bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of three multiple injection regimens for Type 1 diabetes: morning plus dinner or bedtime administration of insulin detemir vs. morning plus bedtime NPH insulin
Authors: Pieber T. R. , Draeger E. , Kristensen A. , Grill V. 
Published: June 2005

AbstractAims  This trial investigated the efficacy and safety of two different administration‐time regimens with insulin detemir (IDet) to that of a conventional basal insulin regimen with NPH insulin (NPH).Methods  This multinational, 16‐week, open, parallel group trial included 400 people with Type 1 diabetes mellitus (DM) randomized to IDet either morning and before dinner (IDetmorn+din) or morning and bedtime (IDetmorn+bed), or to NPH morning and bedtime (NPHmorn+bed), all in combination with mealtime insulin aspart (IAsp).Results  HbA1c was comparable between the three groups after 16 weeks (P = 0.64), with reductions of 0.39–0.49% points. Lower fasting plasma glucose (FPG) was observed with IDetmorn+din and IDetmorn+bed compared with NPHmorn+bed (9.8 and 9.1 vs. 11.1 mmol/l, P = 0.006), whereas the IDet groups did not differ (P = 0.15). Within‐person variation in self‐measured FPG was significantly lower for both IDet regimens (sd IDetmorn+din 2.5, IDetmorn+bed 2.6 mmol/l) than for NPHmorn+bed (sd 3.1 mmol/l, P < 0.001), but was comparable between the IDet groups (P = 0.48). Ten‐point plasma glucose profiles were lower between dinner and breakfast in the IDetmorn+din group (P = 0.043), compared with the two other groups. Risk of overall and nocturnal hypoglycaemia was similar for the three groups. Lower mean bodyweight was observed with IDet compared with NPH after 16 weeks (difference: IDetmorn+din−1.3 kg, P < 0.001, IDetmorn+bed−0.6 kg, P = 0.050).Conclusions  Both IDet regimens were well tolerated and provided lower and less variable glucose levels with no, or less, weight gain than NPH at comparable HbA1c. IDet can be administered either at dinner or bedtime, with similar glycaemic control according to the need of the individual person.Pieber T R, Grill V, Kristensen A, Draeger E: Treatment with insulin detemir allows flexible timing of administration in subjects with Type 1 diabetes. Diabetes 2003; 52 (Suppl. 1): A130.
Self‐monitoring of blood glucose in non‐insulin‐treated diabetic patients: a longitudinal evaluation of its impact on metabolic control
Authors: Franciosi M. , Pellegrini F. , De Berardis G. , Belfiglio M. , Di Nardo B. , Greenfield S. , Kaplan S. H. , Rossi M. C. E. , Sacco M. , Tognoni G. , Valentini M. , Nicolucci A. 
Published: June 2005

AbstractAims  In the framework of a nationwide outcomes research programme, we assessed the impact of self‐monitoring of blood glucose (SMBG) on metabolic control over 3 years in patients with Type 2 diabetes mellitus (DM2) not treated with insulin.Methods  The study involved 1896 patients who completed, at 6‐month intervals for 3 years, a questionnaire investigating SMBG practice. Clinical information was collected by participating clinicians at the same time intervals. The predictive value of SMBG frequency on long‐term metabolic control was estimated using multilevel analysis. The impact of SMBG on metabolic control was also evaluated in distinct and homogeneous subgroups of patients showing different likelihood of performing SMBG, identified using a tree‐growing technique (RECPAM).Results  Overall, 22% of the patients were on diet alone and 78% were treated with oral agents; 41% practiced SMBG ≥ 1/week (10.3%≥ 1/day). The analysis of metabolic control according to the frequency of SMBG failed to show any significant impact of this practice on HbA1c levels over 3 years. Similarly, changes in SMBG frequency during the study were not related to significant changes in HbA1c levels. RECPAM analysis led to the identification of eight classes, characterized by substantial differences in the likelihood of performing SMBG with a frequency of at least 1/week. Nevertheless, in none of the RECPAM classes identified, did SMBG predict a better metabolic control over 3 years of follow‐up. In those RECPAM classes indicating that SMBG was mainly performed to avoid hypoglycaemic episodes, SMBG was associated with a decrease in the frequency of hypoglycaemic episodes during the study.Conclusions  In a large sample of non‐insulin‐treated Type 2 diabetic patients, the performance and frequency of SMBG did not predict better metabolic control over 3 years. We could not identify any specific subgroups of patients for whom SMBG practice was associated with lower HbA1c levels during the study.
Studies of relationships between the GLUT10 Ala206Thr polymorphism and impaired insulin secretion
Authors: Rose C. S. , Andersen G. , Hamid Y. H. , Glümer C. , Drivsholm T. , Borch‐Johnsen K. , Jørgensen T. , Pedersen O. , Hansen T. 
Published: June 2005

AbstractAims  This study aimed to investigate if the previously observed association between the GLUT10 Ala206Thr polymorphism and variation in fasting and oral glucose‐induced serum insulin concentrations could be replicated in a large‐scale population‐based cohort of Danish whites.Methods  The GLUT10 Ala206Thr polymorphism was genotyped in a case‐control study of 880 Type 2 diabetic patients and 4372 glucose‐tolerant control subjects. The latter group was also enrolled in an assessment of fasting and post‐OGTT circulating levels of plasma glucose and serum insulin in relation to genotype. The variant was genotyped by analysis of PCR‐generated primer extension by matrix‐assisted laser desorption/ionization time‐of‐flight analysis.Results  The Ala206Thr variant was equally frequent among Type 2 diabetic patients and glucose‐tolerant subjects (P = 0.9) and there was no difference in the distribution of genotype groups (P = 1.0). In the 4372 glucose‐tolerant subjects there was no statistically significant association between the polymorphism and levels of fasting and post‐oral glucose tolerance test plasma glucose and serum insulin along with the insulinogenic index and the homeostasis model of assessment for insulin resistance and insulin secretion. Likewise, in an age‐stratified subgroup comprising 1264 subjects, we observed no relationships between the GLUT10 polymorphism and the selected metabolic features.Conclusions  The GLUT10 Ala206Thr polymorphism is not associated with Type 2 diabetes in the Danish population. Furthermore, in the present large‐scale cohort, the polymorphism does not associate with phenotypes such as fasting and oral glucose‐induced levels of plasma glucose and serum insulin.
Lower plasma triglycerides are associated with increased need for insulin requirement in poorly controlled Type 2 diabetic patients
Authors: Rigalleau V. , Baillet‐Blanco L. , Perlemoine C. , Salmi L.‐R. , Gin H. 
Published: June 2005

AbstractAims  To identify factors associated with insulin requirement in Type 2 diabetic patients, and to examine the significance of a normal plasma triglyceride level.Methods  One hundred and three poorly controlled (HbA1c = 9.4 ± 1.9%) Type 2 diabetic patients initially not treated with insulin were followed up for 5 years. Insulin was administered if HbA1c > 8% despite maximal oral anti‐diabetic treatment and bodyweight control. Variables were compared between insulin requiring and non‐insulin‐treated patients using unpaired t‐tests. The outcomes of initially normotriglyceridaemic (< 1.7 mmol/l) and hypertriglyceridaemic patients were compared using unpaired t‐tests, and a survival analysis (Cox proportional hazards model).Results  Sixty‐three patients were transferred to insulin. They were 5 years older (P = 0.004), with a 3‐year longer duration of their diabetes (P = 0.03), a 1.2% higher HbA1c (P = 0.002), and 50% lower triglyceride levels (P = 0.02) than the others. The survival analysis showed that a long duration of diabetes, a high HbA1c, and a normal triglyceride level were associated with the need for insulin; the effect of normotriglyceridaemia was significant in the most poorly controlled (HbA1c > 9.5%) patients (relative risk: 2.35, 95% confidence interval: 1.16–5.52, P = 0.016). The 46 normotriglyceridaemic patients were leaner (P = 0.0004) and had lower C‐peptide levels (P = 0.0008) than the others. Despite similar diabetes duration and HBA1c, more were transferred to insulin (normotriglyceridaemic: 71%, hypertriglyceridaemic: 52%, P = 0.03).Conclusion  A normal triglyceride level is associated with a need for insulin in poorly controlled Type 2 diabetes.
The association of birthweight and contemporary size with insulin resistance among children from Estonia and Denmark: findings from the European Youth Heart Study
Authors: Lawlor D. A. , Riddoch C. J. , Page A. S. , Anderssen S. A. , Froberg K. , Harro M. , Stansbie D. , Davey Smith G. 
Published: June 2005

AbstractObjectives  To assess the associations of birthweight, contemporary body mass index and height with insulin resistance in children.Design  Cross‐sectional study.Participants  From Estonia (n = 1174) and Denmark (n = 1018), 2192 school children aged 9 and 15 years were randomly selected.Main outcomes  Insulin resistance (homeostasis model assessment), triglyceride levels, high‐density lipoprotein cholesterol and systolic blood pressure.Results  There was an inverse association between birthweight and insulin resistance and a positive association between contemporary body mass index and insulin resistance. With adjustment for maternal and paternal educational level, income, smoking and body mass index, an increase of one unit of sex, age and country standardized body mass index z‐score was associated with a 5% (95% CI: 2, 7%) increase in homeostasis model assessment (HOMA) score and a one‐unit z‐score increase in birthweight with a 2% (95% CI: 0, 5%) decrease in HOMA score. In the 9‐year‐old age group, height was positively associated with insulin resistance [for a one‐unit increase in height z‐score HOMA score increased by 30% (95% CI: 14, 50%)], but in the 15‐year‐old age group there was no association between height and insulin resistance (4% (95% CI: −5, 14%), P for interaction with age group = 0.001). For both ages, those in the lowest third of the birthweight distribution and highest third of the body mass index distribution were most insulin resistant and, among 9‐year olds, those in the lowest third of the birthweight distribution and highest third of the height distribution were most insulin resistant. Birthweight was only inversely associated with systolic blood pressure when adjustment was made for either contemporary body mass index or height and there was no association between birthweight and high‐density lipoprotein or triglyceride concentrations.Conclusions  Taken together, these results suggest that a slow intrauterine growth trajectory and/or a fast post‐natal growth trajectory is associated with greater insulin resistance in childhood.
Reproducibility and reliability of hypoglycaemic episodes recorded with Continuous Glucose Monitoring System (CGMS) in daily life
Authors: Høi‐Hansen T. , Pedersen‐Bjergaard U. , Thorsteinsson B. 
Published: June 2005

AbstractAim  Continuous glucose monitoring may reveal episodes of unrecognized hypoglycaemia. We evaluated reproducibility and reliability of hypoglycaemic episodes recorded in daily life by the Medtronic MiniMed Continuous Glucose Monitoring System (CGMS).Methods  Twenty‐nine adult patients with Type 1 diabetes underwent 6 days of continuous subcutaneous glucose monitoring, applying one CGMS on each side of the abdomen. Blood glucose was measured by HemoCue B‐Glucose Analyzers six times daily and two different 4‐point calibration sets were generated (set A and B). Using these calibration sets, CGMS raw data were recalibrated generating four different CGMS data sets [left‐A (left side of abdomen, calibration set A), left‐B, right‐A and right‐B]. Agreement between CGMS data sets was evaluated during hypoglycaemic events, comparing CGMS readings = 2.2 mmol/l with nadir values from corresponding CGMS data sets. CGMS readings were also compared with independent self‐monitored blood glucose (SMBG) values.Results  With hypoglycaemia (CGMS readings = 2.2 mmol/l) in calibration set left‐A, values below 3.5 mmol/l were present in 99% (95% CI: 95–100%) of samples in left‐B, 91% (95% CI: 84–96%) of samples in right‐A, and 90% (95% CI: 83–95%) of samples in right B. In 84% of these episodes (95% CI: 59–96%) independent SMBG values were below 3.5 mmol/l. Difference in duration was observed with a median difference of 20 min; (left‐A vs. right‐B).Conclusion  Hypoglycaemic episodes recorded by CGMS are reproducible and agreement with independent SMBG values is acceptable for retrospective recording of hypoglycaemic events with CGMS.
No consistent association between birthweight and parental risk of diabetes and cardiovascular disease
Authors: Adams J. , Pearce M. S. , White M. , Unwin N. C. , Parker L. 
Published: June 2005

AbstractIntroduction  The fetal insulin hypothesis proposes that the inverse relationship between birthweight and risk of diabetes and cardiovascular disease is partly as a result of inherited factors which influence the effect of insulin and insulin‐like growth factors. It has been proposed that an inverse relationship between birthweight and parental risk of diabetes and cardiovascular disease is evidence in support of this hypothesis.Patients and methods  Data from a prospective birth cohort study, followed up to age 50, was used to assess the relationship between birthweight and reported parental diabetes, hypertension, angina and stroke using logistic regression.Results  Of the 832 cohort members traced at age 50, 574 (69%) returned questionnaires that included questions on parental illness. Complete data was available for 541 (94%) of these on maternal illness and for 531 (92%) on paternal illness. Birthweight, standardized for sex and gestational age and adjusted for social class at birth, was inversely associated with maternal stroke (odds ratio = 0.75, 95% confidence intervals 0.60–0.95). There were no other statistically significant associations between birthweight and risk of parental illness.Discussion  We found little evidence of a consistent inverse relationship between birthweight and parental risk of diabetes or cardiovascular disease. This may be because of the quality of our data—which is limited by the problems of collecting robust data over two generations.
Does metformin decrease blood pressure in patients with Type 2 diabetes intensively treated with insulin?
Authors: Wulffelé M. G. , Kooy A. , Lehert P. , Bets D. , Donker A. J. M. , Stehouwer C. D. A. 
Published: June 2005

AbstractAims  We investigated in a double‐blind study whether metformin reduces blood pressure (BP) in patients with Type 2 diabetes intensively treated with insulin.Methods  A total of 220 patients with Type 2 diabetes were asked to undergo 24‐h ambulatory BP monitoring (24‐h ABPM). One hundred and eighty‐two gave informed consent. Eighty‐nine were randomized to metformin and 93 to placebo. Thirty‐five subjects dropped out (13 placebo, 22 metformin users); 147 patients underwent a second 24‐h ABPM, 16 weeks after randomization.Results  Systolic BP (SBP), diastolic BP (DBP), pulse BP (PP), mean BP (MP) and heart rate (HR) were measured as office BP measurements and as 24‐h ABPM for 24‐h, day and night. Office BP measurements did not differ significantly between the placebo‐ and metformin‐treated groups for any BP measure, but showed a non‐significant trend for SBP reduction with metformin use (mean baseline‐adjusted difference, metformin minus placebo: −4.2 mmHg, 95% CI, −9.9 to +1.5; P = 0.15). The baseline‐adjusted differences of the ambulatory measurements were −0.2 mmHg (95% CI, −2.9 to +2.6) for the 24‐h SBP, and +1.1 mmHg (95% CI, −0.7 to +2.8) for the 24‐h DBP. On the whole, BP differences between metformin‐ and placebo‐treated groups were not statistically significant. The only significant difference was for night‐time PP (baseline‐adjusted difference: −2.2 mmHg; 95% CI, −4.2 to −0.2). These results were not different after adjustment for age and diabetes duration, or for (changes in) body mass index, glycated haemoglobin, insulin dose or plasma homocysteine.Conclusion  Metformin does not significantly affect BP in patients with Type 2 diabetes intensively treated with insulin.
Fetal erythrocyte membrane lipids modification: preliminary observation of an early sign of compromised insulin sensitivity in offspring of gestational diabetic women
Authors: Min Y. , Lowy C. , Ghebremeskel K. , Thomas B. , Bitsanis D. , Crawford M. A. 
Published: June 2005

AbstractAims  Intrauterine exposure to diabetes is a significant determinant of the development of obesity and early onset of Type 2 diabetes mellitus in the offspring. Both conditions are characterized by insulin resistance and the latter is associated with reduced membrane arachidonic and docosahexaenoic acids. Hence, we investigated if the membrane arachidonic and docosahexaenoic acids are depressed in the cord blood of babies born to women with gestational diabetes.Methods  Cord (fetal) and maternal blood were obtained at delivery from control subjects (n = 33) and women with gestational diabetes (n = 40) and analysed for plasma triglycerides and cholinephosphoglycerides, and erythrocyte choline‐ and ethanolaminephosphoglycerides fatty acids.Results  Babies of gestational diabetic mothers had reduced docosahexaenoic acid in the plasma (5.9 ± 1.4 vs. 7.1 ± 2.0, P < 0.01) and erythrocyte (4.0 ± 2.2 vs. 5.4 ± 2.9, P < 0.05) cholinephosphoglycerides. Moreover, the total omega‐6 and omega‐3 fatty acids of the erythrocyte cholinephosphoglycerides were significantly lower (P < 0.05) in these babies. A similar trend was observed in plasma triglycerides and erythrocyte ethanolaminephosphoglycerides. The maternal plasma triglycerides and erythrocyte ethanolaminephosphoglycerides fatty acids profile were not different between the two groups. However, there was a reduction in arachidonic acid and total omega‐6 fatty acids in the erythrocyte cholinephosphoglycerides of the gestational diabetic women.Conclusion  The altered plasma and erythrocyte fatty acids in the cord blood of babies born to women with gestational diabetes suggests a perturbation in the maternal‐fetal nutrient transport and/or fetal lipid metabolism.
Management of incidental hyperglycaemia in acute medical emergencies
Authors: Al‐Bermani A. , Desha Y. H. , Morgan J. , Soobrah R. , Symonds C. S. , Taylor R. 
Published: June 2005

AbstractAims  To assess whether compliance with management guidelines for hyperglycaemia in acute medical emergencies was affected by prior diagnosis of diabetes, and to assess the effect of an educational campaign upon management.Methods  Prospective study of management of adult patients admitted to an acute medical admissions unit in 2002, with repeat in 2003 after an educational campaign.Results  The management of 251 patients in 2002 and 357 patients in 2003 was examined. In patients with no prior diagnosis of diabetes, unsatisfactory management was observed in 60% compared with only 30% of those with known diabetes (P < 0.02). In 2003 these proportions fell to 46 and 16%, respectively, but remained significantly different (P < 0.02). Overall, 30 of 70 (42.9%) patients with hyperglycaemia were managed strictly according to the guidelines in 2002 compared with 33 out of 59 (55.9%) in 2003 (P = 0.14). Satisfactory management was delivered in 55.7% in 2002 and 78% in 2003 (P < 0.01).Conclusions  The reluctance of doctors to manage incidental hyperglycaemia in acute medical admissions was especially common when the patient was not known to have diabetes. This was only modestly improved by an educational campaign, even though this group are known to have a greater response in terms of morbidity and mortality. Widespread debate of this issue is required to minimize morbidity and mortality due to hyperglycaemia.
Nutrition in patients with Type 2 diabetes: are low‐carbohydrate diets effective, safe or desirable?
Authors: Kennedy R. L. , Chokkalingam K. , Farshchi H. R. 
Published: June 2005

AbstractLow‐carbohydrate diets have been around for over 100 years. They have become very popular recently but the scientific basis for their use remains to be fully established. This article reviews the recent trials that have been published and also what is known about the effects of low‐carbohydrate, high‐protein diets on energy expenditure and body composition. Although many controversies remain, there is now mounting evidence that these diets can lead to effective weight loss and may thus be a useful intervention for patients who have, or are at risk of, diabetes. The practical aspects of using these diets as a short‐ to medium‐term intervention are discussed.
ADVANCE—Action in Diabetes and Vascular Disease: patient recruitment and characteristics of the study population at baseline
Authors:   ADVANCE Collaborative Group
Published: June 2005

AbstractAims  The primary aim of ADVANCE is to determine the effects on macrovascular and microvascular disease of blood pressure lowering (with an ACE inhibitor–diuretic combination), irrespective of initial blood pressure level; and of intensive glucose lowering, in high‐risk individuals with Type 2 diabetes.Methods  The study is a 2 × 2 factorial randomized controlled trial. Following 6 weeks on active perindopril–indapamide combination, eligible participants were randomized to perindopril/indapamide (initially 2.0/0.625 mg daily, increasing to 4.0/1.25 mg daily after 3 months) or matching placebo; and to an intensive gliclazide MR‐based glucose control regimen aiming for a haemoglobin A1c (HbA1c) value of 6.5% or lower, or local standard therapy. The study is being conducted in 215 centres in 20 countries within Australasia, Asia, Europe and North America.Results  Recruitment commenced in June 2001 and was completed in March 2003, with the inclusion of 11 140 randomized participants. Fifty‐seven per cent of participants are male and the mean age at baseline was 66 years. On average, the diagnosis of diabetes was made 8 years before study entry. At baseline 32 and 10% of patients had a history of macrovascular and microvascular disease, respectively. The mean blood pressure at baseline was 145/81 mmHg; the mean HbA1c concentration was 7.5%. While blood pressure and HbA1c values were broadly similar, certain characteristics of randomized participants varied between countries.Conclusions  With successful worldwide recruitment completed, ADVANCE should provide reliable and broadly generalizable results on the effects of routine blood pressure lowering and intensive glucose control in high‐risk individuals with Type 2 diabetes.