bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment Satisfaction and Quality of Life With Insulin Glargine Plus Insulin Lispro Compared With NPH Insulin Plus Unmodified Human Insulin in Individuals With Type 1 Diabetes
Authors: Ashwell Simon G. , Bradley Clare , Stephens James W. , Witthaus Elke , Home Philip D. 
Published: May 2008

OBJECTIVE—The purpose of this study was to compare quality of life (QoL) and treatment satisfaction using insulin glargine plus insulin lispro with that using NPH insulin plus unmodified human insulin in adults with type 1 diabetes managed with multiple injection regimens.
RESEARCH DESIGN AND METHODS—As part of a 32-week, five-center, two-way crossover study in 56 individuals with type 1 diabetes randomized to evening insulin glargine plus mealtime insulin lispro or to NPH insulin (once or twice daily) plus mealtime unmodified human insulin, the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the Audit of Diabetes Dependent Quality of Life questionnaire were completed at baseline and at weeks 16 and 32, with additional interim DTSQ measurements.
RESULTS—For all patients combined, the mean baseline present QoL score was 1.3, reflecting “good” QoL. Present QoL improved with glargine + lispro but did not change with NPH + human insulin (1.6 ± 0.1 [mean ± SEM] vs. 1.3 ± 0.1, difference 0.3 [95% CI 0.1–0.6]; P = 0.014). Baseline mean average weighted impact score (AWI) of diabetes on QoL was −1.8, indicating a negative impact of diabetes on QoL. The AWI score at end point improved significantly with glargine + lispro but changed little with NPH + human insulin (−1.4 ± 0.1 vs. −1.7 ± 0.1, 0.3 [0.0–0.6]; P = 0.033). Treatment satisfaction (DTSQ 36-0 scale score) at end point was markedly greater with glargine plus lispro compared with that for NPH plus human insulin (32.2 ± 3.4 vs. 23.9 ± 7.2, 8.6 [6.5–10.6]; P &lt; 0.001).
CONCLUSIONS—Insulin glargine plus insulin lispro improves treatment satisfaction, reduces the negative impact of diabetes on QoL, and improves QoL in comparison with NPH insulin plus unmodified human insulin in type 1 diabetes.
Diabetic Retinopathy: More Patients, Less Laser
Authors: Vallance James H. , Wilson Peter J. , Leese Graham P. , McAlpine Ritchie , MacEwen Caroline J. , Ellis John D. 
Published: May 2008

OBJECTIVE—We aim to correlate the incidence of diabetic retinopathy and maculopathy requiring laser treatment with the control of risk factors in the diabetic population of Tayside, Scotland, for the years 2001–2006.
RESEARCH DESIGN AND METHODS—Retinal laser treatment, retinal screening, and diabetes care databases were linked for calendar years 2001–2006. Primary end points were the numbers of patients undergoing first or any laser treatment for diabetic retinopathy or maculopathy. Mean A1C and blood pressure and retinal screening rates were followed over the study period.
RESULTS—Over 6 years, the number of patients with diabetes in Tayside increased from 9,694 to 15,207 (57% increase). The number of patients receiving laser treatment decreased from 222 to 138 and first laser treatments decreased from 100 (1.03% of diabetic population) to 56 (0.37%). The number of patients with type 2 diabetes treated for maculopathy decreased from 180 in 2001 to 103 in 2006 (43% reduction, P = 0.03). Mean A1C decreased for type 1 and type 2 diabetic populations (P &lt; 0.01) and a reduction in blood pressure was observed in type 2 diabetic patients (P &lt; 0.01). The number of patients attending annual digital photographic retinopathy screening increased from 3,012 to 11,932.
CONCLUSIONS—Laser treatment for diabetic maculopathy in type 2 diabetic patients has decreased in Tayside over a six-year period, despite an increased prevalence of diabetes and increased screening effort. We propose that earlier identification of type 2 diabetes and improved risk factor control has reduced the incidence of maculopathy severe enough to require laser treatment.
HLA Class II Alleles Specify Phenotypes of Ketosis-Prone Diabetes
Authors: Nalini Ramaswami , Gaur Lakshmi K. , Maldonado Mario , Hampe Christiane S. , Rodriguez Lucille , Garza Gilberto , Lernmark Ake , Balasubramanyam Ashok 
Published: May 2008

OBJECTIVE—Ketosis-prone diabetes (KPD) comprises four subgroups based on the presence or absence of β-cell autoantibodies (A+ or A−) and β-cell functional reserve (β+ or β−). Genetic factors could contribute to their distinctive phenotypes. Our aim was to specify the role of HLA class II alleles associated with susceptibility or resistance to autoimmune type 1 diabetes in determining KPD phenotypes.
RESEARCH DESIGN AND METHODS—A total of 185 adults presenting with diabetic ketoacidosis were followed longitudinally for a mean of 5.5 years, with measurements of autoantibodies, β-cell functional reserve, insulin sensitivity, and insulin requirement. Frequencies of susceptibility and resistance alleles at HLA DQA1, DQB1, and DRB1 loci were correlated with clinical and phenotypic features of KPD subgroups and compared with those of ethnic-specific population control subjects.
RESULTS—Susceptibility alleles were more frequent (P &lt; 0.0001) in the two A+ than the two A− KPD subgroups; in the latter, the frequency was no greater than in population control subjects (except for DQB1*0302). Susceptibility alleles differentiated the two clinically similar β− subgroups (more frequent in A+β− than A−β− KPD; P &lt; 0.01). Resistance alleles were more frequent in the two β+ than the two β− KPD subgroups (P &lt; 0.01). The frequencies of certain susceptibility (e.g., DQB1*02) and resistance (DQB1*0602) alleles were higher in African-American A−β+ KPD patients than in African-American control subjects. DQB1*0302 was more frequent in all KPD subgroups compared with control subjects.
CONCLUSIONS—HLA class II alleles associated with susceptibility or resistance to autoimmune type 1 diabetes help specify the four subgroups of KPD. Inheritance of these alleles may influence long-term β-cell functional reserve.
Altered Neuroendocrine Sleep Architecture in Patients With Type 1 Diabetes
Authors: Jauch-Chara Kamila , Schmid Sebastian M. , Hallschmid Manfred , Born Jan , Schultes Bernd 
Published: May 2008

OBJECTIVE—The modulatory influence of nocturnal sleep on neuroendocrine secretory activity is increasingly recognized as a factor critical to health. Disturbances of sleep may arise from and contribute to the disease process in chronically ill patients with type 1 diabetes.
RESEARCH DESIGN AND METHODS—Using standard polysomnography and repetitive blood sampling, neuroendocrine sleep architecture was assessed under well-controlled nonhypoglycemic conditions in 14 type 1 diabetic patients and 14 healthy control subjects matched for age, sex, and BMI.
RESULTS—As expected, plasma glucose (P = 0.02) and serum insulin (P &lt; 0.001) levels were constantly higher in type 1 diabetic patients than in healthy subjects throughout the night. Beside these characteristic alterations of glucose metabolism, type 1 diabetic patients displayed higher blood levels of growth hormone (P = 0.001) and epinephrine (P = 0.02) during the entire night and higher levels of ACTH (P = 0.01) as well as a tendency toward higher cortisol levels (P = 0.072) during the first night-half, compared with healthy control subjects. Patients spent slightly less time in slow wave sleep (P = 0.09) during the first night-half (where this sleep stage predominates), and overall exhibited an increased proportion of stage 2 sleep (P = 0.01). Correspondingly, assessment of mood and symptoms after sleep revealed that subjective sleep was less restorative in type 1 diabetic patients than in healthy subjects.
CONCLUSIONS—Our data indicate distinct alterations in the neuroendocrine sleep architecture of patients with type 1 diabetes, which add to the generally adverse impact of the disease on the patients’ health.
Markedly Blunted Metabolic Effects of Fructose in Healthy Young Female Subjects Compared With Male Subjects
Authors: Couchepin Caroline , Lê Kim-Anne , Bortolotti Murielle , da Encarnaçao Joana Amarante , Oboni Jean-Baptiste , Tran Christel , Schneiter Philippe , Tappy Luc 
Published: May 2008

OBJECTIVE—To compare the metabolic effects of fructose in healthy male and female subjects.
RESEARCH DESIGN AND METHODS—Fasting metabolic profile and hepatic insulin sensitivity were assessed by means of a hyperglycemic clamp in 16 healthy young male and female subjects after a 6-day fructose overfeeding.
RESULTS—Fructose overfeeding increased fasting triglyceride concentrations by 71 vs. 16% in male vs. female subjects, respectively (P &lt; 0.05). Endogenous glucose production was increased by 12%, alanine aminotransferase concentration was increased by 38%, and fasting insulin concentrations were increased by 14% after fructose overfeeding in male subjects (all P &lt; 0.05) but were not significantly altered in female subjects. Fasting plasma free fatty acids and lipid oxidation were inhibited by fructose in male but not in female subjects.
CONCLUSIONS—Short-term fructose overfeeding produces hypertriglyceridemia and hepatic insulin resistance in men, but these effects are markedly blunted in healthy young women.
Proliferation of Colo-357 Pancreatic Carcinoma Cells and Survival of Patients With Pancreatic Carcinoma Are Not Altered by Insulin Glargine
Authors: Erbel Saskia , Reers Christina , Eckstein Volker W. , Kleeff Jörg , Büchler Markus W. , Nawroth Peter P. , Ritzel Robert A. 
Published: May 2008

OBJECTIVE—It was reported that the long-acting insulin analogue glargine induces cell proliferation in a human osteosarcoma cell line and therefore might induce or accelerate tumor growth. Induction of cell proliferation would be particularly relevant for insulin treatment of subjects with diabetes and the potential of bearing tumor cells (e.g., a history of a malignant disease).
RESEARCH DESIGN AND METHODS—Proliferation, apoptosis, and the expression levels of insulin receptor, IGF-I receptor, and insulin receptor substrate (IRS) 2 were analyzed in human pancreatic cancer cells (Colo-357) after incubation (72 h) with insulin glargine or regular human insulin at 0–100 nmol/l. A total of 125 subjects, after partial or total pancreatectomy due to pancreatic carcinoma, were analyzed over a median follow-up period of 22 months.
RESULTS—There was no significant difference between glargine and regular human insulin with respect to regulation of proliferation and apoptosis of Colo-357 cells. The expression levels of insulin receptor, IGF-I receptor, and IRS2 as a downstream molecule of both receptor signaling pathways were not altered at any concentration tested. The insulin receptor was downregulated to a similar degree by glargine and regular human insulin at high insulin concentrations (P &lt; 0.0001 for glargine, P = 0.002 for regular human insulin). The median survival time after pancreatic surgery was 15 months. Survival analysis showed that the time-dependent proportion of patients who survived was identical in patients receiving insulin glargine versus insulin treatment without glargine and control subjects without diabetes after surgery (P = 0.4, three-sample comparison).
CONCLUSIONS—Regular human insulin and insulin glargine may be used to treat diabetes in patients with pancreatic cancer.
Glucose Intolerance and Diabetes Are Observed in the Long-Term Follow-Up of Nonpancreatectomized Patients With Persistent Hyperinsulinemic Hypoglycemia of Infancy Due to Mutations in the ABCC8 Gene
Authors: Gussinyer Miquel , Clemente María , Cebrián Rocio , Yeste Diego , Albisu Marian , Carrascosa Antonio 
Published: May 2008

OBJECTIVE—To report the long-term follow-up of three nonpancreatectomized patients with persistent hyperinsulinemic hypoglycemia of infancy due to mutations in the ABCC8 gene.
RESEARCH DESIGN AND METHODS—Oral glucose tolerance test (OGTT) and venous 24-h glucose-insulin profile were performed yearly from adolescence.
RESULTS—Patient 1 (now aged 31 years) developed insulin-dependent diabetes at the age of 25 years. In patient 2 (now aged 17 years), impaired fasting glucose and a diabetic OGTT response with normal A1C values have been observed since the age of 10 years. In patient 3 (now aged 24 years), intolerant OGTT response and hyperglycemic episodes with normal A1C have been observed since the age of 16 years. All patients presented relatively low insulin levels during hyperglycemia, normal BMI, and negative autoantibodies (GAD antibody, insulinoma-associated protein 2, and islet cell antibody).
CONCLUSIONS—Development of glucose metabolism impairment ranging from glucose intolerance to insulin-dependent diabetes is observed in the evolution of these patients.
German Diabetes Disease Management Programs Are Appropriate for Restructuring Care According to the Chronic Care Model
Authors: Szecsenyi Joachim , Rosemann Thomas , Joos Stefanie , Peters-Klimm Frank , Miksch Antje 
Published: May 2008

OBJECTIVE—With the introduction of diabetes disease management programs (DMPs) in Germany, there is a necessity to evaluate whether patients receive care that is congruent to the Chronic Care Model (CCM) and evidence-based behavioral counseling. We examined differences as perceived and experienced by patients with type 2 diabetes between those enrolled in a DMP compared with patients receiving usual care in two federal states of Germany.
RESEARCH DESIGN AND METHODS—A random, heterogeneous sample of 3,546 patients (59.3% female) received a mailed questionnaire from their regional health fund, including the German version of the Patient Assessment of Chonic Illness Care (PACIC) instrument, which had additional items for behavioral advice (5A). Two weeks later, a general reminder was sent out.
RESULTS—A total of 1,532 questionnaires were returned (response rate 42.2%), and valid data could be obtained for 1,399 patients. Mean age of responders was 70.3 years, of which 53.6% were female. Overall, patients enrolled in a DMP scored significantly higher (3.21 of a possible 5) than patients not enrolled in a DMP (2.86) (P &lt; 0.001). Significant differences in the same direction were found on all five subscales of the PACIC. For the 5A scales, similar differences were found for all five subscales plus the sum score (P &lt; 0.001; mean for DMP = 3.08, mean for non-DMP = 2.78).
CONCLUSIONS—DMPs, as currently established in primary care in Germany, may impact provided care significantly. The changes in daily practice that have been induced by the DMPs are recognized by patients as care that is more structured and that to a larger extent reflects the core elements of the CCM and evidence-based counseling compared with usual care.
Liver Enzymes and Incident Diabetes
Authors: Ford Earl S. , Schulze Matthias B. , Bergmann Manuela M. , Thamer Claus , Joost Hans-Georg , Boeing Heiner 
Published: May 2008

OBJECTIVE—We sought to examine the association between plasma concentrations of liver enzymes γ-glutamyltransferase (GGT) and alanine transaminase (ALT) and incident diabetes, prospectively.
RESEARCH DESIGN AND METHODS—We conducted a case-cohort analysis of data from participants mainly aged 35–65 years in the European Prospective Investigation into Cancer and Nutrition–Potsdam Study. The analytic sample included 787 participants with incident diabetes and 2,224 participants without diabetes.
RESULTS—Concentrations of GGT and ALT were significantly associated with incident diabetes after extensive adjustment. Compared with participants in the lowest quintile of GGT, the adjusted hazard ratios for increasing quintiles were 1.13 (95% CI 0.66–1.93), 1.67 (1.01–2.77), 2.77 (1.71–4.49), and 2.67 (1.63–4.37), respectively (P for linear trend &lt;0.001). Compared with participants in the lowest quintile of ALT, the adjusted hazard ratios for incident diabetes were 0.93 (0.56–1.53) for quintile 2, 1.28 (0.83–1.96) for quintile 3, 1.35 (0.88–2.07) for quintile 4, and 1.93 (1.27–2.92) for quintile 5 (P for linear trend = 0.002). The magnitude of the associations were higher among men than women for GGT (P = 0.004) but did not differ significantly between men and women for ALT (P = 0.307).
CONCLUSIONS—Concentrations of GGT and ALT were significant predictors of incident diabetes in this study, even at concentrations still considered to be within the normal range.
Plantar Fascia Thickness, a Measure of Tissue Glycation, Predicts the Development of Complications in Adolescents With Type 1 Diabetes
Authors: Craig Maria E. , Duffin Anthony C. , Gallego Patricia H. , Lam Albert , Cusumano Janine , Hing Stephen , Donaghue Kim C 
Published: May 2008

OBJECTIVE—Direct measurement of collagen glycation requires skin biopsy, which is invasive. We hypothesized that measurement of plantar fascia thickness (PFT) by ultrasound is an alternative index of tissue glycation and a marker of microvascular disease.
RESEARCH DESIGN AND METHODS—This was a prospective longitudinal study of microvascular complications in 344 adolescents with type 1 diabetes, whose PFT was assessed by ultrasound at baseline. Retinopathy was assessed by seven-field fundal photography, albumin excretion rate (AER) measured from three consecutive timed overnight urine specimens, autonomic neuropathy by pupillometry and cardiovascular tests, and peripheral neuropathy by vibration and thermal thresholds. Longitudinal analysis was performed using generalized estimating equations with baseline PFT, duration, and A1C as explanatory variables.
RESULTS—At first assessment, median (interquartile range) age was 15.1 (13.5–17.2) years and diabetes duration was 8.5 (6.0–11.5) years. Median follow up was 3.2 (2.1–4.5) years with a median of 4 (2–13) complications assessments per patient. In multivariate analysis, baseline PFT (abnormal in 132 subjects, 38%) predicted subsequent development of retinopathy (odds ratio 2.4 [95% CI 1.1–5.0]), elevated AER (2.24 [1.05–5.11]), peripheral neuropathy (2.3 [1.2–4.41]), and autonomic neuropathy (4.94 [2.46–9.91]). Limited joint mobility was present in only 4%.
CONCLUSIONS—PFT is a significant predictor of the subsequent development of complications in type 1 diabetes, suggesting that glycation and oxidation of collagen in soft tissues may be independent risk factors for microvascular complications.
Metabolic Phenotype in the Brothers of Women with Polycystic Ovary Syndrome
Authors: Sam Susan , Coviello Andrea D. , Sung Yeon-Ah , Legro Richard S. , Dunaif Andrea 
Published: May 2008

OBJECTIVE—Hyperandrogenemia, insulin resistance, and dyslipidemia demonstrate familial aggregation in the female first-degree relatives of women with polycystic ovary syndrome (PCOS), suggesting that these defects are heritable. Hyperandrogenemia also appears to be the male reproductive phenotype. We performed this study to test the hypothesis that brothers of women with PCOS have metabolic defects similar to those of their proband sisters.
RESEARCH DESIGN AND METHODS—This was a prospective case-control study performed at four academic medical centers in the U.S. Fasting blood was obtained from 196 non-Hispanic white brothers of women with PCOS and 169 control men of age, BMI, and ethnicity comparable to those of brothers. A separate analysis was performed by study site to assess potential regional variations in metabolic parameters.
RESULTS—Overall, brothers of women with PCOS had significantly higher total (P = 0.001) and LDL cholesterol (P = 0.01) as well as triglyceride levels (P = 0.01) compared with control men, although there were regional variations in these differences. There were significant positive correlations between brothers and their sisters with PCOS for total (ρ = 0.2, P = 0.009) and LDL cholesterol (ρ = 0.3, P = 0.001) and triglyceride (ρ = 0.2, P = 0.05) levels. Brothers also had significantly higher fasting insulin levels and homeostatic index of insulin resistance (P = 0.02 for both comparisons) compared with control men.
CONCLUSIONS—Brothers of women with PCOS have dyslipidemia as well as evidence for insulin resistance similar to that of their proband sisters with PCOS. These findings are consistent with the hypothesis that some metabolic abnormalities in PCOS are heritable and are not sex specific.
Cardiorespiratory Fitness as a Feature of Metabolic Syndrome in Older Men and Women
Authors: Hassinen Maija , Lakka Timo A. , Savonen Kai , Litmanen Hannu , Kiviaho Leena , Laaksonen David E. , Komulainen Pirjo , Rauramaa Rainer 
Published: May 2008

OBJECTIVE—We studied the associations of cardiorespiratory fitness with metabolic syndrome in older men and women, because such data are limited in representative population samples.
RESEARCH DESIGN AND METHODS—We studied a population sample of 671 men and 676 women aged 57–79 years at baseline of a randomized controlled intervention study. We assessed maximal oxygen uptake (Vo2max) by respiratory gas analysis during a maximal bicycle exercise test.
RESULTS—Vo2max had a strong, inverse, and graded association with the risk of having metabolic syndrome as defined by the National Cholesterol Education Program criteria. Men and women in the lowest third of Vo2max had 10.2- and 10.8-fold higher risks and those in the middle third had 2.9- and 4.7-fold higher risks (P &lt; 0.001 all) of metabolic syndrome than those with the highest Vo2max after multivariable adjustments. Factor analysis generated a principal factor that was strongly loaded by the main components of metabolic syndrome and Vo2max (−0.68 in men and −0.70 in women).
CONCLUSIONS—Low cardiorespiratory fitness is associated with metabolic syndrome in older men and women. Our findings suggest that low cardiorespiratory fitness could be considered a feature of metabolic syndrome.
A New Zealand Linkage Study Examining the Associations Between A1C Concentration and Mortality
Authors: Brewer Naomi , Wright Craig S. , Travier Noémie , Cunningham Chris W. , Hornell John , Pearce Neil , Jeffreys Mona 
Published: May 2008

OBJECTIVE—To examine associations between A1C concentration and mortality in a New Zealand population.
RESEARCH DESIGN AND METHODS—During a Hepatitis Foundation screening campaign for hepatitis B (1999–2001), participants were offered A1C testing. The participants were anonymously linked to the national mortality collection to 31 December 2004. Hazard ratios (HRs) and 95% CIs adjusted for age, ethnicity, smoking, and sex were estimated using Cox regression.
RESULTS—There were 47,904 participants (71% Mâori, 12% Pacific, 5% Asian, and 12% other). A1C measurements were categorized as &lt;4.0% (n = 142), 4.0 to &lt;5.0% (reference category; n = 12,867), 5.0 to &lt;6.0% (n = 30,222), 6.0 to &lt;7.0% (n = 2,669), and ≥7.0% (n = 1,596); there were also 408 participants with a previous diabetes diagnosis. During the follow-up period, 815 individuals died. In those without a prior diabetes diagnosis, there were steadily increasing HRs from the A1C reference category to the highest category (≥7.0%; HR 2.36 [95% CI 1.72–3.25]). As well as all-cause mortality, A1C was associated with mortality from diseases of the circulatory system; endocrine, nutritional, metabolic, and immunity disorders; and other and unknown causes. Mortality was also elevated in those with a prior diabetes diagnosis (5.19 [3.67–7.35]), but this was only partially explained by their elevated A1C levels.
CONCLUSIONS—This is the largest study to date of A1C levels and subsequent mortality risk. It confirms previous findings that A1C levels are strongly associated with subsequent mortality in both men and women without a prior diabetes diagnosis.