasma insulin levels or in glucose tolerance.

CONCLUSIONS
These results suggest that the previously reported relationships between androgen levels and indexes of plasma glucose-insulin homeostasis are mediated, to a large extent, by concomitant alterations in levels of total body fat and visceral AT in men.
Catheter Complications Associated With Implantable Systems for Peritoneal Insulin Delivery: An analysis of frequency, predisposing factors, and obstructing materials
Authors: Renard Eric , Baldet Pierre , Picot Marie-Christine , Jacques-Apostol Dominique , Lauton Dominique , Costalat Guy , Bringer Jacques , Jaffiol Claude 
Published: March 2007

OBJECTIVE
To evaluate catheter survival and identify mechanisms involved in catheter obstructions during a 109.8 patient-year experience with implanted pumps for peritoneal insulin delivery.

RESEARCH DESIGN AND METHODS
Fifty-one type I diabetic patients were recruited in feasibility studies of two models of implanted systems for peritoneal insulin delivery. Both systems had a silicone–coated polyethylene catheter and infused Hoechst 21 PH neutral insulin (U400 or U100). Catheter obstruction was suspected each time the increase of insulin flow rate over 50% of usual need was insufficient to correct an impairment of glycemie control in the absence of intercurrent factors. A laparoscopie examination was then systematically performed under general anesthesia. The disclosed material occluding the catheter was submitted to a pathological analysis. By actuarial analysis, we examined the estimated effects of the potential determinants of the catheters' durations of proper operation on catheter survival.

RESULTS
Over an implantation duration of 25.8 ± 14.0 months (mean ± SD), 34 catheter obstructions were diagnosed in 24 patients, resulting in an incidence of 31 events per 100 patient–years. Fifty percent survival rate of the first implanted catheter was 27 months (95% confidence interval [CI]: 19–32) on actuarial analysis. Six catheters were cleared under laparos–copy and 24 were replaced, while 2 systems were definitively explan ted and 2 combined replacements of pump and catheter were performed because of an associated pump slowdown. In five cases, an alkaline rinse procedure of the pump was necessary after catheter replacement to restore usual insulin needs, suggesting an associated insulin aggregation in the pump. Twenty obstructions were due to a fibrin clot at the catheter tip, and 14 obstructions were created by a tissue encapsulation around the catheter. A previous experience of peritoneal insulin infusion from portable pumps or a longer duration of diabetes (&gt;21 years) both appeared as conditions significantly reducing the time of a catheter's proper operation (P &lt; 0.01 and P &lt; 0.05, respectively) either by tip obstructions or by encapsulations. Pathological analysis of catheter encapsulations showed a collagen fibrosis in all studied patients (n = 11), which was associated with a lymphocytic infiltrate in five patients and also with anti-insulin immunoreactive amyloid deposits in four patients. Catheter tip clots were composed of fibrinlike material, nonreactive to anti-insulin antibodies.

CONCLUSIONS
Catheter obstruction is a frequent adverse technical event occurring with implanted insulin pumps. Progress is expected in the biocompatibility of catheter material
Comparison of Body Size Measurements as Predictors of NIDDM in Pima Indians
Authors: Warne Donald K , Charles M Aline , Hanson Robert L , Jacobsson Lennart T H , McCance David R , Knowler William C , Pettitt David J 
Published: March 2007

OBJECTIVE
To determine and compare the abilities of various anthropometric measurements to predict the development of non-insulin-dependent diabetes mellitus (NIDDM) in Pima Indian men and women.

RESEARCH DESIGN AND METHODS
A total of 290 male and 443 female Pima Indians were followed for up to 6 years for the development of NIDDM. A proportional hazards analysis was used to assess the ability of anthropometric measurements evaluated at baseline to predict NIDDM. Receiver operating characteristic (ROC) curves were used to compare individual variables in predicting NIDDM.

RESULTS
In separate models controlled for age and sex, body mass index (BMI), waist circumference, thigh circumference, waist-to-thigh ratio (WTR), weight, and percentage body fat (PBF) estimated by bioelectric resistance each predicted NIDDM, which developed in 30 men and 52 women. The highest incidence rate ratios (IRRs; for 1 SD of a variable) were for WTR in men and for PBF in women, although the confidence interval (CI) for PBF was wide. In stepwise analyses, WTR was the most significant predictor in men (IRR for 1 SD = 1.58, 95% CI = 1.20–2.07), and BMI was the most significant predictor in women (IRR for 1 SD = 1.65, 95% CI = 1.29–2.11). However, by ROC analyses, thigh circumference was the only variable significantly worse than WTR in men or BMI in women at predicting NIDDM.

CONCLUSIONS
Measurements such as waist circumference, WTR, weight, and BMI may be useful as more complicated measurements, such as PBF by bioelectrical resistance, for identifying groups of individuals whose body habitus places them at high risk of developing NIDDM.
Kinetics of HbA1c, Glycated Albumin, and Fructosamine and Analysis of Their Weight Functions Against Preceding Plasma Glucose Level
Authors: Tahara Yasuhiro , Shima Kenji 
Published: March 2007

OBJECTIVE
To examine the kinetics of HbA1c, glycated albumin (GA), and fructosamine (FA) levels in response to plasma glucose change and their relationship with the preceding plasma glucose level.

RESEARCH DESIGN AND METHODS
The time courses of HbA1c, GA, and FA after acute glycemic normalization were observed in nine patients with newly diagnosed non-insulin-dependent diabetes mellitus and compared with theoretical ones. Their weight functions against preceding plasma glucose level were analyzed assuming a stepwise plasma glucose change and compared with the theoretical prediction.

RESULTS
The fasting plasma glucose level was acutely normalized after admission with a half-time of 6.3 ± 2.4 days (mean ± SD). The HbA1c level decreased linearly during the initial 2 months with a half-time of 34.6 ± 10.1 days, followed by a gradual decrease thereafter. GA and FA levels decreased very rapidly during the initial 2–3 weeks with half-times of 17.1 ± 2.8 and 12.2 ± 4.8 days, respectively, followed by a gradual decrease thereafter. The time courses of HbA1c, GA, and FA agreed well with theoretically estimated decay curves. Experimental values of weight functions against the preceding plasma glucose level agreed well with the theoretical prediction. The weight functions for glycated proteins had maximum values on the days just before the measurement of glycated proteins and gradually decreased with an increasing time interval. The lengths of the periods over which the weight functions for HbA1c, GA, and FA extend back were estimated to be roughly 100, 40, and 30 days, respectively.

CONCLUSIONS
The levels of HbA1c, GA, and FA do not reflect the simple mean but reflect the weighted mean of the preceding plasma glucose level over a considerably longer period than was previously speculated.
Sex Difference in Lifestyle Factors Predictive of Diabetes in Mexican-Americans
Authors: Monterrosa Ana E , Haffner Steven M , Stern Michael P , Hazuda Helen P 
Published: March 2007

OBJECTIVE
Little is known about the role of lifestyle factors in non-insulin-dependent diabetes mellitus (NIDDM) incidence among Mexican-Americans. Therefore, we examined whether baseline lifestyle factors predictive of 8-year NIDDM incidence differ in Mexican-American men and women.

RESEARCH DESIGN AND METHODS
We studied 353 Mexican-American men and 491 Mexican-American women free of diabetes at baseline who participated in the San Antonio Heart Study follow-up. Lifestyle factors examined were body mass index (BMI), energy intake (total calories/kg), grams of alcohol consumed per week, efforts to control weight by dieting and exercise, leisure physical activity, sugar avoidance, saturated fat/cholesterol avoidance, and 24-h dietary recall assessment of total calories and percentage of calories from total carbohydrate, sucrose, and starch and from total, saturated, monounsaturated, and polyunsaturated fat. Incidence of NIDDM was regressed on lifestyle factors separately for men and women using a backward elimination procedure.

RESULTS
Lifestyle factors significantly associated with NIDDM incidence differed for the two sexes. In men, leisure physical activity, was inversely associated and alcohol consumption, weight control by dieting, and BMI were positively associated with NIDDM. In women, BMI was positively associated with NIDDM and was the strongest lifestyle predictor. Sugar avoidance and leisure physical activity were also associated with increased NIDDM risk, while weight control by dieting was associated with decreased NIDDM risk. Saturated fat/cholesterol avoidance, grams of alcohol consumed per week, and energy intake were also negatively and indirectly associated with NIDDM in women by means of their direct effects on BMI.

CONCLUSIONS
It may be important to tailor interventions designed to prevent NIDDM in Mexican-Americans to address sex differences in lifestyle precursors of this disease.
High Risk of IDDM in African-American and Hispanic Children in Chicago, 1985–1990
Authors: Lipton Rebecca B , Fivecoate Julie A 
Published: March 2007

OBJECTIVE
To determine the incidence of insulin-dependent diabetes mellitus (IDDM) among African-American and Hispanic children &lt;18 years of age in the city of Chicago. These minority communities are large and heterogeneous with respect to socioeconomic status, length of time since migration, and place of origin, so that correlates of IDDM risk can be examined with precision.

RESEARCH DESIGN AND METHODS
Cases occurring during the years 1985–1990 were drawn from records at 37 hospitals in Cook County. African-American and Hispanic patients using insulin, residing within the city limits, and &lt;18 years old at onset were included. Three secondary sources of cases were used: medical records of clinics associated with the Chicago Department of Health, a survey of unaffiliated neighborhood clinics, and lists of children attending diabetes camps. Overall ascertainment was estimated at 86%.

RESULTS
There were 413 new cases during this 6-year interval. The average incidence of IDDM was 12.0/100,000 annually among African-American males, 12.1 among African-American females, 9.1 among Hispanic males, and 10.2 among Hispanic females. Mean age at onset was 11.1, 11.0, 10.7, and 10.1 years for African-American males, African-American females, Hispanic males, and Hispanic females, respectively. Fewer cases occurred during the summer months. Diabetes among the first-degree relatives of children from both ethnic groups was commonly noted on the medical charts.

CONCLUSIONS
The incidence rates in Chicago fall near the upper limits of reports for both African-origin and Hispanic populations worldwide. The relatively early age at onset may point to an environmental factor associated with this high incidence of the disease. Further studies will provide valuable data on comorbid conditions, unusual diabetic syndromes, and family dynamics in childhood chronic disease.
Diabetes in Urban African-Americans. I. Cessation of Insulin Therapy Is the Major Precipitating Cause of Diabetic Ketoacidosis
Authors: Musey Victoria C , Lee Jenny K , Crawford Rochanda , Klatka Morel Ann , McAdams Debra , Phillips Lawrence S 
Published: March 2007

OBJECTIVE
To identify the causes of diabetic ketoacidosis (DKA) in a large urban hospital.

RESEARCH DESIGN AND METHODS
Consecutive patients admitted during a 3-month period with a primary diagnosis of DKA and who had moderate-to-severe illness as shown by serum glucose &gt;13.9 mmol/l (&gt;250 mg/dl), bicarbonate &lt;15 mmol/l, and pH &lt;7.35 were studied. Diabetes nurse educators interviewed patients and reviewed their medical records for the following: precipitating causes of DKA; content of previous diabetes education; frequency of blood glucose monitoring; recognition of symptoms of metabolic decompensation; and types of medical assistance obtained once patients were ill.

RESULTS
There were 56 episodes of DKA, and 75% of the episodes were in patients with known diabetes. In the known diabetic patients, the most common cause of DKA was stopping insulin therapy, which occurred in 67% of episodes. Half of the patients (50%) stopped insulin because of reported lack of money to buy insulin from an outside pharmacy or get transportation to the hospital; 21% stopped insulin because of lack of appetite; 14% stopped insulin because of behavioral or psychological reasons; and 14% did so because they did not know how to manage diabetes on sick days. Of the known diabetic patients, &gt;80% recalled having been instructed as to blood glucose testing and acute and chronic complications, but fewer patients recalled having been instructed as to insulin dose adjustment (28%) or sick day management (35%). Symptoms of decompensated diabetes were recognized in 55% of the 42 episodes of DKA in patients with known diabetes. However, only 5% of patients contacted the Diabetes Unit when they became ill; the majority (95%) went directly to the emergency room.

CONCLUSIONS
DKA occurred most often in patients with known diabetes who stopped insulin therapy because of reported lack of money for purchasing insulin or for transportation to the hospital and limited self-care skills in diabetes management. In urban African-American populations, up to two-thirds of the episodes of DKA may be preventable by improving patient education and access to care.