bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glycaemic control, disease duration and β‐cell function in patients with Type 2 diabetes in a Swedish community. Skaraborg Hypertension and Diabetes Project
Authors: Östgren C. J. , Lindblad U. , Ranstam J. , Melander A. , Råstam L. 
Published: March 2003

AbstractAims To examine determinants for glycaemic control in primary care patients with Type 2 diabetes.Methods In a community‐based surveillance of primary care patients with Type 2 diabetes, 190 men and 186 women were consecutively identified and examined for cardiovascular risk factors. Insulin resistance and β‐cell function were estimated using homeostasis model assessment (HOMA). Good glycaemic control was defined as HbA1c < 6.5%.Results Following adjustment for age and gender, HbA1c≥ 6.5% was associated with duration of diabetes (10.6 vs. 6.4 years, P < 0.001), lower levels of serum insulin (6.3 vs. 8.0 mU/l, P = 0.012), higher serum triglyceride levels (2.0 vs. 1.7 mmol/l, P = 0.002) and impairment of β‐cell function (HOMA index 19.5 vs. 45.8, P < 0.001). The association between HbA1c levels and duration remained with adjustment for age, gender, waist–hip ratio (WHR) and serum triglycerides (odds ratio (OR) for HbA1c≥ 6.5% by 5 years diabetes duration = 1.7; 95% confidence interval (CI) 1.4–2.1) but was lost following additional adjustment for β‐cell function (OR for HbA1c≥ 6.5%= 1.3; 95% CI 0.96–1.7). In a separate linear regression with β‐cell function as the dependent variable there was a significant association with HbA1c after adjustments for differences in age, gender, WHR, serum triglyceride levels and diabetes duration (P < 0.001).Conclusions Increasing HbA1c by time was associated with declining β‐cell function.Diabet. Med. 19, 125–129 (2002)
Evaluation of a district‐wide screening programme for diabetic retinopathy utilizing trained optometrists using slit‐lamp and Volk lenses
Authors: Hulme S. A. , Tin‐U A. , Hardy K. J. , Joyce P. W. 
Published: March 2003

AbstractBackground Debate exists about the optimum way to screen for diabetic retinopathy. Cameras produce a permanent record, but offer patients less choice about when and where to be screened. Optometrists offer flexibility but sensitivity and specificity of schemes have varied considerably, perhaps because of variability in screening methodology and that there is frequently no quality assurance programme.Aims To audit our district‐wide (population 340 000) screening programme for diabetic retinopathy against national targets: sensitivity > 80%, specificity > 95% and referral to review < 3 months.Methods Trained optometrists performed slit‐lamp examination with Volk lenses (78 dioptre) with standardized reporting. Audit was by ophthalmologist with slit‐lamp and Volk lenses through dilated pupils.Results We examined 872 eyes of 439 patients; 64% were normal, 29% background diabetic retinopathy, 7% sight‐threatening eye disease (STED). Sixty‐three percent of patients were seen within 6 months of the original screen. Of these, sensitivity for any retinopathy was 72%, specificity 77%, positive predictive value (PPV) 53%, negative predictive value (NPV) 88%. For STED, in this group, sensitivity was 87% and specificity 91%, PPV 30%, NPV 99%. Median interval referral to ophthalmological review was 11.5 weeks with 73% reviewed in under the 13‐week target. Of those referred 25% received laser therapy. Eleven patients found to have referable eye disease at their initial screen were not referred to an ophthalmologist by their GP.Conclusions We conclude that effective district‐wide screening for diabetic retinopathy by optometrists using slit‐lamp and Volk lenses is possible; however, only 36% of identified people with diabetes in the district were screened over a 4‐year period.
Post‐prandial glucose excursions following four methods of bolus insulin administration in subjects with Type 1 diabetes
Authors: Chase H. P. , Saib S. Z. , MacKenzie T. , Hansen M. M. , Garg S. K. 
Published: March 2003

AbstractAims To determine if one method of short‐acting insulin bolus administration is superior to other methods in managing a meal high in carbohydrates, calories and fat.Methods Nine subjects receiving continuous subcutaneous insulin infusion using insulin lispro (Humalog®) agreed to consume the same meal high in carbohydrates, calories and fat on four occasions 1 week apart. They received the same dose of bolus insulin on each of the four occasions randomly assigned and beginning 10 min prior to the meal as either a single bolus, two separate boluses of one‐half the same total dose (the second after 90 min), the entire bolus given as a square‐wave (over 2 h) or a dual‐wave (70% as a bolus and 30% as a square‐wave over 2 h). Blood glucose levels were measured at –60 and –30 min and at zero time, and then every half‐hour for 6 h using the Hemacue® in the out‐patient clinic.Results Changes in blood glucose values from fasting were the lowest after 90 and 120 min (P < 0.01) when the dual wave was administered. When the dual or square‐wave methods of insulin administration were used, subjects had significantly lower glucose levels after 4 h in comparison with when the single or double boluses were used (P = 0.04).Conclusions We conclude that the dual wave provided the most effective method of insulin administration for this meal. The dual‐ and square‐wave therapies resulted in lower glucose levels 4 h after the meal in comparison with the single and double‐bolus treatments.
Impaired vascular reactivity is present despite normal levels of von Willebrand factor in patients with uncomplicated Type 2 diabetes
Authors: Ihlemann N. , Stokholm K. H. , Eskildsen P. C. 
Published: March 2003

AbstractBackground Type 2 diabetes is associated with an increased risk of cardiovascular disease. Endothelial dysfunction is thought to be an early marker of atherosclerosis. The purpose of this study was to assess whether endothelial function, judged by measurements of flow‐mediated vasodilatation (FMD) and nitroglycerine (NTG)‐induced vasodilatation as well as serum levels of von Willebrand factor, was affected in patients with uncomplicated Type 2 diabetes and normal levels of urinary albumin excretion (UAE).Subjects and methods Twenty‐three patients with Type 2 diabetes, normal UAE and no vascular complications were examined. Twenty‐three healthy subjects matched for age, gender, body mass index and resting vessel size served as controls. All participants were non‐smokers. Endothelial function was assessed by high‐resolution ultrasound which measures changes in diameter of the brachial artery during flow‐mediated and NTG‐induced vasodilatation. We also measured serum levels of von Willebrand factor.Results In Type 2 diabetic patients FMD (3.2 ± 0.5% vs. 4.8 ± 0.5%, P = 0.019) as well as NTG‐induced vasodilatation (15.9 ± 0.6% vs. 18.5 ± 0.9%, P = 0.021) were significantly reduced compared with controls. Levels of von Willebrand factor were not different between groups (0.88 ± 0.07 vs. 0.88 ± 0.07 in patients and controls, respectively) and were not correlated to FMD or NTG‐induced vasodilatation.Conclusion Impaired vascular reactivity is present in uncomplicated Type 2 diabetes and seems to be a more sensitive marker of vascular dysfunction than von Willebrand factor.
Glucose intolerance and associated factors in Mongolia: results of a national survey
Authors: Suvd J. , Gerel B. , Otgooloi H. , Purevsuren D. , Zolzaya H. , Roglic G. , King H. 
Published: March 2003

AbstractAims Prevalence of glucose intolerance—diabetes and impaired glucose tolerance (IGT)—and of related conditions such as obesity and hypertension, was studied in six population samples in Mongolia in 1999.Methods Diagnosis of glucose intolerance was made on the basis of 2‐h blood glucose concentration, according to criteria recommended by the latest report of a WHO Expert Group.Results Crude prevalence of diabetes was 2.9% (2.6% in men and 3.2% in women). Prevalence of IGT was 10.2% (9.3% in men and 10.8% in women). Age standardization to the standard world population of Segi resulted in a total sample prevalence of 3.1% for diabetes and 9.2% for IGT. Prevalence of abnormal glucose tolerance differed according to district of residence. Approximately one‐third of the subjects with diabetes were diagnosed prior to the survey. Of those who were diagnosed previously, approximately one‐half were not under any form of treatment. Subjects with abnormal glucose tolerance were older, more obese and had higher blood pressure and prevalence of hypertension than those with normoglycaemia. One‐half of men and almost one‐half of women were hypertensive. Three‐quarters of the diabetic subjects were hypertensive. One‐third of all subjects were centrally obese. Considering the conditions of principal interest—glucose intolerance, hypertension and obesity—one‐half of all subjects demonstrated one or more of these conditions. Central obesity was the most common condition, followed by hypertension and then glucose intolerance. Central obesity and hypertension was the most common combination (17% of all subjects) and 4% exhibited all three conditions.Conclusions Non‐communicable diseases are already a threat to public health in Mongolia. Although the prevalence of diabetes is not high by international standards, the relatively high prevalence of IGT suggests that the situation may deteriorate in the future in the absence of concerted action to prevent and control diabetes and related conditions.
The prevalence of the mitochondrial DNA 16189 variant in non‐diabetic Korean adults and its association with higher fasting glucose and body mass index
Authors: Kim J. H. , Park K. S. , Cho Y. M. , Kang B. S. , Kim S. K. , Jeon H. J. , Kim S. Y. , Lee H. K. 
Published: March 2003

AbstractAims To evaluate the prevalence of the 16189 variant of mitochondrial DNA in Korean adults and its association with insulin resistance.Methods We investigated 160 non‐diabetic subjects from a community‐based diabetes survey conducted in Yonchon County, Korea in 1993. We extracted the DNA from peripheral blood and examined the 16189 variant by polymerase chain reaction and restrictive enzyme digestion. We compared body mass index (BMI), blood pressure, fasting plasma glucose, 2‐h plasma glucose after 75 g glucose load, fasting insulin, cholesterol, and homeostasis model assessment of insulin resistance and β‐cell function between the subjects with 16189 variant and wild type.Results The prevalence of the 16189 variant in Korean adults was 28.8% (46 of 160). Subjects with the 16189 variant had higher fasting glucose and BMI than those with wild type, but fasting insulin, homeostasis model assessment of insulin resistance and β‐cell function, cholesterol, and blood pressure were not different between two groups.Conclusion Our results provide evidence for an association of a frequent mitochondrial polymorphism with higher fasting glucose and the risk factors of diabetes mellitus.
Continuous subcutaneous insulin infusion (CSII) in the Veneto region: efficacy, acceptability and quality of life
Authors: Bruttomesso D. , Pianta A. , Crazzolara D. , Scaldaferri E. , Lora L. , Guarneri G. , Mongillo A. , Gennaro R. , Miola M. , Moretti M. , Confortin L. , Beltramello G. P. , Pais M. , Baritussio A. , Casiglia E. , Tiengo A. 
Published: March 2003

AbstractAim To study the effect of continuous subcutaneous insulin infusion (CSII) on metabolic control and well‐being in patients with Type 1 diabetes.Methods Efficacy, safety and interference with everyday life associated with CSII were studied retrospectively in 138 diabetic patients from the Veneto region treated for 7.4 ± 0.4 years.Results Glycosylated haemoglobin decreased during the first year of CSII from 9.3 ± 0.2% to 7.9 ± 0.1% (P < 0.0001), and then remained unchanged. Serious hypoglycaemia decreased from 0.31 ± 0.07/year to 0.09 ± 0.02/year (P < 0.003), as did ketoacidosis (from 0.41 ± 0.12/year to 0.11 ± 0.03/year, P < 0.013). During the first year of therapy daily insulin requirement decreased from 49 ± 1 to 42 ± 2 U/day (P < 0.0001) and did not change thereafter. The number of out‐patient consultations and hospital admissions per year also decreased significantly. CSII was associated with a progressive increase of body weight (P < 0.05) and with 0.2 ± 0.04 infections/patient per year at the infusion site. Infection was rated as mild in 72%, moderate in 18%, severe in 10%. Patients reported that CSII improved metabolic control (71%), sense of well‐being (41%), and allowed more freedom (40%). Quality of life, assessed using the DQOL, after 7 years of CSII was rated as good by patients (score of 73.0 ± 1.8 on a scale from 0 to 100).Conclusions This retrospective analysis suggests that CSII improves metabolic control in Type 1 diabetic patients, reduces hypoglycaemic and ketoacidotic events, is well accepted, allows a good quality of life and decreases out‐patient consultations and hospital admissions.
Improved glycaemic control with metformin–glibenclamide combined tablet therapy (Glucovance®) in Type 2 diabetic patients inadequately controlled on metformin
Authors: Marre M. , Howlett H. , Lehert P. , Allavoine T. 
Published: March 2003

AbstractAimsTo evaluate the efficacy and safety of two dosage strengths of a single‐tablet metformin–glibenclamide (glyburide) combination, compared with the respective monotherapies, in patients with Type 2 diabetes mellitus (DM) inadequately controlled by metformin monotherapy.MethodsIn this 16‐week, double‐blind, multicentre, parallel‐group trial, 411 patients were randomized to receive metformin 500 mg, glibenclamide 5 mg, metformin–glibenclamide 500 mg/2.5 mg or metformin–glibenclamide 500 mg/5 mg, titrated with the intention to achieve fasting plasma glucose (FPG) ≤ 7 mmol/l.ResultsDecreases in glycated haemoglobin (HbA1c) and FPG were greater (P < 0.05) for metformin–glibenclamide 500 mg/2.5 mg (−1.20% and −2.62 mmol/l) and 500 mg/5 mg (−0.91% and −2.34 mmol/l), compared with metformin (−0.19% and −0.57 mmol/l) or glibenclamide (−0.33% and −0.73 mmol/l). HbA1c< 7% was achieved by 75% and 64% of patients receiving metformin–glibenclamide 500 mg/2.5 mg and 500 mg/5 mg, respectively, compared with 42% for glibenclamide and 38% for metformin (P = 0.001). These benefits were achieved at lower mean doses of metformin or glibenclamide with metformin–glibenclamide 500 mg/2.5 mg and 500 mg/5 mg (1225 mg/6.1 mg and 1170 mg/11.7 mg) than with glibenclamide (13.4 mg) or metformin (1660 mg). Treatment‐related serious adverse events occurred in two patients receiving glibenclamide. Plasma lipid profiles were unaffected and mean changes in body weight were ≤ 1.0 kg.ConclusionsIntensive management of Type 2 DM with a new metformin–glibenclamide combination tablet improved glycaemic control and facilitated the attainment of glycaemic targets at lower doses of metformin or glibenclamide compared with the respective monotherapies, without compromising tolerability.Diabet. Med. 19, 673–680 (2002)
Perceptions of diabetic retinopathy and screening procedures among diabetic people
Authors: Trento M. , Bajardi M. , Borgo E. , Passera P. , Maurino M. , Gibbins R. , Owens D. R. , Cavallo F. , Porta M. 
Published: March 2003

AbstractAims To assess how diabetic patients perceive retinopathy, screening for sight‐threatening lesions and their own role in preventing blindness.Methods A questionnaire was administered to 258 consecutive patients after screening for retinopathy, according to the European Field Guide‐Book procedure, in Turin (n

=
130) and Wales (n = 128, W). All Welsh patients and 70 in Turin (T1) were on standard diabetes care at their clinic or general practitioner, whereas 60 in Turin (T2) were on permanent group education.Results According to 65%, 84% and 100% of patients in W, T1 and T2, respectively, diabetes may damage the eyes. Retinopathy had been heard of by 48% (W), 67% (T1) and 100% (T2). In T2, 82% of patients could give a meaningful description of retinopathy but only 17% could use correctly the word ‘retina’. In W and T1, 16% and 19% could describe retinopathy but none could describe the retina. In W and T1, 47% and 57% believed they could not help with eye care, whereas 78% in T2 replied that they should control diabetes and 20% that eyes should be checked regularly. Regarding reasons for screening, 100% of patients in T2 answered ‘prevention and checks’, against 61% in T1 and only 9% in W. In T1 and W, 33% and 37% did not know why they were being screened.Conclusions Patients’ health perceptions and internal control mechanisms may be insufficiently developed for optimal participation in retinopathy screening. Diabetes care by long‐term group education may address this problem.
C‐reactive protein is more strongly related to post‐glucose load glucose than to fasting glucose in non‐diabetic subjects; the Insulin Resistance Atherosclerosis Study
Authors: Festa A. , D’Agostino R. , Tracy R. P. , Haffner S. M. 
Published: March 2003

AbstractAims It has been suggested that cardiovascular disease may be more strongly related to post‐challenge glycaemia than to fasting glucose concentrations. We hypothesized that subclinical inflammation, as indicated by elevated serum levels of C‐reactive protein (CRP), may partially explain the association of cardiovascular disease with post‐challenge glycaemia.Methods We studied the relationship of CRP (measured with a highly sensitive immunoassay) with fasting glucose and 2‐h glucose concentrations during an oral glucose tolerance test in non‐diabetic subjects from the Insulin Resistance Atherosclerosis Study.Results Spearman correlation analyses and multiple linear regression analyses showed a significant association of both fasting glucose and 2‐h glucose concentrations with CRP levels, after adjusting for demographic covariates (age, sex, ethnicity, clinical centre; Spearman correlation coefficients: r = 0.18 for fasting glucose, r = 0.27 for 2‐h glucose, both P < 0.0001). However, after additional adjustment for body mass index and waist–hip ratio only 2‐h glucose (and not fasting glucose) was significantly related to CRP (r = 0.03 for fasting glucose, P = NS; r = 0.14 for 2‐h glucose, P < 0.0001). Adding insulin sensitivity to the multivariate models further weakened the relationship of CRP to 2‐h glucose (r = 0.07, P < 0.05). CRP mean values increased by 2‐h glucose category (normal vs. impaired glucose tolerance vs. isolated post‐challenge hyperglycaemia).Conclusions Chronic, subclinical inflammation, as indicated by elevated circulating CRP levels, is more strongly associated with post‐challenge glycaemia than with fasting glucose levels in non‐diabetic subjects. This association is partially independent of body fat and insulin resistance.Diabet. Med. 19, 939–943 (2002)
Differing aspects of insulin resistance in diabetes complications: the shape of things to come. RD Lawrence lecture 2000
Authors: Chaturvedi N. 
Published: March 2003

AbstractThe anticipated global epidemic of diabetes, largely as a consequence of increased rates of obesity, will particularly impact on people of South Asian and African Caribbean descent, two populations at elevated risk of insulin resistance. This article contrasts the consequent heightened risk of heart disease on the one hand in South Asians, and the paradoxical protection from heart disease in African Caribbeans on the other. Protection from the hypertriglyceridaemic effects of insulin resistance is likely to account for much of the African Caribbean paradox, although the mechanisms remain unclear. The growing evidence that insulin resistance is commonly observed in people with Type 1 diabetes, as well as those with Type 2 diabetes, and that features of insulin resistance may play a crucial role in the development of microvascular, as well as macrovascular complications, is also discussed. This indicates novel targets for the prevention and treatment of diabetes complications.Diabet. Med. 19, 973–977 (2002)
A comparison of pinewood and moorland soils in the Abernethy Forest Reserve, Scotland
Authors: Wilson Brian , Puri Geeta 
Published: March 2003

AbstractDespite considerable published literature on the above‐ground ecology of the pinewoods of Scotland, little research has considered the way in which pinewood soils differ from those under other vegetation types. Soil properties were compared between ancient, semi‐natural Scots pine forest and moorland on three soil types in the Abernethy Forest Reserve in the Cairngorm Mountains of Scotland. Soil morphology differed considerably between the vegetation types on each soil type, principally in the thickness of organic layers. Forest soils had thicker organic layers and this was particularly true of the F horizon. Forest soils were slightly less acid than equivalent moorland soils and had accumulated significantly more carbon. Forest soils in this environment therefore have the capacity to sequester larger amounts of carbon than moorland, and therefore represent a significant potential carbon sink. The quantity of nitrogen and phosphorus was also consistently larger in the organic layers under pine forest and since little difference existed in these properties in the mineral horizons, it was concluded that this accumulation was real and represented a net addition to the tree‐soil system.
An avifaunal zonation of Switzerland and its relation to environmental conditions
Authors: Pasinelli Gilberto , Naef‐Daenzer Beat , Schmid Hans , Keller Verena , Holzgang Otto , Graf Roman , Zbinden Niklaus 
Published: March 2003

Abstract

We propose a quantitative zonation of Switzerland based on the distribution of breeding birds. We use a combined dataset from two nationwide bird censuses 20 years apart to account for distribution changes between the censuses. This approach approximates the ‘potential’ distribution of species more closely than a dataset from one period only.
A numerical approach with correspondence analysis and non‐hierarchical clustering resulted in five avifaunal regions, consisting of two lowland regions north of the alpine arch, two alpine regions and one region of southern alpine valleys.
We identified characteristic species for each region using the indicator value analysis of Dufrêne & Legendre (1997) and determined environmental conditions separating the regions with discriminant analysis.
Our zonation partly corresponds with previous subdivisions of Switzerland, but has the advantage of being based on a numerical approach instead of expert knowledge.
We discuss avifaunal and ecological differences between the regions and relate our zonation to the classical biogeographic regions of Europe. Finally, we evaluate the importance of the zonation for bird conservation.
Savanna–forest hysteresis in the tropics
Authors: Da Silveira Lobo Sternberg Leonel 
Published: March 2003

AbstractA simple dynamic model relating forest area in a region, its contribution to dry season precipitation and the effect on its own establishment was developed. The model equation shows hysteresis between forest and savannas as a function of imported dry season precipitation. Regions are either dominated by forests or savannas, with each ecosystem showing stability despite changes in imported dry season precipitation. Deforestation beyond a certain threshold value, however, could cause a collapse of forest ecosystems and replacement by savannas in marginal areas. The predictions of this model corroborate pollen core analysis in the Amazon basin, where historical stability of tropical forest cover has been shown despite global climate change.