bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes as a result of atypical anti‐psychotic drugs – a report of three cases
Authors: Rigalleau V. , Gatta B. , Bonnaud S. , Masson M. , Bourgeois M. L. , Vergnot V. , Gin H. 
Published: March 2003

Summary Aims  Atypical anti‐psychotic drugs (APDs) are widely used in psychotic disorders refractory to conventional neuroleptic agents. Results  Three cases of new‐onset diabetes are reported in Caucasian men who were on clozapine (one) or olanzapine (two) for 3–6 months. They had a distinct presentation: weight loss, ketosis (one ketoacidosis), severe hyperglycaemia requiring insulin therapy, and relative insulin deficiency as reflected by glucagon stimulatory tests. In all cases, insulin was stopped within 1 month after the APD was discontinued. Conclusions  Novel APDs not only induce diabetes as a result of weight gain in predisposed patients, but can also lead to a reversible state of insulin deficiency, and sometimes ketoacidosis.
Oral hypoglycaemic agents in 118 diabetic pregnancies
Authors: Hellmuth E. , Damm P. , Mølsted‐Pedersen L. 
Published: March 2003

SUMMARY Aims  To assess maternal and neonatal complications in pregnancies of diabetic women treated with oral hypoglycaemic agents during pregnancy.Methods  A cohort study including all consecutively registered, orally treated pregnant diabetic patients set in a diabetic obstetrical service at a university hospital: 50 women treated with metformin, 68 women treated with sulphonylurea during pregnancy and a reference group of 42 diabetic women treated with insulin during pregnancy.Results  The prevalence of pre‐eclampsia was significantly increased in the group of women treated with metformin compared to women treated with sulphonylurea or insulin (32 vs. 7 vs. 10%, P < 0.001). No difference in neonatal morbidity was observed between the orally treated and insulin‐treated group; no cases of severe hypoglycaemia or jaundice were seen in the orally treated groups. However, in the group of women treated with metformin in the third trimester, the perinatal mortality was significantly increased compared to women not treated with metformin (11.6 vs. 1.3%, P < 0.02).Conclusion  Treatment with metformin during pregnancy was associated with increased prevalence of pre‐eclampsia and a high perinatal mortality.
Vascular endothelial growth factor (VEGF) in children, adolescents and young adults with Type 1 diabetes mellitus: relation to glycaemic control and microvascular complications
Authors: Chiarelli F. , Spagnoli A. , Basciani F. , Tumini S. , Mezzetti A. , Cipollone F. , Cuccurullo F. , Morgese G. , Verrotti A. 
Published: March 2003

SUMMARY Aims  To evaluate serum levels of vascular endothelial growth factor (VEGF) in a large group of children, adolescents and young adults with Type 1 diabetes mellitus to investigate whether increased VEGF concentrations are associated with long‐term glycaemic control and microvascular complications.Methods  The study involved 196 patients with Type 1 diabetes mellitus (age range 2–24 years, onset of diabetes before the age of 12 years, duration of disease longer than 2 years), without clinical and laboratory signs of microvascular complications; they were divided into three groups (group 1 –n = 37, age < 6 years; group 2 –n = 71, age 6–12 years; group 3 –n = 88–age > 12 years). Fifty‐three adolescents and young adults (age 16.1–29.7) with different grades of diabetic retinopathy and microalbuminuria were also selected (group 4). A total of 223 healthy controls were matched for age and sex with each group of patients with diabetes mellitus.Results  VEGF serum levels were significantly increased in pre‐school and pre‐pubertal children with diabetes as well as in pubertal patients compared to controls. VEGF concentrations were markedly increased in adolescents and young adults with microvascular complications compared with both healthy controls and diabetic patients without retinopathy or nephropathy. Multivariate analysis showed that elevation of VEGF in serum was an independent correlate of complications. One‐year mean HbA1c values were significantly correlated with VEGF concentrations (r = 0.372; P < 0.01). Children with HbA1c levels greater than 10% had significantly higher VEGF concentrations when compared with matched patients whose HbAlc levels were lower than 10%. In poorly controlled diabetic children (HbA1c > 10%), long‐term (2 years) improvement of glycaemic control (aiming at HbA1c < 7%) resulted in a significant reduction of VEGF levels.Conclusions  VEGF serum concentrations are increased in prepubertal and pubertal children with diabetes. Glycaemic control influences VEGF serum levels. Severity of microvascular complications is associated with marked increase of VEGF concentrations in the serum of these patients.
The glycaemic index of a range of gluten‐free foods
Authors: Packer S. C. , Dornhorst A. , Frost G. S. 
Published: March 2003

SUMMARY Aims  The number of people with both diabetes and coeliac disease is increasing. This study examined the effect of gluten‐free, as opposed to gluten‐replete carbohydrate containing foods, on post‐prandial blood glucose concentrations.Methods  The glycaemic index of six commonly used gluten‐free carbohydrates are reported and compared with published figures for similar non‐gluten‐free products.Results  The results indicate that the glycaemic index of gluten‐free and gluten containing foods are similar.Conclusions  The inclusion of gluten‐free foods in the diet of diabetic individuals with coeliac disease should not compromise glycaemic control.
The Child Health Questionnaire in children with diabetes: cross‐sectional survey of parent and adolescent‐reported functional health status
Authors: Wake M. , Hesketh K. , Cameron F. 
Published: March 2003

SUMMARY Aims  To study parent and adolescent‐reported physical, psychosocial and family wellbeing in children aged 5–18 years with diabetes.Methods  Subjects: 5–18‐year‐olds attending a diabetes clinic at a tertiary children's hospital. Measures: (1) Child Health Questionnaire (CHQ) PF‐50, a functional heath status measure for children aged 5–18 years (parents); (2) CHQ CF‐80, a similar self‐report measure (adolescents aged 12–18 years); (3) 11 study‐designed questions related to diabetes‐specific concerns (parents); (4) global ratings of physical and psychosocial health (clinicians); (5) HbA1c level (all subjects). CHQ data were compared with Australian normative data collected six months earlier.Results  Reports were obtained from 128 parents and 71 adolescents (90 and 92% response). The CHQ demonstrated good psychometric properties in this sample of children with diabetes. Parents reported children with diabetes to have generally poorer health than children in the normative sample, especially on psychosocial and parent/family scales. Psychosocial health was markedly lower in 5–11‐year‐olds with HbA1c > 8.8%, but not in 12–18‐year‐olds. Presence of diabetes‐related symptoms and concerns correlated with lower physical and psychosocial functioning. Parents and clinicians concurred in their ratings of health for 12–18‐year‐olds but not 5–11‐year‐olds. Adolescents reported their own health similarly to adolescents in the normative sample.Conclusions  Parents report children aged 5–18 years with diabetes to have poorer health than children in the normative sample across all domains. Clinicians may underrate the impact of diabetes for younger children, with possible therapeutic implications. In providing an overall description of health, instruments like the CHQ may add another dimension to the care of children with diabetes and can feasibly be used within clinical settings.
Lipid hydroperoxide and markers of renal disease susceptibility in African‐Caribbean and Caucasian patients with Type 2 diabetes mellitus
Authors: Mehrotra S. , Ling K. L. E. , Bekele Y. , Gerbino E. , Earle K. A. 
Published: March 2003

SUMMARY Aims  The reasons for the increased incidence of diabetic nephropathy in African‐Caribbean compared with Caucasian subjects are poorly understood. Increased oxidative stress is linked to the development of endothelial dysfunction and histological abnormalities associated with diabetic renal disease. Therefore, it was assessed whether a marker of oxidative stress, lipid hydroperoxide (LOOH) and endothelial damage, von Willebrand factor (vWF) varied according to ethnic origin in the presence or absence of early diabetic nephropathy.Methods  Eighty‐eight patients with Type 2 diabetes mellitus of African‐Caribbean or Caucasian origin without a history of cardiovascular disease or clinical proteinuria were studied. Patients were classified as having microalbuminuria or normal albumin excretion. Fasting plasma vWF and LOOH were measured by an inhouse enzyme‐linked immunoassay and ferrous oxidation with xylenol orange (FOX) assay, respectively. The relationship of LOOH to urinary albumin status, the metabolic disturbances of diabetes, blood pressure and ethnic origin were assessed using multivariate analysis.Results  Compared with Caucasian patients those of African‐Caribbean origin had higher systolic blood pressure and HDL‐cholesterol (157.8 ± 17.0 vs. 147.8 ± 24.4, P = 0.041 and 1.6 ± 0.4 vs. 1.3 ± 0.5, P = 0.018) but lower total triglycerides (1.3 ± 0.8 vs. 1.9 ± 1.1, P = 0.008). LOOH was significantly higher in the African‐Caribbean patients compared with Caucasians (5.98 ± 2.49 vs. 4.49 ± 2.19, P = 0.006). vWF tended to be higher in microalbuminuric patients but showed no variation with ethnicity. In logistic regression analysis, LOOH was the only independent predictor of a raised albumin excretion rate (P = 0.008). In multiple regression analysis, African‐Caribbean ethnicity (P = 0.020) HDL‐cholesterol (P = 0.036), total triglycerides (P = 0.002) and a raised albumin excretion rate (P = 0.002) were independent predictors of LOOH.Conclusions  In this group of Type 2 diabetic patients an increase in LOOH is associated with abnormal urinary albumin excretion. African‐Caribbean origin was a determinant of LOOH independently of microalbuminuria. It is postulated that increased oxidative stress is of pathophysiological significance in accelerating the development of renal disease in African‐Caribbean patients.
Squamous cell carcinoma developing in necrobiosis lipoidica
Authors: Imtiaz K. E. , Khaleeli A. A. 
Published: March 2003

SummaryWe describe a case of squamous cell carcinoma arising in long‐standing necrobiosis lipoidica in a type 1 female diabetic patient. The tumour and the skin lesion were successfully excised and repaired with full thickness skin graft. The development of squamous cell carcinoma in association with this skin disorder is rare (only four cases reported in literature since 1966), but should be considered in chronic, non‐healing and recalcitrant ulcers developing within areas of necrobiosis lipoidica.
Glycated haemoglobin assays. Approaches to standardization of results
Authors: Stott A. , Casson I. F. , Higgins G. J. 
Published: March 2003

SUMMARY Aims  To compare different approaches to DCCT standardization of glycated haemoglobin (HbA1c) results.Methods  In the first part of the study seven laboratories in the Mersey area participated, using a variety of methods of measurement. The approaches used were the Standardization Initiative for Glycated Haemoglobin Scheme (SIGH) using fresh blood samples and the Wales External Quality Assurance Scheme (WEQAS) using both fresh and lyophilized blood samples. Additional studies performed in the Royal Liverpool University Hospital (RLUH) laboratory involved: (i) re‐calibration of the HPLC analyser using lyophilized blood samples supplied by the manufacturer and (ii) the use of fresh blood samples from the UK National External Quality Assurance Scheme (UKNEQAS).Results  Inter‐laboratory analytical coefficients of variation following DCCT alignment showed little change. The effect on percentage bias was more marked and was independent of the level of HbA1c. Comparing DCCT‐aligned HbA1c results from 3902 diabetic patients attending the RLUH, indicated that there was a statistically significant difference (P < 0.0001) between the corrected results produced by the five schemes. The effect of DCCT alignment on reported HbA1c values using the different approaches was variable resulting in an apparent increase in the number of diabetic patients with poor glycaemic control (HbA1c values > 7.0%) in all cases.Conclusion  The method of HbA1c standardization used determines the degree of correction required and a consensus approach is recommended. Implementation will assist extrapolation from research‐based evidence to local practice. Associated changes to patient management must come under the jurisdiction of the physicians responsible for the diabetic service.
Sodium carboxyl‐methyl‐cellulose dressings in the management of deep ulcerations of diabetic foot
Authors: Piaggesi A. , Baccetti F. , Rizzo L. , Romanelli M. , Navalesi R. , Benzi L. 
Published: March 2003

SUMMARYAims To test the safety and effectiveness of carboxyl‐methyl‐cellulose dressing (AquacelTM; ConvaTec, UK) in the management of deep diabetic foot ulcers, a group of consecutive out‐patients attending the foot clinic of the Department of Metabolic Diseases was studied.Methods Patients were selected according to the following inclusion criteria: a foot ulcer deeper than 1 cm for > 3 weeks, good peripheral blood supply (palpable peripheral pulses or ABPI > 0.9). Exclusion criteria were as follows: active infection, as evident from clinical signs (purulent discharge, redness, swelling, tenderness) and confirmed by culture exams, plasma creatinine > 2 mg/dl, recent episodes of ketoacidosis, malignancies, and any therapy or pathology which might interfere with the healing process. Twenty patients were enrolled in the study and having obtained their informed consent, their lesions were surgically debrided with the complete elimination of all necrotic tissue and debris up to the bleeding healthy tissue; then ulcers were staged and measured, and patients were randomly assigned to two different treatment groups. Patients in group A were dressed with saline‐moistened gauze, while patients in group B were dressed with AquacelTMaccording to the manufacturer's instructions. All patients in both groups received special post‐operative shoes (Podiabetes; Zeno Buratto, Treviso, Italy) and crutches until complete re‐epithelialization. Ulcers were all left to heal by secondary intent. After 8 weeks patients were blindly evaluated for: the rate of reduction of lesional volume (RLV), rate of granulation tissue (GT), number of infective complications (IC). Intralesional (ILTC) and perilesional (PLTC) temperatures were also recorded with a thermocouple surface digital thermometer, and the difference between the two values (ΔTC) was calculated. Healing time (HT, days), was then compared between the two groups. Data were compared by analysis of variance (anova), linear regression, Kaplan–Meier survival analysis and Fisher's exact test.Results HT was significantly shorter in Group B than in Group A (P < 0.001). RLV was significantly (P < 0.01) higher in Group B patients compared with Group A, as well as GT (P < 0.05). IC were in 1/10 Group B and in 3/10 Group A (P = 0.582). In addition, both ILTC and ΔTC were higher in Group B compared with Group A ones (P < 0.01).Conclusions Carboxyl‐methyl‐cellulose dressings were shown to be safe, effective and well tolerated in the management of non‐ischaemic, non‐infected deep diabetic foot ulcers.
Assessment of blood pressure in patients with Type 2 diabetes: comparison between home blood pressure monitoring, clinic blood pressure measurement and 24‐h ambulatory blood pressure monitoring
Authors: Masding M. G. , Jones J. R. , Bartley E. , Sandeman D. D. 
Published: March 2003

AbstractAims  To compare a home blood pressure (BP) monitoring device and clinic BP measurement with 24‐h ambulatory BP monitoring in patients with Type 2 diabetes mellitus (DM).Methods  Fifty‐five patients with type 2 DM had BP measured at three consecutive visits to the DM clinic by nurses using a stethoscope and mercury sphygmomanometer (CBP). Twenty‐four‐hour ambulatory BP was measured using a Spacelabs 90207 automatic cuff‐oscillometric device (ABPM). Subjects were then instructed in how to use a Boots HEM 732B semiautomatic cuff‐oscillometric home BP monitoring device and measured BP at home on three specified occasions on each of 4 consecutive days at varying times (HBPM).Results  Correlations between HBPM and ABPM were r = 0.88, P < 0.001 for systolic BP and r = 0.76, P < 0.001 for diastolic BP, with correlations between CBP and ABPM being systolic r = 0.59, P < 0.001, diastolic r = 0.47, P < 0.001. HBPM agreed with ABPM more closely compared with CBP (CBP +10.9/+3.8 (95% confidence intervals (CI) 6.9, 14.8/1.6, 6.1) vs. HBPM +8.2/+3.7 (95% CI 6.0, 10.3/2.0, 5.4)). The sensitivity, specificity and positive predictive value of HBPM in detecting hypertension were 100%, 79% and 90%, respectively, compared with CBP (85%, 46% and 58%, respectively).Conclusions  In patients with Type 2 DM, home BP monitoring is superior to clinic BP measurement, when compared with 24‐h ambulatory BP, and allows better detection of hypertension. It would be a rational addition to the annual review process.Diabet. Med. 18, 431–437 (2001)
Metabolic effects of metformin in patients with impaired glucose tolerance
Authors: Lehtovirta M. , Forsén B. , Gullström M. , Häggblom M. , Eriksson J. G. , Taskinen M.‐R. , Groop L. 
Published: March 2003

AbstractAims

To assess the effect of metformin on insulin sensitivity, glucose tolerance and components of the metabolic syndrome in patients with impaired glucose tolerance (IGT).Methods

Forty first‐degree relatives of patients with Type 2 diabetes fulfilling WHO criteria for IGT and participating in the Botnia study in Finland were randomized to treatment with either metformin 500 mg b.i.d. or placebo for 6 months. An oral glucose tolerance test (OGTT) and a euglycaemic hyperinsulinaemic clamp in combination with indirect calorimetry was performed at 0 and 6 months. The patients were followed after stopping treatment for another 6 months in an open trial and a repeat OGTT was performed at 12 months.Results

Metformin treatment resulted in a 20% improvement in insulin‐stimulated glucose metabolism (from 28.7 ± 13 to 34.4 ± 10.7 µmol/kg fat‐free mass (FFM)/min) compared with placebo (P = 0.01), which was primarily due to an increase in glucose oxidation (from 16.6 ± 3.6 to 19.1 ± 4.4 µmol/kg FFM; P = 0.03) These changes were associated with a minimal improvement in glucose tolerance, which was maintained after 12 months.Conclusions

Metformin improves insulin sensitivity in subjects with IGT primarily by reversal of the glucose fatty acid cycle. Obviously large multicentre studies are needed to establish whether these effects are sufficient to prevent progression to manifest Type 2 diabetes and associated cardiovascular morbidity and mortality.Diabet. Med. 18, 578–583 (2001)
Peripheral blood level alterations of TIMP‐1, MMP‐2 and MMP‐9 in patients with Type 1 diabetes
Authors: Maxwell P. R. , Timms P. M. , Chandran S. , Gordon D. 
Published: March 2003

AbstractAim  To determine the plasma levels of enzymes and inhibitors involved in extracellular matrix turnover in patients with Type 1 diabetes with normal renal function.Methods  Plasma levels of matrix metalloproteinases 2 and 9 (MMP‐2, MMP‐9) and tissue inhibitor of metalloproteinase 1 (TIMP‐1) were measured in 43 Type 1 diabetic subjects and age‐ and sex‐matched controls.Results  No significant difference in plasma MMP‐2 between diabetic patients and controls was observed. MMP‐9 was detected in the plasma of 15 diabetic patients (35%), but undetectable in all control subjects (P < 0.015). Plasma TIMP‐1 concentrations were significantly elevated (P < 0.001) in diabetic patients compared to controls. There was no correlation observed between MMP‐2, MMP‐9 and TIMP‐1 and similarly between MMP‐2, MMP‐9 and TIMP‐1 and age, duration of diabetes, blood pressure and glycated haemoglobin (HbA1c).Conclusions  This study has demonstrated alterations in several plasma extracellular matrix modulators in the absence of significant vascular disease.Diabet. Med. 18, 777–780 (2001)
Abrupt onset of diabetes during interferon‐alpha therapy in patients with chronic hepatitis C
Authors: Recasens M. , Aguilera E. , Ampurdanés S. , Sánchez Tapias J. M. , Simó O. , Casamitjana R. , Conget I. 
Published: March 2003

AbstractIntroduction Interferon‐alpha (IFN‐α) is now widely used in the treatment of chronic hepatitis C. Few patients have been reported as developing impaired glucose tolerance or diabetes mellitus (DM) using this therapy. The explanation for the development of DM in chronic hepatitis C treated with IFN‐α is unclear. We report two patients who developed an abrupt onset of diabetes during IFN‐α for chronic hepatitis C.Case reports  Two male middle‐aged patients were admitted to our hospital for an abrupt onset of diabetes, in diabetic ketoacidosis, with a very short duration of hyperglycaemic symptoms. Their clinical course was similar. Case 1 never demonstrated any markers of pancreatic immunogenicity. Case 2 had high levels of decarboxylase glutamic acid autoantibodies (GADAb), before the IFN‐α treatment that persisted. We compared initial β‐cell function and metabolic control with a group of middle‐aged patients from our hospital who had recently been diagnosed with Type 1 diabetes mellitus (DM1). In contrast to these, the onset of the disease was particularly severe with β‐cell function substantially impaired and displaying unstable short‐term metabolic control.Conclusions  Type 1 diabetes should be considered as a potential complication if IFN is administered to patients with chronic hepatitis C. Its onset may be severe and result in short‐term difficulties in metabolic control.Diabet. Med. 18, 764–767 (2001)
Insulin infusion normalizes fasting and post‐prandial albumin and fibrinogen synthesis in Type 1 diabetes mellitus
Authors: Bruttomesso D. , Iori E. , Kiwanuka E. , Zanetti M. , Pianta A. , Vettore M. , Tiengo A. , Tessari P. 
Published: March 2003

AbstractAims  The effect of metabolic control on hepatic synthesis of plasma proteins in Type 1 diabetes mellitus (T1DM), in the post‐absorptive and post‐prandial state, is not known.Methods  We measured fractional synthetic rates (FSR) of albumin and fibrinogen in six insulin‐infused T1DM patients and in five to nine control subjects, before and for approx. 4 h after a mixed liquid meal. Phenylalanine tracer precursor/product relationships and steady‐state conditions were used. In the post‐absorptive state, patients were studied in near euglycaemic conditions after an overnight intravenous insulin infusion. During the meal (approx. 11 kcal/kg), the insulin infusion rate was increased to maintain plasma glucose concentrations below approx. 10 mmol/l.Results  Post‐absorptive FSR of albumin (5.7 ± 0.6%/day) and fibrinogen (11.3 ± 0.6%/day) in T1DM were similar to control values (6.4 ± 0.9 and 13.1 ± 1.1, respectively). After the meal, albumin FSR increased (P = 0.0032 by anova) in both groups (T1DM, to 14.4 ± 2.7%/day; controls, to 18.2 ± 3.7%/day). Fibrinogen FSR also increased (P = 0.0048 by anova) in both the T1DM (to 18.2 ± 2.6) and the control subjects (to 27.3 ± 6.2). There was no difference between T1DM and control subjects in the post‐prandial FSR of both proteins.Conclusions  Albumin and fibrinogen FSR in T1DM can be maintained within near‐normal ranges by insulin infusion under post‐absorptive and post‐prandial conditions.Diabet. Med. 18, 915–920 (2001)