bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fungal infection of the diabetic foot: two distinct syndromes
Authors: Heald A. H. , O'Halloran D. J. , Richards K. , Webb F. , Jenkins S. , Hollis S. , Denning D. W. , Young R. J. 
Published: March 2003

AbstractAims  Fungal infection of diabetic foot ulcers has not been described. We analysed the features of 17 patients with diabetic foot ulcers probably infected with fungi.Methods  Seventeen patients were identified with clinically infected foot ulcers, (i) which had failed to heal despite prolonged antibiotic therapy and intensive podiatric care, (ii) from which Candida spp. was isolated or hyphae ± yeasts were visualized in material from ulcers or surrounding skin.Results  Multiple ulcers arising simultaneously were present in 10 patients (59%), preceded by blistering in seven cases. Single ulcers with markedly ulcerated margins were present in seven (41%) patients and were preceded by blisters in two. All 17 cases had neuropathy and 15 (88%) had severe peripheral vascular disease. All ulcers responded to antifungal therapy.Conclusions  Candida spp. is associated with two distinctive patterns of protracted ulceration in diabetic feet which improve following systemic antifungal therapy.Diabet. Med. 18, 567–572 (2001)
Glibenclamide improves postprandial hypertriglyceridaemia in Type 2 diabetic patients by reducing chylomicrons but not the very low‐density lipoprotein subfraction levels
Authors: Skrapari I. , Perrea D. , Ioannidis I. , Karabina S.‐A. P. , Elisaf M. , Tselepis A. D. , Karagiannacos P. , Katsilambros N. 
Published: March 2003

AbstractAim  There are scarce data dealing with the degree of postprandial lipaemia after sulphonylurea administration. The aim of this study was to examine the effect of acute glibenclamide administration on postprandial lipaemia in Type 2 diabetic patients.Methods  Eight randomly selected Type 2 diabetic individuals, aged 43–65 years (mean, 54 years), who had never received any anti‐diabetic drug, were included in the study. Each patient was given a 485 kcal mixed meal (45% fat, 40% carbohydrate and 15% protein) twice on separate days after an overnight fast: once with placebo and once with 5 mg glibenclamide, per os, in a random order. The two tests were performed with an interval of 7 days. Venous blood samples were drawn just before and 2 h, 4 h and 6 h after meal consumption. Total triglyceride levels in plasma, in chylomicrons (CM), in CM‐deficient plasma, in very low‐density lipoprotein (VLDL) subfractions (VLDL‐1, VLDL‐2) and in intermediate‐density lipoprotein (IDL) were determined. Free fatty acid (FFA) and total cholesterol levels in plasma, as well as high‐density lipoprotein (HDL) cholesterol and low‐density lipoprotein (LDL) cholesterol levels in CM‐deficient plasma, were also measured. Finally, serum glucose, insulin and C‐peptide concentrations were measured in each sample.Results  As expected there was a significant decrease in postprandial glycaemia after glibenclamide administration compared to placebo (mean area under the curve values: AUC = 53.3 ± 18.2 and 69.1 ± 21.6 mm/h, P = 0.00009). In addition, the mean AUC values of insulin and C‐peptide were significantly greater after drug administration. The AUC values of total plasma triglyceride and of CM triglyceride following glibenclamide administration were significantly lower compared to placebo, while the AUC values of postprandial triglyceride in CM‐deficient plasma and of postprandial triglyceride in VLDL‐1, VLDL‐2 and IDL were not different after drug administration compared to placebo. Finally, no significant differences were noted in the AUC values of total cholesterol, LDL cholesterol, HDL cholesterol and plasma FFA levels after glibenclamide administration.Conclusions  These results demonstrate that glibenclamide administration improves postprandial hypertriglyceridaemia acutely by reducing postprandial triglycerides of intestinal origin.Diabet. Med. 18, 781–785 (2001)
The vitamin D receptor gene variant is associated with the prevalence of Type 2 diabetes mellitus and coronary artery disease
Authors: Ortlepp J. R. , Lauscher J. , Hoffmann R. , Hanrath P. , Joost H. G. 
Published: March 2003

AbstractAims  Vitamin D can influence lipolysis and insulin secretion. A common genetic polymorphism of the vitamin D receptor, which has been found to be associated with bone mineral density, has also been reported to be associated with insulin‐dependent diabetes mellitus. To test the influence of the vitamin D receptor polymorphism on the prevalence of Type 2 diabetes mellitus and coronary artery disease we studied a population of high‐risk patients, who were referred to our clinic for diagnostic coronary angiography.Methods  A total of 293 patients considered at high risk for coronary artery disease because of angina pectoris and known hypercholesterolaemia underwent diagnostic coronary angiography. The BsmI vitamin D receptor polymorphism was analysed by polymerase chain reaction.Results  Prevalence of Type 2 diabetes mellitus and coronary artery disease was gradually dependent on the number of B alleles (BB 28%, Bb 13%, bb 8% for Type 2 diabetes mellitus, P = 0.002; BB 88% Bb 72%, bb 66% coronary artery disease, P = 0.01). Patients with the BB genotype had an odds ratio of 3.64 (95% confidence interval 1.53–8.55, P = 0.002) to have Type 2 diabetes mellitus compared with patients with the bb genotype.Conclusions  The genotype of the vitamin D receptor polymorphism determines the prevalence of Type 2 diabetes mellitus and coronary artery disease in a high‐risk cohort population.Diabet. Med. 18, 842–845 (2001)
Visual symptomatology in patients with sight‐threatening diabetic retinopathy
Authors: Bailey C. C. , Sparrow J. M. 
Published: March 2003

AbstractAims  To assess the level of visual symptomatology in patients with sight‐threatening diabetic retinopathy.Methods  Questionnaires were completed by patients undergoing first photocoagulation treatment for diabetic maculopathy or proliferative retinopathy during a 2‐month period throughout the UK, and at 9 months' follow‐up.Results  There were high levels of visual symptomatology prior to the first laser treatment and at follow‐up for both patients with maculopathy or with proliferative retinopathy. Only 25.1% of patients with maculopathy and 17.2% of patients with proliferative retinopathy were asymptomatic in terms of reading, seeing the television screen, recognizing faces or with their night vision at baseline. For those with maculopathy 20.1% were aware of colour vision abnormality in the eye to be treated at baseline and 9.5% were aware of new central scotomata since the treatment. Of those with proliferative retinopathy, 13% said that they had given up driving due to poor eyesight and 19% were aware of new peripheral field defects since the treatment.Conclusions  There are high levels of visual symptomatology for patients with sight‐threatening diabetic retinopathy in the UK despite that fact that screening should aim to detect retinopathy prior to visual loss occurring. Patients should be aware that there may not be any significant improvement in their vision with laser treatment, and that the main aim of treatment is to reduce the likelihood of further visual deterioration.Diabet. Med. 18, 883–888 (2001)
Diabetic nephropathy is associated with the 5¢‐end dinucleotide repeat polymorphism of the aldose reductase gene in Chinese subjects with Type 2 diabetes
Authors: Liu Y. F. , Wat N. M. S. , Chung S. S. M. , Ko B. C. B. , Lam K. S. L. 
Published: March 2003

AbstractAims We investigated whether the promoter dinucleotide repeat polymorphism of the aldose reductase gene (5′‐ALR2), implicated in the development of nephropathy in Type 1 diabetes, was associated with diabetic nephropathy in Type 2 diabetes.Methods In 265 Southern Chinese with Type 2 diabetes the 5′‐ALR2 polymorphism was identified in genomic DNA using polymerase chain reaction and automated fluorescent scanning. They were classified as normoalbuminuric (n = 128), microalbuminuric (n = 85) or albuminuric (n = 52) according to the mean albumin excretion rate of two 12‐h overnight collections.Results The 5′‐ALR2 allele and genotype distributions differed significantly among the three groups of patients (P < 0.003 and P < 0.01, respectively). Normoalbuminuric patients had the lowest Z − 2 allele frequency: 17.6% vs. 28.2% and 23.1% for microalbuminuric and albuminuric patients, respectively, and the highest Z + 2 allele frequency: 36.7% vs. 21.2% and 23.1% in microalbuminuric and albuminuric patients, respectively. They also had the lowest Z − 2/X genotype frequency (X = any allele other than Z + 2): 18.8% vs. 36.5% in microalbuminuric (P < 0.01) and 38.5% in albuminuric patients (P < 0.02), respectively, but the highest Z + 2/Y genotype frequency (Y = any allele other than Z − 2): 50.7% vs. 27.0% and 34.6% in microalbuminuric (P < 0.001) and albuminuric patients, respectively. In a multiple logistic regression model, the Z − 2/X genotype (odds ratio 3.10; P < 0.025) was an independent risk factor of diabetic nephropathy, microalbuminuria or albuminuria, together with age, mean arterial pressure and body mass index.Conclusions The 5′‐ALR2 dinucleotide repeat polymorphism is associated with the development of diabetic nephropathy in Southern Chinese with Type 2 diabetes.Diabet. Med. 19, 113–118 (2002)
Quality assurance in screening for sight‐threatening diabetic retinopathy
Authors: Pandit R. J. , Taylor R. 
Published: March 2003

AbstractAims There is a need for continuous evaluation of screening services for diabetic retinopathy against agreed performance standards. We describe a quality assurance programme implemented in Newcastle in January 1999 and report on outcomes at 18 months.Methods Annual retinal screening is performed using combined retinal photography and direct ophthalmoscopy in two streams. Diabetologists perform screening in the Hospital Screening Programme, which serves patients whose diabetes is managed in specialist clinics, and trained retinal screeners perform screening in the District Screening Programme, which serves patients whose diabetes is managed in the community. Reference standard examination of dilated fundoscopy with a slit‐lamp and condensing lens was performed by an ophthalmologist at periodic sessions on consecutive patients attending for screening.Results Six hundred and nine (6.4%) of 9468 patients screened underwent reference standard examination. The sensitivity and specificity of detection of sight‐threatening diabetic retinopathy (STDR) was 82.5% and 98%, respectively, for the Hospital Screening Programme; 85.7% and 95.7%, respectively, for the District Screening Programme; and 83.3% and 96.8% for both services combined. One hundred and ten (18.1%) of 609 patients audited were referred to ophthalmology as a result of screening, and this led to 16 patients (2.6%) receiving laser photocoagulation for STDR. Reference standard examination identified a further four patients (0.7%) who required laser photocoagulation.Conclusions Preliminary data indicate that satisfactory performance standards are being achieved. The National Service Framework for Diabetes requires that all units institute quality assurance for retinal screening, and we report the practical implementation of this in one district.Diabet. Med. 19, 285–291 (2002)
Current methods of transfer of young people with Type 1 diabetes to adult services
Authors: Kipps S. , Bahu T. , Ong K. , Ackland F. M. , Brown R. S. , Fox C. T. , Griffin N. K. , Knight A. H. , Mann N. P. , Neil H. A. W. , Simpson H. , Edge J. A. , Dunger D. B. 
Published: March 2003

AbstractAims To determine the efficacy and patient perception of various transfer procedures from paediatric to adult diabetes services.Methods Comparison between four districts in the Oxford Region employing different transfer methods, by retrospective study of case records and interviews of patients recently transferred from paediatric diabetes clinics. The main outcome measures were age at transfer, clinic attendance rates, HbA1c measurements and questionnaire responses.Results Two hundred and twenty‐nine subjects (57% males) > 18 years old in 1998 and diagnosed with Type 1 diabetes < 16 years of age between 1985 and 1995, identified from the regional diabetes register. The notes audit was completed for 222 (97%) and 164 (72%) were interviewed by a single research nurse. Mean age at transfer was 17.9 years (range 13.3–22.4 years). Few young people were lost to follow‐up at the point of transfer. There was a high rate of clinic attendance (at least 6 monthly) 2 years pretransfer (94%), but this declined to 57% 2 years post‐transfer (P < 0.0005). There was large interdistrict variation in clinic attendance 2 years post‐transfer (29% to 71%); higher rates were seen in districts where young people had the opportunity to meet the adult diabetes consultant prior to transfer. The importance of this opportunity was confirmed by questionnaire responses on interview.Conclusions Adolescence is a vulnerable period for patients with diabetes. This regional survey demonstrated a marked decline in clinic attendance around the time of transition from paediatric to adult services. The reasons are complex, but mode of transfer may be an important factor.Diabet. Med 19, 649–654 (2002)
Comparison of vibration perception thresholds obtained with the Neurothesiometer and the CASE IV and relationship to nerve conduction studies
Authors: Bril V. , Perkins B. A. 
Published: March 2003

AbstractAims Vibration perception thresholds (VPTs) are used frequently to assess somatosensory pathways in clinical trials. Different equipment, testing paradigms, and stimulation sites produce varying results which make comparisons between trials and patient populations challenging. Information comparing the VPT obtained with the Neurothesiometer with that with the Vibratron is available, but not for a similar comparison with the CASE IV (computer‐assisted sensory examination device).Methods Subjects (n = 478) including reference, non‐neuropathic subjects with diabetes mellitus (DM), and diabetic patients with mild, moderate and severe diabetic sensorimotor polyneuropathy (DSP) had VPTs measured with the CASE IV and Neurothesiometer, as well as standard sural nerve conduction studies (NCS), all performed during the same half‐day. The dorsum of the foot was used as the site of stimulation for the CASE IV VPT determination and the distal phalanx of the first toe for the Neurothesiometer.Results VPTs by the CASE IV and the Neurothesiometer compared moderately by linear regression analyses (R2 = 0.547, P < 0.0001), and by 95% confidence intervals. Sensitivity for the diagnosis of mild DSP was 70% with the Neurothesiometer and 49% with the CASE IV. VPTs determined by either the Neurothesiometer or the CASE IV correlated with similar agreement to the sural nerve action potential amplitude as determined by nerve conduction studies (NCS) (R2 = 0.456 and 0.461, respectively, P < 0.0001).Conclusions The results demonstrated a significant correlation of VPT values in different stages of DSP obtained by the two methods. The Neurothesiometer was more sensitive for the diagnosis of DSP, particularly in those with mild neuropathy. Similar correlations between VPTs and electrophysiological parameters were observed, indicating that both methods are valid, and thus the Neurothesiometer may be preferable due to the ease and rapidity of testing by this method.Diabet. Med. 19, 661–666 (2002)
Gliclazide improves anti‐oxidant status and nitric oxide‐mediated vasodilation in Type 2 diabetes
Authors: Fava D. , Cassone‐Faldetta M. , Laurenti O. , De Luca O. , Ghiselli A. , De Mattia G. 
Published: March 2003

AbstractAims To evaluate the effects of gliclazide on oxidative status and vascular response to systemic administration of L‐arginine, the natural precursor of nitric oxide (NO), in Type 2 diabetic patients.Methods Thirty Type 2 diabetic patients received glibenclamide (n = 15) or gliclazide (n = 15) in a 12‐week, randomized, observer‐blinded, parallel study. Plasma lipid peroxides, total radical‐trapping anti‐oxidant parameter (TRAP), and blood pressure responses to an intravenous bolus of L‐arginine were measured pre‐ and post‐treatment.Results At 12 weeks, gliclazide patients had lower plasma lipid peroxides (13.3 ± 3.8 µmol/l vs. 19.2 ± 4.3 µmol/l; P = 0.0001) and higher plasma TRAP (1155.6 ± 143.0 µmol/l vs. 957.7 ± 104.3 µmol/l; P = 0.0001) than the glibenclamide patients. Gliclazide but not glibenclamide significantly reduced systolic and diastolic blood pressure (P = 0.0199 and P = 0.00199, respectively, two‐way repeated measures analysis of variance) in response to intravenous L‐arginine.Conclusions Gliclazide reduces oxidative stress in Type 2 diabetic patients by improving plasma anti‐oxidant status. This effect is associated with enhanced NO‐mediated vasodilation.
Comparison of serum concentrations of soluble adhesion molecules in diabetic microangiopathy and macroangiopathy
Authors: Matsumoto K. , Sera Y. , Ueki Y. , Inukai G. , Niiro E. , Miyake S. 
Published: March 2003

AbstractAims To clarify the correlation between serum concentrations of soluble adhesion molecules and diabetic microangiopathy or macroangiopathy in patients with Type 2 diabetes.Methods Patients with diabetic retinopathy and intima‐media thickness of common carotid artery (CCA‐IMT) < 1.1 mm were classified as the microangiopathy group (n

=
62). Patients with CCA‐IMT ≥
1.1 mm and without retinopathy were classified as the macroangiopathy group (n

=
95). Patients with CCA‐IMT < 0.9 mm and without retinopathy were assigned to the no complications group (n = 139). Clinical characteristics and soluble intercellular adhesion molecule‐1 (ICAM‐1), vascular cell adhesion molecule‐1 (VCAM‐1), and E‐selectin levels were compared between the groups.Results Patients with microangiopathy had a significantly longer duration of diabetes, were hypertensive and more likely to have a positive family history of diabetes than the control group. Patients with macroangiopathy were more likely to be smokers, hypertensive, and have a family history of hypertension. Soluble ICAM‐1, VCAM‐1, and E‐selectin levels were significantly higher in the microangiopathy group than in the control group. Soluble VCAM‐1 and E‐selectin levels, but not ICAM‐1 levels, were significantly elevated in the macroangiopathy group. These results were unchanged after adjustment for age, sex, duration of diabetes, blood pressure, HbA1c, HDL‐cholesterol, and smoking status.Conclusions Our results suggest that soluble adhesion molecules are related to both diabetic micro‐ and macroangiopathy. The relative contributions of adhesion molecules may be greater in the former than latter patients with Type 2 diabetes.
Familial clustering of diabetic retinopathy in South Indian Type 2 diabetic patients
Authors: Rema M. , Saravanan G. , Deepa R. , Mohan V. 
Published: March 2003

AbstractAim The aim of the study was to determine whether there is familialclustering of diabetic retinopathy among South Indian Type 2 diabeticsubjects.Methods During the period September 1991 to September 1997, 322 families withat least two diabetic siblings who were registered at our centreand had undergone a retinal examination were selected for the study.The sibling with the longest duration of diabetes was defined as theproband. The prevalence of retinopathy was compared between thesiblings of probands with and without retinopathy.Results Diabetic retinopathy was diagnosed in 11.2% of the siblingsof the probands without diabetic retinopathy and in 35.3% ofthe siblings of the probands with diabetic retinopathy (P < 0.0001). Theincreased prevalence of retinopathy among siblings of probands withretinopathy represented all grades of retinopathy, namely non‐proliferativediabetic retinopathy with and without maculopathy and proliferative diabeticretinopathy, although the latter did not reach statistical significancedue to the small numbers. Hypertension, metabolic control and theduration of diabetes among the probands did not affect the clusteringof retinopathy. The odds ratio for retinopathy in the siblings of probandswith retinopathy after adjusting for age, glycosylated haemoglobin, durationof diabetes, proteinuria and other confounding variables was 3.37(95% confidence interval 1.56–7.29, P = 0.002).Conclusions Familial clustering of diabetic retinopathy was three times higherin siblings of Type 2 diabetic subjects with diabetic retinopathy.Diabet. Med. 19, 910–916 (2002)
Pertussis infection in childhood and subsequent Type 1 diabetes mellitus
Authors: Montgomery S. M. , Ehlin A. G. C. , Ekbom A. , Wakefield A. J. 
Published: March 2003

AbstractAims Pertussis has been implicated but not proven as a risk for Type 1 diabetes mellitus (DM). Previous studies have investigated paediatric, but not adult‐onset Type 1 DM. We investigated association of pertussis exposures and Type 1 DM with follow‐up into adulthood.Methods Longitudinal analysis of 16 820 members (100 with Type 1 DM) of two nationally representative British birth cohorts (the 1970 British Cohort Study (BCS70) and the National Child Development Study (NCDS)) followed from birth to ages 30 years (BCS70) and 42 years (NCDS). Cox regression analysis with age of onset for Type 1 DM as the dependent variable investigated relationships with pertussis infection and immunization, modelled as time‐dependent co‐variates. Simultaneous adjustment was made for Wild measles, mumps and chickenpox infections; tetanus and smallpox immunizations; sex, parental social class and cohort. The potential confounding factors were modelled as fixed co‐variates.Results Cox regression analysis produced adjusted odds ratios (ORs) (with 95% confidence intervals (CIs)) of 2.21 (1.35–3.59) and 0.73 (0.49–1.05) for Type 1 DM (with onset at any age) associated with pertussis infections and immunization (trend over number of vaccinations), respectively. Adjusted ORs from Cox regression for Type 1 DM with onset after age 10 years are 2.59 (1.56–4.30) for pertussis infection and 0.63 (0.42–0.94) for pertussis immunization. None of the other infections or immunizations are notably associated with Type 1 DM.Conclusions Some pertussis infections may be a risk for Type 1 DM and immunization may confer protection. Further research should consider delayed Type 1 DM following pertussis exposures.Diabet. Med. 19, 986–993 (2002)
Microalbuminuria is more frequent in South Asian than in European origin populations: a comparative study in Newcastle, UK
Authors: Fischbacher C. M. , Bhopal R. , Rutter M. K. , Unwin N. C. , Marshall S. M. , White M. , Alberti K. G. M. M. 
Published: March 2003

AbstractAims We aimed to compare levels of urinary albumin excretion and the prevalence of microalbuminuria in UK South Asians and Europeans. Microalbuminuria predicts cardiovascular disease in European origin populations, but evidence from the general population of South Asians is lacking. Coronary heart disease (CHD) mortality is 40–50% higher in UK South Asians compared with the whole population, for reasons that are incompletely understood.Methods Microalbuminuria was measured using the albumin–creatinine ratio in an age‐ and sex‐stratified random sample of 1509 adults from European (n = 825), Indian (n = 259), Pakistani (n = 305) and Bangladeshi (n = 120) ethnic groups.Results Levels of urinary albumin excretion were substantially higher in South Asians (geometric mean albumin creatinine ratio (95% confidence interval) 0.83 (0.75, 0.91)) than in Europeans (0.55 (0.51, 0.60)). Microalbuminuria was associated with older age, hypertension and diabetes, but independently of these risk factors urinary albumin excretion was higher in South Asians than Europeans.Conclusions Urinary albumin excretion is higher and microalbuminuria more frequent in UK South Asians compared with the majority ethnic population. Microalbuminuria may be relevant to the causal pathways leading to the excess of cardiovascular mortality and possibly renal failure in UK South Asians.