bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insulin sensitivity in hypertensive Type 2 diabetic patients after 1 and 19 days' treatment with trandolapril
Authors: New J. P. , Bilous R. W. , Walker M. 
Published: March 2003

Summary Aims The aims of this study were to examine the effects of trandolapril, a long acting angiotensin converting enzyme (ACE) inhibitor with high tissue uptake, on insulin sensitivity and lipid concentrations in hypertensive patients with Type 2 diabetes mellitus. Methods Insulin sensitivity was assessed after an acute dose (day 3) and 19 days continuous treatment (days 3–21) using the isoglycaemic, hyperinsulinaemic glucose clamp with
d[3–3H] labelled glucose, a variable
d[3–3H] priming dose and a ‘hot’ glucose infusion. Rates of glucose appearance (Ra) and glucose disappearance (Rd) were isotopically determined during the basal and insulin stimulated periods of the clamp. Twenty‐four (5 female) hypertensive (blood pressure > 75th centile for age and sex) patients with Type 2 diabetes mellitus were studied. Patients were randomized, in a double‐blind manner, to either trandolapril 4 mg daily (T) or placebo (P). Results Baseline (day 1) systolic (mean ±sd; P 164 ± 14 and T 168 ± 13 mmHg) and diastolic (P 93 ± 6, and T 98 ± 10 mmHg) blood pressures were comparable. On days 3 and 21, significant reductions were observed in both groups (P < 0.001). In the trandolapril‐treated group, serum trandolapril concentrations were > 200 pg/ml on days 3 and 21, in all patients apart from one subject at a single visit, while trandolapril was undetectable in the placebo group. Body mass index (BMI) was greater in T compared with P (32.2 ± 5.4 v 28.3 ± 4.6, P = 0.07). After correcting for BMI, basal hepatic glucose output (HGO) P 2.6 (95% CI 2.23–3.13) and T 1.91 (1.33–2.51) mg.kg−1.min−1 and clamped HGO P 0.32 (−0.44–1.09) and T 0.87 (0.40–1.34) mg.kg−1.min−1 were similar in both groups. The insulin sensitivity index was comparable in both groups on all days. Total cholesterol concentrations were similar in both groups throughout the study. Triglyceride concentrations were significantly lower in group P 1.38 (1.07–1.68); T 2.14 (1.70–2.58) mmol/l, P < 0.01), no significant treatment effect being observed. Conclusions An acute dose and 19 days' continuous treatment with trandolapril resulted in no change in insulin sensitivity or plasma lipid profiles in patients with Type 2 diabetes mellitus and hypertension. These data support the metabolic neutrality of trandolapril in patients with Type 2 diabetes mellitus and hypertension.
Microcirculatory response of skin to benzoic acid and methyl nicotinate in patients with diabetes
Authors: Koivukangas V. , Oikarinen A. , Salmela P. I. , Lahti A. 
Published: March 2003

Summary Aims In view of the relationship between microvascular pathology and organ complications in diabetes mellitus, the aim of the present study was to examine the microvascular response of upper arm skin to non‐immunological contact irritants in 17 insulin‐dependent diabetic patients and 11 non‐diabetic controls. Methods Non‐immunological contact urticaria, an inflammatory reaction mediated in a unique way, not previously studied in diabetic patients, was examined. The test agents were benzoic acid and methyl nicotinate. The intensity of the reactions was measured using laser‐Doppler flowmetry and colorimetry. The patients were divided into two groups, depending on whether they had had diabetes for less or more than 10 years. Results There were no differences in the maximal blood flow responses between the groups, but the diabetic patients showed increased blood flow responses to the lowest irritant concentrations compared to the controls. The reactions in the two groups of diabetic patients were similar. Conclusions The present study suggests that the microvascular reactivity of diabetic skin to non‐immunological contact irritants is increased.
Beneficial effects of C‐peptide on incipient nephropathy and neuropathy in patients with Type 1 diabetes mellitus
Authors: Johansson B. ‐L. , Borg K. , Fernqvist‐Forbes E. , Kernell A. , Odergren T. , Wahren J. 
Published: March 2003

Summary Aims Recent studies have indicated that proinsulin C‐peptide shows specific binding to cell membrane binding sites and may exert biological effects when administered to patients with Type 1 diabetes mellitus. This study was undertaken to determine if combined treatment with C‐peptide and insulin might reduce the level of microalbuminuria in patients with Type 1 diabetes and incipient nephropathy. Methods Twenty‐one normotensive patients with microalbuminuria were studied for 6 months in a double‐blind, randomized, cross‐over design. The patients received s.c. injections of either human C‐peptide (600 nmol/24 h) or placebo plus their regular insulin regimen for 3 months. Results Glycaemic control improved slightly during the study and to a similar extent in both treatment groups. Blood pressure was unaltered throughout the study. During the C‐peptide treatment period, urinary albumin excretion decreased progressively on average from 58 μg/min (basal) to 34 μg/min (3 months, P < 0.01) and it tended to increase, but not significantly so, during the placebo period. The difference between the two treatment periods was statistically significant (P < 0.01). In the 12 patients with signs of autonomic neuropathy prior to the study, respiratory heart rate variability increased by 21 ± 9% (P < 0.05) during treatment with C‐peptide but was unaltered during placebo. Thermal thresholds were significantly improved during C‐peptide treatment in comparison to placebo (n = 6, P < 0.05). Conclusion These results indicate that combined treatment with C‐peptide and insulin for 3 months may improve renal function by diminishing urinary albumin excretion and ameliorate autonomic and sensory nerve dysfunction in patients with Type 1 diabetes mellitus.
Evaluation of a holistic treatment and teaching programme for patients with Type 1 diabetes who failed to achieve their therapeutic goals under intensified insulin therapy
Authors: Bott U. , Bott S. , Hemmann D. , Berger M. 
Published: March 2003

SUMMARY Aims  To evaluate a treatment and teaching programme including psychosocial modules for patients with Type 1 diabetes mellitus on intensified insulin therapy who failed to achieve their treatment goals despite participation in standard programmes.Methods  The 5‐day inpatient programme comprises small groups of 4–6 patients, focusing on individual needs and problems. Beyond the teaching lessons (most topics are deliberately chosen by the patients), the programme provides intensive group discussions and offers individual counselling concerning motivational aspects, psychosocial problems and coping strategies. Of the first consecutive 83 participants, 76 were re‐examined after 17.5 ± 5.5 months (range 9–31 months).Results  At follow‐up, HbA1c was not improved compared to baseline (8.0 ± 1.3% vs. 8.1 ± 1.5%). However, the incidence of severe hypoglycaemia per patient/year (glucose i.v., glucagon injection) was substantially decreased: 0.62 ± 1.5 episodes at baseline compared to 0.16 ± 0.9 at follow‐up (P < 0.001). Twenty‐six per cent of the patients at baseline, and 4% at re‐examination had experienced at least one episode of severe hypoglycaemia during the preceding year (P < 0.001). Sick leave days per patient/year decreased from 17.0 ± 38.5–7.7 ± 13.6 days (P < 0.05). Patients improved their perceptions of self‐efficacy, their relationship to doctors and felt less externally controlled (P < 0.001). The majority of patients perceived an improved competence regarding diet (80.6%) and adaptation of insulin dosage (82.4%), an improved knowledge (82.2%), and a renewed motivation for the treatment (84.5%). Treatment success was significantly associated with baseline HbA1c, stability of motivation, frequency of blood glucose self‐monitoring, control beliefs and change in subsequent outpatient care.Conclusions  The programme improved glycaemic control mainly as a result of a substantial reduction in the incidence of severe hypoglycaemia. Patients with persistent poor glycaemic control may benefit from structured follow‐up care focusing on motivational aspects of self‐management and psychosocial support.
Hyperinsulinaemia in offspring of Type 2 diabetic patients: impaired response of carbohydrate metabolism, but preserved cardiovascular response
Authors: Frontoni S. , Pellegrinotti M. , Bracaglia D. , Farrace S. , Caselli A. , Baroni A. , De Angelis C. , Menzinger G. , Gambardella S. 
Published: March 2003

SUMMARY Aims  To investigate the effects of endogenous insulin on haemodynamics in nine offspring of Type 2 diabetic patients (P), compared with 18 subjects without family history of diabetes (C), all with normal glucose tolerance.Methods  All subjects underwent a 180‐min oral glucose tolerance test with continuous blood pressure and ECG recording. Low‐to‐high frequency ratio (LF/HF), an index of the sympatho‐vagal balance, was calculated by heart rate spectral analysis.Results  At baseline, LF/HF correlated with fasting plasma insulin (r = 0.44, P < 0.03) and with insulin/glucose ratio (r = 0.46, P < 0.03). Plasma insulin, basally similar in the two groups, was significantly increased in P (342 ± 34.2) when compared to C (177.6 ± 25.2 pmol/l), P < 0.005 from time 30 min onward. Blood glucose, also similar at baseline, remained not significantly different in P (5.74 ± 0.25) vs. C (5.08 ± 0.27 mmol/l), throughout the study. Diastolic blood pressure significantly decreased in P, but not in C during the first hour of the study. Finally, LF/HF ratio significantly increased in P (2.5 ± 0.4 vs. C, 1.7 ± 0.2) during the first hour.Conclusions  In conclusion, the offspring of Type 2 diabetic patients with normal glucose tolerance display an increased insulin secretion; however, they are not resistant to the haemodynamic effects of insulin, as suggested by the reduction of diastolic blood pressure. This, in turn, may determine a chronic sympathetic activation, which could be involved in the pathogenesis of Type 2 diabetes mellitus.
Type 2 diabetes mellitus, impaired glucose tolerance and associated factors in a rural Palestinian village
Authors: Husseini A. , Abdul‐Rahim H. , Awartani F. , Giacaman R. , Jervell J. , Bjertness E. 
Published: March 2003

SUMMARY Aims  To investigate the prevalence of Type 2 diabetes mellitus and impaired glucose tolerance (IGT) and to identify risk factors associated with diabetes in a rural Palestinian village.Methods  A cross‐sectional, population‐based study investigating 500 adults aged 30–65 years (response rate 85%) determined the diabetes status using the oral glucose tolerance test (OGTT). A standard questionnaire, a simple clinical examination and laboratory tests assessed blood lipids, blood pressure, waist‐to‐hip ratio (WHR), body mass index (BMI) and other risk factors for diabetesResults  The prevalence of Type 2 diabetes was 9.8% (95% confidence interval 7.3–12.3) and IGT 8.6% (6.1–11.1), while the prevalence standardized to the European population was 11.6% (8.8–14.4) for Type 2 diabetes and 10.3% (7.6–13.0) for IGT. Age, positive family history, high triglycerides level, and high WHR were significantly associated with Type 2 diabetes.Conclusions  Of the factors associated with diabetes, WHR and triglycerides levels are potentially modifiable, and should be addressed by preventive health activities. The high prevalence of Type 2 diabetes mellitus and its potential increase as a result of the ageing of the Palestinian population constitutes a major public health problem.
Incidence and predictors of drug‐treated diabetes in elderly French subjects. The PAQUID Epidemiological Survey
Authors: Bourdel‐Marchasson I. , Dubroca B. , Letenneur L. , Fourrier A. , Richard‐Harston S. , Decamps A. , Rainfray M. , Emeriau J. ‐P. , Dartigues J. ‐F. 
Published: March 2003

SUMMARY Aims  To estimate the incidence and predictors of drug‐treated diabetes in elderly subjects.Methods  The PAQUID epidemiological survey, a population‐based study, has followed up 3777 subjects older than 65 years since 1988. At each visit (baseline, 1, 3, 5 and 8 years), treatment regimen was used to identify new drug‐treated diabetic subjects. Potential predictors of drug‐treated diabetes were collected during the baseline visit (body mass index (BMI), educational level, cigarette smoking and wine consumption, physical activity, depressive symptomatology, subjective health, treatment, and hypertension) and analysed by using a multivariate backward stepwise regression Cox model with delayed entry.Results  The prevalence rate of drug‐treated diabetes was 7.5% at baseline and 7.1% after 8 years' follow‐up. The incidence rate of drug‐treated diabetes was 3.8/1000 person‐years, 5.9/1000 person‐years in men and 2.4/1000 person‐years in women, with no significant variation according to age group. Male sex (relative risk (RR) 2.4, 95% confidence interval (CI) 1.4–4.0, P < 0.001, attributable risk (AR) 0.36), elevated BMI (for one point increase, RR 1.1, 95% CI 1.1–1.1, P < 0.001, ≥ 25 vs. < 25, RR 2.1, 95% CI 1.2–3.5, AR 0.33), thiazide diuretics used alone (RR 5.9, 95% CI 1.8–19.6, P = 0.02), and poorer subjective health (‘the same’ vs. ‘better’ RR 1.8, 95% CI 1.0–3.1, P = 0.04; ‘worse vs. ‘better’ RR 2.3, 95% CI 0.9–5.7, P = 0.06) were independent predictors of drug‐treated diabetes in this population.Conclusions  In older French individuals, men seem to be particularly exposed to drug‐treated diabetes although being overweight was found to be a strong predictor as in younger populations.
Comparison of ADA 1997 and WHO 1985 criteria for diabetes in south Indians – the Chennai Urban Population Study
Authors: Deepa R. , Rani S. Shanthi , Premalatha G. , Mohan V. 
Published: March 2003

SUMMARY Aims  To compare the American Diabetes Association (ADA) fasting criteria and World Health Organization (WHO) 2‐h criteria for diabetes in an urban south Indian population.Methods  Subjects were drawn from the Chennai Urban Population Study. Of the 1001 subjects studied, 52 (5.2%) were diagnosed as having diabetes according to WHO 2‐h criteria and 32 (3.2%) according to the ADA fasting criteria.Results  Twenty‐five (48%) of the subjects diagnosed with diabetes by the WHO 2‐h criteria were not classified as having diabetes by the ADA fasting criteria. Similarly, of the 78 subjects (7.8%) classified as having impaired glucose tolerance (IGT), only eight (10.3%) had impaired fasting glucose (IFG) according to the ADA fasting criteria. The overall agreement between the WHO 2‐h criteria and ADA fasting criteria was poor (κ = 0.40).Conclusions  Use of the ADA fasting criteria results in a lower prevalence rates of diabetes in this lean urban south Indian population.
Intramuscular injection of insulin lispro or soluble human insulin: pharmacokinetics and glucodynamics in Type 2 diabetes
Authors: Milicevic Z. , Profozic V. , Wyatt J. , Ristic S. , Woodworth J. R. , Seger M. , Kaliterna D. , Bates P. , Metelko Z. 
Published: March 2003

AbstractAim  The aim of the study was to compare the pharmacokinetics and glucodynamics of insulin lispro and soluble human insulin following intramuscular (i.m.) injection in patients with Type 2 diabetes with secondary failure of sulphonylureas.Methods  Single 15‐U i.m. doses of insulin lispro or soluble human insulin were administered to 16 patients in a two‐way, randomized, crossover design. Glucodynamic and pharmacokinetic parameters were determined over 6 h after insulin injection using clamp techniques.Results Insulin Cmax was significantly higher (971 ± 217 vs. 659 ± 141 pmol/l, P < 0.001) and Tmax was significantly shorter (46.9 ± 27 vs. 94.7 ± 50.1 min, P = 0.002) with insulin lispro. Glucose infusion rate (GIR) curves showed clear separation 20 min after injection and were significantly greater for insulin lispro during the 40–60, 60–80 and 80–100‐minute time intervals. Total glucose infused was only approximately 5% larger with insulin lispro during the 6‐h follow‐up, due to lower insulinaemia at later time points. The glucose Rmax and TRmax were not statistically different between insulin treatments.Conclusion  This study shows that i.m. injection of insulin lispro is followed by its more rapid absorption, which results in stronger metabolic effect in the first 2 h when compared with soluble human insulin under the same test conditions.Diabet. Med. 18, 562–566 (2001)
Limited joint mobility and plantar fascia function in Charcot's neuroarthropathy
Authors: Chuter V. , Payne C. 
Published: March 2003

AbstractAim  The aim of this study was to investigate the prevalence of limited joint mobility at the first metatarsophalangeal joint (MPJ) and dysfunction of the plantar fascia in people with diabetes mellitus and Charcot's neuroarthropathy and a control group.Methods  Fifteen subjects with a history of mid‐foot Charcot's neuroarthro pathy and 26 controls with sensory neuropathy but no Charcot's neuro arthropathy were recruited. Ranges of ankle and first MPJ dorsiflexion were measured for each participant. Plantar fascia function was assessed using Jack's test.Results The range of dorsiflexion at the first MPJ was significantly reduced in the subject group compared with the control group (51.2 vs. 64.8; P < 0.001). Jack's test demonstrated the plantar fascia to be ruptured or dysfunctional in all feet in the subject group and to be functioning in all feet in the control group.Conclusions  It is not possible to determine from this study if the limited joint mobility at the first MPJ and dysfunction of the plantar fascia preceded or followed the development of Charcot's neuroarthropathy; however, these results are a previously unreported finding in Charcot's neuroarthropathy.Diabet. Med. 18, 558–561 (2001)
Avascular necrosis not Charcot's
Authors: Samarasinghe Y. P. , Brunton S. L. , Feher M. D. 
Published: March 2003

AbstractBackground  A case of avascular necrosis (AN) of the navicular bone, in a 24‐year‐old woman with Type 1 diabetes with peripheral neuropathy, in the absence of any history of direct trauma is presented. The clinical and radiological features at presentation suggested an evolving Charcot arthropathy (CA), but subsequent serial X‐rays clearly confirmed AN.Conclusions Swelling and foot deformity in association with long‐standing diabetic peripheral neuropathy is suggestive of CA, although AN, a less common condition, may show the same clinical features. It is therefore important to undertake further confirmatory radiological investigations if there is any doubt about the diagnosis.Diabet. Med. 18, 846–848 (2001)
Cognitive function and information processing in Type 2 diabetes
Authors: Cosway R. , Strachan M. W. J. , Dougall A. , Frier B. M. , Deary I. J. 
Published: March 2003

AbstractAims  To determine whether uncomplicated Type 2 diabetes is associated with impairment of cognitive function and information processing ability.Methods  Thirty‐eight participants with uncomplicated Type 2 diabetes and 38 non‐diabetic controls were studied. The two groups were comparable for age and premorbid intellectual ability, and did not have other medical disorders likely to affect cognitive function. An extensive battery of tests was administered which assessed different levels and domains of cognitive functions including verbal and visual memory, executive function, general mental ability and efficiency of information processing.Results  No significant differences were found between the diabetic and control groups on any measure of cognitive function or information processing. The performance on these tests was not associated with recent glycaemic control (assessed by HbA1c). Duration of diabetes, however, correlated significantly with poorer performance on several measures of verbal memory.Conclusions  The results of the present study suggest that some aspect of Type 2 diabetes (as indexed by the estimated duration of the disorder) does relate significantly to cognitive function within the group with diabetes. However, other diabetes‐related factors, such as macrovascular disease, hypertension and depression, may contribute more to previously observed cognitive decrements in Type 2 diabetes.Diabet. Med. 18, 803–810 (2001)
Risk of diabetes in siblings of index cases with Type 2 diabetes: implications for genetic studies
Authors: Weijnen C. F. , Rich S. S. , Meigs J. B. , Krolewski A. S. , Warram J. H. 
Published: March 2003

AbstractAims The goal was to estimate the sibling recurrence‐risk ratio for Type 2 diabetes in families with diabetes occurring in middle age. Because diabetes aetiology involves environmental exposures and genetic susceptibility, we sought to identify determinants of the recurrence risk.Methods We surveyed patients diagnosed at ages 35–59 years (n = 563) to obtain information on the occurrence of diabetes in their relatives, particularly siblings (n = 1675). Age‐specific prevalences of diabetes in the US population were used for comparison.Results The overall sibling recurrence‐risk ratio for diabetes was low, about 1.8 in the Joslin families and even lower in three other studies that were reanalysed for comparison. In all studies, the diabetes risk in siblings of index cases without a history of diabetes in a parent was similar to that in the general population, suggesting that genetic factors contributed to the occurrence of diabetes in only a minority of these siblings. The fact that recurrence‐risk ratios were elevated only in families with one or two diabetic parents indicates that susceptibility to Type 2 diabetes is transmitted primarily through an affected parent. In addition, the sibling recurrence‐risk ratios were elevated even further in families with diabetes in both a parent and grandparent of the index case, and in siblings of non‐obese index cases (percent ideal body weight < 120%).Conclusions The selection of families with non‐obese index cases and vertical transmission of diabetes through three generations may improve the success of efforts to map susceptibility genes for Type 2 diabetes.
Paraoxonase gene cluster is a genetic marker for early microvascular complications in Type 1 diabetes
Authors: Kao Y. , Donaghue K. C. , Chan A. , Bennetts B. H. , Knight J. , Silink M. 
Published: March 2003

AbstractBackground Paraoxonase is a serum enzyme, which prevents oxidation of low‐density lipoprotein (LDL) by hydrolyzing lipid peroxides. Two polymorphisms in PON1 gene have been associated with cardiovascular and microvascular diseases in both diabetic and non‐diabetic patients.Aims The current project was designed to investigate the association between the polymorphisms of two PON genes and diabetes microvascular diseases (retinopathy and microalbuminuria) and any potential linkage between Met54Leu of PON1 and Cys311Ser of PON2 gene.Methods Diabetic retinopathy and albumin excretion rate were assessed in 372 adolescents with Type 1 diabetes who were genotyped for the two polymorphisms.Results We confirmed the increased susceptibility for diabetic retinopathy for the Leu/Leu genotype (odds ratio (OR) 3.34 (confidence interval (CI) 1.95, 5.75), P < 0.0001). The Ser/Ser genotype was significantly more common in those patients with microalbuminuria (albumin excretion rate ≥ 20 µg/min) compared with those with albumin excretion rate < 20 µg/min (OR 4.72 (CI 2.65, 8.41), P < 0.0001). The Ser311 of PON2 was in strong linkage disequilibrium with Leu54 of PON1 gene (Δ = 23 × 104, P < 0.001). The delta value was higher for those without complications (28 × 104, P < 0.001) compared with those with complications (15.5 × 104, P < 0.001).Conclusions This study supports the hypothesis that diabetic microangiopathy is genetically heterogeneous. PON1 Leu/Leu increases the risk for retinopathy and PON2 Ser/Ser increases the risk for microalbuminuria.