bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impairment of cardiac function in hypertensive patients with Type 2 diabetes: a LIFE study
Authors: Hildebrandt P. , Wachtell K. , Dahlöf B. , Papademitriou V. , Gerdts E. , Giles T. , Oikarinen L. , Tuxen C. , Olsen M. H. , Devereux R. B. 
Published: September 2005

AbstractAims  Type 2 diabetic patients with hypertension have an increased left ventricular (LV) mass and impaired cardiac function compared to hypertensive patients without diabetes. However, it is unknown if the impaired cardiac function can be explained solely by LV hypertrophy, or is independently related to diabetes.The aim of the present study was to compare LV function between diabetic and non‐diabetic hypertensive patients with electrocardiographic LV hypertrophy.Methods  In 937 patients participating in the LIFE echocardiographic substudy, all echocardiograms were centrally evaluated by a core reading centre measuring LV mass, systolic and diastolic LV function. Known diabetes was present in 105 patients.Results  Left ventricular mass was similar in diabetic and non‐diabetic patients. Endocardial systolic LV function, estimated by LV ejection fraction, was reduced and indices of midwall systolic LV function were impaired in the diabetic patients. Diastolic LV filling pattern was impaired and arterial stiffness, measured by pulse pressure/stroke index, was increased in diabetic patients.Conclusions  Systolic and diastolic LV function in hypertensive patients with electrocardiographic LV hypertrophy and diabetes are impaired independent of LV mass, most likely reflecting the adverse effects of diabetes per se.
Diagnostic screening of NEUROD1 (MODY6) in subjects with MODY or gestational diabetes mellitus
Authors: Sagen J. V. , Baumann M. E. , Salvesen H. B. , Molven A. , Søvik O. , Njølstad P. R. 
Published: September 2005

AbstractAims  Diagnostic screening of NEUROD1 in patients with maturity‐onset diabetes of the young (MODY) without mutations in the known MODY‐genes (MODYX) and in subjects diagnosed with gestational diabetes mellitus.Methods  Direct sequencing of NEUROD1 was performed in (i) 73 probands with clinical MODY without mutations in hepatocyte nuclear factor (HNF)‐4α (MODY1), glucokinase (MODY2) and hepatocyte nuclear factor (HNF)‐1α (MODY3), and (ii) 51 subjects diagnosed with gestational diabetes. Control material consisted of 105 anonymous blood donors.Results  Mean age at diagnosis of diabetes was 22 and 30 years in the MODYX patients and gestational diabetes mellitus subjects, respectively. Mean fasting blood glucose (9.6 ± 4.3 vs. 5.7 ± 1.0 mml/l) as well as glycosylated haemoglobin (8.2 ± 2.4 vs. 6.0 ± 0.6%) were higher in the MODYX patients than subjects with gestational diabetes. NEUROD1 mutations were not detected in our two study groups. Three previously reported polymorphisms were found: Ala45Thr, Pro197His and IVS1 −32 nt C>T. The amino acid substitution serine to cysteine in codon 29 (designated Ser29Cys) was detected in one out of 105 control subjects. As the control material consisted of anonymous blood donors, we were prevented from investigation of possible co‐segregation between the sequence variant Ser29Cys and diabetes mellitus.Conclusions  As we found no NEUROD1 mutations, diagnostic screening for this gene is not warranted in Norwegian MODYX patients. Our study also suggests that NEUROD1 is not a candidate gene in gestational diabetes mellitus (GDM). The sequence variant Ser29Cys was identified in one anonymous DNA sample, but we were prevented from studying possible co‐segregation with diabetes mellitus.
Effects of liraglutide (NN2211), a long‐acting GLP‐1 analogue, on glycaemic control and bodyweight in subjects with Type 2 diabetes
Authors: Feinglos M. N. , Saad M. F. , Pi‐Sunyer F. X. , An B. , Santiago O. ,   on behalf of the Liraglutide Dose‐Response Study Group
Published: September 2005

AbstractAims  Liraglutide (NN2211) is a long‐acting GLP‐1 analogue, with a pharmacokinetic profile suitable for once‐daily administration. This multicentre, double‐blind, parallel‐group, double‐dummy study explored the dose–response relationship of liraglutide effects on bodyweight and glycaemic control in subjects with Type 2 diabetes.Methods  Subjects (BMI 27–42 kg/m2) with Type 2 diabetes who were previously treated with an OAD (oral anti‐diabetic drug) monotherapy (69% with metformin), and had HbA1c ≤ 10% were enrolled. After a 4‐week metformin run‐in period, 210 subjects (27–73 years, 60% female) were randomised to receive liraglutide (0.045–0.75 mg) once daily or continued on metformin 1000 mg b.d. for 12 weeks.Results  Mean baseline values for the six treatment groups ranged from 6.8 to 7.5% for HbA1c, and 8.06–9.44 mmol/l (145–170 mg/dl) for fasting plasma glucose. After 12‐week treatment, a weight change of −0.05 to −1.9% was observed for the six treatment groups. Mean HbA1c changes from baseline for 0.045, 0.225, 0.45, 0.6, 0.75 mg liraglutide and metformin were +1.28%, +0.86%, +0.22%, +0.16%, +0.30% and +0.09%, respectively. No significant differences in HbA1c were observed between liraglutide and metformin groups at the three highest liraglutide dose levels (0.45, 0.6 and 0.75 mg). The lowest two liraglutide doses (0.045 mg and 0.225 mg) were not sufficient to maintain the fasting plasma glucose values achieved by metformin. No major hypoglycaemic episodes were reported. Episodes of nausea and/or vomiting were reported by 11 patients (6.3%) receiving liraglutide and three (8.8%) receiving metformin.Conclusions  Once‐daily liraglutide improved glycaemic control and weight, in a comparable degree to metformin. Liraglutide appeared to be safe and generally well tolerated. Higher doses of liraglutide merit study in future clinical trials.
Sibutramine improves insulin sensitivity without alteration of serum adiponectin in obese subjects with Type 2 diabetes
Authors: Hung Y.‐J. , Chen Y.‐C. , Pei D. , Kuo S.‐W. , Hsieh C.‐H. , Wu L.‐Y. , He C.‐T. , Lee C. H. , Fan S. C. , Sheu W. H.‐H. 
Published: September 2005

AbstractAim  To evaluate the effect of sibutramine on weight loss, insulin sensitivity and serum adiponectin levels in obese patients with Type 2 diabetes.Methods  This study is a randomized, double‐blind, placebo‐controlled parallel comparison study of sibutramine 15 mg/day and placebo. Forty‐eight eligible obese patients with Type 2 diabetes (age between 30 and 75 years with body mass index ≥ 27 kg/m2) were randomly assigned to receive either placebo (n = 24) or sibutramine (15 mg/day) (n = 24) for 6 months. Fifteen subjects in each group underwent meal tests and modified insulin suppression tests before and after 6 months’ treatment.Results  After 6 months of sibutramine treatment statistically significant changes from baseline were observed for body weight (85.4 ± 2.5 vs. 82.9 ± 2.4 kg, P < 0.005) and body mass index (32.0 ± 0.7 vs. 31.4 ± 0.6 kg/m2, P < 0.05) without a significant alteration of waist–hip ratio (W/H), blood pressure, heart rate, glycaemic parameters or lipid profiles. The steady‐state plasma glucose (SSPG) level during the modified insulin suppression test was significantly reduced in the sibutramine group (17.33 ± 2.92 vs. 14.29 ± 4.19 mmol/l, P < 0.05) despite similar steady‐state plasma insulin (SSPI) concentrations. In addition, serum adiponectin and C‐reactive protein (CRP) levels remained unchanged, although modest weight reduction was achieved after sibutramine treatment. There were also no significant correlations between changes in serum adiponectin and reduction of SSPG or body weight. Daily ambient plasma insulin and glucose concentrations in response to a test meal were not significantly different in subjects receiving sibutramine treatment.Conclusions  We conclude that treatment with sibutramine 15 mg once daily effectively reduces weight and enhances insulin sensitivity without alteration of serum adiponectin levels in obese patients with Type 2 diabetes.
Insulin pump therapy vs. multiple daily injections in obese Type 2 diabetic patients
Authors: Wainstein J. , Metzger M. , Boaz M. , Minuchin O. , Cohen Y. , Yaffe A. , Yerushalmy Y. , Raz I. , Harman‐Boehm I. 
Published: September 2005

AbstractAims  To compare the efficacy of insulin pump treatment with multiple daily injections in the treatment of poorly controlled obese Type 2 diabetic patients already receiving two or more daily injections of insulin plus metformin.Methods  Forty obese Type 2 diabetic subjects (using insulin) were randomized to treatment with continuous subcutaneous infusion pump (CSII) (Minimed®) or multiple daily insulin injections (MDI). At the end of the first 18‐week treatment period, patients underwent a 12‐week washout period during which they were treated with MDI plus metformin. They were then crossed‐over to the other treatment for an 18‐week follow‐up period. Patients performed 4‐point daily self blood‐glucose monitoring (SBGM) on a regular basis and 7‐point monitoring prior to visits 2, 8, 10 and 16. A subset of patients underwent continuous glucose monitoring using the Minimed® continuous glucose monitoring system (CGMS) at visits 2, 8, 10 and 16. A standard meal test was performed in which serum glucose was tested at fasting and once each hour for 6 h following a test meal. Glucose levels were plotted against time and the area under the curve (AUC) was calculated. HbA1c, weight, daily insulin dose and hypoglycaemic episodes were recorded.Results  In obese Type 2 diabetic patients already treated with insulin, treatment with CSII significantly reduced HbA1c levels compared with treatment with MDI. An additional CSII treatment benefit was demonstrated by reduced meal‐test glucose AUC. Initial reduction of daily insulin requirement observed in CSII‐treated subjects during the first treatment period was attributable to a period effect and did not persist over time.Conclusions  In the intent‐to‐treat analysis, CSII appeared to be superior to MDI in reducing HbA1c and glucose AUC values without significant change in weight or insulin dose in obese, uncontrolled, insulin‐treated Type 2 diabetic subjects.
Socio‐economic inequalities in the prevalence of Type 2 diabetes, cardiovascular risk factors and chronic diabetic complications in the Basque Country, Spain
Authors: Larrañaga I. , Arteagoitia J. M. , Rodriguez J. L. , Gonzalez F. , Esnaola S. , Piniés J. A. ,   the Sentinel Practice Network of the Basque Country
Published: September 2005

AbstractAims  To establish the relationship between socio‐economic status and the prevalence of known Type 2 diabetes, cardiovascular risk factors and chronic diabetic complications.Methods  In 2000, a cross‐sectional survey was conducted among 61 general practitioners (GPs) who studied 65 651 people older than 24 years. Of those, 2985 known Type 2 diabetic patients were registered. The main outcome measures were: diabetes prevalence, major cardiovascular risk factors, chronic diabetic complications and primary care services utilization in Type 2 diabetic patients. Socio‐economic status was based on area‐based socio‐economic measures.Results  The prevalence of known Type 2 diabetes was higher in patients of lower socio‐economic status (OR: 2.17, 95% CI: 1.77–2.28), especially among women (OR: 2.28, 95% CI: 1.91–2.73). In Type 2 diabetes patients, obesity, sedentary lifestyle, and abnormal levels of low‐density lipoprotein (LDL) cholesterol and HbA1c were more prevalent among those from lower socio‐economic status. Macroangiopathy was inversely associated with socio‐economic status after adjustment for clinical and demographic variables. Patients of lower socio‐economic status more frequently visited primary care services than those of higher status.Conclusions  This study shows an association between deprivation and Type 2 diabetes prevalence, cardiovascular risk factors and chronic diabetic complications in Type 2 diabetes patients. Despite a greater use of health services by less wealthy patients, they showed worse glycaemic control and more chronic complications. Besides clinical variables, socio‐economic status and environmental information need to be considered in the assessment of risk profile of diabetic patients by health professionals and by health service planners.
Association of angiotensin‐converting enzyme DD genotype with 24‐h blood pressure abnormalities in normoalbuminuric children and adolescents with Type 1 diabetes
Authors: Barkai L. , Soós A. , Vámosi I. 
Published: September 2005

AbstractAims  To assess the distribution of the insertion/deletion (I/D) polymorphism of the angiotensin‐converting enzyme (ACE) gene in children and adolescents with Type 1 diabetes and to evaluate the association between ACE genotype and blood pressure (BP).Methods  ACE genotypes were assessed in 124 normoalbuminuric, clinically normotensive Type 1 diabetic children and adolescents and 120 non‐diabetic controls using polymerase chain reaction. Twenty‐four‐hour ambulatory BP monitoring was undertaken in all patients.Results  ACE genotypes distributed in patients as follows: 34 (27%) DD, 57 (46%) ID, 33 (27%) II. The distribution was similar in the control group: DD in 28% (33), ID in 45% (54), and II in 27% (33). Patients with DD genotype had higher mean 24‐h diastolic BP (73.8 ± 6.2 vs. 70.2 ± 5.0 and 69.7 ± 6.3 mmHg; P = 0.005) and lower diurnal variation in BP (11.8 ± 4.6 vs. 14.2 ± 4.2 and 14.8 ± 4.3%; P = 0.011) compared with ID and II groups. Four patients in the DD group proved to be non‐dipper compared with one in the ID and none in the II group (P = 0.026). Twenty‐four‐hour diastolic blood pressure was independently predictive for AER as dependent variable in the DD genotype patient group (r2 = 0.12, P = 0.03).Conclusions  Children and adolescents with Type 1 diabetes do not differ from the non‐diabetic population regarding the I/D polymorphism of the ACE gene. ACE gene polymorphism is associated with BP abnormalities in normotensive and normoalbuminuric children and adolescents with Type 1 diabetes.
Does close glycaemic control promote healing in diabetic foot ulcers? Report of a feasibility study
Authors: Idris I. , Game F. , Jeffcoate W. 
Published: September 2005

AbstractAim  To undertake a pilot study to determine the feasibility of a definitive trial of the effect of close glycaemic control on healing of foot ulcers in diabetes.Methods  All patients attending a dedicated multidisciplinary clinic for the management of established ulcers over a 20‐week period were systematically screened for inclusion in a randomised, single‐blinded study.Findings  Two hundred individuals with foot ulcers attended the clinic during the recruitment period, but only nine met the predefined inclusion and exclusion criteria. One of these was withdrawn because of an adverse event immediately before recruitment, two proved incapable of administering insulin injections and were withdrawn prior to randomization. Four withheld consent, and one was advised to withhold consent by his community nurse. One was randomised and completed the 3‐month study. The study was abandoned at 20 weeks when it was decided that it would be unlikely that a sufficient number of suitable patients would ever be recruited, and that it would therefore be unethical to approach further subjects.Conclusions  It was concluded that although evidence is required to guide future practice in this field, the study design chosen was not feasible.
Coeliac disease in children with Type 1 diabetes mellitus: the effect of the gluten‐free diet
Authors: Sanchez‐Albisua I. , Wolf J. , Neu A. , Geiger H. , Wäscher I. , Stern M. 
Published: September 2005

AbstractPatients and methods  We assessed the frequency of coeliac disease in 281 children with Type 1 diabetes and the effect of gluten‐free diet (GFD) in newly diagnosed cases. Serological screening was performed using anti‐gliadin and anti‐endomysium antibodies. Data were obtained about clinical symptoms, height and weight‐for‐height.Results  A small intestinal biopsy was recommended to 18 patients (6.4%) with positive serological results and 12 children agreed. Nine of them had coeliac disease. Three out of nine coeliac children complained about gastrointestinal symptoms. On a GFD, the symptoms disappeared in two patients. Iron‐deficiency anaemia was present in four subjects and disappeared in the three patients who accepted the GFD. In three patients (33%), coeliac disease was asymptomatic. Height and weight‐for‐height were in the normal range for all patients. For well‐complying patients, there was a significant increase in height standard deviation at diagnosis and on follow‐up (−0.28 vs. +0.35) (P = 0.03). Changes in weight‐for‐height were not significant (−4.0% vs. +1.4%) (P = 0.28). There was a trend to an improvement in HbA1c (8.0 vs. 7.3%) (P = 0.05).Conclusions  Serological screening is effective. There is a therapeutic benefit for some screening‐detected patients, but confirmatory studies are needed.
Long‐term effects of pioglitazone and metformin on insulin sensitivity in patients with Type 2 diabetes mellitus
Authors: Roden M. , Laakso M. , Johns D. , Widel M. , Urquhart R. , Richardson C. , Mariz S. , Tan M. H. 
Published: September 2005

AbstractAim  Despite their comparable glycaemic effects in patients with Type 2 diabetes mellitus (T2DM), pioglitazone and metformin may have different effects on insulin sensitivity because they have different mechanisms of action. We studied the changes in insulin sensitivity, as assessed by the Quantitative Insulin Sensitivity Check Index (QUICKI), in patients with T2DM who used metformin or pioglitazone as monotherapy or in combination therapy with sulphonylurea.Methods  Data in this report are from two multicentre, randomized, double‐blind, double‐dummy studies conducted in Europe (monotherapy) or in Europe and Canada (combination therapy study). Patients were randomized to 52 weeks of treatment consisting of a 12‐week forced titration period and a 40‐week maintenance period. HbA1c, fasting plasma glucose (FPG) and fasting serum insulin (FSI) were quantified from a single blood sample at weeks 0, 8, 16, 24, 32, 42 and 52. Insulin sensitivity was assessed with QUICKI, which is calculated from FSI and fasting blood glucose (FBG) concentrations using the formula 1/(log10 FSI + log10 FBG). Time course effects of the treatments were compared by repeated measures analysis of covariance.Results  As monotherapy, pioglitazone and metformin increased QUICKI compared with baseline (baseline vs. end point [mean ± sem]; pioglitazone [0.303 ± 0.001 vs. 0.321 ± 0.001; P < 0.001] and metformin [0.304 ± 0.001 vs. 0.315 ± 0.001; P < 0.001]). Pioglitazone increased insulin sensitivity more than metformin from week 4 through week 52. There were significant increases in QUICKI from baseline in both combination therapy groups (baseline vs. end point; pioglitazone + sulphonylurea [0.305 ± 0.001 vs. 0.319 ± 0.001; P < 0.001] and metformin + sulphonylurea [0.306 ± 0.001 vs. 0.317 ± 0.001; P < 0.001]). Overall, pioglitazone + sulphonylurea significantly increased insulin sensitivity more than metformin + sulphonylurea.Conclusion  Pioglitazone differed from metformin in its effects on insulin sensitivity despite both drugs having comparable glycaemic effects.
Comparison of metabolic effects of pioglitazone, metformin, and glimepiride over 1 year in Japanese patients with newly diagnosed Type 2 diabetes
Authors: Yamanouchi T. , Sakai T. , Igarashi K. , Ichiyanagi K. , Watanabe H. , Kawasaki T. 
Published: September 2005

AbstractAims  To compare the metabolic effects of pioglitazone, metformin, and glimepiride in the treatment of Japanese patients with newly diagnosed Type 2 diabetes.Methods  A total of 114 patients with Type 2 diabetes who had never used oral hypoglycaemic drugs were studied for 12 months. Patients were randomly assigned to pioglitazone (30–45 mg/day, n = 38), metformin (750 mg/day, n = 39), or glimepiride (1.0–2.0 mg/day, n = 37). The effect of treatment on fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), 1,5‐anhydroglucitol (1,5AG), total cholesterol, high‐density lipoprotein (HDL)‐cholesterol, triglycerides, free fatty acids (FFA), and fasting plasma insulin levels was monitored monthly. Body weight and safety data were also collected.Results  Eight patients withdrew from the study (three in the pioglitazone group, two in the metformin group, and three in the glimepiride group). The rate of reduction of HbA1c was fastest in patients receiving glimepiride and slowest in patients receiving pioglitazone. Although there were no significant differences among the three groups in HbA1c levels at the end of the study, patients taking pioglitazone had relatively lower FPG and 1,5AG levels than patients taking the other two drugs. These results suggest that pioglitazone acts predominantly on nocturnal metabolism rather than at mealtimes. FFA were reduced significantly in those taking pioglitazone (542.2 µEq/l vs. 237.3 µEq/l; P < 0.01) before a decrease in HbA1c was apparent. The change in FFA levels correlated with the change in HbA1c (r = 0.409, P < 0.01). There were no significant differences in other lipid parameters among the groups.Conclusions  Pioglitazone, metformin, and glimepiride are equally effective in reducing blood glucose in patients with newly diagnosed Type 2 diabetes. However, their specific characteristics, such as the rapid action on blood glucose levels of glimepiride and the favourable action on FPG and FFA of pioglitazone, should be considered when choosing an appropriate agent.
Patterns of care as a risk factor for the development of vision‐threatening diabetic retinopathy: a population‐based matched case–control study using insurance claims (Medicare) data
Authors: Orr N. J. , Boyages S. C. 
Published: September 2005

AbstractObjectives  To evaluate systematically the effectiveness of the primary healthcare system in Australia in preventing the development of advanced diabetes complications.Methods  Diabetes patients (n = 4632) who had received their first laser photocoagulation treatment in 2000 were compared with a random sample of diabetes patients who had never received this treatment (n = 4632). Patterns of health care utilization were compared over a 7‐year period (1993–1999) using the Australian Medicare database.Results  There were significant differences in levels of healthcare utilization: cases were less likely to attend a general practitioner, from odds ratio (OR) = 0.21 (P < 0.0001) in 1993 to 0.53 (P < 0.0001) in 1999; less likely to be tested for HbA1c, from OR = 0.24 in 1997 (P < 0.0001) to 0.38 in 1999 (P < 0.0001); for HDL‐cholesterol, from OR = 0.017 (P < 0.0001) in 1999 to 0.04 (P < 0.0001) in 1993; and to attend specialists and consultant physicians, from OR = 0.25 (P < 0.0001) in 1994 to 0.44 (P < 0.0001) in 1999. The multivariate analysis emphasized the importance of timely diagnosis, HDL‐cholesterol testing and optometry attendances in the prevention of advanced diabetes complications.Conclusions  The study supports the contention that healthcare utilization may be as important a determinant of health outcomes as clinical risk factors such as blood glucose control. This highlights the importance of early diagnosis and the need to address systemic barriers so as to increase primary care utilization for people at risk of advanced diabetes complications.