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1

Diabetic Retinopathy Study.  

National Technical Information Service (NTIS)

The Diabetic Retinopathy Study (DRS) was a multicenter clinical trial to evaluate the efficacy of photocoagulation, (argon laser and xenon arc) in the treatment of proliferative diabetic retinopathy. This randomized, controlled study involved 1,758 patien...

1981-01-01

2

Diabetic Retinopathy Study Data.  

National Technical Information Service (NTIS)

The Diabetic Retinopathy Study (DRS) was a multicenter clinical trail to evaluate the efficacy of photocoagulation, (argon laser and xenon arc) in the treatment of proliferative diabetic retinopathy. This randomized, controlled study involved 1,758 patien...

1983-01-01

3

Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study: baseline characteristics and short-term effects of fenofibrate [ISRCTN64783481  

PubMed Central

Objective The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study is examining the effects of long-term fibrate therapy on coronary heart disease (CHD) event rates in patients with diabetes mellitus. This article describes the trial's run-in phase and patients' baseline characteristics. Research design and methods FIELD is a double-blind, placebo-controlled trial in 63 centres in 3 countries evaluating the effects of fenofibrate versus placebo on CHD morbidity and mortality in 9795 patients with type 2 diabetes mellitus. Patients were to have no indication for lipid-lowering therapy on randomization, but could start these or other drugs at any time after randomization. Follow-up in the study was to be for a median duration of not less than 5 years and until 500 major coronary events (fatal coronary heart disease plus nonfatal myocardial infarction) had occurred. Results About 2100 patients (22%) had some manifestation of cardiovascular disease (CVD) at baseline and thus high risk status. Less than 25% of patients without CVD had a (UKPDS determined) calculated 5-year CHD risk of <5%, but nearly all had a 5-year stroke risk of <10%. Despite this, half of the cohort were obese (BMI > 30), most were men, two-thirds were aged over 60 years, and substantial proportions had NCEP ATP III features of the metabolic syndrome independent of their diabetes, including low HDL (60%), high blood pressure measurement or treatment for hypertension (84%), high waist measurement (68%), and raised triglycerides (52%). After a 6-week run-in period before randomisation with all participants receiving 200 mg comicronized fenofibrate, there were declines in total and LDL cholesterol (10%) and triglycerides (26%) and an increase in HDL cholesterol (6.5%). Conclusion The study will show the effect of PPAR-alpha agonist action on CHD and other vascular outcomes in patients with type 2 diabetes including substantial numbers with low to moderate CVD risk but with the various components of the metabolic syndrome. The main results of the study will be reported in late 2005.

2005-01-01

4

The need for a large-scale trial of fibrate therapy in diabetes: the rationale and design of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study. [ISRCTN64783481  

PubMed Central

Background Fibrates correct the typical lipid abnormalities of type 2 diabetes mellitus, yet no study, to date, has specifically set out to evaluate the role of fibrate therapy in preventing cardiovascular events in this setting. Methods Subjects with type 2 diabetes, aged 50–75 years, were screened for eligibility to participate in a long-term trial of comicronized fenofibrate 200 mg daily compared with matching placebo to assess benefits of treatment on the occurrence of coronary and other vascular events. People with total cholesterol levels 3.0–6.5 mmol/L plus either a total-to-HDLc ratio >4.0 or triglyceride level >1.0 mmol/L with no clear indication for lipid-modifying therapy were eligible. Results A total of 9795 people were randomized into the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial. All received dietary advice, followed by a 6-week single-blind placebo run-in, then a 6-week active run-in period before randomization. Participants are being followed up every 6 months for outcome events and safety assessments. The study is designed to yield at least 500 coronary events (primary endpoint: first nonfatal myocardial infarction or coronary death) over 5 years, to have 80% power to identify as statistically significant at 2P = 0.05 a 22% reduction in such events, using intention-to-treat methods. Conclusions Type 2 diabetes is the most common endocrine disorder worldwide, and its prevalence is increasing. The current evidence about use of fibrates in type 2 diabetes, from around 2000 people treated, will increase with FIELD to evidence from around 12000. FIELD will establish the role of fenofibrate treatment in reducing cardiovascular risk in people with type 2 diabetes. The main results are expected to be available in late 2005.

2004-01-01

5

International challenges without borders: a descriptive study of family physicians' educational needs in the field of diabetes  

PubMed Central

Background The optimal care of persons with diabetes by general practitioners and family physicians (GP/FP) is complex and requires multiple competencies. This is a fairly unrecognized key challenge in the healthcare systems. In some cases, local and national Continuous Professional Development (CPD) initiatives target these challenges; however there have been few international initiatives, possibly because challenges emerging from different studies have not been linked across national boundaries. In this context, the authors have compiled data about gaps and/or barriers inherent to GP/FP care of persons with type 2 diabetes from Austria, Canada, Germany and the United Kingdom. Methods Secondary analyzes of pre-existing studies were conducted to identify challenges in the care of patients with type 2 diabetes as faced by GPs/FPs. Two sources of data were reviewed: unpublished research data from collaborating organizations and articles from a literature search (in English and German). Articles retrieved were scanned by the research team for relevance to the study objectives and to extract existing gaps and barriers. The identified challenges were then categorized along three major axes: (1) phase of the continuum of care {from screening to management}; (2) learning domain {knowledge, skills, attitudes, behavior, context}; and (3) by country/region. Compilation and categorization were performed by qualitative researchers and discrepancies were resolved through discussion until concordance was achieved. Results and discussion Thirteen challenges faced by GPs/FPs in the care for patients with type 2 diabetes were common in at least 3 of the 4 targeted countries/regions. These issues were found across the entire continuum of care and included: pathophysiology of diabetes, diagnostic criteria, treatment targets assessment, drugs' modes of action, decision-making in therapies, treatment guidelines, insulin therapy, adherence, management of complications, lifestyle changes, team integration, bureaucracy and third-party payers. The issues reported were not restricted to the physicians' knowledge, but also related to their skills, attitudes, behaviours and context. Conclusions This study revealed challenges faced by GPs/FPs when caring for patients with diabetes, which were similar across international and health system borders. Common issues might be addressed more efficiently through international educational designs, adapted to each country's healthcare system, helping develop and maintain physicians' competencies.

2011-01-01

6

Diabetes, Obesity and Erectile Dysfunction: Field Overview and Research Priorities  

PubMed Central

Purpose We provide an overview of basic, clinical and epidemiological research in the field of erectile dysfunction and important research priorities presented at the 2009 National Institute of Diabetes and Digestive and Kidney Diseases symposium on Urological Complications of Diabetes and Obesity. Materials and Methods Experts in molecular biology, physiology, pharmacology, clinical trials, epidemiology and urological surgery highlighted current knowledge on erectile dysfunction associated with diabetes mellitus and obesity. Results Predictable associations between erectile dysfunction, and poor diabetic control and modifiable risk factors, including body mass index, have not yet been translated into randomized trials in the United States. The relationship between erectile dysfunction and metabolic syndrome, and surrogate markers for erectile dysfunction requires further investigation. Basic research aimed at discovering disease mechanisms and therapeutic targets has focused on autonomic neuropathy, vascular dysfunction, smooth muscle contractile function and matrix. However, significant gaps exist in regard to the integration of molecular, cellular and functional data. Animal models of type 2 diabetes and obesity associated erectile dysfunction require investigation because most basic science studies have used rodent models of type 1 diabetes. Conclusions Studies are needed to synthesize a systems biology understanding of erectile function/dysfunction, and characterize and disseminate rodent models of erectile dysfunction associated with type 2 diabetes and obesity. Clinical studies are needed of promising intervention and prevention strategies. Leveraging existing and future cohort phenotypes, and biological samples is needed for risk factor analysis, biomarker discovery and genome wide association studies.

Chitaley, Kanchan; Kupelian, Varant; Subak, Leslee; Wessells, Hunter

2010-01-01

7

Cognitive Function Is Disrupted by Both Hypo and Hyperglycemia in School-Aged Children With Type 1 Diabetes: A Field Study  

Microsoft Academic Search

OBJECTIVE — We developed a field procedure using personal digital assistant (PDA) tech- nology to test the hypothesis that naturally occurring episodes of hypo- and hyperglycemia are associated with deterioration in cognitive function in children with type 1 diabetes. RESEARCH DESIGN AND METHODS — A total of 61 children aged 6 -11 years with type 1 diabetes received a PDA

LINDA A. GONDER-FREDERICK; JOHN F. ZREBIEC; ANDREA U. BAUCHOWITZ; LEE M. RITTERBAND; JOSHUA C. MAGEE; DANIEL J. COX; WILLIAM L. CLARKE

2009-01-01

8

Diabetic colon preparation comparison study.  

PubMed

The purpose of the present study was to establish an optimal colon preparation for persons with diabetes who are undergoing colonoscopies. Specifically, the aim was to compare the difference between an experimental and standard preparation. Adequacy of bowel preparation is critical for good bowel visualization. Compared with nondiabetic patients, persons with diabetes have slower gastric emptying, colonic transit, and colon evacuation. Inadequate preparations may lead to suboptimal colonoscopy resulting in overlooked pathology, repeated examinations with associated risks, and organizational inefficiencies. Using a single-blind experimental design, 198 persons with diabetes who were scheduled to receive colonoscopies were randomly assigned to either the experimental (diabetic colon preparation) or the control (standard colon preparation) group. Patients in the diabetic colon preparation group had 70% good colon preparations compared with 54% in the standard group, and this finding was significant (? = 5.14, p = 0.02). Results indicate that diabetic patients receiving 10 ounces of magnesium citrate 2 days prior to their colonoscopies followed by 10 ounces of magnesium citrate and 4-L polyethylene glycol the day prior to the procedure had cleaner colons than those receiving standard preparation of 10 ounces of magnesium citrate and 4-L polyethylene glycol the day prior to procedure. This colon preparation is safe, feasible, well-tolerated, and effective. PMID:21979399

Hayes, Ann; Buffum, Martha; Hughes, Joyce

2011-01-01

9

Assessing diabetic retinopathy using two-field digital photography and the influence of JPEG-compression  

Microsoft Academic Search

Objective: To study the effectiveness of two digital 50° photographic fields per eye, stored compressed or integrally, in the grading of diabetic retinopathy, in comparison to 35-mm colour slides. Subjects and methods: Two-field digital non-stereoscopic retinal photographs and two-field 35-mm retinal photographs were made at the same time from patients visiting a diabetic retinopathy outpatient clinic. The digital images were

Catharina Stellingwerf; Peter Hardus; Johanna Hooymans

2004-01-01

10

Health and Diabetes Self-efficacy: A Study of Diabetic and Non-diabetic Free Clinic Patients and Family Members.  

PubMed

Free clinics across the country provide free or reduced fee healthcare to individuals who lack access to primary care and are socio-economically disadvantaged. This study examined perceived health status among diabetic and non-diabetic free clinic patients and family members of the patients. Diabetes self-efficacy among diabetic free clinic patients was also investigated with the goal of developing appropriate diabetes health education programs to promote diabetes self-management. English or Spanish speaking patients and family members (N = 365) aged 18 years or older completed a self-administered survey. Physical and mental health and diabetes self-efficacy were measured using standardized instruments. Diabetic free clinic patients reported poorer physical and mental health and higher levels of dysfunction compared to non-diabetic free clinic patients and family members. Having a family history of diabetes and using emergency room or urgent care services were significant factors that affected health and dysfunction among diabetic and non-diabetes free clinic patients and family members. Diabetic free clinic patients need to receive services not only for diabetes, but also for overall health and dysfunction issues. Diabetes educational programs for free clinic patients should include a component to increase diabetes empowerment as well as the knowledge of treatment and management of diabetes. Non-diabetic patients and family members who have a family history of diabetes should also participate in diabetes education. Family members of free clinic patients need help to support a diabetic family member or with diabetes prevention. PMID:24496670

Kamimura, Akiko; Christensen, Nancy; Myers, Kyl; Nourian, Maziar M; Ashby, Jeanie; Greenwood, Jessica L J; Reel, Justine J

2014-08-01

11

Rapid skin profiling with non-contact full-field optical coherence tomography: study of patients with diabetes mellitus type I  

NASA Astrophysics Data System (ADS)

The application of the full-field optical coherence tomography (OCT) microscope to the characterisation of skin morphology is described. An automated procedure for analysis and interpretation of the OCT data has been developed which provides measures of the laterally averaged depth profiles of the skin reflectance. The skin at the dorsal side of the upper arm of 22 patients with Type 1 Diabetes Mellitus has been characterised in a non-contact way. The OCT signal profile was compared with the optical histological data obtained with a commercial confocal microscope (CM). The highest correlation to the epidermal thickness (ET) obtained using CM was found for the distance from the entrance OCT peak to the first minimum of the reflection profile (R2=0.657, p<0.0001). The distance to the second OCT reflection peak was found to be less correlated to ET (R2=0.403, p=0.0009). A further analysis was undertaken to explore the relation between the subjects' demographical data and the OCT reflection profile. The distance to the second OCT peak demonstrated a correlation with a marginal statistical significance for the body-mass index (positive correlation with p=0.01) and age (negative correlation with p=0.062). At the same time the amplitude of the OCT signal, when compensated for signal attenuation with depth, is negatively correlated with age (p<0.0002). We suggest that this may be an effect of photo degradation of the dermal collagen. In the patient population studied, no relation could be determined between the measured skin morphology and the duration of diabetes or concentration of glycated haemoglobin in the blood.

Zakharov, P.; Talary, M. S.; Kolm, I.; Caduff, A.

2009-07-01

12

Methodology for retinal photography and assessment of diabetic retinopathy: the EURODIAB IDDM Complications Study  

Microsoft Academic Search

Summary  We present the methodology for 45 retinal photography and detail the development, application and validation of a new system of 45 field grading standards for the assessment of diabetic retinopathy. The systems were developed for the EURODIAB IDDM Complications Study, part of a European Community funded Concerted Action Programme into the epidemiology and prevention of diabetes (EURODIAB). Assessment of diabetic

S. J. Aldington; E. M. Kohner; S. Meuer; R. Klein; A. K. SjØlie

1995-01-01

13

Screening for Diabetic Retinopathy by One-Field, Non-Mydriatic, 45° Digital Photography Is Inadequate  

Microsoft Academic Search

Purpose: To evaluate the sensitivity and specificity of one-field, non-mydriatic, 45° digital photography for screening for diabetic retinopathy compared to indirect ophthalmoscopy using a slit-lamp, the reference standard. Methods: A total of 100 consecutive diabetic patients (200 eyes) who underwent digital fundus photography and ocular examinations from June 2002 to November 2002 were included in this retrospective study. The patients,

Hsi-Kung Kuo; Hsin-Hung Hsieh; Rue-Tsuan Liu

2005-01-01

14

The preventive effects of pulsed electromagnetic fields on diabetic bone loss in streptozotocin-treated rats  

Microsoft Academic Search

Summary  The present study was the first report demonstrating that pulsed electromagnetic field (PEMF) could partially prevent bone\\u000a strength and architecture deterioration and improve the impaired bone formation in streptozotocin-induced diabetic rats. The\\u000a findings indicated that PEMF might become a potential additive method for inhibiting diabetic osteopenia or osteoporosis.\\u000a \\u000a \\u000a \\u000a \\u000a Introduction  Diabetes mellitus (DM) can cause various musculoskeletal abnormalities. Optimal therapeutic methods for

D. Jing; J. Cai; G. Shen; J. Huang; F. Li; J. Li; L. Lu; E. Luo; Q. Xu

2011-01-01

15

[Diabetic retinopathy complications--12-year retrospective study].  

PubMed

It is analyzed, on a retrospective study on 12 years, the incidence of diabetus melitus cases, hospitalized in the Ophthalmologic Clinic from Craiova with special mention to the frequency of the diabetic retinopathy, of it's complications and in an accordance to other general diseases, especially cardiovascular's, which contributes to the aggravation of the diabetic ocular in juries evolution. The study underlines the high incidence of the new founded cases with diabetus melitus in complicated diabetes retinopathy stage; the high frequency of ocular complications is explained, according to our statistic facts and through an insufficient treatment, sometimes incorrect and many other cases total neglected by the patients. PMID:12677808

Ignat, Florica; Davidescu, Livia

2002-01-01

16

Diabetic Retinopathy Study Data Tapes Available.  

National Technical Information Service (NTIS)

This citation summarizes a one-page announcement of technology available for utilization. The Diabetic Retinopathy Study (DRS), supported by the National Eye Institute, proved conclusively that photocoagulation reduces the risk of severe visual loss in pe...

1983-01-01

17

DIABETES  

PubMed Central

Limited options for clinical management of patients with juvenile-onset diabetes mellitus call for a novel therapeutic paradigm. Two innovative studies support endoplasmic reticulum as an emerging target for combating both autoimmune and heritable forms of this disease.

Urano, Fumihiko

2014-01-01

18

[Oral protozoans and diabetes: study in 117 patients].  

PubMed

A study on the presence of oral Entamoeba gingivalis and Trichomonas tenax has been carried out on calculus or dental plaque from 117 diabetic subjects. Statistical analysis of results shows no correlation between diabetes and protozoa. The same frequency was found between diabetic and normal subjects. Nevertheless, a significant relation has been found between the diabetes and the yeasts. PMID:372177

Cambon, M; Petavy, A F; Guillot, J; Glanddier, Y; Deguillaume, J; Coulet, M

1979-03-01

19

The Swedish childhood diabetes study — social and perinatal determinants for diabetes in childhood  

Microsoft Academic Search

Summary  Using the Swedish childhood diabetes register, a nationwide, case-referent study was performed from September 1, 1985 to August 31, 1986. Based on the information from a mailed questionnaire sent to all incident diabetic children and for each diabetic child — two referent children matched according to age, sex, and county, we have analysed perinatal events and aspects of the social

L. Blom; G. Dahlquist; L. Nyström; A. Sandström; S. Wall

1989-01-01

20

Predictors, consequences and costs of diabetes-related lower extremity amputation complicating type 2 diabetes: The Fremantle Diabetes Study  

Microsoft Academic Search

Aims\\/hypothesis  The aims of this study were to assess the incidence, predictors, consequences, and inpatient cost of lower extremity amputation (LEA) in a community-based cohort of type 2 diabetic patients.Methods  Between 1993 and 1996, 1,294 patients with type 2 diabetes were recruited to the longitudinal, observational Fremantle Diabetes Study. LEAs and mortality from cardiac causes were monitored until 30 June 2005. Inpatient

W. A. Davis; P. E. Norman; D. G. Bruce; T. M. E. Davis

2006-01-01

21

Type 2 Diabetes May Shrink the Brain, Study Suggests  

MedlinePLUS

... enable JavaScript. Type 2 Diabetes May Shrink the Brain, Study Suggests Loss of gray matter can lead ... People with type 2 diabetes may lose more brain volume than is expected as they age, new ...

22

Study Links Shift Work to Risk for Type 2 Diabetes  

MedlinePLUS

... Study Links Shift Work to Risk for Type 2 Diabetes Researchers cite many possible reasons for the ... July 24, 2014 Related MedlinePlus Pages Diabetes Type 2 Occupational Health Sleep Disorders THURSDAY, July 24, 2014 ( ...

23

Diabetic Retinopathy Education Study. Executive Summary and Final Report.  

National Technical Information Service (NTIS)

The purpose of the Diabetic Retinopathy Educational Study was to test the hypothesis that short-term educational interventions can significantly improve the ability of primary care physicians to identify and appropriately refer patients with diabetic reti...

H. Cupples

1993-01-01

24

Study Characteristics of Juvenile Diabetes Mellitus Cases in Bangladesh  

PubMed Central

Objective To identify the proportion and some selected characteristics of juvenile diabetics attending BIRDEM hospital. Materials and methods This was a cross sectional study. The study was conducted in the BIRDEM hospital. All Diabetic young aged up to 18 years who visit BIRDEM hospital were included in study population. The sample size was 240. Results It was observed that among the respondents 43.3% were protein deficient pancreatic diabetes (PDPD), 30.8% were Type-1 diabetes, 20% were fibro-calculus pancreatic diabetes (FCPD) and remaining 5.8% were Type-2 diabetes. Family history of diabetes was found among one-fifth of the respondents. It was found that majority 86.4% of Type-1 diabetes were presented in early age < 10 years in contrast to Type-2 diabetes 4.5%, PDPD 9.1% and FCPD 0.0%. It was found that 50% of type-1 diabetes patient and 17.6% of Type-2 diabetes patient were from urban area and 24.5% of FCDP patient and 52.8% of PDPD patient were from rural areas. It was observed that Type-1 and Type-2 diabetes were associated with the family history of diabetes mellitus than FCPD and PDPD. Severe underweight and sever stunted was significantly higher among the protein deficient diabetes mellitus compare to Type-2 diabetes. Conclusion Juvenile diabetes is emerging health problem in modern era. Like old population the incidence of juvenile diabetes is increasing day by day. It is time for the health planner to prevent and control the disease; otherwise it will be major problem after a decade.

Mona, Nusrat Jahan

2014-01-01

25

Breast and Prostate Cancer Survivors in a Diabetic Cohort: Results from the Living With Diabetes Study  

PubMed Central

Objective Diabetes is more common in cancer survivors than in the general population. The objective of the present study was to determine cancer frequency in a cohort of patients with diabetes and to examine demographic, clinical, and quality of life differences between cancer survivors and their cancer-free peers to inform better individualized care. Methods Self-reported survey data from 3,466 registrants with type 2 diabetes from Australia’s National Diabetes Services Scheme (NDSS) were analyzed to compare relevant variables between cancer survivors and cancer-free patients. Analyses were focused on breast and prostate cancer to reflect the most common cancers in women and men, respectively. Results Five percent of diabetic women reported a history of breast cancer and 4.2% of men reported a history of prostate cancer. Diabetic patients with a history of breast or prostate cancer were older at time of survey and diabetes diagnosis, less likely to report metformin use (women), and more likely to have two or more comorbidities than their cancer-free peers. More diabetic prostate cancer survivors also reported problems with mobility and performing usual tasks. However, cancer-free diabetic subjects reported a lower diabetes-dependent quality of life than diabetic cancer survivors. There was no association between cancer survivorship and duration of diabetes, indices of glycemic control, obesity, or diabetic complications. Conclusions Cancer survivors comprise a significant minority of diabetic patients that are particularly vulnerable and may benefit from interventions to increase screening and treatment of other comorbidities and promote a healthy lifestyle.

Onitilo, Adedayo A.; Donald, Maria; Stankowski, Rachel V.; Engel, Jessica M.; Williams, Gail; Doi, Suhail A. R.

2013-01-01

26

Sexual Dysfunction in Type II Diabetic Females: A Comparative Study  

Microsoft Academic Search

Diabetes Mellitus (DM) is considered to play a principle role in the etiopathogenesis of sexual dysfunction both in men and women. The aim of this study is to evaluate sexual function in Type II diabetic women. A total of 72 young diabetic women (mean age: 38.8 years) with no other systemic diseases and 60 age-matched healthy women were enrolled in

Bulent Erol; Ahmet Tefekli; Isa Ozbey; Fatih Salman; Nevin Dincag; Ates Kadioglu; Sedat Tellaloglu

2002-01-01

27

Arsenic Exposure, Diabetes Prevalence, and Diabetes Control in the Strong Heart Study  

PubMed Central

This study evaluated the association of arsenic exposure, as measured in urine, with diabetes prevalence, glycated hemoglobin, and insulin resistance in American Indian adults from Arizona, Oklahoma, and North and South Dakota (1989–1991). We studied 3,925 men and women 45–74 years of age with available urine arsenic measures. Diabetes was defined as a fasting glucose level of 126 mg/dL or higher, a 2-hour glucose level of 200 mg/dL or higher, a hemoglobin A1c (HbA1c) of 6.5% or higher, or diabetes treatment. Median urine arsenic concentration was 14.1 µg/L (interquartile range, 7.9–24.2). Diabetes prevalence was 49.4%. After adjustment for sociodemographic factors, diabetes risk factors, and urine creatinine, the prevalence ratio of diabetes comparing the 75th versus 25th percentiles of total arsenic concentrations was 1.14 (95% confidence interval: 1.08, 1.21). The association between arsenic and diabetes was restricted to participants with poor diabetes control (HbA1c ?8%). Arsenic was positively associated with HbA1c levels in participants with diabetes. Arsenic was not associated with HbA1c or with insulin resistance (assessed by homeostatic model assessment to quantify insulin resistance) in participants without diabetes. Urine arsenic was associated with diabetes control in a population from rural communities in the United States with a high burden of diabetes. Prospective studies that evaluate the direction of the relation between poor diabetes control and arsenic exposure are needed.

Gribble, Matthew O.; Howard, Barbara V.; Umans, Jason G.; Shara, Nawar M.; Francesconi, Kevin A.; Goessler, Walter; Crainiceanu, Ciprian M.; Silbergeld, Ellen K.; Guallar, Eliseo; Navas-Acien, Ana

2012-01-01

28

Arsenic exposure, diabetes prevalence, and diabetes control in the Strong Heart Study.  

PubMed

This study evaluated the association of arsenic exposure, as measured in urine, with diabetes prevalence, glycated hemoglobin, and insulin resistance in American Indian adults from Arizona, Oklahoma, and North and South Dakota (1989-1991). We studied 3,925 men and women 45-74 years of age with available urine arsenic measures. Diabetes was defined as a fasting glucose level of 126 mg/dL or higher, a 2-hour glucose level of 200 mg/dL or higher, a hemoglobin A1c (HbA1c) of 6.5% or higher, or diabetes treatment. Median urine arsenic concentration was 14.1 µg/L (interquartile range, 7.9-24.2). Diabetes prevalence was 49.4%. After adjustment for sociodemographic factors, diabetes risk factors, and urine creatinine, the prevalence ratio of diabetes comparing the 75th versus 25th percentiles of total arsenic concentrations was 1.14 (95% confidence interval: 1.08, 1.21). The association between arsenic and diabetes was restricted to participants with poor diabetes control (HbA1c ?8%). Arsenic was positively associated with HbA1c levels in participants with diabetes. Arsenic was not associated with HbA1c or with insulin resistance (assessed by homeostatic model assessment to quantify insulin resistance) in participants without diabetes. Urine arsenic was associated with diabetes control in a population from rural communities in the United States with a high burden of diabetes. Prospective studies that evaluate the direction of the relation between poor diabetes control and arsenic exposure are needed. PMID:23097256

Gribble, Matthew O; Howard, Barbara V; Umans, Jason G; Shara, Nawar M; Francesconi, Kevin A; Goessler, Walter; Crainiceanu, Ciprian M; Silbergeld, Ellen K; Guallar, Eliseo; Navas-Acien, Ana

2012-11-15

29

Validity of Diabetes Self-Reports in the Saku Diabetes Study  

PubMed Central

Background Diabetes is an important risk factor for cardiovascular disease, certain types of cancer, and death, and self-reports are one of the most convenient methods for ascertaining diabetes status. We evaluated the validity of diabetes self-reports among Japanese who participated in a health checkup. Methods Self-reported diabetes was cross-sectionally compared with confirmed diabetes among 2535 participants aged 28 to 85 years in the Saku cohort study. Confirmed diabetes was defined as the presence of at least 1 of the following: fasting plasma glucose (FPG) level of 126 mg/dL or higher, 2-hour post-load glucose (2-hPG) level of 200 mg/dL or higher after a 75-gram oral glucose tolerance test, glycated hemoglobin (HbA1c) level of 6.5% or higher, or treatment with hypoglycemic medication(s). Results Of the 251 participants with self-reported diabetes, 121 were taking hypoglycemic medication(s) and an additional 69 were classified as having diabetes. Of the 2284 participants who did not self-report diabetes, 80 were classified as having diabetes. These data yielded a sensitivity of 70.4%, a specificity of 97.3%, a positive predictive value of 75.7%, and a negative predictive value of 96.5%. The frequency of participants with undiagnosed diabetes was 3.0%. Of these, 64.2% had FPG within the normal range and were diagnosed by 2-hPG and/or HbA1c. Conclusions Our findings provide additional support for the use of self-reported diabetes as a measure of diabetes in epidemiologic studies performed in similar settings in Japan if biomarker-based diagnosis is difficult.

Goto, Atsushi; Morita, Akemi; Goto, Maki; Sasaki, Satoshi; Miyachi, Motohiko; Aiba, Naomi; Kato, Masayuki; Terauchi, Yasuo; Noda, Mitsuhiko; Watanabe, Shaw

2013-01-01

30

Evaluation of the efficacy of pulsed electromagnetic field in the management of patients with diabetic polyneuropathy  

PubMed Central

AIM: The study was carried out to evaluate and compare the effect of low power, low frequency pulsed electromagnetic field (PEMF) of 600 and 800 Hz, respectively, in management of patients with diabetic polyneuropathy. SETTINGS AND DESIGNS: The study was a randomized controlled trial performed in Guru Nanak Dev University and Medical College, Amritsar, India with different subject experimental design. MATERIALS AND METHODS: Thirty subjects within an age group of 40–68 years with diabetic polyneuropathy stages N1a, N1b, N2a were randomly allocated to groups 1, 2, 3 with 10 subjects in each. Group 1 and 2 were treated with low power 600 and 800-Hz PEMF for 30 min for 12 consecutive days. Group 3 served as control on usual medical treatment of diabetic polyneuropathy (DPN). The subjects with neuropathy due to any cause other than diabetes were excluded. The pain and motor nerve conduction parameters (distal latency, amplitude, nerve conduction velocity) were assessed before and after treatment. STATISTICAL ANALYSIS: Related t-test and unrelated t-test were used for data analysis. RESULTS: Significant reduction in pain and statistically significant (P<0.05) improvement in distal latency and nerve conduction velocity were seen in experimental group 1 and 2. CONCLUSIONS: Low-frequency PEMF can be used as an adjunct in reducing neuropathic pain as well as for retarding the progression of neuropathy in a short span of time.

Graak, Vinay; Chaudhary, Sarika; Bal, B. S.; Sandhu, J. S.

2009-01-01

31

Field Polymer Stability Studies  

Microsoft Academic Search

The highlights of the results obtained from a field test designed to study shear degradation of polyacrylamide polymers are presented. Recently, most major research laboratories have been studying shear degradation in the laboratory; however, no extensive field testing has been reported. The field test consisted of injecting Pusher 700 into a well at 4 different rates and back producing the

Bilhartz H. L; G. S. Charlson

1975-01-01

32

Diabetes  

NSDL National Science Digital Library

This booklet summarizes what health professionals know about type 2 diabetes what it is, who is at risk for it, how it can be prevented, and how it is treated. It describes how researchers study the disease and what individuals can do to help reduce the rising number of diabetes cases now affecting millions of children and adults around the country.The Science Inside e-book series is ntended to be a bridge between the consumer health brochure and the scientific paper, the booklets in this series focus on the science that is inside of, or behind, the disease its cause, its possible cure, its treatment, promising research, and so on. These booklets are designed to appeal to people who have not had the opportunity to study the science and to understand why they may have been given some of the advice that they have been given through some of the more consumer-oriented materials.

American Association for the Advancement of Science (;)

2003-01-01

33

Diabetes  

NSDL National Science Digital Library

This booklet summarizes what health professionals know about type 2 diabetes what it is, who is at risk for it, how it can be prevented, and how it is treated. It describes how researchers study the disease and what individuals can do to help reduce the rising number of diabetes cases now affecting millions of children and adults around the country.The Science Inside e-book series is intended to be a bridge between the consumer health brochure and the scientific paper, the booklets in this series focus on the science that is inside of, or behind, the disease its cause, its possible cure, its treatment, promising research, and so on. These booklets are designed to appeal to people who have not had the opportunity to study the science and to understand why they may have been given some of the advice that they have been given through some of the more consumer-oriented materials.

American Association for the Advancement of Science (American Association for the Advancement of Science;)

2006-01-01

34

Association of diabetes mellitus and dementia: The Rotterdam Study  

Microsoft Academic Search

Summary   Dementia and non-insulin-dependent diabetes mellitus (NIDDM) are highly prevalent disorders in the elderly. Diabetes has\\u000a repeatedly been reported to affect cognition, but its relation with dementia is uncertain. We therefore studied the association\\u000a between diabetes and dementia in the Rotterdam Study, a large population-based study in the elderly. Of 6330 participants,\\u000a aged 55 to 99 years old, complete information

A. Ott; R. P. Stolk; A. Hofman; F. van Harskamp; D. E. Grobbee; M. M. B. Breteler

1996-01-01

35

Permanent Neonatal Diabetes Mellitus: Prevalence and Genetic Diagnosis in the SEARCH for Diabetes in Youth Study  

PubMed Central

Background Neonatal diabetes mellitus (NDM) is defined as diabetes with onset before 6 months of age. Nearly half of individuals with NDM are affected by permanent neonatal diabetes mellitus (PNDM). Mutations in KATP channel genes (KCNJ11, ABCC8) and the insulin gene (INS) are the most common causes of PNDM. Objective To estimate the prevalence of PNDM among SEARCH for Diabetes in Youth (SEARCH) study participants (2001-2008) and to identify the genetic mutations causing PNDM. Methods SEARCH is a multi-center population-based study of diabetes in youth < 20 years of age. Participants diagnosed with diabetes before 6 months of age were invited for genetic testing for mutations in the KCNJ11, ABCC8 and INS genes. Results Of the 15,829 SEARCH participants with diabetes, 39 were diagnosed before 6 months of age. Thirty five of them had PNDM (0.22% of all diabetes cases in SEARCH), 3 had transient neonatal diabetes that had remitted by 18 months and one was unknown. The majority of them (66.7%) had a clinical diagnosis of type1 diabetes by their health care provider. Population prevalence of PNDM in youth <20 years was estimated at 1 in 252,000. Seven participants underwent genetic testing; mutations causing PNDM were identified in five (71%), (two KCNJ11, three INS). Conclusions We report the first population-based frequency of PNDM in the US based on the frequency of PNDM in SEARCH. Patients with NDM are often misclassified as having type1 diabetes. Widespread education is essential to encourage appropriate genetic testing and treatment of NDM.

Shankar, Roopa Kanakatti; Pihoker, Catherine; Dolan, Lawrence M.; Standiford, Debra; Badaru, Angela; Dabelea, Dana; Rodriguez, Beatriz; Black, Mary Helen; Imperatore, Giuseppina; Hattersley, Andrew; Ellard, Sian; Gilliam, Lisa K.

2014-01-01

36

Potential efficiency benefits of nonmydriatic ultrawide field retinal imaging in an ocular telehealth diabetic retinopathy program.  

PubMed

OBJECTIVE To compare efficiency of nonmydriatic ultrawide field retinal imaging (UWFI) and nonmydriatic fundus photography (NMFP) in a diabetic retinopathy (DR) ocular telehealth program. RESEARCH DESIGN AND METHODS Patients in this retrospective, comparative cohort study underwent NMFP and UWFI between 1 November 2011 and 1 November 2012. Images were evaluated for DR and diabetic macular edema (DME) by certified graders using a standard protocol at a centralized reading center. Identification of DR, image evaluation time, and rate of ungradable eyes were compared. RESULTS NMFP and UWFI were performed in 1,633 and 2,170 consecutive patients, respectively. No statistically significant differences were found between groups regarding age, diabetes duration, sex, ethnicity, or insulin use. The ungradable rate per patient for DR (2.9 vs. 9.9%, P < 0.0001) and DME (3.8 vs. 8.8%, P < 0.0001) was lower with UWFI than with NMFP. With UWFI, the median image evaluation time per patient was reduced from 12.8 to 9.2 min (P < 0.0001). The identification of patients with DR (38.4 vs. 33.8%) and vision-threatening DR (14.5 vs. 11.9%) was increased with UWFI versus NMFP. In a consecutive subgroup of 502 eyes of 301 patients with DR, the distribution of peripheral retinal lesions outside Early Treatment Diabetic Retinopathy Study fields suggested a more severe DR level in 9.0% (45 eyes). CONCLUSIONS In a standardized DR ocular telehealth program, nonmydriatic UWFI reduced the ungradable rate by 71% (to <3%) and reduced image evaluation time by 28%. DR was identified 17% more frequently after UWFI, and DR peripheral lesions suggested a more severe DR level in 9%. These data suggest that UWFI may improve efficiency of ocular telehealth programs evaluating DR and DME. PMID:23939541

Silva, Paolo S; Cavallerano, Jerry D; Tolls, Dorothy; Omar, Ahmed; Thakore, Komal; Patel, Bina; Sehizadeh, Mina; Tolson, Ann M; Sun, Jennifer K; Aiello, Lloyd M; Aiello, Lloyd Paul

2014-01-01

37

Odontogenic infection involving the secondary fascial space in diabetic and non-diabetic patients: a clinical comparative study  

PubMed Central

Objectives This retrospective study was performed to evaluate the clinical impact of diabetes mellitus on the prognosis in secondary space infection. Materials and Methods Medical records, radiographic images, computed tomography, and microbial studies of 51 patients (25 diabetic patients and 26 non-diabetic patients) were reviewed. Patients were diagnosed as secondary fascial space infections with odontogenic origin and underwent treatment at Chonnam National University Hospital, in Department of Oral and Maxillofacial Surgery, from January 2007 to February 2009. Results Compared to patients without diabetes, patients with diabetes were presented with the following characteristics: older age (diabetic patients: 62.9 years, non-diabetic patients, 47.8 years), more spaces involved (diabetic patients, 60%; non-diabetic patients, 27.3%), more intense treatment, longer hospitalization (diabetic patients, 28.9 days; non-diabetic patients, 15.4 days), higher white blood cell and C-reactive protein values, higher incidence of complication (diabetic patients, 40%; non-diabetic patients, 7.7%), and distinctive main causative microorganisms. Conclusion These results suggest that the prognosis of diabetic patients is poorer than that of non-diabetic patients in secondary space infections since they had greater incidence rates of involved spaces, abnormal hematologic findings, more complications, and additional procedures, such as tracheostomy.

Chang, Je-Shin; Yoo, Kil-Hwa; Yoon, Sung Hwan; Ha, Jiwon; Jung, Seunggon; Kook, Min-Suk; Park, Hong-Ju; Ryu, Sun-Youl

2013-01-01

38

Neurodegeneration and diabetes: UK nationwide study of Wolfram (DIDMOAD) syndrome  

Microsoft Academic Search

SummaryWolfram syndrome is the association of diabetes mellitus and optic atrophy, and is sometimes called DIDMOAD (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness). Incomplete characterisation of this autosomal recessive syndrome has relied on case-reports, and there is confusion with mitochondrial genome disorders. We therefore undertook a UK nationwide cross-sectional case-finding study to describe the natural history, complications, prevalence, and

T. G Barrett; S. E Bundey; A. F Macleod

1995-01-01

39

Metabolic Footprint of Diabetes: A Multiplatform Metabolomics Study in an Epidemiological Setting  

Microsoft Academic Search

BackgroundMetabolomics is the rapidly evolving field of the comprehensive measurement of ideally all endogenous metabolites in a biological fluid. However, no single analytic technique covers the entire spectrum of the human metabolome. Here we present results from a multiplatform study, in which we investigate what kind of results can presently be obtained in the field of diabetes research when combining

Karsten Suhre; Christa Meisinger; Angela Döring; Elisabeth Altmaier; Petra Belcredi; Christian Gieger; David Chang; Michael V. Milburn; Walter E. Gall; Klaus M. Weinberger; Hans-Werner Mewes; Martin Hrabé de Angelis; H.-Erich Wichmann; Florian Kronenberg; Jerzy Adamski; Thomas Illig; Bernadette Breant

2010-01-01

40

Addressing cardiovascular disease risk in diabetes: insights from mechanistic studies  

PubMed Central

Subjects with diabetes have increased cardiovascular disease risk compared to those without diabetes. Addressing residual cardiovascular disease risk in this disease, beyond blood pressure and LDL cholesterol control, remains important as the prevalence of diabetes increases worldwide. The accelerated atherosclerosis and cardiovascular disease in diabetes is likely multifactorial and there are numerous therapeutic approaches that can be considered. Results of mechanistic studies conducted in isolated cells, animals, or humans can provide important insights with potential to influence clinical management decisions and improve outcomes. In this review, we focus on three areas in which pathophysiologic considerations could be particularly informative in this regard; the roles of hyperglycemia, diabetic dyslipidemia (beyond LDL cholesterol level), and inflammation (including that in adipose tissue) for accelerating vascular injury and the rates of cardiovascular disease in Type 2 diabetes are outlined and evaluated.

Mazzone, Theodore; Chait, Alan; Plutzky, Jorge

2009-01-01

41

Diabetes  

MedlinePLUS

... and risk factors are different for each type: Type 1 diabetes can occur at any age, but it is ... high blood sugar have no symptoms. Symptoms of type 1 diabetes develop over a short period. People may be ...

42

Congenital Heart Disease in Infants of Diabetic Mothers: Echocardiographic Study  

Microsoft Academic Search

Our objective was to study neonates born to insulin-dependent diabetes mellitus (IDDM) mothers to detect the spectrum of congenital heart disease (CHD). Between July 2000 and June 2001, a prospective study of 100 consecutive infants of diabetic mothers (IDMs) at King Khalid University Hospital in Riyadh was undertaken. Family and maternal history, physical examination with special attention to the cardiovascular

R. M. Abu-Sulaiman; B. Subaih

2004-01-01

43

Describing Support: A Qualitative Study of Couples Living with Diabetes  

Microsoft Academic Search

Family and marital support have been shown to be associated with better treatment adherence, illness adaptation, and blood sugar control in studies of individuals with diabetes. However, the behaviors and attitudes that describe appropriate support have not been defined. This is a qualitative study which asked couples who live with diabetes to define support. Seventy-four individuals (patients and spouses) participated

Paula M. Trief; Jonathan Sandberg; Roger P. Greenberg; Keri Graff; Nina Castronova; Miyoung Yoon; Ruth S. Weinstock

2003-01-01

44

Rates of Complications and Mortality in Older Diabetes Patients: The Diabetes and Aging Study  

PubMed Central

Importance In the coming decades, the population of older adults with diabetes is expected to grow substantially. Understanding the clinical course of diabetes in this population is critical for establishing evidence-based clinical practice recommendations, research priorities, allocating resources, and setting health policies. Objective Contrast rates of diabetes complications and mortality across age and diabetes duration categories. Design, Setting, Participants This cohort study (2004–2010) included 72,310 older (?60 years of age) patients with type 2 diabetes enrolled in a large, integrated healthcare delivery system. Incidence densities (events per 1000 person-years (pys)) were calculated for each age category (60s, 70s, 80+ years) and duration of diabetes (shorter: 0–9 years vs. longer: 10+ years). Main Outcome Measures Incident acute hyperglycemic events, acute hypoglycemic events (hypoglycemia), microvascular complications [end-stage renal disease (ESRD), peripheral vascular disease, lower extremity amputation, advanced eye disease], cardiovascular complications [coronary artery disease (CAD), cerebrovascular disease (CVD), congestive heart failure (CHF)], and all-cause mortality. Results Among older adults with diabetes of short duration, cardiovascular complications followed by hypoglycemia were the most common non-fatal complications. For example, among 70–79 year olds with short duration of diabetes, CAD and hypoglycemia rates were higher (11.5 and 5.0/1000 pys respectively), compared to ESRD (2.6/1000), amputation (1.3/1000), and acute hyperglycemic events (0.8/1000). We observed a similar pattern among subjects in the same age group with long diabetes duration where CAD and hypoglycemia had some of the highest incidence rates (19.0 and 15.9 /1000 pys respectively), compared to ESRD (7.6/1000), amputation (4.3/1000), and acute hyperglycemic events (1.8/1000). For a given age group, rates of each outcome, particularly hypoglycemia and microvascular complications, increased dramatically with longer duration. However, for a given duration of diabetes, rates of hypoglycemia, cardiovascular complications, and mortality increased steeply with advancing age, while rates of microvascular complications remained stable or declined. Conclusion Duration of diabetes and advancing age independently predict diabetes morbidity and mortality rates. As long-term survivorship with diabetes increases and as the population ages, more research and public health efforts to reduce hypoglycemia will be needed, to complement ongoing efforts to reduce cardiovascular and microvascular complications.

Huang, Elbert S.; Laiteerapong, Neda; Liu, Jennifer Y.; John, Priya M.; Moffet, Howard H.; Karter, Andrew J.

2014-01-01

45

Albuminuria and Diabetic Retinopathy in Type 2 Diabetes Mellitus Sankara Nethralaya Diabetic Retinopathy Epidemiology And Molecular Genetic Study (SN-DREAMS, report 12)  

Microsoft Academic Search

Background  The concordance of microalbuminuria and diabetic retinopathy (DR) has been well reported in persons with type 1 diabetes;\\u000a however, for type 2 diabetes, there is paucity of data especially from population-based studies. The aim of this study was\\u000a to estimate the prevalence of albuminuria (micro - and macroalbuminuria) among persons with type 2 diabetes and determine\\u000a its role as a

Padmaja K Rani; Rajiv Raman; Aditi Gupta; Swakshyar S Pal; Vaitheeswaran Kulothungan; Tarun Sharma

2011-01-01

46

JAMA Study on Diabetes Treatments: Insulin Use as a Secondary Treatment for Type 2 Diabetes Linked to Heart Disease, ...  

MedlinePLUS

... Secondary Treatment for Type 2 Diabetes linked to Heart Disease, Death: JAMA Study on Diabetes Treatments. June 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/ ...

47

Systemic Perturbations of Key Metabolites in Diabetic Rats During the Evolution of Diabetes Studied by Urine Metabonomics  

PubMed Central

Background Elucidation of metabolic profiles during diabetes progression helps understand the pathogenesis of diabetes mellitus. In this study, urine metabonomics was used to identify time-related metabolic changes that occur during the development of diabetes mellitus and characterize the biochemical process of diabetes on a systemic, metabolic level. Methodology/Principal Findings Urine samples were collected from diabetic rats and age-matched controls at different time points: 1, 5, 10, and 15 weeks after diabetes modeling. 1H nuclear magnetic resonance (1H NMR) spectra of the urine samples were obtained and analyzed by multivariate data analysis and quantitative statistical analysis. The metabolic patterns of diabetic groups are separated from the controls at each time point, suggesting that the metabolic profiles of diabetic rats were markedly different from the controls. Moreover, the samples from the diabetic 1-wk group are closely associated, whereas those of the diabetic 15-wk group are scattered, suggesting that the presence of various of complications contributes significantly to the pathogenesis of diabetes. Quantitative analysis indicated that urinary metabolites related to energy metabolism, tricarboxylic acid (TCA) cycle, and methylamine metabolism are involved in the evolution of diabetes. Conclusions/Significance The results highlighted that the numbers of metabolic changes were related to diabetes progression, and the perturbed metabolites represent potential metabolic biomarkers and provide clues that can elucidate the mechanisms underlying the generation and development of diabetes as well as its complication.

Guan, Mimi; Xie, Liyun; Diao, Chengfeng; Wang, Na; Hu, Wenyi; Zheng, Yongquan; Jin, Litai; Yan, Zhihan; Gao, Hongchang

2013-01-01

48

Diabetes Tied to Higher Risk of Pancreatic Cancer in Study  

MedlinePLUS

... enable JavaScript. Diabetes Tied to Higher Risk of Pancreatic Cancer in Study But it's not always clear which ... Friday, April 4, 2014 Related MedlinePlus Pages Diabetes Pancreatic Cancer FRIDAY, April 4, 2014 (HealthDay News) -- People with ...

49

Trends in Postpartum Diabetes Screening and Subsequent Diabetes and Impaired Fasting Glucose Among Women With Histories of Gestational Diabetes Mellitus A report from the Translating Research Into Action for Diabetes (TRIAD) Study  

Microsoft Academic Search

OBJECTIVE — The purpose of this study was to examine trends in postpartum glucose screening for women with gestational diabetes mellitus (GDM), predictors of screening, trends in postpartum impaired fasting glucose (IFG) and diabetes, and diabetes and pre-diabetes detected by postpartum fasting plasma glucose (FPG) versus a 75-g oral glucose tolerance test (OGTT). RESEARCH DESIGN AND METHODS — This was

ASSIAMIRA FERRARA; TIFFANY PENG; CATHERINE KIM

50

Diabetes insipidus, diabetes mellitus, optic atrophy and deafness. A clinical and genetic study.  

PubMed

Two Iraqi sisters and a female cousin developed diabetes insipidus (DI), diabetes mellitus (DM), optic atrophy (OA), and deafness (D), (the 'DIDMOAD' syndrome) before the age of 12 years. One girl exhibited all the features of this disease complex only 3 months after an unusually late onset of recognizable symptoms at 11 years 9 months. Another girl died suddenly and unexpectedly. This family study illustrates the recessive inheritance pattern of the syndrome. PMID:482181

Nagi, N A

1979-06-01

51

Sense of coherence and diabetes: A prospective occupational cohort study  

PubMed Central

Background Sense of coherence (SOC) is an individual characteristic related to a positive life orientation leading to effective coping. A weak SOC has been associated with indicators of general morbidity and mortality. However, the relationship between SOC and diabetes has not been studied in prospective design. The present study prospectively examined the relationship between a weak SOC and the incidence of diabetes. Methods The relationship between a weak SOC and the incidence of diabetes was investigated among 5827 Finnish male employees aged 18–65 at baseline (1986). SOC was measured by questionnaire survey at baseline. Data on prescription diabetes drugs from 1987 to 2004 were obtained from the Drug Imbursement Register held by the Social Insurance Institution. Results During the follow-up, 313 cases of diabetes were recorded. A weak SOC was associated with a 46% higher risk of diabetes in participants who had been =<50 years of age on entry into the study. This association was independent of age, education, marital status, psychological distress, self-rated health, smoking status, binge drinking and physical activity. No similar association was observed in older employees. Conclusion The results suggest that besides focusing on well-known risk factors for diabetes, strengthening SOC in employees of =<50 years of age can also play a role in attempts to tackle increasing rates of diabetes.

Kouvonen, Anne M; Vaananen, Ari; Woods, Stephen A; Heponiemi, Tarja; Koskinen, Aki; Toppinen-Tanner, Salla

2008-01-01

52

Genetics of Kidneys in Diabetes (GoKinD) Study: A Genetics Collection Available for Identifying Genetic Susceptibility Factors for Diabetic Nephropathy in Type 1 Diabetes  

Microsoft Academic Search

The Genetics of Kidneys in Diabetes (GoKinD) study is an initiative that aims to identify genes that are involved in diabetic nephropathy. A large number of individuals with type 1 diabetes were screened to identify two subsets, one with clear-cut kidney disease and another with normal renal status despite long-term diabetes. Those who met additional entry criteria and consented to

Patricia W. Mueller; John J. Rogus; Patricia A. Cleary; Yuan Zhao; Adam M. Smiles; Michael W. Steffes; Jean Bucksa; Therese B. Gibson; Suzanne K. Cordovado; Andrzej S. Krolewski; Concepcion R. Nierras; James H. Warram

53

Frequency, severity and risk indicators of retinopathy in patients with diabetes screened by fundus photographs: a study from primary health care.  

PubMed

Objective: To determine the frequency, severity and risk indicators of diabetic retinopathy (DR) in patients with diabetes attending a primary care diabetes centre. Methods: This observational study was conducted at Diabetic Association of Pakistan - a World Health Organization collaborating center in Karachi, from March 2009 to December 2011. Registered patients with diabetes were screened by two field fundus photographs. Retina specialists graded the signs of retinopathy according to diabetic retinopathy disease severity scale. Results: Of total registered diabetic patients (n=11,158), 10,768 (96.5 %) were screened for DR. Overall DR was found in 2661 (24.7%) patients. DR was found in decreasing order of frequency in patients with type 2 (n= 2555, 23.7%) followed by patients with type 1 diabetes (n=101, 0.93% ) and patients with gestational diabetes mellitus (GDM) (n=5, 0.46%). Among patients with DR, signs of non-sight threatening retinopathy was dominant. Females and patients of working age group predominantly had retinopathy. Type 1 patients >16 years and type 2 patients < 5 years of history of diabetes had sign of retinopathy in increased frequency. Conclusion: Every forth patient with diabetes in this large cohort had signs of diabetic retinopathy. Females and patients in working age group predominantly had retinopathy. Type 2 patients with short while type 1 patients with long history of diabetes most frequently had DR. Dissemination of the present study findings may help in increasing the awareness of this serious complication of diabetes. PMID:24772145

Memon, Saleh; Ahsan, Shahid; Riaz, Qamar; Basit, Abdul; Ali Sheikh, Sikandar; Fawwad, Asher; Shera, A Samad

2014-03-01

54

Frequency, severity and risk indicators of retinopathy in patients with diabetes screened by fundus photographs: a study from primary health care  

PubMed Central

Objective: To determine the frequency, severity and risk indicators of diabetic retinopathy (DR) in patients with diabetes attending a primary care diabetes centre. Methods: This observational study was conducted at Diabetic Association of Pakistan - a World Health Organization collaborating center in Karachi, from March 2009 to December 2011. Registered patients with diabetes were screened by two field fundus photographs. Retina specialists graded the signs of retinopathy according to diabetic retinopathy disease severity scale. Results: Of total registered diabetic patients (n=11,158), 10,768 (96.5 %) were screened for DR. Overall DR was found in 2661 (24.7%) patients. DR was found in decreasing order of frequency in patients with type 2 (n= 2555, 23.7%) followed by patients with type 1 diabetes (n=101, 0.93% ) and patients with gestational diabetes mellitus (GDM) (n=5, 0.46%). Among patients with DR, signs of non-sight threatening retinopathy was dominant. Females and patients of working age group predominantly had retinopathy. Type 1 patients >16 years and type 2 patients < 5 years of history of diabetes had sign of retinopathy in increased frequency. Conclusion: Every forth patient with diabetes in this large cohort had signs of diabetic retinopathy. Females and patients in working age group predominantly had retinopathy. Type 2 patients with short while type 1 patients with long history of diabetes most frequently had DR. Dissemination of the present study findings may help in increasing the awareness of this serious complication of diabetes.

Memon, Saleh; Ahsan, Shahid; Riaz, Qamar; Basit, Abdul; Ali Sheikh, Sikandar; Fawwad, Asher; Shera, A Samad

2014-01-01

55

The Association between Adiponectin/Leptin Ratio and Diabetes Type: The SEARCH for Diabetes in Youth Study  

PubMed Central

We tested the association of adiponectin/leptin ratio (ALR) with diabetes type after adjusting for multiple factors in 1,156 youth with newly diagnosed diabetes in the SEARCH study. Although ALR is associated with diabetes type in youth, it is due to differences in adiponectin, but not leptin levels.

Maahs, David M.; Hamman, Richard F.; D'Agostino, Ralph; Dolan, Lawrence M.; Imperatore, Guiseppina; Lawrence, Jean M.; Marcovina, Santica M.; Mayer-Davis, Elizabeth J.; Pihoker, Catherine; Dabelea, Dana

2009-01-01

56

Correlates of Dietary Intake in Youth with Diabetes: Results from the SEARCH for Diabetes in Youth Study  

ERIC Educational Resources Information Center

Objective: To explore demographic, socioeconomic, diabetes-related, and behavioral correlates of dietary intake of dairy, fruit, vegetables, sweetened soda, fiber, calcium, and saturated fat in youth with diabetes. Methods: Cross-sectional study of youth 10-22 years old with type 1 (T1DM, n = 2,176) and type 2 diabetes (T2DM, n = 365). Association…

Bortsov, Andrey; Liese, Angela D.; Bell, Ronny A.; Dabelea, Dana; D'Agostino, Ralph B., Jr.; Hamman, Richard F.; Klingensmith, Georgeanna J.; Lawrence, Jean M.; Maahs, David M.; McKeown, Robert; Marcovina, Santica M.; Thomas, Joan; Mayer-Davis, Elizabeth J.

2011-01-01

57

A prospective study of contact lens wear in diabetes mellitus.  

PubMed

A prospective, controlled, observer-masked study was conducted to investigate the suitability of contact lenses for patients with diabetes mellitus. Forty diabetic patients and 40 non-diabetic control subjects were fitted with soft hydrogel contact lenses to be worn on a daily wear basis for 12 months. The ocular response was assessed using slit lamp biomicroscopy, ultrasonic pachometry, corneal aesthesiometry and visual acuity measures. Compared to non-diabetic subjects, diabetic patients displayed significantly reduced corneal transparency, variable vision and reduced comfort with the contact lenses (p < 0.05). There were no significant differences between the two groups with respect to ocular hyperaemia, corneal staining, corneal thickness, corneal sensitivity or high contrast visual acuity. Contrary to previous reports, the response of the diabetic eye to contact lenses--as observed clinically--does not differ appreciably from that of the non-diabetic eye. These results suggest that current generation daily wear soft contact lenses can be a viable mode of vision correction for diabetic patients. PMID:11261347

O'Donnell, C; Efron, N; Boulton, A J

2001-03-01

58

Assessment of Automated Disease Detection in Diabetic Retinopathy Screening Using Two-Field Photography  

Microsoft Academic Search

AimTo assess the performance of automated disease detection in diabetic retinopathy screening using two field mydriatic photography.MethodsImages from 8,271 sequential patient screening episodes from a South London diabetic retinopathy screening service were processed by the Medalytix iGrading™ automated grading system. For each screening episode macular-centred and disc-centred images of both eyes were acquired and independently graded according to the English

Keith Goatman; Amanda Charnley; Laura Webster; Stephen Nussey

2011-01-01

59

Treatment of Diabetic Foot Ulcers through Systemic Effects of Extremely Low Frequency Electromagnetic Fields  

NASA Astrophysics Data System (ADS)

This study was designed to, investigate the healing effects of extremely low frequency electromagnetic fields (ELF-EMF) on diabetic foot ulcers and test two different exposure systems aimed at reducing the ELF-EMF exposure time of patients. In the first system the ELF-EMF were applied to the arm where only 3% of the total blood volume/min circulates at any given time. In the second system the ELF-EMF were applied to the thorax where more than 100% of the total blood volume/minute circulates at any given time. Twenty-six diabetic patients, with superficial neuropathic ulcers unresponsive to medical treatment were included in this preliminary report. In the first group (17 patients), the arm was exposed two hours twice a week to a extremely low frequency electromagnetic field of 0.45-0.9 mTrms, 120 Hz generated inside a solenoid coil of 10.1 cm by 20.5 cm long. In the second group the thorax of 7 patients was exposed 25 minutes twice a week to an electromagnetic field of 0.4-0.85 mTrms, 120 Hz generated in the center of a squared quasi-Helmholtz coil 52 cm by side. One patient was assigned to a placebo configuration of each exposure system with identical appearance as the active equipment but without magnetic field. Patients with deep ulcers, infected ulcers, cancer, or auto-immune disease were excluded. These preliminary results showed that the two exposure systems accelerate the healing process of neuropathic ulcers. Complete healing of the ulcer had a median duration of 90 days in both exposure systems. Therefore thorax exposure where more blood is exposed to ELF-EMF per unit of time was able to reduce 4.8 times the patient treatment time. In those patients assigned to the placebo equipment no healing effects were observed. This study will continue with a parallel, double blind placebo controlled protocol.

Trejo-Núñez, A. D.; Pérez-Chávez, F.; García-Sánchez, C.; Serrano-Luna, G.; Cañendo-Dorantes, L.

2008-08-01

60

Diabetics Fare Well After Kidney Transplants, Study Finds  

MedlinePLUS

... on this page, please enable JavaScript. Diabetics Fare Well After Kidney Transplants, Study Finds Five-year survival ... factors that influence their kidney function and overall well-being," he added. SOURCE: Mayo Clinic, news release, ...

61

Type 1 Diabetes, Diabetic Nephropathy, and Pregnancy: A Systematic Review and Meta-Study  

PubMed Central

BACKGROUND: In the last decade, significant improvements have been achieved in maternal-fetal and diabetic care which make pregnancy possible in an increasing number of type 1 diabetic women with end-organ damage. Optimal counseling is important to make the advancements available to the relevant patients and to ensure the safety of mother and child. A systematic review will help to provide a survey of the available methods and to promote optimal counseling. OBJECTIVES: To review the literature on diabetic nephropathy and pregnancy in type 1 diabetes. METHODS: Medline, Embase, and the Cochrane Library were scanned in November 2012 (MESH, Emtree, and free terms on pregnancy and diabetic nephropathy). Studies were selected that report on pregnancy outcomes in type 1 diabetic patients with diabetic nephropathy in 1980-2012 (i.e. since the detection of microalbuminuria). Case reports with less than 5 cases and reports on kidney grafts were excluded. Paper selection and data extraction were performed in duplicate and matched for consistency. As the relevant reports were highly heterogeneous, we decided to perform a narrative review, with discussions oriented towards the period of publication. RESULTS: Of the 1058 references considered, 34 fulfilled the selection criteria, and one was added from reference lists. The number of cases considered in the reports, which generally involved single-center studies, ranged from 5 to 311. The following issues were significant: (i) the evidence is scattered over many reports of differing format and involving small series (only 2 included over 100 patients), (ii) definitions are non-homogeneous, (iii) risks for pregnancy-related adverse events are increased (preterm delivery, caesarean section, perinatal death, and stillbirth) and do not substantially change over time, except for stillbirth (from over 10% to about 5%), (iv) the increase in risks with nephropathy progression needs confirmation in large homogeneous series, (v) the newly reported increase in malformations in diabetic nephropathy underlines the need for further studies. CONCLUSIONS: The heterogeneous evidence from studies on diabetic nephropathy in pregnancy emphasizes the need for further perspective studies on this issue.

Piccoli, Giorgina B.; Clari, Roberta; Ghiotto, Sara; Castelluccia, Natascia; Colombi, Nicoletta; Mauro, Giuseppe; Tavassoli, Elisabetta; Melluzza, Carmela; Cabiddu, Gianfranca; Gernone, Giuseppe; Mongilardi, Elena; Ferraresi, Martina; Rolfo, Alessandro; Todros, Tullia

2013-01-01

62

Metabolic Footprint of Diabetes: A Multiplatform Metabolomics Study in an Epidemiological Setting  

PubMed Central

Background Metabolomics is the rapidly evolving field of the comprehensive measurement of ideally all endogenous metabolites in a biological fluid. However, no single analytic technique covers the entire spectrum of the human metabolome. Here we present results from a multiplatform study, in which we investigate what kind of results can presently be obtained in the field of diabetes research when combining metabolomics data collected on a complementary set of analytical platforms in the framework of an epidemiological study. Methodology/Principal Findings 40 individuals with self-reported diabetes and 60 controls (male, over 54 years) were randomly selected from the participants of the population-based KORA (Cooperative Health Research in the Region of Augsburg) study, representing an extensively phenotyped sample of the general German population. Concentrations of over 420 unique small molecules were determined in overnight-fasting blood using three different techniques, covering nuclear magnetic resonance and tandem mass spectrometry. Known biomarkers of diabetes could be replicated by this multiple metabolomic platform approach, including sugar metabolites (1,5-anhydroglucoitol), ketone bodies (3-hydroxybutyrate), and branched chain amino acids. In some cases, diabetes-related medication can be detected (pioglitazone, salicylic acid). Conclusions/Significance Our study depicts the promising potential of metabolomics in diabetes research by identification of a series of known and also novel, deregulated metabolites that associate with diabetes. Key observations include perturbations of metabolic pathways linked to kidney dysfunction (3-indoxyl sulfate), lipid metabolism (glycerophospholipids, free fatty acids), and interaction with the gut microflora (bile acids). Our study suggests that metabolic markers hold the potential to detect diabetes-related complications already under sub-clinical conditions in the general population.

Suhre, Karsten; Meisinger, Christa; Doring, Angela; Altmaier, Elisabeth; Belcredi, Petra; Gieger, Christian; Chang, David; Milburn, Michael V.; Gall, Walter E.; Weinberger, Klaus M.; Mewes, Hans-Werner; Hrabe de Angelis, Martin; Wichmann, H.-Erich; Kronenberg, Florian; Adamski, Jerzy; Illig, Thomas

2010-01-01

63

MCE Field Study Project.  

ERIC Educational Resources Information Center

The effectiveness of six microcomputer programs designed for the secondary to adult population to teach concepts associated with daily living skills (vocations, elementary budgeting, money management assessment, banking, and home safety) was studied. These programs were field tested in special education classrooms in three different school…

Taber, Florence M.

64

Ecological Field Studies  

ERIC Educational Resources Information Center

Field studies are an excellent way for students to learn ecological concepts and practice doing science. This article presents an approach for the secondary science classroom that permits students to ask and answer their own questions, a prerequisite for truly experiencing the process of science. Students explore a local natural area and, in…

Dobson, Christopher

2008-01-01

65

Microbial field pilot study  

SciTech Connect

The objective of this project is to perform a microbial enhanced oil recovery field pilot test in the Southeast Vassar Vertz Sand Unit (SEVVSU) in Payne County, Oklahoma. Indigenous, anaerobic, nitrate-reducing bacteria will be stimulated to selectively plug flow paths which have been preferentially swept by a prior waterflood. This will force future flood water to invade bypassed regions of the reservoir and increase sweep efficiency. During this quarter an additional tracer study was performed in the field to determine pre-treatment flow paths and the first nutrients were injected. 2 figs.

Knapp, R.M.; McInerney, M.J.; Menzie, D.E.

1991-12-06

66

Assessment of Automated Disease Detection in Diabetic Retinopathy Screening Using Two-Field Photography  

PubMed Central

Aim To assess the performance of automated disease detection in diabetic retinopathy screening using two field mydriatic photography. Methods Images from 8,271 sequential patient screening episodes from a South London diabetic retinopathy screening service were processed by the Medalytix iGrading™ automated grading system. For each screening episode macular-centred and disc-centred images of both eyes were acquired and independently graded according to the English national grading scheme. Where discrepancies were found between the automated result and original manual grade, internal and external arbitration was used to determine the final study grades. Two versions of the software were used: one that detected microaneurysms alone, and one that detected blot haemorrhages and exudates in addition to microaneurysms. Results for each version were calculated once using both fields and once using the macula-centred field alone. Results Of the 8,271 episodes, 346 (4.2%) were considered unassessable. Referable disease was detected in 587 episodes (7.1%). The sensitivity of the automated system for detecting unassessable images ranged from 97.4% to 99.1% depending on configuration. The sensitivity of the automated system for referable episodes ranged from 98.3% to 99.3%. All the episodes that included proliferative or pre-proliferative retinopathy were detected by the automated system regardless of configuration (192/192, 95% confidence interval 98.0% to 100%). If implemented as the first step in grading, the automated system would have reduced the manual grading effort by between 2,183 and 3,147 patient episodes (26.4% to 38.1%). Conclusion Automated grading can safely reduce the workload of manual grading using two field, mydriatic photography in a routine screening service.

Goatman, Keith; Charnley, Amanda; Webster, Laura; Nussey, Stephen

2011-01-01

67

Validating self-report of diabetes use by participants in the 45 and up study: a record linkage study  

PubMed Central

Background Prevalence studies usually depend on self-report of disease status in survey data or administrative data collections and may over- or under-estimate disease prevalence. The establishment of a linked data collection provided an opportunity to explore the accuracy and completeness of capture of information about diabetes in survey and administrative data collections. Methods Baseline questionnaire data at recruitment to the 45 and Up Study was obtained for 266,848 adults aged 45 years and over sampled from New South Wales, Australia in 2006–2009, and linked to administrative data about hospitalisation from the Admitted Patient Data Collection (APDC) for 2000–2009, claims for medical services (MBS) and pharmaceuticals (PBS) from Medicare Australia data for 2004–2009. Diabetes status was determined from response to a question ‘Has a doctor EVER told you that you have diabetes’ (n?=?23,981) and augmented by examination of free text fields about diagnosis (n?=?119) or use of insulin (n?=?58). These data were used to identify the sub-group with type 1 diabetes. We explored the agreement between self-report of diabetes, identification of diabetes diagnostic codes in APDC data, claims for glycosylated haemoglobin (HbA1c) in MBS data, and claims for dispensed medication (oral hyperglycaemic agents and insulin) in PBS data. Results Most participants with diabetes were identified in APDC data if admitted to hospital (79.3%), in MBS data with at least one claim for HbA1c testing (84.7%; 73.4% if 2 tests claimed) or in PBS data through claim for diabetes medication (71.4%). Using these alternate data collections as an imperfect ‘gold standard’ we calculated sensitivities of 83.7% for APDC, 63.9% (80.5% for two tests) for MBS, and 96.6% for PBS data and specificities of 97.7%, 98.4% and 97.1% respectively. The lower sensitivity for HbA1c may reflect the use of this test to screen for diabetes suggesting that it is less useful in identifying people with diabetes without additional information. Kappa values were 0.80, 0.70 and 0.80 for APDC, MBS and PBS respectively reflecting the large population sample under consideration. Compared to APDC, there was poor agreement about identifying type 1 diabetes status. Conclusions Self-report of diagnosis augmented with free text data indicating diabetes as a chronic condition and/or use of insulin among medications used was able to identify participants with diabetes with high sensitivity and specificity compared to available administrative data collections.

2013-01-01

68

Diabetic nephropathy. A clinical study of risk factors in type-I diabetes mellitus.  

PubMed

The aim of the study was to evaluate risk factors for the development and progression of diabetic nephropathy. For this purpose, a reliable method of monitoring renal function is necessary. Five different methods of estimating renal function (plasma and renal clearance of 51Cr EDTA, serum creatinine, plasma beta-2-microglobulin and endogenous creatinine clearance) were compared. The risk factors studied were hyperglycaemia, smoking, diabetic cystopathy and dietary protein. All patients were treated for hypertension. The metabolic control was evaluated by assay of HbA1c and repeated estimation of blood glucose. A careful interview about previous and current smoking habits was used for evaluation of the role of smoking. Presence of residual urine, registered with an isotope technique using 131I-Hippuran, was used as the criterion of diabetic cystopathy. Dietary protein intake was studied with a dietary history interview and by measuring the urinary excretion of nitrogen. All five renal function tested evaluated have disadvantages. The most reliable information is given by the combined measurement of plasma clearance and renal clearance of 51Cr EDTA. Hypertension is the most important factor for progression but metabolic control also has an impact, which can be shown when hypertension is adequately controlled. Diabetic patients with nephropathy have smoked more and still smoke more than patients without nephropathy. Diabetic cystopathy is common but with instructions it can be kept constant for several years. Although a correlation of cystopathy to progression is likely, it could not be demonstrated. The study of protein intake does not support the theory of a harmful effect of dietary protein on the development or progression of diabetic nephropathy. By intervening against risk factors, it is possible to achieve a very low progression rate or even to arrest the progression for several years. PMID:3227321

Nordén, G

1988-01-01

69

Microbial field pilot study  

SciTech Connect

A multi-well microbially enhanced oil recovery field pilot has been performed in the Southeast Vassar Vertz Sand Unit in Payne County, Oklahoma. The primary emphasis of the experiment was preferential plugging of high permeability zones for the purpose of improving waterflood sweep efficiency. Studies were performed to determine reservoir chemistry, ecology, and indigenous bacteria populations. Growth experiments were used to select a nutrient system compatible with the reservoir that encouraged growth of a group of indigenous nitrate-using bacteria and inhibit growth of sulfate-reducing bacteria. A specific field pilot area behind an active line drive waterflood was selected. Surface facilities were designed and installed. Injection protocols of bulk nutrient materials were prepared to facilitate uniform distribution of nutrients within the pilot area. By the end of December, 1991, 82.5 tons (75.0 tonnes) of nutrients had been injected in the field. A tracer test identified significant heterogeneity in the SEVVSU and made it necessary to monitor additional production wells in the field. The tracer tests and changes in production behavior indicate the additional production wells monitored during the field trial were also affected. Eighty two and one half barrels (13.1 m[sup 3]) of tertiary oil have been recovered. Microbial activity has increased CO[sub 2] content as indicated by increased alkalinity. A temporary rise in sulfide concentration was experienced. These indicate an active microbial community was generated in the field by the nutrient injection. Pilot area interwell pressure interference test results showed that significant permeability reduction occurred. The interwell permeabilities in the pilot area between the injector and the three pilot production wells were made more uniform which indicates a successful preferential plugging enhanced oil recovery project.

Knapp, R.M.; McInerney, M.J.; Menzie, D.E.; Coates, J.D.; Chisholm, J.L.

1993-05-01

70

Diabetes mellitus after kidney transplantation: a French multicentre observational study  

Microsoft Academic Search

Background. New-onset diabetes mellitus (NODM)—a common complication of kidney transplantation—is associated with increases in graft loss, morbidity and mortality. Methods. This is a purely observational study of 527 patients taking a calcineurin inhibitor (CNI), based on data collected at a single routine visit 6-24 months after kidney transplantation. Diabetes was defined according to ADA\\/WHO guidelines. Results. The mean age of

Nassim Kamar; Christophe Mariat; Michel Delahousse; Jacques Dantal; Azmi Al Najjar; Elisabeth Cassuto; Nicole Lefrancois; Olivier Cointault; Guy Touchard; Florence Villemain

2007-01-01

71

Diabetes  

MedlinePLUS

... to develop type 2 diabetes later in life. Polycystic ovary syndrome Polycystic ovary syndrome (PCOS) is a condition that occurs when an imbalance ... to form on the ovaries. Women who have PCOS are at an increased risk of developing type ...

72

Short wavelength automated perimetry can detect visual field changes in diabetic patients without retinopathy  

PubMed Central

Purpose: The purpose of the following study is to compare short wave automated perimetry (SWAP) versus standard automated perimetry (SAP) for early detection of diabetic retinopathy (DR). Materials and Methods: A total of 40 diabetic patients, divided into group I without DR (20 patients = 40 eyes) and group II with mild non-proliferative DR (20 patients = 40 eyes) were included. They were tested with central 24-2 threshold test with both shortwave and SAP to compare sensitivity values and local visual field indices in both of them. A total of 20 healthy age and gender matched subjects were assessed as a control group. Results: Control group showed no differences between SWAP and SAP regarding mean deviation (MD), corrected pattern standard deviation (CPSD) or short fluctuations (SF). In group I, MD showed significant more deflection in SWAP (?4.44 ± 2.02 dB) compared to SAP (?0.96 ± 1.81 dB) (P =0.000002). However, CPSD and SF were not different between SWAP and SAP. In group II, MD and SF showed significantly different values in SWAP (?5.75 ± 3.11 dB and 2.0 ± 0.95) compared to SAP (?3.91 ± 2.87 dB and 2.86 ± 1.23) (P =0.01 and 0.006 respectively). There are no differences regarding CPSD between SWAP and SAP. The SWAP technique was significantly more sensitive than SAP in patients without retinopathy (p), but no difference exists between the two techniques in patients with non-proliferative DR. Conclusion: The SWAP technique has a higher yield and efficacy to pick up abnormal findings in diabetic patients without overt retinopathy rather than patients with clinical retinopathy.

Zico, Othman Ali; El-Shazly, Amany Abdel-Fattah; Ahmed, Eslam Elsayed Abdel-Hamid

2014-01-01

73

Is the Hp 2-2 diabetic mouse model a good model to study diabetic nephropathy?  

PubMed

Diabetic nephropathy (DN) is the leading cause of end stage renal disease and dialysis worldwide. Despite aggressive treatment, the number of patients on hemodialysis due to type 1 and type 2 diabetes mellitus is increasing annually. The lack of reliable animal models that mimic human disease has delayed the identification of specific factors that cause or predict DN. Different investigators around the world are testing different murine models. Validation criteria for early and advanced DN, phenotypic methods, background strain have recently been developed. Establishment of an authentic mouse model of DN will undoubtedly facilitate the understanding of the underlying genetic mechanisms that contribute to the development of DN and to study new treatments. Here we describe the characteristics of our new mouse model with type 1 diabetes mellitus and different haptoglobin genotypes that can mimic human DN. PMID:23490597

Nakhoul, Farid; Nakhoul, Nakhoul; Asleh, Rabea; Miller-Lotan, Rachel; Levy, Andrew P

2013-06-01

74

Obstructive sleep apnea and incident diabetes. A historical cohort study.  

PubMed

Rationale: Despite emerging evidence that obstructive sleep apnea (OSA) may cause metabolic disturbances independently of other known risk factors, it remains unclear whether OSA is associated with incident diabetes. Objectives: To evaluate whether risk of incident diabetes was related to the severity and physiologic consequences of OSA. Methods: A historical cohort study was conducted using clinical and provincial health administrative data. All adults without previous diabetes referred with suspected OSA who underwent a diagnostic sleep study at St. Michael's Hospital (Toronto, Canada) between 1994 and 2010 were followed through health administrative data until May 2011 to examine the occurrence of diabetes. All OSA-related variables collected from the sleep study were examined as predictors in Cox regression models, controlling for sex, age, body mass index, smoking status, comorbidities, and income. Measurements and Main Results: Over a median follow-up of 67 months, 1,017 (11.7%) of 8,678 patients developed diabetes, giving a cumulative incidence at 5 years of 9.1% (95% confidence interval, 8.4-9.8%). In fully adjusted models, patients with apnea-hypopnea index (AHI) greater than 30 had a 30% higher hazard of developing diabetes than those with AHI less than 5. Among other OSA-related variables, AHI in rapid eye movement sleep and time spent with oxygen saturation less than 90% were associated with incident diabetes, as were heart rate, neck circumference, and sleep time. Conclusions: Among people with OSA, and controlling for multiple confounders, initial OSA severity and its physiologic consequences predicted subsequent risk for incident diabetes. PMID:24897551

Kendzerska, Tetyana; Gershon, Andrea S; Hawker, Gillian; Tomlinson, George; Leung, Richard S

2014-07-15

75

Sexual dysfunction in type II diabetic females: a comparative study.  

PubMed

Diabetes Mellitus (DM) is considered to play a principle role in the etiopathogenesis of sexual dysfunction both in men and women. The aim of this study is to evaluate sexual function in Type II diabetic women. A total of 72 young diabetic women (mean age: 38.8 years) with no other systemic diseases and 60 age-matched healthy women were enrolled in our study. We sought from them a detailed medical and sexual history and used the Index of Female Sexual function (IFSF) questionnaire (Kaplan et al., 1999). The mean IFSF score of diabetic women was 29.3 +/- 6.4 and was 37.7 +/- 3.5 in normal cases (p < 0.05). Lack of libido was the most common symptom in diabetics and was observed in 77% of the women. Diminished clitoral sensation was observed in 62.5% of the women, 37.5% complained of vaginal dryness and 41.6% had vaginal discomfort. Orgasmic dysfunction was found in 49% of the women. The incidence of all these related symptoms were significantly higher when compared to controls. We concluded that significant percentage of diabetic women that we observed experience sexual dysfunction of varying degrees that diminishes their quality of life. PMID:11898710

Erol, Bulent; Tefekli, Ahmet; Ozbey, Isa; Salman, Fatih; Dincag, Nevin; Kadioglu, Ates; Tellaloglu, Sedat

2002-01-01

76

Limitations of diabetes pharmacotherapy: results from the Vermont Diabetes Information System study  

Microsoft Academic Search

BACKGROUND: There are a wide variety of medications available for the treatment of hyperglycemia in diabetes, including some categories developed in recent years. The goals of this study were to describe the glycemic medication profiles in a cohort of adult patients enrolled in primary care, to compare the regimens with measures of glycemic control, and to describe potential contraindicated regimens.

Charles D MacLean; Benjamin Littenberg; Amanda G Kennedy

2006-01-01

77

Microbial Field Pilot Study  

SciTech Connect

This report covers progress made during the first year of the Microbial Field Pilot Study project. Information on reservoir ecology and characterization, facility and treatment design, core experiments, bacterial mobility, and mathematical modeling are addressed. To facilitate an understanding of the ecology of the target reservoir analyses of the fluids which support bacteriological growth and the microbiology of the reservoir were performed. A preliminary design of facilities for the operation of the field pilot test was prepared. In addition, procedures for facilities installation and for injection treatments are described. The Southeast Vassar Vertz Sand Unit (SEVVSU), the site of the proposed field pilot study, is described physically, historically, and geologically. The fields current status is presented and the ongoing reservoir simulation is discussed. Core flood experiments conducted during the last year were used to help define possible mechanisms involved in microbial enhanced oil recovery. Two possible mechanisms, relative permeability effects and changes in the capillary number, are discussed and related to four Berea core experiments' results. The experiments were conducted at reservoir temperature using SEVVSU oil, brine, and bacteria. The movement and activity of bacteria in porous media were investigated by monitoring the growth of bacteria in sandpack cores under no flow conditions. The rate of bacteria advancement through the cores was determined. A mathematical model of the MEOR process has been developed. The model is a three phase, seven species, one dimensional model. Finite difference methods are used for solution. Advection terms in balance equations are represented with a third- order upwind differencing scheme to reduce numerical dispersion and oscillations. The model is applied to a batch fermentation example. 52 refs., 26 figs., 21 tabs.

Knapp, R.M.; McInerney, M.J.; Menzie, D.E.; Chisholm, J.L.

1990-11-01

78

Glycaemic effects of traditional European plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice.  

PubMed

Twelve plants used for the traditional treatment of diabetes mellitus in northern Europe were studied using normal and streptozotocin diabetic mice to evaluate effects on glucose homeostasis. The plants were administered in the diet (6.25% by weight) and/or as decoctions or infusions in place of drinking water, to coincide with the traditional method of preparation. Treatment for 28 days with preparations of burdock (Arctium lappa), cashew (Anacardium occidentale), dandelion (Taraxacum officinale), elder (Sambucus nigra), fenugreek (Trigonella foenum-graecum), guayusa (Ilex guayusa), hop (Humulus lupulus), nettle (Urtica dioica), cultivated mushroom (Agaricus bisporus), periwinkle (Catharanthus roseus), sage (Salvia officinale), and wild carrot (Daucus carrota) did not affect the parameters of glucose homeostasis examined in normal mice (basal plasma glucose and insulin, glucose tolerance, insulin-induced hypoglycaemia and glycated haemoglobin). After administration of streptozotocin (200 mg/kg) burdock and nettle aggravated the diabetic condition, while cashew, dandelion, elder, fenugreek, hop, periwinkle, sage and wild carrot did not significantly affect the parameters of glucose homeostasis studied (basal glucose and insulin, insulin-induced hypoglycaemia, glycated haemoglobin and pancreatic insulin concentration). Guayusa and mushroom retarded the development of hyperglycaemia in streptozotocin diabetes and reduced the hyperphagia, polydipsia, body weight loss, and glycated haemoglobin. Mushroom also countered the initial reduction in plasma insulin and the reduction in pancreatic insulin concentration, and improved the hypoglycaemic effect of exogenous insulin. These studies suggest the presence of potentially useful antidiabetic agents in guayusa and mushroom. PMID:2743711

Swanston-Flatt, S K; Day, C; Flatt, P R; Gould, B J; Bailey, C J

1989-02-01

79

Cortisol correlates with metabolic disturbances in a population study of type 2 diabetic patients  

Microsoft Academic Search

Objective: The prevalence of type 2 diabetes mellitus is increasing rapidly in industrialized countries, and adrenal glucocorticoids may intensify this disease. We sought to assess the relationship between diabetes-associated metabolic disturbances and cortisol concentrations in patients with type 2 diabetes. Design: We investigated 190 type 2 diabetic patients who volunteered from a population study of 12430 people in Luebeck and

Kerstin M Oltmanns; Baerbel Dodt; Bernd Schultes; Hans H Raspe; Ulrich Schweiger; Jan Born; Horst L Fehm; Achim Peters

2006-01-01

80

[Diabetes].  

PubMed

The new recommendations on the pharmacological treatment of type 2 diabetes have introduced two important changes. The first is to have common strategies between European and American diabetes societies. The second, which is certainly the most significant, is to develop a patient centred approach suggesting therapies that take into account the patient's preferences and use of decision support tools. The individual approach integrates six factors: the capacity and motivation of the patient to manage his illness and its treatment, the risks of hypoglycemia, the life expectancy, the presence of co-morbidities and vascular complications, as well as the financial resources of the patient and the healthcare system. Treatment guidelines for cardiovascular risk reduction in diabetic remains the last point to develop. PMID:23409644

Ruiz, J

2013-01-16

81

Therapeutic Effects of 15 Hz Pulsed Electromagnetic Field on Diabetic Peripheral Neuropathy in Streptozotocin-Treated Rats  

PubMed Central

Although numerous clinical studies have reported that pulsed electromagnetic fields (PEMF) have a neuroprotective role in patients with diabetic peripheral neuropathy (DPN), the application of PEMF for clinic is still controversial. The present study was designed to investigate whether PEMF has therapeutic potential in relieving peripheral neuropathic symptoms in streptozotocin (STZ)-induced diabetic rats. Adult male Sprague–Dawley rats were randomly divided into three weight-matched groups (eight in each group): the non-diabetic control group (Control), diabetes mellitus with 15 Hz PEMF exposure group (DM+PEMF) which were subjected to daily 8-h PEMF exposure for 7 weeks and diabetes mellitus with sham PEMF exposure group (DM). Signs and symptoms of DPN in STZ-treated rats were investigated by using behavioral assays. Meanwhile, ultrastructural examination and immunohistochemical study for vascular endothelial growth factor (VEGF) of sciatic nerve were also performed. During a 7-week experimental observation, we found that PEMF stimulation did not alter hyperglycemia and weight loss in STZ-treated rats with DPN. However, PEMF stimulation attenuated the development of the abnormalities observed in STZ-treated rats with DPN, which were demonstrated by increased hind paw withdrawal threshold to mechanical and thermal stimuli, slighter demyelination and axon enlargement and less VEGF immunostaining of sciatic nerve compared to those of the DM group. The current study demonstrates that treatment with PEMF might prevent the development of abnormalities observed in animal models for DPN. It is suggested that PEMF might have direct corrective effects on injured nerves and would be a potentially promising non-invasive therapeutic tool for the treatment of DPN.

Jiang, Maogang; Li, Feijiang; Cai, Jing; Wu, Xiaoming; Tang, Chi; Xu, Qiaoling; Liu, Juan; Guo, Wei; Shen, Guanghao; Luo, Erping

2013-01-01

82

Therapeutic effects of 15 Hz pulsed electromagnetic field on diabetic peripheral neuropathy in streptozotocin-treated rats.  

PubMed

Although numerous clinical studies have reported that pulsed electromagnetic fields (PEMF) have a neuroprotective role in patients with diabetic peripheral neuropathy (DPN), the application of PEMF for clinic is still controversial. The present study was designed to investigate whether PEMF has therapeutic potential in relieving peripheral neuropathic symptoms in streptozotocin (STZ)-induced diabetic rats. Adult male Sprague-Dawley rats were randomly divided into three weight-matched groups (eight in each group): the non-diabetic control group (Control), diabetes mellitus with 15 Hz PEMF exposure group (DM+PEMF) which were subjected to daily 8-h PEMF exposure for 7 weeks and diabetes mellitus with sham PEMF exposure group (DM). Signs and symptoms of DPN in STZ-treated rats were investigated by using behavioral assays. Meanwhile, ultrastructural examination and immunohistochemical study for vascular endothelial growth factor (VEGF) of sciatic nerve were also performed. During a 7-week experimental observation, we found that PEMF stimulation did not alter hyperglycemia and weight loss in STZ-treated rats with DPN. However, PEMF stimulation attenuated the development of the abnormalities observed in STZ-treated rats with DPN, which were demonstrated by increased hind paw withdrawal threshold to mechanical and thermal stimuli, slighter demyelination and axon enlargement and less VEGF immunostaining of sciatic nerve compared to those of the DM group. The current study demonstrates that treatment with PEMF might prevent the development of abnormalities observed in animal models for DPN. It is suggested that PEMF might have direct corrective effects on injured nerves and would be a potentially promising non-invasive therapeutic tool for the treatment of DPN. PMID:23637830

Lei, Tao; Jing, Da; Xie, Kangning; Jiang, Maogang; Li, Feijiang; Cai, Jing; Wu, Xiaoming; Tang, Chi; Xu, Qiaoling; Liu, Juan; Guo, Wei; Shen, Guanghao; Luo, Erping

2013-01-01

83

Neighborhood context and incidence of type 1 diabetes: The SEARCH for Diabetes in Youth Study  

PubMed Central

Findings regarding type 1 diabetes mellitus (T1DM) and neighborhood-level characteristics are mixed, with few US studies examining the influence of race/ethnicity. We conducted an ecologic study using SEARCH for Diabetes in Youth Study data to explore the association of neighborhood characteristics and T1DM incidence. 2002–2003 incident cases among youth at four SEARCH centers were included. Residential addresses were geocoded to US Census Tract. Standardized incidence ratios tended to increase with increasing education and median household income. Results from Poisson regression mixed models were similar and stable across race/ethnic groups and population density. Our study suggests a relationship of T1DM incidence with neighborhood-level socioeconomic status, independent of individual-level race/ethnic differences.

Puett, Robin C.; Lamichhane, Archana P.; Nichols, Michele D.; Lawson, Andrew B.; Standiford, Debra A.; Liu, Lenna; Dabelea, Dana; Liese, Angela D.

2014-01-01

84

Eating disorders in adolescent females with and without type 1 diabetes: cross sectional study  

Microsoft Academic Search

Objective To determine the prevalence of eating disorders in adolescent females with type 1 diabetes mellitus compared with that in their non›diabetic peers. Design Cross sectional case›control led study. Setting Diabetes clinics and schools in three Canadian cities. Subjects 356 females aged 12›19 with type 1 diabetes and 1098 age matched non›diabetic controls. Main outcome measure Eating disorders meeting Diagnostic

Jennifer M Jones; Margaret L Lawson; Denis Daneman; Marion P Olmsted; Gary Rodin

2000-01-01

85

The need for obtaining accurate nationwide estimates of diabetes prevalence in India - Rationale for a national study on diabetes  

PubMed Central

According to the World Diabetes Atlas, India is projected to have around 51 million people with diabetes. However, these data are based on small sporadic studies done in some parts of the country. Even a few multi-centre studies that have been done, have several limitations. Also, marked heterogeneity between States limits the generalizability of results. Other studies done at various time periods also lack uniform methodology, do not take into consideration ethnic differences and have inadequate coverage. Thus, till date there has been no national study on the prevalence of diabetes which are truly representative of India as a whole. Moreover, the data on diabetes complications is even more scarce. Therefore, there is an urgent need for a large well-planned national study, which could provide reliable nationwide data, not only on prevalence of diabetes, but also on pre-diabetes, and the complications of diabetes in India. A study of this nature will have enormous public health impact and help policy makers to take action against diabetes in India.

Anjana, R.M.; Ali, M.K.; Pradeepa, R.; Deepa, M.; Datta, M.; Unnikrishnan, R.; Rema, M.; Mohan, V.

2011-01-01

86

Health-related quality of life in diabetic patients and controls without diabetes in refugee camps in the Gaza strip: a cross-sectional study  

Microsoft Academic Search

BACKGROUND: Prevalence of diabetes mellitus is increasing in developed and developing countries. Diabetes is known to strongly affect the health-related quality of life (HRQOL). HRQOL is also influenced by living conditions. We analysed the effects of having diabetes on HRQOL under the living conditions in refugee camps in the Gaza strip. METHODS: We studied a sample of 197 diabetic patients

Ashraf Eljedi; Rafael T Mikolajczyk; Alexander Kraemer; Ulrich Laaser

2006-01-01

87

Studies on the anti-diabetic and hypolipidemic potentials of mangiferin (Xanthone Glucoside) in streptozotocin-induced Type 1 and Type 2 diabetic model rats  

Microsoft Academic Search

Context: Mangifera indica (Anacardiaceae) stem bark contains a rich content of mangiferin and is used traditionally in Indian Ayurvedic system to treat diabetes. Purpose of the study: To investigate anti-diabetic and hypolipidemic effects of mangiferin in type 1 and type 2 diabetic rats models. Streptozotocin was used to induce type 1 and type 2 diabetic rats. Mangiferin (at a dose

Dineshkumar B; Analava Mitra; M Manjunatha

2010-01-01

88

Epidemiology of childhood diabetes mellitus in Finland — background of a nationwide study of Type 1 (insulin-dependent) diabetes mellitus  

Microsoft Academic Search

Summary  A nationwide study of childhood Type 1 (insulin-dependent) diabetes mellitus was established in 1986 in Finland, the country with the highest incidence of this disease worldwide. The aim of the project called Childhood Diabetes in Finland is to evaluate the role of genetic, environmental and immunological factors and particularly the interaction between genetic and environmental factors in the development of

J. Tuomilehto; R. Lounamaa; E. Tuomilehto-Wolf; A. Reunanen; E. Virtala; E. A. Kaprio; H. K. Åkerblom; L. Toivanen; A. Fagerlund; M. Flittner; B. Gustafsson; A. Hakulinen; L. Herva; P. Hiltunen; T. Huhtamäki; N.-P. Huttunen; T. Huupponen; M. Hyttinen; C. Häggqvist; T. Joki; R. Jokisalo; S. Kallio; U. Kaski; M. Knip; M.-L. Käär; L. Laine; J. Lappalainen; J. Mäenpää; A.-L. Mäkelä; K. Niemi; A. Niiranen; A. Nuuja; P. Ojajärvi; T. Otonkoski; K. Pihlajamäki; S. Pöntynen; J. Ranjantie; J. Sankala; J. Schumacher; M. Sillanpää; C.-H. Stråhlmann; M.-R. Ståhlberg; T. Uotila; P. Varimo; G. Wetterstrand; M. Väre; A. Aro; H. Hurme; H. Hyöty; J. Ilonen; J. Karjalainen; R. LaPorte; P. Leinikki; A. Miettinen; L. Räsänen; E. Savilahti; S. M. Virtanen

1992-01-01

89

Supporting adolescents with type 1 diabetes mellitus: a qualitative study.  

PubMed

Without sufficient support, type 1 diabetes mellitus often disturbs patients' normal lives. This study describes and explores the support that Iranian adolescents with type 1 diabetes mellitus experienced. Semistructured interviews were conducted with ten adolescents, seven family members, one dietitian, one nurse, and one school nurse. Participants were chosen using purposive sampling from two teaching hospitals and one high school in two urban areas of Iran. Using standard procedures for content analysis, three main themes were identified: maintaining a normal life; receiving tangible, informational, and emotional support from the family and society; and advancement of life toward normalization. The cornerstone of maintaining a normal life for adolescents with type 1 diabetes mellitus is to adopt an active role in taking care of themselves within their systems of support. PMID:23692212

Rostami, Shahnaz; Parsa-Yekta, Zohreh; Najafi Ghezeljeh, Tahereh; Vanaki, Zohreh

2014-03-01

90

Electromagnetic Field Penetration Studies  

NASA Technical Reports Server (NTRS)

A numerical method is presented to determine electromagnetic shielding effectiveness of rectangular enclosure with apertures on its wall used for input and output connections, control panels, visual-access windows, ventilation panels, etc. Expressing EM fields in terms of cavity Green's function inside the enclosure and the free space Green's function outside the enclosure, integral equations with aperture tangential electric fields as unknown variables are obtained by enforcing the continuity of tangential electric and magnetic fields across the apertures. Using the Method of Moments, the integral equations are solved for unknown aperture fields. From these aperture fields, the EM field inside a rectangular enclosure due to external electromagnetic sources are determined. Numerical results on electric field shielding of a rectangular cavity with a thin rectangular slot obtained using the present method are compared with the results obtained using simple transmission line technique for code validation. The present technique is applied to determine field penetration inside a Boeing-757 by approximating its passenger cabin as a rectangular cavity filled with a homogeneous medium and its passenger windows by rectangular apertures. Preliminary results for, two windows, one on each side of fuselage were considered. Numerical results for Boeing-757 at frequencies 26 MHz, 171-175 MHz, and 428-432 MHz are presented.

Deshpande, M.D.

2000-01-01

91

Microbial field pilot study.  

National Technical Information Service (NTIS)

The objective of this project is to perform a microbial enhanced oil recovery field pilot in the Southeast Vassar Vertz Sand Unit (SEVVSU) in Payne County, Oklahoma. Indigenous, anaerobic, nitrate reducing bacteria will be stimulated to selectively plug f...

R. M. Knapp M. J. McInerney D. E. Menzie J. L. Chisholm

1992-01-01

92

Does diabetic status in the ICU predict haemofiltration requirement? The Haemofiltration in the ICU and Diabetic Status (HIDS) Study.  

PubMed

Diabetes is already a major health burden and prevalence is expected to double by 2025. The impact of diabetes and clinical outcomes in the intensive care unit is an evolving area of research. This study seeks to identify whether diabetic status is an independent risk factor for haemofiltration. This is a retrospective cohort study. All unique patients from a seven-year period from 2004 to 2010 at a major intensive care unit in Melbourne, Australia were analysed using multivariate regression to look for an association between diabetic status and haemofiltration. After exclusion criteria there were 7262 patients, 1674 with a history of diabetes (median age of 69, 66.72% male) and 5588 without a history of diabetes (median age 64, 64.13% male). Diabetic status was an independent risk factor (odds ratio 1.401, 95% confidence interval 1.079 to 1.820, P=0.011) for haemofiltration. Further research may identify intensive care unit-based renoprotective measures specifically for patients with diabetes. PMID:24967758

Williams, Pd; Chan, Sc

2014-07-01

93

Regression from Pre-diabetes to Normal Glucose Regulation is Associated with Long-term Reduction in Diabetes Risk: Results from the Diabetes Prevention Program Outcomes Study  

PubMed Central

Background Our objective was to quantify and predict diabetes risk reduction during the Diabetes Prevention Program Outcomes Study (DPPOS) among those who returned to normal glucose regulation (NGR) at least once during DPP compared to those who were consistently considered to have pre-diabetes. Methods Diabetes cumulative incidence in DPPOS was calculated for subjects with NGR or pre-diabetes status during DPP with and without stratification by prior randomized treatment group. Cox proportional hazards modeling and generalized linear mixed models were used to quantify the impact of previous (DPP) glycemic status on risk of later (DPPOS) diabetes and NGR status, respectively, per standard deviation in change. Included in this analysis are 1990 participants of DPPOS (who had been randomized during DPP: N=736 in intensive lifestyle (ILS), N=647 to metformin (MET), and N=607 to placebo (PLB)). Findings Diabetes risk during DPPOS was 56% lower in NGR vs. pre-diabetes (HR=0.44, 95% CI 0.37-0.55, p<0.0001) and was unaffected by prior group assignment (interaction test for NGR*ILS, p=0.1722; NGR*MET, p=0.3304). Many, but not all, of the variables that increased diabetes risk were inversely associated with the chance of reaching NGR status in DPPOS. Specifically, having had prior NGR (OR=3.18, 95% CI 2.71-3.72, p<0.0001), higher ?-cell function (OR=1.28; 95% CI 1.18-1.39, p<0.0001) and insulin sensitivity (OR=1.16, 95% CI 1.08-1.25, p<0.0001) were associated with NGR in DPPOS, whereas the opposite was true for predicting diabetes (HR=0.80, 95% CI 0.71-0.89; HR=0.83, 95% CI 0.74-0.94, respectively, p<0.0001 for both). Surprisingly, among subjects who failed to return to NGR in DPP, those randomized to ILS had a higher diabetes risk (HR=1.31, 95% CI 1.03-1.68, p=0.0304) and lower chance of NGR (OR=0.59, 95% CI 0.42-0.82, p=0.0014) vs. placebo in DPPOS. Interpretation We conclude that pre-diabetes represents a high-risk state for diabetes, especially among those who remain so despite ILS. Reversion to NGR, even if transient, is associated with a significantly lower risk of future diabetes independent of prior treatment group.

Perreault, Leigh; Pan, Qing; Mather, Kieren J.; Watson, Karol E.; Hamman, Richard F.; Kahn, Steven E.

2013-01-01

94

49 CFR 391.64 - Grandfathering for certain drivers participating in vision and diabetes waiver study programs.  

Code of Federal Regulations, 2013 CFR

...certain drivers participating in vision and diabetes waiver study programs. 391.64 ...certain drivers participating in vision and diabetes waiver study programs. (a) The...properly monitor and manage his/her diabetes; and (iv) Not likely to...

2013-10-01

95

49 CFR 391.64 - Grandfathering for certain drivers participating in vision and diabetes waiver study programs.  

Code of Federal Regulations, 2011 CFR

...certain drivers participating in vision and diabetes waiver study programs. 391.64 ...certain drivers participating in vision and diabetes waiver study programs. (a) The...properly monitor and manage his/her diabetes; and (iv) Not likely to...

2011-10-01

96

Eating habits in elderly diabetic subjects: Assessment in the InCHIANTI Study  

Microsoft Academic Search

Background and aimsNutritional therapy is a cornerstone of the treatment of type 2 diabetes. The aim of this study was to assess differences in dietary habits between subjects with and without known type 2 diabetes.

E. Mannucci; B. Bartali; R. Molino Lova; M. Papucci; F. Lauretani; M. L. Luisi; A. Pietrobelli; C. Macchi

2008-01-01

97

Microbial field pilot study  

SciTech Connect

The objective of this project is to perform a microbially enhanced oil recovery field pilot test in the Southeast Vassar Vertz Sand Unit in Payne County, Oklahoma. Indigenous, anaerobic, nitrate-reducing bacteria will be stimulated to selectively plug flow paths which have been preferentially swept by a prior waterflood. This will force future flood water to invade bypassed regions of the reservoir and increase sweep efficiency. 1 fig., 2 tabs.

Knapp, R.M.; McInerney, M.J.; Menzie, D.E.

1991-01-01

98

Can procalcitonin predict bone infection in people with diabetes with infected foot ulcers? A pilot study  

Microsoft Academic Search

AimsThe diagnosis of osteomyelitis is a key step of diabetic foot management. Previous studies showed that procalcitonin (PCT), a novel infection marker, is superior to conventional infection markers in the diagnosis of diabetic foot infection. This study aimed to investigate the serum levels of PCT and other conventional infection markers in diabetic persons with and without osteomyelitis.

Mesut Mutluo?lu; Günalp Uzun; Osman M. ?pcio?lu; Onur Sildiroglu; Ömer Özcan; Vedat Turhan; Hakan Mutlu; Senol Yildiz

2011-01-01

99

Clinical study of pulp capping in diabetes patients  

Microsoft Academic Search

Summary  Diabetes is, generally speaking, a contraindication for conservative treatment concerning caries with pulp exposure. In certain\\u000a situations, we can successfully use the pulp capping if we assure some conditions (asepsis, young patients). I) This study\\u000a shows the advantages and disadvantages of this kind of treatment. We studied 60 patients (34 female and 26 male) aged between\\u000a 25 and 35 years

M. R?escu; G. P?troi; M. V. Constantinescu; D. Ghergic; M. Leontescu

2010-01-01

100

Duration of Diabetes and Risk of Ischemic Stroke: The Northern Manhattan Study  

PubMed Central

Background and Purpose Diabetes increases stroke risk, but whether diabetes status immediately prior to stroke improves prediction, and whether duration is important, are less clear. We hypothesized that diabetes duration independently predicts ischemic stroke. Methods Among 3,298 stroke-free participants in the Northern Manhattan Study (NOMAS), baseline diabetes and age at diagnosis were determined. Incident diabetes was assessed annually (median=9 years). Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals (HR, 95% CI) for incident ischemic stroke using baseline diabetes, diabetes as a time-dependent covariate, and duration of diabetes as a time-varying covariate; models were adjusted for demographic and cardiovascular risk factors. Results Mean age was 69±10 years (52% Hispanic, 21% white, and 24% black); 22% were diabetic at baseline and 10% developed diabetes. There were 244 ischemic strokes, and both baseline diabetes (HR 2.5, 95% CI 1.9-3.3) and diabetes considered as a time-dependent covariate (HR 2.4, 95% CI 1.8-3.2) were similarly associated with stroke risk. Duration of diabetes was associated with ischemic stroke (adjusted HR=1.03 per year with diabetes, 95% CI=1.02-1.04). Compared to non-diabetic participants, those with diabetes for 0-5 years (adjusted HR=1.7, 95% CI=1.1-2.7), 5-10 years (adjusted HR=1.8, 95% CI=1.1-3.0), and ?10 years (adjusted HR=3.2, 95% CI=2.4-4.5) were at increased risk. Conclusion Duration of diabetes is independently associated with ischemic stroke risk adjusting for risk factors. The risk increases 3% each year, and triples with diabetes ?10 years.

Banerjee, Chirantan; Moon, Yeseon P; Paik, Myunghee C; Rundek, Tatjana; Mora-McLaughlin, Consuelo; Vieira, Julio R; Sacco, Ralph L; Elkind, Mitchell SV

2012-01-01

101

Impact of Fenofibrate on Type 2 Diabetes Patients with Features of the Metabolic Syndrome: Subgroup Analysis From FIELD.  

PubMed

Given evidence of increasing prevalence in developed and developing countries, as a result of obesity trends and sedentary lifestyles, the metabolic syndrome represents an increasing burden on healthcare systems. Management guidelines for dyslipidaemia have primarily focused on LDL-C reduction; however, this approach fails to sufficiently address other lipid abnormalities associated with the metabolic syndrome. Atherogenic dyslipidaemia (characterized by elevated triglycerides and low HDL-C) is strongly associated with insulin-resistant states, such as type 2 diabetes and the metabolic syndrome, and is also a common finding among patients receiving treatment for dyslipidaemia. Intervening against atherogenic dyslipidaemia may address a substantial modifiable fraction of residual cardiovascular risk that remains after treatment with a statin. Recent findings from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study support this view. Fenofibrate treatment was shown to be especially effective in treating marked atherogenic dyslipidaemia, with a significant 27% relative risk reduction for cardiovascular events (P=0.0005, vs. 11%, P=0.035 for all patients) relative to placebo. These data, together with the earlier demonstration of significant microvascular benefits associated with this treatment, suggest a role for fenofibrate, in addition to statin therapy and lifestyle intervention, for reducing global vascular risk in type 2 diabetes patients and for impacting atherogenic dyslipidaemia associated with the metabolic syndrome. PMID:21532777

Hermans, Michel P

2010-05-01

102

Gender disparities in diabetes and coronary heart disease medication among patients with type 2 diabetes: results from the DIANA study  

PubMed Central

Background Coronary heart disease (CHD) is one of the most common long-term complications in people with type 2 diabetes. We analyzed whether or not gender differences exist in diabetes and CHD medication among people with type 2 diabetes. Methods The study was based on data from the baseline examination of the DIANA study, a prospective cohort study of 1,146 patients with type 2 diabetes conducted in South-West Germany. Information on diabetes and CHD medication was obtained from the physician questionnaires. Bivariate and multivariate analyses using logistic regression were employed in order to assess associations between gender and prescribed drug classes. Results In total, 624 men and 522 women with type 2 diabetes with a mean age of 67.2 and 69.7 years, respectively, were included in this analysis. Compared to women, men had more angiopathic risk factors, including smoking, alcohol consumption and worse glycemic control, and had more often a diagnosed CHD. Bivariate analyses showed higher prescription of thiazolidinediones and oral combination drugs as well as of angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers and aspirin in men than in women. After full adjustment, differences between men and women remained significant only for ACE inhibitors (OR?=?1.44; 95%-confidence interval (CI): 1.11 – 1.88) and calcium channel blockers (OR?=?1.42, 95%-CI: 1.05 – 1.91). Conclusions These findings contribute to current discussions on gender differences in diabetes care. Men with diabetes are significantly more likely to receive oral combination drugs, ACE inhibitors and calcium channel blockers in the presence of coronary heart disease, respectively. Our results suggest, that diabetic men might be more thoroughly treated compared to women. Further research is needed to focus on reasons for these differences mainly in treatment of cardiovascular diseases to improve quality of care.

2012-01-01

103

Parental diabetes and birthweight in 236 030 individuals in the UK Biobank Study  

PubMed Central

Background The UK Biobank study provides a unique opportunity to study the causes and consequences of disease. We aimed to use the UK Biobank data to study the well-established, but poorly understood, association between low birthweight and type 2 diabetes. Methods We used logistic regression to calculate the odds ratio for participants’ risk of type 2 diabetes given a one standard deviation increase in birthweight. To test for an association between parental diabetes and birthweight, we performed linear regression of self-reported parental diabetes status against birthweight. We performed path and mediation analyses to test the hypothesis that birthweight partly mediates the association between parental diabetes and participant type 2 diabetes status. Results Of the UK Biobank participants, 277 261 reported their birthweight. Of 257 715 individuals of White ethnicity and singleton pregnancies, 6576 had type 2 diabetes, 19 478 reported maternal diabetes (but not paternal), 20 057 reported paternal diabetes (but not maternal) and 2754 participants reported both parents as having diabetes. Lower birthweight was associated with type 2 diabetes in the UK Biobank participants. A one kilogram increase in birthweight was associated with a lower risk of type 2 diabetes (odds ratio: 0.74; 95% CI: 0.71, 0.76; P = 2 × 10?57). Paternal diabetes was associated with lower birthweight (45 g lower; 95% CI: 36, 54; P = 2 × 10?23) relative to individuals with no parental diabetes. Maternal diabetes was associated with higher birthweight (59 g increase; 95% CI: 50, 68; P = 3 × 10?37). Participants’ lower birthweight was a mediator of the association between reported paternal diabetes and participants’ type 2 diabetes status, explaining 1.1% of the association, and participants’ higher birthweight was a mediator of the association between reported maternal diabetes and participants’ type 2 diabetes status, explaining 1.2% of the association. Conclusions Data from the UK Biobank provides the strongest evidence by far that paternal diabetes is associated with lower birthweight, whereas maternal diabetes is associated with increased birthweight. Our findings with paternal diabetes are consistent with a role for the same genetic factors influencing foetal growth and type 2 diabetes.

Tyrrell, Jessica S; Yaghootkar, Hanieh; Freathy, Rachel M; Hattersley, Andrew T; Frayling, Timothy M

2013-01-01

104

Microbial field pilot study  

SciTech Connect

The objective of this project is to perform a microbially enhanced oil recovery field pilot test in the Southeast Vassar Vertz Sand Unit (SEVVSU) in Payne County, Oklahoma. Indigenous, anaerobic, nitrate-reducing bacteria will be stimulated to selectively plug flow paths which have been preferentially swept by a prior waterflood. This will force future flood water to invade bypassed regions or the reservoir and increase sweep efficiency. Injection of nutrient stimulates the growth and metabolism of reservoir bacteria, which produces beneficial products to enhance oil recovery. Sometimes, chemical treatments are used to clean or condition injection water. Such a chemical treatment has been initiated by Sullivan and Company at the Southeast Vassar Vertz Sand Unit. The unit injection water was treated with a mixture of water, methanol, isopropyl alcohol, and three proprietary chemicals. To determine if the chemicals would have an impact on the pilot, it was important to determine the effects of the chemical additives on the growth and metabolism of the bacteria from wells in this field. Two types of media were used: a mineral salts medium with molasses and nitrate, and this medium with 25 ppm of the treatment chemicals added. Samples were collected anaerobically from each of two wells, 1A-9 and 7-2. A sample from each well was inoculated and cultured in the broth tubes of molasses-nitrate medium with and without the chemicals. Culturing temperature was 35{degrees}C. Absorbance, pressure and cell number were checked to determine if the chemicals affected the growth and metabolism of bacteria in the brine samples. 12 figs.

Knapp, R.M.; McInerney, M.J.; Menzie, D.E.

1991-01-01

105

Is neuronal dysfunction an early sign of diabetic retinopathy? Microperimetry and Spectral Domain Optical Coherence Tomography (SD-OCT) Study in individuals with diabetes, but no diabetic retinopathy  

Microsoft Academic Search

PurposeTo elucidate changes in the neurosensory retina in the macular area, using spectral domain OCT and correlate with functional loss on fundus-related microperimetry, in patients with diabetes and no diabetic retinopathy compared with age-matched healthy volunteers.MethodsThis was a prospective study enroling 39 patients in each group. All patients underwent comprehensive dilated eye examination. The foveal thickness and the photoreceptor layer

A Verma; P K Rani; R Raman; S S Pal; G Laxmi; M Gupta; C Sahu; K Vaitheeswaran; T Sharma

2009-01-01

106

Literacy and health outcomes: a cross-sectional study in 1002 adults with diabetes  

Microsoft Academic Search

BACKGROUND: Inconsistent findings reported in the literature contribute to the lack of complete understanding of the association of literacy with health outcomes. We evaluated the association between literacy, physiologic control and diabetes complications among adults with diabetes. METHODS: A cross-sectional study of 1,002 English speaking adults with diabetes, randomly selected from the Vermont Diabetes Information System, a cluster-randomized trial of

Nancy S Morris; Charles D MacLean; Benjamin Littenberg

2006-01-01

107

Self-care coping strategies in people with diabetes: a qualitative exploratory study  

Microsoft Academic Search

BACKGROUND: The management of diabetes self-care is largely the responsibility of the patient. With more emphasis on the prevention of complications, adherence to diabetes self-care regimens can be difficult. Diabetes self-care requires the patient to make many dietary and lifestyle changes. This study will explore patient perceptions of diabetes self-care, with particular reference to the burden of self-care and coping

Margaret M Collins; Colin P Bradley; Tony O'Sullivan; Ivan J Perry

2009-01-01

108

A Feasibility Study of a Culturally Tailored Diabetes Intervention for Mexican Americans  

Microsoft Academic Search

Latinos, the fastest growing minority group in the United States, are among the hardest hit by diabetes. Among Latinos, Mexican Americans have the highest rate (23.9%) of diabetes. Good self-management can improve glycemic control and decrease diabetes complications but can be challenging to achieve. The purpose of this study was to test the feasibility and examine the effects of a

Deborah Vincent; Alice Pasvogel; Lourdes Barrera

2007-01-01

109

Nutritional status in patients with diabetes and chronic kidney disease: a prospective study1-3  

Microsoft Academic Search

Background: A poor nutritional status reduces the life expectancy of diabetes patients undergoing hemodialysis. Objective: The study objective was to specify the nutritional out- come in patients with chronic kidney disease (CKD) and well- controlled diabetes. Design: Forty-five diabetes patients with CKD were enrolled in a cooperative-care program designed to control glucose, blood pres- sure, LDL cholesterol, and the albumin

Christelle Raffaitin; Catherine Lasseur; Philippe Chauveau; Nicole Barthe; Henri Gin; Christian Combe; Vincent Rigalleau

110

Antidiabetic Properties of Azardiracta indica and Bougainvillea spectabilis: In Vivo Studies in Murine Diabetes Model  

Microsoft Academic Search

Diabetes mellitus is a metabolic syndrome characterized by an increase in the blood glucose level. Treatment of diabetes is complicated due to multifactorial nature of the disease. Azadirachta indica Adr. Juss and Bougainvillea spectabilis are reported to have medicinal values including antidiabetic properties. In the present study using in vivo diabetic murine model, A. indica and B. spectabilis chloroform, methanolic

Menakshi Bhat; Sandeepkumar K. Kothiwale; Amruta R. Tirmale; Shobha Y. Bhargava; Bimba N. Joshi

2009-01-01

111

Effects of the Diabetic Condition on Grafted Fat Survival: An Experimental Study Using Streptozotocin-Induced Diabetic Rats  

PubMed Central

Background Autologous fat grafts have been widely used for cosmetic purposes and for soft tissue contour reconstruction. Because diabetes mellitus is one of the major chronic diseases in nearly every country, the requirement for fat grafts in diabetes patients is expected to increase continuously. However, the circulation complications of diabetes are serious and have been shown to involve microvascular problems, impairing ischemia-driven neovascularization in particular. After injection, revascularization is vital to the survival of the grafted fat. In this study, the authors attempted to determine whether the diabetic condition inhibits the survival of injected fat due to impaired neovascularization. Methods The rat scalp was used for testing fat graft survival. Forty-four seven-week-old male Sprague-Dawley rats were allocated to a diabetic group or a control group. 1.0 mL of processed fat was injected subcutaneously into the scalp of each rat. The effect of diabetes was evaluated by calculating the volume and the weight of the grafted fat and by histologically analyzing the fat sections. Results The surviving fat graft volume and weight were considerably smaller in the diabetic group than in the control group (P<0.05), and histological evaluations showed less vascularity, and more cysts, vacuoles, and fibrosis in the diabetic group (P<0.05). Cellular integrity and inflammation were not considerably different in the two groups. Conclusions As the final outcome, we found that the presence of diabetes might impair the survival and the quality of fat grafts, as evidenced by lower fat graft weights and volumes and poor histologic graft quality.

Jung, Jae A; Kim, Yang Woo; Cheon, Young Woo

2014-01-01

112

A Study of Adiponectin in Children with Diabetes Mellitus  

PubMed Central

Objectives: Adiponectin is a hormone produced by adipose tissue. It is secreted exclusively by adipocytes and appears to play a role in the pathophysiology of obesity, diabetes mellitus (DM), and its comorbidities. The aim of this study was to assess adiponectin levels in diabetic children with type 1 DM (T1DM) and type 2 DM (T2DM), and to detect its prognostic role in them. Methods: This study was undertaken from April to July 2011 at Minia University Children’s Hospital, Egypt, and included 314 children aged 2–18 years divided into two patient groups. Group I consisted of 164 pre-diagnosed diabetic patients, further subdivided into Group Ia which included 142 patients with T1DM and Group Ib, 22 patients with T2DM; Group 2 included 150 apparently healthy children as a controls; they were age- and sex-matched to the diseased group. Patients were subjected to a thorough history taking, clinical examination, and laboratory investigations including assessment of HbA1c percentages, fasting C-peptide levels, lipid profiles and fasting serum adiponectin levels. Results: Adiponectin levels did not differ significantly between patients with T1DM and T2DM, but it was significantly higher in diabetic patients than in the controls. In T1DM, adiponectin had positive significant correlations with the duration of the disease and waist circumference, while in T2DM, it had a positive significant correlation with the dose of insulin given and negative significant associations with diastolic blood pressure, cholesterol, and C-peptide levels. Conclusion: The results of the study suggest that adiponectin can play a protective role against the metabolic complications of DM.

Ali, Basma A.; Mahrous, Doaa M.; Abdallah, Ahlam M.; Fikri, Mina

2013-01-01

113

Wright Field turboprop study  

SciTech Connect

The considered investigation was conducted as part of an effort to reduce aircraft fuel costs. Turboprops are very fuel efficient at speeds below Mach 0.6. One of the most promising approaches to reduce fuel consumption in the speed range from Mach 0.6 to 0.8 is related to an employment of the swept eight to ten blade propeller (propfan) being developed by NASA. All studies to date indicate that turboshaft engines with propfans might save 15% or more of the fuel used by a turbofan engine of comparable technology. Attention is given to a turboprop status review, contractor studies, the NASA propfan program, an in-house performance study, specific problems which have to be solved to make a twin-turboprop, 100-150 passenger transport a viable possibility for the early 1990s, and turboprop dilemmas.

Lorenzetti, R.C.; Dull, P.P.

1981-01-01

114

Weight and elevated albumin to creatinine ratio in youth with diabetes: the SEARCH for Diabetes in Youth study  

Microsoft Academic Search

Low birth weight (BWT) may contribute to kidney disease and could explain some of the variance in the development of early\\u000a diabetic kidney disease. This hypothesis was tested in the multicenter SEARCH study (3,714 youth with diabetes <20 years of\\u000a age). A morning spot urine sample, laboratory and anthropometric data, and a medical history were obtained. Elevated albumin\\u000a to creatinine ratio

David M. Maahs; Beverly M. Snively; Jennifer Beyer; Giuseppina Imperatore; Ronny Bell; Elizabeth J. Mayer-Davis; Lawrence M. Dolan; David J. Pettitt; Irl Hirsch; Beatriz Rodriguez; Dana Dabelea

2008-01-01

115

Urinary Neutrophil Gelatinase-Associated Lipocalin and Progression of Diabetic Nephropathy in Type 1 Diabetic Patients in a Four-Year Follow-Up Study  

Microsoft Academic Search

Background: Neutrophil gelatinase-associated lipocalin (NGAL), a marker of renal tubular damage, predicts progression in non-diabetic chronic kidney. We evaluated urinary (u)-NGAL as a predictor of progression in diabetic nephropathy in type 1 diabetic (T1D) patients. Methods: As a substudy of a 4-year randomized, intervention study evaluating low-protein diet in T1D patients with diabetic nephropathy, 78 patients were studied with yearly

Stine Elkjaer Nielsen; Henrik Post Hansen; Berit Ruud Jensen; Hans-Henrik Parving; Peter Rossing

2011-01-01

116

Assessment of Diabetic Retinopathy Using Nonmydriatic Ultra-Widefield Scanning Laser Ophthalmoscopy (Optomap) Compared With ETDRS 7-Field Stereo Photography  

PubMed Central

OBJECTIVE To compare the diagnostic properties of a nonmydriatic 200° ultra-widefield scanning laser ophthalmoscope (SLO) versus mydriatic Early Treatment of Diabetic Retinopathy Study (ETDRS) 7-field photography for diabetic retinopathy (DR) screening. RESEARCH DESIGN AND METHODS A consecutive series of 212 eyes of 141 patients with different levels of DR were examined. Grading of DR and clinically significant macular edema (CSME) from mydriatic ETDRS 7-field stereo photography was compared with grading obtained by Optomap Panoramic 200 SLO images. All SLO scans were performed through an undilated pupil, and no additional clinical information was used for evaluation of all images by the two independent, masked, expert graders. RESULTS Twenty-two eyes from ETDRS 7-field photography and 12 eyes from Optomap were not gradable by at least one grader because of poor image quality. A total of 144 eyes were analyzed regarding DR level and 155 eyes regarding CSME. For ETDRS 7-field photography, 22 eyes (18 for grader 2) had no or mild DR (ETDRS levels ? 20) and 117 eyes (111 for grader 2) had no CSME. A highly substantial agreement between both Optomap DR and CSME grading and ETDRS 7-field photography existed with ? = 0.79 for DR and 0.73 for CSME for grader 1, and ? = 0.77 (DR) and 0.77 (CSME) for grader 2. CONCLUSIONS Determination of CSME and grading of DR level from Optomap Panoramic 200 nonmydriatic images show a positive correlation with mydriatic ETDRS 7-field stereo photography. Both techniques are of sufficient quality to assess DR and CSME. Optomap Panoramic 200 images cover a larger retinal area and therefore may offer additional diagnostic properties.

Kernt, Marcus; Hadi, Indrawati; Pinter, Florian; Seidensticker, Florian; Hirneiss, Christoph; Haritoglou, Christos; Kampik, Anselm; Ulbig, Michael W.; Neubauer, Aljoscha S.

2012-01-01

117

Assessment of diabetes screening by general practitioners in France: the EPIDIA Study  

PubMed Central

Aims To audit type 2 diabetes screening in General Practice in France and to evaluate the frequency of undiagnosed diabetes in patients at high risk, after systematic screening and diagnosis. Methods For this study, 288 General Practitioners volunteered to include all consecutive non-diabetic patients under 65 years who had at least two risk factors for diabetes, whatever the reason for consultation. If a plasma glucose had not been recorded in the previous 12 months, a fasting plasma glucose (FPG) was prescribed, with a second test if FPG ? 7.0 mmol/l. Results 5950 patients were included. The most frequent diabetes risk factors were: age ? 40 years, 92%; overweight (BMI ? 27 kg/m2), 59%; treated hypertension, 48%; treated dyslipidemia, 37%; family history of diabetes, 24%. Of these subjects at high risk for diabetes, 88% had a FPG measurement in their medical record (75% measured during the preceding 12 months). Among the 1499 patients prescribed a FPG, diabetes was diagnosed in 40 patients (2.7% 95% CI: 1.9–3.5) and 22% had IFG. Thus the frequency of undiagnosed diabetes in the 5950 high risk patients was 0.67% (0.46–0.88). Conclusion Screening for diabetes by General Practitioners in France appears to be adequate and undiagnosed diabetes is rare in patients with risk factors for diabetes, at least in those consulting the General Practitioners studied.

Cogneau, Joel; Balkau, Beverley; Weill, Alain; Liard, Francois; Simon, Dominique

2006-01-01

118

Social and economic impact of diabetics in Bangladesh: protocol for a case-control study  

PubMed Central

Background Diabetes affects both individuals and their families and has an impact on economic and social development of a country. Information on the availability, cost, and quality of medical care for diabetes is mostly not available for many low- and middle-income countries including Bangladesh. Complications from diabetes, which can be devastating, could largely be prevented by wider use of several inexpensive generic medicines, simple tests and monitoring and can be a cost saving intervention. This study will provide an in-depth and comprehensive picture of social and economic impacts of diabetes in Bangladesh and propose clear recommendations for improving prevention and management of diabetes. The objectives of the study are: 1) To study the association between diabetes and other health problems and its social impacts 2) To estimate the economic impact of diabetes including total direct and indirect costs 3) To measure the impact of diabetes on quality of life among diabetes patients in Bangladesh 4) To study the impact of diabetes on the health care system Methods This is a case–control study comparing cases with type 2 diabetes to controls without diabetes matched on age, sex and place of residence. 564 cases and 564 controls will be selected from the outpatient department of a tertiary hospital in Dhaka, Bangladesh. Data on socioeconomic status, health utility index, direct and indirect costs for diabetes, medication adherence, quality of life, treatment satisfaction, diet, physical activity, mental state examination, weight, height, hip and waist circumference, blood pressure, pulse, medication history, laboratory data and physical examination will be conducted. Outcome measures: The primary outcome measures will be association between diabetes and other health problems, cost of diabetes, impact of diabetes on quality of life and secondary outcome measures are impact of diabetes on healthcare systems in Bangladesh. Discussion This study will provide an in-depth and comprehensive picture of social and economic impacts of diabetics in Bangladesh and propose clear recommendations for improving prevention and management of diabetics. It will help to develop programs and policies for better management of Diabetics and cost effective strategies in Bangladesh context.

2013-01-01

119

Illness perceptions in Turkish migrants with diabetes: A qualitative study.  

PubMed

OBJECTIVES Illness perceptions are usually conceptualized using the self-regulatory model of illness. Although a few examinations of illness perceptions among Turkish language populations exist, the validity of the self-regulatory model of illness has never been confirmed for this population group. The aim of our study was to explore the validity of the self-regulatory model of illness in chronically ill Turkish migrants residing in Germany using diabetes mellitus type 2 as an example. METHODS Qualitative semi-structured interviews were conducted with 24 Turkish migrants with self-reported diabetes who were recruited through key persons. The core aspects of the qualitative data were extracted through a hermeneutic approach. Subsequently, a system of categories and sub-categories was developed by means of content analysis. RESULTS Seven distinct core dimensions of illness perceptions, each with a different number of sub-domains, could be identified in the sample. They comprised the perceived timeline of diabetes, its consequences, its causes, its controllability as well as the identity/coherence and the emotional response with respect to the condition. DISCUSSION As regards the conceptualization of illness perceptions, the dimensions identified are in line with the self-regulatory model of illness. Addressing illness perceptions through tailored interventions may contribute to improving health care and health outcomes in Turkish migrants. PMID:23986085

Yilmaz-Aslan, Yüce; Brzoska, Patrick; Bluhm, Martina; Aslan, Abdulselam; Razum, Oliver

2014-06-01

120

Diabetes and Oral Health: A Case-control Study  

PubMed Central

Background: Diabetes mellitus, according to World Health Organization (WHO) is a silent epidemic which affects large number of people around the world and is directly related to the oral health status of the patients. Objectives: To know the prevalence of common dental diseases such as dental caries, periodontal diseases (pyorrhea), and treatment needs in a group of adult diabetic patients in private medical establishments of Tumkur city, south India, in comparison with non-diabetic patients. To create awareness among general medical practitioners about the common oral manifestations of diabetes and the importance of periodical dental check up for diabetics. Methods: A group of 300 diabetic patients (males = 186, females = 114) and a control group of 300 non-diabetics (males = 180, females = 120) matched by age and sex were examined according to WHO criteria, for a period of eight months. Results: The prevalence of dental caries was comparatively more in non-diabetics (32.3%) than in diabetics (13.6%). However, the prevalence of periodontal diseases (pyorrhea) was more in diabetics (92.6%) when compared to non-diabetics (83%). Conclusions: Oral health is an integral part of general health. Though dental caries was comparatively low in diabetics, periodontal status was compromised. Complex treatment needs was more in the diabetics (58%) when compared to controls (41%). Regular follow-up of dental problems of the diabetics and oral health education is much required.

Bharateesh, JV; Ahmed, Mansoor; Kokila, Ganganna

2012-01-01

121

Actos Now for the prevention of diabetes (ACT NOW) study  

PubMed Central

Background Impaired glucose tolerance (IGT) is a prediabetic state. If IGT can be prevented from progressing to overt diabetes, hyperglycemia-related complications can be avoided. The purpose of the present study was to examine whether pioglitazone (ACTOS®) can prevent progression of IGT to type 2 diabetes mellitus (T2DM) in a prospective randomized, double blind, placebo controlled trial. Methods/Design 602 IGT subjects were identified with OGTT (2-hour plasma glucose = 140–199 mg/dl). In addition, IGT subjects were required to have FPG = 95–125 mg/dl and at least one other high risk characteristic. Prior to randomization all subjects had measurement of ankle-arm blood pressure, systolic/diastolic blood pressure, HbA1C, lipid profile and a subset had frequently sampled intravenous glucose tolerance test (FSIVGTT), DEXA, and ultrasound determination of carotid intima-media thickness (IMT). Following this, subjects were randomized to receive pioglitazone (45 mg/day) or placebo, and returned every 2–3 months for FPG determination and annually for OGTT. Repeat carotid IMT measurement was performed at 18 months and study end. Recruitment took place over 24 months, and subjects were followed for an additional 24 months. At study end (48 months) or at time of diagnosis of diabetes the OGTT, FSIVGTT, DEXA, carotid IMT, and all other measurements were repeated. Primary endpoint is conversion of IGT to T2DM based upon FPG ? 126 or 2-hour PG ? 200 mg/dl. Secondary endpoints include whether pioglitazone can: (i) improve glycemic control (ii) enhance insulin sensitivity, (iii) augment beta cell function, (iv) improve risk factors for cardiovascular disease, (v) cause regression/slow progression of carotid IMT, (vi) revert newly diagnosed diabetes to normal glucose tolerance. Conclusion ACT NOW is designed to determine if pioglitazone can prevent/delay progression to diabetes in high risk IGT subjects, and to define the mechanisms (improved insulin sensitivity and/or enhanced beta cell function) via which pioglitazone exerts its beneficial effect on glucose metabolism to prevent/delay onset of T2DM. Trial Registration clinical trials.gov identifier: NCT00220961

DeFronzo, Ralph A; Banerji, MaryAnn; Bray, George A; Buchanan, Thomas A; Clement, Stephen; Henry, Robert R; Kitabchi, Abbas E; Mudaliar, Sunder; Musi, Nicolas; Ratner, Robert; Reaven, Peter D; Schwenke, Dawn; Stentz, Frankie B; Tripathy, Devjit

2009-01-01

122

Design of a randomized trial of diabetes genetic risk testing to motivate behavior change: The Genetic Counseling\\/Lifestyle Change (GC\\/LC) Study for Diabetes Prevention  

Microsoft Academic Search

Background The efficacy of diabetes genetic risk testing to motivate behavior change for diabetes prevention is currently unknown.Purpose This paper presents key issues in the design and implementation of one of the first randomized trials (The Genetic Counseling\\/Lifestyle Change (GC\\/LC) Study for Diabetes Prevention) to test whether knowledge of diabetes genetic risk can motivate patients to adopt healthier behaviors.Methods Because

Richard W Grant; James B Meigs; Jose C Florez; Elyse R Park; Robert C Green; Jessica L Waxler; Linda M Delahanty; Kelsey E O’Brien

2011-01-01

123

Cardiovascular mortality in non-insulin-dependent diabetes mellitus. A controlled study among 683 diabetics and 683 age- and sex-matched normal subjects  

Microsoft Academic Search

Although non-insulin-dependent diabetes mellitus (NIDDM) is considered a major cause of death, the role of some independent risk factors in diabetic patients is under debate. In fact the prognosis of NIDDM diabetes varies considerably in relation to the individual risk pattern, and the different studies are not directly comparable because of differences in size, age and geography of the samples,

E. Casiglia; G. Zanette; A. Mazza; V. Donadon; C. Donada; A. Pizziol; V. Tikhonoff; P. Palatini; A. C. Pessina

2000-01-01

124

Prevalence and risk factors accounting for true silent myocardial ischemia: a pilot case-control study comparing type 2 diabetic with non-diabetic control subjects  

Microsoft Academic Search

BACKGROUND: Given the elevated risk of cardiovascular events and the higher prevalence of silent coronary artery disease (CAD) in diabetic versus non-diabetic patients, the need to screen asymptomatic diabetic patients for CAD assumes increasing importante. The aims of the study were to assess prospectively the prevalence and risk factor predictors of true silent myocardial ischemia (myocardial perfusion defects in the

Cristina Hernández; Jaume Candell-Riera; Andreea Ciudin; Gemma Francisco; Santiago Aguadé-Bruix; Rafael Simó

2011-01-01

125

Diabetes-related symptoms and negative mood in participants of a targeted population-screening program for type 2 diabetes: The Hoorn Screening study  

Microsoft Academic Search

Objective: To determine the level of diabetes-related symptom distress and its association with negative mood in subjects participating in a targeted population-screening program, comparing those identified as having type 2 diabetes vs. those who did not. Research design and methods: This study was conducted within the framework of a targeted screening project for type 2 diabetes in a general Dutch

Marcel C. Adriaanse; Jacqueline M. Dekker; Annemieke M. W. Spijkerman; Jos W. R. Twisk; Giel Nijpels; Henk M. van der Ploeg; Robert J. Heine; Frank J. Snoek

2005-01-01

126

The sensitivity and specificity of single-field nonmydriatic monochromatic digital fundus photography with remote image interpretation for diabetic retinopathy screening: a comparison with ophthalmoscopy and standardized mydriatic color photography 1 1 InternetAdvance publication at ajo.com. April 12, 2002  

Microsoft Academic Search

PURPOSE: To evaluate single-field digital monochromatic nonmydriatic fundus photography as an adjunct in the screening of diabetic retinopathy.DESIGN: Prospective, comparative, observational case series.METHODS: Patients with type I and type II diabetes mellitus (n = 197) were sequentially evaluated by three different techniques: single-field digital monochromatic nonmydriatic photography; dilated ophthalmoscopy by an ophthalmologist; and seven Early Treatment Diabetic Retinopathy Study (ETDRS)

Danny Y Lin; Mark S Blumenkranz; Rosemary J Brothers; David M Grosvenor

2002-01-01

127

Family history of diabetes modifies the effect of blood pressure for incident diabetes in Middle Eastern women: Tehran Lipid and Glucose Study.  

PubMed

Elevated blood pressure (BP) may lead to incident diabetes. However, data about the effect of different BP components on incident diabetes in Middle Eastern women is lacking. We evaluated systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP) and mean arterial pressure (MAP) as independent predictors of diabetes in Iranian women. We performed a population-based prospective study among 3028 non-diabetic women, aged ?20 years. Odds ratios (ORs) of diabetes were calculated for every 1 s.d. increase in SBP, DBP, PP and MAP. During ?6 years of follow-up, 220 women developed diabetes. There were significant interactions between family history of diabetes and SBP, PP and MAP (P?0.01) in predicting incident diabetes. In women without a family history of diabetes, all BP components were significantly associated with diabetes in the age-adjusted model; the risk factor-adjusted ORs were significant (P<0.05) for SBP, PP and MAP (1.30, 1.34 and 1.27, respectively) with similar predictive ability (area under the receiver operating characteristic curve ?83%). In women with family history of diabetes, in the age-adjusted model, SBP, DBP and MAP were associated with diabetes; in multivariable model, they were not independent predictors of diabetes. In conclusion, in women without family history of diabetes, SBP, PP and MAP, were independent predictors of diabetes with almost similar predictive ability; hence, in the evaluation of the risk of BP components for prediction of diabetes, the presence of family history of diabetes should be considered. PMID:21289645

Hatami, M; Hadaegh, F; Khalili, D; Sheikholeslami, F; Azizi, F

2012-02-01

128

Mental health issues decrease diabetes-specific quality of life independent of glycaemic control and complications: findings from Australia's living with diabetes cohort study  

PubMed Central

Background While factors associated with health-related quality of life for people with chronic diseases including diabetes are well researched, far fewer studies have investigated measures of disease-specific quality of life. The purpose of this study is to assess the impact of complications and comorbidities on diabetes-specific quality of life in a large population-based cohort of type 2 diabetic patients. Methods The Living with Diabetes Study recruited participants from the National Diabetes Services Scheme in Australia. Data were collected via a mailed self-report questionnaire. Diabetes-specific quality of life was measured using the Audit of Diabetes-Dependent Quality of Life (ADDQoL) questionnaire. The analyses are for 3609 patients with type 2 diabetes. Regression models with adjustment for control variables investigated the association of complications and comorbidities with diabetes-specific quality of life. Next, the most parsimonious model for diabetes-specific quality of life after controlling for important covariates was examined. Results The expected associations with better diabetes-specific quality of life were evident, such as increased income, not on insulin, better glycaemic control and older age. However, being single and having been diagnosed with cancer were also associated with better ADDQoL. Additionally, poorer diabetes-specific quality of life was strongly sensitive to the presence of diabetes complications and mental health conditions such as depression, anxiety and schizophrenia. These relationships persisted after adjustment for gender, age, duration of diabetes, treatment regimen, sampling region and other treatment and socio-demographic variables. Conclusions A greater appreciation of the complexities of diabetes-specific quality of life can help tailor disease management and self-care messages given to patients. Attention to mental health issues may be as important as focusing on glycaemic control and complications. Therefore clinicians’ ability to identify and mange mental health issues and/or refer patients is critical to improving patients’ diabetes-specific quality of life.

2013-01-01

129

Knowledge and Awareness of Diabetes and Diabetic Ketoacidosis (DKA) Among Medical Students in a Tertiary Teaching Hospital: An Observational Study  

PubMed Central

Background: The management of Diabetes Mellitus and its important complication Diabetic Ketoacidosis is very crucial in today’s world where the prevalence of Diabetes is very high. Medical students are the pillars of our future healthcare system and it is important to evaluate and update their knowledge and awareness regarding these both conditions. Materials and Methods: This study was a cross-sectional; Questionnaire based observational study conducted in a tertiary care hospital. The respondents were final year MBBS students of that college. Study instrument was a self developed, pre-validated, semi-structured questionnaire. Results: A total of 73 questionnaires were considered for analysis, giving a response rate of 90.12% with 43.83% and 56.16% were male and female respondents respectively. About 81.25% and 90.24% of male and female respondents gave correct answer to question related to the best indicator of glycemic control. Lack of knowledge was seen regarding the world Diabetes day. Approximately 37% of the respondent’s parents were diabetic. Only 12 out of 73 respondents were aware about the factors leading to DKA.8 out of 73 were aware about investigations to be done in DKA. Around 43.84% of responders knew regarding the proper screening duration in person with risk of diabetes. Conclusion: From the study it was concluded that most of the students have basic knowledge regarding diabetes mellitus, its clinical features and management etc but only 50 % of the respondent were aware about DKA and further teaching and post teaching evaluation are needed in future direction.

Thangaraju, Pugazhenthan; Kumar, Suresh; Aravindan, U; Balasubramanian, Hariharan; Selvan, Tamil

2014-01-01

130

Diabetes insipidus, diabetes mellitus, optic atrophy and deafness. A clinical and genetic study  

Microsoft Academic Search

Two Iraqi sisters and a female cousin developed diabetes insipidus (DI), diabetes mellitus (DM), optic atrophy (OA), and deafness (D), (the 'DIDMOAD' syndrome) before the age of 12 years. One girl exhibited all the features of this disease complex only 3 months after an unusually late onset of recognizable symptoms at 11 years 9 months. Another girl died suddenly and

N. A. Nagi

1979-01-01

131

Diabetes May Be Bigger Threat to The Female Heart: Study  

MedlinePLUS

... weight, Huxley said. Because of this, men receive aggressive treatment sooner both for their diabetes and potential ... this gender differential, we need to be more aggressive in screening and treating women for diabetes or ...

132

10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study  

PubMed Central

Summary Background In the 2·8 years of the Diabetes Prevention Program (DPP) randomised clinical trial, diabetes incidence in high-risk adults was reduced by 58% with intensive lifestyle intervention and by 31% with metformin, compared with placebo. We investigated the persistence of these effects in the long term. Methods All active DPP participants were eligible for continued follow-up. 2766 of 3150 (88%) enrolled for a median additional follow-up of 5·7 years (IQR 5·5–5·8). 910 participants were from the lifestyle, 924 from the metformin, and 932 were from the original placebo groups. On the basis of the benefits from the intensive lifestyle intervention in the DPP, all three groups were offered group-implemented lifestyle intervention. Metformin treatment was continued in the original metformin group (850 mg twice daily as tolerated), with participants unmasked to assignment, and the original lifestyle intervention group was offered additional lifestyle support. The primary outcome was development of diabetes according to American Diabetes Association criteria. Analysis was by intention-to-treat. This study is registered with ClinicalTrials.gov, number NCT00038727. Findings During the 10·0-year (IQR 9·0–10·5) follow-up since randomisation to DPP, the original lifestyle group lost, then partly regained weight. The modest weight loss with metformin was maintained. Diabetes incidence rates during the DPP were 4·8 cases per 100 person-years (95% CI 4·1–5·7) in the intensive lifestyle intervention group, 7·8 (6·8–8·8) in the metformin group, and 11·0 (9·8–12·3) in the placebo group. Diabetes incidence rates in this follow-up study were similar between treatment groups: 5·9 per 100 person-years (5·1–6·8) for lifestyle, 4·9 (4·2–5·7) for metformin, and 5·6 (4·8–6·5) for placebo. Diabetes incidence in the 10 years since DPP randomisation was reduced by 34% (24–42) in the lifestyle group and 18% (7–28) in the metformin group compared with placebo. Interpretation During follow-up after DPP, incidences in the former placebo and metformin groups fell to equal those in the former lifestyle group, but the cumulative incidence of diabetes remained lowest in the lifestyle group. Prevention or delay of diabetes with lifestyle intervention or metformin can persist for at least 10 years. Funding National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

2011-01-01

133

The Healthy Living Partnerships to Prevent Diabetes Study  

PubMed Central

Background Since the Diabetes Prevention Project (DPP) demonstrated that lifestyle weight-loss interventions can reduce the incidence of diabetes by 58%, several studies have translated the DPP methods to public health–friendly contexts. Although these studies have demonstrated short-term effects, no study to date has examined the impact of a translated DPP intervention on blood glucose and adiposity beyond 12 months of follow-up. Purpose To examine the impact of a 24-month, community-based diabetes prevention program on fasting blood glucose, insulin, insulin resistance as well as body weight, waist circumference, and BMI in the second year of follow-up. Design An RCT comparing a 24-month lifestyle weight-loss program (LWL) to an enhanced usual care condition (UCC) in participants with prediabetes (fasting blood glucose=95–125 mg/dL). Data were collected in 2007–2011; analyses were conducted in 2011–2012. Setting/participants 301 participants with prediabetes were randomized; 261 completed the study. The intervention was held in community-based sites. Intervention The LWL program was led by community health workers and sought to induce 7% weight loss at 6 months that would be maintained over time through decreased caloric intake and increased physical activity. The UCC received two visits with a registered dietitian and a monthly newsletter. Main outcome measures The main measures were fasting blood glucose, insulin, insulin resistance, body weight, waist circumference, and BMI. Results Intent-to-treat analyses of between-group differences in the average of 18- and 24-month measures of outcomes (controlling for baseline values) revealed that the LWL participants experienced greater decreases in fasting glucose (?4.35 mg/dL); insulin (?3.01 ?U/ml); insulin resistance (?0.97); body weight (?4.19 kg); waist circumference (?3.23 cm); and BMI (?1.40), all p-values <0.01. Conclusions A diabetes prevention program administered through an existing community-based system and delivered by community health workers is effective at inducing significant long-term reductions in metabolic indicators and adiposity. Trial registration This study is registered at Clinicaltrials.gov NCT00631345.

Katula, Jeffrey A.; Vitolins, Mara Z.; Morgan, Timothy M.; Lawlor, Michael S.; Blackwell, Caroline S.; Isom, Scott P.; Pedley, Carolyn F.; Goff, David C.

2013-01-01

134

Diabetic worker with history of falls: a case study.  

PubMed

A 58-year old male employee presented to the occupational health clinic for evaluation after experiencing several falls. He had been diagnosed as having type II diabetes 5 years earlier. The physical examination noted peripheral neuropathy. This article reviews the effects of diabetes on peripheral nerves and discusses interventions that the occupational health nurse may use to monitor workers with diabetes. PMID:24806036

Lurati, Ann R

2014-05-01

135

Strategies to Optimize Participation in Diabetes Prevention Programs following Gestational Diabetes: A Focus Group Study  

PubMed Central

Objective We performed a qualitative study among women within 5 years of Gestational Diabetes (GDM) diagnosis. Our aim was to identify the key elements that would enhance participation in a type 2 diabetes (DM2) prevention program. Research Design and Methods Potential participants received up to three invitation letters from their GDM physician. Four focus groups were held. Discussants were invited to comment on potential facilitators/barriers to participation and were probed on attitudes towards meal replacement and Internet/social media tools. Recurring themes were identified through qualitative content analysis of discussion transcripts. Results Among the 1,201 contacted and 79 eligible/interested, 29 women attended a focus group discussion. More than half of discussants were overweight/obese, and less than half were physically active. For DM2 prevention, a strong need for social support to achieve changes in dietary and physical activity habits was expressed. In this regard, face-to-face interactions with peers and professionals were preferred, with adjunctive roles for Internet/social media. Further, direct participation of partners/spouses in a DM2 prevention program was viewed as important to enhance support for behavioural change at home. Discussants highlighted work and child-related responsibilities as potential barriers to participation, and emphasized the importance of childcare support to allow attendance. Meal replacements were viewed with little interest, with concerns that their use would provide a poor example of eating behaviour to children. Conclusions Among women within 5 years of a GDM diagnosis who participated in a focus group discussion, participation in a DM2 prevention program would be enhanced by face-to-face interactions with professionals and peers, provision of childcare support, and inclusion of spouses/partners.

Dasgupta, Kaberi; Da Costa, Deborah; Pillay, Sabrina; De Civita, Mirella; Gougeon, Rejeanne; Leong, Aaron; Bacon, Simon; Stotland, Stephen; Chetty, V. Tony; Garfield, Natasha; Majdan, Agnieszka; Meltzer, Sara

2013-01-01

136

Abnormal sleep patterns in subjects with type II diabetes mellitus and its effect on diabetic microangiopathies: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study (SN-DREAMS, report 20)  

Microsoft Academic Search

To study the prevalence of Abnormal Sleep Patterns (ASPs), gender-wise, in subjects with type II diabetes mellitus and its\\u000a influence on diabetic microangiopathies. A population-based cross-sectional survey was conducted among 1,414 patients having\\u000a type II diabetes mellitus. Diabetic retinopathy was graded using stereoscopic digital fundus photography. Neuropathy was assessed\\u000a by measuring vibration perception threshold using a sensitometer. Nephropathy was diagnosed

Rajiv Raman; Aditi Gupta; Kadri Venkatesh; Vaitheeswaran Kulothungan; Tarun Sharma

137

An exploratory qualitative interview study about collaboration between medicine and dentistry in relation to diabetes management  

PubMed Central

Objective To explore knowledge and attitudes regarding the links between diabetes and periodontitis of medical and dental healthcare professionals as well as those of people with diabetes. Design Qualitative interview study. Participants 4 people with diabetes, four dental professionals, three general practitioners (GPs) with a specialist interest in diabetes, one GP without a specialist interest in diabetes, three diabetic nurse specialists and two consultant diabetologists. Setting Primary and secondary care in Newcastle upon Tyne. Methods Interviews were audio recorded and transcribed verbatim. Framework analysis was used iteratively to achieve progressive focusing and to develop conceptual ideas. Results 3 inter-related themes emerged: (1) uncertain knowledge—a lack of familiarity about the links between periodontitis and diabetes; (2) unworkable knowledge—that even if the links between periodontitis and diabetes were known, it is impossible for anything to be done for patient benefit given the differing systems that medical and dental health professionals work in and (3) isolated knowledge—the perceived division that exists between the medical and dental professions has the potential to negatively impact on advances in diabetes patient care. The patients simply wanted all the healthcare professionals to be giving the same messages consistently and to help them access the (dental) care they need. Conclusions The research on the links between periodontal disease and diabetes appears to have limited impact on the organisation of diabetes care, and the divisions that exist between the medical and dental professions have the potential to negatively impact on patient care.

Bissett, Susan M; Stone, Kerry Marie; Rapley, Tim; Preshaw, Philip M

2013-01-01

138

Single Dose Streptozotocin Induced Diabetes: Considerations for Study Design in Islet Transplantation Models  

PubMed Central

Streptozotocin (STZ)-induced diabetes mellitus (DM) offers a very cost effective and expeditious technique that can be used in most strains of rodents, opening the field of DM research to an array of genotypic and phenotypic options that would otherwise be inaccessible. Despite widespread use of STZ in small animal models, the data available concerning drug preparation, dosing and administration, time to onset and severity of DM, and any resulting moribundity and mortality are often limited and inconsistent. Because of this, investigators inexperienced with STZ-induced diabetes may find it difficult to precisely design new studies with this potentially toxic chemical and account for the severity of DM it is capable of inducing. Until a better option becomes available, attempts need to be made to address shortcomings with current STZ-induced DM models. In this paper we review the literature and provide data from our pancreatic islet transplantation experiments using single high dose STZ-induced DM in NCr Athymic Nude mice with hopes of providing clarification for study design, suggesting refinements to the process, and developing a more humane process of chemical diabetes induction.

Deeds, MC; Anderson, JM; Armstrong, AS; Gastineau, DA; Hiddinga, HJ; Jahangir, A; Eberhardt, NL; Kudva, YC

2014-01-01

139

Quantitative Estimation of Temperature Variations in Plantar Angiosomes: A Study Case for Diabetic Foot  

PubMed Central

Thermography is a useful tool since it provides information that may help in the diagnostic of several diseases in a noninvasive and fast way. Particularly, thermography has been applied in the study of the diabetic foot. However, most of these studies report only qualitative information making it difficult to measure significant parameters such as temperature variations. These variations are important in the analysis of the diabetic foot since they could bring knowledge, for instance, regarding ulceration risks. The early detection of ulceration risks is considered an important research topic in the medicine field, as its objective is to avoid major complications that might lead to a limb amputation. The absence of symptoms in the early phase of the ulceration is conceived as the main disadvantage to provide an opportune diagnostic in subjects with neuropathy. Since the relation between temperature and ulceration risks is well established in the literature, a methodology that obtains quantitative temperature differences in the plantar area of the diabetic foot to detect ulceration risks is proposed in this work. Such methodology is based on the angiosome concept and image processing.

Peregrina-Barreto, H.; Morales-Hernandez, L. A.; Rangel-Magdaleno, J. J.; Avina-Cervantes, J. G.; Ramirez-Cortes, J. M.; Morales-Caporal, R.

2014-01-01

140

Noninvasive, optical detection of diabetes: model studies with porcine skin  

NASA Astrophysics Data System (ADS)

An in vitro study was performed to evaluate noninvasive spectroscopic measurement of advanced glycation endproducts (AGEs) in skin collagen. A porcine dermis preparation was incubated in solutions simulating normal and hyperglycemic conditions. The AGEs kinetics of increase were determined by HPLC and GC/MS assays, and compared to near-infrared (NIR) and ultraviolet/visible fluorescence skin spectra. Multivariate analysis indicated that, although NIR did not discriminate between collagen samples exposed to different glucose concentrations, fluorescence changes were readily detected and correlated strongly with skin concentration of AGEs. These results suggest that measurement of skin AGEs by fluorescence spectroscopy may be useful for detection and diagnosis of type II diabetes.

Hull, E. L.; Ediger, M. N.; Unione, A. H. T.; Deemer, E. K.; Stroman, M. L.; Baynes, J. W.

2004-09-01

141

Study design of DIACORE (DIAbetes COhoRtE) - a cohort study of patients with diabetes mellitus type 2  

PubMed Central

Background Diabetes mellitus type 2 (DM2) is highly associated with increased risk for chronic kidney disease (CKD), end stage renal disease (ESRD) and cardiovascular morbidity. Epidemiological and genetic studies generate hypotheses for innovative strategies in DM2 management by unravelling novel mechanisms of diabetes complications, which is essential for future intervention trials. We have thus initiated the DIAbetes COhoRtE study (DIACORE). Methods DIACORE is a prospective cohort study aiming to recruit 6000 patients of self-reported Caucasian ethnicity with prevalent DM2 for at least 10 years of follow-up. Study visits are performed in University-based recruiting clinics in Germany using standard operating procedures. All prevalent DM2 patients in outpatient clinics surrounding the recruiting centers are invited to participate. At baseline and at each 2-year follow-up examination, patients are subjected to a core phenotyping protocol. This includes a standardized online questionnaire and physical examination to determine incident micro- and macrovascular DM2 complications, malignancy and hospitalization, with a primary focus on renal events. Confirmatory outcome information is requested from patient records. Blood samples are obtained for a centrally analyzed standard laboratory panel and for biobanking of aliquots of serum, plasma, urine, mRNA and DNA for future scientific use. A subset of the cohort is subjected to extended phenotyping, e.g. sleep apnea screening, skin autofluorescence measurement, non-mydriatic retinal photography and non-invasive determination of arterial stiffness. Discussion DIACORE will enable the prospective evaluation of factors involved in DM2 complication pathogenesis using high-throughput technologies in biosamples and genetic epidemiological studies.

2013-01-01

142

Diabetes and Cardiovascular Disease: Original Insights from the Framingham Heart Study  

PubMed Central

The role of diabetes in the pathogenesis of cardiovascular disease (CVD) was unclear until 1979 when Kannel et al used data from the Framingham Heart Study (FHS) to identify diabetes as a major cardiovascular risk factor. It was also one of the first studies to demonstrate the higher risk of CVD in women with diabetes compared to men with diabetes. Since then, multiple studies have been done to recognize and curtail cardiovascular risk factors such as smoking, obesity, hypertension, hyperlipidemia, and insulin resistance. This review will examine the contribution of the Kannel article and subsequent studies in defining the contribution of several risk factors on cardiovascular disease.

Qazi, Mohammad U.; Malik, Shaista

2013-01-01

143

The care process of diabetic foot ulcer patients: a qualitative study in Iran  

PubMed Central

Background The Purpose of this study is to clarify the care process for Iranian diabetic patients with diabetic foot ulcer condition. Methods The main question of this research was “How is the care process for diabetic foot ulcer patients and how do patients experience it?” This study was within the Grounded Theory method. Data collection was carried out until data saturation was achieved. Saturation was achieved after interviewing 11 patients, 4 physicians, one head nurse and one nurse. Results Three main themes emerged from this study, including: “disease management, disease experience and continuity of care”. Each of these themes is consisted of different sub-themes. Conclusions This is the first study to describe the care process in Iranian diabetic patients with diabetic foot ulcer disease. Knowing patients’ experience and the manner of dealing with them once faced with foot ulcer condition could facilitate a comprehensive decision making by therapists and better recovery of diabetic patients.

2012-01-01

144

Diabetes Risk Factors, Diabetes Risk Algorithms, and the Prediction of Future Frailty: The Whitehall II Prospective Cohort Study  

PubMed Central

Objective To examine whether established diabetes risk factors and diabetes risk algorithms are associated with future frailty. Design Prospective cohort study. Risk algorithms at baseline (1997–1999) were the Framingham Offspring, Cambridge, and Finnish diabetes risk scores. Setting Civil service departments in London, United Kingdom. Participants There were 2707 participants (72% men) aged 45 to 69 years at baseline assessment and free of diabetes. Measurements Risk factors (age, sex, family history of diabetes, body mass index, waist circumference, systolic and diastolic blood pressure, antihypertensive and corticosteroid treatments, history of high blood glucose, smoking status, physical activity, consumption of fruits and vegetables, fasting glucose, HDL-cholesterol, and triglycerides) were used to construct the risk algorithms. Frailty, assessed during a resurvey in 2007–2009, was denoted by the presence of 3 or more of the following indicators: self-reported exhaustion, low physical activity, slow walking speed, low grip strength, and weight loss; “prefrailty” was defined as having 2 or fewer of these indicators. Results After a mean follow-up of 10.5 years, 2.8% of the sample was classified as frail and 37.5% as prefrail. Increased age, being female, stopping smoking, low physical activity, and not having a daily consumption of fruits and vegetables were each associated with frailty or prefrailty. The Cambridge and Finnish diabetes risk scores were associated with frailty/prefrailty with odds ratios per 1 SD increase (disadvantage) in score of 1.18 (95% confidence interval: 1.09–1.27) and 1.27 (1.17–1.37), respectively. Conclusion Selected diabetes risk factors and risk scores are associated with subsequent frailty. Risk scores may have utility for frailty prediction in clinical practice.

Bouillon, Kim; Kivimaki, Mika; Hamer, Mark; Shipley, Martin J.; Akbaraly, Tasnime N.; Tabak, Adam; Singh-Manoux, Archana; Batty, G. David

2013-01-01

145

A diagnostic approach for defining idiopathic remitting diabetes: a retrospective cohort study  

PubMed Central

Background 11 patients were referred to our Molecular Genetics Department at the Royal Devon and Exeter Hospital between 2000-2012 with a physician’s diagnosis of remitting diabetes. Our aim was to identify patients with remitting diabetes whose clinical presentation is not explained by any known aetiology of diabetes. Methods We obtained longitudinal clinical data on all 11 patients from the hospital records. All patients were aged between 0.5 and 35 years at diagnosis. We applied clinical criteria derived from the literature to establish 1) definite diabetes, 2) diabetes initially severe-requiring treatment with insulin, 3) remission of diabetes, and 4) exclusion of known causes of remitting diabetes. Results 10 out of 11 patients had an alternative explanation for their remission or a clear diagnosis was not identified. We identified a single patient with idiopathic remitting diabetes using these criteria. The patient was a white Caucasian female diagnosed aged 15 with symptoms of diabetes, laboratory glucose of 21.2 mmol/L and HbA1c 134 mmol/mol. Her BMI was 23.6 kg/m2. She was treated with basal bolus insulin but discontinued two years after diagnosis due to hypoglycaemia. 13 years post diagnosis, she had a normal oral glucose tolerance test during pregnancy (fasting glucose 4.5 mmol/L, 2 hr glucose 4.8 mmol/L) and an HbA1c of 30 mmol/mol. This patient does not appear to have Type 1 or Type 2 diabetes, and furthermore does not fit into current classifications of diabetes. Conclusions Idiopathic remitting diabetes is rare but does exist. Strict clinical criteria are important to ensure patients have a robust clinical diagnosis. Identification of more patients with idiopathic remitting diabetes will enable further study of the clinical course of this syndrome. Applying these strict criteria will allow the identification of patients with remitting diabetes to assess its aetiology.

2014-01-01

146

Identification of diabetic retinopathy genes through a genome-wide association study among Mexican-Americans from Starr County, Texas  

Microsoft Academic Search

To identify genetic susceptibility loci for severe diabetic retinopathy, 286 Mexican-Americans with type 2 diabetes from Starr County, Texas completed detailed physical and ophthalmologic examinations including fundus photography for diabetic retinopathy grading. 103 individuals with moderate-to-severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy were defined as cases for this study. DNA samples extracted from study subjects were genotyped using the

Yi-Ping Fu

2009-01-01

147

Health behaviours, socioeconomic status and diabetes incidence: the Australian Diabetes Obesity and Lifestyle Study (AusDiab)  

Microsoft Academic Search

Aims\\/hypothesis  To identify the impact of socioeconomic status on incident impaired glucose metabolism and type 2 diabetes and to investigate\\u000a the mediating role of health behaviours on this relationship using national, population-based data.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The Australian Diabetes Obesity and Lifestyle (AusDiab) Study is a national, population-based, longitudinal study of adults\\u000a aged 25 years and above. A total sample of 4,405 people provided complete

E. D. Williams; R. J. Tapp; D. J. Magliano; J. E. Shaw; P. Z. Zimmet; B. F. Oldenburg

2010-01-01

148

Acute Kidney Injury in the Diabetic Rat: Studies in the Isolated Perfused and Intact Kidney  

Microsoft Academic Search

Background\\/Aim: Diabetes leads to chronic renal hypoxia and cellular hypoxia response (mediated by hypoxia-inducible factors) and predisposes to acute kidney injury. We studied the impact of acute and chronic hypoxic stress on the development of acute kidney injury in the diabetic rat kidney. Methods: Control (CTR) and streptozotocin (STZ)-diabetic rats were studied following acute medullary hypoxic stress, induced by combinations

Christian Rosenberger; Mogher Khamaisi; Marina Goldfarb; Ahuva Shina; Vitali Shilo; Fanni Zilbertrest; Seymour Rosen; Samuel N. Heyman

2008-01-01

149

Prevalence of diabetic retinopathy in Tehran province: a population-based study  

PubMed Central

Background To determine the prevalence and characteristics of diabetic retinopathy (DR) among Iranian patients with diabetes. Methods Design: population-based cross-sectional study. Participants: patients with diabetes aged 25 to 64 years in Tehran province, Iran. This survey was conducted from April to October 2007. The study sample was derived from the first national survey of risk factors for non-communicable disease. Diabetes mellitus was defined as a fasting plasma glucose of ? 7.0 mmol/l (126 mg/dl) or more, use of diabetic medications, or a physician's diagnosis of diabetes. All patients known to have diabetes underwent an eye examination by bio-microscope and indirect ophthalmoscope to check for any signs of DR through dilated pupils by + 78 lens. Participants were also interviewed and examined to determine their demographic characteristics, medical conditions and the regularity of their eye visits. Results Among 7989 screened patients, 759 (9.5%) had diabetes. Of them, 639 patients (84.2%) underwent eye examination. Five patients (0.7%) with media opacity were excluded. Of 634 examined patients with diabetes, 240 had some degree of diabetic retinopathy, and the overall standardized prevalence of any retinopathy was 37.0% (95% CI: 33.2-40.8), including 27.3% (95% CI: 23.7-30.8) (n = 175) with non-proliferative and 9.6% (95% CI: 7.3-11.9) (n = 65) with proliferative diabetic retinopathy. Clinically significant macular edema and vision-threatening retinopathy were detected in 5.8% (95% CI: 4.0-7.7) (n = 38) and 14.0% (95% CI: 11.3-16.7) (n = 95) of patients, respectively. Only 143 patients (22.6%) with diabetes had a history of regular eye examination. Conclusion This study demonstrated a high prevalence and poor control of DR in Tehran province. This suggests the need for adequate prevention and treatment in patients with diabetes.

Javadi, Mohammad Ali; Katibeh, Marzieh; Rafati, Nasrin; Dehghan, Mohammad Hossein; Zayeri, Farid; Yaseri, Mehdi; Sehat, Mojtaba; Ahmadieh, Hamid

2009-01-01

150

Clinical Study of Advanced Glycation End Products in Egyptian Diabetic Obese and Non-Obese Patients  

PubMed Central

Advanced glycation end products (AGEs) are complex, heterogenous molecules generated by glycation and oxidation of proteins in vivo, which are thought to markedly increase in diabetic patients. One of the recently identified AGEs is carboxy methyl lysine (CML), which is the main ligand of receptors for advanced glycation end products (RAGE). The present study aimed to assess the effect of obesity on such pathways in presence and absence of Type 2 diabetes mellitus. CML, soluble receptors for advanced glycation end products (sRAGE), HbA1C, lipid profile, liver function tests and kidney function tests were determined in 29 diabetic obese, 29 diabetic non-obese, 15 non-diabetic obese and 15 non-diabetic non-obese subjects. The study compared obese and non-obese subjects in presence and absence of type 2 diabetes. The results showed a significant increase in CML and a significant decrease in sRAGE in each of the diabetic obese group when compared with the diabetic non-obese group and the non-diabetic obese group when compared with the non-diabetic non-obese group. A significant positive correlation was found between CML and markers of obesity (body mass index and waist/hip ratio). These results suggest that obesity can increase CML independent of diabetes and support the reports that CML could be generated from both sugars and lipids. The present study suggests that treatment using glycation inhibitors like aminoguanidine or recombinant sRAGE will not only retard the diabetic complications, but may also have a prophylactic effect.

Amin, Mohamed N.; Mosa, Amany A.; El-Shishtawy, Mamdouh M.

2011-01-01

151

A 15-year follow-up study of patients with non-insulin-dependent diabetes mellitus (NIDDM) in Osaka, Japan. Factors predictive of the prognosis of diabetic patients  

Microsoft Academic Search

Risk factors related to the prognosis of diabetic patients were studied in a follow-up study of 1939 patients with non-insulin-dependent diabetes mellitus (NIDDM) for a mean observation period of 15 years at our institute. Age at entry into the study was the most powerful risk factor related to the survival of diabetic patients in this study. Moreover, the risk of

Akira Sasaki; Masuko Uehara; Naruto Horiuchi; Kyoichi Hasegawa; Takao Shimizu

1997-01-01

152

Associations of sex hormone-binding globulin and testosterone with diabetes among men and women (the Saku Diabetes study): a case control study  

PubMed Central

Background Sex hormone-binding globulin (SHBG) levels and sex hormones have been implicated in the pathogenesis of type 2 diabetes and cardiovascular diseases. As fatty liver has been suggested to be a major determinant of SHBG levels, we examined whether the associations of SHBG and testosterone with diabetes were independent of fatty liver. Methods We conducted a case–control study that included 300 diabetes cases (215 men and 85 women) and 300 matched controls from the Saku cohort study. Diabetes was defined by either fasting plasma glucose levels ?126 mg/dL, 2-h post-load glucose levels ?200 mg/dL after a 75 g oral glucose tolerance test, or diabetes diagnosed by physicians. We fitted conditional logistic regression models to examine the associations between SHBG and total testosterone levels with diabetes by sex. To evaluate the impact of fatty liver, we used the fatty liver index (FLI), a validated measure derived from serum triglyceride levels, body mass index (BMI), waist circumference, and ?-glutamyltransferase levels. Results After adjusting for age, family history of diabetes, smoking, physical activity, BMI, and FLI, SHBG levels were inversely associated with diabetes among women (odds ratio [OR] comparing the highest with the lowest quartiles, 0.13 [95% confidence interval {CI}, 0.02–0.96]), but not among men. Similar patterns were observed in a subgroup analysis restricted to postmenopausal women"(OR, 0.12 [95% CI, 0.01–1.17]). In contrast, testosterone levels were inversely associated with diabetes among men (OR, 0.45 [95% CI, 0.23–0.89]), but not among women. Conclusions Our findings suggest that SHBG in women and testosterone in men may be inversely associated with diabetes.

2012-01-01

153

Atrial Natriuretic Peptide and Type 2 Diabetes Development - Biomarker and Genotype Association Study  

PubMed Central

Background We have recently shown that low plasma levels of mid-regional atrial natriuretic peptide (MR-ANP) predict development of diabetes and glucose progression over time, independently of known risk factors for diabetes development. However, since MR-ANP levels might be influenced by unknown factors causing diabetes, we cannot rule out that such relationship might be confounded. Previous studies have shown an association of a single nucleotide polymorphism rs5068 on the natriuretic peptide precursor A (NPPA) locus gene with higher levels of circulating ANP. Since gene variants are inherited randomly and not subject to confounding, we aimed to investigate whether the variant rs5068 within the NPPA locus is associated with incident type 2 diabetes. Methods We genotyped the variant rs5068 within the NPPA locus in 27,307 individuals without known diabetes from the Malmö Diet Cancer Study. Incident diabetes was retrieved through national and regional registers (median follow-up time of 14 years, 2,823 incident diabetes cases). Results In Cox regression analysis adjusted for age, sex and BMI, we found that the carriers of at least one copy of the G allele of rs5068 had lower likelihood of incident diabetes within 14 years (HR?=?0.88, 95% CI 0.78–0.99, p?=?0.037). Conclusion Our results indicate a role of the ANP system in the etiology of type 2 diabetes and might help provide insight in the metabolic actions of natriuretic peptides and the pathophysiology of type 2 diabetes.

Jujic, Amra; Nilsson, Peter M.; Engstrom, Gunnar; Hedblad, Bo; Melander, Olle; Magnusson, Martin

2014-01-01

154

Thyroid dysfunction in type 2 diabetes mellitus: A retrospective study  

PubMed Central

Introduction: Type 2 diabetes mellitus (DM) is a growing problem in our country and we have observed that many patients are associated with thyroid dysfunction later in their life. However, the prevalence of thyroid dysfunction in these patients has not been investigated. Aims and Objectives: To find the prevalence of thyroid dysfunction in type 2 DM in Manipur, India. Materials and Methods: In this retrospective study, data of 202 Type 2 DM patients who attended the diabetic clinic of the Regional Institute of Medical Sciences, Imphal from January 2011 to July 2012, and whose thyroid stimulating hormone (TSH) level was investigated were included. The inclusion criteria are known cases of type 2 DM. Exclusion criteria are patients with previous history of hypothyroidism and those on drugs affecting the thyroid profile. Results: Out the 202 type 2 DM patients for the study of which 61 are males and 141 are females, 139 (68.8%) are euthyroid, 33 (16.3%) have subclinical hypothyroidism (10 males and 23 females), 23 (11.4%) have hypothyroidism (6 males and 17 females), 4 (2%) have subclinical hyperthyroidism and 3 (1.5%) are hyperthyroidism cases. Maximum cases were of hypothyroidism (subclinical and clinical) seen in the age group of 45-64 years. Patients with BMI > 25 were at increased risk of having hypothyroidism (P < 0.016). Conclusion: Prevalence of hypothyroidism is quite high in type 2 DM patients above 45 years and more so if their BMI is over 25.

Demitrost, Laloo; Ranabir, Salam

2012-01-01

155

Assessment of demographics, treatment strategies, and evidence-based medicine use among diabetic and non-diabetic patients with acute coronary syndrome: A cohort study  

PubMed Central

Objectives: To evaluate and compare clinical and epidemiological characteristics, treatment strategies, and utilization of evidence-based medicine (EBM) among coronary artery disease (CAD) patients with or without diabetes. Materials and Methods: Prospective observational cohort study from a tertiary care hospital in India among patients with CAD (myocardial infarction, unstable angina, or chronic stable angina). Data included demographic information, vital signs, personal particulars, risk factors for CAD, treatment strategies, and discharge medications. We evaluated epidemiologic characteristics and treatment strategies for diabetic and non-diabetic patients. Results: Of 1,073 patients who underwent angiography, 960 patients (30% diabetic) had CAD. Proportion of hypertensive patients was higher among diabetic patients (58 vs 35% non-diabetic, P < 0.001). Similar proportion of patients received medical management in diabetic vs non-diabetic CAD patients (35 vs 34%, P = 0.091); in diabetics the use of surgical procedure was higher (22 vs 17%, P = 0.0230) than interventional strategy (percutaneous transluminal coronary angioplasty, 43 vs 49%, P = 0.0445). Key medications (antiplatelet agents, angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB), beta-blockers, and ahtihyperlipidemic agents) were prescribed in 95, 53/12, 67, and 91% diabetic (n = 252) and 96, 51/8, 67, and 94% non-diabetic (n = 673) patients, respectively on discharge. Conclusions: Clustering of several risk factors at presentation, typically diabetes and hypertension, is common in CAD patients. Though diabetic patients are managed more conservatively, utilization of EBM for diabetic and non-diabetic patients is consistent with the recommendations.

Shah, Bhavik S.; Deshpande, Shrikalp S.

2014-01-01

156

Systematic study to evaluate anti-diabetic potential of Amaranthus spinosus on type-1 and type-2 diabetes.  

PubMed

The present study was designed to systematically investigate the antidiabetic potential of Amaranthus spinosus leaves which are traditionally known to have various medicinal properties and used for the treatment of diabetes mellitus. The ethanolic extract of leaves of Amaranthus spinosus was administered (150, 300 and 450 mg/kg bw) to type-1 and type-2 diabetic rats. Standard drugs, glibenclamide and metformin were used as a positive control for comparison. Changes in carbohydrate and lipid metabolism and antioxidants were assessed and compared with control and standard drug treated animals. Among the standardized extract doses tested (150, 300 and 450 mg/kg bw), higher doses significantly decreased plasma glucose levels (p<0.01 and p<0.001), hepatic glucose-6-phophatase activity (p<0.01 and p<0.001) and increased the hepatic glycogen content (p<0.01) with a concurrent increase in hexokinase activity in both type 1 and 2 diabetic rats (p<0.01 and p<0.001). Besides, the higher doses also significantly lowered the plasma and hepatic lipids, urea, creatinine levels (p<0.001) and lipid peroxidation with an improvement in the antioxidant profiles (p<0.001) of both type-1 and type-2 diabetic rats. It is concluded that Amaranthus spinosus has potential antidiabetic activity and significantly improves disrupted metabolisms and antioxidant defense in type-1 and type-2 diabetic rats. PMID:23374451

Bavarva, J H; Narasimhacharya, A V

2013-01-01

157

Advanced glycation end products and diabetic nephropathy: a comparative study using diabetic and normal rats with methylglyoxal-induced glycation.  

PubMed

Hyperglycemia-related advanced glycation end product (AGE) formation is a key mechanism in diabetic nephropathy. Since methylglyoxal (MG) is a potent AGE precursor, we aimed to assess the role of MG-related AGE formation in the progression of renal damages. A comparative study between Wistar (W, normal) and Goto-Kakizaki (GK, nonobese type 2 diabetic) rats was performed at 6 and 14 months old and after 14 weeks of MG administration to 6-month-old rats. Diabetic rats showed progressive structural, biochemical, and functional alterations, including AGE, albuminuria, and tissue hypoxia, which were partially mimicked by MG administration to young GK rats. Aged Wistar rats had an impairment of some parameters, whereas MG administration caused a phenotype similar to young GK rats, including oxidative stress, impaired apoptotic and angiogenic markers, and structural lesions. MG accumulation specifically impaired several of the renal disease markers progressively observed in diabetic rats, and thus, it contributes to the progression of diabetic nephropathy. PMID:24078283

Rodrigues, Lisa; Matafome, Paulo; Crisóstomo, Joana; Santos-Silva, Daniela; Sena, Cristina; Pereira, Paulo; Seiça, Raquel

2014-03-01

158

A GENOME WIDE ASSOCIATION STUDY FOR DIABETIC NEPHROPATHY GENES IN AFRICAN AMERICANS  

PubMed Central

A genome-wide association study was performed using the Affymetrix 6.0 chip to identify genes associated with diabetic nephropathy in African Americans. Association analysis was performed adjusting for admixture in 965 type 2 diabetic African American patients with end-stage renal disease (ESRD) and in 1029 African Americans without type 2 diabetes or kidney disease as controls. The top 724 single nucleotide polymorphisms (SNPs) with evidence of association to diabetic nephropathy were then genotyped in a replication sample of an additional 709 type 2 diabetes-ESRD patients and 690 controls. SNPs with evidence of association in both the original and replication studies were tested in additional African American cohorts consisting of 1246 patients with type 2 diabetes without kidney disease and 1216 with non-diabetic ESRD to differentiate candidate loci for type 2 diabetes-ESRD, type 2 diabetes, and/or all-cause ESRD. Twenty-five SNPs were significantly associated with type 2 diabetes-ESRD in the genome-wide association and initial replication. Although genome-wide significance with type 2 diabetes was not found for any of these 25 SNPs, several genes, including RPS12, LIMK2, and SFI1 are strong candidates for diabetic nephropathy. A combined analysis of all 2890 patients with ESRD showed significant association SNPs in LIMK2 and SFI1 suggesting that they also contribute to all-cause ESRD. Thus, our results suggest that multiple loci underlie susceptibility to kidney disease in African Americans with type 2 diabetes and some may also contribute to all-cause ESRD.

McDonough, Caitrin W.; Palmer, Nicholette D.; Hicks, Pamela J.; Roh, Bong H.; An, S. Sandy; Cooke, Jessica N.; Hester, Jessica M.; Wing, Maria R.; Bostrom, Meredith A.; Rudock, Megan E.; Lewis, Joshua P.; Talbert, Matthew E.; Blevins, Rebecca A.; Lu, Lingyi; Ng, Maggie C.Y.; Sale, Michele M.; Divers, Jasmin; Langefeld, Carl D.; Freedman, Barry I.; Bowden, Donald W.

2011-01-01

159

Early aggregation studies of diabetic amyloid in solution  

NASA Astrophysics Data System (ADS)

Islet amyloid polypeptide (IAPP, also known as amylin) is responsible for pancreatic amyloid deposits in type II diabetes. The deposits, as well as intermediates in their assembly, are cytotoxic to pancreatic ?-cells and contribute to the loss of ?-cell mass associated with type II diabetes. To better understand the mechanism and cause of such aggregation, molecular simulations with explicit solvent models were used to compare monomer structure and early aggregation mechanism. Using free-energy maps generated through a variety of novel, enhanced sampling free-energy calculation techniques, we have found that, in water, the peptide adopts three major structures. One has a small ?-helix at the N-terminus and a small ?-hairpin at the other end. The second and the most stable one, is a complete ?-hairpin, and the third is a random coil structure. Transition Path Sampling simulations along with reaction coordinate analysis reveal that the peptide follows a "zipping mechanism" in folding from ?-helical to ?-hairpin state. From studies of the dimerization of monomers in water, we have found that the early aggregation proceeds by conversion of all ?-helical configurations to ?-hairpins, and by two ?-hairpins coming together to form a parallel ?-sheet. Several aspects of the proposed mechanism have been verified by concerted 2D IR experimental measurements, thereby adding credence to the validity of our predictions.

Singh, Sadanand; de Pablo, Juan

2011-03-01

160

A pilot study of chronic recombinant interferon-alfa 2a for diabetic proliferative retinopathy: Metabolic effects and opthalmologic effects  

Microsoft Academic Search

The objective of this study was to evaluate the metabolic effects and opthalmologic effects of ?-interferon therapy in diabetes mellitus patients with proliferative diabetic retinopathy (PDR). Three volunteer patients [insulin-dependent diabetes mellitus (IDDM), insulin requiring non-insulin-dependent diabetes mellitus (NIDDM), and maturity onset diabetes of the young (MODY)] threatened with blindness due to progressive PDR were treated with a interferon for

W. Ronald Skowsky; Tariq Siddiqui; David Hodgetts; Fred H. Lambrou; Michael W. Stewart; Malcolm T. Foster

1996-01-01

161

Factors affecting the disclosure of diabetes by ethnic minority patients: a qualitative study among Surinamese in the Netherlands  

Microsoft Academic Search

Background  Diabetes and related complications are common among ethnic minority groups. Community-based social support interventions are\\u000a considered promising for improving diabetes self-management. To access such interventions, patients need to disclose their\\u000a diabetes to others. Research on the disclosure of diabetes in ethnic minority groups is limited. The aim of our study was\\u000a to explore why diabetes patients from ethnic minority populations

Mirjam JE Kohinor; Karien Stronks; Joke A Haafkens

2011-01-01

162

Sensorineural deafness in patients of type 2 diabetes mellitus in uttar pradesh: a pilot study.  

PubMed

B/L symmetrical sensorineural hearing loss has long been associated with diabetes Mellitus. Microangiopathy associated with thickening of the basement membrane of small vessels has been implicated as a major source. This study was done to observe the predominant site of lesion whether cochlear or retrocochlear in patients of diabetic sensorineural hearing loss. This was a random study. Forty two patients with diabetic B/L symmetrical sensorineural hearing loss were selected in a tertiary referral centre. All the patients selected were of diabetic B/L symmetrical sensorineural hearing loss. The study was designed to show the predominant site of lesion whether cochlear or retrocochlear in patients of diabetes with or without noise exposure. The parameter for inferring blood sugar control was level of glycosylated haemoglobin (Hb1AC). The incidence of the classical symptoms of diabetes mellitus namely polyurea, polydypsia and polyphagia were seen in (40.8%) of patients. The present study was designed to show that even early diabetic patients without symptoms of hearing loss had mild bilaterally symmetrical purely sensorineural hearing loss (32.65%) signifying the diabetic hypoacusis is present significantly even in early aural symptomless diabetics. On follow up it was revealed that the hearing loss of these patients was irreversible. The predominant site of lesion was found to be cochlear by performing Chi Square test P < .05 and so this is applicable to the general population of Uttar Pradesh. PMID:24427709

Misra, Vilas; Agarwal, C G; Bhatia, N; Shukla, G K

2013-12-01

163

The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study  

Microsoft Academic Search

Summary  Foot ulceration results in substantial morbidity amongst diabetic patients. We have studied prospectively the relationship between high foot pressures and foot ulceration using an optical pedobarograph. A series of 86 diabetic patients, mean age 53.3 (range 17–77) years, mean duration of diabetes 17.1 (range 1–36) years, were followed-up for a mean period of 30 (range 15–34) months. Clinical neuropathy was

A. Veves; H. J. Murray; M. J. Young; A. J. M. Boulton

1992-01-01

164

Diabetic Nephropathy Is Associated With AGT Polymorphism T235 Results of a Family-Based Study  

Microsoft Academic Search

Diabetic nephropathy is a serious and frequent complication of insulin-dependent diabetes mellitus (IDDM) that has a strong genetic component. Several case-control studies have reported conflicting results with regard to the role of angiotensinogen gene polymorphisms, specifically the M235T T allele, in the development of diabetic nephropathy. The primary limitation of the case-control approach is that bias may be introduced by

John J. Rogus; Dariusz Moczulski; Maria Beatriz; S. Freire; Yadong Yang; James H. Warram; Andrzej S. Krolewski

165

The growing volume of diabetes-related dialysis: a population based study  

Microsoft Academic Search

Background. End-stage renal failure requiring dialysis is one of the most serious complications of diabetes mellitus, and diabetes is the most common cause of end-stage renal failure. The aim of this large, observa- tional study is to describe the population-based incidence and prevalence rates and outcomes of diabetic individuals in Ontario, Canada who require dialysis therapy. Methods. Two cohorts of

Charmaine E. Lok; Matthew J. Oliver; Deanna M. Rothwell; Janet E. Hux

2004-01-01

166

Renal enlargement: Comparative autoradiographic studies of 3 H-thymidine uptake in diabetic and uninephrectomized rats  

Microsoft Academic Search

Summary  Incorporation of 3H-thymidine into renal cortical tissue has been studied by light microscopic autoradiography in streptozotocin-diabetic rats, uninephrectomized rats, uninephrectomized diabetic rats, insulin-treated diabetic rats and control rats. The percentage of labelled cortical nuclei (the labelling index) was determined separately in glomeruli, proximal tubules and distal tubules after 2, 4 and 6 days on autoradiographs from 1 m thick plastic

R. Rasch; J. O. Rytter Nörgaard

1983-01-01

167

A Pilot Study of School Counselor's Preparedness to Serve Students with Diabetes: Relationship to Self-Reported Diabetes Training  

ERIC Educational Resources Information Center

This cross-sectional, observational pilot study investigated the knowledge, attitudes, and awareness of 132 school counselors regarding students with diabetes. Respondents were primarily white, female, with a masters degree, aged 42 years, and with 10 years of school counseling experience. Most counselors worked at large, public, suburban, and…

Wagner, Julie; James, Amy

2006-01-01

168

"This does my head in". Ethnographic study of self-management by people with diabetes  

PubMed Central

Background Self-management is rarely studied 'in the wild'. We sought to produce a richer understanding of how people live with diabetes and why self-management is challenging for some. Method Ethnographic study supplemented with background documents on social context. We studied a socio-economically and ethnically diverse UK population. We sampled 30 people with diabetes (15 type 1, 15 type 2) by snowballing from patient groups, community contacts and NHS clinics. Participants (aged 5-88, from a range of ethnic and socio-economic groups) were shadowed at home and in the community for 2-4 periods of several hours (total 88 visits, 230 hours); interviewed (sometimes with a family member or carer) about their self-management efforts and support needs; and taken out for a meal. Detailed field notes were made and annotated. Data analysis was informed by structuration theory, which assumes that individuals' actions and choices depend on their dispositions and capabilities, which in turn are shaped and constrained (though not entirely determined) by wider social structures. Results Self-management comprised both practical and cognitive tasks (e.g. self-monitoring, menu planning, medication adjustment) and socio-emotional ones (e.g. coping with illness, managing relatives' input, negotiating access to services or resources). Self-management was hard work, and was enabled or constrained by economic, material and socio-cultural conditions within the family, workplace and community. Some people managed their diabetes skilfully and flexibly, drawing on personal capabilities, family and social networks and the healthcare system. For others, capacity to self-manage (including overcoming economic and socio-cultural constraints) was limited by co-morbidity, cognitive ability, psychological factors (e.g. under-confidence, denial) and social capital. The consequences of self-management efforts strongly influenced people's capacity and motivation to continue them. Conclusion Self-management of diabetes is physically, intellectually, emotionally and socially demanding. Non-engagement with self-management may make sense in the context of low personal resources (e.g. health literacy, resilience) and overwhelming personal, family and social circumstances. Success of self-management as a policy solution will be affected by interacting influences at three levels: [a] at micro level by individuals' dispositions and capabilities; [b] at meso level by roles, relationships and material conditions within the family and in the workplace, school and healthcare organisation; and [c] at macro level by prevailing economic conditions, cultural norms and expectations, and the underpinning logic of the healthcare system. We propose that the research agenda on living with diabetes be extended and the political economy of self-management systematically studied.

2012-01-01

169

The effectiveness and efficiency of diabetes screening in Ontario, Canada: a population-based cohort study  

PubMed Central

Background Little is known about the efficiency and effectiveness of the current level of diabetes screening activity in Ontario where there is universal access to health services. Our study aims were to: (i) determine how often Ontarians are screened for diabetes; (ii) estimate screening efficiency based on the number needed to screen (NNS) to diagnosis one diabetes case; (iii) examine the population effectiveness of screening as estimated by the number of undiagnosed diabetes cases. Methods Ontario respondents of the Canadian Community Health Survey who agreed to have their responses linked to health care data (n = 37,400) provided the cohort. The five-year probabilities of glucose testing and diabetes diagnoses were estimated using a Cox Proportional Hazards Model. We defined NNS as the ratio of diabetes tests to number of diabetes diagnoses over the study period. We estimated the number of undiagnosed diabetes by dividing the number not tested at the end of study period by the NNS. Results 80% of women and 66% of men had a blood glucose test within 5 years. The efficiency of screening was estimated by a NNS of 14 among men and 22 among women. 127,100 cases of undiagnosed diabetes were estimated, representing 1.4% of the Ontario adult population. Increasing age, hypertension, immigrant and non-white ethnicity, and number of general practitioner visits were associated with an increased likelihood of having a glucose test (LR ?2 p < 0.001). Low income men were less likely to be tested. Conclusions Diabetes screening was high in this population-based cohort of Ontarians. Screening efficiency varied considerably in the population. Undiagnosed diabetes continues to be prevalent and remains concentrated in the highest risk groups for diabetes, especially among men.

2010-01-01

170

Zinc, the Pancreas, and Diabetes: Insights from Rodent Studies and Future Directions  

Microsoft Academic Search

Molecular and cellular studies have demonstrated several roles for zinc (Zn) in insulin production and the consequent actions of insulin on metabolism. Clinical and epidemiological studies suggest that reduced Zn status is associated with diabetes. Investigations of Zn in rodent models of diabetes have provided a valuable link for understanding the molecular, cellular, clinical and epidemiological observations in the context

Carla G. Taylor

2005-01-01

171

Study Circles at the Pharmacy--A New Model for Diabetes Education in Groups.  

ERIC Educational Resources Information Center

Tests the feasibility of a one-year group education model for patients with type 2 diabetes in Sweden. Within study circles led by pharmacists, participants learned to self-monitor glucose, to interpret the results and to act upon them. Results show that study circles held at pharmacies are a feasible way of education persons with type 2 diabetes.…

Sarkadi, Anna; Rosenqvist, Urban

1999-01-01

172

Diabetes Mellitus and Cancer Risk in a Network of Case-Control Studies  

Microsoft Academic Search

Diabetes has been associated to the risk of a few cancer sites, though quantification of this association in various populations remains open to discussion. We analyzed the relation between diabetes and the risk of various cancers in an integrated series of case-control studies conducted in Italy and Switzerland between 1991 and 2009. The studies included 1,468 oral and pharyngeal, 505

Cristina Bosetti; Valentina Rosato; Jerry Polesel; Fabio Levi; Renato Talamini; Maurizio Montella; Eva Negri; Alessandra Tavani; Antonella Zucchetto; Silvia Franceschi; Giovanni Corrao; Carlo La Vecchia

2012-01-01

173

Diabetes Control among Vietnamese Patients in Ho Chi Minh City: An Observational Cross-Sectional Study  

ERIC Educational Resources Information Center

The objective of this study was to assess the extent of diabetic control and its associated factors among Vietnamese patients with diabetes mellitus (DM). The study was conducted among 652 outpatients who were recruited at a public general hospital (People Hospital 115) and a private clinic (Medic Center) in Ho Chi Minh City, Vietnam. Median age…

Yokokawa, Hirohide; Khue, Nguyen Thy; Goto, Aya; Nam, Tran Quang; Trung, Tran The; Khoa, Vo Tuan; Ngoc, Nguyen Thi Boi; Minh, Pham Nghiem; Vinh, Nguyen Quang; Okayama, Akira; Yasumura, Seiji

2010-01-01

174

Observational study of homeopathic and conventional therapies in patients with diabetic polyneuropathy  

Microsoft Academic Search

Methods: The feasibility and outcomes of homeopathic therapy in a group of type-2 di- abetes mellitus patients with diabetic neuropathy were studied in a prospective observa- tional study. Patients were followed from baseline (T0) for 6 months (T1) and for 12 months (T2), treatment was adjusted as necessary. Primary outcome was diabetic neu- ropathy symptom (DNS) score, secondary outcomes were

Raffaella Pomposelli; Valeria Piasere; Cristina Andreoni; Gavina Costini; Elena Tonini; Antonietta Spalluzzi; Daniela Rossi; Chiara Quarenghi; Maria Elisabetta Zanolin; Paolo Bellavite

2009-01-01

175

Quality of life in pregnancy and post-partum: a study in diabetic patients  

Microsoft Academic Search

Purpose  We evaluated quality of life in pregnant women with diabetes followed up at Italian diabetes clinics.\\u000a \\u000a \\u000a \\u000a Methods  A total of 245 pregnant women (30 type 1 diabetes mellitus (T1DM), 176 gestational diabetes (GDM) and 39 controls) were asked\\u000a to fill in a questionnaire including the SF-36 Health Survey and the Center for Epidemiological Studies-Depression (CES-D)\\u000a Scale in third trimester of pregnancy

M. G. Dalfrà; A. Nicolucci; T. Bisson; B. Bonsembiante; A. Lapolla

176

Patient and provider perceptions of care for diabetes: results of the cross-national DAWN Study  

Microsoft Academic Search

Aims\\/hypothesis  We assessed country-level and individual-level patterns in patient and provider perceptions of diabetes care.\\u000a \\u000a \\u000a \\u000a Methods  The study used a cross-sectional design with face-to-face or telephone interviews of diabetic patients and healthcare providers\\u000a in 13 countries from Asia, Australia, Europe and North America. Participants were randomly selected adults with type 1 or\\u000a type 2 diabetes (n=5,104), and randomly selected diabetes-care providers, including

M. Peyrot; R. R. Rubin; T. Lauritzen; S. E. Skovlund; F. J. Snoek; D. R. Matthews; R. Landgraf

2006-01-01

177

Diabetes and Risk of Hip Fracture in the Singapore Chinese Health Study  

PubMed Central

OBJECTIVE Asian populations are documenting rapid increases in the rates of diabetes and hip fracture, but there are no prospective data linking both diseases in Asian studies. We investigated this association among a cohort of Chinese in Singapore. RESEARCH DESIGN AND METHODS A prospective cohort of 63,257 Chinese in the Singapore Chinese Health Study, established between 1993 and 1998, was followed up for a mean duration of 12 years. Diabetes status was ascertained by baseline interviews, and incidence of hip fracture post-enrollment was identified through a nationwide hospital discharge database. RESULTS The risk of hip fracture, after adjustment for other risk factors, was almost double among people with diabetes compared with people without diabetes (relative risk 1.98, 95% CI 1.71–2.29). When stratified by BMI, the increase in risk of hip fracture among people with diabetes relative to people without diabetes was similar in all four strata. There was a very strong dose-dependent relationship between duration of diabetes and risk of hip fracture (P for trend <0.0001). Compared with people without diabetes, the relative risk (95% CI) among subjects with diabetes for <5 years at recruitment was 1.40 (1.08–1.82), and this risk increased to 2.66 (2.04–3.47) among individuals with diabetes for ?15 years. CONCLUSIONS Asians with diabetes, like their Western counterparts, experience an increased risk of hip fracture. Early assessment for osteoporosis and increased fracture risk, as well as prevention of falls, should be part of the management of diabetes.

Koh, Woon-Puay; Wang, Renwei; Ang, Li-Wei; Heng, Derrick; Yuan, Jian-Min; Yu, Mimi C.

2010-01-01

178

Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men.  

PubMed Central

OBJECTIVE--To examine the association between smoking, alcohol consumption, and the incidence of non-insulin dependent diabetes mellitus in men of middle years and older. DESIGN--Cohort questionnaire study of men followed up for six years from 1986. SETTING--The health professionals' follow up study being conducted across the United States. SUBJECTS--41,810 male health professionals aged 40-75 years and free of diabetes, cardiovascular disease, and cancer in 1986 and followed up for six years. MAIN OUTCOME MEASURE--Incidence of non-insulin dependent diabetes mellitus diagnosed in the six years. RESULTS--During 230,769 person years of follow up 509 men were newly diagnosed with diabetes. After controlling for known risk factors men who smoked 25 or more cigarettes daily had a relative risk of diabetes of 1.94 (95% confidence interval 1.25 to 3.03) compared with non-smokers. Men who consumed higher amounts of alcohol had a reduced risk of diabetes (P for trend < 0.001). Compared with abstainers men who drank 30.0-49.9 g of alcohol daily had a relative risk of diabetes of 0.61 (95% confidence interval 0.44 to 0.91). CONCLUSIONS--Cigarette smoking may be an independent, modifiable risk factor for non-insulin dependent diabetes mellitus. Moderate alcohol consumption among healthy people may be associated with increased insulin sensitivity and a reduced risk of diabetes.

Rimm, E. B.; Chan, J.; Stampfer, M. J.; Colditz, G. A.; Willett, W. C.

1995-01-01

179

Immigrant Generation and Diabetes Risk Among Mexican Americans: The Sacramento Area Latino Study on Aging  

PubMed Central

Objectives We examined whether acculturation and immigrant generation, a marker for assimilation, are associated with diabetes risk in an aging Mexican-origin population. Methods We analyzed data on 1789 adults aged 60 to 101 years from the Sacramento Area Latino Study on Aging. We ascertained type 2 diabetes on the basis of diabetic medication use, self-report of physician diagnosis, or a fasting glucose of 126 milligrams/deciliter or greater. Logistic regression modeled prevalent diabetes. Results Adjusting for age and gender, we observed significant but divergent associations between immigrant generation, acculturation, and diabetes risk. Relative to first-generation adults, second-generation adults had an odds ratio (OR) of 1.8 (95% confidence interval [CI] = 1.4, 2.4) and third-generation adults had an OR of 2.1 (95% CI = 1.4, 3.1) of having diabetes. Greater US acculturation, however, was associated with a slightly decreased diabetes rate. In the full model adjusting for socioeconomic and lifestyle factors, the association between generation (but not acculturation) and diabetes remained significant. Conclusions Our study lends support to the previously contested notion that assimilation is associated with an increased diabetes risk in Mexican immigrants. Researchers should examine the presence of a causal link between assimilation and health more closely.

Afable-Munsuz, Aimee; Mayeda, Elizabeth Rose; Perez-Stable, Eliseo J.; Haan, Mary N.

2013-01-01

180

Immigrant Generation and Diabetes Risk Among Mexican Americans: The Sacramento Area Latino Study on Aging  

PubMed Central

Objectives We examined whether acculturation and immigrant generation, a marker for assimilation, are associated with diabetes risk in an aging Mexican-origin population. Methods We analyzed data on 1789 adults aged 60 to 101 years from the Sacramento Area Latino Study on Aging. We ascertained type 2 diabetes on the basis of diabetic medication use, self-report of physician diagnosis, or a fasting glucose of 126 milligrams/deciliter or greater. Logistic regression modeled prevalent diabetes. Results Adjusting for age and gender, we observed significant but divergent associations between immigrant generation, acculturation, and diabetes risk. Relative to first-generation adults, second-generation adults had an odds ratio (OR) of 1.8 (95% confidence interval [CI] = 1.4, 2.4) and third-generation adults had an OR of 2.1 (95% CI = 1.4, 3.1) of having diabetes. Greater US acculturation, however, was associated with a slightly decreased diabetes rate. In the full model adjusting for socioeconomic and lifestyle factors, the association between generation (but not acculturation) and diabetes remained significant. Conclusions Our study lends support to the previously contested notion that assimilation is associated with an increased diabetes risk in Mexican immigrants. Researchers should examine the presence of a causal link between assimilation and health more closely.

Afable-Munsuz, Aimee; Mayeda, Elizabeth Rose; Perez-Stable, Eliseo J.; Haan, Mary N.

2014-01-01

181

Communication and Medication Adherence: The Diabetes Study of Northern California  

PubMed Central

Background Poor medication adherence contributes to poor cardiometabolic control and diabetes outcomes. Studies linking patient-provider communication to adherence often use self-reported adherence and have not explored differences across communication domains or therapeutic indications. Methods To investigate associations between patient communication ratings and cardiometabolic medication adherence, we conducted a cross-sectional analysis of 9,377 patients in the Diabetes Study of Northern California (DISTANCE), a race-stratified, random sample of Kaiser Permanente survey respondents. Eligible participants received ?1 oral hypoglycemic, lipid-lowering, or anti-hypertensive medication in the 12 months preceding the survey. Communication was measured with a 4-item Consumer Assessment of Healthcare Providers and Systems Survey (CAHPS) score and 4 items from the Trust in Physicians and Interpersonal Processes of Care instruments. Poor adherence was >20% continuous medication gap for ongoing medications. Using modified least squares regression, we calculated differences in poor adherence prevalence for a 10-point decrease in CAHPS score and comparing higher vs. lower communication ratings on other items, adjusting for necessary sociodemographic and medical confounders derived from a directed acyclic graph. Results In this cohort, 30% had poor cardiometabolic medication adherence. For each 10-point decrease in CAHPS score, the adjusted prevalence of poor adherence increased by 0.9% (p=0.01). Compared with patients offering higher ratings, patients who gave lower ratings for providers’ involving patients in decisions, understanding patients’ problems with treatment, and eliciting confidence and trust were more likely to have poor adherence, with absolute differences of 4% (p=0.04), 5% (p=0.02) and 6% (p=0.03), respectively. Associations between communication and adherence were somewhat larger for hypoglycemic medications than other medications. Conclusions Poor communication ratings were independently associated with objectively measured inadequate cardiometabolic medication adherence, particularly for oral hypoglycemic medications. Future studies should investigate whether improving communication skills among clinicians with poorer patient communication ratings could improve their patients’ cardiometabolic medication adherence and outcomes.

Ratanawongsa, Neda; Karter, Andrew J.; Parker, Melissa M.; Lyles, Courtney R.; Heisler, Michele; Moffet, Howard H.; Adler, Nancy; Warton, E. Margaret; Schillinger, Dean

2013-01-01

182

The Development and Field Testing of Materials on Diabetes for Persons with Low Vision or Low Literacy.  

ERIC Educational Resources Information Center

Instructional materials on hypoglycemia, foot care, and exercise were developed and field tested with 98 diabetes patients who had low vision and/or low literacy. A pretest and posttest revealed an 81% reduction in wrong answers overall and a 72% reduction in wrong answers by a subset with low vision. (Author/DB)

Reardon, A. W.; And Others

1993-01-01

183

Association of HCV with diabetes mellitus: an Egyptian case-control study  

PubMed Central

Background The highest Hepatitis C Virus (HCV) prevalence in the world occurs in Egypt. Several studies from different parts of the world have found that 13% to 33% of patients with chronic HCV have associated diabetes, mostly type II Diabetes Mellitus (DM). In Egypt the prevalence of DM is 25.4% among HCV patients. Therefore, it is important to identify the magnitude of the problem of diabetes in order to optimize the treatment of chronic hepatitis C. Methods The objective of this case-control study was to evaluate the prevalence of DM and other extrahepatic (EH) manifestations among patients with different HCV morbidity stages including asymptomatic, chronic hepatic and cirrhotic patients. In this study, 289 HCV patients older than 18 were selected as cases. Also, 289 healthy controls were included. Laboratory investigations including Liver Function tests (LFT) and blood glucose level were done. Also serological assays including cryoglobulin profile, rheumatoid factor, antinuclear antibody, HCV-PCR were performed. Results Out of 289 HCV cases, 40 (13.84%) were diabetic. Out of 289 healthy controls, 12 (4.15%) were diabetic. It was found that the diabetic HCV group mean age was [48.1 (± 9.2)]. Males and urbanians represented 72.5% and 85% respectively. Lower level of education was manifested in 52.5% and 87.5% were married. In the nondiabetic HCV group mean age was [40.7 (± 10.4)]. Males and urbanians represented 71.5% and 655% respectively. secondary and higher level of education was attained in 55.4% and 76.7% were married. Comparing between the diabetic HCV group and the non diabetic HCV group, age, residence and alcohol drinking were the only significant factors affecting the incidence of diabetes between the two groups. There was no significant difference regarding sonar findings although cirrhosis was more prevalent among diabetic HCV cases and the fibrosis score was higher in diabetic HCV patients than among the non diabetic HCV cases. Conclusion The diabetic patients in the HCV group were older, more likely to have a history of alcohol drinking than the non diabetic HCV cases. Age and alcohol drinking are factors that could potentially contribute to the development of type 2 diabetes. Logistic regression analyses showed that age and residence in urban regions were the predictive variables that could be associated with the presence of diabetes. Alcohol consumption was not a significant predictive factor.

2011-01-01

184

Diabetes related risk factors did not explain the increased risk for urinary incontinence among women with diabetes. The Norwegian HUNT/EPINCONT study  

PubMed Central

Background Previous studies have shown an association between diabetes mellitus (DM) and urinary incontinence (UI) in women, especially severe UI. The purpose of this study was to investigate whether diabetes related variables could explain this association. Methods The study is part of the EPINCONT study, which is based on the large Nord-Trøndelag Health Study 2 (HUNT 2), performed in the county of Nord-Trøndelag, Norway, during the years 1995 - 1997. Questions on diabetes and UI were answered by a total of 21 057 women aged 20 years and older. Of these 685 were identified as having diabetes, and thus comprise the population of our study. A variety of clinical and biochemical variables were recorded from the participants. Results Blood-glucose, HbA1c, albumine:creatinine ratio (ACR), duration of diabetes, diabetes treatment, type of diabetes, cholesterol and triglycerides did not significantly differ in women with and without UI in crude analyses. However, the diabetic women with UI had more hospitalizations during the last 12 months, more homecare, and a higher prevalence of angina and use of oestrogene treatment (both local and oral/patch). After adjusting for age, BMI, parity and smoking, there were statistically significant associations between any UI and angina (OR 1.89; 95% CI: 1.22 - 2.93), homecare (OR 1.72; 95% CI: 1.02 - 2.89), and hospitalization during the last 12 months (OR 1.67; 95% CI: 1.18 - 2.38). In adjusted analyses severe UI was also significantly associated with the same variables, and also with diabetes drug treatment (OR 2.10; 95% CI: 1.07 - 4.10) and stroke (OR 2.47; 95% CI: 1.09 - 5.59). Conclusion No single diabetes related risk factor seems to explain the increased risk for UI among women with diabetes. However, we found associations between UI and some clinical correlates of diabetes.

Ebbesen, Marit Helen; Hannestad, Yngvild S; Midthjell, Kristian; Hunskaar, Steinar

2009-01-01

185

Timing of access to secondary healthcare services for diabetes management and lower extremity amputation in people with diabetes: a protocol of a case-control study  

PubMed Central

Background Lower extremity amputation (LEA) is a complication of diabetes and a marker of the quality of diabetes care. Clinical and sociodemographic determinants of LEA in people with diabetes are well known. However, the role of service-related factors has been less well explored. Early referral to secondary healthcare is assumed to prevent the occurrence of LEA. The objective of this study is to investigate a possible association between the timing of patient access to secondary healthcare services for diabetes management, as a key marker of service-related factors, and LEA in patients with diabetes. Methods/design This is a case–control study. The source population is people with diabetes. Cases will be people with diabetes who have undergone a first major LEA, identified from the hospital discharge data at each of three regional centres for diabetes care. Controls will be patients with diabetes without LEA admitted to the same centre either electively or as an emergency. Frequency-matching will be applied for gender, type of diabetes, year and centre of LEA. Three controls per case will be selected from the same population as the cases. With a power of 90% to detect OR of 0.4 for an association between ‘good quality care’ and LEA in people with diabetes, 107 cases and 321 controls are required. Services involved in diabetes management are endocrinology, ophthalmology, renal, cardiology, vascular surgery and podiatry; timing of first contact with any of these services is the main exploratory variable. Using unconditional logistic regression, an association between this exposure and the outcome of major LEA in people with diabetes will be explored, while adjusting for confounders. Ethics and dissemination Ethical approval was granted by the Clinical Research Ethics Committee of the Cork Teaching Hospitals, Ireland. Results will be presented at conferences and published in peer-reviewed journals.

Buckley, Claire M; Ali, Fauzi; Roberts, Graham; Kearney, Patricia M; Perry, Ivan J; Bradley, Colin P

2013-01-01

186

Noninvasive, optical detection of diabetes: model studies with porcine skin.  

PubMed

An in vitro study was performed to evaluate noninvasive spectroscopic measurement of advanced glycation endproducts (AGEs) in skin collagen. A porcine dermis preparation was incubated in solutions simulating normal and hyperglycemic conditions. The AGEs kinetics of increase were determined by HPLC and GC/MS assays, and compared to near-infrared (NIR) and ultraviolet/visible fluorescence skin spectra. Multivariate analysis indicated that, although NIR did not discriminate between collagen samples exposed to different glucose concentrations, fluorescence changes were readily detected and correlated strongly with skin concentration of AGEs. These results suggest that measurement of skin AGEs by fluorescence spectroscopy may be useful for detection and diagnosis of type II diabetes. PMID:19484001

Hull, E; Ediger, M; Unione, A; Deemer, E; Stroman, M; Baynes, J

2004-09-20

187

Different angiotensin receptor blockers and incidence of diabetes: a nationwide population-based cohort study  

PubMed Central

Background Angiotensin receptor blockers (ARBs) have been shown to exert various peroxisome proliferator-activated receptor gamma (PPAR?) binding activities and insulin-sensitizing effects. The objective of this study was to investigate the association of different ARBs with new-onset diabetes mellitus. Methods In the respective cohort, a total of 492,530 subjects who initiated ARB treatment between January 2004 and December 2009 were identified from Taiwan National Health Insurance Database. The primary outcome was newly diagnosed diabetes, defined as at least one hospital admission or two or more outpatient visits within a year with an ICD-9-CM code 250. Cox proportional regression was used to estimate the risk of diabetes associated with each ARB, using losartan as the reference. Results A total of 65,358 incident diabetes cases were identified out of 1,771,173 person-years. Olmesartan initiators had a small but significantly increased risk of developing diabetes after adjusting for baseline characteristics and mean daily dose (hazard ratio [HR], 1.07; 95% confidence interval [CI], 1.03-1.12). After excluding those followed for less than one year, the increase in diabetes risk are more pronounced (HR, 1.09; 95% CI, 1.05-1.14). This association was consistent across all subgroup analyses. Similar results were observed when a more strict definition of diabetes combining both diabetes diagnosis and anti-diabetic treatment was used. On the other hand, there was no difference in diabetes risk between telmisartan and losartan. Conclusions Among all ARBs, olmesartan might be associated with a slightly increased risk of diabetes mellitus. Our data suggest differential diabetes risks associated with ARBs beyond a class effect.

2014-01-01

188

Diabetes care in Norwegian pharmacies: a descriptive study  

Microsoft Academic Search

Objective To describe Norwegian pharmacies’ involvement in diabetes care, to investigate pharmacists’ views on future services and\\u000a to investigate whether the recommendations in the Norwegian diabetes declaration for pharmacies have been implemented. Setting Hospital and community pharmacies in Norway. Method All 543 pharmacies in Norway, of which 511 were community pharmacies and 32 were hospital pharmacies, received a link to

Reidun L. S. Kjome; Sverre Sandberg; Anne Gerd Granås

2008-01-01

189

Mechanistic studies of lifestyle interventions in type 2 diabetes  

PubMed Central

AIM: To investigate the effect of lifestyle interventions in the non-pharmacological management of type 2 diabetes via a mechanistic approach. METHODS: A randomized controlled trial was carried out on 60 type 2 diabetic male and female volunteers that fulfilled the inclusion criteria, with their proper consent and permission of the International Electrotechnical Commission for 1 year. 30 patients were included in the test group and 30 patients in the control group. Demographic details, anthropometrical status, physical activity, food habits and blood glucose lipid profile of the volunteers were recorded at baseline, the test group was directed for lifestyle intervention and final blood glucose lipid data were collected at the end of one year of patient follow-up. RESULTS: After 1 year, the test group who had a lifestyle intervention was found to show a significant improvement in blood glucose lipid profile. The fasting plasma glucose level (FPG), postprandial plasma glucose level (PPG), glycosylated hemoglobin (HbA1c) and body mass index (BMI) values of the test group were reduced significantly, up to 145 ± 2.52, 174 ± 2.59, 6.3 ± 0.32 and 25 ± 0.41 respectively at the end of the study period, in comparison to the control group where FPG, PPG, HbA1c and BMI values were 193 ± 3.36, 249 ± 4.24, 7.2 ± 0.42 and 26 ± 0.65 respectively. Improvement in the total cholesterol (TC), triglyceride (TG), high-density lipoproteins (HDL) and low-density lipoproteins (LDL) values of the test group was also remarkable in comparison to the control group. The TC, TG, HDL and LDL values of the test group were reduced significantly, up to 149 ± 3.32, 124 ± 2.16, 58 ± 0.62 and 118 ± 2.31, respectively. CONCLUSION: The significant improvement in the blood glucose lipid profile of the test group after 1 year signifies the value of non-pharmacological management of type 2 diabetes via lifestyle intervention strategies.

Mitra, Analava; Dewanjee, Debasis; Dey, Baishakhi

2012-01-01

190

Retinal microvascular calibre and risk of incident diabetes: The multi-ethnic study of atherosclerosis  

PubMed Central

Aim To prospectively examine the association of retinal microvascular signs with incident diabetes and impaired fasting glucose (IFG) in a multi-ethnic population-based cohort. Methods The multi-ethnic study of atherosclerosis comprised Caucasians, African-Americans, Hispanics and Chinese aged 45–84 years. Retinal vascular calibre and retinopathy were quantified from baseline retinal photographs. Incident diabetes and IFG were ascertained prospectively. Results After a median follow-up of 3 years, 243 (4.9%) people developed diabetes and 565 (15.0%) developed IFG. After adjusting for known risk factors, participants with wider retinal arteriolar calibre had a higher risk of developing diabetes [HR: 1.60; 95% CI: 1.12–2.29, p = 0.011 comparing highest with lowest arteriolar calibre tertile]. In ethnic subgroup analysis, the association between wider retinal arteriolar calibre and incident diabetes was stronger and statistically significant only in Caucasians [HR: 2.78; 95% CI: 1.37–5.62, p = 0.005]. Retinal venular calibre and retinopathy signs were not related to risk of diabetes or IFG. Conclusion Wider retinal arteriolar calibre is independently associated with an increased risk of diabetes, supporting a possible role for early arteriolar changes in diabetes development. This effect was largely seen in Caucasians, and not in other ethnic groups, and may reflect ethnic differences in susceptibility to diabetes from microvascular pathways.

Yau, Joanne Wen Yee; Xie, Jing; Lamoureux, Ecosse; Klein, Ronald; Klein, Barbara E.K.; Cotch, Mary Frances; Bertoni, Alain G.; Shea, Steven; Wong, Tien Y.

2012-01-01

191

Type 2 Diabetes : An Independent Risk Factor for Tuberculosis: A Nationwide Population-Based Study  

PubMed Central

Objective Tuberculosis continues to be a major global health problem. We wanted to investigate whether Type 2 diabetes was a risk factor for tuberculosis in an Asian population. Methods From Taiwan’s National Health Insurance Research Database, we collected data from 31,237 female patients with type 2 diabetes and 92,642 female controls and 32,493 male patients with type 2 diabetes and 96,977 male controls. Cox proportional hazard regression was performed to evaluate independent risk factors for tuberculosis in all patients and to identify risk factors in patients with type 2 diabetes. Results During the study period, both female (standardized incidence ratio (SIR): 1.40, p<0.01) and male (SIR: 1.48, p<0.01) patients with type 2 diabetes were found to have a significantly higher rate of incident tuberculosis than the control group. Type 2 diabetes (HR:1.31, 1.23–1.39, p<0.001) was significantly associated with tuberculosis after adjusting sex, age, bronchiectasis, asthma and chronic obstructive lung disease. Conclusions Patients with type 2 diabetes have a higher risk of tuberculosis compared to control subjects after adjusting for confounding factors. The current diabetes epidemic may lead to a resurgence of tuberculosis in endemic regions. Therefore, preventive measures, including addressing the possibility that type 2 diabetes increase the individual’s susceptibility for incident TB, should be taken to further reduce the incidence of tuberculosis.

Kuo, Ming-Chun; Lin, Sheng-Hao; Lin, Ching-Hsiung; Mao, I-Chieh; Chang, Shun-Jen; Hsieh, Ming-Chia

2013-01-01

192

A model to estimate the lifetime health outcomes of patients with Type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS no. 68)  

Microsoft Academic Search

Aims\\/hypothesis  The aim of this study was to develop a simulation model for Type 2 diabetes that can be used to estimate the likely occurrence of major diabetes-related complications over a lifetime, in order to calculate health economic outcomes such as quality-adjusted life expectancy.Methods  Equations for forecasting the occurrence of seven diabetes-related complications and death were estimated using data on 3642 patients

P. M. Clarke; A. M. Gray; A. Briggs; A. J. Farmer; P. Fenn; R. J. Stevens; D. R. Matthews; I. M. Stratton; R. R. Holman

2004-01-01

193

Skin, a mirror reflecting diabetes mellitus: A longitudinal study in a tertiary care hospital in Gujarat  

PubMed Central

Context: Diabetes mellitus (DM) is the most common of the endocrine disorders. Mucocutaneous manifestations of diabetes mellitus are many and vary from trivial to life-threatening. Sometimes, mucocutaneous disorders may herald the onset of diabetes. Aims: To study the pattern of mucocutaneous manifestations in diabetics and role of it in diagnosing diabetes mellitus and its complications. Settings and Design: It was a longitudinal observational study of patients having diabetes with skin complaints attending skin outdoor department or admitted in wards for any reason in a tertiary care hospital. Materials and Methods: Total 300 patients were included in the study. Detailed history, clinical examination, and relevant investigations were done to diagnose the mucocutaneous disorders, diabetes, and diabetic complications. Statistical Analysis Used: The data was analyzed by using Epi info software. Results: Demographic profile shown majority of cases (78.66%) in more than 40 years of age with almost equal male and female preponderance. Mucocutaneous manifestations as presenting feature of diabetes were observed in 21.67% cases. Infections were most common in 119 (39.66%) cases, followed by acanthosis nigricans in 46 (15.33%) cases. Various associated complications like hypertension, retinopathy, hyperlipidemia, coronary artery disease, neuropathy, nephropathy, and diabetic ketoacidosis were observed in 160 (53.3%). Conclusions: Skin is the mirror, which reflects internal diseases; this aptly applies to skin and diabetes mellitus. Through awareness about cutaneous manifestations of DM, dermatologist can not only take credit for detecting DM but also facilitate early diagnosis of systemic complications of DM. This is immensely beneficial to patients in long run.

Vahora, Roshni; Thakkar, Sejal; Marfatia, Yogesh

2013-01-01

194

Microalbuminuria prevalence study in hypertensive patients with type 2 diabetes mellitus in Singapore  

Microsoft Academic Search

Introduction: Microalbuminuria is a marker of increased cardiovascular morbidity and mortality. It represents the earliest clinical evidence of diabetic nephropathy. Its early detection allows for implementation of individually-tailored cardiovascular risk reduction management programmes. Despite this, information on the prevalence of microalbuminuria in hypertensive patients with type 2 diabetes mellitus in Singapore is limited. Methods: The Microalbuminuria Prevalence Study (MAPS) assessed

Tan E K Wu Nephrology; Mount Elizabeth

195

Kidney Outcomes in Long-Term Studies of Ruboxistaurin for Diabetic Eye Disease  

Microsoft Academic Search

Background: A pilot study showed that ruboxistaurin (RBX), a protein kinase C inhibitor, significantly decreased albuminuria and stabilized kidney function over 1 yr in patients who had diabetic nephropathy and persistent macroalbu- minuria despite receiving the current standard of care, including renin-angiotensin system inhibition. In contrast, in a trial of patients with diabetic retinopathy, investigators reported the adverse event \\

Katherine R. Tuttle; Janet B. McGill; Douglas J. Haney; Toni E. Lin; Pamela W. Anderson

2007-01-01

196

Non-invasive study for peripheral circulation in patients with diabetes mellitus  

Microsoft Academic Search

The purpose of this study is to establish a new, non - invasive diagnostic technique for peripheral circulation in patients with diabetes mellitus in the early stage of arteriosclerosis obliterans (ASO) as one of the complications of diabetes mellitus. We observed peripheral circulation quantitatively by thermography and Laser- Doppler blood flowmetry. The body surface peripheral circulation in 27 patients with

Yasuhiro Hosaki; Fumihiro Mitsunobu; Kouzou Ashida; Hirofumi Tsugeno; Makoto Okamoto; Norikazu Nishida; Shingo Takata; Tadashi Yokoi; Yoshiro Tanizaki

197

A Survey Study on Diabetes Management and Complication Status in Primary Care Setting in Thailand  

Microsoft Academic Search

Objective: Healthcare service in Thailand is stratified into three levels with different facilities of care. This cross-sectional survey study described diabetes management, diabetes control, and late complication status among patients managed in urban primary health care clinics. Material and method: Thirty-seven primary health care units were randomly selected. Each unit enrolled up to 30 patients having been managed in the

Wannee Nitiyanant

198

Hypertension prevalence and control in type 2 diabetes: a primary care-based study  

Microsoft Academic Search

The purpose of the study was to determine hypertension prevalence and control within type 2 diabetics attending primary care settings.We performed a cross-sectional observation of patients with type 2 diabetes being the first 20 unselected cases seen by 178 family physicians from 16 of the 17 departments of Spain. Following variables were determined: BP level, BMI, serum creatinine, glucose, total

Rafael Marin; Manuel Gorostidi; Salvador Tranche; Leocadio Rodriguez-Mañas; Jose Abellan

2002-01-01

199

Aerobic exercise in obese diabetic patients with chronic kidney disease: a randomized and controlled pilot study  

Microsoft Academic Search

BACKGROUND: Patients with obesity, diabetes, and chronic kidney disease (CKD) are generally physically inactive, have a high mortality rate, and may benefit from an exercise program. METHODS: We performed a 24-week randomized controlled feasibility study comparing aerobic exercise plus optimal medical management to medical management alone in patients with type 2 diabetes, obesity (body mass index [BMI] > 30 kg\\/m2),

David J Leehey; Irfan Moinuddin; Joseph P Bast; Shahzad Qureshi; Christine S Jelinek; Cheryl Cooper; Lonnie C Edwards; Bridget M Smith; Eileen G Collins

2009-01-01

200

Retinal Thickness Study with Optical Coherence Tomography in Patients with Diabetes  

Microsoft Academic Search

PURPOSE. To quantitatively assess retinal thickness by optical coherence tomography (OCT) in normal subjects and patients with diabetes. This study was intended to determine which retinal thickness value measured with OCT best discriminates between diabetic eyes, with and without macular edema. METHODS. OCT retinal thickness was measured by a manual technique in a total of 26 healthy volunteers (44 control

Hortensia Sanchez-Tocino; Aurora Alvarez-Vidal; Miguel J. Maldonado; Javier Moreno-Montanes; Alfredo Garcõ ´ a-Layana

2002-01-01

201

Podiatric care for diabetic patients with foot problems: an observational study  

Microsoft Academic Search

The aims of this study were to describe podiatric care for diabetic patients with foot problems and to explore the changes in knowledge, self-care behaviour and physical functioning after podiatric care. the treatment characteristics of 26 diabetic patients referred to podiatry were assessed. Prior to the first podiatric visit (T1) and 20 weeks later (T2) these patients filled in a

P. M. Rijken; J. Dekker; G. J. Lankhorst; E. Dekker; K. Bakker; J. Dooren; J. A. Rauwerda

1999-01-01

202

Mortality of Type 1 (insulin-dependent) diabetes mellitus in Denmark: A study of relative mortality in 2930 Danish type 1 diabetic patients diagnosed from 1933 to 1972  

Microsoft Academic Search

Summary  This study included 2930 (1642 male, 1288 female) Type 1 (insulin-dependent) diabetic patients diagnosed before the age of 31 years and between 1933 to 1972. The patients were followed from first admission to Steno Memorial Hospital until death, emigration, or until 1 January 1983. Relative mortality was studied, and the influence of calendar year of diagnosis, diabetes duration, age at

K. Borch-Johnsen; S. Kreiner; T. Deckert

1986-01-01

203

Genetic susceptibility to type 2 diabetes and obesity: from genome-wide association studies to rare variants and beyond.  

PubMed

During the past 7 years, genome-wide association studies have shed light on the contribution of common genomic variants to the genetic architecture of type 2 diabetes, obesity and related intermediate phenotypes. The discoveries have firmly established more than 175 genomic loci associated with these phenotypes. Despite the tight correlation between type 2 diabetes and obesity, these conditions do not appear to share a common genetic background, since they have few genetic risk loci in common. The recent genetic discoveries do however highlight specific details of the interplay between the pathogenesis of type 2 diabetes, insulin resistance and obesity. The focus is currently shifting towards investigations of data from targeted array-based genotyping and exome and genome sequencing to study the individual and combined effect of low-frequency and rare variants in metabolic disease. Here we review recent progress as regards the concepts, methodologies and derived outcomes of studies of the genetics of type 2 diabetes and obesity, and discuss avenues to be investigated in the future within this research field. PMID:24859358

Grarup, Niels; Sandholt, Camilla H; Hansen, Torben; Pedersen, Oluf

2014-08-01

204

Quality of life in people with diabetes: a systematic review of studies in Iran  

PubMed Central

Evaluation of health-related quality of life (HRQoL) among people with diabetes has been growing in Iran over the last decade. The main aim of the current study was to systematically review the characteristics of these studies and examine quality of their findings. Persian (SID, Magiran) and English (Pubmed, Medline, Web of Science, CINAHL, Scopus, PsycINFO and ERIC) databases were systematically searched using the search terms: “diabetes” AND “quality of life” AND “Iran”. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A total of 46 studies passed the inclusion criteria and were included in the review. The included studies were conducted in 20 out of 30 provinces of the country. Most studies investigated HRQoL among people with type 2 diabetes. The Short Form Health Survey (SF-36) and WHO quality of life instruments (WHOQOL) were the main instruments used in these studies. Studies showed that people with diabetes had lower HRQoL than people without diabetes. Better socioeconomic status and better control of cardiovascular risk factors were associated with better HRQoL among the patients with diabetes. In general, the predictors of HRQoL among Iranian patients were similar to their international counterparts implying that diabetes patients share many common features. The reviewed studies suffer from major methodological and reporting flaws which limit validity and generalizability of their findings.

2013-01-01

205

A metabolomic study on the effect of intravascular laser blood irradiation on type 2 diabetic patients.  

PubMed

Intravenous laser blood irradiation (ILBI) is widely applied in the treatment of different pathologies including diabetes mellitus. The aim of this study is to evaluate the effects of ILBI on the metabolites of blood in diabetic type 2 patients using metabolomics. We compared blood samples of nine diabetic type 2 patients, using metabolomics, before and after ILBI with blue light laser. The results showed significant decrease in glucose, glucose 6 phosphate, dehydroascorbic acid, R-3-hydroxybutyric acid, L-histidine, and L-alanine and significant increase in L-arginine level in blood and blood sugar in the patients have reduced significantly (p?study clearly demonstrated a significant positive effect of ILBI on metabolites of blood in diabetic type 2 patients. These findings support the therapeutic potential of ILBI in diabetic patients. PMID:23358875

Kazemi Khoo, N; Iravani, A; Arjmand, M; Vahabi, F; Lajevardi, M; Akrami, S M; Zamani, Z

2013-11-01

206

DreamTel; Diabetes risk evaluation and management tele-monitoring study protocol  

PubMed Central

Background The rising prevalence of type 2 diabetes underlines the importance of secondary strategies for the prevention of target organ damage. While access to diabetes education centers and diabetes intensification management has been shown to improve blood glucose control, these services are not available to all that require them, particularly in rural and northern areas. The provision of these services through the Home Care team is an advance that can overcome these barriers. Transfer of blood glucose data electronically from the home to the health care provider may improve diabetes management. Methods and design The study population will consist of patients with type 2 diabetes with uncontrolled A1c levels living on reserve in the Battlefords region of Saskatchewan, Canada. This pilot study will take place over three phases. In the first phase over three months the impact of the introduction of the Bluetooth enabled glucose monitor will be assessed. In the second phase over three months, the development of guidelines based treatment algorithms for diabetes intensification will be completed. In the third phase lasting 18 months, study subjects will have diabetes intensification according to the algorithms developed. Discussion The first phase will determine if the use of the Bluetooth enabled blood glucose devices which can transmit results electronically will lead to changes in A1c levels. It will also determine the feasibility of recruiting subjects to use this technology. The rest of the Diabetes Risk Evaluation and Management Tele-monitoring (DreamTel) study will determine if the delivery of a diabetes intensification management program by the Home Care team supported by the Bluetooth enabled glucose meters leads to improvements in diabetes management. Trial Registration Protocol NCT00325624

Tobe, Sheldon W; Wentworth, Joan; Ironstand, Laurie; Hartman, Susan; Hoppe, Jackie; Whiting, Judi; Kennedy, Janice; McAllister, Colin; Kiss, Alex; Perkins, Nancy; Vincent, Lloyd; Pylypchuk, George; Lewanczuk, Richard Z

2009-01-01

207

The Relationship between Hypomagnesemia, Metformin Therapy and Cardiovascular Disease Complicating Type 2 Diabetes: The Fremantle Diabetes Study  

PubMed Central

Background Low serum magnesium concentrations have been associated with cardiovascular disease risk and outcomes in some general population studies but there are no equivalent studies in diabetes. Metformin may have cardiovascular benefits beyond blood glucose lowering in type 2 diabetes but its association with hypomagnesemia appears paradoxical. The aim of this study was to examine relationships between metformin therapy, magnesium homoeostasis and cardiovascular disease in well-characterized type 2 patients from the community. Methods and Findings We studied 940 non-insulin-treated patients (mean±SD age 63.4±11.6 years, 49.0% males) from the longitudinal observational Fremantle Diabetes Study Phase I (FDS1) who were followed for 12.3±5.3 years. Baseline serum magnesium was measured using stored sera. Multivariate methods were used to determine associates of prevalent and incident coronary heart disease (CHD) and cerebrovascular disease (CVD) as ascertained from self-report and linked morbidity/mortality databases. 19% of patients were hypomagnesemic (serum magnesium <0.70 mmol/L). Patients on metformin, alone or combined with a sulfonylurea, had lower serum magnesium concentrations than those on diet alone (P<0.05). There were no independent associations between serum magnesium or metformin therapy and either CHD or CVD at baseline. Incident CVD, but not CHD, was independently and inversely associated with serum magnesium (hazard ratio (95% CI) 0.28 (0.11–0.74); P?=?0.010), but metformin therapy was not a significant variable in these models. Conclusions Since hypomagnesemia appears to be an independent risk factor for CVD complicating type 2 diabetes, the value of replacement therapy should be investigated further, especially in patients at high CVD risk.

Peters, Kirsten E.; Chubb, S. A. Paul; Davis, Wendy A.; Davis, Timothy M. E.

2013-01-01

208

The Relation of Markers of Inflammation and Endothelial Dysfunction to the Prevalence and Progression of Diabetic Retinopathy. Wisconsin Epidemiologic Study of Diabetic Retinopathy  

PubMed Central

Context Levels of glycemia, blood pressure, and serum total cholesterol are associated with prevalence and incidence of diabetic retinopathy. It has been reported the markers of systemic inflammation and endothelial dysfunction may be important additional risk factors. Objective To determine the association of several systemic markers of inflammation and endothelial dysfunction to prevalence and incidence of diabetic retinal outcomes in persons with long duration type 1 diabetes. Design Longitudinal population based study of persons with type 1 diabetes who were receiving care for their diabetes in south central Wisconsin in 1978-1979. Data for this investigation were from 1990-1992 through 2005-2007. Main Outcome Measures Severity of diabetic retinopathy and macular edema. Results In prevalence data from 1990-1992, soluble vascular cell adhesion molecule (sVCAM-1), tumor necrosis factor alpha (TNF-?) and homocysteine (Hcy) were associated with increased odds of more severe retinopathy (Odds ratios [highest versus lowest quartile] 2.43, 95% Confidence Interval 1.56, 3.78; 3.14 [1.98, 4.99]; 3.79 [2.33, 6.15], respectively) in those with kidney disease while controlling for relevant confounders. Similar odds were found for proliferative diabetic retinopathy. Only homocysteine was associated with increased odds of macular edema (4.68; 1.25-17.57) irrespective of kidney disease. None of the markers were associated with incidence of proliferative retinopathy, macular edema, or progression of retinopathy 15 years later. Conclusions A limited number of markers was associated with increased odds of prevalent retinal outcomes in persons with type 1 diabetes and kidney disease. Only Hcy was associated with macular edema in those with and without kidney disease. In the absence of kidney disease the markers do not add to the more conventional descriptors and predictors of diabetic retinopathy in persons with type 1 diabetes. This may reflect the close association of diabetic retinopathy and diabetic kidney disease.

Klein, Barbara E.K.; Knudtson, Michael D.; Tsai, Michael Y.; Klein, Ronald

2009-01-01

209

How adolescents with diabetes experience social support from friends: two qualitative studies.  

PubMed

Self-management of diabetes is challenging, especially for adolescents who face multiple changes, including closer peer relationships. Few studies have explored how friends can provide constructive support in this effort. The present research investigated, in two qualitative studies, the perceptions of adolescents with diabetes and their friends with respect to the positive social support that friends can offer. In study 1, 28 adolescents aged 12-15 with type 1 diabetes participated in online focus groups. In study 2, 11 of these adolescents were interviewed in person together with their best friends. The data were analysed by means of content analysis. In study 1, the adolescents with diabetes identified various supportive behaviours of friends, particularly concerning emotional support: treating them normally, showing interest, having fun, providing a distraction, and taking their diabetes into account. They differed in their attitude towards support, and this influenced which behaviours they perceived as supportive. Study 2 showed that the adolescents with diabetes and their friends often had similar opinions on the desired degree of support. Fear of stigmatization and sense of autonomy withheld some adolescents with diabetes from soliciting more support. These insights can be useful in patient education aiming to promote social support. PMID:24511414

Peters, Louk W H; Nawijn, Laura; van Kesteren, Nicole M C

2014-01-01

210

How Adolescents with Diabetes Experience Social Support from Friends: Two Qualitative Studies  

PubMed Central

Self-management of diabetes is challenging, especially for adolescents who face multiple changes, including closer peer relationships. Few studies have explored how friends can provide constructive support in this effort. The present research investigated, in two qualitative studies, the perceptions of adolescents with diabetes and their friends with respect to the positive social support that friends can offer. In study 1, 28 adolescents aged 12–15 with type 1 diabetes participated in online focus groups. In study 2, 11 of these adolescents were interviewed in person together with their best friends. The data were analysed by means of content analysis. In study 1, the adolescents with diabetes identified various supportive behaviours of friends, particularly concerning emotional support: treating them normally, showing interest, having fun, providing a distraction, and taking their diabetes into account. They differed in their attitude towards support, and this influenced which behaviours they perceived as supportive. Study 2 showed that the adolescents with diabetes and their friends often had similar opinions on the desired degree of support. Fear of stigmatization and sense of autonomy withheld some adolescents with diabetes from soliciting more support. These insights can be useful in patient education aiming to promote social support.

Peters, Louk W. H.; Nawijn, Laura; van Kesteren, Nicole M. C.

2014-01-01

211

Gut Microbes Differ in Obese or Diabetic People, Study Finds  

MedlinePLUS

... lower levels of the most common types of gut bacteria than those in the control group, the investigators ... have found a link between certain species of gut bacteria and obesity and diabetes, Basaran noted. He believes ...

212

[Polish Multicenter Study on Diabetes Epidemiology (PMSDE)--1998-2000].  

PubMed

Diabetes mellitus is a growing health problem at all ages in all countries. The Saint Vincent Declaration signed by the representatives of all European countries--among them by Poland--indicated the main goals to reduce this burden. This may be achieved by elaboration and initiation of the nation-wide programme for early detection and control of diabetes on the population level. The Polish Task Force for Diabetes Management worked out and put into operation in 1998 the project commissioned by the Ministry of Health funded by the Polish State Committee for Research (PBZ-018-11). The urgent need for the implementation of this programme was a result of the increasing number of diabetic patients on the primary health care level, diabetic complications and hospitalisations. The programme was based on the assumption that primary and secondary prevention of NIDDM may eliminate or reduce its risk factors and therefore decrease its prevalence and morbidity and should integrate epidemiology, identification of risk factors, education, intervention models and economics of diabetes. This issue of the Polish Archives of Internal Medicine contains the main results of the programme and reflects an actual situation of diabetes in Poland creating a rational basis for intervention on the population level. Evaluation of the incidence rate of the diabetes type 1 in 10 selected areas (population basis 30% of age group 0-29) revealed values from 8.4 to 14.7/100,000 in the age group 1-14 and from 4.4 to 11.2/100,000 in the age group 15-29. It accounts for the 2-3 fold increase in comparison with the results achieved in 1986 (Z. Szybinski). However an ascertainment of the register in the age group 15-29 dropped down during the last 10 years and additional sources of data must be involved in the survey. Prevalence of diabetes type 2 in 3 selected areas Krakow 10.77% (M. Szurkowska), Lublin 15.6% (J. ?opatynski) and ?ód? 15.7% (J. Drzewoski) based on the population random sample over 35 years of age, constitutes over 90% of all patients with diabetes. When standardized to the Polish population the prevalence of diabetes type 2 accounts for 5.37% and reflects a true endemic state. With comparison to a similar survey carried out in 1986 in Wroc?aw the prevalence 3.71% of the diabetes type 2 increased 2-3 times. It allowed to calculate an actual number of patients with diabetes type 2--over 2 million and around 50% of them represents "unknown" diabetes. Such high contribution of the unknown non-diagnosed diabetes has been confirmed in the survey carried out in Pozna? on the non-randomized professional group of persons (B. Wierusz-Wysocka) in investigation on the first-degree relatives of patients with known diabetes in Warsaw (T. Kasperska-Czyzyk) and in Wroclaw (R. Wasikowa). This raises the question about the criteria of diagnosis for unknown diabetes. Comparative analysis carried out in Krakow revealed that fasting glycemia 7.0 mmol/L allowed to diagnose diabetes with 50% with respect to the 2 hours oral glucose tolerance test (WHO 1985) and shouldn't be use as a tool for early diagnosis of diabetes type 2 (Z. Szybinski, M. Szurkowska) Identification of the risk factors in PMSDE for diabetes type 2 allowed to introduce the term "global risk factors", divided into two groups primary (obesity, age, pregnancy and genetic background) and secondary (hyperinsulinemia, hyperglycemia, dyslipidemia and hypertension). In the multifactor analysis obesity and hyperinsulinemia are the strongest predictors and modifiable risk factors of the development of diabetes type 2 and late complications. Especially hyperinsulinemia as an independent secondary risk factor for hypertension, dyslipidemia--in consequences late diabetic complications and perhaps carcinogenesis may play an important role as a predictor of diabetes type 2 and biochemical marker of effectiveness of non-pharmacological and pharmacological approach in the global concept of diabetes type 2 treatment (Z. Szybinski). Analysis of the late complications of diabetes were focuss

Szybi?ski, Z

2001-09-01

213

Serum Adiponectin and Type 2 Diabetes: A 6-Year Follow-Up Cohort Study  

PubMed Central

Background Studies on factors which may predict the risk of diabetes are scarce. This prospective cohort study was conducted to determine the association between adiponectin and type 2 diabetes among Korean men and women. Methods A total of 42,845 participants who visited one of seven health examination centers located in Seoul and Gyeonggi province, Republic of Korea between 2004 and 2008 were included in this study. The incidence rates of diabetes were determined through December 2011. To evaluate the effects of adiponectin on type 2 diabetes, the Cox proportional hazard model was used. Results Of the 40,005 participants, 959 developed type 2 diabetes during a 6-year follow-up. After the adjustment for age, body mass index (BMI), and waist circumference, the risks for type 2 diabetes in participants with normoglycemia had a 1.70-fold (95% confidence interval [CI], 1.21 to 2.38) increase in men and a 1.83-fold (95% CI, 1.17 to 2.86) increase in women with the lowest tertile of adiponectin when compared to the highest tertile of adiponectin. For participants with impaired fasting glucose (IFG), the risk for type 2 diabetes had a 1.46-fold (95% CI, 1.17 to 1.83) increase in men and a 2.52-fold (95% CI, 1.57 to 4.06) increase in women with the lowest tertile of adiponectin. Except for female participants with normoglycemia, all the risks remained significant after the adjustment for fasting glucose and other confounding variables. Surprisingly, BMI and waist circumference were not predictors of type 2 diabetes in men or women with IFG after adjustment for fasting glucose and other confounders. Conclusion A strong association between adiponectin and diabetes was observed. The use of adiponectin as a predictor of type 2 diabetes is considered to be useful.

Ahn, Chul Woo; Park, Jong Suk; Park, Chang Gyu; Kim, Hyon-Suk; Lee, Sang-Hak; Park, Sungha; Lee, Myoungsook; Lee, Chang Beom; Park, Hye Soon; Kimm, Heejin; Choi, Sung Hee; Sung, Jidong; Oh, Seungjoon; Joung, Hyojee; Kim, Sung Rae; Youn, Ho-Joong; Kim, Sun Mi; Lee, Hong Soo; Mok, Yejin; Choi, Eunmi; Yun, Young Duk; Baek, Soo-Jin; Jo, Jaeseong; Huh, Kap Bum

2013-01-01

214

Did the diabetes check improve drug adherence of Dutch patients with diabetes?: an intervention study  

Microsoft Academic Search

Background: Poor adherence to treatment of chronic diseases is a worldwide problem. Medicines are often part of therapy and appropriate drug use is important in optimizing health care outcomes. Pharmacies can improve drug adherence by providing information and assistance to their patients.\\u000aSeveral interventions have taken place in Dutch pharmacies to enhance pharmaceutical care. We\\u000ainvestigated whether the Diabetes Check

M. Hendriks; M. Vervloet; L. van Dijk

2005-01-01

215

Australian diabetes screening study: Impaired glucose tolerance and non—insulin-dependent diabetes mellitus  

Microsoft Academic Search

In preventing non—insulin-dependent diabetes mellitus (NIDDM) and its complications, screening high-risk individuals complements public health measures. Our screening instrument for patients of general practitioners was a questionnaire for self-determined high-risk groups plus a laboratory measurement of a random venous plasma glucose level. Collaborating practitioners evaluated 100 consecutive outpatients aged 40 years or older. The questionnaire identified patients with two or

Timothy A. Welborn; Christopher M. Reid; Gerarda Marriott

1997-01-01

216

Prevalence of Type 2 Diabetes Mellitus in Hepatitis C Virus Infected Population: A Southeast Asian Study  

PubMed Central

Purpose. The study was aimed to investigate the frequency of diabetes mellitus type 2 in patients infected with chronic hepatitis C virus and its association with cirrhosis. Patients and Methods. This prospective case series was conducted at Section of Gastroenterology and Hepatology, Isra University Hospital, Hyderabad, over a period of 4 months from June 2009 to October 2009. Hepatitis C virus seropositive patients who were older than 18 years, diabetic or nondiabetic, were included. Basic demographic data collected by questionnaire and laboratory investigations including fasting blood glucose levels, serum cholesterol, and liver function tests were done. A logistic regression model was used to explore the association between diabetic and nondiabetic HCV seropositives and type 2 diabetes mellitus with cirrhosis. Results. A total of 361 patients with hepatitis C were analyzed; the prevalence of type 2 diabetes mellitus in HCV patients was 31.5%. Out of the total number of the participants, 58.4% (n = 211) were cirrhotics, while 41.6% (n = 150) were noncirrhotic HCV seropositives. In multivariate analysis, cirrhotic patients appeared significantly more likely (P = 0.01) to be diabetic as compared with noncirrhotic patients (OR = 2.005, 95% CI: 1.15, 3.43). Conclusion. Advancing age, increased weight, and HCV genotype 3 are independent predictors of type 2 diabetes in HCV seropositive patients, and there is a statistically significant association of cirrhosis observed with type 2 diabetes mellitus.

Arain, Zain Islam; Naz, Farukh; Zaki, Madiha; Kumar, Suresh; Burney, Asif Ali

2013-01-01

217

Cohort study of diabetes in HIV-infected adult patients: evaluating the effect of diabetes mellitus on immune reconstitution.  

PubMed

We conducted a retrospective cohort study assessing the association between diabetes mellitus (DM) and immune recovery in HIV-infected adults. Immune reconstitution after initiating antiretroviral therapy was more rapid in DM patients (120.4 cells/year) compared to non-DM patients (94.2 cells/year, p<0.023). Metformin use was associated with improved CD4 recovery (p=0.034). PMID:24485344

Moyo, D; Tanthuma, G; Cary, M S; Mushisha, O; Kwadiba, G; Chikuse, F; Steenhoff, A P; Reid, M J A

2014-03-01

218

Persistence with statin therapy in diabetic and non-diabetic persons: a nation-wide register study in 1995-2005 in Finland.  

PubMed

Persistence with statin therapy was studied among 562 598 new statin users in 1995-2005 in Finland. Discontinuation was most likely during the first year. Persons with diabetes (15.0% of initiators) were significantly more likely to continue statin therapy compared with person not having diabetes. PMID:19167127

Helin-Salmivaara, Arja; Lavikainen, Piia; Ruokoniemi, Päivi; Korhonen, Maarit; Huupponen, Risto

2009-04-01

219

The Role of Insulin Resistance in Diabetic Neuropathy in Koreans with Type 2 Diabetes Mellitus: A 6-Year Follow-Up Study  

PubMed Central

Purpose We previously reported that insulin resistance, low high-density lipoprotein (HDL) cholesterol, and glycaemic exposure Index are independently associated with peripheral neuropathy in Korean patients with type 2 diabetes mellitus. We followed the patients who participated in that study in 2006 for another 6 years to determine the relationship between insulin resistance and neuropathy. Materials and Methods This study involved 48 of the original 86 Korean patients with type 2 diabetes mellitus who were referred to the Neurology clinic for the assessment of diabetic neuropathy from January 2006 to December 2006. These 48 patients received management for glycaemic control and prevention of diabetic complications in the outpatient clinic up to 2012. We reviewed blood test results and the nerve conduction study findings of these patients, taken over a 6-year period. Results Low HDL cholesterol and high triglycerides significantly influenced the development of diabetic neuropathy. Kitt value (1/insulin resistance) in the previous study affected the occurrence of neuropathy, despite adequate glycaemic control with HbA1c <7%. Insulin resistance affected the development of diabetic neuropathy after 6 years: insulin resistance in 2006 showed a positive correlation with a change in sural sensory nerve action potential in 2012. Conclusion Diabetic neuropathy can be affected by previous insulin resistance despite regular glycaemic control. Dyslipidaemia should be controlled in patients who show high insulin resistance because HDL cholesterol and triglycerides are strongly correlated with later development of diabetic neuropathy.

Cho, Yu Na; Lee, Kee Ook; Jeong, Julie; Park, Hyung Jun; Kim, Seung-Min; Shin, Ha Young; Hong, Ji-Man; Ahn, Chul Woo

2014-01-01

220

Gender differences in the incidence and progression of diabetic retinopathy among Japanese patients with type 2 diabetes mellitus: a clinic-based retrospective longitudinal study.  

PubMed

A clinic-based retrospective longitudinal study conducted for 5.8 ± 2.5 years, including 383 (M/F 245/138) Japanese patients with type 2 diabetes mellitus showed that females exhibit a significantly higher prevalence of proliferative diabetic retinopathy (DR) at baseline and that female gender is an independent risk factor for the development of DR. PMID:24503044

Kajiwara, A; Miyagawa, H; Saruwatari, J; Kita, A; Sakata, M; Kawata, Y; Oniki, K; Yoshida, A; Jinnouchi, H; Nakagawa, K

2014-03-01

221

Effect of glucose and pH on uropathogenic and non-uropathogenic Escherichia coli: studies with urine from diabetic and non-diabetic individuals  

Microsoft Academic Search

It is generally assumed that one of the reasons why diabetics are more susceptible to urinary tract infections than non-diabetics is their 'sweet urine'. However, very little information is available on this subject. Therefore, the growth rates of different Escherichia coli strains were studied in human urine with and without added glucose and with and without a constant pH, and

S. E. GEERLINGS; E. C. BROUWER; W. GAASTRA; J. VERHOEF; A. I. M. HOEPELMAN

1999-01-01

222

Healer shopping in Africa: new evidence from rural-urban qualitative study of Ghanaian diabetes experiences  

PubMed Central

Objectives To provide counterevidence to existing literature on healer shopping in Africa through a systematic analysis of illness practices by Ghanaians with diabetes; to outline approaches towards improving patient centred health care and policy development regarding diabetes in Ghana. Design Longitudinal qualitative study with individual interviews, group interviews, and ethnographies. Settings Two urban towns (Accra, Tema) and two rural towns (Nkoranza and Kintampo) in Ghana. Participants 26 urban people and 41 rural people with diabetes with diverse profiles (sex, age, education, socioeconomic status, diabetes status). Results Six focus groups, 20 interviews, and three ethnographical studies were conducted to explore experiences and illness practices. Analysis identified four kinds of illness practice: biomedical management, spiritual action, cure seeking (passive and active), and medical inaction. Most participants privileged biomedicine over other health systems and emphasised biomedical management as ideal self care practice. However, the psychosocial impact of diabetes and the high cost of biomedical care drove cure seeking and medical inaction. Cure seeking constituted healer shopping between biomedicine, ethnomedicine, and faith healing; medical inaction constituted passive disengagement from medical management and active engagement with faith healing. Crucially, although spiritual causal theories of diabetes existed, they were secondary to dietary, lifestyle, and physiological theories and did not constitute the primary motivation for cure seeking. Cure seeking within unregulated ethnomedical systems and non-pharmacological faith healing systems exacerbated the complications of diabetes. Conclusions To minimise inappropriate healer shopping and maximise committed biomedical and regulated ethnomedical management for Ghanaians with diabetes, the greatest challenges lie in providing affordable pharmaceutical drugs, standardised ethnomedical drugs, recommended foods, and psychosocial support. For health systems, the greatest challenges lie in correcting structural deficiencies that impinge on biomedical practices, regulating ethnomedical diabetes treatment, and foregrounding faith healer practices within diabetes policy discussions.

de-Graft Aikins, Ama

2005-01-01

223

Comorbidity Study on Type 2 Diabetes Mellitus Using Data Mining  

PubMed Central

Background/Aims The aim of this study was to analyze comorbidity in patients with type 2 diabetes mellitus (T2DM) by using association rule mining (ARM). Methods We used data from patients who visited Keimyung University Dongsan Medical Center from 1996 to 2007. Of 411,414 total patients, T2DM was present in 20,314. The Dx Analyze Tool was developed for data cleansing and data mart construction, and to reveal associations of comorbidity. Results Eighteen associations reached threshold (support, ? 3%; confidence, ? 5%). The highest association was found between T2DM and essential hypertension (support, 17.43%; confidence, 34.86%). Six association rules were found among three comorbid diseases. Among them, essential hypertension was an important node between T2DM and stroke (support, 4.06%; confidence, 8.12%) as well as between T2DM and dyslipidemia (support, 3.44%; confidence, 6.88%). Conclusions Essential hypertension plays an important role in the association between T2DM and its comorbid diseases. The Dx Analyze Tool is practical for comorbidity studies that have an enormous clinical database.

Kim, Hye Soon; Shin, A Mi; Kim, Mi Kyung

2012-01-01

224

The Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) Study: Methodological Details  

PubMed Central

Background Currently available estimates of diabetes prevalence in India are based on published data derived from very few studies. The Indian Council of Medical Research–India Diabetes (ICMR–INDIAB) study is a community-based survey conceived with the aim of obtaining the prevalence rates of diabetes in India as a whole, covering all 28 states, the National Capital Territory of Delhi, and two of the union territories in the mainland of India, with a total sample size of 124,000 individuals. Methods A stratified multistage sampling design has been used. In all study subjects, a structured questionnaire was administered and anthropometric parameters and blood pressure were measured. Fasting capillary blood glucose was first determined using a glucose meter. An oral glucose load was then administered to all subjects except those with self-reported diabetes, and the 2 h post-load capillary blood glucose was estimated. In every fifth subject, a fasting venous sample was collected for measurement of lipids and creatinine, a resting 12-lead electrocardiogram was performed, and dietary assessment questionnaire was administered. In all diabetic subjects, an additional diabetes questionnaire was used and a fasting venous sample drawn for glycated hemoglobin. Results All biological samples collected were analyzed in a central laboratory. All data collected were stored electronically. Quality control was achieved through multiple tiers of checks. Conclusions The ICMR–INDIAB study is the first of its kind attempting to provide accurate and comprehensive state- and national-level data on diabetes prevalence in India.

Anjana, Ranjit Mohan; Pradeepa, Rajendra; Deepa, Mohan; Datta, Manjula; Sudha, Vasudevan; Unnikrishnan, Ranjit; Nath, Lalith M; Das, Ashok Kumar; Madhu, Sri Venkata; Rao, Paturi Vishnupriya; Shukla, Deepak Kumar; Kaur, Tanvir; Ali, Mohammed K; Mohan, Viswanathan

2011-01-01

225

Momordica charantia and type 2 diabetes: from in vitro to human studies.  

PubMed

Type 2 diabetes is a growing health problem worldwide that is particularly severe in India and China. In these areas, bitter gourd (Momordica charantia) is a popular vegetable which is traditionally known to have health beneficial effects not only, but mainly, on diabetes. Bitter gourd could be a cheap possibility to help the poor in these and other countries to control their blood glucose levels. This review describes anti-diabetic effects of bitter gourd reported in the literature and discusses what still needs to be clarified for developing an evidence-based and safe use of the bitter gourd for diabetes. Analyses of bioactive compounds have shown that bitter gourd is rich in nutrients and phytochemicals of which some have anti-diabetic effects. Juices, powders, extracts, and isolated compounds have been tested in vitro and in vivo. Bitter gourd increases insulin secretion of the pancreas, decreases intestinal glucose uptake, and increases uptake and utilization of glucose in peripheral tissues. Although human studies with type 2 diabetics are weak in their design and/or results, some of the studies do indicate anti-diabetic effects in patients and safety for bitter gourd treatment in humans. In the future, well designed studies with rodents will help to understand what kind of bitter gourd variety, dosage, preparation, and duration of administration is optimal. Such results will help to design human studies which are necessary to prove the effectiveness of bitter gourd in patients. PMID:24295371

Habicht, Sandra D; Ludwig, Christine; Yang, Ray-yu; Krawinkel, Michael B

2014-01-01

226

Hypoglycemia is More Common Among Type 2 Diabetes Patients with Limited Health Literacy: The Diabetes Study of Northern California (DISTANCE)  

PubMed Central

BACKGROUND Little is known about the frequency of significant hypoglycemic events in actual practice. Limited health literacy (HL) is common among patients with type 2 diabetes, may impede diabetes self-management, and thus HL could increase the risk of hypoglycemia. OBJECTIVE To determine the proportion of ambulatory, pharmacologically-treated patients with type 2 diabetes reporting ?1 significant hypoglycemic events in the prior 12 months, and evaluate whether HL is associated with hypoglycemia. RESEARCH DESIGN Cross-sectional analysis in an observational cohort, the Diabetes Study of Northern California (DISTANCE). SUBJECTS The subjects comprised 14,357 adults with pharmacologically-treated, type 2 diabetes who are seen at Kaiser Permanente Northern California (KPNC), a non-profit, integrated health care delivery system. MEASURES Patient-reported frequency of significant hypoglycemia (losing consciousness or requiring outside assistance); patient-reported health literacy. RESULTS At least one significant hypoglycemic episode in the prior 12 months was reported by 11% of patients, with the highest risk for those on insulin (59%). Patients commonly reported limited health literacy: 53% reported problems learning about health, 40% needed help reading health materials, and 32% were not confident filling out medical forms by themselves. After adjustment, problems learning (OR 1.4, CI 1.1-1.7), needing help reading (OR 1.3, CI 1.1-1.6), and lack of confidence with forms (OR 1.3, CI 1.1-1.6) were independently associated with significant hypoglycemia. CONCLUSIONS Significant hypoglycemia was a frequent complication in this cohort of type 2 diabetes patients using anti-hyperglycemic therapies; those reporting limited HL were especially vulnerable. Efforts to reduce hypoglycemia and promote patient safety may require self-management support that is appropriate for those with limited HL, and consider more vigilant surveillance, conservative glycemic targets or avoidance of the most hypoglycemia-inducing medications. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1389-7) contains supplementary material, which is available to authorized users.

Karter, Andrew J.; Liu, Jennifer Y.; Moffet, Howard H.; Adler, Nancy E.; Schillinger, Dean

2010-01-01

227

Field of Dreams Program Evaluation: Empowering the Latino Population in Type2 Diabetes Self-Management  

ERIC Educational Resources Information Center

Adult onset, type2 diabetes affects Latino families at a higher rate than other ethnicities and negatively impacting their quality of life, ability to financially succeed, and ultimately impacting our overall economy. Multiple resources are available in the country to help people learn how to prevent, control, and manage diabetes. However, the…

Urteaga, Edie

2011-01-01

228

The Melbourne Diabetes Prevention Study (MDPS): study protocol for a randomized controlled trial  

PubMed Central

Background Worldwide, type 2 diabetes (T2DM) prevalence has more than doubled over two decades. In Australia, diabetes is the second highest contributor to the burden of disease. Lifestyle modification programs comprising diet changes, weight loss and moderate physical activity, have been proven to reduce the incidence of T2DM in high risk individuals. As part of the Council of Australia Governments, the State of Victoria committed to develop and support the diabetes prevention program ‘Life! Taking action on diabetes’ (Life!) which has direct lineage from effective clinical and implementation trials from Finland and Australia. The Melbourne Diabetes Prevention Study (MDPS) has been set up to evaluate the effectiveness and cost-effectiveness of a specific version of the Life! program. Methods/design We intend to recruit 796 participants for this open randomized clinical trial; 398 will be allocated to the intervention arm and 398 to the usual care arm. Several methods of recruitment will be used in order to maximize the number of participants. Individuals aged 50 to 75 years will be screened with a risk tool (AUSDRISK) to detect those at high risk of developing T2DM. Those with existing diabetes will be excluded. Intervention participants will undergo anthropometric and laboratory tests, and comprehensive surveys at baseline, following the fourth group session (approximately three months after the commencement of the intervention) and 12 months after commencement of the intervention, while control participants will undergo testing at baseline and 12 months only. The intervention consists of an initial individual session followed by a series of five structured-group sessions. The first four group sessions will be carried out at two week intervals and the fifth session will occur eight months after the first group session. The intervention is based on the Health Action Process Approach (HAPA) model and sessions will empower and enable the participants to follow the five goals of the Life! program. Discussion This study will determine whether the effect of this intervention is larger than the effect of usual care in reducing central obesity and cardiovascular risk factors and thus the risk of developing diabetes and cardiovascular disease. Also it will evaluate how these two options compare economically. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12609000507280

2013-01-01

229

The economic costs of diabetes: a population-based study in Tehran, Iran  

Microsoft Academic Search

Aim\\/hypothesis  The aim of the study was to determine the annual healthcare expenditures of an individual with diabetes in Tehran, between\\u000a March 2004 and March 2005.\\u000a \\u000a \\u000a \\u000a Methods  This prevalence-based ‘cost-of-illness’ study was conducted in two phases. In the first phase, 23,707 randomly selected individuals\\u000a were interviewed to gather a cohort of participants with diabetes. In the second phase, 710 diabetic patients and

A. Esteghamati; O. Khalilzadeh; M. Anvari; A. Meysamie; M. Abbasi; M. Forouzanfar; F. Alaeddini

2009-01-01

230

The db/db Mouse: A Useful Model for the Study of Diabetic Retinal Neurodegeneration  

PubMed Central

Background To characterize the sequential events that are taking place in retinal neurodegeneration in a murine model of spontaneous type 2 diabetes (db/db mouse). Methods C57BLKsJ-db/db mice were used as spontaneous type 2 diabetic animal model, and C57BLKsJ-db/+ mice served as the control group. To assess the chronological sequence of the abnormalities the analysis was performed at different ages (8, 16 and 24 weeks). The retinas were evaluated in terms of morphological and functional abnormalities [electroretinography (ERG)]. Histological markers of neurodegeneration (glial activation and apoptosis) were evaluated by immunohistochemistry. In addition glutamate levels and glutamate/aspartate transporter (GLAST) expression were assessed. Furthermore, to define gene expression changes associated with early diabetic retinopathy a transcriptome analyses was performed at 8 week. Furthermore, an additional interventional study to lower blood glucose levels was performed. Results Glial activation was higher in diabetic than in non diabetic mice in all the stages (p<0.01). In addition, a progressive loss of ganglion cells and a significant reduction of neuroretinal thickness were also observed in diabetic mice. All these histological hallmarks of neurodegeneration were less pronounced at week 8 than at week 16 and 24. Significant ERG abnormalities were present in diabetic mice at weeks 16 and 24 but not at week 8. Moreover, we observed a progressive accumulation of glutamate in diabetic mice associated with an early downregulation of GLAST. Morphological and ERG abnormalities were abrogated by lowering blood glucose levels. Finally, a dysregulation of several genes related to neurotransmission and oxidative stress such as UCP2 were found at week 8. Conclusions Our results suggest that db/db mouse reproduce the features of the neurodegenerative process that occurs in the human diabetic eye. Therefore, it seems an appropriate model for investigating the underlying mechanisms of diabetes-induced retinal neurodegeneration and for testing neuroprotective drugs.

A. Villena, Josep; Carvalho, Andrea R.; Garcia-Arumi, Jose; Ramos, David; Ruberte, Jesus; Simo, Rafael; Hernandez, Cristina

2014-01-01

231

Diabetes but Not Insulin Increases the Risk of Lung Cancer: A Taiwanese Population-Based Study  

PubMed Central

Background The trend of lung cancer incidence in Taiwan is unknown, and the association between type 2 diabetes/insulin use and lung cancer is rarely studied. Methods The trends of lung cancer incidence in 1979–2007 in the Taiwanese general population were calculated. A random sample of 1,000,000 subjects covered by the National Health Insurance in 2005 was recruited. A total of 494,002 men and 502,948 women and without lung cancer were followed for the annual cumulative incidence of lung cancer in 2005, with calculation of the risk ratios between diabetic and non-diabetic subjects. Logistic regression estimated the adjusted odds ratios for risk factors. Results The trends increased significantly in both sexes (P<0.0001). The sex-specific annual cumulative incidence increased with age in either the diabetic or non-diabetic subjects, but the risk ratios attenuated with age. In logistic regressions, diabetes was associated with a significantly higher risk, with odds ratios (95% confidence interval) for diabetes duration <1, 1–3, 3–5 and ?5 years versus non-diabetes of 2.189 (1.498-3.200), 1.420 (1.014-1.988), 1.545 (1.132-2.109), and 1.329 (1.063-1.660), respectively. Such an association was not related to a higher detection with chest X-ray examination. Insulin use and medications including oral anti-diabetic drugs, statin, fibrate, and anti-hypertensive agents were not significantly associated with lung cancer. Age, male sex, and chronic obstructive pulmonary disease were positively; but dyslipidemia, stroke and higher socioeconomic status were negatively associated with lung cancer. Conclusions Diabetes is significantly associated with a higher risk of lung cancer, but insulin use does not increase the risk.

Tseng, Chin-Hsiao

2014-01-01

232

Myocardial blood flow under general anaesthesia with sevoflurane in type 2 diabetic patients: a pilot study  

PubMed Central

Background In type 2 diabetic patients, cardiac events in the perioperative period may be associated with diminished myocardial vasomotor function and endothelial dysfunction. The influence of sevoflurane anaesthesia on myocardial endothelial dysfunction in type 2 diabetic mellitus is investigated in this pilot study. Methods Six males with type 2 diabetes mellitus and eight healthy controls were included. Using myocardial contrast echocardiography, myocardial blood flow (MBF) was measured at rest, during adenosine-induced hyperaemia (endothelium-independent vasodilation) and after sympathetic stimulation by the cold pressor test (endothelium-dependent vasodilation). Measurements were performed before and after induction of sevoflurane anaesthesia. Results Sevoflurane anaesthesia decreased resting MBF in diabetics but not in controls (P?=?0.03), while baseline MBF did not differ between diabetics and controls. Without anaesthesia, adenosine-induced hyperaemia increased MBF in both groups compared to resting values. Adenosine combined with sevoflurane resulted in a lower hyperaemic MBF in both groups compared to no anaesthesia. Differences in MBF in response to adenosine before and after sevoflurane administration were larger in diabetic patients, however not statistically significant in this pilot group (P?=?0.08). Myocardial blood flow parameters after the cold pressor test were not different between groups. Conclusion These pilot data in type 2 diabetic patients show that sevoflurane anaesthesia decreases resting myocardial blood flow compared to healthy controls. Further, we observed a trend towards a lower endothelium-independent vasodilation capacity in diabetic patients under sevoflurane anaesthesia. Endothelium-dependent vasodilation was not affected by sevoflurane in diabetic patients. These data provide preliminary insight into myocardial responses in type 2 diabetic patients under general anaesthesia. Trial registration http://www.clinicialtrials.gov, NCT00866801

2014-01-01

233

Cohort study of predictive value of urinary albumin excretion for atherosclerotic vascular disease in patients with insulin dependent diabetes  

Microsoft Academic Search

AbstractObjective: To examine whether slightly elevated urinary albumin excretion precedes development of atherosclerotic vascular disease in patients with insulin dependent diabetes independently of conventional atherogenic risk factors and of diabetic nephropathy.Design: Cohort study with 11 year follow up.Setting: Diabetes centre in Denmark.Subjects: 259 patients aged 19-51 with insulin dependent diabetes of 6-34 years' duration and without atherosclerotic vascular disease or

Torsten Deckert; Hiroki Yokoyama; Elisabeth Mathiesen; Birgitte Ronn; Tonny Jensen; Bo Feldt-Rasmussen; Knut Borch-Johnsen; Jan Skov Jensen

1996-01-01

234

Predictors for the development of microalbuminuria and macroalbuminuria in patients with type 1 diabetes: inception cohort study  

Microsoft Academic Search

Objective To evaluate baseline predictors for the development of persistent microalbuminuria and macroalbuminuria prospectively in patients with type 1 diabetes. Design Prospective observational study of an inception cohort. Setting Outpatient diabetic clinic in a tertiary referral centre, Gentofte, Denmark. Participants 286 patients (216 adults) newly diagnosed with type 1 diabetes consecutively admitted to the clinic between 1 September 1979 and

Peter Hovind; Lise Tarnow; Peter Rossing; Berit Ruud Jensen; Malene Graae; Inge Torp; Christian Binder; Hans-Henrik Parving

2004-01-01

235

EFFECT OF DRUG THERAPY AND RISK INVOLVED IN CORONARY VASCULAR DISEASE IN TYPE 2 DIABETES MILLITUS - A CASE STUDY  

Microsoft Academic Search

Type 2 Diabetes Mellitus (T2DM) is one of the chronic diseases in the world. According to World Health Organization (WHO) approximately 171 million people worldwide currently on diabetic and that type 2 diabetes accounts to about 90% . This study presents Oral hypoglycemic agent (OHA) prescription pattern by the physicians among Out patients of two hospital and risk involved in

Omi Bajracharya; B. S Rao; G. M. Khan

236

Metabonomic study of biochemical changes in the serum of type 2 diabetes mellitus patients after the treatment of metformin hydrochloride  

Microsoft Academic Search

A metabonomic study on biochemical changes in the serum of type 2 diabetes mellitus patients after the treatment of metformin hydrochloride was performed. 1H NMR and UPLC\\/MS were used to generate metabolic fingerprints for the metabonomic analysis of serum samples obtained from 20 type 2 diabetes mellitus patients without any drugs treatment and 15 type 2 diabetes mellitus patients treated

Taoguang Huo; Shuang Cai; Xiumei Lu; Yi Sha; Mingyang Yu; Famei Li

2009-01-01

237

The use of complementary and alternative medicine by patients with diabetes mellitus in Bahrain: a cross-sectional study  

Microsoft Academic Search

BACKGROUND: CAM use is widespread, especially among patients with diabetes. The Gulf States have a high prevalence of diabetes, alongside a long tradition of CAM use. The aim of this study is to establish the prevalence of CAM use among patients with diabetes mellitus in Bahrain and to examine the characteristics of the CAM users. METHODS: A questionnaire was developed

Abeer J. Khalaf; David L Whitford

2010-01-01

238

Maternal and neonatal risk factors for childhood type 1 diabetes: a matched case-control study  

PubMed Central

Background An interaction between genetic susceptibility and environmental factors is thought to be involved in the aetiology of type 1 diabetes. The aim of this study was to investigate maternal and neonatal risk factors for type 1 diabetes in children under 15 years old in Grampian, Scotland. Methods A matched case-control study was conducted by record linkage. Cases (n = 361) were children born in Aberdeen Maternity Hospital from 1972 to 2002, inclusive, who developed type 1 diabetes, identified from the Scottish Study Group for the Care of Diabetes in the Young Register. Controls (n = 1083) were randomly selected from the Aberdeen Maternity Neonatal Databank, matched by year of birth. Exposure data were obtained from the Aberdeen Maternity Neonatal Databank. Conditional logistic regression was used to evaluate the association between various maternal and neonatal factors and the risk of type 1 diabetes. Results There was no evidence of statistically significant associations between type 1 diabetes and maternal age, maternal body mass index, previous abortions, pre-eclampsia, amniocentesis, maternal deprivation, use of syntocinon, mode of delivery, antepartum haemorrhage, baby's sex, gestational age at birth, birth order, birth weight, jaundice, phototherapy, breast feeding, admission to neonatal unit and Apgar score (P > 0.05). A significantly decreased risk of type 1 diabetes was observed in children whose mothers smoked at the booking appointment compared to those whose mothers did not, with an adjusted OR of 0.67, 95% CI (0.46, 0.99). Conclusions This case-control study found limited evidence of a reduced risk of the development of type 1 diabetes in children whose mothers smoked, compared to children whose mothers did not. No evidence was found of a significant association between other maternal and neonatal factors and childhood type 1 diabetes.

2010-01-01

239

Change in DASH diet score and cardiovascular risk factors in youth with type 1 and type 2 diabetes mellitus: The SEARCH for Diabetes in Youth Study  

PubMed Central

Youth with diabetes are at an increased risk of cardiovascular disease (CVD). Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet has been shown to improve CVD risk. In this study, we evaluated whether changes in diet quality as characterized by DASH are associated with changes in CVD risk factors in youth with diabetes over time. Longitudinal mixed models were applied to data from 797 participants in the SEARCH for Diabetes in Youth Study representing three time points: baseline, 12- and 60-month follow-up. Data were restricted to youth whose diabetes was first diagnosed in 2002–2005. DASH-related adherence was poor and changed very little over time. However, an increase in DASH diet score was significantly associated with a decrease in HbA1c levels in youth with type 1 diabetes (?=?0.20, P-value=0.0063) and a decrease in systolic blood pressure among youth with type 2 diabetes (?=?2.02, P-value=0.0406). Improvements in dietary quality may be beneficial in youth with type 1 or type 2 diabetes. However, further work in larger groups of youth with type 1 and 2 diabetes is desirable.

Barnes, T L; Crandell, J L; Bell, R A; Mayer-Davis, E J; Dabelea, D; Liese, A D

2013-01-01

240

Type 2 Diabetes Patient Outcomes Research Team (PORT) Study. Abstract, Executive Summary, and Final Report.  

National Technical Information Service (NTIS)

The Type II Diabetes PORT was a longitudinal observational study of utilization, quality, and effectiveness of care for this expensive and common condition. Patients (n = 3,500) of widely diverse socioeconomic, geographic and payment status were included,...

S. Greenfield S. H. Kaplan

1996-01-01

241

NIH Researchers Find Resveratrol Helps Protect Against Diabetes in Animal Study  

MedlinePLUS

... diet. In a new study of non-human primates, researchers have found that resveratrol counters some of ... high sugar diet on the pancreas, protecting these primates from developing diabetes. A healthy pancreas responds to ...

242

Diabetes and pancreatic cancer survival: a prospective cohort-based study.  

PubMed

Background:Diabetes is a risk factor for pancreatic cancer but its association with survival from pancreatic cancer is poorly understood. Our objective was to investigate the association of diabetes with survival among pancreatic cancer patients in a prospective cohort-based study where diabetes history was ascertained before pancreatic cancer diagnosis.Methods:We evaluated survival by baseline (1993-2001) self-reported diabetes history (n=62) among 504 participants that developed exocrine pancreatic cancer within the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality were estimated using Cox proportional hazards model, adjusted for age, sex, body mass index, race, smoking, and tumour stage (local, locally advanced, and metastatic).Results:The multivariable-adjusted HR for mortality comparing participants with diabetes to those without was 1.52 (95% CI=1.14-2.04, P-value <0.01). After excluding those diagnosed with pancreatic cancer within 3 years of study enrolment, HR for mortality among those with diabetes was 1.45 (95% CI=1.06-2.00, P-value=0.02).Conclusions:Using prospectively collected data, our findings indicate that diabetes is associated with worse survival among patients with pancreatic cancer. PMID:24786605

Toriola, A T; Stolzenberg-Solomon, R; Dalidowitz, L; Linehan, D; Colditz, G

2014-07-01

243

Effect of Urtica dioica on morphometric indices of kidney in streptozotocin diabetic rats--a stereological study.  

PubMed

The aim of the present study was to investigate the effect of Urtica dioica on Morphometric indices of kidney in diabetic rats. Thirty male adult albino wistar rats of 125-175 g divided into control, diabetic and Urtica dioica treatment groups. In treatment Group, diabetic rats received 100 mg kg(-1) daily hydroalcoholic extract of U. dioica intraperitoneally for 4 weeks. After the animals had been sacrified, the kidneys were removed and fixed by formaldehyde, cut horizontally into 1 mm slices and processed, Stained with H and E. Stereological study performed using light microscope and the image projected on a table of olysa software. Cavalieri principle was used to estimate the volume of cortex, medulla and whole kidney. All the grouped data statistically evaluated using Student's t-test, expressed as the Mean +/- SE. Ration of kidney weight/body weight in diabetes (0.51) and diabetes-extract group (0.67) were higher then control group (0.42). Ratio of kidney volume/body weight in diabetes (350) and diabetes-extract group (348) were higher then control group (323). Volume Ratio of cortex/medulla in diabetes-extract group (1.65) was higher then control (1.34) and diabetes group (1.33). Glomerular area and diameter and proximal tubule diameter in diabetes-Extract group was higher than control and diabetes groups. This study revealed that Urtica dioica has no effect on renal morphometric indices in induced diabetic rats. PMID:19090245

Golalipour, Mohammad Jafar; Gharravi, Anneh Mohammad; Ghafari, Sorya; Afshar, Mohammad

2007-11-01

244

Asthma and the risk of type 2 diabetes in the Singapore Chinese Health Study  

PubMed Central

Aim Asthma is believed to increase the risk for several proinflammatory diseases, yet epidemiologic studies on asthma in relation to risk of developing type 2 diabetes are sparse and have reported inconsistent results. In the present study, we investigated the hypothesis that asthma is associated with an increased risk of incident type 2 diabetes in Chinese adults. Methods We used data from the Singapore Chinese Health Study, including Chinese men and women aged 45–74 years, free of cancer, heart disease, stroke, and diabetes at baseline (1993–1998) and followed through 2004 for incident physician-diagnosed diabetes. Cox regression models were used to examine the associations between self-reported history of physician-diagnosed asthma and risk of diabetes. Results During an average follow-up of 5.7 years per person, 2,234 of the 42,842 participants included in the current analyses reported diagnoses of type 2 diabetes. After adjustment for potential confounders, not including body mass index (BMI), asthma was associated with a 31% increased risk of incident diabetes (HR = 1.31; 95% CI: 1.00–1.72). The association was attenuated after adjustment for adult BMI (HR = 1.25 95% CI: 0.95–1.64). The asthma-diabetes association appeared stronger for adult- versus child-diagnosed asthma cases, and for participants who were obese compared to non-obese. Conclusions In Singaporean Chinese adults we observed a positive association between self-reported, physician-diagnosed asthma and risk of developing type 2 diabetes that was modestly attenuated upon adjustment for BMI.

Mueller, Noel T.; Koh, Woon-Puay; Odegaard, Andrew O.; Gross, Myron D.; Yuan, Jian-Min; Pereira, Mark A.

2012-01-01

245

Influences on the uptake of diabetes screening: a qualitative study in primary care  

PubMed Central

Background To address the increasing global prevalence of type 2 diabetes healthcare organisations have been contemplating different screening and intervention strategies. Patient acceptability is a key criterion of a screening programme. Aim To explore the perspectives of those invited to attend the MY-WAIST screening study for type 2 diabetes, particularly explanations for attending or not, and views on the specific screening strategy. Design and setting Qualitative study with patients from11 general practices (Leicestershire, UK). Method Semi-structured interviews were conducted with 24 individuals (40–69 years) invited to attend the MY-WAIST screening study, comprising 13 who attended and 11 who did not attend the screening. Additional data included reply slips from 73 individuals who declined the offer of screening. Analysis was informed by the constant comparative method. Results Two categories of influence on the decision about attending screening emerged. 1) Beliefs about type 2 diabetes candidacy and severity: perceived susceptibility to type 2 diabetes was more common amongs those who had attended; lack of perceived severity of type 2 diabetes was more common amongs those who did not attend. 2) Practical aspects about the screening strategy: the lengthy, early morning screening appointments were a barrier to uptake; screening attendees found the procedure largely acceptable. Pre-screening waist self-measurement was more memorable than the remainder of the risk-score calculation; neither impacted on uptake. Conclusion The barriers to screening uptake highlighted contribute to current debates about different screening and diagnostic tests for type 2 diabetes and future risk of type 2 diabetes. The findings are useful for those contemplating implementation of screening programmes for identifying type 2 diabetes and pre-diabetes.

Eborall, Helen; Stone, Margaret; Aujla, Navneet; Taub, Nicholas; Davies, Melanie; Khunti, Kamlesh

2012-01-01

246

Rationale and design of diabetics exposed to telmisartan and enalapril (DETAIL) study  

Microsoft Academic Search

The DETAIL (diabetics exposed to telmisartan and enalapril) study will compare the long-term renal outcome of treatment with the angiotensin II receptor antagonist (ARA) telmisartan versus the angiotensin-converting enzyme (ACE) inhibitor enalapril in patients with mild-to-moderate hypertension and diabetic nephropathy. In short-term clinical studies, ACE inhibitors reduce microalbuminuria and, in the longer term, they are superior to conventional therapies in

J. Rippin; S. C. Bain; A. H. Barnett

2002-01-01

247

Diabetes mellitus and breast cancer: a retrospective population-based cohort study  

Microsoft Academic Search

SummaryPurpose  Evidence suggests that women with type 2 diabetes may be at increased risk of breast cancer, possibly due to chronic exposure to insulin resistance and\\/or hyperinsulinemia. The purpose of this study was to compare the incidence of breast cancer in postmenopausal women with and without diabetes.Methods  Using population-based validated health databases from Ontario, Canada, this retrospective cohort study compared breast cancer

Lorraine L. Lipscombe; Pamela J. Goodwin; Bernard Zinman; John R. McLaughlin; Janet E. Hux

2006-01-01

248

A study on the hypoglycemic and hypolipidemic effects of an ayurvedic drug Rajanyamalakadi in diabetic patients  

Microsoft Academic Search

A study was undertaken for evaluating the hypoglycemic and hypolipidemic effects of an ayurvedic medicine “Rajanyamalakadi”\\u000a containing Curcuma longa, Emblica officinalis and Salacia oblonga in type II diabetic patients over a period of 3 months.\\u000a Ethical committee consent for the study was given by the Director, Indian Systems of Medicine, Kerala. A total of 43 patients\\u000a with established diabetes mellitus

P. Faizal; S. Suresh; R. Satheesh Kumar; K. T. Augusti

2009-01-01

249

Geographical variation of presentation at diagnosis of Type I diabetes in children: the EURODIAB Study  

Microsoft Academic Search

.\\u000a Aims\\/hypothesis:   We aimed to describe the frequency and degree of diabetic ketoacidosis in children across Europe at the time of diagnosis\\u000a of Type I (insulin-dependent) diabetes mellitus and to determine if factors such as age and geographical region contribute\\u000a to the risk of diabetic ketoacidosis. \\u000a \\u000a \\u000a \\u000a Methods:   The study was part of the EURODIAB project. A total of 24 centres,

C. Lévy-Marchal; C. C. Patterson; A. Green

2001-01-01

250

Type 2 diabetes impairs pulmonary function in morbidly obese women: a case–control study  

Microsoft Academic Search

Aims\\/hypothesis  To determine whether the presence of type 2 diabetes and the degree of metabolic control are related to reduced pulmonary\\u000a function in obese individuals.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Seventy-five morbidly obese women (25 with type 2 diabetes [cases]—and 50 without diabetes [controls]) with a history of non-smoking\\u000a and without prior cardiovascular or respiratory disease were prospective recruited for a case–control study in the outpatient

A. Lecube; G. Sampol; X. Muñoz; C. Hernández; J. Mesa; R. Simó

2010-01-01

251

Penn Medicine study finds a class of diabetes drugs raises risk of bladder cancer  

Cancer.gov

A popular class of diabetes drugs increases patients’ risk of bladder cancer, according to a new study published online this month in the Journal of the National Cancer Institute. Researchers from the Perelman School of Medicine at the University of Pennsylvania found that patients taking thiazolidinedione (TZDs) drugs – which account for up to 20 percent of the drugs prescribed to diabetics in the United States -- are two to three times more likely to develop bladder cancer than those who took a sulfonylurea drug, another common class of medications for diabetes. The University of Pennsylvania is home to the Abramson Cancer Center.

252

Preliminary studies on the hypoglycaemic effect ofAbroma augusta in alloxan diabetic rats.  

PubMed

The hypoglycemic effect of the aqueous extract ofAbroma augusta (Family: Steculiceae) was studied in normal as well as alloxan diabetic rats. Treatement of diabetic rats with 4 ml (4gm dry weight) of agueous extract ofA. augusta for 16 weeks resulted in gradual but significant fall in fasting blood glucose and improvement in glucose tolerance. Serum total and LDL cholesterol and triacylglycerol which increased in diabetic rats showed improvement. These results show that the water extract ofA. augusta has both hypoglycemic and hypocholesterolemic effects. PMID:23105296

Eshrat, H; Hussain, M A; Jamil, K; Rao, M

2001-01-01

253

Field-structured composite studies.  

SciTech Connect

Field-structured composites (FSCs) were produced by hosting micron-sized gold-coated nickel particles in a pre-polymer and allowing the mixture to cure in a magnetic field environment. The feasibility of controlling a composite's electrical conductivity using feedback control applied to the field coils was investigated. It was discovered that conductivity in FSCs is primarily determined by stresses in the polymer host matrix due to cure shrinkage. Thus, in cases where the structuring field was uniform and unidirectional so as to produce chainlike structures in the composite, no electrical conductivity was measured until well after the structuring field was turned off at the gel point. In situations where complex, rotating fields were used to generate complex, three-dimensional structures in a composite, very small, but measurable, conductivity was observed prior to the gel point. Responsive, sensitive prototype chemical sensors were developed based on this technology with initial tests showing very promising results.

Martin, James Ellis; Williamson, Rodney L.

2004-04-01

254

A family history of diabetes is associated with reduced physical fitness in the Prevalence, Prediction and Prevention of Diabetes (PPP)–Botnia study  

Microsoft Academic Search

Aims\\/hypothesis  We studied the impact of a family history of type 2 diabetes on physical fitness, lifestyle factors and diabetes-related metabolic\\u000a factors.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The Prevalence, Prediction and Prevention of Diabetes (PPP)–Botnia study is a population-based study in Western Finland, which\\u000a includes a random sample of 5,208 individuals aged 18 to 75 years identified through the national Finnish Population Registry.\\u000a Physical activity, dietary habits

B. Isomaa; B. Forsén; K. Lahti; N. Holmström; J. Wadén; O. Matintupa; P. Almgren; J. G. Eriksson; V. Lyssenko; M.-R. Taskinen; T. Tuomi; L. C. Groop

2010-01-01

255

PAI-1 -675 4G/5G Polymorphism in Association with Diabetes and Diabetic Complications Susceptibility: a Meta-Analysis Study  

PubMed Central

A meta-analysis was performed to assess the association between the PAI-1 -675 4G/5G polymorphism and susceptibility to diabetes mellitus (DM), diabetic nephropathy (DN), diabetic retinopathy (DR) and diabetic coronary artery disease (CAD). A literature-based search was conducted to identify all relevant studies. The fixed or random effect pooled measure was calculated mainly at the allele level to determine heterogeneity bias among studies. Further stratified analyses and sensitivity analyses were also performed. Publication bias was examined by the modified Begg’s and Egger’s test. Twenty published articles with twenty-seven outcomes were included in the meta-analysis: 6 studies with a total of 1,333 cases and 3,011 controls were analyzed for the PAI-1 -675 4G/5G polymorphism with diabetes risk, 7 studies with 1,060 cases and 1,139 controls for DN risk, 10 studies with 1,327 cases and 1,557 controls for DR and 4 studies with 610 cases and 1,042 controls for diabetic CAD risk respectively. Using allelic comparison (4G vs. 5G), the PAI-1 -675 4G/5G polymorphism was observed to have no significant association with diabetes (REM OR 1.07, 95% CI 0.96, 1.20), DN (REM OR 1.10, 95% CI 0.98, 1.25), DR (REM OR 1.09, 95% CI 0.97, 1.22) or diabetic CAD risk (REM OR 1.07, 95% CI 0.81, 1.42), and similar results were obtained in the dominant, recessive and co-dominant models. Our meta-analyses suggest that the PAI-1 -675 4G/5G polymorphism might not be a risk factor for DM, DN, DR or diabetic CAD risk in the populations investigated. This conclusion warrants confirmation by further studies.

Yang, Fan; Cui, Dai; Shi, Yun; Shen, Chong; Tang, Wei; Yang, Tao

2013-01-01

256

Evolution assessment of head and neck infections in diabetic patients - A case control study.  

PubMed

This research aimed to assess the occurrence and progression of head and neck infections in diabetic compared to non-diabetic patients. A retrospective study was carried out over a period of 10 years in 899 patients with head and neck infections. The patients who met the inclusion criteria were divided into cases and controls according to the presence/absence of diabetes. Seventy-three patients (8%, 95% CI [6.45%-10.12%]) were included in the case group and 826 (92%, 95% CI [89.87%-93.55%]) were assigned to the control group. The extension of the infection proved to be significantly (p < 0.001) higher in diabetic patients compared to non-diabetic patients. The difference between the two groups was statistically significant (Mann-Whitney U statistics = 18205.500, p < 1.56·10(-8)). A more than 10 year history of diabetes was statistically related to a wider extent of head and neck infections (p < 0.001). Diabetes proved to be associated with large necrotic areas and the spread of head and neck infections to more than two cavities. PMID:23911119

Juncar, Mihai; Popa, Amorin R; Baciu?, Mihaela F; Juncar, Raluca Iulia; Onisor-Gligor, Florin; Bran, Simion; B?ciu?, Grigore

2014-07-01

257

Evaluating the implementation of HeLP-Diabetes within NHS services: study protocol  

PubMed Central

Background Self-management by people with type 2 diabetes is central to good health outcomes and the prevention of associated complications. Structured education to teach self-management is recommended by the National Institute for Heath and Clinical Excellence; however, only a small proportion of patients report being offered this education and even fewer attend. This study aims to evaluate the implementation of a new internet-based self-management intervention: HeLP-Diabetes (Healthy Living for People with type 2 Diabetes) within the National Health Service. Specific objectives are to a) determine the uptake and use of HeLP-Diabetes by services and patients; b) identify the factors which inhibit or facilitate use; c) identify the resources needed for effective implementation; d) explore possible effects of HeLP-Diabetes use on self-reported patient outcome measures. Methods/Design This study will use an iterative design to implement HeLP-Diabetes into existing health services within the National Health Service. A two stage implementation process will be taken, whereby batches of General Practice surgeries and diabetes clinics will be offered HeLP-Diabetes and will subsequently be asked to participate in evaluating the implementation. We will collect data to describe the number of services and patients who sign up to HeLP-Diabetes, the types of services and patients who sign up and the implementation costs. Semi-structured interviews will be conducted with patients and health professionals and cohorts of patient participants will be asked to complete self-report measures at baseline, 3 months, and 12 months. Discussion This study will evaluate the implementation of a new online self-management intervention and describe what happens when it is made available to existing National Health Services and patients with type 2 diabetes. We will collect data to describe the uptake and use of the intervention and the resources needed for widespread implementation. We will report on patient benefits from using HeLP-Diabetes and the resources needed to achieve these in routine practice. Interviews with key stake holders will identify, define and explain factors that promote or inhibit the normalization of new patterns of patient and professional activity arising from HeLP-Diabetes.

2014-01-01

258

Type 2 diabetes genetic association database manually curated for the study design and odds ratio  

PubMed Central

Background The prevalence of type 2 diabetes has reached epidemic proportions worldwide, and the incidence of life-threatening complications of diabetes through continued exposure of tissues to high glucose levels is increasing. Advances in genotyping technology have increased the scale and accuracy of the genotype data so that an association genetic study has expanded enormously. Consequently, it is difficult to search the published association data efficiently, and several databases on the association results have been constructed, but these databases have their limitations to researchers: some providing only genome-wide association data, some not focused on the association but more on the integrative data, and some are not user-friendly. In this study, a user-friend database of type 2 diabetes genetic association of manually curated information was constructed. Description The list of publications used in this study was collected from the HuGE Navigator, which is an online database of published genome epidemiology literature. Because type 2 diabetes genetic association database (T2DGADB) aims to provide specialized information on the genetic risk factors involved in the development of type 2 diabetes, 701 of the 1,771 publications in the type 2 Diabetes case-control study for the development of the disease were extracted. Conclusions In the database, the association results were grouped as either positive or negative. The gene and SNP names were replaced with gene symbols and rsSNP numbers, the association p-values were determined manually, and the results are displayed by graphs and tables. In addition, the study design in publications, such as the population type and size are described. This database can be used for research purposes, such as an association and functional study of type 2 diabetes related genes, and as a primary genetic resource to construct a diabetes risk test in the preparation of personalized medicine in the future.

2010-01-01

259

Knowledge of diabetes and its associated ocular manifestations by diabetic patients: A study at Korle-Bu Teaching Hospital, Ghana  

PubMed Central

Background: Diabetes mellitus is a significant cause of visual impairment, hence adequate knowledge on this condition and its ocular manifestations is of immense importance to diabetic patients. Aim: To assess the knowledge of diabetic patients on the disorder and its ocular manifestations, and their attitude towards ocular examinations. Materials and Methods: A cross-sectional survey involving the use of a structured interview was conducted among diabetic patients attending the Diabetic Clinic of the Korle-Bu Teaching Hospital. Using Fishers Exact Chi-square (?2) and Odds Ratios (ORs), data obtained was analyzed. Results: Only 103 (26.4%) patients knew the type of diabetes mellitus they were suffering from. Knowledge on ocular effects of diabetes mellitus was low and only 15 (3.8%) knew that it could affect the ocular refraction with no patient mentioning that diabetes mellitus could cause cataract or diabetic retinopathy. Attitude to routine eye examination was poor. As much as 135 (34.6%) had never had an eye examination since being diagnosed of diabetes. Knowledge of the type of diabetes mellitus the individual had or any ocular complication of this disorder was significantly related (OR: 4.22; P < 0.001 and OR: 2.55; P < 0.001) respectively to their attitude to seeking eye care. Conclusion: Diabetic patients’ knowledge on diabetes mellitus and its ocular manifestations, and the attitude of diabetic patients towards eye examination were poor. Intensive health education by diabetes care givers and leaders of the Ghana Diabetic Association for diabetic patient is therefore required to improve attitude towards eye care to prevent visual impairment.

Ovenseri-Ogbomo, Godwin O.; Abokyi, Samuel; Koffuor, G. A.; Abokyi, Eric

2013-01-01

260

United Kingdom prospective diabetes study (UKPDS): what now or so what?  

PubMed

The UKPDS was a 20-year study involving 23 centres in the United Kingdom. More than 5000 patients with Type 2 diabetes were recruited. The aim of the study was to determine the impact of intensive blood glucose control on 21 predetermined clinical endpoints using, in the care of blood glucose control, sulphonylureas or insulin therapy or, in the overweight patient, treatment with metformin. In addition, the study investigated the impact of intensive blood pressure control on macro- and microvascular complications of diabetes and compared captopril treatment with atenolol. UKPDS found that improved control of blood glucose or blood pressure reduced the risk of major diabetic eye disease by one quarter, serious deterioration of vision by nearly one half, early kidney damage by one third, strokes by one third, and death from diabetes-related causes by one third. Blood glucose control had little or no effect on macrovascular events. There was no evidence of a major detrimental effect of the drugs or insulin on survival or outcome other than the expected risk of hypoglycaemia. Metformin appeared to be the drug of choice in obese diabetic patients. The targets of glucose and blood pressure control were often achieved by using several drugs. Many patients at the end of the studies were on four or five drugs for blood glucose and blood pressure treatment. The results and implications of the study are discussed. It is proposed that the results of UKPDS herald a new era of more focused therapy of Type 2 diabetes. PMID:10398549

Leslie, R D

1999-01-01

261

Mortality in older people with diabetes mellitus.  

PubMed

It is universally acknowledged that diabetes mellitus is a common cause of morbidity in the elderly population but it is less well established that the mortality of people with diabetes is greater at any given age. This comprehensive literature review aims to examine the evidence in order to clarify the relationship between diabetes and mortality risk in elderly diabetic patients. Information was obtained by carrying out a MEDLINE search for relevant papers published in 1980 and onwards; a key paper on mortality in non-insulin-dependent (Type 2) diabetes mellitus (NIDDM) was used as an index paper; Diabetes, Diabetologia, Diabetic Medicine, Diabete et Metabolisme, and Diabetes Care were hand searched; and, finally, other experts in the field were contacted. Two reviewers independently extracted the data from each of the studies and disagreements were discussed and resolved. The studies in elderly study populations comprised mainly NIDDM. The review demonstrated that diabetes is a significant contributor to mortality and reduced life expectancy in elderly subjects. Demographic trends in our population indicate that diabetes will continue to be a challenging health problem. PMID:9272589

Sinclair, A J; Robert, I E; Croxson, S C

1997-08-01

262

Regional differences in clinical care among patients with type 1 diabetes in Brazil: Brazilian Type 1 Diabetes Study Group  

PubMed Central

Background To determine the characteristics of clinical care offered to type 1 diabetic patients across the four distinct regions of Brazil, with geographic and contrasting socioeconomic differences. Glycemic control, prevalence of cardiovascular risk factors, screening for chronic complications and the frequency that the recommended treatment goals were met using the American Diabetes Association guidelines were evaluated. Methods This was a cross-sectional, multicenter study conducted from December 2008 to December 2010 in 28 secondary and tertiary care public clinics in 20 Brazilian cities in north/northeast, mid-west, southeast and south regions. The data were obtained from 3,591 patients (56.0% females and 57.1% Caucasians) aged 21.2 ± 11.7 years with a disease duration of 9.6 ± 8.1 years (<1 to 50 years). Results Overall, 18.4% patients had HbA1c levels <7.0%, and 47.5% patients had HbA1c levels ? 9%. HbA1c levels were associated with lower economic status, female gender, age and the daily frequency of self-blood glucose monitoring (SBGM) but not with insulin regimen and geographic region. Hypertension was more frequent in the mid-west (32%) and north/northeast (25%) than in the southeast (19%) and south (17%) regions (p<0.001). More patients from the southeast region achieved LDL cholesterol goals and were treated with statins (p<0.001). Fewer patients from the north/northeast and mid-west regions were screened for retinopathy and nephropathy, compared with patients from the south and southeast. Patients from the south/southeast regions had more intensive insulin regimens than patients from the north/northeast and mid-west regions (p<0.001). The most common insulin therapy combination was intermediate-acting with regular human insulin, mainly in the north/northeast region (p<0.001). The combination of insulin glargine with lispro and glulisine was more frequently used in the mid-west region (p<0.001). Patients from the north/northeast region were younger, non-Caucasian, from lower economic status, used less continuous subcutaneous insulin infusion, performed less SBGM and were less overweight/obese (p<0.001). Conclusions A majority of patients, mainly in the north/northeast and mid-west regions, did not meet metabolic control goals and were not screened for diabetes-related chronic complications. These results should guide governmental health policy decisions, specific to each geographic region, to improve diabetes care and decrease the negative impact diabetes has on the public health system.

2012-01-01

263

Study on the mechanism causing elevation of serum CA19-9 levels in diabetic patients.  

PubMed

Serum CA19-9 levels are often elevated in diabetic patients. To elucidate this mechanism, we investigated the metabolism of CA19-9 in diabetic patients without obvious cancer. Study 1 included 119 patients in whom HbA1c, glycated albumin (GA) and CA19-9 were measured at the time of hospital admission. Study 2 examined 6 patients with markedly elevated CA19-9 levels (?100 U/mL). Their half-lives for HbA1c, GA, and serum CA19-9 were calculated using the data before and after diabetes treatment. Three diabetic patients with pancreatic cancer were also examined as controls. In Study 1, serum CA19-9 (logarithmically transformed value) was significantly correlated with fasting plasma glucose (FPG), HbA1c and GA. On multivariate analysis, GA and FPG, but not HbA1c, were significant explanatory variables for serum CA19-9. In Study 2, serum CA19-9 decreased together with HbA1c and GA after diabetes treatment. The calculated half-lives for HbA1c, GA, and serum CA19-9 were 33.8 days, 16.1 days, and 10.9 days, respectively. The half-life of serum CA19-9 was longer in the study patients than that reported in patients with malignant tumors. By contrast, in the diabetic patients with pancreatic cancer serum CA19-9 showed a marginal decrease after diabetes treatment. Taken all together, prolonged half-life of serum CA19-9 may contribute to the increase in serum CA19-9 levels in diabetic patients without obvious cancer. PMID:23708182

Murai, Jun; Soga, Sumiko; Saito, Hiroshi; Otsuki, Michio; Kitada, Takatoshi; Saisho, Yoshifumi; Nakamura, Hideji; Kasayama, Soji; Koga, Masafumi

2013-01-01

264

Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study  

PubMed Central

Objective To assess the relation between adherence to a Mediterranean diet and the incidence of diabetes among initially healthy participants. Design Prospective cohort study with estimates of relative risk adjusted for sex, age, years of university education, total energy intake, body mass index, physical activity, sedentary habits, smoking, family history of diabetes, and personal history of hypertension. Setting Spanish university department. Participants 13?380 Spanish university graduates without diabetes at baseline followed up for a median of 4.4 years. Main outcome measures Dietary habits assessed at baseline with a validated 136 item food frequency questionnaire and scored on a nine point index. New cases of diabetes confirmed through medical reports and an additional detailed questionnaire posted to those who self reported a new diagnosis of diabetes by a doctor during follow-up. Confirmed cases of type 2 diabetes. Results Participants who adhered closely to a Mediterranean diet had a lower risk of diabetes. The incidence rate ratios adjusted for sex and age were 0.41 (95% confidence interval 0.19 to 0.87) for those with moderate adherence (score 3-6) and 0.17 (0.04 to 0.75) for those with the highest adherence (score 7-9) compared with those with low adherence (score <3). In the fully adjusted analyses the results were similar. A two point increase in the score was associated with a 35% relative reduction in the risk of diabetes (incidence rate ratio 0.65, 0.44 to 0.95), with a significant inverse linear trend (P=0.04) in the multivariate analysis. Conclusion Adherence to a Mediterranean diet is associated with a reduced risk of diabetes.

2008-01-01

265

Height, ethnicity, and the incidence of diabetes: the San Antonio Heart Study.  

PubMed

Mexican Americans are more obese and have more diabetes than non-Hispanic whites, but are also shorter. Height is used in some diabetes prediction models. Therefore, we examined the effect of height on the relationship between ethnicity and incident diabetes. Incident diabetes was ascertained in 1730 participants in the San Antonio Heart Study (age range, 25-64 years) after 7.4 years of follow-up. Height predicted diabetes in neither men (odds ratio [OR] x 1 SD, 1.14 [0.85-1.51]) nor women (OR x 1 SD, 0.88 [0.70-1.11]) after adjusting for age and ethnicity. The area under the receiver operating characteristic curve for predicting diabetes of a model that included waist circumference (in men, 0.775; in women, 0.781) was similar to that of models that included waist circumference + height (in men, 0.775, P = .702; in women, 0.783, P = .680) or waist-to-height ratio (in men, 0.764, P = .161; in women, 0.783, P = .619). The OR of incident diabetes according to ethnicity was lower in the model that was adjusted for the waist-to-height ratio than in the model that accounted only for waist circumference (in women, 1.45 [0.86-2.46] vs 1.84 [1.10-3.08], P < .001; in men, 2.00 [1.11-3.58] vs 2.74 [1.52-4.95], P < .001). In conclusion, the addition of height to adjust waist circumference does not increase the ability of waist circumference to predict diabetes, but may be useful in exploring differences in diabetic risk between populations of different race/ethnicity. PMID:19586642

Lorenzo, Carlos; Williams, Ken; Stern, Michael P; Haffner, Steven M

2009-11-01

266

Height, Ethnicity, and the Incidence of Diabetes: the San Antonio Heart Study  

PubMed Central

Mexican Americans are more obese and have more diabetes than non-Hispanic whites, but are also shorter. Height is used in some diabetes prediction models. Therefore we examined the effect of height on the relationship between ethnicity and incident diabetes. Incident diabetes was ascertained in 1,730 participants in the San Antonio Heart Study (age range, 25 to 64 years) after 7.4 years of follow-up. Height predicted diabetes in neither men (odds ratio [OR] × 1 standard deviation [SD], 1.14 [0.85 – 1.51]) nor women (OR × 1 SD, 0.88 [0.70 – 1.11]) after adjusting for age and ethnicity. The area under the receiver operating characteristic curve (AUC) for predicting diabetes of a model that included waist circumference (in men, 0.775; in women, 0.781) was similar to that of models that included waist circumference + height (in men, 0.775, p = 0.702; in women, 0.783, p = 0.680) or waist-to-height ratio (in men, 0.764, p = 0.161; in women, 0.783, p = 0.619). The OR of incident diabetes according to ethnicity was lower in the model that was adjusted for the waist-to-height ratio than in the model that accounted only for waist circumference (in women, 1.45 (0.86 – 2.46) vs. 1.84 (1.10 – 3.08), p <0.001; in men, 2.00 (1.11 – 3.58) vs. 2.74 (1.52 – 4.95), p <0.001). In conclusion, the addition of height to adjust waist circumference does not increase the ability of waist circumference to predict diabetes, but may be useful in exploring differences in diabetic risk between populations of different race/ethnicity.

Lorenzo, Carlos; Williams, Ken; Stern, Michael P; Haffner, Steven M

2009-01-01

267

Four-Year Incidence of Diabetic Retinopathy in a Spanish Cohort: The MADIABETES Study  

PubMed Central

Objective To evaluate the incidence of diabetic retinopathy in patients with Type 2 Diabetes Mellitus, to identify the risk factors associated with the incidence of retinopathy and to develop a risk table to predict four-year retinopathy risk stratification for clinical use, from a four-year cohort study. Design The MADIABETES Study is a prospective cohort study of 3,443 outpatients with Type 2 Diabetes Mellitus, sampled from 56 primary health care centers (131 general practitioners) in Madrid (Spain). Results The cumulative incidence of retinopathy at four-year follow-up was 8.07% (95% CI?=?7.04–9.22) and the incidence density was 2.03 (95% CI?=?1.75–2.33) cases per 1000 patient-months or 2.43 (95% CI?=?2.10–2.80) cases per 100 patient-years. The highest adjusted hazard ratios of associated risk factors for incidence of diabetic retinopathy were LDL-C >190 mg/dl (HR?=?7.91; 95% CI?=?3.39–18.47), duration of diabetes longer than 22 years (HR?=?2.00; 95% CI?=?1.18–3.39), HbA1c>8% (HR?=?1.90; 95% CI?=?1.30–2.77), and aspirin use (HR?=?1.65; 95% CI?=?1.22–2.24). Microalbuminuria (HR?=?1.17; 95% CI?=?0.75–1.82) and being female (HR?=?1.12; 95% CI?=?0.84–1.49) showed a non-significant increase of diabetic retinopathy. The greatest risk is observed in females who had diabetes for more than 22 years, with microalbuminuria, HbA1c>8%, hypertension, LDL-Cholesterol >190 mg/dl and aspirin use. Conclusions After a four-year follow-up, the cumulative incidence of retinopathy was relatively low in comparison with other studies. Higher baseline HbA1c, aspirin use, higher LDL-Cholesterol levels, and longer duration of diabetes were the only statistically significant risk factors found for diabetic retinopathy incidence. This is the first study to demonstrate an association between aspirin use and diabetic retinopathy risk in a well-defined cohort of patients with Type 2 Diabetes Mellitus at low risk of cardiovascular events. However, further studies with patients at high cardiovascular and metabolic risk are needed to clarify this issue.

Salinero-Fort, Miguel A.; San Andres-Rebollo, Francisco Javier; de Burgos-Lunar, Carmen; Arrieta-Blanco, Francisco Jesus; Gomez-Campelo, Paloma

2013-01-01

268

Residential Indoor Air Quality Field Studies.  

National Technical Information Service (NTIS)

Our best estimate of population exposure to indoor air pollutants is provided by results of indoor air quality field studies. Field studies are conducted to answer a variety of objectives. Frequently, secondary objectives, compatible with the primary obje...

A. R. Hawthorne

1986-01-01

269

Early Treatment Diabetic Retinopathy Study (ETDRS) Manual of Operations.  

National Technical Information Service (NTIS)

Diabetic retinopathy accounts for at least 12% of new cases of blindness each year in the United States; it is the most common cause of newly reported blindness in the 41 to 60 year age group and the second most common cause, second only to congenital def...

1985-01-01

270

Epidemiologic study of type 2 diabetes in Taiwan  

Microsoft Academic Search

Diabetes mellitus (DM) in adults is a global health problem, although its prevalence varies widely between different populations and the rate has generally increased worldwide. In Taiwan, the mortality rate from DM has almost doubled over the past 10 years. The prevalence of DM in Taiwan was established between 1985 and 1996 and the rates were between 4.9 and 9.2%.

Chih-Jen Chang; Feng-Hwa Lu; Yi-Ching Yang; Jin-Shang Wu; Ta-Jen Wu; Muh-Shy Chen; Lee-Ming Chuang; Tong-Yuan Tai

2000-01-01

271

The Environmental Determinants of Diabetes in the Young (TEDDY) Study.  

PubMed

The etiology of type 1 diabetes (T1D) remains unknown, but a growing body of evidence points to infectious agents and/or components of early childhood diet. The National Institutes of Health has established the TEDDY Study consortium of six clinical centers in the United States and Europe and a data coordinating center to identify environmental factors predisposing to, or protective against, islet autoimmunity and T1D. From 2004-2009, TEDDY will screen more than 360,000 newborns from both the general population and families already affected by T1D to identify an estimated 17,804 children with high-risk HLA-DR,DQ genotypes. Of those, 7,801 (788 first-degree relatives and 7,013 newborns with no family history of T1D) will be enrolled in prospective follow-up beginning before the age of 4.5 months. As of May 2008, TEDDY has screened more than 250,000 newborns and enrolled nearly 5,000 infants--approximately 70% of the final cohort. Participants are seen every 3 months up to 4 years of age, with subsequent visits every 6 months until the subject is 15 years of age. Blood samples are collected at each visit for detection of candidate infectious agents and nutritional biomarkers; monthly stool samples are collected for infectious agents. These samples are saved in a central repository. Primary endpoints include (1) appearance of one or more islet autoantibodies (to insulin, GAD65 or IA-2) confirmed at two consecutive visits; (2) development of T1D. By age 15, an estimated 800 children will develop islet autoimmunity and 400 will progress to T1D; 67 and 27 children have already reached these endpoints. PMID:19120261

2008-12-01

272

The Environmental Determinants of Diabetes in the Young (TEDDY) Study  

PubMed Central

The etiology of type 1 diabetes (T1D) remains unknown, but a growing body of evidence points to infectious agents and/or components of early childhood diet. The National Institutes of Health has established the TEDDY Study consortium of six clinical centers in the United States and Europe and a data coordinating center to identify environmental factors predisposing to, or protective against, islet autoimmunity and T1D. From 2004–2009, TEDDY will screen more than 360,000 newborns from both the general population and families already affected by T1D to identify an estimated 17,804 children with high-risk HLA-DR, DQ genotypes. Of those, 7,801 (788 first-degree relatives and 7,013 newborns with no family history of T1D) will be enrolled in prospective follow-up beginning before the age of 4.5 months. As of May 2008, TEDDY has screened more than 250,000 newborns and enrolled nearly 5,000 infants—approximately 70% of the final cohort. Participants are seen every 3 months up to 4 years of age, with subsequent visits every 6 months until the subject is 15 years of age. Blood samples are collected at each visit for detection of candidate infectious agents and nutritional biomarkers; monthly stool samples are collected for infectious agents. These samples are saved in a central repository. Primary endpoints include (1) appearance of one or more islet autoantibodies (to insulin, GAD65 or IA-2) confirmed at two consecutive visits; (2) development of T1D. By age 15, an estimated 800 children will develop islet autoimmunity and 400 will progress to T1D; 67 and 27 children have already reached these endpoints.

2010-01-01

273

How Can We Improve the Management of Vascular Risk in Type 2 Diabetes: Insights from FIELD  

Microsoft Academic Search

Purpose  Intensive multifactorial risk factor intervention, targeting blood glucose, blood pressure and low-density lipoprotein cholesterol,\\u000a is central to therapeutic management of type 2 diabetes. This strategy reduces, but does not eliminate the risk for cardiovascular\\u000a complications, and microvascular complications such as diabetic retinopathy and nephropathy still continue to develop or progress.\\u000a Fibrates have been shown to be effective in managing mixed

George Steiner

2009-01-01

274

Experience Using the Heidelberg Retina Angiograph 2 with a Wide-Field Contact Lens System in Diabetic Retinopathy Cases  

PubMed Central

Introduction: HRA (Heiderberg Retina Angiograph) 2 uses a confocal scanning laser system which can provide high quality digital images but its imaging field is only 30°at most. HRA2 with a wide-field contact lens system allows an imaging field of up to 150°. Methods: We examined the advantages and disadvantages of HRA2, with a wide-field contact lens, for the evaluating diabetic retinopathy (DR). Results: HRA2 was beneficial for obtaining images of the entire retina simultaneously, without missing peripheral retinal non-perfusion and neovascularization. On the other hand, clear images connot be acquired in cases with media opacities such as corneal dystrophy, cataract and asteroid hyalosis, or in those with yellow tinted IOL. Conclusions: HRA2 with a wide-field contact lens is useful for visualizing peripheral retinal lesions in DR cases.

Shiibashi, Miyo; Yoshimoto, Miwako; Shigeeda, Takashi; Kitano, Shigehiko; Kato, Satoshi

2013-01-01

275

Association between serum uric acid level and diabetic peripheral neuropathy (A case control study).  

PubMed

Background: The role of uric acid is well known for the development of nephropathy and retinopathy in diabetic patients. The aim of this study was to evaluate the serum uric acid levels in patients with or without diabetic neuropathy (DPN). Methods: Forty-two patients with DPN (case group) and 42 patients without DPN (control group) matched with regard to age, gender, body mass index (BMI) and duration of their disease were entered into the study. The diagnosis of DPN was based on the nerve conduction studies on sural, peroneal and tibial nerves in lower limbs. Serum uric acid was measured in these two groups. Results: The mean age of the patients in the case group was 54.6±6.9 and in the control group was 55.8±5.8 years (p=0.389). The demographic characteristics of the patients in these two groups were equal, but only the history of diabetic foot ulcer was higher in patients with DPN (p<0.05). The mean serum uric acid was 4.70±0.96 in diabetic patients with DPN and 4.36±0.89 mg/dl in patients without DPN (p=0.019). Conclusion: The results show the higher level of serum uric acid level in diabetic patients with diabetic neuropathy. Further studies are required to determine the role of uric acid in the development and progression of DPN. PMID:24490008

Kiani, Javad; Habibi, Zahra; Tajziehchi, Ali; Moghimbeigi, Abbas; Dehghan, Arash; Azizkhani, Homeyra

2014-01-01

276

Association between serum uric acid level and diabetic peripheral neuropathy (A case control study)  

PubMed Central

Background: The role of uric acid is well known for the development of nephropathy and retinopathy in diabetic patients. The aim of this study was to evaluate the serum uric acid levels in patients with or without diabetic neuropathy (DPN). Methods: Forty-two patients with DPN (case group) and 42 patients without DPN (control group) matched with regard to age, gender, body mass index (BMI) and duration of their disease were entered into the study. The diagnosis of DPN was based on the nerve conduction studies on sural, peroneal and tibial nerves in lower limbs. Serum uric acid was measured in these two groups. Results: The mean age of the patients in the case group was 54.6±6.9 and in the control group was 55.8±5.8 years (p=0.389). The demographic characteristics of the patients in these two groups were equal, but only the history of diabetic foot ulcer was higher in patients with DPN (p<0.05). The mean serum uric acid was 4.70±0.96 in diabetic patients with DPN and 4.36±0.89 mg/dl in patients without DPN (p=0.019). Conclusion: The results show the higher level of serum uric acid level in diabetic patients with diabetic neuropathy. Further studies are required to determine the role of uric acid in the development and progression of DPN.

Kiani, Javad; Habibi, Zahra; Tajziehchi, Ali; Moghimbeigi, Abbas; Dehghan, Arash; Azizkhani, Homeyra

2014-01-01

277

Clinical studies of advanced glycation end product inhibitors and diabetic kidney disease.  

PubMed

Current treatment of the nephropathy complication of diabetes mellitus is suboptimal in halting the progression of the complex disease. Among the irreversible effects of sustained hyperglycemia is the heightened formation of advanced glycation end products (AGEs). The role of AGEs in diabetic nephropathy has been established by years of basic research. This article reports progression through human studies of the few AGE inhibitors that have reached clinical development, including pimagedine, pyridoxamine, and alagebrium. PMID:15539009

Williams, Mark E

2004-12-01

278

Proliferative retinopathy predicts nephropathy: a 25-year follow-up study of type 1 diabetic patients  

Microsoft Academic Search

We wanted to examine proliferative retinopathy as a marker of incident nephropathy in a 25-year follow-up study of a population-based\\u000a cohort of Danish type 1 diabetic patients and to examine cross-sectional associations between nephropathy and retinopathy\\u000a in long-term surviving patients of the same cohort. All type 1 diabetic patients from Fyn County, Denmark, were identified\\u000a as of 1 July 1973.

Charlotte Karlberg; Christine Falk; Anders Green; Anne Katrin Sjølie; Jakob Grauslund

279

New mouse model to study islet transplantation in insulin-dependent diabetes mellitus  

Microsoft Academic Search

BACKGROUND: Islet transplantation studies with diabetic rodents frequently use treatment with diabetogens such as alloxan or streptozotocin to render hosts hyperglycemic. These chemicals produce unwanted toxic side effects, which complicate interpretations of damage produced by hyperglycemia versus direct toxin-induced damage. A mouse that spontaneously developed insulin-sensitive diabetes without beta-cell autoimmunity would provide an excellent vehicle for testing beta-cell replacement protocols.

Clayton E. Mathews; Stephen H. Langley; Edward H. Leiter

2002-01-01

280

Prevention of type 2 diabetes in British Bangladeshis: qualitative study of community, religious, and professional perspectives  

Microsoft Academic Search

Objective To understand lay beliefs and attitudes, religious teachings, and professional perceptions in relation to diabetes prevention in the Bangladeshi community.Design Qualitative study (focus groups and semistructured interviews).Setting Tower Hamlets, a socioeconomically deprived London borough, United Kingdom.Participants Bangladeshi people without diabetes (phase 1), religious leaders and Islamic scholars (phase 2), and health professionals (phase 3).Methods 17 focus groups were run

Clare Grace; Reha Begum; Syed Subhani; Peter Kopelman; Trisha Greenhalgh

2008-01-01

281

Impact of diabetes on health-related quality of life in a population study in Japan  

Microsoft Academic Search

Diabetes may impact on health-related quality of life (HRQOL). The aim of this population-based study was to confirm this influence. We examined 2135 residents aged ?30 years in an entire community, who had no history of cancer or cardiovascular disease and did not require care for daily activity. The response rate was 87.8%. The status of diabetes, other chronic diseases

Isao Saito; Fujiko Inami; Toshiko Ikebe; Chinatsu Moriwaki; Akiko Tsubakimoto; Kunio Yonemasu; Hideki Ozawa

2006-01-01

282

Differences in Risk Factors for Coronary Heart Disease among Diabetic and Nondiabetic Individuals from a Population with High Rates of Diabetes: The Strong Heart Study  

PubMed Central

Context: Coronary heart disease (CHD) is the leading cause of death in the United States. Objective: This study compares differences in risk factors for CHD in diabetic vs. nondiabetic Strong Heart Study participants. Design: This was an observational study. Setting: The study was conducted at three centers in Arizona, Oklahoma, and North and South Dakota. Participants: Data were obtained from 3563 of 4549 American Indians free of cardiovascular disease at baseline. Intervention(s): CHD events were ascertained during follow-up. Main Outcome Measure: CHD events were classified using standardized criteria. Results: In diabetic and nondiabetic participants, 545 and 216 CHD events, respectively, were ascertained during follow-up (21,194 and 22,990 person-years); age- and sex-adjusted incidence rates of CHD were higher for the diabetic group (27.5 vs. 12.1 per 1,000 person-years). Risk factors for incident CHD common to both groups included older age, male sex, prehypertension or hypertension, and elevated low-density lipoprotein cholesterol. Risk factors specific to the diabetic group were lower high-density lipoprotein cholesterol, current smoking, macroalbuminuria, lower estimated glomerular filtration rate, use of diabetes medication, and longer duration of diabetes. Higher body mass index was a risk factor only for the nondiabetic group. The association of male sex and CHD was greater in those without diabetes than in those with diabetes. Conclusions: In addition to higher incidence rates of CHD events in persons with diabetes compared with those without, the two groups differed in CHD risk factors. These differences must be recognized in estimating CHD risk and managing risk factors.

Lee, Elisa T.; Peterson, Leif E.; Devereux, Richard B.; Rhoades, Everett R.; Umans, Jason G.; Best, Lyle G.; Howard, William J.; Paranilam, Jaya; Howard, Barbara V.

2012-01-01

283

A prospective study of the risk of congenital defects associated with maternal obesity and diabetes mellitus.  

PubMed

This study was designed to evaluate the effects of maternal obesity and diabetes mellitus on the risk of nonchromosomal congenital defects. We used data from 22,951 pregnant women enrolled in a prospective cohort study of early prenatal exposures and pregnancy outcome. The relative risks [prevalence ratios (PRs)] of major nonchromosomal congenital defects associated with obesity and diabetes, alone or in combination, were calculated using multiple logistic regression analysis. In this study, in the absence of diabetes, obese women (body mass index > or =28) had no higher risk, overall, of having an offspring with a major defect [PR = 0.95; 95% confidence interval (CI) = 0.62-1.5]. Their offspring, however, did have a higher prevalence of certain types of defects, including orofacial clefts; club foot; cardiac septal defects; and, to a lesser extent, hydrocephaly and abdominal wall defects. Women with pre-existing or gestational diabetes who were not obese also had no excess risk overall of having offspring affected by a major defect (PR = 0.98; 95% CI = 0.43-2.2), although they did have a higher prevalence of musculoskeletal defects. The pregnancies of women who were both obese and diabetic were 3.1 times as likely (95% CI = 1.2-7.6) to result in an offspring with a defect than were those of nonobese, nondiabetic women, which suggests that obesity and diabetes mellitus may act synergistically in the pathogenesis of congenital anomalies. The defects were largely craniofacial or musculoskeletal. PMID:11055631

Moore, L L; Singer, M R; Bradlee, M L; Rothman, K J; Milunsky, A

2000-11-01

284

Association study of the ABCC8 gene variants with type 2 diabetes in south Indians  

PubMed Central

BACKGROUND: The ABCC8 gene which encodes the sulfonylurea receptor plays a major role in insulin secretion and is a potential candidate for type 2 diabetes. The -3c ? t (rs1799854) and Thr759Thr (C ? T, rs1801261) single nucleotide polymorphisms (SNPs) of the ABCC8 gene have been associated with type 2 diabetes in many populations. The present study was designed to investigate the association of these two SNPs in an Asian Indian population from south India. MATERIALS AND METHODS: A total of 1,300 subjects, 663 normal glucose tolerant (NGT) and 637 type 2 diabetic subjects were randomly selected from the Chennai Urban Rural Epidemiology Study (CURES). The -3c ? t and Thr759Thr were genotyped in these subjects using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and a few variants were confirmed by direct sequencing. RESULTS: The frequency of the ‘t’ allele of the -3c ? t SNP was found to be 0.27 in NGT and 0.29 in type 2 diabetic subjects (P = 0.44). There was no significant difference in the genotypic frequency between the NGT and type 2 diabetic group (P = 0.18). Neither the genotypic frequency nor the allele frequency of the Thr759Thr polymorphism was found to differ significantly between the NGT and type 2 diabetic groups. CONCLUSION: The -3c ? t and the Thr759Thr polymorphisms of the ABCC8 gene were not associated with type 2 diabetes in this study. However, an effect of these genetic variants on specific unidentified sub groups of type 2 diabetes cannot be excluded.

Venkatesan, Radha; Bodhini, Dhanasekaran; Narayani, Nagarajan; Mohan, Viswanathan

2014-01-01

285

Association between a deletion\\/insertion polymorphism in the ?2B-adrenergic receptor gene and insulin secretion and Type 2 diabetes. The Finnish Diabetes Prevention Study  

Microsoft Academic Search

Aims\\/hypothesis  Impaired insulin secretion has a strong genetic component. In this study we investigated whether the 12Glu9 polymorphism in the gene encoding the 2B-adrenergic receptor (ADRA2B) is associated with insulin secretion and\\/or the incidence of Type 2 diabetes in individuals with impaired glucose tolerance.Methods  We investigated a total of 506 subjects with impaired glucose tolerance participating in the Finnish Diabetes Prevention Study

N. Siitonen; J. Lindström; J. Eriksson; T. T. Valle; H. Hämäläinen; P. Ilanne-Parikka; S. Keinänen-Kiukaanniemi; J. Tuomilehto; M. Laakso; M. Uusitupa

2004-01-01

286

Posttraumatic stress disorder and incidence of type-2 diabetes: A prospective twin study.  

PubMed

Growing evidence has linked posttraumatic stress disorder (PTSD) to insulin resistance and type-2 diabetes, but most previous studies were cross-sectional. We examined the association between PTSD and incidence of diabetes in a prospective study of middle-aged male twins from the Vietnam Era Twin Registry. Lifetime PTSD was diagnosed at baseline with the Diagnostic Interview Schedule (DIS) according to DSM-III-R criteria. Subthreshold PTSD was defined by meeting some, but not all, criteria for PTSD. A total of 4340 respondents without self-reported diabetes at baseline were included. Of these, 658 reported a new diagnosis of treated diabetes over a median of 19.4 years of follow-up. At baseline, twins with PTSD showed more behavioral and metabolic risk factors such as overweight and hypertension. The age-adjusted cumulative incidence of diabetes was significantly higher in twins with PTSD (18.9%) than those without PTSD (14.4%), [odds ratio (OR) = 1.4, 95% confidence interval (CI) 1.03-1.8], and intermediate in those with subthreshold PTSD (16.4%) (OR = 1.2, 95% CI 0.9-1.5, p for trend = 0.03). Adjustment for military, lifestyle and metabolic factors diminished the association. No significant association was found comparing twin pairs discordant for PTSD. In conclusion, PTSD was prospectively associated with a 40% increased risk of new-onset type-2 diabetes which was partially explained by a cluster of metabolic and behavioral risk factors known to influence insulin resistance. Shared biological or behavioral precursors which occur within families may lead to both PTSD and insulin resistance/diabetes. Thus, PTSD could be a marker of neuroendocrine and metabolic dysregulation which may lead to type-2 diabetes. PMID:24950602

Vaccarino, Viola; Goldberg, Jack; Magruder, Kathryn M; Forsberg, Christopher W; Friedman, Matthew J; Litz, Brett T; Heagerty, Patrick J; Huang, Grant D; Gleason, Theresa C; Smith, Nicholas L

2014-09-01

287

Adiponectin and bariatric surgery: associations with diabetes and cardiovascular disease in the Swedish obese subjects study.  

PubMed

OBJECTIVE Adiponectin has been implicated in the pathogenesis of type 2 diabetes, but its role for incident diabetes, myocardial infarction, or stroke in obesity is unclear. The aim of this study was to analyze the associations between systemic levels of adiponectin and the aforementioned outcomes in a population with severe obesity at high risk of diabetes and cardiovascular events. RESEARCH DESIGN AND METHODS We measured serum concentrations of total adiponectin in 3,299 participants of the prospective controlled Swedish Obese Subjects (SOS) Study (bariatric surgery group, n = 1,570; control group given usual care, n = 1,729). Median follow-up periods ranged between 10 and 13 years for different outcomes. RESULTS In models containing both baseline adiponectin and 2-year changes in adiponectin, high baseline adiponectin and 2-year increases in adiponectin were associated with decreased risk of diabetes and myocardial infarction among controls. In the surgery group, the 2-year weight loss was paralleled by substantial increase in circulating adiponectin (1,807-1,958 ng/mL per 10-kg weight loss). However, neither baseline adiponectin nor 2-year increases in adiponectin were associated with risk of diabetes or myocardial infarction in the fully adjusted models in the surgery group. No associations were found for stroke in either group. CONCLUSIONS Taken together, baseline adiponectin and 2-year changes were associated with incident diabetes and myocardial infarction in the control group but not in the surgery group. Baseline adiponectin did not predict treatment benefit of bariatric surgery. PMID:24574342

Herder, Christian; Peltonen, Markku; Svensson, Per-Arne; Carstensen, Maren; Jacobson, Peter; Roden, Michael; Sjöström, Lars; Carlsson, Lena

2014-05-01

288

Topical Phenytoin Application in Grade I and II Diabetic Foot Ulcers: A Prospective Study  

PubMed Central

Background: India is fast becoming world diabetes capital. Diabetic foot infections are major problems among innumerable complications associated with diabetes. Material and Methods: A randomized control study was conducted to evaluate the effect of topical phenytoin on healing in diabetic foot ulcers. One hundred patients with grade I/ II diabetic foot ulcers were randomly divided into two equal groups. Patients subjected to topical phenytoin dressing were classified under study and those who underwent normal salinewound dressings were classified as control. Both the groups were compared in terms of discharge, slough, wound area reduction and duration of hospital stay. Results: Discharge and slough from wound reduced significantly by day 14 in phenytoin group and within 21 days in control group. Mean duration of hospital stay in phenytoin group was 20 days, whereas in control group, it was 26 days. This difference was statistically significant (p value <0.005,df 1). Conclusion: Hence, Phenytoin proved to be useful as a topical agent in promoting healing and in controlling infections in diabetic foot ulcers.

Patil, Vijaya; Patil, Rashmi; Kariholu, P. L.; Patil, L. S.; Shahapur, Praveeen

2013-01-01

289

New Research Methods Developed for Studying Diabetic Foot Ulceration  

NASA Technical Reports Server (NTRS)

Dr. Brian Davis, one of the Cleveland Clinic Foundation's researchers, has been investigating the risk factors related to diabetic foot ulceration, a problem that accounts for 20 percent of all hospital admissions for diabetic patients. He had developed a sensor pad to measure the friction and pressure forces under a person's foot when walking. As part of NASA Lewis Research Center's Space Act Agreement with the Cleveland Clinic Foundation, Dr. Davis requested Lewis' assistance in visualizing the data from the sensor pad. As a result, Lewis' Interactive Data Display System (IDDS) was installed at the Cleveland Clinic. This computer graphics program is normally used to visualize the flow of air through aircraft turbine engines, producing color two- and three-dimensional images.

1998-01-01

290

HLA Genotype studies in juvenile insulin-dependent diabetes  

Microsoft Academic Search

Summary  HLA genotypes were ascertained in 53 French Caucasian families, comprising 68 juvenile onset insulin-dependent diabetic siblings. Among the 49 alleles detected at different loci in the HLA complex (A, C, B, Bf, DR) 4 appeared to occur at a significantly higher frequency among the 53 index cases than in a control series of 116 healthy individuals: HLA-B18 (p-3), DRw3, DRw4

I. Deschamps; H. Lestradet; C. Bonaïti; M. Schmid; M. Busson; A. Benajam; A. Marcelli-Barge; J. Hors

1980-01-01

291

Postural Blood Pressure Changes and Associated Factors in Long-Term Type 1 Diabetes: Wisconsin Epidemiologic Study of Diabetic Retinopathy  

PubMed Central

Purpose To describe the frequency of orthostatic hypotension and hypertension and associations with risk factors in a cohort of persons with long term type 1 diabetes (n=440) participating in the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR). Methods Evaluations included detailed medical history, electrocardiography (ECG), and laboratory tests. Blood pressure (BP) was measured in supine and standing positions. Standing decrease in systolic (SBP) or diastolic (DBP) BP of at least 20 mmHg or 10 mmHg, respectively, was defined as orthostatic hypotension; increase of SBP from <140 to ? 140mmHg or DBP from < 90 to ? 90mmHg was defined as orthostatic hypertension. Results Prevalence of orthostatic hypotension and orthostatic hypertension was 16.1% and 15.2%, respectively. Some ECG measurements of cardiac autonomic dysfunction were significantly associated with orthostatic hypotension. Association between SBP and orthostatic hypotension and orthostatic hypertension were significant (Odds Ratio (95% CI), 1.02 (1.01–1.05) and 1.02 (1.01–1.04), respectively) after adjusting for confounders. Interaction between SBP and age was observed. SBP was significantly associated with orthostatic hypotension and orthostatic hypertension in people ? 40 years old (1.35 (1.02–1.78) and 1.12 (1.05–1.18), respectively). Conclusions Results showed that measurements derived from the ECG can help describe an individual at increased risk of having postural BP changes. Moreover, SBP was associated with postural BP changes among individuals who were < 40 years of age with long-term type 1 diabetes.

Hirai, Flavio E.; Moss, Scot E.; Klein, Barbara E. K.; Klein, Ronald

2009-01-01

292

Long-Term Exposure to Road Traffic Noise and Incident Diabetes: A Cohort Study  

PubMed Central

Background: Road traffic noise at normal urban levels can lead to stress and sleep disturbances. Both excess of stress hormones and reduction in sleep quality and duration may lead to higher risk for type 2 diabetes. Objective: We investigated whether long-term exposure to residential road traffic noise is associated with an increased risk of diabetes. Methods: In the population-based Danish Diet, Cancer and Health cohort of 57,053 people 50–64 years of age at enrollment in 1993–1997, we identified 3,869 cases of incident diabetes in a national diabetes registry between enrollment and 2006. The mean follow-up time was 9.6 years. Present and historical residential addresses from 1988 through 2006 were identified using a national register, and exposure to road traffic noise was estimated for all addresses. Associations between exposure to road traffic noise and incident diabetes were analyzed in a Cox regression model. Results: A 10-dB higher level of average road traffic noise at diagnosis and during the 5 years preceding diagnosis was associated with an increased risk of incident diabetes, with incidence rate ratios (IRR) of 1.08 (95% CI: 1.02, 1.14) and 1.11 (95% CI: 1.05, 1.18), respectively, after adjusting for potential confounders including age, body mass index, waist circumference, education, air pollution (nitrogen oxides), and lifestyle characteristics. After applying a stricter definition of diabetes (2,752 cases), we found IRRs of 1.11 (95% CI: 1.03, 1.19) and 1.14 (95% CI: 1.06, 1.22) per 10-dB increase in road traffic noise at diagnosis and during the 5 years preceding diagnosis, respectively. Conclusion: Exposure to residential road traffic noise was associated with a higher risk of diabetes. This study provides further evidence that urban noise may adversely influence population health.

Andersen, Zorana J.; Nordsborg, Rikke B.; Becker, Thomas; Tj?nneland, Anne; Overvad, Kim; Raaschou-Nielsen, Ole

2012-01-01

293

Prostate Cancer Risk in Pre-Diabetic Men: A Matched Cohort Study  

PubMed Central

Background Diagnosis and duration of type 2 diabetes mellitus (DM) appear to be associated with decreased prostate cancer risk. Limitations of previous studies include methods of subject selection and accurate definition of DM diagnosis. We examined the temporal relationship between DM and prostate cancer risk exploring the period of greatest risk starting from the prediabetic to the post-diabetic period using clinical and administrative data to accurately define the date of DM diagnosis. Methods We identified 5,813 men who developed DM between January 1, 1995 and December 31, 2009 (reference date, date of DM onset or matched date for non-diabetic cohort) and 28,019 non-diabetic men matched by age, smoking history, residence, and reference date. Prostate cancer incidence before and after the reference date was assessed using Cox regression modeling adjusted for matching variables, body mass index, insurance status, and comorbidities. Primary outcomes included hazard ratio (HR) and number needed to be exposed to DM for one additional person to be harmed (NNEH) or benefit (NNEB) with respect to prostate cancer risk. Results After full adjustment, the HR for prostate cancer before DM diagnosis was 0.96 (95% CI 0.85–1.08; P=0.4752), and the NNEB was 974 at DM diagnosis. After the reference date, the fully-adjusted HR for prostate cancer in diabetic men was 0.84 (95% CI 0.72–0.97, P=0.0167), and the NNEB 3 years after DM onset was 425. The NNEB continued to decrease over time, reaching 63 at 15 years after DM onset, suggesting an increasing protective effect of DM on prostate cancer risk over time. No significant difference between the diabetic and non-diabetic cohort was found prior to reference date. Conclusion Prostate cancer risk is not reduced in pre-diabetic men but decreases after DM diagnosis and the protective effect of DM onset on prostate cancer risk increases with DM duration.

Onitilo, Adedayo A.; Berg, Richard L.; Engel, Jessica M.; Stankowski, Rachel V.; Glurich, Ingrid; Williams, Gail M.; Doi, Suhail A. R.

2013-01-01

294

A cross-sectional study of the association between persistent organochlorine pollutants and diabetes  

PubMed Central

Background Experimental evidence supports the hypothesis that persistent organochlorine pollutants (POPs) may cause type 2 diabetes mellitus, whereas there is no fully convincing epidemiological evidence for such an association. In Sweden the most important source of POP exposure is fatty fish. We have assessed the association between serum levels of POPs and prevalence of diabetes in Swedish fishermen and their wives, with high consumption of fatty fish from the Baltic Sea. Methods In 196 men (median age 60 years) and 184 women (median age 64 years), we analyzed 2,2',4,4',5,5'-hexachlorobiphenyl (CB-153) and 1,1-dichloro-2,2-bis(p-chlorophenyl)-ethylene (p,p'-DDE) in serum using gas chromatography-mass spectrometry. The participants were asked if they had diabetes and, if so, since which year and about medication and diet. The Odds Ratios (OR) for diabetes with respect to continuous exposure variables were analyzed with logistic regression, adjusting for potential confounders. Moreover trends of diabetes prevalence with respect to trichotomized exposure variables were tested with Jonckheere-Terpstra's test. Results Six percent of the men and 5% of the women had diabetes. After confounder adjustment CB-153 was significantly associated with diabetes prevalence using both categorized and continuous exposure data (an increase of 100 ng/g lipid corresponded to an OR of 1.16, 95% confidence interval [CI] 1.03, 1.32, p = 0.03). Similar associations were observed for p,p'-DDE (an increase of 100 ng/g lipid corresponded to an OR of 1.05, 95% CI 1.01, 1.09, p = 0.006). Gender stratified analyses showed among men consistent positive associations with CB-153, but a more ambiguous pattern with respect to DDE. In contrast, among the women the associations with p,p'-DDE were stronger than with CB-153. Conclusion The study provides support that POP exposure might contribute to type 2 diabetes mellitus.

Rylander, Lars; Rignell-Hydbom, Anna; Hagmar, Lars

2005-01-01

295

White Matter Structural Differences in Young Children With Type 1 Diabetes: A Diffusion Tensor Imaging Study  

PubMed Central

OBJECTIVE To detect clinical correlates of cognitive abilities and white matter (WM) microstructural changes using diffusion tensor imaging (DTI) in young children with type 1 diabetes. RESEARCH DESIGN AND METHODS Children, ages 3 to <10 years, with type 1 diabetes (n = 22) and age- and sex-matched healthy control subjects (n = 14) completed neurocognitive testing and DTI scans. RESULTS Compared with healthy controls, children with type 1 diabetes had lower axial diffusivity (AD) values (P = 0.046) in the temporal and parietal lobe regions. There were no significant differences between groups in fractional anisotropy and radial diffusivity (RD). Within the diabetes group, there was a significant, positive correlation between time-weighted HbA1c and RD (P = 0.028). A higher, time-weighted HbA1c value was significantly correlated with lower overall intellectual functioning measured by the full-scale intelligence quotient (P = 0.03). CONCLUSIONS Children with type 1 diabetes had significantly different WM structure (as measured by AD) when compared with controls. In addition, WM structural differences (as measured by RD) were significantly correlated with their HbA1c values. Additional studies are needed to determine if WM microstructural differences in young children with type 1 diabetes predict future neurocognitive outcome.

Aye, Tandy; Barnea-Goraly, Naama; Ambler, Christian; Hoang, Sherry; Schleifer, Kristin; Park, Yaena; Drobny, Jessica; Wilson, Darrell M.; Reiss, Allan L.; Buckingham, Bruce A.

2012-01-01

296

Health beliefs and folk models of diabetes in British Bangladeshis: a qualitative study  

PubMed Central

Objective: To explore the experience of diabetes in British Bangladeshis, since successful management of diabetes requires attention not just to observable behaviour but to the underlying attitudes and belief systems which drive that behaviour. Design: Qualitative study of subjects’ experience of diabetes using narratives, semi-structured interviews, focus groups, and pile sorting exercises. A new qualitative method, the structured vignette, was developed for validating researchers’ understanding of primary level culture. Subjects: 40 British Bangladeshi patients with diabetes, and 10 non-Bangladeshi controls, recruited from primary care. Result: Several constructs were detected in relation to body image, cause and nature of diabetes, food classification, and knowledge of complications. In some areas, the similarities between Bangladeshi and non-Bangladeshi subjects were as striking as their differences. There was little evidence of a fatalistic or deterministic attitude to prognosis, and most informants seemed highly motivated to alter their diet and comply with treatment. Structural and material barriers to behaviour change were at least as important as “cultural” ones. Conclusion: Bangladeshi culture is neither seamless nor static, but some widely held beliefs and behaviours have been identified. Some of these have a potentially beneficial effect on health and should be used as the starting point for culturally sensitive diabetes education.

Greenhalgh, Trisha; Helman, Cecil; Chowdhury, A Mu'min

1998-01-01

297

Minocycline improves peripheral and autonomic neuropathy in type 2 diabetes: MIND study.  

PubMed

Diabetic peripheral neuropathy and diabetic autonomic neuropathy are serious and common complications of diabetes associated with increased risk of mortality and cardiovascular disease. We sought to evaluate the safety and efficacy of minocycline in type 2 diabetic patients with diabetic peripheral and autonomic neuropathy. In a randomized placebo controlled study, 50 outpatients were randomly assigned to receive 100 mg minocycline or placebo. Outcome measures included the vibration perception threshold (VPT), Leeds assessment of neuropathic symptoms and signs (LANSS), Pain Disability Index (PDI), Visual Analog Scale (VAS), beck depression inventory (BDI), health assessment questionnaire (HAQ) and autonomic neuropathy, assessed by cardiovascular reflex tests according to Ewing and peripheral sympathetic autonomic function was assessed by FDA approved Sudoscan. At baseline there were no significant differences between demographic variables and the neuropathy variables in the minocycline and placebo groups. After treatment, VPT significantly improved in the minocycline group as compared to the placebo group. Mean posttreatment scores on the LANSS, PDI and HAQ were significantly lower in the minocycline group compared with the placebo group. However, BDI and VAS significantly (p = 0.01) improved in both minocycline and placebo groups (Table 2). After treatment with minocycline, heart rate (HR) response to standing significantly improved, while there was a borderline significance toward a reduction in HR response to deep breath. These finding indicate that 6-week oral treatment with minocycline is safe, well tolerated and significantly improves peripheral and autonomic neuropathy in type 2 diabetic patients. PMID:24497205

Syngle, Ashit; Verma, Inderjeet; Krishan, Pawan; Garg, Nidhi; Syngle, Vijaita

2014-07-01

298

Training peers to provide ongoing diabetes self-management support (DSMS): Results from a pilot study  

PubMed Central

Objective This study determined the feasibility of training adults with diabetes to lead diabetes self-management support (DSMS) interventions, examined whether participants can achieve the criteria required for successful graduation, and assessed perceived efficacy of and satisfaction with the peer leader training (PLT) program. Methods We recruited nine African-American adults with diabetes for a 46-hour PLT pilot program conducted over 12 weeks. The program utilized multiple instructional methods, reviewed key diabetes education content areas, and provided communication, facilitation, and behavior change skills training. Participants were given three attempts to achieve the pre-established competency criteria for diabetes knowledge, empowerment-based facilitation, active listening, and self-efficacy. Results On the first attempt 75%, 75%, 63%, and 75% passed diabetes knowledge, empowerment-based facilitation, active listening, and self-efficacy, respectively. Those participants who did not pass on first attempt passed on the second attempt. Participants were highly satisfied with the program length, balance between content and skills development, and preparation for leading support activities. Conclusion Findings suggest that it is feasible to train and graduate peer leaders with the necessary knowledge and skills to facilitate DSMS interventions. Practical Implications With proper training, peer support may be a viable model for translating and sustaining DSMS interventions into community-based settings.

Tang, Tricia S.; Funnell, Martha M.; Gillard, Marylou; Nwankwo, Robin; Heisler, Michele

2013-01-01

299

Impact of informed-choice invitations on diabetes screening knowledge, attitude and intentions: an analogue study  

PubMed Central

Background Despite concerns that facilitating informed choice would decrease diabetes screening uptake, 'informed choice' invitations that increased knowledge did not affect attendance (the DICISION trial). We explored possible reasons using data from an experimental analogue study undertaken to develop the invitations. We tested a model of the impact on knowledge, attitude and intentions of a diabetes screening invitation designed to facilitate informed choices. Methods 417 men and women aged 40-69 recruited from town centres in the UK were randomised to receive either an invitation for diabetes screening designed to facilitate informed choice or a standard type of invitation. Knowledge of the invitation, attitude towards diabetes screening, and intention to attend for diabetes screening were assessed two weeks later. Results Attitude was a strong predictor of screening intentions (? = .64, p = .001). Knowledge added to the model but was a weak predictor of intentions (? = .13, p = .005). However, invitation type did not predict attitudes towards screening but did predict knowledge (? = -.45, p = .001), which mediated a small effect of invitation type on intention (indirect ? = -.06, p = .017). Conclusions These findings may explain why information about the benefits and harms of screening did not reduce diabetes screening attendance in the DICISION trial.

2010-01-01

300

Health-related quality of life in diabetic patients and controls without diabetes in refugee camps in the Gaza strip: a cross-sectional study  

PubMed Central

Background Prevalence of diabetes mellitus is increasing in developed and developing countries. Diabetes is known to strongly affect the health-related quality of life (HRQOL). HRQOL is also influenced by living conditions. We analysed the effects of having diabetes on HRQOL under the living conditions in refugee camps in the Gaza strip. Methods We studied a sample of 197 diabetic patients who were recruited from three refugee camps in the Gaza strip and 197 age- and sex-matched controls living in the same camps. To assess HRQOL, we used the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) including four domains (physical health, psychological, social relations and environment). Domain scores were compared for cases (diabetic patients) and controls (persons without diabetes) and the impact of socio-economic factors was evaluated in both groups. Results All domains were strongly reduced in diabetic patients as compared to controls, with stronger effects in physical health (36.7 vs. 75.9 points of the 0–100 score) and psychological domains (34.8 vs. 70.0) and weaker effects in social relationships (52.4 vs. 71.4) and environment domains (23.4 vs. 36.2). The impact of diabetes on HRQOL was especially severe among females and older subjects (above 50 years). Low socioeconomic status had a strong negative impact on HRQOL in the younger age group (<50 years). Conclusion HRQOL is strongly reduced in diabetic patients living in refugee camps in the Gaza strip. Women and older patients are especially affected.

Eljedi, Ashraf; Mikolajczyk, Rafael T; Kraemer, Alexander; Laaser, Ulrich

2006-01-01

301

Fructose Intake and Cardiovascular Risk Factors in Youth with Type 1 Diabetes: SEARCH for Diabetes in Youth Study  

PubMed Central

Aims High consumption of dietary fructose has been shown to contribute to dyslipidemia and elevated blood pressure in adults, but there are few data in youth, particularly those at greater risk of cardiovascular disease (CVD). The aim of this study was to examine the association between fructose intake and CVD risk factors in a diverse population of youth with type 1diabetes (T1D). Methods This was a cross-sectional analysis of data from the SEARCH for Diabetes in Youth study, including 2085 youth ages 10–22 years with T1D, of which 22% were racial/ethnic minority and 50% were female. A semi-quantitative food frequency questionnaire was used to assess intake. Results Median daily fructose consumption was 7.9% of total calories. Fructose intake was positively associated with triglycerides (p<.01), but not with total cholesterol, LDL-cholesterol, HDL-cholesterol, or blood pressure after adjustment for physical activity and socio-demographic, clinical, and dietary covariates. An increase in fructose intake of 22 grams (equivalent to a 12 oz. can of soda) was associated with a 23% higher odds of borderline/ high versus low triglycerides (p<.005). Conclusion These data suggest that children with T1D should moderate their intake of fructose, particularly those with borderline or high triglycerides.

Couch, Sarah C.; Crandell, Jamie L.; Shah, Amy S.; Dolan, Lawrence M.; Merchant, Anwar T.; Liese, Angela D.; Lawrence, Jean M.; Pihoker, Catherine; Mayer-Davis, Elizabeth J.

2013-01-01

302

Risk Factors for Falls in Older Disabled Women With Diabetes: The Women's Health and Aging Study  

PubMed Central

Background The aim of this study was to determine whether older disabled women with diabetes have an increased risk of falls compared to women without diabetes and to identify fall risk factors among this high-risk subgroup of patients. Methods Data are from the Women’s Health and Aging Study I (n = 1002, age ? 65 years), a prospective, population-based cohort study of the one third most disabled women in the Baltimore (MD) urban community-dwelling population. Participants were followed semiannually for 3 years. Falls were ascertained at each interview. Diabetes was ascertained by means of a standardized algorithm using multiple sources of information. Results Baseline prevalence of diabetes was 15.5%. Of the 878 women who participated in at least one follow-up visit and were able to walk at baseline, 64.9% fell at least once during the study and 29.6% experienced two or more falls during a follow-up interval. After adjustment for traditional risk factors, women with diabetes had a higher probability of any fall (odds ratio [OR] 1.38; 95% confidence interval [CI], 1.04–1.81) and of falling two or more times during a follow-up interval (OR 1.69; CI, 1.18–2.43), compared with women without diabetes. Among diabetic women, presence of widespread musculoskeletal pain (OR 5.58; CI, 1.89–16.5), insulin therapy (OR 2.02; CI, 1.10–3.71), overweight (OR 3.50; CI, 1.21–10.1), and poor lower-extremity performance (OR 7.76; CI, 1.03–58.8) were independently associated with increased likelihood of recurrent falls, after adjusting for major risk factors. There were synergistic effects of diabetes and lower-extremity pain and also diabetes and body mass index levels on the risk of falling (p for interactions < .05). Conclusion Even among disabled older women diabetes is associated with an increased risk of falling, independent of established fall risk factors. In this specific group of older women, pain, high body mass index, and poor lower-extremity performance are powerful predictors of falling.

Volpato, Stefano; Leveille, Suzanne G.; Blaum, Caroline; Fried, Linda P.; Guralnik, Jack M.

2008-01-01

303

Post-prandial glucose and diabetic complications: systematic review of observational studies.  

PubMed

Post-prandial hyperglycemia is considered a relevant therapeutic target in type 2 diabetic patients, and it could represent per se an independent risk factor for diabetic complications. Aim of the present systematic review is to collect and summarize evidence from observational studies on the relationship between post-prandial glucose (PPG) and cardiovascular or microvascular disease in patients with diabetes. An extensive search of Medline (any date up to December 31, 2010) was performed for all longitudinal epidemiological studies with a cohort design. The following endpoints were taken into consideration: death from any cause; cardiovascular death and micro- and macrovascular complications. The number of epidemiological studies assessing the relationship between PPG and microvascular or cardiovascular disease in subjects with diabetes is surprisingly scarce. In fact, of the 391 retrieved studies, only 8 fulfilled the inclusion criteria. Most of those investigations enrolled small samples, which in many instances were not representative of the general population. Furthermore, the assessment of PPG varied widely across studies. These considerations prevent any formal meta-analysis. Despite this, the few available studies show that higher PPG is associated with increased all-cause and cardiovascular death, incidence of major cardiovascular events (including myocardial infarction and stroke), and progression of diabetic retinopathy. PMID:22116350

Mannucci, Edoardo; Monami, Matteo; Lamanna, Caterina; Adalsteinsson, Johan Erpur

2012-08-01

304

Incidence and outcomes of diabetes mellitus in elderly people: report from the Canadian Study of Health and Aging  

PubMed Central

BACKGROUND: The epidemiology of diabetes in elderly people is not well understood. The purpose of this study was to estimate the incidence of diabetes mellitus among elderly people in Canada and the relative risks of death and admission to an institution among elderly diabetic patients. METHODS: The study was a secondary analysis of data for a community-dwelling sample from the Canadian Study of Health and Aging, a nationwide representative cohort study of 9008 elderly people (65 years of age or older at baseline) in Canada. Diabetes was identified primarily by self-reporting, and a clinician's diagnosis and the presence of treatments for diabetes were used to identify diabetic patients who did not report that they had the condition. RESULTS: The reliability of self-reported diabetes (the kappa statistic) was 0.85. The estimated annual incidence of diabetes was 8.6 cases per thousand for elderly Canadians. Incidence decreased with age, from 9.5 for subjects 65-74 years of age, to 7.9 for those 75-84 years of age and then to 3.1 for those 85 years of age and older. Diabetes was associated with death (relative risk 1.87, 95% confidence interval 1.59-2.19) and admission to an institution (relative risk 1.58, 95% confidence interval 1.28-1.94). INTERPRETATION: Diabetes mellitus is common among elderly people, but the incidence declines among the very old.

Rockwood, K; Awalt, E; MacKnight, C; McDowell, I

2000-01-01

305

Advanced field magnetometers comparative study  

Microsoft Academic Search

The application of flux-gate and search-coil magnetometers for geophysical prospecting is more and more widespread. The physical principle of their operation determines their use for the measurement of weak magnetic fields in the frequency band where their sensitivity threshold is lower: from DC to some tens of Hz for flux-gates and from some fractions of Hz till ?1 MHz for

V. Korepanov; R. Berkman; L. Rakhlin; Ye. Klymovych; A. Prystai; A Marussenkov; M. Afanassenko

2001-01-01

306

A pilot study on the effects of a polyherbal formulation cream on diabetic foot ulcers  

PubMed Central

Background & objectives: Diabetic foot ulcers are the most common cause of non-traumatic lower extremity amputations in developing countries. The aim of this pilot study was to evaluate the safety of using a polyherbal formulation in healing diabetic foot ulcers in comparison with standard silver sulphadiazine cream among patients with type 2 diabetes. Methods: A total of 40 (M:F=29:14) consecutive type 2 diabetes patients with foot ulcers were enrolled in this study. They were randomly assigned to two groups of 20 each; Group 1 was treated with polyherbal formulation and group 2 with silver sulphadiazine cream. All the patients were followed up for a period of 5 months. The baseline ulcer size was noted and photograph of the wound was taken at the baseline and at each follow up visit. Number of days taken for healing of the wound was recorded. Results: The mean age of patients, duration of diabetes and HbA1c% were similar in both the study groups. The mean length and width of the ulcers was also similar in both the groups at baseline visit. There was a significant decrease in the size of the wound (length and width) in both the study groups (P<0.001). The mean time taken for the healing of the ulcer was around 43 days in both groups. Interpretation & conclusions: Diabetic wound cream prepared by using polyherbal formulation was found to be effective as well as safe in healing diabetic foot ulcers like the standard silver sulphadiazine cream.

Viswanathan, Vijay; Kesavan, Rajesh; Kavitha, K.V.; Kumpatla, Satyavani

2011-01-01

307

Markers of endothelial dysfunction in the prediction of coronary artery disease in Type 1 diabetes. The Pittsburgh Epidemiology of Diabetes Complications Study  

Microsoft Academic Search

Low-density lipoprotein (LDL) oxidation, the immune response it provokes, and lipoprotein subclasses measured by nuclear magnetic resonance (NMR) spectroscopy have explained some of the enhanced coronary artery disease (CAD) risks in Type 1 diabetes. We examined whether cellular adhesion molecules further improve CAD prediction.Participants were identified from the Epidemiology of Diabetes Complications (EDC) cohort, a 10-year prospective study of childhood-onset

Tina Costacou; Maria F. Lopes-Virella; Janice C. Zgibor; Gabriel Virella; Jim Otvos; Michael Walsh; Trevor J. Orchard

2005-01-01

308

Genome-Wide Linkage Scan to Identify Loci Associated with Type 2 Diabetes and Blood Lipid Phenotypes in the Sikh Diabetes Study  

Microsoft Academic Search

In this investigation, we have carried out an autosomal genome-wide linkage analysis to map genes associated with type 2 diabetes (T2D) and five quantitative traits of blood lipids including total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, very low-density lipoprotein (VLDL) cholesterol, and triglycerides in a unique family-based cohort from the Sikh Diabetes Study (SDS). A total of

Dharambir K. Sanghera; Latonya F. Been; Sarju Ralhan; Gurpreet S. Wander; Narinder K. Mehra; Jai Rup Singh; Robert E. Ferrell; Mohammed I. Kamboh; Christopher E. Aston

2011-01-01

309

Pulsed Field Emission Cathode Studies  

NASA Astrophysics Data System (ADS)

Field emission cathodes have been a topic of research in recent years as efforts have mounted to find a cathode material that has low gas evolution with negligible impedance collapse and high current densities. In the explosive field emission cathodes utilized for high power microwave tubes, microwave pulse shortening can occur due to motion of the cathode plasma across the anode-cathode (A-K) gap. This motion is affected by the gas evolution. Ultimately, this gap closure can sufficiently change the diode impedance such that the tube can no longer operate under the desired conditions. We discuss comparisons of CsI coated carbon fiber and bare carbon fiber to velvet cathodes as potential solutions to this problem. These cathodes have demonstrated low A-K gap closure times with applied fields in the range of a few tens of kV/cm to several hundred kV/cm with currents into the several kiloampere range. We review the results of experiments on the Cathode Test Bed at the Air Force Research Laboratory and comparison with simulation.

Shiffler, Don; Umstattd, Ryan; Lacour, Matthew; Sena, Miguel; Luginsland, John; Hendricks, Kyle; Spencer, Thomas; Gibbs, Aimee; Voss, Don

1999-11-01

310

Effect of panretinal photocoagulation on serum levels of laminin in patients with diabetes: a prospective study  

PubMed Central

BACKGROUND/AIM—Laminin, a major specific non-collagenous glycoprotein of basement membrane, has been proposed as an index of diabetic retinopathy and high serum concentrations have been reported in patients with proliferative diabetic retinopathy. On the other hand, panretinal photocoagulation (PRP) prevents the progression of severe diabetic retinopathy and reverses preretinal neovascularisation. The aim of the study was to investigate the effect of PRP on serum levels of laminin in patients with diabetes.?METHODS—20 patients with diabetes undergoing PRP and 15 patients with mild or moderate non-proliferative diabetic retinopathy in whom a PRP was not performed were included in the study. Serum laminin-P1 (Lam-P1), the largest pepsin resistant fragment of laminin, was determined by radioimmunoassay in each patient before starting PRP and 3 months after it was accomplished. Similarly, a baseline and a 4 month sample were analysed in the non-photocoagulated controls.?RESULTS—Serum Lam-P1 concentrations obtained 3 months after PRP were significantly lower when compared with the initial values (1.62 (SD 0.36) U/ml v 1.91 (0.37) U/ml; p <0.001). A decrease of serum levels of Lam-P1 could be seen in all patients. By contrast, in those patients with mild or moderate non-proliferative diabetic retinopathy in whom a PRP was not performed, no significant changes were detected in serum Lam-P1 concentrations (1.72 (0.20) U/ml v 1.74 (0.17); p=0.250).?CONCLUSION—PRP decreases serum Lam-P1 levels in patients with severe diabetic retinopathy. Thus, the studies addressed to evaluate the usefulness of Lam-P1 as a marker of diabetic retinopathy should consider previous PRP as an influencing factor. Finally, our results suggest that retinal source of Lam-P1 strongly contributes to serum Lam-P1 in patients with severe diabetic retinopathy.??

Masmiquel, L; Burgos, R.; Mateo, C.; Marti, R.; Segura, R.; Simo, R.

1999-01-01

311

Prevalence of Gall Bladder Stones among Type 2 Diabetic Patients in Benghazi Libya: A Case-control Study  

PubMed Central

Background: Diabetes mellitus and gall bladder stones are both common and costly diseases. Increasing age, female gender, overweight, familial history of the disease and type 2 diabetes mellitus is all associated with an increased risk of gallstones. Several studies from around the world reported an increased prevalence of gall bladder stones in patients with diabetes mellitus. Aims and objectives: The aim of this study was to define the frequency of gall bladder stones among Libyan diabetics and to evaluate the possible associated risk factors in these patients. Patients and methods: A case-control study was performed during 2007 at Benghazi Diabetes and endocrinology Center. The study involved 161 randomly selected type-2 diabetic patients under regular follow up at the center, and 166 age and sex matched non-diabetic outpatients at the 7th of October teaching hospital. Real-time abdominal ultrasound was performed by two radiologists to examine the abdomen after an overnight fast. Results: About 40% of the diabetic cohort had gall bladder stones as compared to 17.5% of non-diabetic patients. Females were significantly more affected than males. Patients with gall bladder stones were significantly older and had a significantly higher body mass index than those without stones. Conclusion: The prevalence of gallstones in Libyan diabetic patients is higher than the rates reported in other parts of the world. Libyan diabetic patients with gallstones tend to be older and more obese than those without gallstones. Duration of diabetes mellitus and type of treatment does not seem to influence the frequency of gall bladder stones among Libyan diabetics.

Elmehdawi, RR; Elmajberi, SJ; Behieh, A; Elramli, A

2009-01-01

312

Diabetes mellitus and risk of hepatocellular carcinoma: findings from the Singapore Chinese Health Study  

PubMed Central

Background: The increasing prevalence of diabetes may contribute to the rising incidence of hepatocellular carcinoma (HCC) in the US and other developed countries where HCC incidence is relatively low. Data from prospective studies on diabetes and risk of HCC in at-risk populations due to high prevalence of viral hepatitis in southeast Asia are sparse. Methods: The Singapore Chinese Health Study is a prospective cohort of 63?257 middle-aged and older Chinese men and women enrolled in 1993–1998. Besides an in-person interview administered to all participants at baseline, testing of serologic markers of hepatitis B or C infections were performed on a subset of cohort subjects. After a mean follow-up of 14 years, 499 cohort participants developed HCC. Results: A history of diabetes at baseline was associated with a hazard ratio of 2.14 (95% confidence interval, 1.69–2.71). This statistically significant association was comparable in magnitude between men and women, and remained equally strong across strata of subjects defined by the number of years between their first clinical diagnosis of diabetes and time of enrolment in this cohort. Within a nested case-control set of cohort subjects tested for serological markers of hepatitis B or C infections, the diabetes–HCC association was found to be present mainly among those devoid of any markers. Conclusion: A history of diabetes at baseline is highly associated with non-viral HCC. Future studies are warranted to elucidate the biological mechanism underpinning the role of diabetes in nonviral-related hepatocarcinogenesis.

Koh, W-P; Wang, R; Jin, A; Yu, M C; Yuan, J-M

2013-01-01

313

[Prospective observational studies of the development of type 1 diabetes during childhood and puberty].  

PubMed

The incidence of type 1 diabetes is increasing rapidly. Detecting the mechanisms underlying the autoimmune disease is a main goal of research. Studies investigating the pathogenesis of type 1 diabetes are working on the identification and characterization of exogenous, endogenous and genetic factors which induce or modify autoimmunity. Islet cell autoimmunity can be detected through screening for islet cell autoantibodies. This quantitative analysis allows the stratification of the individual risk for the development of type 1 diabetes. Prospective observational studies are most suitable to assess persons at risk, either because of the occurrence of type 1 diabetes in the family or because of a genotype associated with increased risk. Age-related factors which are analysed in observational studies include nutrition, increase in height and weight, childhood diseases and vaccinations as well as psychosocial aspects. Identification and characterization of these risk factors will serve as a basis for working on new approaches to prevent or to cure type 1 diabetes. Aim of this article is to provide an overview of the most relevant observational studies. PMID:21287431

Meier-Stiegen, F; Ziegler, A-G

2011-02-01

314

Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors  

Microsoft Academic Search

BACKGROUND: Anxiety and depression contribute to poor disease outcomes among individuals with diabetes. This study aimed to assess the prevalence of anxiety and depression and to identify their associated factors including metabolic components among people with type 2 diabetes. METHODS: We conducted a cross-sectional, multi-center study in four out-patient clinics in Karachi, Pakistan. In all, 889 adults with type-2 diabetes

Ali Khan Khuwaja; Saima Lalani; Raheem Dhanani; Iqbal Syed Azam; Ghazala Rafique; Franklin White

2010-01-01

315

Field Guides in Academe: A Citation Study  

ERIC Educational Resources Information Center

Field guides are common in libraries but are generally not considered scholarly. This study examines citations to fifty field guides to determine how they were used in scholarly publications, finding that field guides are frequently cited as a source of data on the ranges, habits, and descriptions of plants and animals.

Schmidt, Dianne

2006-01-01

316

Cardiorespiratory fitness and the incidence of type 2 diabetes: a cohort study of Japanese male athletes  

PubMed Central

Background In Japan, although the incidence of overweight (BMI???25) is still low compared with that in Europe and the United States, the prevalence of type 2 diabetes has increased over the last 15 years,. In both Japanese and Caucasian populations it has been reported that a high level of cardiorespiratory fitness protects against the development of type 2 diabetes. However, there are no reports focused specifically on athletes that investigate whether high cardiorespiratory fitness at a young age can prevent disease later in life. We examined the relationship between cardiorespiratory fitness at a young age and the development of type 2 diabetes in Japanese athletes using a cohort study. Methods The cardiorespiratory fitness of male alumni of the physical education department of Juntendo University, as measured by stored data of a 1,500-m endurance run in college (1971–1991) was compared with their incidence of type 2 diabetes as determined by follow-up questionnaires (2007–2009). This study used Cox’s proportional hazards models and adjusted for age, year of graduation, BMI, smoking, and sports club participation at college age. Results We collected data on cardiorespiratory fitness at college age and medical history survey data during 2007–2009 from 570 male alumni. The median follow-up period was 26 years (IQR: 23–29 years), and 22 men had developed type 2 diabetes. An inverse relationship was observed between incidence of type 2 diabetes and level of cardiorespiratory fitness at time of college after adjustment for age, year of graduation, BMI, smoking, and sports participation. The adjusted hazards ratio and 95% CI by category (low, medium, and high) were 1.00 (reference), 0.40 (0.14–1.13) and 0.26 (0.07–1.00) (p?=?0.03 for trend). Conclusions A high level of cardiorespiratory fitness at a young age can help prevent type 2 diabetes later in life.

2014-01-01

317

Study of antihyperglycaemic activity of medicinal plant extracts in alloxan induced diabetic rats  

PubMed Central

Background: Diabetes mellitus, for a long time, has been treated with plant derived medicines in Sri Lanka. Aim: The aim of this study is to determine the efficacy and dose response of oral antihyperglycaemic activity of eight Sri Lankan medicinal plant extracts, which are used to treat diabetes in traditional medicine in diabetic rats. Materials and Methods: Medicinal plants selected for the study on the basis of documented effectiveness and wide use among traditional Ayurveda physicians in the Southern region of Sri Lanka for the treatment of diabetes mellitus. The effect of different doses of aqueous stem bark extracts of Spondias pinnata (Anacardiaceae), Kokoona zeylanica (Celastraceae), Syzygium caryophyllatum (Myrtaceae), Gmelina arborea (Verbenaceae), aerial part extracts of Scoparia dulcis (Scrophulariaceae), Sida alnifolia (Malvaceae), leaf extract of Coccinia grandis (Cucurbitaceae) and root extract of Languas galanga (Zingiberaceae) on oral glucose tolerance test was evaluated. A single dose of 0.25, 0.50, 0.75, 1.00, 1.25, 2.00 g/kg of plant extract was administered orally to alloxan induced (150 mg/kg, ip) diabetic Wistar rats (n = 6). Glibenclamide (0.50 mg/kg) was used as the standard drug. The acute effect was evaluated over a 4 h period using area under the oral glucose tolerance curve. Statistical Analysis: The results were evaluated by analysis of variance followed by Dunnett's test. Results: The eight plant extracts showed statistically significant dose dependent improvement on glucose tolerance (P < 0.05). The optimum effective dose on glucose tolerance for six extracts was found to be 1.00 g/kg in diabetic rats with the exception of C. grandis: 0.75 g/kg and L. galanga: 1.25 g/kg. Conclusion: The aqueous extract of G. arborea, S. pinnata, K. zeylanica, S. caryophyllatum, S. dulcis, S. alnifolia, L. galanga and C. grandis possess potent acute antihyperglycaemic activity in alloxan induced diabetic rats.

Attanayake, Anoja P.; Jayatilaka, Kamani A. P. W.; Pathirana, Chitra; Mudduwa, Lakmini K. B.

2013-01-01

318

Chronic inflammation role in the obesity-diabetes association: a case-cohort study  

PubMed Central

Background Chronic inflammation is related to both obesity and diabetes. Our aim was to investigate to what extent this inflammation contributes to the association between obesity and diabetes. Methods Using a case-cohort design, we followed 567 middle-aged individuals who developed diabetes and 554 who did not over 9 years within the ARIC Study. Weighted Cox proportional hazards analyses permitted statistical inference to the entire cohort. Results Obese individuals (BMI?30 kg/m2), compared to those with BMI<25 kg/m2, presented a large increased risk of developing diabetes (HR[obesity]=6.4, 95%CI 4.5–9.2), as did those in the highest (compared to the lowest) quartile of waist circumference (HR[waist]=8.3, 95%CI 5.6–12.3), in analyses adjusted for age, gender, ethnicity, study center, and parental history of diabetes. Notably, further adjustment for adiponectin and inflammation markers halved the magnitude of these associations (HR[obesity]=3.2, 95%CI 2.1–4.7; and HR[waist]=4.2, 95%CI 2.8–6.5). In similar modeling, attenuation obtained by adding fasting insulin, instead of these markers, was only slightly more pronounced HR[obesity]=2.7, 95%CI 1.7–4.1; and HR[waist]=3.6, 95%CI 2.3–5.8). Conclusions The marked decrease in the obesity-diabetes association after taking into account inflammation markers and adipokines indicates their major role in the pathways leading to adult onset of diabetes in obese individuals.

2013-01-01

319

Association between Nutrient Intake and Obesity in Type 2 Diabetic Patients from the Korean National Diabetes Program: A Cross-Sectional Study  

PubMed Central

The aim of the study was to assess the association between usual dietary nutrient intake and obesity in Korean type 2 diabetic patients. We examined 2,832 type 2 diabetic patients from the Korean National Diabetes Program cohort who completed dietary assessment and clinical evaluation in this cross-sectional study. In men, higher dietary fiber intake was associated with a lower odds of being obese (Ptrend = 0.003) and in women, higher protein intake was associated with a lower odds of being obese (Ptrend = 0.03) after adjustment for age, diabetes duration, HbA1c, alcohol drinking, income, education level, and calorie intake. In men, higher fiber intake was associated with lower odds of obesity after further adjustment for diastolic blood pressure, physical activity, and possible confounding nutritional intake and medication. The multivariable adjusted odds ratio for the highest quintile of fiber intake was 0.37 (Ptrend < 0.001). In women, protein intake was not associated with obesity after further adjustment. In conclusion, higher intake of dietary fiber is associated with lower odds of being obese in type 2 diabetic men, suggesting a role for dietary fiber in the management and prevention of obesity in type 2 diabetes (ClinicalTrials.gov: NCT 01212198).

Kim, So Hun; Hong, Seong Bin; Suh, Young Ju; Choi, Yun Jin; Lee, Hyoung Woo; Park, Ie Byung; Chon, Suk; Woo, Jeong-Taek; Baik, Sei Hyun; Park, Yongsoo; Kim, Dae Jung; Lee, Kwan Woo; Kim, Young Seol

2012-01-01

320

Health benefits of Tai Chi for older patients with type 2 diabetes: The "Move It for Diabetes Study" - A randomized controlled trial  

PubMed Central

Older adults with type 2 diabetes have mobility impairment and reduced fitness. This study aimed to test the efficacy of the “Tai Chi for Diabetes” form, developed to address health-related problems in diabetes, including mobility and physical function. Thirty-eight older adults with stable type 2 diabetes were randomized to Tai Chi or sham exercise, twice a week for 16 weeks. Outcomes included gait, balance, musculoskeletal and cardiovascular fitness, self-reported activity and quality of life. Static and dynamic balance index (?5.8 ± 14.2; p = 0.03) and maximal gait speed (6.2 ± 11.6%; p = 0.005) improved over time, with no significant group effects. There were no changes in other measures. Non-specific effects of exercise testing and/or study participation such as outcome expectation, socialization, the Hawthorne effect, or unmeasured changes in health status or compliance with medical treatment may underlie the modest improvements in gait and balance observed in this sham-exercise-controlled trial. This Tai Chi form, although developed specifically for diabetes, may not have been of sufficient intensity, frequency, or duration to effect positive changes in many aspects of physiology or health status relevant to older people with diabetes.

Tsang, Tracey; Orr, Rhonda; Lam, Paul; Comino, Elizabeth J; Singh, Maria Fiatarone

2007-01-01

321

Development of cataract caused by diabetes mellitus: Raman study  

NASA Astrophysics Data System (ADS)

Diabetes mellitus succeeded by diabetic cataract was induced to experimental animals (Wistar rats) by applying an Alloxan injection. Eye properties deterioration were monitored from clinical standpoint and using Raman and infrared spectroscopies. All cases of developed cataract were followed by important changes in vibrational spectra, but Raman spectroscopy proved to be more useful because of larger number of resolved bands. Each kth Raman spectrum of diseased lens (in our notation k denotes disease age and cataract degree as described in chapter Alloxan diabetes) can be expressed as a sum of the Raman spectrum of healthy lens, I R, multiplied by a suitable constant ck, and the fluorescent background spectrum, I FB. We introduce the ratio of integrated intensities IFB and ck* IR as a physical parameter called fluorescent background index F FB. It turns out that FFB grows as cataract progresses and has its maximum at approx. 4, whence it decreases. FFB values are larger for 200-1800 cm -1 spectral interval than for 2500-4000 cm -1 interval. In the same manner another quantity called water band index FW is defined for each Raman spectrum of diseased lens in the 2800-3730 cm -1 interval. It is the ratio of the integrated intensity from 3100 to 3730 cm -1 (water band interval) divided by the integrated intensity of the 2800-3100 cm -1 interval (C-H stretching region). FW increases monotonously with cataract progression with maximum at the end of monitored period (5 months). These two indices helped us to formulate a model describing disease development from the earliest molecular changes to its macroscopic manifestation. As glucose and other small saccharide molecules enter the lens tissue, they bind to crystallin and other proteins via O- and S-glycosidic linkages which occur probably at tyrosine and cystein sites. In Raman spectrum this corresponds to broad bands at 540 and 1100 cm -1 which grow together with the fluorescent background, because both contributions originate in nonenzimatically glycated proteins. The maximum of possible binding ends after approximately 4 months (cataract degree 4), but the water continues to enter the tissue and resides in water agglomerates. The lens impairing caused by fluorescent light scattering on aberrant glycoproteins and other fluorescent centers appears first and is usually associated with the ageing cataract, while deterioration of lens properties caused by increased binding of water steadily rises with glucose and is characteristic of diabetic cataract. This interpretation is in agreement with electron microscopy results of other groups and with our preliminary findings obtained with light microscopy.

Furi?, Krešimir; Moha?ek-Grošev, Vlasta; Hadžija, Mirko

2005-06-01

322

Patterns of Obesity Development before the Diagnosis of Type 2 Diabetes: The Whitehall II Cohort Study  

PubMed Central

Background Patients with type 2 diabetes vary greatly with respect to degree of obesity at time of diagnosis. To address the heterogeneity of type 2 diabetes, we characterised patterns of change in body mass index (BMI) and other cardiometabolic risk factors before type 2 diabetes diagnosis. Methods and Findings We studied 6,705 participants from the Whitehall II study, an observational prospective cohort study of civil servants based in London. White men and women, initially free of diabetes, were followed with 5-yearly clinical examinations from 1991–2009 for a median of 14.1 years (interquartile range [IQR]: 8.7–16.2 years). Type 2 diabetes developed in 645 (1,209 person-examinations) and 6,060 remained free of diabetes during follow-up (14,060 person-examinations). Latent class trajectory analysis of incident diabetes cases was used to identify patterns of pre-disease BMI. Associated trajectories of cardiometabolic risk factors were studied using adjusted mixed-effects models. Three patterns of BMI changes were identified. Most participants belonged to the “stable overweight” group (n?=?604, 94%) with a relatively constant BMI level within the overweight category throughout follow-up. They experienced slightly worsening of beta cell function and insulin sensitivity from 5 years prior to diagnosis. A small group of “progressive weight gainers” (n?=?15) exhibited a pattern of consistent weight gain before diagnosis. Linear increases in blood pressure and an exponential increase in insulin resistance a few years before diagnosis accompanied the weight gain. The “persistently obese” (n?=?26) were severely obese throughout the whole 18 years before diabetes diagnosis. They experienced an initial beta cell compensation followed by loss of beta cell function, whereas insulin sensitivity was relatively stable. Since the generalizability of these findings is limited, the results need confirmation in other study populations. Conclusions Three patterns of obesity changes prior to diabetes diagnosis were accompanied by distinct trajectories of insulin resistance and other cardiometabolic risk factors in a white, British population. While these results should be verified independently, the great majority of patients had modest weight gain prior to diagnosis. These results suggest that strategies focusing on small weight reductions for the entire population may be more beneficial than predominantly focusing on weight loss for high-risk individuals. Please see later in the article for the Editors' Summary

Vistisen, Dorte; Witte, Daniel R.; Tabak, Adam G.; Herder, Christian; Brunner, Eric J.; Kivimaki, Mika; Faerch, Kristine

2014-01-01

323

Cell-Based Regenerative Strategies for Treatment of Diabetic Skin Wounds, a Comparative Study between Human Umbilical Cord Blood-Mononuclear Cells and Calves' Blood Haemodialysate  

PubMed Central

Background Diabetes-related foot problems are bound to increase. However, medical therapies for wound care are limited; therefore, the need for development of new treatment modalities to improve wound healing in diabetic patients is essential and constitutes an emerging field of investigation. Methods Animals were randomly divided into 8 groups (I–VIII) (32 rats/group), all were streptozotocin (STZ)-induced diabetics except groups III and VIII were non-diabetic controls. The study comprised two experiments; the first included 3 groups. Group I injected with mononuclear cells (MNCs) derived from human umbilical cord blood (HUCB), group II a diabetic control group (PBS i.v). The second experiment included 5 groups, groups IV, V, and VI received topical HUCB-haemodialysate (HD), calves' blood HD, and solcoseryl, respectively. Group VII was the diabetic control group (topical saline). Standard circular wounds were created on the back of rats. A sample of each type of HD was analyzed using the high performance liquid chromatography-electrospray ionization-mass spectrometry (HPLC-ESI-MS) system. Wound area measurement and photography were carried out every 4 days. Plasma glucose, catalase (CAT), malondialdehyde (MDA), nitric oxide (NO) and platelets count were assessed. Wound samples were excised for hydroxyproline (HP) and histopathological study. Results Treatment with HUCB MNCs or HUCB-HD resulted in wound contraction, increased CAT, NO, platelets count, body weights, and HP content, and decreased MDA and glucose. Conclusion Systemic administration of HUCB MNCs and topical application of the newly prepared HUCB-HD or calves' blood HD significantly accelerated the rate of diabetic wound healing and would open the possibility of their future use in regenerative medicine.

El-Mesallamy, Hala O.; Diab, Mohamed R.; Hamdy, Nadia M.; Dardir, Sarah M.

2014-01-01

324

Type 2 Diabetes Risk among Asian Indians in the US: A Pilot Study.  

PubMed

The purpose of this pilot study was to investigate type 2 diabetes risk among Asian Indians of Kerala ethnicity living in a West Texas County of the USA. The study used a descriptive correlational design with thirty-seven adult nondiabetic Asian Indian subjects between 20 and 70 years of age. The measurement included nonbiochemical indices of obesity, family history of type 2 diabetes, length of immigration in the US, history of hypertension, physical activity pattern, and fruit and vegetable intake. The majority of the subjects showed an increased nonbiochemical indices corresponding with overweight and obesity, placing them at risk for type 2 diabetes and associated cardiovascular complications. The physical activity pattern indicated a sedentary lifestyle. The decreased physical activity was associated with a higher Body Mass Index (BMI) and body fat percentage; length of residence in the US greater than 10 years was associated with increased body fat percentage and BMI; family history of type 2 diabetes was associated with an increase in body fat percentage. Fruit and vegetable intake pattern was not associated with a risk for type 2 diabetes. Further studies are recommended for risk surveillance among Asian Indian population living in the US. PMID:23970965

Thomas, Annie; Ashcraft, Alyce

2013-01-01

325

Treatment of diabetic foot ulcers using cultured allogeneic keratinocytes--a pilot study.  

PubMed

Diabetic foot ulcers often pose a difficult treatment problem. Repeated applications of cell-based products have been reported to result in acceleration of diabetic wound healing. The purpose of this clinical trial study was to report preliminary findings of the efficacy and safety of the cultured allogeneic keratinocyte sheets in the treatment of diabetic foot ulcers. Fifty-nine patients with diabetic foot ulcers were randomized to either the keratinocyte treatment group (n = 27) or the control group treated with vaseline gauze (n = 32). Except for the application of keratinocytes, treatment of study ulcers was identical for patients in both groups. Either keratinocyte sheet or vaseline gauze was applied at the beginning of the study and weekly thereafter for a maximum of 11 weeks. The maximum follow-up period for each patient was 12 weeks. Complete ulcer healing was achieved in 100% of the treatment group and 69% of the control group (p < 0.05). The Kaplan-Meier median times to complete closure were 35 and 57 days for the keratinocyte and control groups, respectively. No adverse events related to the treatment occurred. These results indicate that cultured allogeneic keratinocytes may offer a safe and effective treatment for diabetic foot ulcers. PMID:22672334

You, Hi-Jin; Han, Seung-Kyu; Lee, Jin-Woo; Chang, Hak

2012-01-01

326

Preadmission metformin use and mortality among intensive care patients with diabetes: a cohort study  

PubMed Central

Introduction Metformin has anti-inflammatory and anti-thrombotic effects that may improve the outcome of critical illness, but clinical data are limited. We examined the impact of preadmission metformin use on mortality among intensive care unit (ICU) patients with type 2 diabetes. Methods We conducted this population-based cohort study among all persons admitted to the 17 ICUs in Northern Denmark (population approximately 1.8 million). We focused on all patients with type 2 diabetes who were admitted to the ICUs between January 2005 and December 2011. Through individual-level linkage of population-based medical databases, type 2 diabetes was identified using a previously validated algorithm including hospital diagnoses, filled prescriptions for anti-diabetic drugs, and elevated HbA1c levels. Metformin use was identified by filled prescriptions within 90 days before admission. Covariates included surgery, preadmission morbidity, diabetes duration, and concurrent drug use. We computed 30-day mortality and hazard ratios (HRs) of death using Cox regression adjusted for covariates, both overall and after propensity score matching. Results We included 7,404 adult type 2 diabetes patients, representing 14.0% of 52,964 adult patients admitted to the ICUs. Among type 2 diabetes patients, 1,073 (14.5%) filled a prescription for metformin as monotherapy within 90 days before admission and 1,335 (18.0%) received metformin in combination with other anti-diabetic drugs. Thirty-day mortality was 17.6% among metformin monotherapy users, 17.9% among metformin combination therapy users, and 25.0% among metformin non-users. The adjusted HRs were 0.80 (95% confidence interval (CI): 0.69, 0.94) for metformin monotherapy users and 0.83 (95% CI: 0.71, 0.95) for metformin combination therapy users, compared to non-users. Propensity-score-matched analyses yielded the same results. The association was evident across most subgroups of medical and surgical ICU patients, but most pronounced in elderly patients and in patients with well-controlled diabetes. Former metformin use was not associated with decreased mortality. Conclusions Preadmission metformin use was associated with reduced 30-day mortality among medical and surgical intensive care patients with type 2 diabetes.

2013-01-01

327

Factors affecting the disclosure of diabetes by ethnic minority patients: a qualitative study among Surinamese in the Netherlands  

PubMed Central

Background Diabetes and related complications are common among ethnic minority groups. Community-based social support interventions are considered promising for improving diabetes self-management. To access such interventions, patients need to disclose their diabetes to others. Research on the disclosure of diabetes in ethnic minority groups is limited. The aim of our study was to explore why diabetes patients from ethnic minority populations either share or do not share their condition with people in their wider social networks. Methods We conducted a qualitative study using semi-structured interviews with 32 Surinamese patients who were being treated for type 2 diabetes by general practitioners in Amsterdam, the Netherlands. Results Most patients disclosed their diabetes only to very close family members. The main factor inhibiting disclosure to people outside this group was the Surinamese cultural custom that talking about disease is taboo, as it may lead to shame, gossip, and social disgrace for the patient and their family. Nevertheless, some patients disclosed their diabetes to people outside their close family circles. Factors motivating this decision were mostly related to a need for facilities or support for diabetes self-management. Conclusions Cultural customs inhibited Surinamese patients in disclosing their diabetes to people outside their very close family circles. This may influence their readiness to participate in community-based diabetes self-management programmes that involve other groups. What these findings highlight is that public health researchers and initiatives must identify and work with factors that influence the disclosure of diabetes if they are to develop community-based diabetes self-management interventions for ethnic minority populations.

2011-01-01

328

Associations of processed meat and unprocessed red meat intake with incident diabetes: the Strong Heart Family Study1234  

PubMed Central

Background: Fifty percent of American Indians (AIs) develop diabetes by age 55 y. Whether processed meat is associated with the risk of diabetes in AIs, a rural population with a high intake of processed meat (eg, canned meats in general, referred to as “spam”) and a high rate of diabetes, is unknown. Objective: We examined the associations of usual intake of processed meat with incident diabetes in AIs. Design: This prospective cohort study included AI participants from the Strong Heart Family Study who were free of diabetes and cardiovascular disease at baseline and who participated in a 5-y follow-up examination (n = 2001). Dietary intake was ascertained by using a Block food-frequency questionnaire at baseline. Incident diabetes was defined on the basis of 2003 American Diabetes Association criteria. Generalized estimating equations were used to examine the associations of dietary intake with incident diabetes. Results: We identified 243 incident cases of diabetes. In a comparison of upper and lower quartiles, intake of processed meat was associated with a higher risk of incident diabetes (OR: 1.63; 95% CI: 1.21, 2.63), after adjustment for potential confounders. The relation was particularly strong for spam (OR for the comparison of upper and lower quartiles: 2.06; 95% CI: 1.30, 3.27). Intake of unprocessed red meat was not associated with incident diabetes (OR for the comparison of upper and lower quartiles: 0.90; 95% CI: 0.59, 1.37). Conclusion: The consumption of processed meat, such as spam, but not unprocessed red meat, was associated with higher risk of diabetes in AIs, a rural population at high risk of diabetes and with limited access to healthy foods.

Howard, Barbara V; McKnight, Barbara; Duncan, Glen E; Beresford, Shirley AA; Mete, Mihriye; Eilat-Adar, Sigal; Zhang, Ying; Siscovick, David S

2012-01-01

329

Vitamin D Intake and Risk of Type 1 Diabetes: A Meta-Analysis of Observational Studies  

PubMed Central

Vitamin D is suggested to have protective effects against type 1 diabetes. However, the results from observational studies have been inconsistent. We aimed to examine their association by conducting a meta-analysis of observational studies. Multiple databases were searched in June 2013 to identify relevant studies including both case-control and cohort studies. Either a fixed- or random-effects model was used to calculate the pooled risk estimate. We identified eight studies (two cohort studies and six case-control studies) on vitamin D intake during early life and three studies (two cohort studies and one case-control study) on maternal vitamin D intake during pregnancy. The pooled odds ratio for type 1 diabetes comparing vitamin D supplementation with non-supplementation during early life was 0.71 (95% confidence interval [CI], 0.51–0.98). Similar results were observed in the case-control subgroup analysis but not in the cohort subgroup analysis. The pooled odds ratio with maternal intake of vitamin D during pregnancy was 0.95 (95% CI, 0.66–1.36). In conclusion, vitamin D intake during early life may be associated with a reduced risk of type 1 diabetes. However, there was not enough evidence for an association between maternal intake of vitamin D and risk of type 1 diabetes in the offspring.

Dong, Jia-Yi; Zhang, Weiguo; Chen, Jiong Jack; Zhang, Zeng-Li; Han, Shu-Fen; Qin, Li-Qiang

2013-01-01

330

Study of 27 aqueous humor cytokines in patients with type 2 diabetes with or without retinopathy  

PubMed Central

Purpose To compare the changes in the levels of 27 aqueous humor cytokines between nondiabetic controls and patients with type 2 diabetes and to ascertain the association of these cytokines with diabetic retinopathy (DR). Methods Undiluted aqueous humor samples were obtained from 102 nondiabetic patients (102 eyes) and 136 consecutive diabetic patients (136 eyes) who were divided into nine groups according to the Early Treatment of Diabetic Retinopathy Study severity scale. The concentrations of 27 cytokines in the aqueous humor samples were measured using a multiplex bead immunoassay. Results Compared with the nondiabetic controls, the diabetic patients had significantly higher concentrations of interleukin-1? (IL-1?; p<0.001), IL-6 (p<0.001), IL-8 (p<0.001), monocyte chemoattractant protein-1 (p<0.001), interferon gamma-induced protein-10 (p<0.001), and vascular endothelial growth factor (p<0.001) in the aqueous humor. However, the IL-10 (p=0.002) and IL-12 (p=0.013) concentrations were significantly lower for the diabetic patients. There were no significant differences in the concentrations of other cytokines between the diabetic patients and the controls. The IL-1?, IL-6, IL-8, monocyte chemoattractant protein-1, and interferon gamma-induced protein-10 levels in the aqueous humor increased as the severity of DR increased. The correlation was significant. However, the vascular endothelial growth factor concentration was not correlated with the severity of DR. In addition, the IL-10 and IL-12 levels in the aqueous humor decreased as the severity of DR increased, and this negative correlation was significant. Conclusions Various cytokines associated with inflammation and angiogenesis may contribute to the pathogenesis of DR, and chemokines may be more closely related to the development of this disease.

Dong, Ning; Xu, Bing; Wang, Bingsong

2013-01-01

331

Achievement of Cardiometabolic Goals among Diabetic Patients in Spain. A Nationwide Population-Based Study  

PubMed Central

Background No previous study has reported a comprehensive assessment of the attainment of cardiometabolic goals in the diabetic population of a European country. We examined the achievement of cardiometabolic goals among diabetics in Spain. Methods and Findings A cross-sectional survey was performed in 2008–2010 among 12,077 individuals representative of the Spanish population aged ?18 years. Information on cardiometabolic characteristics was collected at the participants’ homes through structured questionnaires, physical examination, and fasting blood samples. Attainment of cardiometabolic goals was evaluated according to the most well-known guidelines. A total of 834 individuals had diabetes (fasting serum glucose ?126 mg/dl, or glycosylated hemoglobin ?6.5%,) or were being treated with oral antidiabetic drugs or insulin). Among diabetic patients, 661 (79.2%) were aware of their condition. Among the aware diabetic patients, only 11.4% had neither general (body mass index <25 kg/m2) nor abdominal obesity (waist circumference ?102 cm in men and ?88 cm in women), 8.6% consumed <7% of calories daily from saturated fats, and 41.1% achieved the recommendation on weekly physical activity. About 71% had glycosylated hemoglobin <7%, 22% had blood pressure <130/80 mmHg, and 36% reached the LDL-cholesterol goal of <100 mg/dl. Although a large proportion of aware diabetic individuals received lifestyle medical advice, only 38% of overweight individuals and 20% of daily smokers were offered a specific strategy for weight loss or quitting smoking, respectively. Conclusions In a European country with universal healthcare coverage, achievement of many cardiometabolic goals, in particular lifestyle, among aware diabetic individuals is poor. This suggests a need for improvement in both clinical guidelines' implementation and patients’ adherence.

Navarro-Vidal, Beatriz; Banegas, Jose R.; Leon-Munoz, Luz M.; Rodriguez-Artalejo, Fernando; Graciani, Auxiliadora

2013-01-01

332

Omega-3 fatty acids and incident type 2 diabetes: the Singapore Chinese Health Study1234  

PubMed Central

Background: The role of omega-3 (n–3) fatty acids (FAs) in the development of type 2 diabetes is uncertain, especially with regard to any differential influence of ?-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). Objective: The objective was to examine the association between total omega-3 FAs, marine omega-3 (EPA, DHA), nonmarine omega-3 (ALA), and omega-6 (n–6) FAs and omega-6:omega-3 ratio and risk of type 2 diabetes in a Chinese population in Singapore. Design: The analysis included 43,176 Chinese men and women free of chronic disease, aged 45–74 y, in the Singapore Chinese Health Study. Baseline data collection occurred between 1993 and 1998, with follow-up interviews between 1999 and 2004. Cox regression models were used to examine the associations between FA intakes at baseline and risk of developing diabetes. Results: Increased intakes of total omega-3 FAs were inversely associated with diabetes incidence [hazard ratio (HR) for the fifth compared with the first quintile: 0.78; 95% CI: 0.65, 0.94; P for trend = 0.02]. Omega-3 FAs from marine sources were not associated with diabetes risk, whereas nonmarine omega-3 FA intake was strongly associated (HR for the fifth compared with the first quintile: 0.79; 95% CI: 0.67, 0.93; P for trend = 0.004). Omega-6 and omega-6:omega-3 ratio were not associated with incidence of type 2 diabetes. Conclusion: Consumption of nonmarine sources (ALA) of omega-3 FAs is associated with a decreased risk of type 2 diabetes in Chinese Singaporeans.

Brostow, Diana P; Odegaard, Andrew O; Koh, Woon-Puay; Duval, Sue; Gross, Myron D; Yuan, Jian-Min; Pereira, Mark A

2011-01-01

333

Severe hypoglycaemia, metabolic control and diabetes management in children with type 1 diabetes in the decade after the Diabetes Control and Complications Trial – a large-scale multicentre study  

Microsoft Academic Search

Hypoglycaemia is frequently the limiting factor in achieving optimal glycaemic control. Therefore, insulin therapy, the incidence of hypoglycaemia, and glycaemic control were investigated in 6309 unselected children with type 1 diabetes in a large-scale multicentre study. Using standardised computer-based documentation, the incidence of severe hypoglycaemia, HbA1 c levels, insulin regimen, diabetes duration, and the number of patients attending a treatment

Verena M. Wagner; Matthias Grabert; Reinhard W. Holl

2005-01-01

334

An open label study on the supplementation of Gymnema sylvestre in type 2 diabetics.  

PubMed

Diabetes mellitus is a complex metabolic disorder characterized by chronic hyperglycemia, and associated with long-term damage and dysfunction of various organs. Management of diabetes is therefore vital and involves maintaining euglycemia as much as possible by reducing blood glucose and by increasing insulin sensitivity and peripheral glucose uptake. Ayurveda has promoted the management of diabetes by regulating carbohydrate metabolism using several medicinal herbs, one of which is Gymnema sylvestre (GS). GS has been used in parts of India as a hypoglycemic agent and the results have been encouraging. Accordingly, we planned a quasi-experimental study to investigate the efficacy of the herb among type 2 diabetics. Patients enrolled from free-living population were purposively assigned to experimental or control groups, based on their willingness to participate in the study. The experimental group was supplemented with 500 mg of the herb per day for a period of 3 months, and the efficacy of the herb was assessed through a battery of clinical and biochemical tests. Supplementation of the diet with GS reduced polyphagia, fatigue, blood glucose (fasting and post-prandial), and glycated hemoglobin and there was a favorable shift in lipid profiles and in other clinico-biochemical tests. These findings suggest a beneficial effect of GS in the management of diabetes mellitus. PMID:22432517

Kumar, Smriti Nanda; Mani, Uliyar Vitaldas; Mani, Indirani

2010-09-01

335

Motor strategy patterns study of diabetic neuropathic individuals while walking. A wavelet approach.  

PubMed

The aim of this study was to investigate muscle?s energy patterns and spectral properties of diabetic neuropathic individuals during gait cycle using wavelet approach. Twenty-one diabetic patients diagnosed with peripheral neuropathy, and 21 non-diabetic individuals were assessed during the whole gait cycle. Activation patterns of vastus lateralis, medial gastrocnemius and tibialis anterior were studied by means of bipolar surface EMG. The signal?s energy and frequency were compared between groups using t-test. The energy was compared in each frequency band (7-542Hz) using ANOVAs for repeated measures for each group and each muscle. The diabetic individuals displayed lower energies in lower frequency bands for all muscles and higher energies in higher frequency bands for the extensors? muscles. They also showed lower total energy of gastrocnemius and a higher total energy of vastus, considering the whole gait cycle. The overall results suggest a change in the neuromuscular strategy of the main extensor muscles of the lower limb of diabetic patients to compensate the ankle extensor deficit to propel the body forward and accomplish the walking task. PMID:24816334

Sacco, I C N; Hamamoto, A N; Onodera, A N; Gomes, A A; Weiderpass, H A; Pachi, C G F; Yamamoto, J F; von Tscharner, V

2014-07-18

336

Risk factors for development of incipient and overt diabetic nephropathy in patients with non-insulin dependent diabetes mellitus: prospective, observational study.  

PubMed Central

OBJECTIVE: To evaluate putative risk factors for the development of incipient diabetic nephropathy (persistent microalbuminuria) and overt diabetic nephropathy (persistent macroalbuminuria) in patients with non-insulin dependent diabetes. DESIGN: Prospective, observational study of a cohort of white, non-insulin dependent diabetic patients followed for a median period of 5.8 years. SETTING: Outpatient clinic in tertiary referral centre. SUBJECTS: 191 patients aged under 66 years with non-insulin dependent diabetes and normoalbuminuria (urinary albumin excretion rate < 30 mg/24 h) who attended the clinic during 1987. MAIN OUTCOME MEASURES: Incipient and overt diabetic nephropathy. RESULTS: Fifteen patients were lost to follow up. Thirty six of the 176 remaining developed persistent microalbuminuria (30-299 mg/24 h in two out of three consecutive 24 hour urine collections) and five developed persistent macroalbuminuria (> or = mg/24 h in two out of three consecutive collections) during follow up. The five year cumulative incidence of incipient diabetic nephropathy was 23% (95% confidence interval 17% to 30%). Cox's multiple stepwise regression analysis revealed the following risk factors for the development of incipient or overt diabetic nephropathy: increased baseline log urinary albumin excretion rate (relative risk 11.1 (3.4 to 35.9); P < 0.0001); male sex (2.6 (1.2 to 5.4); P < 0.02); presence of retinopathy (2.4 (1.3 to 4.7); P < 0.01); increased serum cholesterol concentration (1.4 (1.1 to 1.7); P < 0.01); haemoglobin A1c concentration (1.2 (1.0 to 1.4); P < 0.05); and age (1.07 (1.02 to 1.12); P < 0.01). Known duration of diabetes, body mass index, arterial blood pressure, serum creatinine concentration, pre-existing coronary heart disease, and history of smoking were not risk factors. CONCLUSION: Several potentially modifiable risk factors predict the development of incipient and overt diabetic nephropathy in normoalbuminuric patients with non-insulin dependent diabetes.

Gall, M. A.; Hougaard, P.; Borch-Johnsen, K.; Parving, H. H.

1997-01-01

337

VDTs: Field levels, epidemiology, and laboratory studies  

SciTech Connect

As the use of video display terminals (VDTs) has expanded, questions have been raised as to whether working at a VDT affects the risk of adverse pregnancy outcome. A particular focus for these questions has been the very low frequency (VLF) magnetic field produced by a VDT's horizontal deflection coil. VDTs also produce VLF electric fields, extremely low frequency (ELF) electric and magnetic fields, and static electric fields, Ten studies of pregnancy outcome in VDT operators have been conducted in six countries, and with one exception, none has concluded that magnetic fields from VDTs may predispose pregnant operators to spontaneous abortion or congenital malformation. The epidemiologic studies conducted thus far do not provide a basis for concluding that VDT work and adverse pregnancy outcome are associated. Studies of fetal resorptions and malformations in rodents exposed to VLF magnetic fields have produced inconsistent findings. Two laboratories in Sweden that studied mice have reported positive results, one laboratory showing field-related malformations (but not resorptions) and the other showing field-related resorptions (but not malformations). Two Canadian laboratories have reported negative results in rats and mice. Studies of avian embryos have also yielded inconsistent results, but lacking a maternal-fetal placental interface, avian embryos are a questionable model for evaluating human reproductive risks. Finally, VLF electric and magnetic fields measured at the operator position are in compliance with field strength standards and guidelines that have been established around the world. 55 refs.

Kavet, R.; Tell, R.A. (Richard Tell Associates, Inc., Las Vegas, NV (USA))

1991-07-01

338

Do characteristics of practices and general practitioners influence the yield of diabetes screening in primary care? The ADDITION Netherlands study  

PubMed Central

Objective To investigate whether the yield of population-based diabetes screening is influenced by characteristics of the general practitioner (GP) and the practice. Design Cross-sectional study. Setting Seventy-nine general practices in the south-western region of the Netherlands. Subjects From 2002 to 2004, 56 978 people were screened for diabetes. GPs completed a questionnaire containing items on the GP (age, gender, employment, special interest in diabetes, providing insulin therapy) and the practice (setting, location, number of patients from ethnic minority groups, specific diabetes clinic, involvement of practice assistant, practice nurse or diabetes nurse in diabetes care). Main outcome measures The ratio screen-detected diabetic patients/known diabetic patients per practice (SDM/KDM) and the number of detected diabetic patients per practice adjusted for practice size and age distribution (SDM per standardized practice). Results The yield of screening per practice varied widely. Higher age of the GP (regression coefficient 0.20; 95% confidence interval, CI 0.07–0.34), urban location (?4.60; 95% CI ?6.41 to ?2.78) and involvement of the practice assistant (2.27; 95% CI 0.49–4.06) were independently associated with SDM/KDM. Using the other outcome variable, results were similar. Additionally, cooperation with a diabetes nurse was associated with a lower yield. Conclusion A lower yield of screening, reflecting a lower prevalence of undiagnosed diabetes, was found in practices of younger GPs and in urban practices. A lower yield was not associated with an appropriate practice organization regarding diabetes care nor with a specialty of the GP in diabetes. The wide variation in the yield of screening stresses the importance of a screening programme in each general practice.

Janssen, Paul G. H.; Gorter, Kees J.; Stolk, Ronald P.; Rutten, Guy E. H. M.

2008-01-01

339

Association of liver enzymes with incident type 2 diabetes: A nested case control study in an Iranian population  

Microsoft Academic Search

BACKGROUND: To investigate the association of Aspartate aminotransferase (AST), Alanin aminotranferase (ALT) and Gamma glutamyl transferase (GGT) with incident type 2 diabetes. METHODS: In a nested case-control study, AST, ALT, GGT as well as classic diabetes risk factors, insulin and C-reactive protein (CRP) were measured in 133 non-diabetic subjects at baseline of which 68 were cases and 65 were controls.

Maryam Tohidi; Hadi Harati; Farzad Hadaegh; Yadolladh Mehrabi; Fereidoun Azizi

2008-01-01

340

Role of blood pressure in development of early retinopathy in adolescents with type 1 diabetes: prospective cohort study  

Microsoft Academic Search

Objective To examine the relation between blood pressure and the development of early retinopathy in adolescents with childhood onset type 1 diabetes.Design Prospective cohort study.Setting Diabetes Complications Assessment Service at the Children’s Hospital at Westmead, Sydney, Australia.Participants 1869 patients with type 1 diabetes (54% female) screened for retinopathy with baseline median age 13.4 (interquartile range 12.0-15.2) years, duration 4.9 (3.1-7.0)

Patricia Herold Gallego; Maria E Craig; Stephen Hing; Kim C Donaghue

2008-01-01

341

Metabolic instability in type I diabetic patients. Studies on insulin absorption, hepatic production of metabolites and glucose counterregulation  

Microsoft Academic Search

Summary  In order to investigate the causes underlying metabolic instability in type I diabetes mellitus, we studied 8 unstable (group\\u000a 1) and 4 well-controlled (group 2) diabetic patients, matched for age and duration of diabetes. Subjects were connected overnight\\u000a to an artificial pancreas and brought to normoglycemia. On the following morning, insulin administration was discontinued\\u000a for 6 hours and both metabolic

Piero Micossi; Marina Scavini; Flaviano Dosio; Lucilla Monti; Pier Marco Piatti

1985-01-01

342

A nationwide population-based study of the familial aggregation of Type 1 (insulin-dependent) diabetes mellitus in Denmark  

Microsoft Academic Search

Summary  The objective of the present study was to assess the prevalence of familial aggregation of Type 1 (insulin-dependent) diabetes mellitus among Danish families with a diabetic child aged 20 years or less and to compare epidemiological data for familial and sporadic cases. We attempted to identify all patients with Type 1 diabetes aged 0–19 years in Denmark treated at paediatric

F. Pociot; K. Nørgaard; N. Hobolth; O. Andersen; J. Nerup

1993-01-01

343

Creative Expression as a Way of Knowing in Diabetes Adult Health Education: An Action Research Study  

ERIC Educational Resources Information Center

This action research study explores the meaning-making process using forms of creative expression for eight women with insulin-dependent diabetes. The study is theoretically informed by arts-based ways of knowing and aspects of feminist poststructuralism, and explains the process of creativity used in the action research process. The findings…

Stuckey, Heather L.

2009-01-01

344

Participants' perspective on maintaining behaviour change: a qualitative study within the European Diabetes Prevention Study  

PubMed Central

Background The European Diabetes Prevention Study (EDIPS) is an RCT of diet and exercise interventions in people with impaired glucose tolerance. We undertook a qualitative study, nested within the EDIPS in Newcastle-upon-Tyne, UK, aiming to understand the experience of participants who maintained behaviour change, in order to inform future interventions. Methods Participants were purposively sampled, according to success criteria for diet and physical activity change maintenance, and invited to attend individual semi-structured interviews. Fifteen participants completed an interview and reflected on their experience over three to five years. We used the Framework method to analyse the transcribed data. Results Main themes were identified as factors that help (props) and those that hinder (burdens) behaviour change maintenance at different organisational levels: individual (both physical and psychological), social and environmental. Pre-existing physical conditions (such as arthritis) and social demands (such as caring for an ageing relative) hindered, whereas the benefits of becoming fitter and of having social and professional support helped, participants in maintaining behaviour change. Participants' long term experiences highlighted the salience of the continuous change in their physical, social and environmental conditions over time. Conclusion The construct of props and burdens facilitates a holistic view of participants' behaviour. Efforts to encourage behaviour change maintenance should take account of context and the way this changes over time, and should include strategies to address these issues. The experience of participants who maintain behaviour change highlights the challenges for the wider implementation of diabetes prevention strategies. Trial Registration (ISRCTN 15670600)

Penn, Linda; Moffatt, Suzanne M; White, Martin

2008-01-01

345

Preventing renal complications in diabetic patients: the Diabetics Exposed to Telmisartan And enalaprIL (DETAIL) study  

Microsoft Academic Search

Diabetic nephropathy is characterised by hypertension and persistent proteinuria. If ineffectively controlled, a progressive decline in renal function can result in end-stage renal disease. Patients with diabetic nephropathy are also at greatly increased risk of cardiovascular disease. Angiotensin-converting enzyme (ACE) inhibitors display additional renoprotective effects beyond systemic blood pressure lowering, perhaps due to reduction in intraglomerular pressure by inhibition of

A. H. Barnett

2005-01-01

346

Diabetes mellitus, plasma glucose and lung function in a cross-sectional population study.  

PubMed

To assess possible associations between diabetes mellitus (DM), plasma glucose, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), we analysed the results from a cross-sectional study of 11,763 subjects. The subjects were 20 yrs of age or older and were representative of the population of Copenhagen City. Two hundred and eighty four of the participants had DM as assessed by questionnaire. One hundred and seven subjects who did not report having DM had a plasma concentration of glucose higher than or equal to 11.1 mmol.l-1. In all age groups of diabetic subjects there was a slight impairment of lung function. It was more prominent in diabetic subjects treated with insulin than in subjects treated with oral hypoglycaemic agents and/or diet. Even in subjects without known DM, there was a significant association between reduction in lung function and raised plasma glucose concentration. On average, FVC (and FEV1) was reduced by 334 ml (and 239 ml) in diabetic subjects treated with insulin, and by 184 ml (and 117 ml) in diabetic subjects treated with hypoglycaemic agents and/or diet compared to control subjects. PMID:2651148

Lange, P; Groth, S; Kastrup, J; Mortensen, J; Appleyard, M; Nyboe, J; Jensen, G; Schnohr, P

1989-01-01

347

Diffuse reflectance spectroscopy for monitoring diabetic foot ulcer - A pilot study  

NASA Astrophysics Data System (ADS)

Foot ulceration due to diabetes mellitus is a major problem affecting 12-25% of diabetic subjects in their lifetime. An untreated ulcer further gets infected which causes necrosis leading to amputation of lower extremities. Early identification of risk factors and treatment for these chronic wounds would reduce health care costs and improve the quality of life for people with diabetes. Recent clinical investigations have shown that a series of factors including reduced oxygen delivery and disturbed metabolism have been observed on patients with foot ulceration due to diabetes. Also, these factors can impair the wound healing process. Optical techniques based on diffuse reflectance spectroscopy provide characteristic spectral finger prints shed light on tissue oxygenation levels and morphological composition of a tissue. This study deals with the application of diffuse reflectance intensity ratios based on oxyhemoglobin bands (R542/R580), ratios of oxy- and deoxy-hemoglobin bands (R580/R555), total hemoglobin concentration and hemoglobin oxygen saturation between normal and diabetic foot ulcer sites. Preliminary results obtained are found to be promising indicating the application of reflectance spectroscopy in the assessment of foot ulcer healing.

Anand, Suresh; Sujatha, N.; Narayanamurthy, V. B.; Seshadri, V.; Poddar, Richa

2014-02-01

348

A national study of problematic care experiences among Latinos with diabetes.  

PubMed

Despite the large disease burden of diabetes, little is known about the care experiences of Latinos with diabetes across diverse primary care settings. This study compares problematic care experiences among Latinos with diabetes across usual care sites (community health centers [CHCs], private physician practices, or without a usual source of care), using a national sample of Latino diabetic patients (N=583). Nearly half of the respondents reported at least one problematic care experience during their last clinician visit. Compared with respondents treated primarily by private physicians, respondents receiving care in CHCs or without a usual source of care reported more problematic care experiences. However, patient health insurance coverage and acculturation accounted for the highest proportion of explainable differences in problematic care experiences between CHCs and private physician offices. Initiatives should clarify the extent to which the care experiences of Latino diabetics, particularly uninsured and less acculturated patients who tend to be cared for by CHCs, can be improved through clinician communication and patient self-management interventions. PMID:21099068

Rodriguez, Hector P; Chen, Jie; Rodriguez, Michael A

2010-11-01

349

Antidiabetic Properties of Azardiracta indica and Bougainvillea spectabilis: In Vivo Studies in Murine Diabetes Model.  

PubMed

Diabetes mellitus is a metabolic syndrome characterized by an increase in the blood glucose level. Treatment of diabetes is complicated due to multifactorial nature of the disease. Azadirachta indica Adr. Juss and Bougainvillea spectabilis are reported to have medicinal values including antidiabetic properties. In the present study using invivo diabetic murine model, A. indica and B. spectabilis chloroform, methanolic and aqueous extracts were investigated for the biochemical parameters important for controlling diabetes. It was found that A. indica chloroform extract and B. spectabilis aqueous, methanolic extracts showed a good oral glucose tolerance and significantly reduced the intestinal glucosidase activity. Interestingly, A. indica chloroform and B. spectabilis aqueous extracts showed significant increase in glucose-6-phosphate dehydrogenase activity and hepatic, skeletal muscle glycogen content after 21 days of treatment. In immunohistochemical analysis, we observed a regeneration of insulin-producing cells and corresponding increase in the plasma insulin and c-peptide levels with the treatment of A. indica chloroform and B. spectabilis aqueous, methanolic extracts. Analyzing the results, it is clear that A. indica chloroform and B. spectabilis aqueous extracts are good candidates for developing new neutraceuticals treatment for diabetes. PMID:19389871

Bhat, Menakshi; Kothiwale, Sandeepkumar K; Tirmale, Amruta R; Bhargava, Shobha Y; Joshi, Bimba N

2011-01-01

350

Diabetic Patients with Severe Sepsis Admitted to Intensive Care Unit Do Not Fare Worse than Non-Diabetic Patients: A Nationwide Population-Based Cohort Study  

PubMed Central

Background We sought to examine whether type 2 diabetes increases the risk of acute organ dysfunction and of hospital mortality following severe sepsis that requires admission to an intensive care unit (ICU). Methods Nationwide population-based retrospective cohort study of 16,497 subjects with severe sepsis who had been admitted for the first time to an ICU during the period of 1998–2008. A diabetic cohort (n?=?4573) and a non-diabetic cohort (n?=?11924) were then created. Relative risk (RR) of organ dysfunctions, length of hospital stay (LOS), 90-days hospital mortality, ICU resource utilization and hazard ratio (HR) of mortality adjusted for age, gender, Charlson-Deyo comorbidity index score, surgical condition and number of acute organ dysfunction, were compared across patients with severe sepsis with or without diabetes. Results Diabetic patients with sepsis had a higher risk of developing acute kidney injury (RR, 1.54; 95% confidence interval (CI), 1.44–1.63) and were more likely to be undergoing hemodialysis (15.55% vs. 7.24%) in the ICU. However, the diabetic cohort had a lower risk of developing acute respiratory dysfunction (RR?=?0.96, 0.94–0.97), hematological dysfunction (RR?=?0.70, 0.56–0.89), and hepatic dysfunction (RR?=?0.77, 0.63–0.93). In terms of adjusted HR for 90-days hospital mortality, the diabetic patients with severe sepsis did not fare significantly worse when afflicted with cardiovascular, respiratory, hepatic, renal and/or neurologic organ dysfunction and by numbers of organ dysfunction. There was no statistically significant difference in LOS between the two cohorts (median 17 vs. 16 days, interquartile range (IQR) 8–30 days, p?=?0.11). Multiple logistic regression analysis to predict the occurrence of mortality shows that being diabetic was not a predictive factor with an odds ratio of 0.972, 95% CI 0.890–1.061, p?=?0.5203. Interpretation This large nationwide population-based cohort study suggests that diabetic patients do not fare worse than non-diabetic patients when suffering from severe sepsis that requires ICU admission.

Tseng, Ta-Chien; Horng, Jorng-Tzong; Liu, Chun-Eng

2012-01-01

351

Genetic testing of newborns for type 1 diabetes susceptibility: a prospective cohort study on effects on maternal mental health  

Microsoft Academic Search

BACKGROUND: Concerns about the general psychological impact of genetic testing have been raised. In the Environmental Triggers of Type 1 Diabetes (MIDIA) study, genetic testing was performed for HLA-conferred type 1 diabetes susceptibility among Norwegian newborns. The present study assessed whether mothers of children who test positively suffer from poorer mental health and well-being after receiving genetic risk information about

Kaja K Aas; Kristian Tambs; Marit S Kise; Per Magnus; Kjersti S Rønningen

2010-01-01

352

Thiazolidinediones and the risk of asthma exacerbation among patients with diabetes: a cohort study  

PubMed Central

Background Thiazolidinediones are oral diabetes medications that selectively activate peroxisome proliferator-activated receptor gamma and have potent anti-inflammatory properties. While a few studies have found improvements in pulmonary function with exposure to thiazolidinediones, there are no studies of their impact on asthma exacerbations. Our objective was to assess whether exposure to thiazolidinediones was associated with a decreased risk of asthma exacerbation. Methods We performed a cohort study of diabetic Veterans who had a diagnosis of asthma and were taking oral diabetes medications during the period of 10/1/2005 – 9/30/2006. The risk of asthma exacerbations and oral steroid use during 10/1/2006 – 9/30/2007 was compared between patients who were prescribed thiazolidinediones and patients who were on alternative oral diabetes medications. Multivariable logistic regression and negative binomial regression analyses were used to characterize this risk. A sensitivity analysis was performed, restricting our evaluation to patients who were adherent to diabetes therapy. Results We identified 2,178 patients who were on thiazolidinediones and 10,700 who were not. Exposure to thiazolidinediones was associated with significant reductions in the risk of asthma exacerbation (OR?=?0.79, 95% CI, 0.62 – 0.99) and oral steroid prescription (OR?=?0.73, 95% CI 0.63 – 0.84). Among patients who were adherent to diabetes medications, there were more substantial reductions in the risks for asthma exacerbation (OR?=?0.64, 95% CI 0.47 – 0.85) and oral steroid prescription (OR?=?0.68, 95% CI 0.57 – 0.81). Conclusions Thiazolidinediones may provide a novel anti-inflammatory approach to asthma management by preventing exacerbations and decreasing the use of oral steroids.

2014-01-01

353

An economic evaluation for prevention of diabetes mellitus in a developing country: a modelling study  

PubMed Central

Background The serious consequences of diabetes mellitus, and the subsequent economic burden, call for urgent preventative action in developing countries. This study explores the clinical and economic outcomes of strategies that could potentially prevent diabetes based on Chinese circumstances. It aims to provide indicators for the long-term allocation of healthcare resources for authorities in developing countries. Methods A representative sample of Chinese adults was used to create a simulated population of 20,000 people aged 25 years and above. The hybrid decision tree Markov model was developed to compare the long-term clinical and economic outcomes of four simulated diabetes prevention strategies with a control group, where no prevention applied. These preventive strategies were the following: (i) one-off screening for undiagnosed diabetes and impaired glucose tolerance (IGT), with lifestyle interventions on diet, (ii) on exercise, (iii) on diet combined exercise (duo-intervention) respectively in those with IGT, and (iv) one-off screening alone. Independent age-specific models were simulated based on diverse incidences of diabetes, mortalities and health utilities. The reported outcomes were the following: the remaining survival years, the quality-adjusted life years (QALYs) per diabetes or IGT subjects, societal costs per simulated subject and the comparisons between preventions and control over 40 years. Sensitivity analyses were performed based on variations of all assumptions, in addition to the performance and the compliance of screening. Results Compared with the control group, all simulated screening programmes prolonged life expectancy at the initiation ages of 25 and 40 years, postponed the onset of diabetes and increased QALYs at every initiation age. Along with an assumption of six years intervention, prevention programmes were associated with cost-saving compared with the control group, especially in the population aged 25 years. The savings were at least US$2017 per subject, but no statistically significant difference was observed among the intervention strategies within each age groups. The cost savings were reduced when screening was affected by poor performance and noncompliance. Conclusions Developing countries have few effective strategies to manage the prevention of diabetes. One-off screening for undiagnosed diabetes and IGT, with appropriate lifestyle interventions for those with IGT are cost saving in China, especially in young adults.

2013-01-01

354

Electron autoradiographic study of intracellular conversion of fatty acids into glycogen in rats with alloxan diabetes  

SciTech Connect

An electron-autoradiographic study was undertaken of the intracellular distribution of hydrogen of fatty acids in alloxan diabetes. Alloxan diabetes was induced in rats; between 2 weeks and 2 months after development of the disease 0.1 ml of tritium-oleic or tritium-arachidonic acid was injected into the caudel vein of the rats. After decapitation, myocardial tissue from the subendocardial zone of the left ventricle, liver tissue, and glycogen isolated from the liver by a biochemical method, were taken for electron-autoradiographic investigation. Analysis of the data showed that a radioactive isotope, injected into the blood stream of the animals in the form of oleic or arachidonic acids, is incorporated into various structures of hepatocytes and cardiomyocytes. Direct proof is obtained to show that glycogen in hepatocytes and cardiomyoctyes of diabetic rats may be formed from fatty acids.

Lebkova, N.P.; Bobkov, Y.I.; Gorbonova, V.D.; Kolesova, O.E.

1985-05-01

355

High Incidence of Diabetes after Stroke in Young Adults and Risk of Recurrent Vascular Events: The FUTURE Study  

PubMed Central

Background Diabetes diagnosed prior to stroke in young adults is strongly associated with recurrent vascular events. The relevance of impaired fasting glucose (IFG) and incidence of diabetes after young stroke is unknown. We investigated the long-term incidence of diabetes after young stroke and evaluated the association of diabetes and impaired fasting glucose with recurrent vascular events. Methods This study was part of the FUTURE study. All consecutive patients between January 1, 1980, and November 1, 2010 with TIA or ischemic stroke, aged 18–50, were recruited. A follow-up assessment was performed in survivors between November 1, 2009 and January 1, 2012 and included an evaluation for diabetes, fasting venous plasma glucose and recurrent vascular events. The association of diabetes and IFG with recurrent vascular events was assessed by logistic regression analysis, adjusted for age, sex and follow-up duration. Results 427 survivors without a medical history of diabetes were included in the present analysis (mean follow-up of 10.1 (SD 8.4) years; age 40.3 (SD 7.9) years). The incidence rate of diabetes was 7.9 per 1000 person-years and the prevalence of IFG was 21.1%. Patients with diabetes and IFG were more likely to have experienced any vascular event than those with normal fasting glucose values (OR 3.5 (95%CI 1.5–8.4) for diabetes and OR 2.5 (95%CI 1.3–4.8) for IFG). Conclusions Diabetes or IFG in young stroke survivors is frequent and is associated with recurrent vascular events. Regular screening for IFG and diabetes in this population, yields potential for secondary prevention.

Arntz, Renate M.; Maaijwee, Noortje A. M.; Schoonderwaldt, Henny C.; Dorresteijn, Lucille D.; van der Vlugt, Maureen J.; van Dijk, Ewoud J.; de Leeuw, Frank-Erik

2014-01-01

356

A crossover study of rosuvastatin and pitavastatin in patients with type 2 diabetes  

Microsoft Academic Search

Introduction  The effects of a low dose of rosuvastatin (ROS) and pitavastatin (PIT) on lipid profiles and inflammation markers were assessed\\u000a in subjects with type 2 diabetes mellitus.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A total of 90 Japanese type 2 diabetes patients with hyperlipidemia (low-density lipoprotein cholesterol [LDL-C] ?140 mg\\/dL)\\u000a were enrolled in this study. They were randomly assigned to four groups with open-label treatment with

Kazunori Yanagi; Tsuyoshi Monden; Shiori Ikeda; Mihoko Matsumura; Kikuo Kasai

2011-01-01

357

Renal Dysfunction in the Presence of Normoalbuminuria in Type 2 Diabetes: Results from the DEMAND Study  

PubMed Central

Background/Aims Microalbuminuria is associated with diabetes and is an independent risk factor for developing diabetic nephropathy. We have previously reported the overall prevalence of normoalbuminuria, microalbuminuria, and macroalbuminuria to be 51, 39, and 9.8%, respectively, in an unselected population of patients with type 2 diabetes. Renal dysfunction was present in a large proportion of these patients without proteinuria, assessed by a single random albumin-to-creatinine ratio (ACR). We therefore undertook to characterize the nature of this association of non-proteinuric renal dysfunction in type 2 diabetes. Methods In the DEMAND (Developing Education on Microalbuminuria for Awareness of Renal and Cardiovascular Risk in Diabetes) study, a global, cross-sectional study which described the prevalence and risk factors for albuminuria in a clinic-based cohort, kidney function was assessed in 11,573 patients; ACR was measured using the Bayer reagent strip Multistix® 10SG. Normoalbuminuria was defined as ACR <30 mg/g, microalbuminuria as 30–299 mg/g, and macroalbuminuria as >300 mg/g. Results Among the patients with estimated kidney function determined, chronic kidney disease was noted in 17% of those with normoalbuminuria (stage 3–5), and significant kidney dysfunction was found in 27% of those with microalbuminuria and 31% of those with overt proteinuria. CrCl was <60 ml/min in 20.5% of normoalbuminurics, 30.7% of microalbuminurics, and 35.0% of macroalbuminurics (p < 0.0001). Conclusion A large proportion of diabetic patients with completely normal urinary albumin excretion or microalbuminuria presented with significant kidney dysfunction. Therefore, further investigation is warranted.

Dwyer, Jamie P.; Parving, Hans-Henrik; Hunsicker, Lawrence G.; Ravid, Moti; Remuzzi, Giuseppe; Lewis, Julia B.

2012-01-01

358

Insulin Resistance and Excess Risk of Diabetes in Mexican-Americans: The San Antonio Heart Study  

PubMed Central

Context: Mexican-Americans have more diabetes than non-Hispanic whites, but the extent to which insulin resistance and insulin secretion explain the ethnic difference is unknown. Objective: We analyzed selected indices of insulin resistance and secretion for both the ethnic difference and predictive discrimination. Design and Setting: The San Antonio Heart Study is a longitudinal population-based study with a follow-up period of 7.5 yr. Participants: A total of 1540 nondiabetic individuals aged 25–64 yr were enrolled from January 1984 to December 1988. Interventions: Homeostasis model assessment (HOMA) of insulin resistance and secretion were estimated by available formulas (HOMA-IR and HOMA ?-cell) and computer program (HOMA2S and HOMA2B). Matsuda index and insulinogenic index from 0 to 30 and 0 to 120 min (?I0–30/?G0–30 and ?I0–120/?G0–120) were also calculated. Main Outcome Measure: Incident diabetes was defined by the 2003 American Diabetes Association criteria. Results: Incident diabetes was in excess in Mexican-Americans [odds ratio 2.26 (95% confidence interval, 1.53–3.34)]. Matsuda index explained a larger proportion of the ethnic difference than did HOMA-IR (49.2 vs. 31.0%; P < 0.001). The ethnic difference was not explained by measures of insulin secretion. Matsuda index and ?I0–30/?G0–30 had a better predictive discrimination than their HOMA equivalents and ?I0–120/?G0–120. HOMA estimates by the computer program offered no advantage over simple formulas for HOMA. Conclusions: Insulin resistance accounts for a large and significant proportion of the excess risk of diabetes in Mexican-Americans. Matsuda index is better than HOMA-IR for both explaining the ethnic difference and predicting diabetes.

Hazuda, Helen P.; Haffner, Steven M.

2012-01-01

359

Health-care cost of diabetes in South India: A cost of illness study  

PubMed Central

Objective: The objective of this study is to analyze the health-care cost by calculating the direct and indirect costs of diabetes with co-morbidities in south India. Methods: A prospective observational study was conducted at Rohini super specialty hospital (India). Patient data as well as cost details were collected from the patients for a period of 6 months. The study was approved by the hospital committee prior to the study. The diabetic patients of age >18 years, either gender were included in the study. The collected data was analyzed for the average cost incurred in treating the diabetic patients and was calculated based on the total amount spent by the patients to that of total number of patients. Findings: A total of 150 patients were enrolled during the study period. The average costs per diabetic patient with and without co-morbidities were found to be United States dollar (USD) 314.15 and USD 29.91, respectively. The average cost for those with diabetic complications was USD 125.01 for macrovascular complications, USD 90.43 for microvascular complications and USD 142.01 for other infections. Out of USD 314.15, the average total direct medical cost was USD 290.04, the average direct non-medical cost was USD 3.75 and the average total indirect cost was USD 20.34. Conclusion: Our study results revealed that more economic burden was found in male patients (USD 332.06), age group of 51-60 years (USD 353.55) and the patients bearing macrovascular complications (USD 142.01). This information can be a model for future studies of economic evaluations and outcomes research.

Akari, Sadanandam; Mateti, Uday Venkat; Kunduru, Buchi Reddy

2013-01-01

360

Diabetes in the workplace - diabetic's perceptions and experiences of managing their disease at work: a qualitative study  

PubMed Central

Background Diabetes represents one of the biggest public health challenges facing the UK. It is also associated with increasing costs to the economy due to working days lost as people with diabetes have a sickness absence rate 2–3 times greater than the general population. Workplaces have the potential to support or hinder self- management of diabetes but little research has been undertaken to examine the relationship between work and diabetes in the UK. This paper seeks to go some way to addressing this gap by exploring the perceptions and experiences of employees with diabetes. Methods Forty three people with diabetes were purposively recruited to ascertain ways in which they managed their disease in the workplace. Semi-structured, interviews were undertaken, tape recorded and transcribed. Analysis was conducted using a constant comparative approach. Results Although respondents had informed managers of their diabetic status they felt that their managers had little concept of the effects of the work environment on their ability to manage their disease. They did not expect support from their managers and were concerned about being stigmatised or treated inappropriately. Work requirements took priority. They had to adapt their disease management to fit their job and reported running their blood glucose levels at higher than optimal levels, thereby putting themselves at higher risk of long term complications. Conclusions Little research has examined the way in which employees with diabetes manage their disease in the workplace. This research shows there is a need to increase the awareness of managers of the short and long term economic benefit of supporting employees with diabetes to manage their disease effectively whist at work. Employees may need individually assessed and tailored support on the job in order to manage their disease effectively.

2013-01-01

361

Effect of advertising on awareness of symptoms of diabetes among the general public: the British Diabetic Association Study.  

PubMed Central

OBJECTIVE--To determine the impact of posters advertising symptoms of diabetes on public knowledge of these symptoms. DESIGN--Structured street interviews of members of the general public before, at the end of, and 10 weeks after a campaign advertising the main symptoms of diabetes. SETTING--Basingstoke and Wolverhampton. SUBJECTS--Three samples of 1000 members of the general public were interviewed. Samples were selected randomly but stratified to match the local population's age (20-75), sex, social class, and racial characteristics. MAIN OUTCOME MEASURES--Knowledge of symptoms of diabetes; perceived seriousness of diabetes; and induction of anxiety about symptoms in the target population. RESULTS--Advertising significantly raised knowledge (without prompting) of symptoms: thirst, 245 before v 411 at end of campaign (P < 0.0001) v 341 after (P = 0.0012 v before); polyuria, 72 v 101 (P = 0.0211) v 92 (P = 0.5169); lethargy, 180 v 373 (P < 0.0001) v 298 (P < 0.0001); knowledge of weight loss and visual disturbance was unaffected. The number of subjects lacking knowledge of any symptoms was reduced from 550 to 388 (P < 0.0001). The perceived seriousness of diabetes was unaffected (mean 7.6 in each phase on a scale of 1 (not) to 10 (very). Before advertising, 449 (45%) claimed to have one or more symptoms of diabetes, but this number fell at the end of the campaign (403; P = 0.0419) and 10 weeks afterwards (278; P < 0.0001). CONCLUSIONS--An advertising campaign raised public knowledge of diabetes symptoms without inducing fear of diabetes or anxiety about symptoms. Its potential for achieving earlier detection of non-insulin dependent diabetes should be evaluated. Images FIG 1 FIG 2

Singh, B. M.; Prescott, J. J.; Guy, R.; Walford, S.; Murphy, M.; Wise, P. H.

1994-01-01

362

Individual and Family Factors Impacting Diabetic Control for the Adolescent: A Preliminary Study.  

ERIC Educational Resources Information Center

Sixteen adolescents between the ages of 15 and 18 years and their parents participated in a preliminary study on the impact of family and individual factors on diabetes control for the adolescent. It was hypothesized that there was a relationship between the adolescent's perception of adolescent development, social support, depression, family…

Lawler, Mary; And Others

363

Identifying and Overcoming Barriers to Diabetes Management in the Elderly: An Intervention Study.  

National Technical Information Service (NTIS)

During this research period, we have nearly completed recruitment of patients over age 70 with diabetes and poor glycemic control as defined by A1c>8%, and have started analysis of the data. We have now recruited 50 subjects for the study and have additio...

M. Munshi

2010-01-01

364

Early Malnutrition and Child Neurobehavioral Development: Insights from the Study of Children of Diabetic Mothers.  

ERIC Educational Resources Information Center

Studied whether disturbances in mothers' metabolism (N=139) during pregnancy may exert long-range effects on neurobehavioral development of singleton progeny. Examined detailed pregnancy and perinatal records of mothers who experienced diabetes in pregnancy and intelligence tests of their offspring, administered at ages 7 to 11 years. All…

Rizzo, Thomas A.; And Others

1997-01-01

365

The Chronic CARe for diAbeTes study (CARAT): a cluster randomized controlled trial  

Microsoft Academic Search

BACKGROUND: Diabetes is a major challenge for the health care system and especially for the primary care provider. The Chronic Care Model represents an evidence-based framework for the care for chronically ill. An increasing number of studies showed that implementing elements of the Chronic Care Model improves patient relevant outcomes and process parameters. However, most of these findings have been

Anja Frei; Corinne Chmiel; Hansueli Schläpfer; Beatrice Birnbaum; Ulrike Held; Johann Steurer; Thomas Rosemann

2010-01-01

366

Infantile-Onset Diabetes Mellitus: A 1Year Follow-up Study  

Microsoft Academic Search

This study evaluates the clinical profiles and outcomes of children with infantile-onset diabetes mellitus (IODM) (onset at <1 year). Twelve infants with IODM presenting to our hospital from January 2003 to December 2007 are analyzed. All undergo thorough history, clinical examination, and investigations and are managed as per hospital-approved protocol and periodically followed up. Of 12 infants (3 boys and

Ramaswamy Ganesh; Ravindrakumar Arvindkumar; Thiruvengadam Vasanthi

2009-01-01

367

Microalbuminuria in Diabetic Adolescents and Children—Feasibility Phase of a National Cross-Sectional Study  

Microsoft Academic Search

Our objective was to assess the feasibility of examining the prevalence of microalbuminuria nationally and to validate the effectiveness of the collection and central analysis of biological specimens. In a centrally coordinated, cross-sectional, multicenter pilot study in pediatric,diabetes outpatients clinics in UK and the Republic of Ireland, blood and urine samples were collected from patients aged between 10 and 20

Theresa H Moore

1999-01-01

368

Antiretroviral Therapy and the Prevalence and Incidence of Diabetes Mellitus in the Multicenter AIDS Cohort Study  

Microsoft Academic Search

Background: The risk of diabetes mellitus (DM) in hu- man immunodeficiency virus (HIV)-infected patients re- ceiving highly active antiretroviral therapy (HAART) has not been well defined. Methods: We conducted an analysis in the Multicenter AIDS Cohort Study to determine the prevalence and incidence of DM in this cohort of HIV-infected and HIV- seronegative men. Prevalence analysis included 1278 men (710

Todd T. Brown; Stephen R. Cole; Xiuhong Li; Lawrence A. Kingsley; Frank J. Palella; Sharon A. Riddler; Barbara R. Visscher; Joseph B. Margolick; Adrian S. Dobs

2005-01-01

369

A case-control study of diabetes mellitus and cancer risk  

Microsoft Academic Search

The relationship between diabetes mellitus and cancer risk was investigated using data from an integrated series of case-control studies conducted in Northern Italy between 1983 and 1992. Cases were 9,991 patients with incident, histologically confirmed neoplasms below age 75, including 181 cancers of the oral cavity and pharynx, 316 of the oesophagus, 723 of the stomach, 828 of the colon,

C La Vecchia; E Negri; S Franceschi; B D'Avanzo; P Boyle

1994-01-01

370

Direct Medical Costs for Patients with Type 2 Diabetes and Related Complications: A Prospective Cohort Study Based on the Korean National Diabetes Program  

PubMed Central

We analyzed the direct medical costs for Korean patients with type 2 diabetes according to the type of complications and the number of microvascular complications. We analyzed costs for type 2 diabetes and associated complications in 3,125 patients. These data were obtained from the Korean National Diabetes Program (KNDP), a large, ongoing, prospective cohort study that began in 2005. The cost data were prospectively collected, using an electronic database, for the KNDP cohort at six hospitals. The costs were analyzed according to complications for 1 yr from enrollment in the study. Among 3,125 patients, 918 patients had no vascular complications; 1,883 had microvascular complications only; 51 had macrovascular complications only; and 273 had both complications. The annual direct medical costs for a patient with only macrovascular, only microvascular, or both macrovascular and microvascular complications were 2.7, 1.5, and 2.0 times higher than the medical costs of patients without complications. Annual direct medical costs per patient increased with the number of microvascular complications in patients without macrovascular complications. The economic costs for type 2 diabetes are attributable largely to the management of microvascular and macrovascular complications. Proper management of diabetes and prevention of related complications are important for reducing medical costs.

Kim, Tae Ho; Chun, Ki Hong; Kim, Hae Jin; Han, Seung Jin; Kim, Dae Jung; Kwak, Jiyeong; Kim, Young Seol; Woo, Jeong Taek; Park, Yongsoo; Nam, Moonsuk; Baik, Sei Hyun; Ahn, Kyu Jeung

2012-01-01

371

Pioglitazone and bladder cancer in human studies: is it diabetes itself, diabetes drugs, flawed analyses or different ethnicities?  

PubMed

This article reviews human observations on pioglitazone and bladder cancer risk. The PROspective pioglitAzone Clinical Trial In macroVascular Events trial showed an imbalance in bladder cancer between users of pioglitazone and placebo (14 versus six cases, p = 0.069). However, after excluding bladder cancer probably ascribed to other etiology, a blind assessment concluded that the imbalance might not be related to pioglitazone. Epidemiologic studies conducted in the United States and France using insurance databases independently suggested that pioglitazone use for >2 years might confer a 20%-40% higher risk. Another study evaluating bladder cancer risk in diabetic patients using the National Health Insurance in Taiwan did not find any incident bladder cancer case among 422 pioglitazone users for a follow-up of up to 3 years. Because observational studies may suffer from selection and information bias, and inadequate adjustment for confounders may inflate the estimated risk, causal inference from these studies should be interpreted with caution. While investigating cancer risk associated with a medication, indication bias should also be attended, especially when the medication is used at a late stage of the disease. Because pioglitazone is usually a second or third line antidiabetic agent, the users are always characterized by older age, longer diabetes duration, poorer glycemic control, and higher rates of complications and comorbidities. Biased estimates will also result if these differences are not appropriately addressed in the analyses. Current evidence neither concludes nor excludes a causal role of pioglitazone on bladder cancer. Clinical trials aiming at evaluating the risk of cancer associated with a medication is not ethical and may not be expected to provide an answer on the issue of pioglitazone-related bladder cancer. However, a meta-analysis using all available clinical trials to compare the bladder cancer risk between pioglitazone and comparators will be helpful. Well-conducted epidemiologic observational studies are probably other options. Because bladder cancer incidence and their risk factors may differ significantly among different ethnicities, a clarification of such a link in different ethnicities is needed, better by using long-term databases with large and representative sample size and appropriate adjustment for confounders. Furthermore, the interactions with other comorbidities and concomitant medications should be addressed. PMID:22423665

Tseng, Chin-Hsiao

2012-03-01

372

Coffee, tea, and incident type 2 diabetes: the Singapore Chinese Health Study  

PubMed Central

Background Increasing coffee intake was inversely associated with risk of type 2 diabetes in populations of European descent; however, data from high-risk Asian populations are lacking as are data on tea intake in general. Objective We investigated the prospective associations between intakes of coffee, black tea, and green tea with the risk of type 2 diabetes in Singaporean Chinese men and women. Design We analyzed data from 36 908 female and male participants in the Singapore Chinese Health Study aged 45-74 y in 1993-1998 who had multiple diet and lifestyle measures assessed and then were followed up between 1999 and 2004. We used Cox regression models to investigate the association of baseline coffee and tea intakes with incident type 2 diabetes during follow-up, with adjustment for a number of possible confounding or mediating variables. Results In multivariate models participants reporting ?4 cups of coffee/d had a 30% reduction in risk of diabetes [relative risk (RR): 0.70; 95% CI: 0.53, 0.93] compared with participants who reported nondaily consumption. Participants reporting ?1 cup of black tea/d had a suggestive 14% reduction in risk of diabetes (RR: 0.86; 95% CI: 0.74, 1.00) compared with participants who reported 0 cups/d, and we observed no association with green tea. Conclusion Regular consumption of coffee and potentially black tea, but not green tea, is associated with lower risk of type 2 diabetes in Asian men and women in Singapore.

Odegaard, Andrew O; Pereira, Mark A; Koh, Woon-Puay; Arakawa, Kazuko; Lee, Hin-Peng; Yu, Mimi C

2009-01-01

373

Chronic Pain with Neuropathic Characteristics in Diabetic Patients: A French Cross-Sectional Study  

PubMed Central

Objective Our aim was to estimate the prevalence of distal chronic pain with neuropathic characteristics in patients with type 1 and type 2 diabetes mellitus and its impact on quality of life, mood, anxiety, sleep and healthcare utilization. Methods In total, 885 patients were screened and 766 diabetic patients (38.7% with type 1 diabetes mellitus, 44.8% women, mean age: 57.2±14.9 years) were enrolled consecutively over a three-month period in this observational study by 85 diabetes specialists working in a hospital department or in private practice. All the patients completed a series of questionnaires for the detection of chronic pain (i.e. daily pain for more than three months) in the lower limbs and assessment of health-related quality of life (Medical Outcomes Short Form 12 scale), sleep disturbances (MOS sleep scale), depression and anxiety (Hospital Anxiety and Depression scale). Patients with chronic pain were also assessed with the 7-item DN4-interview questionnaire, the monofilament test and the Michigan Neuropathy Screening Instrument (MNSI). Results The overall prevalence of chronic pain with neuropathic characteristics was 20.3% [95% CI 17.4–23.1]. The MNSI examination score suggested that pain was related to polyneuropathy, in 80.1% of these patients (89.5% of those with bilateral pain). Patients with chronic pain had a poorer quality of life and more sleep disturbances, anxiety and depression than patients without pain and the presence of neuropathic characteristics was predictive of such impairments. Only 38.6% of the patients had received appropriate treatment for neuropathic pain. Conclusions Chronic pain with neuropathic characteristics concerns one in five diabetic patients, has a significant impact on quality of life and is not adequately managed. The close correlation between the DN4 questionnaire and MNSI results suggests that screening tools for neuropathic pain could be used in daily practice for the identification of painful diabetic polyneuropathy.

Bouhassira, Didier; Letanoux, Martine; Hartemann, Agnes

2013-01-01

374

Diabetic retinopathy risk prediction for fundus examination using sparse learning: a cross-sectional study  

PubMed Central

Background Blindness due to diabetic retinopathy (DR) is the major disability in diabetic patients. Although early management has shown to prevent vision loss, diabetic patients have a low rate of routine ophthalmologic examination. Hence, we developed and validated sparse learning models with the aim of identifying the risk of DR in diabetic patients. Methods Health records from the Korea National Health and Nutrition Examination Surveys (KNHANES) V-1 were used. The prediction models for DR were constructed using data from 327 diabetic patients, and were validated internally on 163 patients in the KNHANES V-1. External validation was performed using 562 diabetic patients in the KNHANES V-2. The learning models, including ridge, elastic net, and LASSO, were compared to the traditional indicators of DR. Results Considering the Bayesian information criterion, LASSO predicted DR most efficiently. In the internal and external validation, LASSO was significantly superior to the traditional indicators by calculating the area under the curve (AUC) of the receiver operating characteristic. LASSO showed an AUC of 0.81 and an accuracy of 73.6% in the internal validation, and an AUC of 0.82 and an accuracy of 75.2% in the external validation. Conclusion The sparse learning model using LASSO was effective in analyzing the epidemiological underlying patterns of DR. This is the first study to develop a machine learning model to predict DR risk using health records. LASSO can be an excellent choice when both discriminative power and variable selection are important in the analysis of high-dimensional electronic health records.

2013-01-01

375

Symptoms of depression but not anxiety are associated with central obesity and cardiovascular disease in people with type 2 diabetes: the Edinburgh Type 2 Diabetes Study  

Microsoft Academic Search

Aims\\/hypothesis  The aim of the study was to identify risk factors for depression and anxiety in a well-characterised cohort of individuals\\u000a with type 2 diabetes mellitus.\\u000a \\u000a \\u000a \\u000a Methods  We used baseline data from participants (n?=?1,066, 48.7% women, aged 67.9?±?4.2 years) from the Edinburgh Type 2 Diabetes Study. Symptoms of anxiety and depression\\u000a were assessed using the Hospital Anxiety and Depression Scale (HADS). Obesity was

J. Labad; J. F. Price; M. W. J. Strachan; F. G. R. Fowkes; J. Ding; I. J. Deary; A. J. Lee; B. M. Frier; J. R. Seckl; B. R. Walker; R. M. Reynolds

2010-01-01

376

Sense of coherence in people with and without type 2 diabetes mellitus: an observational study from Greece  

PubMed Central

Background Antonovsky's concept of sense of coherence (SOC) has been suggested to relate to health, especially mental health and preventive health behaviours. Psychological distress has been identified as a risk factor for pre-diabetes and type 2 diabetes mellitus. The study of SOC and diabetes has not received much attention in Greece. This study aims to explore the extent to which type 2 diabetes mellitus can affect the SOC score. Methods An observational design was used to test the study hypothesis that individuals with type 2 diabetes mellitus would have a lower SOC than those without diabetes mellitus. A total of 202 individuals were studied, consisting of 100 people with diabetes mellitus (the study group) and 102 people with non-chronic orthopaedic conditions (the control group). All of the participants were patients of the Diabetic Clinic or the Orthopaedic Clinic of Livadia Hospital in Central Greece. SOC was assessed using a 29-item SOC questionnaire that had been translated into Greek and validated. Results Patients without type 2 diabetes mellitus had 2.4 times higher odds of having a high SOC score than patients with type 2 diabetes mellitus (P = 0.036; odds ratio [OR] = 2.35, 95% confidence interval [CI] = 1.06–5.23). Male patients had 3.9 times higher odds of having a high SOC score (P < 0.001; OR = 3.85, 95% CI = 1.71–8.67) than female patients. With regard to education, patients with a lower level of education had almost three times higher odds of having a high SOC score than patients with a higher level of education (P = 0.024; OR = 2.97, 95% CI = 1.15–7.67). Conclusions This study adds to the existing literature and indicates that SOC is a health asset. A study with an experimental design would clarify the interesting hypothesis of this study.

2013-01-01

377

Diabetes Insipidus  

MedlinePLUS

... but not thirst and fluid intake. This fluid overload can lead to water intoxi cation, a condition ... current studies, visit www.ClinicalTrials.gov. For More Information The Diabetes Insipidus and Related Disorders Network 535 ...

378

Lifestyle changes - a continuous, inner struggle for women with type 2 diabetes: A qualitative study  

PubMed Central

Objective The objective of this study was to describe how women handle necessary lifestyle changes due to a chronic disease using diabetes as a model. Design Interview study. Setting Ten women living in western Sweden were interviewed. Method In-depth interviews and analysis were performed using the phenomenological ideas of Giorgi. Subjects Ten women diagnosed with type 2 diabetes, mean age 65. All were either on disability pension or retired with varying complications ranging from none to stroke. Results The findings revealed five themes: the ambiguous feeling of others’ involvement, becoming a victim of pressurizing demands, experiencing knowledge deficits, experiencing an urge, and finding reasons to justify not changing. The invariant meaning of a continuous inner struggle illuminates the experience of making lifestyle changes for women with type 2 diabetes. Conclusion The findings of the present study show that it is vital for health care professionals to treat women diagnosed with type 2 diabetes with great respect and understanding regarding the struggle that they are going through. By being aware of the everyday burden for these women, acknowledging the fact that they want their lives to go on as before, may serve as a “key” to assist women in changing attitudes towards living in accordance with the disease and appreciating the lifestyle changes as a challenge as they become healthier and improve their quality of life.

Ahlin, Kristina; Billhult, Annika

2012-01-01

379

Intervention with vitamins in patients with nonproliferative diabetic retinopathy: a pilot study  

PubMed Central

Background The purpose of this study was to determine whether a combination of vitamins B6, B9, and B12 is an effective intervention for reducing the signs and symptoms of nonproliferative diabetic retinopathy. Methods Ten subjects with type 2 diabetes mellitus (n = 20 eyes) with clinically diagnosed mild to moderate nonproliferative diabetic retinopathy were recruited from a private practice ophthalmology clinic for this open-label, uncontrolled, prospective six-month study. Metanx® vitamin tablets (containing 3 mg L-methylfolate calcium, 35 mg pyridoxal-5?-phosphate, and 2 mg methylcobalamin) were administered at a dosage of two tablets daily. Primary outcome indicators were the percent change in mean retinal sensitivity threshold measured by macular microperimetry and the percent change in mean central retinal thickness measured by spectral-domain optical coherence tomography. Results Three subjects were lost to follow-up. In the remaining seven subjects, two of 14 eyes had foveal edema that prevented microperimetry measurements due to poor fixation. The remaining 12 eyes showed a nonlinear improvement in mean threshold retinal sensitivity (P < 0.001). Overall change in mean central retinal thickness in 14 eyes was linear (R2 = 0.625; P = 0.034), with a significant reduction between one and six months (P = 0.012). Conclusion In this pilot study, the Metanx intervention appeared to have some beneficial effects with respect to reducing retinal edema and increasing light sensitivity in subjects with nonproliferative diabetic retinopathy.

Smolek, Michael K; Notaroberto, Neil F; Jaramillo, Arley G; Pradillo, Lisa R

2013-01-01

380

Patient-provider interaction from the perspectives of type 2 diabetes patients in Muscat, Oman: a qualitative study  

Microsoft Academic Search

BACKGROUND: Patients' expectations and perceptions of the medical encounter and interactions are important tools in diabetes management. Some problems regarding the interaction during encounters may be related to a lack of communication skills on the part of either the physician or the patient. This study aimed at exploring the perceptions of type 2 diabetes patients regarding the medical encounters and

Nadia Abdulhadi; Mohammed Al Shafaee; Solveig Freudenthal; Claes-Göran Östenson; Rolf Wahlström

2007-01-01