bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and determinants of diabetes mellitus and glucose intolerance in a Canarian Caucasian population – comparison of the 1997 ADA and the 1985 WHO criteria. The Guía Study.
Authors: De Pablos‐Velasco P. L. , Martínez‐Martín F. J. , Rodríguez‐Pérez F. , Anía B. J. , Losada A. , Betancor P. 
Published: December 2004

SummaryAims  To estimate the prevalence of diabetes mellitus, impaired fasting glucose and impaired glucose tolerance in a Canarian population according to the 1997 ADA and the 1985 WHO criteria; and to study the cardiovascular risk factors associated with these categories.Methods  A total of 691 subjects over 30 years old were chosen in a random sampling of the population (stratified by age and sex). An oral glucose tolerance test was performed (excluding known diabetic patients) and lipids were determined in the fasting state. Anthropometric and blood pressure measurements were performed, and history of smoking habits and medications was recorded.Results  The prevalence of diabetes was 15.9% (1997 ADA) and 18.7% (1985 WHO); the prevalence of impaired fasting glucose and impaired glucose tolerance was 8.8 and 17.1%, respectively. The age‐adjusted prevalence of diabetes (Segi's standard world population) for the population aged 30–64 years was 12.4% (1985 WHO). The risk factors significantly associated with diabetes (1997 ADA and 1985 WHO) were age, body mass index; waist‐to‐hip ratio, systolic and mean blood pressure, triglycerides, total cholesterol and low HDL‐cholesterol. Age, body mass index and systolic blood pressure were associated with impaired fasting glucose and impaired glucose tolerance; triglycerides were also associated with impaired fasting glucose.Conclusions  The prevalence of diabetes mellitus and glucose intolerance in Guía is one of the highest among studied Caucasian populations. The new 1997 ADA criteria estimate a lower prevalence of diabetes. Impaired fasting glucose also had a lower prevalence than impaired glucose intolerance and the overlap of these categories was modest.
Correction of hyperglycaemia reduces insulin resistance and serum soluble E‐selectin levels in patients with Type 2 diabetes mellitus
Authors: Matsumoto K. , Nakamura H. , Ueki Y. , Tominaga T. , Miyake S. 
Published: December 2004

SUMMARY Aims  To investigate the effects of glycaemic control on insulin sensitivity and serum concentrations of soluble vascular cell adhesion molecule (sVCAM)‐1 and E‐selectin (sE‐selectin) in patients with Type 2 diabetes mellitus. To examine whether reductions in serum adhesion molecule levels correlate with improvement in insulin resistance.Methods  A total of 54 patients with Type 2 diabetes were treated for 4 weeks with either diet alone, sulphonylurea or insulin. Fasting glucose, insulin sensitivity, lipids, sVCAM‐1, and sE‐selectin levels were measured before and after treatment.Results  All treatment modalities successfully corrected hyperglycemia. Reductions in blood glucose levels resulted in improvement in insulin sensitivity (diet KITT 2.40 ± 0.26–3.09 ± 0.36, P < 0.01; sulphonylurea 2.24 ± 0.16–2.94 ± 0.18, P < 0.01; insulin 1.68 ± 0.27–2.16 ± 0.22%/min, P < 0.05), and decrease in sE‐selectin levels (diet 88.4 ± 14.9–66.2 ± 10.8, P < 0.05; sulphonylurea 85.1 ± 11.6–59.8 ± 7.8, P < 0.01; insulin 84.4 ± 8.7–66.8 ± 7.4 ng/ml, P < 0.01), but no change in sVCAM‐1 levels. There was a significant correlation between the degree of decrease in sE‐selectin levels and improvement in insulin sensitivity (r = −0.38, P < 0.01).Conclusions  Correction of hyperglycaemia, independent of treatment modality, resulted in improvement of insulin resistance and decrease in sE‐selectin levels. These changes might, in part, contribute to reduce the risk of diabetic microvascular and macrovascular complications in patients with Type 2 diabetes mellitus.
Factor analysis of thermal and vibration thresholds in young patients with Type 1 diabetes mellitus
Authors: Kalter‐Leibovici O. , Yosipovitch G. , Gabbay U. , Yarnitsky D. , Karp M. 
Published: December 2004

SummaryAims  To identify factors that represent relationships among sets of interrelated thermal and vibration threshold variables and to find clinical correlates that are significantly associated with these factors.Methods  Thermal and vibration perception thresholds were tested in the hands and feet of Type 1 diabetic patients treated in an outpatient clinic for juvenile‐onset diabetes. Factor analysis was used to identify factors that represent relationships among sets of thermal and vibration threshold variables.Results  One hundred and forty‐eight patients (47.3% males, median current age 22.3 years and median duration of diabetes 11.4 years) were evaluated. Three factors explained 77% of the total variance: ‘hand sensation’ factor, underlying cold, warmth and vibration perception thresholds in the hand; ‘foot sensation’ factor, underlying the same sensory thresholds in the foot; and ‘heat‐related pain’ factor, underlying heat pain perception threshold in both limbs. The ‘foot sensation’ factor was the only factor that significantly correlated with diabetes‐related variables (e.g. duration and cumulative glycaemic control of the disease) and concurrent diabetic microangiopathy. Male sex was associated with higher values of the ‘heat‐related’ factor, while the ‘hand sensation’ factor did not correlate with any of the study variables.Conclusions  The distribution of the various thermal and vibration threshold variables according to the three factors may point at length‐dependent mechanism of axonal degeneration. Cold, warmth and vibration perception thresholds in the foot may be the only valuable psychophysical parameters in the evaluation of early sensory impairment associated with diabetes.
Pathophysiological implications of insulin resistance on vascular endothelial function
Authors: Wheatcroft S. B. , Williams I. L. , Shah A. M. , Kearney M. T. 
Published: December 2004

AbstractBackground Insulin resistance is a key component of the insulin resistance syndrome and is a crucially important metabolic abnormality in Type 2 diabetes. Insulin‐resistant individuals are at significantly increased risk of cardiovascular disease, although the underlying mechanisms remain incompletely understood. The endothelium is thought to play a critical role in maintaining vascular homeostasis, a process dependent on the balance between the production of nitric oxide, superoxide and other vasoactive substances. Endothelial dysfunction has been demonstrated in insulin‐resistant states in animals and humans and may represent an important early event in the development of atherosclerosis. Insulin resistance may be linked to endothelial dysfunction by a number of mechanisms, including disturbances of subcellular signalling pathways common to both insulin action and nitric oxide production. Other potential unifying links include the roles of oxidant stress, endothelin, the renin angiotensin system and the secretion of hormones and cytokines by adipose tissue. Lifestyle measures and drug therapies which improve insulin sensitivity and ameliorate endothelial dysfunction may be important in delaying the progression to overt cardiovascular disease in at risk individuals.Methods We conducted a literature search using Medline, restricted to articles published in the English language between 1966 and the present, and reviewed bibliographies of relevant articles. An initial search strategy employing combinations of the MeSH terms: insulin resistance; endothelium, vascular; insulin; nitric oxide or hyperinsulinaemia produced over 300 references. Focused searches using keywords relevant to the molecular aspects of endothelial function and insulin signalling, and lifestyle or pharmacological interventions relevant to insulin resistance or endothelial function, produced over 300 further references. Abstracts of all references were screened before selecting those relevant to this review.
Impaired fasting glucose and impaired glucose tolerance in urban population in India
Authors: Ramachandran A. , Snehalatha C. , Satyavani K. , Vijay V. 
Published: December 2004

AbstractAims To study prevalence of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) in urban Indians and their demographic and anthropometric characteristics.Methods Data on capillary blood glucose (OGTT), anthropometric and demography details were available in 10 025 subjects (M : F 4711 : 5314) aged ≥ 20 years. Glucose tolerance was categorized as normal, isolated IFG, isolated IGT, IFG + IGT and diabetes using the fasting and 2‐h blood glucose (2hBG; 75‐g glucose load) values. Subjects with known diabetes were excluded.Results Age‐standardized prevalences of IFG, IGT and newly detected diabetes were 8.7%, 8.1% and 13.9%, respectively. IFG was more prevalent in women (9.8%) than in men (7.4%) (χ2 = 13.62, P = 0.0002), while the gender differences in IGT (men 8.4%, women 7.9%) and diabetes (men 13.3%, women 14.3%) were not significant. Body mass index and waist circumference were higher in glucose‐intolerant groups than in normal glucose tolerance (NGT). Prevalence of diabetes, IGT and IFG + IGT increased with age. Among the IFG, 4% had diabetes and 27.1% had IGT using 2hBG criteria. In IFG, the fasting and 2hBG values were not correlated.Conclusions Prevalences of IFG and IGT were similar in urban Indians and an overlap occurred in only less than half of these subjects. IFG was more common in women. Subjects with IFG were older and had more adverse anthropometric characteristics in comparison with NGT. IFG did not show an increasing trend with age.Diabet. Med. 20, 220–224 (2003)
Transcription factor 1 and β‐cell function in glucose‐tolerant subjects
Authors: Chiu K. C. , Chuang L.‐M. , Chu A. , Wang M. 
Published: December 2004

AbstractAims Although β‐cell dysfunction and insulin resistance are observed in patients with Type 2 diabetes, β‐cell dysfunction plays a crucial role in the development of the disease. Mutations of transcription factor 1 (TCF1, or hepatocyte nuclear factor‐1α) affect β‐cell function. We examined the impact of amino acid polymorphisms of this gene on β‐cell function in 60 glucose‐tolerant Caucasians.Methods Insulin sensitivity index (ISI) and 1st and 2nd phase insulin responses (1stIR, 2ndIR) were measured using the hyperglycaemic clamp. The genotypes were determined from genomic DNA and their impact on β‐cell function was investigated.Results Among three polymorphisms (I27L, A98V, and S487N), significant impact on β‐cell function was found in the I27L polymorphism. Univariate analyses revealed differences for the I27L polymorphism in both 1stIR (P = 0.0052) and 2ndIR (P = 0.0432). Multivariate analysis revealed that the I27L polymorphism (P = 0.0124) with ISI accounted for 32% of the variation in 1stIR and had a marginal impact on 2ndIR (P = 0.0343), accounting for 52% of the variation with ISI and age. By dissecting out the impact of other covariate(s), the I27L polymorphism independently explained 12% of the variation in 1stIR and 6% of the variation in 2ndIR.Conclusion The I27L polymorphism of TCF1 is an independent determinant of β‐cell function by affecting both 1st and 2nd phase insulin response. This polymorphism could play a role in the pathogenesis of Type 2 diabetes. A large‐scale association study (approx. 2000 subjects) will be required to demonstrate the genetic susceptibility of this polymorphism to Type 2 diabetes.Diabet. Med. 20, 225–230 (2003)
How do people with Type 2 diabetes perceive and respond to cardiovascular risk?
Authors: Carroll C. , Naylor E. , Marsden P. , Dornan T. 
Published: December 2004

AbstractObjectives To explore how people with Type 2 diabetes perceive cardiovascular risk, and how those perceptions might affect their motivation to make lifestyle changes.Methods The setting was a diabetes clinic in a UK teaching hospital. A qualitative study was conducted, using semistructured individual interviews and template analysis of content. The participants were 20 Type 2 diabetic patients, aged between 52 and 77 years, half with and half without cardiovascular disease (CVD).Results Whether they had CVD or not, most people were aware they were at risk of it, of its causative factors, and possible effects. However, they were more likely to attribute it to unchangeable factors like ‘stress’ and ‘heredity’, than medical risk factors like cholesterol and smoking. Patients with pre‐existing CVD correctly regarded their risk as higher than those without. Few saw any direct link between being diabetic per se and cardiovascular risk. Lifestyle changes were precipitated by major life events and motivated by family support, fear of complications, and a belief that one should follow doctors’ advice. A common reaction to CVD and diabetes was stoical acceptance, allowing patients to view their lives positively, whilst living with unpredictable potentially disabling diseases.Conclusions Patients were unaware how strongly diabetes influences cardiovascular risk. Their ideas about risk were very different from those of conventional medicine, and provided individual rationales for making choices about treatment and risk‐influencing behaviour. Contextual factors, such as family milieu, also influenced their behaviour. Clinicians should not assume patients share the same mental model of risk as they, and must be prepared to explore peoples’ individual constructs and health beliefs.Diabet. Med. 20, 355–360 (2003)
Does the autonomic nervous system play a role in the development of insulin resistance? A study on heart rate variability in first‐degree relatives of Type 2 diabetes patients and control subjects
Authors: Lindmark S. , Wiklund U. , Bjerle P. , Eriksson J. W. 
Published: December 2004

AbstractAims To investigate dysregulation of the autonomic nervous system as a potential mechanism for early insulin resistance in the development of Type 2 diabetes.Methods Thirteen healthy individuals with first‐degree relatives with Type 2 diabetes (R) were compared with 14 control subjects without family history of diabetes (C), matched for age, body mass index and sex. An oral glucose tolerance test and a hyperinsulinaemic euglycaemic clamp were performed. Analysis of heart rate variability during rest, controlled breathing, an orthostatic manoeuvre and a standardized physical stress (cold pressor test (CPT)), were used to evaluate the activity of the autonomic nervous system.Results Fasting blood glucose, HbA1c and serum insulin were similar in the R and C groups. The M‐value, reflecting insulin sensitivity, did not differ significantly between the groups. Total spectral power and high‐frequency power were lower in R during controlled breathing (P = 0.05 and P = 0.07, respectively), otherwise there were no significant differences between R and C in heart rate variability. However, low‐frequency (LF)/high‐frequency (HF) spectral power ratio during CPT, reflecting sympathetic/parasympathetic balance, was negatively associated with insulin sensitivity (r = −0.53, P = 0.006). When all subjects were divided into two groups by the mean M‐value, the low M‐value group displayed an overall higher LF/HF ratio (P = 0.04). HF power was lower in the low M‐value group during controlled breathing and CPT (P = 0.01 and P = 0.03, respectively).Conclusion An altered balance of the parasympathetic and sympathetic nervous activity, mainly explained by an attenuated parasympathetic activity, might contribute to the development of insulin resistance and Type 2 diabetes.Diabet. Med. 20, 399–405 (2003)
Development, reliability and validity of the Diabetes Illness Representations Questionnaire: four studies with adolescents
Authors: Skinner T. C. , Howells L. , Greene S. , Edgar K. , McEvilly A. , Johansson A. 
Published: December 2004

AbstractAims This article reports on the development and validity of a Diabetes‐specific Illness Representations Questionnaire (DIRQ) to assess all five dimensions of an individual's perception of diabetes, for adolescents with Type 1 diabetes mellitus.Methods There were two development studies. Study 1: participants (n = 115) completed a questionnaire assessing perceptions of the consequences of diabetes and the effectiveness of treatment, along with a questionnaire assessing self‐care. Study 2: participants (n = 79) completed a questionnaire assessing their identity, timeline and causal beliefs, along with a diabetes self‐efficacy and barriers to adherence questionnaire. Subsequently there were two validation studies. Study 3: participants (n = 44 adolescents and 28 parents) completed the DIRQ and questionnaires assessing their self‐care and psychological well‐being. Glycaemic control was assessed through retrieval of routine assay results. Study 4: participants (n = 70) completed the DIRQ and questionnaires to assess their psychological well‐being, with glycaemic control assessed through retrieval of routine assay results.Results The development studies suggest that the perceived consequences of diabetes consist of two subscales, perceived threat and perceived impact, and provide further support for the distinction between treatment effectiveness to control diabetes and treatment effectiveness to prevent complications. Along with the validation studies, the results indicate that the questionnaire scales showed good internal consistency and construct validity through their associations with measures of self‐care and psychological well‐being.Conclusion The data reported here suggest that the DIRQ has the potential to be a useful tool for clinical assessment and evaluating the impact of psycho‐educational and medical interventions.Diabet. Med. 20, 283–289 (2003)
Prediction of cardiovascular risk in people with diabetes
Authors: Winocour P. H. , Fisher M. 
Published: December 2004

AbstractPeople with diabetes are at high risk of cardiovascular morbidity and mortality, especially if they have already developed vascular problems. For patients who are apparently free of vascular complications, risk tables are often used to assess the risk of cardiovascular events in the following years, and to decide on treatment with statins or anti‐platelet therapy. These risk prediction tables include estimates of traditional cardiovascular risk factors and are based on populations, some of which only contained a very small number of people with diabetes. Multiple problems can be identified with these tables, and many seriously underestimate cardiovascular risk in people with diabetes. Possible ways of addressing this include using risk estimation tools based solely on diabetic populations, adding in additional traditional variables such as triglycerides or left ventricular hypertrophy, including novel cardiovascular risk factors, or intervening at a lower level of estimated risk in people with diabetes compared with non‐diabetic subjects. Alternatively, estimates of individual risk could be abandoned and all people with diabetes could be treated with statins and other effective agents.Diabet. Med. 20, 515–527 (2003)
Central fat predicts deterioration of insulin secretion index and fasting glycaemia: 6‐year follow‐up of subjects at varying risk of Type 2 diabetes mellitus
Authors: Kriketos A. D. , Carey D. G. , Jenkins A. B. , Chisholm D. J. , Furler S. M. , Campbell L. V. 
Published: December 2004

AbstractAims To examine the relationships between body composition and changes in fasting glycaemia, and in indices of insulin secretion and insulin action over 6 years in females with a family history of Type 2 diabetes with or without prior gestational diabetes (‘at risk’ group, AR) and control females (control group, C).Methods At baseline and at follow‐up, an oral glucose tolerance test and dual energy X‐ray absorptiometry assessment of body composition were performed. Indices of insulin resistance (HOMA R′) and insulin secretion (HOMA β′) were obtained from fasting insulin and glucose concentrations.Results At baseline, the groups were similar for age, body mass index, fasting levels of plasma glucose and insulin, HOMA R′ and HOMA β′. Despite similar total body fatness, AR had significantly greater waist circumference and central fat (both P < 0.02) compared with C. At follow‐up there was a significant increase in central adiposity only in AR, and the fasting plasma glucose (FPG) level was higher in AR compared with C (5.0 ± 0.2 vs. 4.3 ± 0.2 mmol/l, P = 0.02). This rise in plasma glucose in AR was related to a decline in HOMA β′ (r = 0.45, P = 0.0065). Both the baseline and the increments in total and central abdominal fat mass were associated with the time‐related decline in HOMA β′.Conclusions Six years after initial assessment, AR showed deterioration in FPG levels due predominantly to a decline in insulin secretion index without major change in insulin resistance index. Importantly, baseline body fatness (especially central adiposity), as well as increases in fatness with time, were the major predictors of the subsequent decline of insulin secretion index and the consequent rise in FPG.
Associations of LDL size with in vitro oxidizability and plasma levels of in vivo oxidized LDL in Type 2 diabetic patients
Authors: Scheffer P. G. , Bos G. , Volwater H. G. F. M. , Dekker J. M. , Heine R. J. , Teerlink T. 
Published: December 2004

AbstractAims Oxidative modification of low‐density lipoprotein (LDL) is believed to be a key step in the genesis of atherosclerotic lesions. The presence of small, dense LDL is associated with accelerated atherosclerosis and is common in diabetic patients. The aim of this study was to investigate the relationship of in vitro LDL oxidizability and circulating in vivo oxidized LDL with LDL particle size in Type 2 diabetic patients and healthy control subjects.Subjects and methods The study group consisted of 58 elderly well controlled Type 2 diabetic patients and 58 control subjects with normal glucose metabolism. LDL particle size was measured by high‐performance gel‐filtration chromatography. In vitro oxidizability of LDL was measured by monitoring conjugated diene formation and plasma levels of circulating oxidized LDL were determined by ELISA.Results In vitro susceptibility of LDL to oxidation was not related to plasma levels of in vivo oxidized LDL, nor to LDL particle size. In the diabetic patients, but not in the control group, an inverse relation between LDL size and in vivo oxidized LDL was observed (r = −0.35, P = 0.007). This relation was strengthened after controlling for LDL‐cholesterol concentration (r = −0.52, P < 0.001).Conclusions In agreement with the view that small, dense LDL accelerates atherosclerosis, an inverse relationship was observed between LDL size and circulating in vivo oxidized LDL in Type 2 diabetic patients. Our results also suggest that in vitro susceptibility to oxidation is not a suitable surrogate measure for in vivo LDL oxidation.Diabet. Med. 20, 563–567 (2003)