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1

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. PMID:16111499

2005-01-01

2

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. PMID:21569337

2011-01-01

3

Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomised controlled trial  

Microsoft Academic Search

Summary Background Laser treatment for diabetic retinopathy is often associated with visual fi eld reduction and other ocular side-eff ects. Our aim was to assess whether long-term lipid-lowering therapy with fenofi brate could reduce the progression of retinopathy and the need for laser treatment in patients with type 2 diabetes mellitus. Methods The Fenofi brate Intervention and Event Lowering in

AC Keech; P Mitchell; PA Summanen; J O'Day; TME Davis; M-R Taskinen; RJ Simes; D Tse; E Williamson; A Merrifield; LT Laatikainen; MC d'Emden; DC Crimet; RL O'Connell; PG Colman

2007-01-01

4

Type 1 Diabetes Lowered Survival in Study  

MedlinePLUS

... features on this page, please enable JavaScript. Type 1 Diabetes Lowered Survival in Study Better blood sugar ... 2014 Related MedlinePlus Pages Blood Sugar Diabetes Type 1 WEDNESDAY, Nov. 19, 2014 (HealthDay News) -- People with ...

5

Diabetics Face Much Greater Risk of Heart Damage, Study Says  

MedlinePLUS

... new study suggest that people with diabetes and pre-diabetes may be suffering undetectable -- but potentially dangerous -- heart ... underscores the need for prevention of diabetes and pre-diabetes." The study relied on an ultra-sensitive test ...

6

[Pathogenesis of diabetes mellitus and diabetic complications. Studies on diabetic mouse models].  

PubMed

Diabetic mouse models created via random mutagenesis or genetic modification are essential tools to unravel the mechanisms involved in the development of diabetes mellitus and associated diseases. Three diabetic mutant mouse lines derived from the Munich N-ethyl-N-nitrosourea (ENU) mouse mutagenesis project and one transgenic mouse line were analyzed with respect to diabetes-relevant clinical, pathomorphological and therapeutic aspects. An Ins2 mutation and two Gck mutations were identified as the cause of diabetes mellitus in the mutant lines. Heterozygous Ins2 and homozygous Gck mutants serve as model for permanent neonatal diabetes mellitus (PNDM) and heterozygous Gck mutants develop maturity onset diabetes of the young type 2. Dominant-negative glucose-dependent insulinotropic polypeptide receptor (GIPR(dn)) transgenic mice exhibit defective postnatal islet growth, develop PNDM and progressive diabetes-associated kidney lesions. The mutant and transgenic diabetic mouse models analyzed in the study were shown to represent valuable models to study the pathogenesis of monogenic diabetes and to establish novel treatment strategies. PMID:23052340

Herbach, N

2012-11-01

7

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

8

Blood Glucose Levels and Performance in a Sports Camp for Adolescents with Type 1 Diabetes Mellitus: A Field Study  

PubMed Central

Background. Acute hypo- and hyperglycemia causes cognitive and psychomotor impairment in individuals with type 1 diabetes mellitus (T1DM) that may affect sports performance. Objective. To quantify the effect of concurrent and antecedent blood glucose concentrations on sports skills and cognitive performance in youth with T1DM attending a sports camp. Design/Methods. 28 youth (ages 6–17 years) attending a sports camp carried out multiple skill-based tests (tennis, basketball, or soccer skills) with glucose monitoring over 4 days. Glucose levels at the time of testing were categorized as (a) hypoglycemic (<3.6?mM); (b) within an acceptable glycemic range (3.6–13.9?mM); or (c) hyperglycemic (>13.9?mM). Results. Overall, sports performance skill was ?20% lower when glucose concentrations were hypoglycemic compared to either acceptable or hyperglycemic at the time of skill testing (P < .05). During Stroop testing, “reading” and “color recognition” also degraded during hypoglycemia, while “interference” scores improved (P < .05). Nocturnal hypoglycemia was present in 66% of subjects, lasting an average of 84 minutes, but this did not affect sports skill performance the following day. Conclusions. Mild hypoglycemia markedly reduces sports skill performance and cognition in young athletes with T1DM. PMID:20811595

Kelly, Dylan; Hamilton, Jill K.; Riddell, Michael C.

2010-01-01

9

Stereo nonmydriatic digital-video color retinal imaging compared with Early Treatment Diabetic Retinopathy Study seven standard field 35-mm stereo color photos for determining level of diabetic retinopathy 1 1 The Joslin Vision Network Research Team consists of Rita Botti; Dahlia K. Bursell, Richard M. Calderon, OD; W. Kelley Gardner, BS; Richard Jackson, MD; Paula Katalinic, B. Optom.; Vincent O’Brien, BS; Philip M. Silver, OD; James Strong, BS; Ann Tolson, BA  

Microsoft Academic Search

ObjectiveTo evaluate the ability to determine clinical levels of diabetic retinopathy, timing of next appropriate retinal evaluation, and necessity of referral to ophthalmology specialists using stereoscopic nonmydriatic digital-video color retinal images as compared with Early Treatment Diabetic Retinopathy Study (ETDRS) seven standard field 35-mm stereoscopic color fundus photographs.

Sven-Erik Bursell; Jerry D Cavallerano; Anthony A Cavallerano; Allen C Clermont; Deborah Birkmire-Peters; Lloyd Paul Aiello; Lloyd M Aiello

2001-01-01

10

Ultrawide-field Fluorescein Angiography for Evaluation of Diabetic Retinopathy  

PubMed Central

Purpose To investigate the advantages of ultrawide-field fluorescein angiography (FA) over the standard fundus examination in the evaluation of diabetic retinopathy (DR). Methods Ultrawide-field FAs were obtained in 118 eyes of 59 diabetic patients; 11 eyes with no DR, 71 eyes with nonproliferative diabetic retinopathy (NPDR), and 36 eyes with proliferative diabetic retinopathy (PDR), diagnosed by the standard method. The presence of peripheral abnormal lesions beyond the standard seven fields was examined. Results Ultrawide-field FA images demonstrated peripheral microaneurysms in six (54.5%) of 11 eyes with no DR and all eyes with moderate to severe NPDR and PDR. Peripheral retinal neovascularizations were detected in three (4.2%) of 71 eyes with NPDR and in 13 (36.1%) of 36 eyes with PDR. Peripheral vascular nonperfusion and vascular leakage were found in two-thirds of eyes with severe NPDR and PDR. Conclusions Ultrawide-field FA demonstrates peripheral lesions beyond standard fields, which can allow early detection and a close evaluation of DR. PMID:23204797

Kong, Mingui; Lee, Mee Yon

2012-01-01

11

Electrophysiological studies in diabetic neuropathy  

Microsoft Academic Search

In 30 patients with diabetic neuropathy sensory potentials in the median nerve, motor conduction in the lateral popliteal and median nerves, and electromyographic findings in distal and proximal muscles were compared with the severity of symptoms and signs. All patients had abnormalities in at least one of the electrophysiological parameters. The sensory potentials were the most sensitive indicator of subclinical

Albert Lamontagne; Fritz Buchthal

1970-01-01

12

The context of empowerment and self-care within the field of diabetes.  

PubMed

There is a growing emphasis within the diabetes literature on the importance of empowerment as a way of encouraging people to take control of and responsibility for the successful management of their disease. Patients are actively encouraged to become active participants in their care, and there is an expectation that health-care professionals will facilitate this process. This article uses Bourdieu's concept of field, as a bounded social space in which actors conduct their lives day-to-day, to explore the context within which issues of empowerment are addressed and negotiated. The practice of empowerment within the biologically defined and biomedically 'policed' field of diabetes is explored using empirical data from a study of diabetes health-care professionals' understanding and practices around empowerment. It is concluded that rather than promoting active self-management and empowerment, the nature of the field of diabetes, and in particular its privileging of the biomedical, can mitigate against people with diabetes negotiating the field effectively and taking control of the disease and its management. PMID:24695383

Scambler, Sasha; Newton, Paul; Asimakopoulou, Koula

2014-11-01

13

Detection of a diabetic sural nerve from the magnetic field after electric stimulation  

NASA Astrophysics Data System (ADS)

In this study, we proposed a new diagnostic technique for diabetic neuropathy using biomagnetic measurement. Peripheral neuropathy is one of the most common complications of diabetes. To examine the injury, the skin potential around the nerve is often measured after electric stimulation. However, measuring the magnetic field may reveal precise condition of the injury. To evaluate the effect of measuring the magnetic field, a simulation study was performed. A diabetic sural nerve was simulated as a bundle of myelinated nerve fibers. Each fiber was modeled as an electric cable of Ranvier's nodes. Anatomical data were used to determine the number of nerve fibers and distribution of nerve fiber diameters. The electric potential and the magnetic field on the skin after electric stimulation were computed to the boundary element method. Biphasic time courses were obtained as the electric potential and the magnetic flux density at measurement points. In diabetic nerves, the longer interpeak latency of the electric potential wave and the shorter interpeak latency of the magnetic flux wave were obtained. Measuring both the electric potential and the magnetic flux density seemed to provide a noninvasive and objective marker for diabetic neuropathy.

Hayami, Takehito; Iramina, Keiji; Hyodo, Akira; Chen, Xian; Sunagawa, Kenji

2009-04-01

14

Accuracy of reported family history of diabetes mellitus. Results from San Luis Valley Diabetes Study.  

PubMed

There are two possible sources of bias in the assessment of family history of diabetes: 1) a person with diabetes may be more likely to report a diabetic relative than a nondiabetic person would be, and 2) relatives of individuals with diabetes may be more likely to be tested for diabetes than relatives of nondiabetic individuals. We conducted a study on a subsample of families of subjects in the San Luis Valley Diabetes Study to examine these issues. A sample of 5 White and 5 Hispanic subjects (probands) with diabetic glucose tolerance tests and the same number with normal glucose tolerance were selected. The 20 probands all provided contact information on their 227 primary family members. Ninety-two percent of the family members had interviews completed by themselves or, if deceased, by surrogates other than the proband. Family members were asked by telephone if they had ever been tested for diabetes, when they had been most recently tested, why they had been tested, and if they had ever been told they had diabetes. The results showed that study subjects accurately reported family history of diabetes, because there were no discrepancies between proband and family reports. A positive family history of diabetes was associated with increased reported screening in Hispanics, but a similar effect in White families was not seen. Women were also more likely to report being screened than men regardless of whether there was a positive family history of diabetes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2387195

Kahn, L B; Marshall, J A; Baxter, J; Shetterly, S M; Hamman, R F

1990-07-01

15

Knowledge, attitude and practice (KAP) study on diabetes mellitus among Nepalese diabetic patients.  

PubMed

Present study was carried out to understand the knowledge, attitude and practices (KAP) regarding diabetes mellitus (DM) among the diabetic patients attending a diabetic education programme. Results showed that the majority of patients had correct knowledge regarding diabetic diet, three-fourths of them were subjected themselves to blood sugar checking at good intervals and almost all were under regular contact with physicians. This study might help in implementation of diabetic education programme giving more emphasis among older and younger groups of patients and encouraged the patients to have more contact with concerning physicians, so that complications that occurring at early stage of disease could be prevented. PMID:16295723

Shrestha, Lochana; Nagra, Jaswant Singh

2005-06-01

16

Have clinical studies demonstrated diabetes prevention or delay of diabetes through early treatment?  

PubMed

The incidence of type 2 diabetes continues to increase at alarming rates. Prediabetes is a state of abnormal glycemic values that are not abnormal enough to result in the diagnosis of type 2 diabetes. Significant interest in the prevention of diabetes has resulted in trials evaluating pharmacologic intervention and lifestyle intervention to prevent the development of diabetes. Controversy exists over the exact definition of diabetes prevention. Agents might possibly delay diagnosis of diabetes via pharmacologic lowering of blood glucose. Goals of diabetes prevention include decreased cardiovascular disease. Trials assessing diabetes prevention should assess 1) Impact of the study drug upon the incidence of diabetes, 2) Impact of the study drug upon diagnosis of diabetes after post-treatment washout phase, 3) Assessment of insulin sensitivity/@-cell function/insulin secretion and blood glucose, 4) Assessment of confounding factors, 5) Impact of the study drug on the occurrence of cardiovascular disease. The published studies were reviewed using these criteria. Six studies evaluating seven agents have been were reviewed. Six of the seven agents reduced diagnosis of diabetes during use, but only two demonstrated effect after washout phase. One of the two agents has been withdrawn from the market. The second agent had a short follow-up period making the results difficult to interpret. Assessment of insulin secretion at entry to trial was common, however ongoing reassessment was uncommon. All studies attempted to assess confounding factors, however stratification of drug benefit relative to amount of lifestyle modification benefit was not reported in trials. Cardiovascular benefit in the form of reduced hypertension was documented with three agents. Pharmacologic prevention of type 2 diabetes remains unproven, due in part to the difficulty distinguishing between prevention and delay. Reduction in cardiovascular benefit is unproven with most agents studied. Larger studies powered to detect cardiovascular endpoints are necessary to determine benefit of diabetes prevention. PMID:20305401

Southwood, Robin L

2010-01-01

17

Screening for Diabetic Retinopathy in Rural Area Using Single-Field, Digital Fundus Images  

Microsoft Academic Search

Objective: To evaluate the practicability of using single-field, 2.3 million-pixel, digital fundus images for screening of diabetic retinopathy in rural areas. Material and Method: All diabetic patients who regularly attended the diabetic clinic at Kabcheang Community Hospital, located at 15 kilometers from the Thailand-Cambodia border, were appointed to the hospital for a 3-day diabetic retinopathy screening programme. The fundi of

Paisan Ruamviboonsuk; Nattapon Wongcumchang; Pattamaporn Surawongsin; Ekchai Panyawatananukul; Montip Tiensuwan

18

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. PMID:24393784

Urano, Fumihiko

2014-01-01

19

Study on cavity induced conditions in diabetic patients  

Microsoft Academic Search

Diabetes mellitus (DM) is a chronic illness with multiple complications including oral cavity com- ponents. The study aims at identifying dental lesions in diabetic patients and assessing correlations between diabetes mellitus and dental caries index (DMF-T Decayed Missing, Filled Tooth). The analysis includes two patient samples: one with 52 patients previously diagnosed with DM and a control group with 50

Adina Magdalena Bunget; Gabriela P; Sanda Mihaela Popescu

20

Evaluation of traditional plant treatments for diabetes: Studies in streptozotocin diabetic mice  

Microsoft Academic Search

Summary  Seven plants and a herbal mixture used for traditional treatment of diabetes were studied in streptozotocin diabetic mice.\\u000a The treatments were supplied as 6.25% by weight of the diet for 9 days. Consumption of diets containing bearberry (Arctostaphylos uva-ursi), golden seal (Hydrastis canadensis), mistletoe (Viscum album) and tarragon (Artemisia dracunculus) significantly reduced the hyperphagia and polydipsia associated with streptozotocin diabetes,

Sara K. Swanston-Flatt; Caroline Day; Clifford J. Bailey; Peter R. Flatt

1989-01-01

21

Pulsed electromagnetic fields (PEMF) promote early wound healing and myofibroblast proliferation in diabetic rats.  

PubMed

Reduced collagen deposition possibly leads to slow recovery of tensile strength in the healing process of diabetic cutaneous wounds. Myofibroblasts are transiently present during wound healing and play a key role in wound closure and collagen synthesis. Pulsed electromagnetic fields (PEMF) have been shown to enhance the tensile strength of diabetic wounds. In this study, we examined the effect of PEMF on wound closure and the presence of myofibroblasts in Sprague-Dawley rats after diabetic induction using streptozotocin. A full-thickness square-shaped dermal wound (2?cm?×?2?cm) was excised aseptically on the shaved dorsum. The rats were randomly divided into PEMF-treated (5?mT, 25?Hz, 1?h daily) and control groups. The results indicated that there were no significant differences between the groups in blood glucose level and body weight. However, PEMF treatment significantly enhanced wound closure (days 10 and 14 post-wounding) and re-epithelialization (day 10 post-wounding), although these improvements were no longer observed at later stages of the wound healing process. Using immunohistochemistry against ?-smooth muscle actin (?-SMA), we demonstrated that significantly more myofibroblasts were detected on days 7 and 10 post-wounding in the PEMF group when compared to the control group. We hypothesized that PEMF would increase the myofibroblast population, contributing to wound closure during diabetic wound healing. PMID:24395219

Cheing, Gladys Lai-Ying; Li, Xiaohui; Huang, Lin; Kwan, Rachel Lai-Chu; Cheung, Kwok-Kuen

2014-04-01

22

Characteristics and outcome of type 2 diabetes in urban Aboriginal people: the Fremantle Diabetes Study.  

PubMed

We analysed data from Aboriginal patients with type 2 diabetes recruited to the community-based Fremantle Diabetes Study and compared them with those from the Anglo-Celt participants. Diabetes prevalence among Aboriginal people in the Fremantle area was more than double that of Anglo-Celts and the average age at diagnosis was 14 years or younger. Glycaemic control, urinary albumin :creatinine and the proportion of smokers were all higher in the Aboriginal group and there was evidence of lower diabetes-related quality of life and high rates of disability at a young age. The Aboriginal patients died 18 years or younger than their Anglo-Celt counterparts. Specialized, culturally-sensitive and sustainable programmes are urgently needed to improve the management of diabetes in urban Aboriginal communities. PMID:17199846

Davis, T M E; McAullay, D; Davis, W A; Bruce, D G

2007-01-01

23

Blood glucose levels and performance in a sports cAMP for adolescents with type 1 diabetes mellitus: a field study.  

PubMed

Background. Acute hypo- and hyperglycemia causes cognitive and psychomotor impairment in individuals with type 1 diabetes mellitus (T1DM) that may affect sports performance. Objective. To quantify the effect of concurrent and antecedent blood glucose concentrations on sports skills and cognitive performance in youth with T1DM attending a sports camp. Design/Methods. 28 youth (ages 6-17 years) attending a sports camp carried out multiple skill-based tests (tennis, basketball, or soccer skills) with glucose monitoring over 4 days. Glucose levels at the time of testing were categorized as (a) hypoglycemic (<3.6 mM); (b) within an acceptable glycemic range (3.6-13.9 mM); or (c) hyperglycemic (>13.9 mM). Results. Overall, sports performance skill was approximately 20% lower when glucose concentrations were hypoglycemic compared to either acceptable or hyperglycemic at the time of skill testing (P < .05). During Stroop testing, "reading" and "color recognition" also degraded during hypoglycemia, while "interference" scores improved (P < .05). Nocturnal hypoglycemia was present in 66% of subjects, lasting an average of 84 minutes, but this did not affect sports skill performance the following day. Conclusions. Mild hypoglycemia markedly reduces sports skill performance and cognition in young athletes with T1DM. PMID:20811595

Kelly, Dylan; Hamilton, Jill K; Riddell, Michael C

2010-01-01

24

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. PMID:24471039

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

25

Diabetes  

NSDL National Science Digital Library

Diabetes, in a variety of forms, affects many Americans and is the 4th leading cause of death by disease in the US. Diabetes is fundamentally a disease in which the body cannot produce or effectively use a critical hormone called insulin. Untreated / unmanaged diabetes can lead to blindness, kidney failure, heart disease, loss of limbs and stroke.

Dr. Leslie Nader (MSMR)

1993-04-14

26

Pulse Pressure and Mortality from Cerebrovascular Diseases in Type 2 Diabetic Patients: The Verona Diabetes Study  

Microsoft Academic Search

Background\\/Objective: Previous studies conducted both in the general and diabetic population have shown that pulse pressure (PP) can predict mortality from cardiovascular diseases. The aim of the present study was to investigate the relationship between PP and specific cardiovascular mortality, i.e. from cerebrovascular and ischemic heart diseases, in a well-characterized cohort of type 2 diabetic patients. Methods: A cohort of

Giacomo Zoppini; Giuseppe Verlato; Cristina Zamboni; Cristina Venturi; Nicola Gennaro; Valeria Biasi; Enzo Bonora; Michele Muggeo

2007-01-01

27

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. PMID:24322595

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

2014-01-01

28

Evaluation of traditional plant treatments for diabetes: studies in streptozotocin diabetic mice.  

PubMed

Seven plants and a herbal mixture used for traditional treatment of diabetes were studied in streptozotocin diabetic mice. The treatments were supplied as 6.25% by weight of the diet for 9 days. Consumption of diets containing bearberry (Arctostaphylos uva-ursi), golden seal (Hydrastis canadensis), mistletoe (Viscum album) and tarragon (Artemisia dracunculus) significantly reduced the hyperphagia and polydipsia associated with streptozotocin diabetes, but bayberry (Cinnamomum tamala), meadowsweet (Filipendula ulmaria), senna (Cassia occidentalis) and the herbal mixture did not alter these parameters. Bearberry, mistletoe and tarragon retarded the body weight loss but none of the eight treatments significantly altered plasma glucose or insulin concentrations. These studies suggest that bearberry, golden seal, mistletoe and tarragon may counter some of the symptoms of streptozotocin diabetes without, however, affecting glycemic control. PMID:2750445

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

1989-01-01

29

Obesity Fueling Rise in Diabetes Rates, Study Finds  

MedlinePLUS

... sharing features on this page, please enable JavaScript. Obesity Fueling Rise in Diabetes Rates, Study Finds Increase ... 2, 2014 Related MedlinePlus Pages Diabetes Health Statistics Obesity TUESDAY, Sept. 2, 2014 (HealthDay News) -- The U.S. ...

30

Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64)  

Microsoft Academic Search

Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64).BackgroundThe progression of nephropathy from diagnosis of type 2 diabetes has not been well described from a single population. This study sought to describe the development and progression through the stages of microalbuminuria, macroalbuminuria, persistently elevated plasma creatinine or renal replacement therapy (RRT), and

Amanda I Adler; Richard J Stevens; Sue E Manley; Rudy W Bilous; Carole A Cull; Rury R Holman

2003-01-01

31

Sexual dysfunctions in patients with diabetes: a study from Iran  

PubMed Central

Background Diabetes mellitus is a chronic disease that causes short and long-term complications. This study aimed to investigate the prevalence of sexual dysfunctions (SD) among diabetic patients in Iran and to examine whether glycemic control has a role in SD. Methods A consecutive sample of diabetic women and men who were registered in the Isfahan Endocrine and Metabolism Center, Iran were studied. Sexual dysfunction was evaluated using the Female Sexual Function Index (FSFI) in women and the International Index of Erectile Function (IIEF) in men. In addition the level of glycosylated hemoglobin was assessed to classify the diabetes status in patients. Results In all 200 patients (100 male and 100 female) were entered into the study. The mean age of patients was 48.6 (SD = 7.3) years and most had type 2 diabetes (91.0%). The results showed that sexual dysfunctions were widespread in both gender and 165 (82.5%) patients reported that experienced at least one sexual dysfunction. There were significant associations between sexual dysfunctions and gender and type of diabetes (P = 0.04). Women and patients with type 1 diabetes had higher rates of SD. No major differences were found between SD and age, diabetes status, duration of diabetes and hypertension. In addition, glycemic control did not show a significant association with SD in both genders. Conclusion The findings of this study showed that SD prevalence was high in diabetic patients of both genders and the glycemic control did not correlate with the frequency of SD in the study population. It is recommended that SD should be addressed more precisely in health care practice in Iran. PMID:20482781

2010-01-01

32

Retinal Blood Flow Changes in Patients With Insulin Dependent Diabetes Mellitus and No Diabetic Retinopathy A Video Fluorescein Angiography Study  

Microsoft Academic Search

Purpose. The authors investigated retinal blood flow changes in patients with insulin-depen- dent diabetes mellitus (IDDM) and no diabetic retinopathy compared to age-matched subjects without diabetes. They also investigated whether blood glucose levels could modulate retinal blood flow in these patients with diabetes and whether this modulation would impact retinal blood flow data used in cross-sectional studies assessing changes in

Sven-Erik Bursell; Allen C. Clermont; Brendan T. Kinsley; Donald C. Simonson; Lloyd M. Aiello; Howard A. Wolpertf

33

Care of vision and ocular health in diabetic members of a national diabetes organization: A cross-sectional study  

Microsoft Academic Search

BACKGROUND: Regular examination and early treatment of diabetic retinopathy can prevent visual loss. The aim of the study was to describe the care of vision and ocular health in people with diabetes in Norway. METHODS: A cross-sectional questionnaire survey of a random sample (n = 1,887) of the Norwegian Diabetic Associations' (NDA) members was carried out in 2005. Questions were

Vibeke Sundling; Pål Gulbrandsen; Jak Jervell; Jørund Straand

2008-01-01

34

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

35

SERPINE 1 Links Obesity and Diabetes: A Pilot Study  

PubMed Central

In the past decade there has been a dramatic increase in the number of Americans considered obese. Over this same period, the number of individuals diagnosed with diabetes has increased by over 40%. Interestingly, in a great number of cases individuals considered obese develop diabetes later on. Although a link between obesity and diabetes has been suggested, conclusive scientific evidence is thus far just beginning to emerge. The present pilot study is designed to identify a possible link between obesity and diabetes. The plasma proteome is a desirable biological sample due to their accessibility and representative complexity due, in part, to the wide dynamic range of protein concentrations, which lead to the discovery of new protein markers. Here we present the results for the specific depletion of 14 high-abundant proteins from the plasma samples of obese and diabetic patients. Comparative proteomic profiling of plasma from individuals with either diabetes or obesity and individuals with both obesity and diabetes revealed SERPINE 1 as a possible candidate protein of interest, which might be a link between obesity and diabetes. PMID:21113241

Kaur, Punit; Reis, Michael D.; Couchman, Glen R.; Forjuoh, Samuel N.; Greene, John F.; Asea, Alexzander

2010-01-01

36

Prevalence of dialysis-related amyloidosis in diabetic patients. Diabetes Amyloid Study Group.  

PubMed

It has recently been shown that beta 2-microglobulin isolated from amyloid deposits in dialysis patients is modified by advanced glycation (AGE). In this context it appeared of interest to examine in a cross-sectional multicentre study whether dialysis-related amyloidosis, as evaluated by X-ray assessment of cysts in the metacarpal bones, was different in diabetic patients on maintenance haemodialysis for more than 5 years time compared with matched non-diabetic controls. We evaluated the hand skeleton of 75 diabetic patients (9 type I, 66 type II; 35 male, 40 female; median age 64 years, range 31-86; median duration of dialysis 7 years, range 5-17). They were compared with 150 patients without diabetes mellitus who were matched for age, gender and duration of dialysis. Hand X-rays were centrally evaluated by one radiologist unaware of the underlying clinical diagnosis. The overall frequency of amyloid cysts was 9/75 (12%) in diabetic patients (95% confidence interval 4.6-19.3%) and 28/150 (19%) in matched controls (95% confidence interval 12.4-24.9%). The results indicate that diabetes mellitus does not confer an increased risk of dialysis-related amyloid cysts. The results are of interest with respect to the mechanism of amyloid formation. PMID:8918714

Lehnert, H; Jacob, C; Marzoll, I; Schmidt-Gayk, H; Stein, G; Ritz, E

1996-10-01

37

A Comparative Study of Relationship between Micronutrients and Gestational Diabetes  

PubMed Central

In this paper, we studied the relation between the micronutrient and gestational diabetes. Therefore, we measured micronutrient concentration including Ni, Al, Cr, Mg, Fe, Zn, Cu, and Se in serum of women with gestational diabetes between 24 and 28 weeks of gestational age (study group) who had inclusion criteria and comparison with micronutrient levels in normal pregnant women with same gestational age (control group). Results showed that there was no significant difference between the serum micronutrient level (Ni, Al, Cr, Mg, Zn, Cu, Se) in study and control groups except serum level of iron which in serum of gestational diabetic women was lower than normal pregnant women and difference was significant. PMID:22988520

Akhlaghi, Farideh; Bagheri, Seyyed Majid; Rajabi, Omid

2012-01-01

38

Nonmydriatic ultra-wide-field scanning laser ophthalmoscopy (Optomap) versus two-field fundus photography in diabetic retinopathy.  

PubMed

The purpose of this study was to investigate the diagnostic properties of a 2-laser wavelength nonmydriatic 200° ultra-wide-field scanning laser ophthalmoscope (SLO) versus mydriatic 2-field 45° color fundus photography (EURODIAB standard) for assessing diabetic retinopathy (DR). A total of 143 consecutive eyes of patients with different levels of DR were graded regarding DR level and macular edema based on 2-field color photographs or 1 Optomap Panoramic 200 SLO image. All SLO images were nonmydriatic and all photographs mydriatic. Grading was performed masked to patient and clinical data. Based on photography, 20 eyes had no DR, 44 had mild, 18 moderate and 42 severe nonproliferative DR, and 19 eyes had proliferative DR. Overall correlation for grading DR level compared to Optomap SLO was moderate with kappa 0.54 (p < 0.001), fair-to-moderate in macular edema grading with kappa 0.39 (p < 0.001), and substantial for grading clinically significant macular edema (kappa 0.77). The wide-field SLO offers a wider field of view and can potentially better differentiate lesions by applying the 2 laser wavelengths. However, these advantages over 2-field fundus photography need to be confirmed in further studies. PMID:24247157

Liegl, Raffael; Liegl, Kristine; Ceklic, Lala; Haritoglou, Christos; Kampik, Anselm; Ulbig, Michael W; Kernt, Marcus; Neubauer, Aljoscha S

2014-01-01

39

[Clinical studies that have influenced the treatment of diabetes].  

PubMed

In the article, the author addresses the development of the targets of diabetes treatment. He provides an overview of the key clinical studies in diabetology from which we draw knowledge and therapeutical recommendations nowadays, i.e. in the times of evidence-based medicine. The author emphasizes the need for comprehensive treatment of diabetes, i.e. the treatment of obesity, hypertension, dyslipidemia and also the impact on blood coagulation, however, focuses, in particular, on clinical studies focusing on the influence of diabetes compensation (the impact on hyperglycemia) on the development of vascular complications. PMID:19449748

Olsovský, J

2009-04-01

40

Strategies for Improving Participation in Diabetes Education. A Qualitative Study  

PubMed Central

Objective Diabetes mellitus is highly prevalent and can lead to serious complications and mortality. Patient education can help to avoid negative outcomes, but up to half of the patients do not participate. The aim of this study was to analyze patients' attitudes towards diabetes education in order to identify barriers to participation and develop strategies for better patient education. Methods We conducted a qualitative study. Seven GP practices were purposively selected based on socio-demographic data of city districts in Hamburg, Germany. Study participants were selected by their GPs in order to increase participation. Semi-structured face-to-face interviews were conducted with 14 patients. Interviews were audiotaped and transcribed verbatim. The sample size was determined by data saturation. Data were analysed by qualitative content analysis. Categories were determined deductively and inductively. Results The interviews yielded four types of barriers: 1) Statements and behaviour of the attending physician influence the patients' decisions about diabetes education. 2) Both, a good state of health related to diabetes and physical/psychosocial comorbidity can be reasons for non-participation. 3) Manifold motivational factors were discussed. They ranged from giving low priority to diabetes to avoidance of implications of diabetes education as being confronted with illness narratives of others. 4) Barriers also include aspects of the patients' knowledge and activity. Conclusions First, physicians should encourage patients to participate in diabetes education and argue that they can profit even if actual treatment and examination results are promising. Second, patients with other priorities, psychic comorbidity or functional limitations might profit more from continuous individualized education adapted to their specific situation instead of group education. Third, it might be justified that patients do not participate in diabetes education if they have slightly increased blood sugar values only and no risk for harmful consequences or if they already have sufficient knowledge on diabetes. PMID:24733428

Schafer, Ingmar; Pawels, Marc; Kuver, Claudia; Pohontsch, Nadine Janis; Scherer, Martin; van den Bussche, Hendrik; Kaduszkiewicz, Hanna

2014-01-01

41

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

42

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

43

The Belgian Diabetes in Pregnancy Study (BEDIP-N), a multi-centric prospective cohort study on screening for diabetes in pregnancy and gestational diabetes: methodology and design  

PubMed Central

Background The International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommends universal screening with a 75 g oral glucose tolerance test (OGTT) using stricter criteria for gestational diabetes (GDM). This may lead to important increases in the prevalence of GDM and associated costs, whereas the gain in health is unclear. The goal of ‘The Belgian Diabetes in Pregnancy Study’ (BEDIP-N) is to evaluate the best screening strategy for pregestational diabetes in early pregnancy and GDM in an ethnically diverse western European population. The IADPSG screening strategy will be followed, but in addition risk questionnaires and a 50 g glucose challenge test (GCT) will be performed, in order to define the most practical and most cost effective screening strategy in this population. Methods BEDIP-N is a prospective observational cohort study in 6 centers in Belgium. The aim is to enroll 2563 pregnant women in the first trimester with a singleton pregnancy, aged 18–45 years, without known diabetes and without history of bariatric surgery. Women are universally screened for overt diabetes and GDM in the first trimester with a fasting plasma glucose and for GDM between 24–28 weeks using the 50 g GCT and independently of the result of the GCT, all women will receive a 75 g OGTT using the IADPSG criteria. Diabetes and GDM will be treated according to a standardized routine care protocol. Women with GDM, will be reevaluated three months postpartum with a 75 g OGTT. At each visit blood samples are collected, anthropometric measurements are obtained and self-administered questionnaires are completed. Recruitment began in April 2014. Discussion This is the first large, prospective cohort study rigorously assessing the prevalence of diabetes in early pregnancy and comparing the impact of different screening strategies with the IADPSG criteria on the detection of GDM later in pregnancy. Trial registration ClinicalTrials.gov: NCT02036619. Registered 14-1-2014. PMID:25015413

2014-01-01

44

Microbial Field Pilot Study  

Microsoft Academic Search

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

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

1990-01-01

45

Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) study  

PubMed Central

Background Diabetes in pregnancy carries an increased risk of adverse pregnancy outcomes for both the mother and foetus, but it also provides an excellent early opportunity for intervention in the life course for both mother and baby. In the context of the escalating epidemic of chronic diseases among Indigenous Australians, it is vital that this risk is reduced as early as possible in the life course of the individual. The aims of the PANDORA Study are to: (i) accurately assess rates of diabetes in pregnancy in the Northern Territory (NT) of Australia, where 38% of babies are born to Indigenous mothers; (ii) assess demographic, clinical, biochemical, anthropometric, socioeconomic and early life development factors that may contribute to key maternal and neonatal birth outcomes associated with diabetes in pregnancy; and (iii) monitor relevant post-partum clinical outcomes for both the mothers and their babies. Methods/Design Eligible participants are all NT women with diabetes in pregnancy aged 16 years and over. Information collected includes: standard antenatal clinical information, diagnosis and management of diabetes in pregnancy, socio-economic status, standard clinical birth information (delivery, gestational age, birth weight, adverse antenatal and birth outcomes). Cord blood is collected at the time of delivery and detailed neonatal anthropometric measurements performed within 72 hours of birth. Information will also be collected regarding maternal post-partum glucose tolerance and cardio-metabolic risk factor status, breastfeeding and growth of the baby up to 2 years post-partum in the first instance. Discussion This study will accurately document rates and outcomes of diabetes in pregnancy in the NT of Australia, including the high-risk Indigenous Australian population. The results of this study should contribute to policy and clinical guidelines with the goal of reducing the future risk of obesity and diabetes in both mothers and their offspring. PMID:24289168

2013-01-01

46

RENAL FUNCTION IN NON-INSULIN DEPENDENT DIABETES MELLITUS-A FOLLOW-UP STUDY  

Microsoft Academic Search

Summary : Assessment of renal function was done in one hundred non-insulin dependent diabetes mellitus patients with varying duration of diabetes, attending the Diabetes Research Centre, Madras. The parameters studied included blood urea, serum creatinine, creatinine clearance and 24 hour urinary protein excretion. The patients were followed up and the renal function tests were repeated at periodical intervals. Diabetic nephropathy

K. S. Usha Rani; M. Viswanathan; C. Snehalatha

47

A community-based study for the utility values associated with diabetic retinopathy among type 2 diabetics in Kinmen, Taiwan  

Microsoft Academic Search

A community-based cross-sectional study was conducted to assess the utility values associated with varying degrees of diabetic retinopathy (DR) among type 2 diabetics in Kinmen, Taiwan. A total of 725 eligible type 2 diabetics received DR screening during 1999–2002 and then evaluated utility values in 2003. The diagnosis of DR was performed by a panel of ophthalmologists using ophthalmoscopy and

Tao-Hsin Tung; Shih-Jen Chen; Fenq-Li Lee; Jorn-Hon Liu; Ching-Heng Lin; Pesus Chou

2005-01-01

48

Health Promotion in diabetes care : Studies on adult type 1 diabetes patients.  

E-print Network

??Introduction: A landmark report has shown that improving glycaemic control among type 1 diabetes patients markedly reduces diabetes-related complications. In clinical practice, however, many patients… (more)

Amsberg, Susanne

2008-01-01

49

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

50

Staying Healthy with Diabetes  

MedlinePLUS

... help people with diabetes stay healthy? Research studies in the United States and other countries have shown that controlling blood ... Diabetes Issues Rate of Increase Type 2 Diabetes in the United States CDC Study Gestational Diabetes Diabetes in the United ...

51

Lessons from the look action for health in diabetes study.  

PubMed

The Look Action for Health in Diabetes AHEAD Study was designed as a long-term randomized controlled clinical trial and powered to detect differences in cardiovascular outcomes, the primary cause of early morbidity and mortality in type 2 diabetes, among subjects randomized to receive an intensive lifestyle intervention or a control group of diabetes support and education. The study was terminated early due to the absence of any difference in the primary outcome, defined as a composite of the first postrandomization occurrence of fatal and nonfatal myocardial infarction and stroke, or angina requiring hospitalization. However, important secondary favorable outcomes were observed in those receiving the intensive lifestyle intervention. This included more weight loss, greater fitness, less disability, less depression, reductions in sleep apnea and urinary incontinence, better glycemic control, and more subjects experiencing diabetes remission. These results underscore the importance of lifestyle interventions as a component of diabetes therapy. Long-term follow-up of Look AHEAD participants is planned, despite discontinuation of the intensive lifestyle program. PMID:24910828

Korytkowski, Mary T

2013-12-01

52

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

53

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. PMID:23637830

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

2013-01-01

54

Short-wavelength sensitive visual field loss in patients with clinically significant diabetic macular oedema  

Microsoft Academic Search

Summary   The aim of the study was to compare the sensitivity of short-wavelength and conventional automated static threshold perimetry\\u000a for the psychophysical detection of abnormality in patients with clinically significant diabetic macular oedema. The sample\\u000a comprised 24 patients with clinically significant diabetic macular oedema (mean age 59.75 years, range 45–75 years). One eye\\u000a of each patient was selected. Exclusion criteria

C. Hudson; J. G. Flanagan; G. S. Turner; H. C. Chen; L. B. Young; D. McLeod

1998-01-01

55

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

56

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

57

Genome-wide association studies in type 2 diabetes  

PubMed Central

Despite numerous candidate gene and linkage studies, the field of type 2 diabetes (T2D) genetics had until recently succeeded in identifying few genuine disease-susceptibility loci. The advent of genome-wide association (GWA) scans has transformed the situation, leading to an expansion in the number of established, robustly replicating T2D loci to almost 20. These novel findings offer unique insights into the pathogenesis of T2D and in the main point towards the etiological importance of disorders of beta-cell development and function. All associated variants have common allele frequencies in the discovery populations, and exert modest to small effects on the risk of disease, characteristics which limit their prognostic and diagnostic potential. However, ongoing studies focussing on the role of copy number variation and targeting low frequency polymorphisms should identify additional T2D-susceptibility loci, some of which may have larger effect sizes and offer better individual prediction of disease risk. PMID:19323962

McCarthy, Mark I; Zeggini, Eleftheria

2009-01-01

58

Microbial field pilot study  

SciTech Connect

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 flow paths which have been referentially swept by a prior waterflood. This will force future flood water to invade bypassed regions of the reservoir and increase sweep efficiency. This report covers progress made during the second year, January 1, 1990 to December 31, 1990, of the Microbial Field Pilot Study project. Information on reservoir ecology, surface facilities design, operation of the unit, core experiments, modeling of microbial processes, and reservoir characterization and simulation are presented in the report. To better understand the ecology of the target reservoir, additional analyses of the fluids which support bacteriological growth and the microbiology of the reservoir were performed. The results of the produced and injected water analysis show increasing sulfide concentrations with respect to time. In March of 1990 Mesa Limited Partnership sold their interest in the SEVVSU to Sullivan and Company. In April, Sullivan and Company assumed operation of the field. The facilities for the field operation of the pilot were refined and implementation was begun. Core flood experiments conducted during the last year were used to help define possible mechanisms involved in microbial enhanced oil recovery. The experiments were performed at SEVVSU temperature using fluids and inoculum from the unit. The model described in last year`s report was further validated using results from a core flood experiment. The model was able to simulate the results of one of the core flood experiments with good quality.

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

1992-03-01

59

Microbial field pilot study  

SciTech Connect

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 flow paths which have been referentially swept by a prior waterflood. This will force future flood water to invade bypassed regions of the reservoir and increase sweep efficiency. This report covers progress made during the second year, January 1, 1990 to December 31, 1990, of the Microbial Field Pilot Study project. Information on reservoir ecology, surface facilities design, operation of the unit, core experiments, modeling of microbial processes, and reservoir characterization and simulation are presented in the report. To better understand the ecology of the target reservoir, additional analyses of the fluids which support bacteriological growth and the microbiology of the reservoir were performed. The results of the produced and injected water analysis show increasing sulfide concentrations with respect to time. In March of 1990 Mesa Limited Partnership sold their interest in the SEVVSU to Sullivan and Company. In April, Sullivan and Company assumed operation of the field. The facilities for the field operation of the pilot were refined and implementation was begun. Core flood experiments conducted during the last year were used to help define possible mechanisms involved in microbial enhanced oil recovery. The experiments were performed at SEVVSU temperature using fluids and inoculum from the unit. The model described in last year's report was further validated using results from a core flood experiment. The model was able to simulate the results of one of the core flood experiments with good quality.

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

1992-03-01

60

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, P D; Chan, S C

2014-07-01

61

Nutritionist Visits, Diabetes Classes, and Hospitalization Rates and Charges: the Urban Diabetes Study  

PubMed Central

Objectives We evaluated the association of different types of educational visits for diabetic patients of the 8 Philadelphia Health Care Centers (PHCCs), (public safety-net primary care clinics), with hospital admission rates and charges reported to the Pennsylvania Health Care Cost Containment Council. Research Design and Methods The study population included 18,404 patients who had a PHCC visit with a diabetes diagnosis recorded between March 1, 1993 and December 31, 2001 and had at least one month follow-up time. Results A total of 31,657 hospitalizations were recorded for 7,839 (42.6%) patients in the cohort. After adjustment for demographic variables, baseline comorbid conditions, hospitalizations prior to the diabetes diagnosis, and number of other primary care visits, having had any type of educational visit was associated with 9.18 fewer hospitalizations per 100 person years (95% confidence interval [CI] 5.02 to 13.33), and $11,571 less (95% CI $6,377 to $16,765) in hospital charges per person. Each nutritionist visit was associated with 4.70 fewer hospitalizations per 100 person years (95% CI 2.23 to 7.16) and a $6,503 reduction (95% CI $3,421 to $9,586) in total hospital charges. Conclusions Any type of educational visit was associated with lower hospitalization rates and charges. Nutritionist visits were more strongly associated with reduced hospitalizations than diabetes classes. Each nutritionist visit was associated with a substantial reduction in hospital charges, suggesting that providing these services in the primary care setting may be highly cost-effective for the health care system. PMID:18184894

Robbins, Jessica M.; Thatcher, Gail E.; Webb, David A.; Valdmanis, Vivian G.

2008-01-01

62

Living with diabetes: rationale, study design and baseline characteristics for an Australian prospective cohort study  

PubMed Central

Background Diabetes mellitus is a major global public health threat. In Australia, as elsewhere, it is responsible for a sizeable portion of the overall burden of disease, and significant costs. The psychological and social impact of diabetes on individuals with the disease can be severe, and if not adequately addressed, can lead to the worsening of the overall disease picture. The Living With Diabetes Study aims to contribute to a holistic understanding of the psychological and social aspects of diabetes mellitus. Methods/Design The Living With Diabetes Study is a 5-year prospective cohort study, based in Queensland, Australia. The first wave of data, which was collected via a mailed self-report survey, was gathered in 2008, with annual collections thereafter. Measurements include: demographic, lifestyle, health and disease characteristics; quality of life (EQ-5D, ADDQoL); emotional well-being (CES-D, LOT-R, ESSI); disease self-management (PAM); and health-care utilisation and patient-assessed quality of care (PACIC). 29% of the 14,439 adults who were invited to participate in the study agreed to do so, yielding a sample size of 3,951 people. Discussion The data collected by the Living With Diabetes Study provides a good representation of Australians with diabetes to follow over time in order to better understand the natural course of the illness. The study has potential to further illuminate, and give a comprehensive picture of the psychosocial implications of living with diabetes. Data collection is ongoing. PMID:22216947

2012-01-01

63

A Prospective Study of Inflammatory Biomarkers and Risk of Diabetic Retinopathy in the Diabetes Control and Complications Trial  

PubMed Central

Objective To determine whether baseline levels of hsCRP and ICAM-1 predict development and progression of diabetic retinopathy (DR), clinically significant macular edema (CSME), retinal hard exudates, and proliferative DR in the Diabetes Control and Complications Trial (DCCT) cohort. Design The DCCT was a large multicenter randomized controlled clinical trial of 1441 subjects with type 1 diabetes aged 13–39 years at study entry. We measured levels of hsCRP, ICAM-1, VCAM-1, and TNFR1 in stored baseline blood samples and assessed their association with incident DR endpoints ascertained from grading of standardized seven-field stereoscopic retinal color photographs taken at baseline and every 6 months during follow-up. Results After adjustment for randomized treatment assignment and other factors, we observed a statistically significant association between hsCRP and risk of CSME, with a hazard ratio (HR) for the top versus bottom quintile of 1.83 (95%CI=0.94–3.55), P for trend=0.01. Similarly, for the development of retinal hard exudates, the HR for the top versus bottom quintile of hsCRP was 1.78 (95%CI=0.98–3.25), P for trend=0.004; whereas for ICAM-1, the HR comparing the top versus bottom quintiles was 1.50 (95%CI=0.84–2.68), P for trend=0.05. There were no statistically significant associations between baseline VCAM-1 or TNFR1 and risk of any of the DR endpoints. Conclusions After adjusting for known risk factors, increasing quintiles of baseline hsCRP predicted higher risks of incident CSME and macular hard exudate in the DCCT cohort. Circulating levels of ICAM-1 may also be associated with the development of retinal hard exudates. PMID:23392399

Muni, R.H.; Kohly, R.P.; Quant, E.C.; Manson, J.E.; Semba, R.D.; Schaumberg, D.A.

2013-01-01

64

Strength of association for incident diabetes risk factors according to diabetes case definitions: the Atherosclerosis Risk in Communities Study.  

PubMed

Prospective epidemiologic studies have characterized major risk factors for incident diabetes by a variety of diabetes case definitions. Whether different definitions alter the association of diabetes with risk factors is largely unknown. Using 1987-1998 data from the ongoing Atherosclerosis Risk in Communities (ARIC) Study, the authors assessed the relation of traditional risk factors with 3 different diabetes case definitions and 4 fasting glucose categories. They compared the study protocol case definition with 2 nested case definitions, self-reported diabetes and a multiple-evidence definition. Significant differences in risk factor associations by case definition and by screening cutpoints were observed. Specifically, the magnitude of the association between the risk factors (baseline metabolic syndrome, fasting glucose, blood pressure, body mass index, and serum insulin) and incident diabetes differed by case definition. Associations with these risk factors were weaker with a case definition based on self-report compared with other definitions. These results illustrate the potential limitations of case definitions that rely solely on self-report or those that incorporate measured glucose values to ascertain undiagnosed cases. Although the ability to identify risk factors of diabetes was consistent for the case definitions studied, tests of novel risk factors may result in different estimates of effect sizes depending on the definition used. PMID:22247044

Bielinski, Suzette J; Pankow, James S; Rasmussen-Torvik, Laura J; Bailey, Kent; Li, Man; Selvin, Elizabeth; Couper, David; Vazquez, Gabriela; Brancati, Frederick

2012-03-01

65

External validation of the UK Prospective Diabetes Study (UKPDS) risk engine in patients with type 2 diabetes  

Microsoft Academic Search

Aims\\/hypothesis  Treatment guidelines recommend the UK Prospective Diabetes Study (UKPDS) risk engine for predicting cardiovascular risk in\\u000a patients with type 2 diabetes, although validation studies showed moderate performance. The methods used in these validation\\u000a studies were diverse, however, and sometimes insufficient. Hence, we assessed the discrimination and calibration of the UKPDS\\u000a risk engine to predict 4, 5, 6 and 8 year cardiovascular

S. van Dieren; L. M. Peelen; U. Nöthlings; Y. T. van der Schouw; G. E. H. M. Rutten; A. M. W. Spijkerman; D. L. van der A; D. Sluik; H. Boeing; K. G. M. Moons; J. W. J. Beulens

2011-01-01

66

Prospective Study of Social and Other Risk Factors for Incidence of Type 2 Diabetes  

E-print Network

Prospective Study of Social and Other Risk Factors for Incidence of Type 2 Diabetes in the incidence of type 2 diabetes and the relation of health behaviors and psy- chosocial factors to the incidence of type 2 diabetes are not well established. Methods: Prospective occupational cohort study

Brown, Lucy L.

67

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

68

Improving Diabetes Management With a Patient Portal: Qualitative Study of a Diabetes Self-Management Portal  

PubMed Central

Background Effective management and care of diabetes is crucial to reducing associated risks such as heart disease and kidney failure. With increasing access and use of the Internet, online chronic disease management is being explored as a means of providing patients with support and the necessary tools to monitor and manage their disease. Objective The objective of our study was to evaluate the experience of patients and providers using an online diabetes management portal for patients. Methods Participants were recruited from a large sample population of 887 for a follow-up questionnaire to be completed after 6 months of using the patient portal. Participants were presented with the option to participate in an additional interview and, if the participant agreed, a time and date was scheduled for the interview. A 5-item, open-ended questionnaire was used to capture providers' opinions of the patient portal. Providers included general practitioners (GPs), nurses, nurse practitioners (NPs), dieticians, diabetes educators (DECs), and other clinical staff. Results A total of 854 patients were consented for the questionnaire. Seventeen (8 male, 9 female) patients agreed to participate in a telephone interview. Sixty-four health care providers completed the five open-ended questions; however, an average of 48.2 responses were recorded per question. Four major themes were identified and will be discussed in this paper. These themes have been classified as: facilitators of disease management, barriers to portal use, patient-provider communication and relationship, and recommendations for portal improvements. Conclusions This qualitative study shows that online chronic disease management portals increase patient access to information and engagement in their health care, but improvements in the portal itself may improve usability and reduce attrition. Furthermore, this study identifies a grey area that exists in the roles that GPs and AHPs should play in the facilitation of online disease management. PMID:23195925

Dupak, Kourtney; Kuehner, Zachary; Leonard, Kevin; Lovrics, Emily; Picton, Peter; Seto, Emily; Cafazzo, Joe

2012-01-01

69

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

70

Candidate gene association study for diabetic retinopathy in Chinese patients with type 2 diabetes  

PubMed Central

Purpose To investigate whether variants in a set of eight candidate genes are associated with diabetic retinopathy (DR) in a cohort of Chinese patients with type 2 diabetes mellitus (T2DM). Methods Case-control study. Patients with T2DM were recruited from the Desheng community in urban Beijing and assigned into a DR group or diabetic without retinopathy (DWR) group, based on the duration of diabetes and grading of fundus images. Twenty-six single-nucleotide polymorphisms (SNPs) within eight candidate genes, including PPAR?, vascular endothelial growth factor (VEGF) and its receptor kinase insert domain receptor (KDR), erythropoietin, aldose reductase, protein kinase C-?, angiotensin-converting enzyme, and intercellular adhesion molecule 1, were analyzed using the MassARRAY genotyping system. Results A total of 500 patients with T2DM (216 with DR and 284 with DWR) were enrolled in the study. Significant associations of DR were noted with genotypes of four SNPs—rs699947 (p<0.001), rs833061 (p=0.001), rs13207351 (p<0.001), and rs2146323 (p=0.006)—in the VEGF gene and one variant, rs2071559, in the KDR gene (p=0.034). After adjustment for covariates, significant association of DR remained with the homozygous genotype of the minor allele for the SNPs rs699947 (odds ratio [OR] = 3.54, 95% confidence interval [CI]: 1.12–11.19), rs833061 (OR = 3.72, 95% CI: 1.17–11.85), rs13207351 (OR = 3.76, 95% CI: 1.21–11.71), and rs2146323 (OR = 2.8, 95% CI: 1.46–5.37) in the VEGF gene as well as the SNP rs2071559 (OR = 1.62, 95% CI: 1.08–2.41) in the KDR gene. However, only rs699947 and rs13207351 in the VEGF gene remained statistically significant after Bonferroni correction. No associations were found in other genes tested. Conclusions These data expanded previous observations on the association of DR with variants in the VEGF gene in Chinese patients with T2DM. Moreover, a possible association between DR and KDR polymorphisms is suggested. PMID:24623964

Yang, Xiufen; Deng, Yu; Gu, Hong; Ren, Xuetao; Li, Na; Lim, Apiradee; Snellingen, Torkel; Liu, Xipu; Wang, Ningli

2014-01-01

71

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. PMID:24336895

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

2013-01-01

72

Urban-Rural Differences in Atherogenic Dyslipidaemia (URDAD Study): A Retrospective Report on Diabetic and Non-diabetic Subjects of Northern India  

PubMed Central

ABSTRACT Diabetes and urbanization are major contributors to increased risk factors of cardiovascular diseases. Studying whether atherogenic dyslipidaemia increases with urbanization in type 2 diabetes mellitus is, therefore, important. The sample of the present study consisted of 400 subjects. They were categorized according to residential area and diabetes into four groups: urban diabetic group, urban non-diabetic control group (from a metropolitan city Delhi), rural non-diabetic diabetic group, and rural control group (from villages of Khanpur Kalan, Sonepat, Haryana). Differences in lipid levels and risk factors of emerging cardiovascular diseases between groups were evaluated with analysis of variance. Diabetic patients of both urban and rural areas had significantly higher total cholesterol (TC), triglycerides (TG), very low-density lipoproteins (VLDL), TC to high-density lipoprotein cholesterol (TC/HDL) ratio, TG to high-density lipoprotein cholesterol (TG/HDL) ratio, and atherogenic index (AI) compared to respective controls (p<0.05). The HDL concentrations in urban diabetics were significantly lower (p<0.05) than in urban non-diabetic group and rural diabetic group. Comparison between urban and rural diabetic groups showed significantly higher atherogenic dyslipidaemia (AD) in the urban patient-group (p<0.05). We evaluated significant relationships of diabetes and urbanization with AD by multiple regression analysis. Receiver operating curve (ROC) analysis showed high area under curve (AUC) for TG/HDL in urban diabetic group (0.776, p<0.0001) and in rural diabetic group (0.692, p<0.0001). It is concluded that diabetes was associated with higher AD parameters. Urbanization in diabetes is also associated with elevated levels of AD, indicating higher risk in urban population. This study suggests that TG/HDL may be particularly useful as atherogenic risk predictor in newly-diagnosed type 2 diabetic patients.

Agrawal, Poonam; Madaan, Himanshu; Patra, Surajeet Kumar; Garg, Renu

2014-01-01

73

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

74

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

E-print Network

1/17 Assessment of diabetes screening by general practitioners in France: the EPIDIA Study J word count: 1956 3 tables 1 figure Running title: Diabetes screening in France Corresponding author Dr.blackwell-synergy.com HALauthormanuscriptinserm-00128528,version1 HAL author manuscript Diabet Med 07/2006; 23 803-7 #12;2/17 Abstract Aims

Boyer, Edmond

75

IDEA: A Study of Waist Circumference, Cardiovascular Disease and Diabetes in  

E-print Network

1/31 R2 IDEA: A Study of Waist Circumference, Cardiovascular Disease and Diabetes in 168 Running head: Waist circumference, diabetes and CVD HALauthormanuscriptinserm-00186711,version1 HAL author (CVD) and diabetes in different regions around the world, and thus whether measuring waist

Paris-Sud XI, Université de

76

Impact of Diabetes on Work Cessation Data from the GAZEL cohort study  

E-print Network

Impact of Diabetes on Work Cessation Data from the GAZEL cohort study ELÃ?ONORE HERQUELOT, MSC ALICE of diabetes on work cessation, i.e., on the risks of work disability, early retirement, and death while with diabetes and randomly selected 2,530 nondiabetic employed control subjects matched for major socio

Boyer, Edmond

77

Older adults, diabetes mellitus and visual acuity: a community-based case-control study  

Microsoft Academic Search

Main objectives: to screen for impaired distance visual acuity in older adults living at home, both with and without diabetes mellitus to determine whether diabetes increases the likelihood of visual impairment and to identify associated factors. Design: case-control study. Settings: three districts of Wales: North Clwyd, Powys and South Glamorgan, with assessments in subjects' homes. Subjects: 385 with diabetes mellitus

ALAN J. SINCLAIR; ANTONY J. BAYER; A LAN J. GIRLING; K EN W. WOODHOUSE

78

Statins May Help Prevent Diabetes-Related Nerve Damage, Study Finds  

MedlinePLUS

... sharing features on this page, please enable JavaScript. Statins May Help Prevent Diabetes-Related Nerve Damage, Study ... MedlinePlus Pages Diabetic Eye Problems Diabetic Nerve Problems Statins TUESDAY, Sept. 9, 2014 (HealthDay News) -- Cholesterol-busting ...

79

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

80

Proteomic study reveals downregulation of apolipoprotein A1 in plasma of poorly controlled diabetes: a pilot study.  

PubMed

Proteomic approaches aid in gaining a better understanding of the pathophysiology of diabetic complications. In view of this, differential protein expression in diabetic plasma samples was studied by a combination of proteomic and western blot analyses. Diabetic plasma samples were categorized based on glycated haemoglobin levels as controlled diabetes (CD; 7-8%), poorly controlled diabetes (PCD; >8%) and non-diabetic control (ND;<6.4%). Two-dimensional electrophoresis and liquid chromatography?mass spectrometry revealed differential expression of proteins including upregulation of fibrinogen and haptoglobin and downregulation of vitamin D binding protein, ?-1-antitrypsin, transthyretin and apolipoprotein A1 (Apo A1) in diabetic compared with non-diabetic plasma samples. Amongst these proteins, Apo A1 downregulation was prominent in PCD. Downregulation of Apo A1 may serve as an early predictive marker of diabetic complications. PMID:23232761

Bhonsle, Hemangi S; Korwar, Arvind M; Chougale, Ashok D; Kote, Sachin S; Dhande, Nitin L; Shelgikar, Kishore M; Kulkarni, Mahesh J

2013-02-01

81

The use of pulsed electromagnetic fields with complex modulation in the treatment of patients with diabetic polyneuropathy.  

PubMed

Clinical and electroneuromyographic studies were performed in 121 patients with diabetic polyneuropathy (DPN) before and after courses of treatment with pulsed electromagnetic fields with complex modulation (PEMF-CM) at different frequencies (100 and 10 Hz). Testing of patients using the TSS and NIS LL scales demonstrated a correlation between the severity and frequency of the main subjective and objective effects of disease and the stage of DPN. The severity of changes in the segmental-peripheral neuromotor apparatus--decreases in muscle bioelectrical activity, the impulse conduction rate along efferent fibers of peripheral nerves, and the amplitude of the maximum M response--depended on the stage of DPN and the duration of diabetes mellitus. The earliest and most significant electroneuromyographic signs of DPN were found to be decreases in the amplitude of the H reflex and the Hmax/Mmax ratio in the muscles of the lower leg. Application of PEMF-CM facilitated regression of the main clinical symptoms of DPN, improved the conductive function of peripheral nerves, improved the state of la afferents, and improved the reflex excitability of functionally diverse motoneurons in the spinal cord. PEMF-CM at 10 Hz was found to have therapeutic efficacy, especially in the initial stages of DPN and in patients with diabetes mellitus for up to 10 years. PMID:14635988

Musaev, A V; Guseinova, S G; Imamverdieva, S S

2003-10-01

82

The effect of excess weight gain with intensive diabetes treatment on cardiovascular disease risk factors and atherosclerosis in type 1 diabetes: Results from the Diabetes Control and Complications Trial / Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC) study  

PubMed Central

Rationale Intensive diabetes therapy of type 1 diabetes (T1DM) reduces diabetes complications but can be associated with excess weight gain, central obesity, and dyslipidemia. Objective The purpose of this study was to determine if excessive weight gain with diabetes therapy of T1DM is prospectively associated with atherosclerotic disease. Methods and Results Subjects with T1DM (97% Caucasian, 45% female, mean age 35 years) randomly assigned to intensive (INT) or conventional (CONV) diabetes treatment during the Diabetes Control and Complications Trial (DCCT) underwent intima-media thickness (IMT) (n=1015) and coronary artery calcium (CAC) score (n=925) measurements during follow-up in the Epidemiology of Diabetes Interventions and Complications (EDIC) Study. INT subjects were classified by quartile of BMI change during the DCCT. Excess gainers (4th quartile, including CONV subjects meeting this threshold) maintained greater BMI and waist circumference (WC), needed more insulin, had greater IMT (+5%, P<0.001 EDIC year 1, P=0.003 EDIC year 6), and trended towards greater CAC scores (OR 1.55, CI 0.97 – 2.49, P=0.07) than minimal gainers. DCCT subjects meeting metabolic syndrome criteria for WC and blood pressure had greater IMT in both EDIC years (P =0.02 to <0.001); those meeting HDL criteria had greater CAC scores (OR 1.6 and CI 1.1 – 2.4, P=0.01) during follow-up. Increasing frequency of a family history of diabetes, hypertension, and hyperlipidemia was associated with greater IMT thickness with INT but not CONV. Conclusions Excess weight gain in DCCT is associated with sustained increases in central obesity, insulin resistance, dyslipidemia and blood pressure, as well as more extensive atherosclerosis during EDIC. PMID:23212717

Purnell, Jonathan Q; Hokanson, John E.; Cleary, Patricia A.; Nathan, David M; Lachin, John M; Zinman, Bernard; Brunzell, John D.

2013-01-01

83

School for Field Studies  

NSDL National Science Digital Library

SFS promotes an interdisciplinary, experiential approach to education, matching college students with conservation projects worldwide. Month-long summer programs are offered at each of their field sites in Kenya, Australia, Caribbean, Central America. Students in science or liberal arts help confront environmental problems and assist resource dependent communities while working alongside an international research team. College credit available and program fees apply, but financial aid available on first-come, first-served basis. Online application process.

84

Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study (SN--DREAMS III): Study design and research methodology  

Microsoft Academic Search

Background  To describe the methodology of the Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study III, an\\u000a ongoing epidemiological study to estimate the prevalence of Diabetes and Diabetic Retinopathy in rural population of Kanchipuram\\u000a and Thiravallur districts of Tamil Nadu, India and to elucidate the clinical, anthropometric, biochemical and genetic risk\\u000a factors associated with diabetic retinopathy in this rural population.

Swakshyar Saumya Pal; Rajiv Raman; Suganeswari Ganesan; Chinmaya Sahu; Tarun Sharma

2011-01-01

85

Phenotyping animal models of diabetic neuropathy: a consensus statement of the diabetic neuropathy study group of the EASD (Neurodiab).  

PubMed

NIDDK, JDRF, and the Diabetic Neuropathy Study Group of EASD sponsored a meeting to explore the current status of animal models of diabetic peripheral neuropathy. The goal of the workshop was to develop a set of consensus criteria for the phenotyping of rodent models of diabetic neuropathy. The discussion was divided into five areas: (1) status of commonly used rodent models of diabetes, (2) nerve structure, (3) electrophysiological assessments of nerve function, (4) behavioral assessments of nerve function, and (5) the role of biomarkers in disease phenotyping. Participants discussed the current understanding of each area, gold standards (if applicable) for assessments of function, improvements of existing techniques, and utility of known and exploratory biomarkers. The research opportunities in each area were outlined, providing a possible roadmap for future studies. The meeting concluded with a discussion on the merits and limitations of a unified approach to phenotyping rodent models of diabetic neuropathy and a consensus formed on the definition of the minimum criteria required for establishing the presence of the disease. A neuropathy phenotype in rodents was defined as the presence of statistically different values between diabetic and control animals in 2 of 3 assessments (nocifensive behavior, nerve conduction velocities, or nerve structure). The participants propose that this framework would allow different research groups to compare and share data, with an emphasis on data targeted toward the therapeutic efficacy of drug interventions. PMID:24934510

Biessels, G J; Bril, V; Calcutt, N A; Cameron, N E; Cotter, M A; Dobrowsky, R; Feldman, E L; Fernyhough, P; Jakobsen, J; Malik, R A; Mizisin, A P; Oates, P J; Obrosova, I G; Pop-Busui, R; Russell, J W; Sima, A A; Stevens, M J; Schmidt, R E; Tesfaye, S; Veves, A; Vinik, A I; Wright, D E; Yagihashi, S; Yorek, M A; Ziegler, D; Zochodne, D W

2014-06-01

86

Fixation Stability and Macular Light Sensitivity in Patients with Diabetic Maculopathy: A Microperimetric Study with a Scanning Laser Ophthalmoscope  

Microsoft Academic Search

Background: In patients with diabetic maculopathy, evaluation of visual acuity alone may not represent central retinal function sufficiently. Despite good visual acuity, patients may suffer from visual disturbances like waviness, relative scotoma, loss of fixation and decrease of contrast sensitivity. The aim of the study was to assess localized light sensitivity in the central visual field and to determine fixation

Thomas Kube; Stephanie Schmidt; Frank Toonen; Bernd Kirchhof; Sebastian Wolf

2005-01-01

87

Detection of retinal lesions in diabetic retinopathy: comparative evaluation of 7-field digital color photography versus red-free photography.  

PubMed

Red-free light allows better detection of vascular lesions as this wavelength is absorbed by hemoglobin; however, the current gold standard for the detection and grading of diabetic retinopathy remains 7-field color fundus photography. The goal of this study was to compare the ability of 7-field fundus photography using red-free light to detect retinopathy lesions with corresponding images captured using standard 7-field color photography. Non-stereoscopic standard 7-field 30° digital color fundus photography and 7-field 30° digital red-free fundus photography were performed in 200 eyes of 103 patients with various grades of diabetic retinopathy ranging from mild to moderate non-proliferative diabetic retinopathy to proliferative diabetic retinopathy. The color images (n = 1,400) were studied with corresponding red-free images (n = 1,400) by one retina consultant (PV) and two senior residents training in retina. The various retinal lesions [microaneurysms, hemorrhages, hard exudates, soft exudates, intra-retinal microvascular anomalies (IRMA), neovascularization of the retina elsewhere (NVE), and neovascularization of the disc (NVD)] detected by all three observers in each of the photographs were noted followed by determination of agreement scores using ? values (range 0-1). Kappa coefficient was categorized as poor (?0), slight (0.01-0.20), fair (0.2 -0.40), moderate (0.41-0.60), substantial (0.61-0.80), and almost perfect (0.81-1). The number of lesions detected by red-free images alone was higher for all observers and all abnormalities except hard exudates. Detection of IRMA was especially higher for all observers with red-free images. Between image pairs, there was substantial agreement for detection of hard exudates (average ? = 0.62, range 0.60-0.65) and moderate agreement for detection of hemorrhages (average ? = 0.52, range 0.45-0.58), soft exudates (average ? = 0.51, range 0.42-0.61), NVE (average ? = 0.47, range 0.39-0.53), and NVD (average ? = 0.51, range 0.45-0.54). Fair agreement was noted for detection of microaneurysms (average ? = 0.29, range 0.20-0.39) and IRMA (average ? = 0.23, range 0.23-0.24). Inter-observer agreement with color images was substantial for hemorrhages (average ? = 0.72), soft exudates (average ? = 0.65), and NVD (average ? = 0.65); moderate for microaneurysms (average ? = 0.42), NVE (average ? = 0.44), and hard exudates (average ? = 0.59) and fair for IRMA (average ? = 0.21). Inter-observer agreement with red-free images was substantial for hard exudates (average ? = 0.63) and moderate for detection of hemorrhages (average ? = 0.56), SE (average ? = 0.60), IRMA (average ? = 0.50), NVE (average ? = 0.44), and NVD (average ? = 0.45). Digital red-free photography has a higher level of detection ability for all retinal lesions of diabetic retinopathy. More advanced grades of retinopathy are likely to be detected earlier with red-free imaging because of its better ability to detect IRMA, NVE, and NVD. Red-free monochromatic imaging of the retina is a more effective and less costly alternative for detection of vision-threatening diabetic retinopathy. PMID:22961609

Venkatesh, Pradeep; Sharma, Reetika; Vashist, Nagender; Vohra, Rajpal; Garg, Satpal

2012-09-01

88

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. PMID:24359558

2013-01-01

89

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

90

Hyperreflective Intraretinal Spots in Diabetics without and with Nonproliferative Diabetic Retinopathy: An In Vivo Study Using Spectral Domain OCT  

PubMed Central

Purpose. To evaluate the presence of hyperreflective spots (HRS) in diabetic patients without clinically detectable retinopathy (no DR) or with nonproliferative mild to moderate retinopathy (DR) without macular edema, and compare the results to controls. Methods. 36 subjects were enrolled: 12 with no DR, 12 with DR, and 12 normal subjects who served as controls. All studied subjects underwent full ophthalmologic examination and spectral domain optical coherence tomography (SD-OCT). SD-OCT images were analyzed to measure and localize HRS. Each image was analyzed by two independent, masked examiners. Results. The number of HRS was significantly higher in both diabetics without and with retinopathy versus controls (P < 0.05) and in diabetics with retinopathy versus diabetics without retinopathy (P < 0.05). The HRS were mainly located in the inner retina layers (inner limiting membrane, ganglion cell layer, and inner nuclear layer). The intraobserver and interobserver agreement was almost perfect (? > 0.9). Conclusions. SD-OCT hyperreflective spots are present in diabetic eyes even when clinical retinopathy is undetectable. Their number increases with progressing retinopathy. Initially, HRS are mainly located in the inner retina, where the resident microglia is present. With progressing retinopathy, HRS reach the outer retinal layer. HRS may represent a surrogate of microglial activation in diabetic retina. PMID:24386645

Midena, Giulia; Pilotto, Elisabetta; Midena, Edoardo

2013-01-01

91

School performance in children with type 1 diabetes—a population-based register study  

Microsoft Academic Search

Aims\\/hypothesis  We examined the school marks of diabetic children in Sweden at the time of leaving compulsory education. Marks were examined\\u000a in comparison with non-diabetic children and with special regard to age at onset of diabetes.\\u000a \\u000a \\u000a \\u000a Subjects and methods  The study involved 5,159 children who developed diabetes between 1 July 1977 and 1 July 2000, and 1,330,968 non-diabetic children.\\u000a We linked the

G. Dahlquist; B. Källén

2007-01-01

92

Is increased colon subepithelial collagen layer thickness in diabetic patients related to collagenous colitis? An immunohistochemical study  

Microsoft Academic Search

In this study, we evaluated immunohistochemically whether increased thickness of the colon subepithelial collagen layer in diabetic patients relates to collagenous colitis.A total of 100 patients (25 in each group) were included in this study. There were diabetic patients with chronic diarrhea in the first group, diabetic patients without chronic diarrhea in the second group, non-diabetic patients with chronic diarrhea

Aydin Unal; Kadri Guven; Alper Yurci; Edip Torun; Sebnem Gursoy; Mevlut Baskol; Figen Ozturk; Vedat Arsav

2008-01-01

93

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. PMID:23861824

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

94

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. PMID:23498294

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

95

Prevalence and Associated Factors of Diabetic Retinopathy in Rural Korea: The Chungju Metabolic Disease Cohort Study  

PubMed Central

This study was aimed to investigate the prevalence of diabetic retinopathy and its associated factors in rural Korean patients with type 2 diabetes. A population-based, cross-sectional diabetic retinopathy survey was conducted from 2005 to 2006 in 1,298 eligible participants aged over 40 yr with type 2 diabetes identified in a rural area of Chungju, Korea. Diabetic retinopathy was diagnosed by a practicing ophthalmologist using funduscopy. The overall prevalence of diabetic retinopathy in the population was 18% and proliferative or severe non-proliferative form was found in 5.0% of the study subjects. The prevalence of retinopathy was 6.2% among those with newly diagnosed type 2 diabetes and 2.4% of them had a proliferative or severe non-proliferative diabetic retinopathy. The odds ratio of diabetic retinopathy increased with the duration of diabetes mellitus (5-10 yr: 5.2- fold; > 10 yr: 10-fold), postprandial glucose levels (> 180 mg/dL: 2.5-fold), and HbA1c levels (every 1% elevation: 1.34-fold). The overall prevalence of diabetic retinopathy in rural Korean patients was similar to or less than that of other Asian group studies. However, the number of patients with proliferative or severe non-proliferative diabetic retinopathy was still high and identified more frequently at the time of diagnosis. This emphasizes that regular screening for diabetic retinopathy and more aggressive management of glycemia can reduce the number of people who develop diabetic retinopathy. PMID:21860558

Kim, Ji-Hyun; Kwon, Hyuk-Sang; Park, Yong-Moon; Lee, Jin-Hee; Kim, Man-Soo; Yoon, Kun-Ho; Lee, Won Chul; Cha, Bong-Yun

2011-01-01

96

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

97

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

98

Prospective study of cytomegalovirus seropositivity and risk of mortality from diabetes.  

PubMed

Cytomegalovirus (CMV) infects 40 % of the world population and has been suggested to be associated with diabetes; however, no prospective study has ever examined diabetes mortality associated with the infection. A cohort of 14,404 non-diabetic adult participants aged 17-90 years from the Third National Health and Nutrition Examination Survey (1988-1994) was prospectively followed for mortality through 2006. CMV immunoglobulin G was measured by enzyme-linked immunosorbent assay and immunofluorescence assay. Diabetes death was assessed with death records from the National Death Index. Cox proportional hazards modeling was used to determine diabetes mortality risk associated with CMV infection, adjusting for socio-demographics, diabetes risk factors, and comorbidities. At baseline, 76.8 % of subjects were CMV seropositive, and after an average follow-up of 13.7 years, diabetes mortality rate per 10,000 person-years was 6.8 (95 % CI 5.7, 8.0). Among seropositive participants, the diabetes death rate (8.4, 95 % CI 7.0, 9.9) was more than four times the rate in seronegative ones (2.0, 95 % CI 1.1, 3.6) (P value for the difference <0.001). In the adjusted Cox proportional hazards analysis, CMV seropositivity more than doubled the risk of diabetes mortality (HR 2.06, 95 % CI 1.05, 4.06). CMV infection may thus predict future mortality from diabetes in non-diabetic people. PMID:24633860

Mendy, Angelico; Gasana, Janvier; Vieira, Edgar R; Diallo, Hamidou

2014-10-01

99

Antimicrobial Susceptibility Pattern in Diabetic Foot Ulcer: A Pilot Study  

PubMed Central

Background: Diabetic foot infections (DFIs) are major public health problems and knowledge of microbes that cause infections are helpful to determine proper antibiotic therapy. Aims: The aim was to investigate the antimicrobial susceptibility pattern of microbes in DFIs. Subjects and Methods: A cross-sectional study was conducted for a period of 6 months at the Department of General Surgery, KMC hospital, Manipal University, Manipal, India. During this period, 108 patients having DFIs admitted in the general surgery wards were tracked from the hospital data management system. These patients’ pus samples were examined as Gram-stained smear and cultured aerobically on blood agar and MacConkey agar plates. Antimicrobial susceptibility test was performed by disc diffusion techniques according to Clinical and Laboratory Standards Institute guidelines. Results: Of the 108 specimens of the diabetic foot lesions, culture showed polymicrobial growth in 44.4% (48/108). Prevalence of Gram-negative organisms (56%, 84/150) was found to be more than Gram-positive organisms (44%, 66/150). However, Staphylococcus aureus was the most frequent pathogen (28%, 42/150). All Gram-positive aerobes were sensitive to doxycycline. All Gram-negative isolates, including extended spectrum beta lactamase producing strains of Proteus mirabilis and Klebsiella oxytoca except Acinetobacter were highly sensitive to amikacin, cefoperazone/sulbactam, and meropenem. Acinetobacter was completely resistant to all the common antibiotics tested. Conclusion: Prevalence showed Gram-negative bacteria was slightly more than Gram-positive bacteria in diabetic foot ulcers. This study recommends doxycycline should be empirical treatment of choice for Gram-positive isolates and amikacin, cefoperazone/sulbactam, and meropenem should be considered for most of the Gram-negatives aerobes. PMID:25328786

Sekhar, SM; Vyas, N; Unnikrishnan, MK; Rodrigues, GS; Mukhopadhyay, C

2014-01-01

100

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. PMID:24688595

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

101

Field Studies versus Laboratory Studies, Degradation Rates  

Microsoft Academic Search

The use of laboratory biodegradation half-lives to predict rates of degradation in the field has been studied in several recent publications. In general, laboratory studies are not accurate predictors of field degradation rates. The reasons for this have included: changes to the soil during preparation steps or storage of the soil, the static conditions of the laboratory study versus dynamic

Philip Howard

102

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. PMID:24103860

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

2013-01-01

103

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

104

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. PMID:24909320

2014-01-01

105

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

106

A study of bladder dysfunction in women with type 2 diabetes mellitus  

PubMed Central

Introduction: Diabetes mellitus has been associated with an earlier onset and increased severity of urologic diseases that often result in debilitating urologic complications. Diabetic bladder dysfunction refers to a group of bladder symptoms occurring in patients with diabetes mellitus ranging from bladder over activity to impaired bladder contractility. Aim: Bladder dysfunction is an under evaluated issue in women with diabetes. Aim of our study was to investigate prevalence of bladder dysfunction and its relation with other chronic complications of diabetes in women with type 2 diabetes. Materials and Methods: In a hospital-based cross sectional study, a cohort of women with type 2 diabetes mellitus who had lower urinary tract symptoms (LUTS) were enrolled. We used the American Urological Association Symptom Index (AUA-SI) to assess the severity of LUTS and the Indevus Urgency Severity Scale (IUSS) to assess presence of overactive bladder (OAB). Age-BMI- matched controls that did not have diabetes but had lower urinary tract symptoms were also studied and compared with women with type 2 diabetes. Urodynamic evaluation was done in willing patients. Results: LUTS attributable to bladder dysfunction were reported in 67% of women with type 2 diabetes after exclusion of other causes. Out of them, 36% had moderate to severe LUTS (total AUA-SI score >7). Prevalence of OAB was 53%. Urodynamic evaluation revealed presence of stress urinary incontinence in 48% patients and changes of detrusor over activity and detrusor under activity in 23% and 11% patients, respectively. Among the chronic complications of diabetes, peripheral neuropathy, nephropathy, and presence of metabolic syndrome were significantly associated with moderate to severe LUTS and OAB. Conclusion: Bladder dysfunction is a highly prevalent complication in women with diabetes. Chronic complications of diabetes especially neuropathy, nephropathy, and presence of metabolic syndrome are important predictors of bladder dysfunction. PMID:25143916

Karoli, Ritu; Bhat, Sanjay; Fatima, Jalees; Priya, S.

2014-01-01

107

Clinical study on erectile dysfunction in diabetic and non-diabetic subjects and its management with Ficus relegiosa Linn.  

PubMed

Healthy sexual functioning plays an essential role in maintaining the harmony and happiness in marital life. It provides a media to express love, which is the base for all sorts of creative activities. The absence of this function hampers the marital relationship, leading to frustration and, sometimes, ending in divorce, and causes inadequacy in performing the routine duties. In this study, 53 patients having diabetes mellitus were surveyed to find out the incidence of erectile dysfunction (ED). Considering the high prevalence of the disease and the need to look for alternative medicine, a clinical trial on 44 patients of ED was carried out. These patients were divided into two main groups: diabetic and non-diabetic, and were further divided into two subgroups as trial group and placebo group. In the trial group, Ashvattha Kshirpaka prepared with 10 g powder of its root bark, stem bark, fruit and tender leaf buds was given twice a day. In both the diabetic and the non-diabetic subjects, Ashvattha provided encouraging results on ED as well as on seminal parameters in comparison to the placebo. PMID:22131726

Virani, Nilesh V; Chandola, H M; Vyas, S N; Jadeja, D B

2010-07-01

108

Clinical study on erectile dysfunction in diabetic and non-diabetic subjects and its management with Ficus relegiosa Linn.  

PubMed Central

Healthy sexual functioning plays an essential role in maintaining the harmony and happiness in marital life. It provides a media to express love, which is the base for all sorts of creative activities. The absence of this function hampers the marital relationship, leading to frustration and, sometimes, ending in divorce, and causes inadequacy in performing the routine duties. In this study, 53 patients having diabetes mellitus were surveyed to find out the incidence of erectile dysfunction (ED). Considering the high prevalence of the disease and the need to look for alternative medicine, a clinical trial on 44 patients of ED was carried out. These patients were divided into two main groups: diabetic and non-diabetic, and were further divided into two subgroups as trial group and placebo group. In the trial group, Ashvattha Kshirpaka prepared with 10 g powder of its root bark, stem bark, fruit and tender leaf buds was given twice a day. In both the diabetic and the non-diabetic subjects, Ashvattha provided encouraging results on ED as well as on seminal parameters in comparison to the placebo. PMID:22131726

Virani, Nilesh V.; Chandola, H. M.; Vyas, S. N.; Jadeja, D. B.

2010-01-01

109

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

110

Educational Disparities in Rates of Smoking Among Diabetic Adults: The Translating Research Into Action for Diabetes Study  

PubMed Central

Objectives. We assessed educational disparities in smoking rates among adults with diabetes in managed care settings. Methods. We used a cross-sectional, survey-based (2002–2003) observational study among 6538 diabetic patients older than 25 years across multiple managed care health plans and states. For smoking at each level of self-reported educational attainment, predicted probabilities were estimated by means of hierarchical logistic regression models with random intercepts for health plan, adjusted for potential confounders. Results. Overall, 15% the participants reported current smoking. An educational gradient in smoking was observed that varied significantly (P<.003) across age groups, with the educational gradient being strong in those aged 25 to 44 years, modest in those aged 45 to 64 years, and nonexistent in those aged 65 years or older. Of particular note, the prevalence of smoking observed in adults aged 25–44 years with less than a high school education was 50% (95% confidence interval: 36% to 63%). Conclusions. Approximately half of poorly educated young adults with diabetes smoke, magnifying the health risk associated with early-onset diabetes. Targeted public health interventions for smoking prevention and cessation among young, poorly educated people with diabetes are needed. PMID:17600269

Karter, Andrew J.; Stevens, Mark R.; Gregg, Edward W.; Brown, Arleen F.; Tseng, Chien-Wen; Marrero, David G.; Duru, O. Kenrik; Gary, Tiffany L.; Piette, John D.; Waitzfelder, Beth; Herman, William H.; Beckles, Gloria L.; Safford, Monika M.; Ettner, Susan L.

2008-01-01

111

Descriptive Epidemiology of Diabetes Prevalence and HbA1c Distributions Based on a Self-Reported Questionnaire and a Health Checkup in the JPHC Diabetes Study  

PubMed Central

Background The present study examined the prevalence of diabetes in Japan during the late 1990s and early 2000s using the Japan Public Health Center-based Prospective Diabetes cohort. We also investigated the distributions of HbA1c values in noncompliant diabetic participants in the cohort. Methods A total of 28 183 registered inhabitants aged 46–75 years from 10 public health center areas were included in the initial survey. The 5-year follow-up survey included 20 129 participants. The prevalence of diabetes was estimated using both a self-reported questionnaire and laboratory measurements. Among the participants who reported the presence of diabetes on the questionnaire (self-reported diabetes), the distributions of HbA1c values were described according to their treatment status. Results The age-standardized prevalence of diabetes in 55- to 74-year-old adults was 8.2% at the initial survey and 10.6% at the 5-year follow-up. At the initial survey, among participants with self-reported diabetes, the mean HbA1c values in the participants who had never and who had previously received diabetes treatment were 7.01% (standard deviation [SD] 1.56%) and 6.56% (SD 1.46%), respectively. Approximately 15% of the participants who had self-reported diabetes but had never received diabetes treatment had an HbA1c ? 8.4%. Conclusions The prevalence of diabetes increased in the JPHC cohort between the late 1990s and early 2000s. A certain proportion of participants who were aware of their diabetes but were not currently receiving treatment had poor diabetic control. Efforts to promote continuous medical attendance for diabetes care may be necessary. PMID:24998950

Kabeya, Yusuke; Kato, Masayuki; Isogawa, Akihiro; Takahashi, Yoshihiko; Matsushita, Yumi; Goto, Atsushi; Iso, Hiroyasu; Inoue, Manami; Mizoue, Tetsuya; Tsugane, Shoichiro; Kadowaki, Takashi; Noda, Mitsuhiko

2014-01-01

112

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. PMID:21150874

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

113

A genome-wide association study for diabetic nephropathy genes in African Americans.  

PubMed

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. PMID:21150874

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

2011-03-01

114

Selenium and diabetes--evidence from animal studies.  

PubMed

Whereas selenium was found to act as an insulin mimic and to be antidiabetic in earlier studies, recent animal experiments and human trials have shown an unexpected risk of prolonged high Se intake in potentiating insulin resistance and type 2 diabetes. Elevating dietary Se intake (0.4 to 3.0mg/kg of diet) above the nutrient requirements, similar to overproduction of selenoproteins, led to insulin resistance and/or diabetes-like phenotypes in mice, rats, and pigs. Although its diabetogenic mechanism remains unclear, high Se intake elevated activity or production of selenoproteins including GPx1, MsrB1, SelS, and SelP. This upregulation diminished intracellular reactive oxygen species and then dysregulated key regulators of ? cells and insulin synthesis and secretion, leading to chronic hyperinsulinemia. Overscavenging intracellular H2O2 also attenuated oxidative inhibition of protein tyrosine phosphatases and suppressed insulin signaling. High Se intake might affect expression and/or function of key regulators of glycolysis, gluconeogenesis, and lipogenesis. Future research is needed to find out if certain forms of Se metabolites in addition to selenoproteins and if mechanisms other than intracellular redox control mediate the diabetogenic effects of high Se intake. Furthermore, a potential interactive role of high Se intake in the interphase of carcinogenesis and diabetogenesis should be explored to make optimal use of Se in human nutrition and health. PMID:23867154

Zhou, Jun; Huang, Kaixun; Lei, Xin Gen

2013-12-01

115

Antihyperlipidemic effect of fisetin, a bioflavonoid of strawberries, studied in streptozotocin-induced diabetic rats.  

PubMed

Chronic hyperglycemia in diabetes is associated with profound changes in lipid and lipoprotein metabolism, with resultant alterations in particle distribution within lipoprotein classes. In the present study, an attempt has been made to explore the antihyperlipidemic effect of fisetin in streptozotocin-induced experimental diabetes in rats. Upon fisetin treatment to diabetic rats, the levels of blood glucose were significantly reduced with an improvement in plasma insulin. The increased levels of lipid contents in serum, hepatic, and renal tissues observed in diabetic rats were normalized upon fisetin administration. Also, the decreased levels of high-density lipoprotein cholesterol, and increased levels of low-density lipoprotein (LDL) and very LDL (VLDL) cholesterol in serum of diabetic rats were normalized. Oil Red O staining established a large number of intracellular lipid droplets accumulation in the diabetic rats. Fisetin treatment exacerbated the degree of lipid accumulation. The results of the present study exemplify the antihyperlipidemic property of the fisetin. PMID:24939606

Prasath, Gopalan Sriram; Subramanian, Sorimuthu Pillai

2014-10-01

116

Associations among health literacy, diabetes knowledge, and self-management behavior in adults with diabetes: results of a dutch cross-sectional study.  

PubMed

Various studies have examined the association between health literacy and self-management behavior, but few have explored ways through which this occurs. The present study examines to what extent health literacy is associated with diabetes self-management behavior and to what extent diabetes knowledge is a mechanism in this association. The study was based on cross-sectional data retrieved from patient registrations and questionnaires completed in 2010. The sample included 1,714 predominantly type 2 diabetes patients, with a mean age of 67 years. Diabetes self-management was indicated by HbA1c level, glucose self-control and self-reported monitoring of glucose levels, physical activity, and smoking. Multilevel analyses were applied based on multiple imputed data. Lower health literacy was significantly associated with less diabetes knowledge, higher HbA1c level, less self-control of glucose level, and less physical activity. Participants with more diabetes knowledge were less likely to smoke and more likely to control glucose levels. Diabetes knowledge was a mediator in the association between health literacy and glucose self-control and between health literacy and smoking. This study indicates that higher health literacy may contribute to participation in certain self-management activities, in some cases through diabetes knowledge. Diabetes knowledge and health literacy skills may be important targets for interventions promoting diabetes self-management. PMID:25315588

van der Heide, Iris; Uiters, Ellen; Rademakers, Jany; Struijs, Jeroen N; Schuit, A Jantine; Baan, Caroline A

2014-10-01

117

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

118

Hyperglycemia in poor controlled diabetes from crude tamarind herbal pill: a case study  

PubMed Central

Hyperglycemia is an important finding in the diabetic patient with poor glycemic control. There are several possible causes of hyperglycemic. Here, the author presents an interesting case study on a female diabetic patient presenting with hyperglycemic due to intake of crude tamarind herbal pill. General practitioner should realize that the use of alternative medicine can be a cause of unexplained hyperglycemic episode in diabetic patient. PMID:23569730

Wiwanitkit, Viroj

2011-01-01

119

A genome-wide association study for diabetic nephropathy genes in African Americans  

Microsoft Academic Search

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

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

2011-01-01

120

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

121

Clinical and morphological studies in streptozotocin diabetic pregnant rats.  

PubMed

Diabetes was induced in pregnant rats by administration of streptozotocin and the changes of the feto-placental unit were investigated. Dead fetuses were found in 12% of the untreated diabetic animals. In comparison to the controls, the fetal weights were significantly smaller and placental weights greater in diabetic animals. The changes were clearly characterized by the ratio fetal placental weight. Edema and cystic degeneration were characteristic of insulin treated diabetic placentas while fibrosis and ischemia were observed mainly in untreated animals. Insulin treatment resulted in hemorrhages and necrosis in the placenta of normal pregnant rats; the change is ascribed to hypoglycaemia. PMID:135471

Szalay, J; Gaál, M

1975-01-01

122

Participant and parent experiences in the oral insulin study of the Diabetes Prevention Trial for Type 1 Diabetes  

PubMed Central

Objective To assess the experiences of participants and parents of children in the oral insulin study of the Diabetes Prevention Trial –Type 1. Method Before trial results were publicized, surveys were completed by 124 participants and 219 parents of children in the oral trial. Results Although most of those surveyed were positive about the trial, survey results suggest that participant perspective (adult, child, parent, and gender), study procedures, and beliefs about placebo vs. active drug assignment have important implications for planning future clinical trials. Parents and children reported greater distress, worry, and difficulty making the decision to join the trial compared with adult participants. Mothers and female participants were particularly interested in additional psychosocial support during the study. Random assignment was viewed negatively by both parents and children, and close observation for diabetes onset was viewed as the most favorable aspect of the study. Adherence to study procedures declined over time and behaviors outside the study protocol to prevent/delay diabetes onset were common, particularly among those who believed the participant was taking a placebo. Children and respondents who believed that the participant was taking the active drug expressed confidence in oral insulin’s ability to delay or prevent type 1 diabetes. Conclusions Although most participants were positive about the trial and many expressed optimism about the intervention’s potential for success, future trials need to address negative reactions to random assignment, the unique concerns of children and their parents, declining adherence, and behaviors – external to the trial – designed to delay or prevent diabetes. PMID:18823410

Johnson, Suzanne Bennett; Baughcum, Amy E; Rafkin-Mervis, Lisa E; Schatz, Desmond A

2014-01-01

123

Association of vagal tone with serum insulin, glucose, and diabetes mellitus--The ARIC Study.  

PubMed

Reduced vagal activity assessed by heart rate variability (HRV) has been observed in studies of diabetics, but this association has not been reported at the population level. To investigate the association of HRV with diabetes mellitus, as well as fasting serum insulin, and glucose, we examined a stratified random sample of 1933 individuals (154 diabetics and 1779 non-diabetics), aged 45-65 years from the Atherosclerosis Risk in Communities (ARIC) study cohort. Two-minute, resting, supine beat-to-beat heart rate records were collected. Power spectral density estimation was used to derive HRV high frequency power (HF, 0.15-0.35 Hz) as the conventional marker of vagal function. Age, race, and gender-adjusted geometric means of HF were 0.78 and 1.27 (beat/min)(2) for diabetics and non-diabetics respectively (P for mean difference <0.01), reflecting a reduced vagal activity in diabetics. In individuals not diagnosed as diabetics, a graded, inverse association was observed between fasting serum insulin and HF (P for trend <0.01): the age, race, and gender-adjusted geometric mean values of HF in the lowest and highest quartiles of serum insulin were 1.34 and 1.14 (beat/minute)(2), respectively. A similar association was observed between glucose and HF in a univariate model, but not in the adjusted model. This first population-based study on this subject confirmed that diabetics have significantly lower vagal activity than non-diabetics. In individuals not diagnosed as diabetics, serum insulin, and, to a lesser degree, serum glucose were inversely associated with vagal function, suggesting a role in the pathogenesis of diabetic neuropathy. PMID:8861461

Liao, D; Cai, J; Brancati, F L; Folsom, A; Barnes, R W; Tyroler, H A; Heiss, G

1995-12-01

124

Pharmacokinetic study of niosome-loaded insulin in diabetic rats  

PubMed Central

Background and the purpose of the study Encapsulation of human insulin in lipid vesicular systems such as niosomes was sought as a route to protect this protein against proteolytic enzymes and to improve its oral bioavailability. The purpose of this study was to assess the effect of insulin encapsulation in niosomes on oral bioavailability in diabetic rats. Methods Recombinant human insulin was entrapped in multilamellar niosomes composed of polyoxyethylene alkyl ether surfactants (Brij 52 and Brij 92) or sorbitan monostearate (Span 60) and cholesterol. The amount of insulin released in simulated intestinal fluid (SIF) and simulated gastric fluid (SGF) were measured at 37°C. The protection of entrapped insulin against pepsin, ?-chymotrypsin and trypsin were evaluated in comparison with free insulin solution. Diabetes was induced by IP injection of streptozotocin (65 mg/kg) in male wistar rats and effects of orally administered niosomes and subcutaneously injected insulin on hypoglycemia and elevation of insulin levels in serum were compared. Results and conclusion The extent and rate of insulin release from Brij 92 and Span 60 vesicles were lower than that of Brij 52 niosomes (P<0.05). Vesicles protected insulin in comparison with free insulin solution against proteolytic enzymes (P<0.05) significantly. Animals treated with oral niosome-encapsulated insulin (100 IU/kg) showed decreased levels of blood glucose and elevated serum insulin, which in the case of Brij 92 niosomes, hypoglycemic effect was significant (P<0.05). Niosomes were also stable in solubilizing bile salt solutions and could effectively prolong the release of insulin in both SGF and SIF. Results of this study showed that niosomes may be utilized as oral carriers of insulin; however, to increase bioavailability of insulin, further studies on the protease inhibitor co-encapsulation in niosomal formulations might be helpful. PMID:23008685

Pardakhty, A.; Moazeni, E.; Varshosaz, J.; Hajhashemi, V.; Rouholamini Najafabadi, A.

2011-01-01

125

"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. PMID:22458767

2012-01-01

126

Microalbuminuria Prevalence Study (MAPS) in hypertensive Patients with Type 2 Diabetes in Thailand  

Microsoft Academic Search

Background: Microalbuminuria represents the earliest clinical evidence of diabetic nephropathy, and is a marker of increased cardiovascular (CV) morbidity and mortality. Objectives: This analysis of Thai data from the Microalbuminuria Prevalence Study (MAPS) assessed the prevalence of macroalbuminuria and microalbuminuria in hypertensive patients with type 2 diabetes. Design: Cross-sectional clinic-based epidemiological study. Material and Method: A total of 100 patients

Peera Buranakitjaroen

127

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

128

A prospective study of cigarette smoking and the incidence of diabetes mellitus among us male physicians  

Microsoft Academic Search

PURPOSE: To determine the association between cigarette smoking and the incidence of type 2 diabetes mellitus.SUBJECTS AND METHODS: We studied 21,068 US male physicians aged 40 to 84 years in the Physicians’ Health Study who were initially free of diagnosed diabetes mellitus, cardiovascular disease, and cancer. Information about cigarette smoking and other risk indicators was obtained at baseline. The primary

JoAnn E Manson; Umed A Ajani; Simin Liu; David M Nathan; Charles H Hennekens

2000-01-01

129

Moderate alcohol consumption is associated with lower risk for incident diabetes and mortality: the Hoorn Study  

Microsoft Academic Search

In the present study we examined the association between baseline alcohol consumption and 10-year mortality in subjects with normal and abnormal glucose levels (diabetes, impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)). Furthermore, we assessed the 6-year cumulative incidence of diabetes in categories of alcohol consumption. In the Hoorn Study, which started in 1989, alcohol intake was assessed by

Femmie de Vegt; Jacqueline M. Dekker; Willem-Jan A. Groeneveld; Giel Nijpels; Coen D. A. Stehouwer; Lex M. Bouter; Robert J. Heine

2002-01-01

130

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

131

Late onset hypogonadism in type 2 diabetic and nondiabetic male: a comparative study.  

PubMed

Sexual dysfunction in diabetic men can result from a variety of causes of which late onset hypogonadism is now a recognised entity. The study described here was conducted to determine this entity by comparing diabetic men with age matched controls. A significant number of diabetic men had low levels of testosterone and free testosterone. Among the patients with low testosterone a large percentage had low pituitary gonadotrophic hormones signifying that the disorder was actually hypogonadotrophic hypogonadism. This finding was then correlated with various risk factors present in the diabetic patients and positive correlations were found for many parameters. PMID:23741825

Basu, Asish Kumar; Singhania, Pankaj; Bandyopadhyay, Ramtanu; Biswas, Kalidas; Santra, Sukamal; Singh, Sudhakar; Mukherjee, Sekhar Kumar; Raychaudhuri, Pradip

2012-08-01

132

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. PMID:23277199

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

133

Mental health service users' experiences of diabetes care by Mental Health Nurses: an exploratory study.  

PubMed

This paper is a report of a study exploring mental health service users' (MHSUs') experiences of diabetes care. Diabetes is a growing clinical concern in mental health nursing practice. However, little is known about MHSUs' experience of diabetes care. This is a descriptive qualitative study. Semi-structured telephone interviews were held between June and October 2011, with seven MHSUs who had diabetes. Participants reported experiences of stigma and diagnostic overshadowing (DO) when reporting symptoms of diabetes or when feeling unwell. Participants also encountered a split between their mental health and diabetes care needs, which resulted in a lack of holistic or integrated care. All participants mentioned experiencing complications of diabetes even to the extent of diabetic ketoacidosis. Mental health nurses (MHNs) must critically reflect on their attitudes towards service users that report physical symptoms to ensure that stigma and DO do not constitute barriers to appropriate screening and treatment. The complex relationship that exists between mental illness and diabetes requires MHNs to ensure physical and mental health care are wholly integrated and not split. Education needs are apparent so that symptoms and complications can be recognized and treated accordingly. PMID:24548452

Nash, M

2014-10-01

134

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. PMID:23488481

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

2013-01-01

135

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. PMID:24096980

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

2014-01-01

136

Medication Adherence in Type 2 Diabetes: The ENTRED Study 2007, a French Population-Based Study  

E-print Network

Medication Adherence in Type 2 Diabetes: The ENTRED Study 2007, a French Population-Based Study´cile Fournier4 , Anne Fagot-Campagna5 , Alfred Penfornis6 * 1 Medical Information Department, University of Public Health Surveillance (InVS), Saint-Maurice, France, 6 Department of Endocrinology

Boyer, Edmond

137

Knowledge and awareness of diabetes in urban and rural India: The Indian Council of Medical Research India Diabetes Study (Phase I): Indian Council of Medical Research India Diabetes 4  

PubMed Central

Background: Representative data on knowledge and awareness about diabetes is scarce in India and is extremely important to plan public health policies aimed at preventing and controlling diabetes. Aim: The aim of the following study is to assess awareness and knowledge about diabetes in the general population, as well as in individuals with diabetes in four selected regions of India. Materials and Methods: The study subjects were drawn from a representative sample of four geographical regions of India, Chandigarh, Tamil Nadu, Jharkhand and Maharashtra representing North, South, East and West and covering a population of 213 million. A total of 16,607 individuals (5112 urban and 11,495 rural) aged ?20 years were selected from 188 urban and 175 rural areas. Awareness of diabetes and knowledge of causative factors and complications of diabetes were assessed using an interviewer administered structured questionnaire in 14,274 individuals (response rate, 86.0%), which included 480 self-reported diabetic subjects. Results: Only 43.2% (6160/14,274) of the overall study population had heard about a condition called diabetes. Overall urban residents had higher awareness rates (58.4%) compared to rural residents (36.8%) (P < 0.001). About 46.7% of males and 39.6% of females reported that they knew about a condition called diabetes (P < 0.001). Of the general population, 41.5% (5726/13,794) knew about a condition called diabetes. Among them, 80.7% (4620/5726) knew that the prevalence of diabetes was increasing, whereas among diabetic subjects, it was 93.0% (448/480). Among the general and diabetic population, 56.3% and 63.4% respectively, were aware that diabetes could be prevented. Regarding complications, 51.5% of the general population and 72.7% diabetic population knew that diabetes could affect other organs. Based on a composite knowledge score to assess knowledge among the general population, Tamil Nadu had the highest (31.7) and Jharkhand the lowest score (16.3). However among self-reported diabetic subjects, Maharashtra had the highest (70.1) and Tamil Nadu, the lowest score (56.5). Conclusion: Knowledge and awareness about diabetes in India, particularly in rural areas, is poor. This underscores the need for conducting large scale diabetes awareness and education programs. PMID:24944935

Deepa, M.; Bhansali, A.; Anjana, R. M.; Pradeepa, R.; Joshi, S. R.; Joshi, P. P.; Dhandhania, V. K.; Rao, P. V.; Subashini, R.; Unnikrishnan, R.; Shukla, D. K.; Madhu, S. V.; Das, A. K.; Mohan, V.; Kaur, T.

2014-01-01

138

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. PMID:24171939

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

2013-01-01

139

Re-analysis of Ranch Hand study supports reverse causation hypothesis between dioxin and diabetes.  

PubMed

A dose-response relationship between serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin) and adult diabetes risk has been reported among U.S. Vietnam veterans in the Ranch Hand (RH) cohort. We examine the hypothesis that diabetes progression leads to higher serum dioxin (reverse causation) rather than higher serum dioxin leading to diabetes (causation) across the longitudinal medical monitoring data on these airmen. Lipid-adjusted serum dioxin levels and clinical parameters relating to diabetes progression were examined. Potential confounding due to age, race, diabetes family history, serum total lipid, and body mass index (BMI) was accounted for. The similar incidence of diabetes in RH and Comparison veterans, along with generally similar incidence trends with dioxin decile and lipid decile despite the large differential in serum dioxin, is evidence consistent with reverse causation. Of 135 RH diabetics with at least two dioxin measurements, 32.6% had a temporary serum dioxin increase more than a decade after Vietnam tour and another 22.2% had an interval of unusually slow half-life (>15.5 years); these diabetes-related changes shifted more diabetics into the higher dioxin deciles. Further, the increased diabetes odds ratio among the generally younger RH veterans in the highest dioxin decile is associated with a higher incidence of adult obesity in this RH subgroup, both at tour of duty and decades later. Change in serum dioxin levels is likely due to diabetes progression or poor control and is not independently related to serum dioxin concentrations. In summary, the data from the Ranch Hand studies does not indicate that dioxin increases adult diabetes risk. PMID:22720712

Kerger, Brent D; Scott, Paul K; Pavuk, Marian; Gough, Michael; Paustenbach, Dennis J

2012-09-01

140

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. PMID:24886542

2014-01-01

141

A Resilience Intervention in African American Adults with Type 2 Diabetes: A Pilot Study of Efficacy  

PubMed Central

Purpose The purpose of this pilot study was to determine the feasibility of offering our Diabetes Coaching Program (DCP), adapted for African Americans, in a sample of African American adults with type 2 diabetes. Methods The study utilized a one-group, pretest-posttest design to test the acceptance and potential effectiveness of the DCP. Subjects were a convenience sample of 16 African Americans (8 females; 8 males) with type 2 diabetes; twelve subjects (6 females; 6 males) completed the program. The DCP included four weekly class sessions devoted to resilience education and diabetes self-management, followed by eight biweekly support group meetings. Psychosocial process variables (resilience, coping strategies, diabetes empowerment), and proximal (perceived stress, depressive symptoms, diabetes self-management) and distal outcomes (BMI, fasting blood glucose, HbA1c, lipidemia, blood pressure) were assessed at baseline and six-months post study entry. Qualitative data were collected at eight-months via a focus group conducted to examine the acceptability of the DCP. Results Preliminary paired t-tests indicated statistically significant improvements in diabetes empowerment, diabetes self-management, BMI, HbA1c, total cholesterol, LDL-cholesterol, and systolic and diastolic blood pressure. Medium to large effect sizes were reported. Resilience, perceived stress, fasting blood glucose, and HDL-cholesterol improved, but changes were not statistically significant. Focus group data confirmed that participants held positive opinions regarding the DCP and follow-up support group sessions, although they suggested an increase in program length from 4 to 8 weeks. Conclusions The pilot study documented the feasibility and potential effectiveness of the DCP to enhance diabetes empowerment, diabetes self-management, and reductions in the progression of obesity, type 2 diabetes, and CVD in the African American community. Randomized experimental designs are needed to confirm these findings. PMID:19204102

Steinhardt, Mary A.; Mamerow, Madonna M.; Brown, Sharon A.; Jolly, Christopher A.

2010-01-01

142

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

143

Skin autofluorescence provides additional information to the UK Prospective Diabetes Study (UKPDS) risk score for the estimation of cardiovascular prognosis in type 2 diabetes mellitus  

Microsoft Academic Search

Aims\\/hypothesis  The UK Prospective Diabetes Study (UKPDS) risk engine has become a standard for cardiovascular risk assessment in type 2 diabetes\\u000a mellitus. Skin autofluorescence was recently introduced as an alternative tool for cardiovascular risk assessment in diabetes.\\u000a We investigated the prognostic value of skin autofluorescence for cardiovascular events in combination with the UKPDS risk\\u000a engine in a cohort of patients with

H. L. Lutgers; E. G. Gerrits; R. Graaff; T. P. Links; W. J. Sluiter; R. O. Gans; H. J. Bilo; A. J. Smit

2009-01-01

144

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

145

A concept mapping study of nutritional knowledge in diabetic children and their parents : detailled version  

E-print Network

The therapeutic education of a diabetic child and his parents is directed towards the acquisition of self1 A concept mapping study of nutritional knowledge in diabetic children and their parents account for similarities and differences in children and parents preoccupations. Key Words : Children

Boyer, Edmond

146

Electronic Disease Surveillance for Sensitive Population Groups - The Diabetics Case Study  

Microsoft Academic Search

Diabetics are quite susceptible to infectious diseases and can easily spread them under certain circumstances. Their blood glucose levels are increased after infection and this can cause a hyperglycemic crisis. Our study indicates that this increase results in glucosylated hemoglobin elevation, even when a diabetic is monitored closely and his\\/her blood glucose is under tight control. Thus, it is important

Taxiarchis Botsis; Ole K. Hejlesen; Johan Gustav Bellika; Gunnar Hartvigsen

2008-01-01

147

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

148

PhD Scholarship in an EU Cost-effectiveness Study of Diabetes and Health Literacy  

E-print Network

PhD Scholarship in an EU Cost-effectiveness Study of Diabetes and Health Literacy UCD Michael for a 3 year fully funded PhD Scholarship in the research area of diabetes and health literacy, commencing implementation'. What is the value of the Health Literacy Scholarship? This funded research Scholarship will fund

149

Characteristics of undiagnosed diabetes in community-dwelling French elderly: the 3C study  

E-print Network

Characteristics of undiagnosed diabetes in community-dwelling French elderly: the 3C study I in the elderly 1: Geriatric Department, Hôpital Xavier Arnozan, 33604 Pessac cedex, France and UMR.5536 CNRS community-living elderly people. Diagnosed and undiagnosed diabetes, impaired fasting glucose (IFG

Paris-Sud XI, Université de

150

SHOCK WAVE LITHOTRIPSY AND DIABETES MELLITUS: A POPULATION-BASED COHORT STUDY  

PubMed Central

OBJECTIVES The pancreas is vulnerable to injury at the time of shock wave lithotripsy (SWL) as evidenced by case studies; thus, concern exists for the development of diabetes mellitus following SWL. Since previous studies may have been limited by referral and detection biases, the current study was completed in a population-based cohort. METHODS The Rochester Epidemiologic Project (REP) was used to identify all Olmsted County, Minnesota residents diagnosed with urolithiasis from 1985 to 2008. New onset diabetes was identified by diagnostic codes and treatment with SWL by surgical codes. Cox proportional hazards models were used to determine the risk of diabetes following SWL therapy. RESULTS There were 5,287 incident stone formers without pre-existing diabetes and with at least 3 months of follow-up. After an average follow-up of 8.7 years, 423 patients (8%) were treated with SWL and new onset diabetes developed in 743 (12%). The diagnosis of diabetes followed SWL in 77 patients. However, there was no evident association between SWL and the development of diabetes before (HR=0.98, 95% CI: 0.76 to 1.26) or after (HR 0.92, 95% CI: 0.71 to 1.18) controlling for age, gender, and obesity. CONCLUSION In this large, population-based cohort, the long-term risk for developing diabetes was not increased in persons who received SWL to treat their kidney stones. PMID:22088569

de Cogain, Mitra; Krambeck, Amy E.; Rule, Andrew D.; Li, Xujian; Bergstralh, Eric J.; Gettman, Matthew T.; Lieske, John C.

2011-01-01

151

Prescription Pattern of Chinese Herbal Products for Diabetes Mellitus in Taiwan: A Population-Based Study  

PubMed Central

Background. Traditional Chinese medicine (TCM), when given as a therapy for symptom relief, has gained widespread popularity among diabetic patients. The aim of this study is to analyze the utilization of TCM among type 2 diabetic patients in Taiwan. Methods. The use of TCM for type 2 diabetic patients were evaluated using a randomly sampled cohort of 1,000,000 beneficiaries recruited from the National Health Insurance Research Database. Results. Overall, 77.9% (n = 31,289) of type 2 diabetic patients utilized TCM and 13.9% (n = 4,351) of them used TCM for the treatment of type 2 diabetes. Among the top ten most frequently prescribed herbal formulae, four remedies, Zhi-Bo-Di-Huang-Wan, Qi-Ju-Di-Huang-Wan, Ji-Sheng-Shen-Qi-Wan and Ba-Wei-Di-Huang-Wan are derivative formulae of Liu-Wei-Di-Huang-Wan. In other words, Liu-Wei-Di-Huang-Wan and its derivatives were found to be the most common herbal formulae prescribed by TCM doctors for the treatment of diabetes in Taiwan. Conclusion. Although some evidence does support the use TCM to treat diabetes, the results from the current study may have been confounded by placebo effect, which emphasize the need for well conducted, double-blind, randomized, placebo-controlled studies in order to further evaluate the efficacy of Liu-Wei-Di-Huang-Wan on patients with type 2 diabetes. PMID:23843864

Huang, Chung-Yu; Lai, Jung-Nien; Hsu, Feng-Lin

2013-01-01

152

Adherence to anti-diabetic drugs among patients with Type 2 diabetes mellitus at Muhimbili National Hospital, Dar es Salaam, Tanzania- A cross-sectional study  

PubMed Central

Introduction Adherence to diabetes mellitus treatment regimens among Type 2 diabetes patients in Tanzania has not been well documented. This study sought to assess adherence to antidiabetic drugs and associated factors among patients with Type 2 diabetes mellitus. Methods A cross-sectional study was conducted among type 2 diabetes mellitus patients who were attending the Diabetic clinic of Muhimbili National hospital between May 2009 and February 2010. Assement ofadherence to antidiabetic medications was based on patients’ self-reported recall of skipped days without taking medications, over the past one week and three months. Data wereentered and analyzed using Statistical Package for Social Sciences (SPSS Inc. Chicago, Illinois version 16). The crude and adjusted odds ratio (COR/ AOR) and 95% Confidence Interval (CI) were performed to determine factors associated with anti-diabetic medications adherence and a p-value of 0.05 or less was considered statistically significant. Results Adherence rates to antidiabetic drugs were found to be 60.2% and 71.2% at one week and three months respectively. High cost of medication was significantly associated with anti-diabetic non-adherence. Adherence to anti-diabetic drugs significantly increased with an increase in number of non-diabetic medications. Conclusion Adherence to antidiabetic drugs was found to be suboptimal. Patients with other medical conditions in addition to diabetes mellitus are more likely to adhere to anti-diabetic medications. There is a need for the responsible authorities to set policies that subsidize cost of anti-diabetic drugs to improve adherence and reduce associated complications.

Rwegerera, Godfrey Mutashambara

2014-01-01

153

Cohort profile: The Japan Diabetes Complications Study: a long-term follow-up of a randomised lifestyle intervention study of type 2 diabetes.  

PubMed

The Japan Diabetes Complications Study, a randomised lifestyle intervention study of type 2 diabetes conducted at 59 institutes throughout Japan that enrolled 2033 eligible patients from January 1995 to March 1996, was directed at: (i) determining the incidence and progression rates of complications of diabetes; (ii) exploring clinical risk factors for complications of diabetes; and (iii) determining the association between lifestyle factors, including diet and physical activity, and complications of diabetes, in addition to comparing, in a randomised manner, the effects on type 2 diabetes of an extensive lifestyle intervention and conventional treatment. The protocol for the study originally specified four study populations according to primary outcomes, consisting of: (1) a macroangiopathy group (N = 1771); (ii) a nephropathy group (N = 1607); (iii) a retinopathy-incident group (N = 1221); and (iv) a retinopathy-progression group (N = 410). The primary outcomes were: (i) development of retinopathy; (ii) progression of retinopathy; (iii) development of overt nephropathy; and (iv) occurrence of macroangiopathic events including proven coronary heart disease and stroke. The study was originally planned to follow patients for 8 years, and an extended follow-up is ongoing. Information about primary outcomes, laboratory tests, and other clinical variables for each patient was collected at a central data centre through an annual report from each investigator. Additionally, extensive lifestyle surveys were conducted at baseline and 5 years after the beginning of the study intervention in both the intervention and conventional treatment groups. A description of the occurrence of complications of diabetes and of all-cause mortality, provided in this paper, demonstrated a clear gender-based difference in cardiovascular disease and all-cause mortality. PMID:23687126

Tanaka, Shiro; Tanaka, Sachiko; Iimuro, Satoshi; Yamashita, Hidetoshi; Katayama, Shigehiro; Ohashi, Yasuo; Akanuma, Yasuo; Yamada, Nobuhiro; Sone, Hirohito

2014-08-01

154

A population-based observational study of diabetes during pregnancy in Victoria, Australia, 1999–2008  

PubMed Central

Objectives This paper reports secular trends in diabetes in pregnancy in Victoria, Australia and examines the effect of including or excluding women with pre-existing diabetes on gestational diabetes (GDM) prevalence estimates. Design Population-based observational study. Setting All births in Victoria, Australia between 1999 and 2008 Participants 634?932 pregnancies resulting in a birth registered with the Victorian Perinatal Data Collection Outcome measures Crude and age-standardised secular trends in pre-existing diabetes and GDM prevalence; secular GDM trends by maternal birthplace; effects on GDM prevalence of including and excluding pre-existing diabetes from the denominator. Results Of the 634?932 pregnancies, 2954 (0.5%) occurred in women with pre-existing diabetes and 29?147 (4.6%) were complicated by GDM. Mean maternal age increased from 29.7?years in 1999 to 30.8?years in 2008. GDM prevalence increased in most maternal age groups. In 2008, age-standardised GDM prevalence was 31% higher than in 1999; secular increases were greater for Australian-born non-Indigenous (29% increase) than immigrant women (12.3% increase). The annual number of pregnancies in women with pre-existing diabetes almost doubled from 1999 to 2008 and prevalence increased from 0.4% to 0.6%. However, including or excluding pre-existing diabetes had little effect on GDM prevalence estimates. Conclusions Pre-existing diabetes and GDM prevalence increased in Victoria between 1999 and 2008 and rising maternal age does not fully explain these trends. These findings have important implications for preventive initiatives. Including or excluding small numbers of women with pre-existing diabetes resulted in minimal changes in GDM estimates. As pre-existing diabetes in young women increases, this methodological issue will likely become important. PMID:25398676

Abouzeid, Marian; Versace, Vincent L; Janus, Edward D; Davey, Mary-Ann; Philpot, Benjamin; Oats, Jeremy; Dunbar, James A

2014-01-01

155

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. PMID:24019966

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

2013-01-01

156

Diabetic nephropathy in type 1 (insulin-dependent) diabetes: An epidemiological study  

Microsoft Academic Search

Summary  A follow-up of 1475 Type 1 (insulin-dependent) diabetic patients diagnosed before 1953 (815 males, 660 females) and before the age of 31 years was conducted. All patients were seen at the Steno Memorial Hospital and were referred from all parts of Denmark; 91 (6%) could not be traced. The rest (94%) were followed until death or for at least 25

A. R. Andersen; J. Sandahl Christiansen; J. K. Andersen; S. Kreiner; T. Deckert

1983-01-01

157

Study Finds No Added Benefit from Routine Heart Scans for Diabetics  

MedlinePLUS

... page, please enable JavaScript. Study Finds No Added Benefit From Routine Heart Scans for Diabetics Proper management ... of unstable angina. The study authors concluded the benefits of the screenings were not significant enough to ...

158

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

159

Improving Diabetes Care for Young People With Type 1 Diabetes Through Visual Learning on Mobile Phones: Mixed-Methods Study  

PubMed Central

Background Only 17% of Norwegian children and adolescents with diabetes achieve international treatment goals measured by glycated hemoglobin (HbA1c). Classic patient–physician consultations seem to be poorly adapted to young children. New strategies that are better attuned to young people to improve support of adolescents’ self-management of diabetes need to be tested and evaluated. Objective (1) To explore how applications for mobile phones can be used in follow-up of adolescents with type 1 diabetes, and (2) to use the findings to guide further development of the applications and as a basis for future studies. Method We pilot tested two mobile phone applications: (1) an application that contained a picture-based diabetes diary to record physical activity and photos taken with the phone camera of food eaten, where the phone also communicated with the glucometer by Bluetooth technology to capture blood glucose values, and (2) a Web-based, password-secured and encrypted short message service (SMS), based on access using login passwords received via SMS to be used by participants to send messages to their providers when they faced obstacles in everyday life, and to send educational messages to the participants. At the end of the 3-month pilot study, 12 participants (7 girls and 5 boys ) aged 13–19 years completed semistructured interviews. The participants had a mean HbA1c value of 8.3 (SD 0.3), mean age of 16.2 (SD 1.7) years, mean body mass index of 23.3 (SD 3.2) kg/m2, and mean diabetes duration of 7.5 (SD 4.6) years. We applied three additional measurements: change in metabolic control as measured by HbA1c, the System Usability Scale, and diabetes knowledge. Results From the interviews, three main categories emerged: visualization, access, and software changes. Participants appreciated the picture-based diary more than the SMS solution. Visualization of cornerstones in diabetes self-care (ie, diet, insulin dosage, physical activity, and pre- and postprandial glucose measurements all transformed into one picture) in the mobile diary was found to be an important educational tool through reflections in action. This led to a change in participants’ applied knowledge about the management of their disease. Additional measurements supplemented and supported the qualitative findings. However, changes in HbA1c and participants’ theoretical knowledge as tested by a 27-item questionnaire, based on a national health informatics’ diabetes quiz, before and after the intervention were not statistically significant (P = .38 and P = .82, respectively, paired-samples t test). Participants suggested additional functionality, and we will implement this in the design of the next software generation. Conclusion Participants reported an increased understanding of applied knowledge, which seem to positively affect diabetes self-care. Visual impressions seem well adapted to the maturation of the adolescent brain, facilitating the link between theoretical knowledge and executive functions. SMS gave the adolescents a feeling of increased access and security. Participants gave valuable input for further development of these applications. PMID:22868871

Fr?island, Dag Helge; Skarderud, Finn

2012-01-01

160

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

161

Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study  

Microsoft Academic Search

To examine whether intensive glycemic control could decrease the frequency or severity of diabetic microvascular complications, we performed a prospective study of Japanese patients with non-insulin-dependent diabetes mellitus (NIDDM) treated with multiple insulin injection treatment. A total of 110 patients with NIDDM was randomly assigned to multiple insulin injection treatment group (MIT group) or to conventional insulin injection treatment group

Yasuo Ohkubo; Hideki Kishikawa; Eiichi Araki; Takao Miyata; Satoshi Isami; Sadatoshi Motoyoshi; Yujiro Kojima; Naohiko Furuyoshi; Motoaki Shichiri

1995-01-01

162

Alcohol and the risk for latent autoimmune diabetes in adults: results based on Swedish ESTRID study  

PubMed Central

Objective Moderate alcohol consumption is associated with a reduced risk of type 2 diabetes. Our aim was to investigate whether alcohol consumption is associated with the risk of latent autoimmune diabetes in adults (LADA), an autoimmune form of diabetes with features of type 2 diabetes. Design A population-based case–control study was carried out to investigate the association of alcohol consumption and the risk of LADA. Methods We used data from the ESTRID case–control study carried out between 2010 and 2013, including 250 incident cases of LADA (glutamic acid decarboxylase antibodies (GADAs) positive) and 764 cases of type 2 diabetes (GADA negative), and 1012 randomly selected controls aged ?35. Logistic regression was used to estimate the odds ratios (ORs) of diabetes in relation to alcohol intake, adjusted for age, sex, BMI, family history of diabetes, smoking, and education. Results Alcohol consumption was inversely associated with the risk of type 2 diabetes (OR 0.95, 95% CI 0.92–0.99 for every 5-g increment in daily intake). Similar results were observed for LADA, but stratification by median GADA levels revealed that the results only pertained to LADA with low GADA levels (OR 0.85, 95% CI 0.76–0.94/5?g alcohol per day), whereas no association was observed with LADA having high GADA levels (OR 1.00, 95% CI 0.94–1.06/5?g per day). Every 5-g increment of daily alcohol intake was associated with a 10% increase in GADA levels (P=0.0312), and a 10% reduction in homeostasis model assessment of insulin resistance (P=0.0418). Conclusions Our findings indicate that alcohol intake may reduce the risk of type 2 diabetes and type 2-like LADA, but has no beneficial effects on diabetes-related autoimmunity. PMID:25117461

Rasouli, Bahareh; Andersson, Tomas; Carlsson, Per-Ola; Dorkhan, Mozhgan; Grill, Valdemar; Groop, Leif; Martinell, Mats; Tuomi, Tiinamaja; Carlsson, Sofia

2014-01-01

163

Psoriatic Arthritis and Diabetes: A Population-Based Cross-Sectional Study  

PubMed Central

Background. Diabetes has been associated with psoriasis, but little is known about the association between psoriatic arthritis and diabetes. Methods. Patients diagnosed with psoriatic arthritis by a rheumatologist were compared to age- and sex-matched patients without psoriatic arthritis regarding the prevalence of diabetes in a population-based cross-sectional study using logistic multivariate models. The study was performed utilizing the medical database of Clalit, the largest healthcare provider organization in Israel. Results. The study included 549 patients with psoriatic arthritis ?21 years and 1,098 patients without psoriatic arthritis. The prevalence of diabetes in patients with psoriatic arthritis was increased as compared to the prevalence in patients without psoriatic arthritis (15.3%?versus 10.7%, P value = 0.008). The difference was prominent among females (18.7%?versus 10.3%, P < 0.001) but not among males (11.2% in patients with and without psoriatic arthritis, P = 1.000). In a multivariate analysis, psoriatic arthritis was associated with diabetes among females (OR = 1.60, 95% CI:?1.02–2.52, P = 0.040) but not among males (OR = 0.71, 95% CI:?0.42–1.22, P = 0.213). Conclusion. Our study suggests a possible association between psoriatic arthritis and diabetes in women. Women with psoriatic arthritis might be candidates for diabetes screening. PMID:23843781

Dreiher, Jacob; Freud, Tamar; Cohen, Arnon D.

2013-01-01

164

Psoriatic arthritis and diabetes: a population-based cross-sectional study.  

PubMed

Background. Diabetes has been associated with psoriasis, but little is known about the association between psoriatic arthritis and diabetes. Methods. Patients diagnosed with psoriatic arthritis by a rheumatologist were compared to age- and sex-matched patients without psoriatic arthritis regarding the prevalence of diabetes in a population-based cross-sectional study using logistic multivariate models. The study was performed utilizing the medical database of Clalit, the largest healthcare provider organization in Israel. Results. The study included 549 patients with psoriatic arthritis ?21 years and 1,098 patients without psoriatic arthritis. The prevalence of diabetes in patients with psoriatic arthritis was increased as compared to the prevalence in patients without psoriatic arthritis (15.3%?versus 10.7%, P value = 0.008). The difference was prominent among females (18.7%?versus 10.3%, P < 0.001) but not among males (11.2% in patients with and without psoriatic arthritis, P = 1.000). In a multivariate analysis, psoriatic arthritis was associated with diabetes among females (OR = 1.60, 95% CI:?1.02-2.52, P = 0.040) but not among males (OR = 0.71, 95% CI:?0.42-1.22, P = 0.213). Conclusion. Our study suggests a possible association between psoriatic arthritis and diabetes in women. Women with psoriatic arthritis might be candidates for diabetes screening. PMID:23843781

Dreiher, Jacob; Freud, Tamar; Cohen, Arnon D

2013-01-01

165

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. PMID:21880233

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

166

Passive smoke exposure and risk of diabetes: a meta-analysis of prospective studies.  

PubMed

Epidemiological evidence suggests that passive smoke exposure is related to the development of diabetes. However, data on this issue are controversial. We conducted a meta-analysis to provide a quantitative assessment of the association between passive smoking and the risk of diabetes. We searched the Medline and Embase databases up to October 2013 to identify prospective cohort studies related to passive smoke exposure and incident diabetes. Summary effect estimates with 95 % confidence intervals (CI) were derived using a fixed or random effects model, depending on the heterogeneity of the included studies. Six prospective studies that span three continents involving 154,406 participants (ages 18-74) with 7,116 new diabetes cases were included in the meta-analysis. On the basis of the Newcastle Ottawa Scale system, five studies were identified as relatively high-quality. In our primary analysis, compared to never smokers without passive smoke exposure, never smokers reporting passive smoke exposure was associated with increased risk of diabetes (pooled relative risk 1.21, 95 % CI 1.07-1.38). Such association persisted in the dose-response analysis. No indications of significant heterogeneity and publication bias were detected. Estimates of total effects were generally consistent in the sensitivity and subgroup analyses. Findings of the present meta-analysis suggest that passive smoke exposure is independently associated with the risk of diabetes. The conclusion may have a far-reaching significance for public health in countries of high smoking intensity and high incident diabetes. PMID:24532101

Sun, Kan; Liu, Dan; Wang, Chuan; Ren, Men; Yang, Chuan; Yan, Li

2014-11-01

167

Management of diabetes mellitus and associated cardiovascular risk factors in Brazil - the Brazilian study on the practice of diabetes care  

PubMed Central

Background The Brazilian Study on the Practice of Diabetes Care main objective was to provide an epidemiological profile of individuals with type 1 and 2 diabetes mellitus (DM) in Brazil, concerning therapy and adherence to international guidelines in the medical practice. Methods This observational, cross-sectional, multicenter study collected and analyzed data from individuals with type 1 and 2 DM attending public or private clinics in Brazil. Each investigator included the first 10 patients with type 2 DM who visited his/her office, and the first 5 patients with type 1 DM. Results A total of 1,358 patients were analyzed; 375 (27.6%) had type 1 and 983 (72.4%) had type 2 DM. Most individuals were women, Caucasian, and private health care users. High prevalence rates of hypertension, dyslipidemia and central obesity were observed, particularly in type 2 DM. Only 7.3% and 5.1% of the individuals with types 1 and 2 DM, respectively, had optimal control of blood pressure, plasma glucose and lipids. The absence of hypertension and female sex were associated with better control of type 1 DM and other cardiovascular risk factors. In type 2 DM, older age was also associated with better control. Conclusions Female sex, older age, and absence of hypertension were associated with better metabolic control. An optimal control of plasma glucose and other cardiovascular risk factors are obtained only in a minority of individuals with diabetes. Local numbers, compared to those from other countries are worse. PMID:23972112

2013-01-01

168

A genome-wide search for type 2 diabetes susceptibility genes in West Africans: the Africa America Diabetes Mellitus (AADM) Study.  

PubMed

The incidence of type 2 diabetes is growing rapidly, not only in developed countries but also worldwide. We chose to study type 2 diabetes in West Africa, where diabetes is less common than in the U.S., reasoning that in an environment where calories are less abundant, incident cases of type 2 diabetes might carry a proportionately greater genetic component. Through the Africa America Diabetes Mellitus (AADM) study, we carried out a genome-wide linkage analysis of type 2 diabetes in a cohort of 343 affected sibling pairs (691 individuals) enrolled from five West African centers in two countries (Ghana: Accra and Kumasi; Nigeria: Enugu, Ibadan, and Lagos). A total of 390 polymorphic markers were genotyped, and multipoint linkage analysis was conducted using the GENEHUNTER-PLUS and ASM programs. Suggestive evidence of linkage was observed in four regions on three chromosomes (12, 19, and 20). The two largest logarithm of odds scores of 2.63 and 1.92 for chromosomes 20q13.3 and 12q24, respectively, are particularly interesting because these regions have been reported to harbor diabetes susceptibility genes in several other populations and ethnic groups. Given the history of forced migration of West African populations during the slave trade, these results should have considerable relevance to the study of type 2 diabetes in African Americans. PMID:14988271

Rotimi, Charles N; Chen, Guanjie; Adeyemo, Adebowale A; Furbert-Harris, Paulette; Parish-Gause, Debra; Zhou, Jie; Berg, Kate; Adegoke, Olufemi; Amoah, Albert; Owusu, Samuel; Acheampong, Joseph; Agyenim-Boateng, Kofi; Eghan, Benjamin A; Oli, Johnnie; Okafor, Godfrey; Ofoegbu, Ester; Osotimehin, Babatunde; Abbiyesuku, Fayeofori; Johnson, Thomas; Rufus, Theresa; Fasanmade, Olufemi; Kittles, Rick; Daniel, Harold; Chen, Yuanxiu; Dunston, Georgia; Collins, Francis S; Guass, Debra

2004-03-01

169

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

170

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. PMID:24991802

Tseng, Chin-Hsiao

2014-01-01

171

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 PMID:24656118

2014-01-01

172

Diabetes Care, Glycemic Control, Complications, and Concomitant Autoimmune Diseases in Children with Type 1 Diabetes in Turkey: A Multicenter Study  

PubMed Central

Objective: Epidemiologic and clinical features of type 1 diabetes mellitus (T1DM) may show substantial differences among countries. The primary goal in the management of T1DM is to prevent micro- and macrovascular complications by achieving good glycemic control. The present study aimed to assess metabolic control, presence of concomitant autoimmune diseases, and of acute and long-term complications in patients diagnosed with T1DM during childhood and adolescence. The study also aimed to be a first step in the development of a national registry system for T1DM, in Turkey. Methods: Based on hospital records, this cross-sectional, multicenter study included 1 032 patients with T1DM from 12 different centers in Turkey, in whom the diagnosis was established during childhood. Epidemiological and clinical characteristics of the patients were recorded. Metabolic control, diabetes care, complications, and concomitant autoimmune diseases were evaluated. Results: Mean age, diabetes duration, and hemoglobin A1c level were 12.5±4.1 years, 4.7±3.2 years, and 8.5±1.6%, respectively. Acute complications noted in the past year included ketoacidosis in 5.2% of the patients and severe hypoglycemia in 4.9%. Chronic lymphocytic thyroiditis was noted in 12%, Graves’ disease in 0.1%, and celiac disease in 4.3% of the patients. Chronic complications including neuropathy, retinopathy, and persistent microalbuminuria were present in 2.6%, 1.4%, and 5.4% of the patients, respectively. Diabetic nephropathy was not present in any of the patients. Mean diabetes duration and age of patients with neuropathy, retinopathy and microalbuminuria were significantly different from the patients without these long-term complications (p<0.01). A significant difference was found between pubertal and prepubertal children in terms of persistent microalbuminuria and neuropathy (p=0.02 and p<0.001, respectively). Of the patients, 4.4% (n:38) were obese and 5% had short stature; 17.4% of the patients had dyslipidemia, and 14% of the dyslipidemic patients were obese. Conclusions: Although the majority of the patients in the present study were using insulin analogues, poor glycemic control was common, and chronic complications were encountered. Conflict of interest:None declared. PMID:23419424

Simsek, Damla Goksen; Aycan, Zehra; Ozen, Samim; Cetinkaya, Semra; Kara, Cengiz; Abal?, Sayg?n; Demir, Korcan; Tunc, Ozgul; Ucakturk, Ahmet; Asar, Gulgun; Bas, Firdevs; Cetinkaya, Ergun; Ayd?n, Murat; Karaguzel, Gulay; Orbak, Zerrin; Orbak, Zerrin; S?klar, Zeynep; Alt?nc?k, Ayca; Okten, Aysenur; Ozkan, Behzat; Ocal, Gonul; Semiz, Serap; Arslanoglu, Ilknur; Evliyaoglu, Olcay; Bundak, Ruveyde; Darcan, Sukran

2013-01-01

173

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

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. PMID:24126768

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

2013-01-01

174

EDF field operation computerization study  

SciTech Connect

The main control room has been the subject of extensive research and actions into improved operations assistance. On the other hand, few studies concern the need for field operation improvements, which have few assistance resources adapted to working requirements. Why? Past studies have shown the inability of technology to assume job constraints (insufficient screen readability, excessive equipment weight, prohibitive response times). Nevertheless, today new technologies can be adapted to field operations, and they justify further study. Real needs exist: local operations are often complex and are led in difficult environments where conditions prevent the use of paper-based documents. The issue is a significant risk of error which might impact plant reliability. The cumbersome nature of paper procedures, the working environment and the operational feed-back of experience led us to concentrate on the field operation to identify how it may be improved by the use of these new technologies. Such equipment would allow a better traceability and quality of actions. Possibility of communications with other plant personnel and information sharing may be also immediately available for all. This paper presents a study which intends to collect assistance requirements through an analysis of working practices and organizations with local personnel. Our aim is to identify which of those might benefit from IT support. This collection was obtained through interviews and observations. These two methods helped us to define potential needs, constraints and consequences for work organization. This paper presents the study results and findings, identifies professions which may benefit from the use of wearable computers and describes how the reliability and efficiency of human actions would be improved. Finally we identify design requirements and criteria to be used for writing the technical specifications for a test prototype. (authors)

Guillot, L.; Pirus, D. [EDF SEPTEN, Service Etudes et Projets Thermiques et Nucleaires, 12-14, Avenue Dutrievoz, 69628 Villeurbanne Cedex (France)

2006-07-01

175

Day and Night Home Closed-Loop Insulin Delivery in Adults with Type 1 Diabetes: Three Centre Randomised Crossover Study  

E-print Network

/l (hyperglycaemia), low and high blood glucose index and insulin delivery. We estimated glycaemic variability by the standard deviation of glucose and the coefficient of variation. The low and high blood glucose index assessing the duration and extent of hypo... differences in pediatric diabetes care: do advances in diabetes treatment improve outcome? The Hvidoere Study Group on Childhood Diabetes. Diabetes Care 2007;30:2245-2250 3. Hoerger TJ, Segel JE, Gregg EW, Saaddine JB: Is glycemic control improving in U...

Leelarathna, Lalantha; Dellweg, Sibylle; Mader, Julia K.; Allen, Janet M.; Benesch, Carsten; Doll, Werner; Ellmerer, Martin; Hartnell, Sara; Heinemann, Lutz; Kojzar, Harald; Michalewski, Lucy; Nodale, Marianna; Thabit, Hood; Wilinska, Malgorzata E.; Pieber, Thomas R.; Arnolds, Sabine; Evans, Mark L.; Hovorka, Roman

176

Complex Relationship Between Blood Pressure and Mortality in Type 2 Diabetic Patients A Follow-Up of the Botnia Study  

Microsoft Academic Search

The presence of hypertension aggravates the high cardiovascular risk in type 2 diabetic patients. Pulse pressure is a marker of arterial stiffness and constitutes a risk factor for cardiovascular mortality. This study examines the relationship between different blood pressure indices and mortality in a cohort of type 2 diabetic patients. A total of 1294 type 2 diabetic patients with a

Mats Ronnback; Bo Isomaa; Johan Fagerudd; Carol Forsblom; Per-Henrik Groop

177

Utility of genetic and non-genetic risk factors in prediction of type 2 diabetes: Whitehall II prospective cohort study  

Microsoft Academic Search

Objectives To assess the performance of a panel of common single nucleotide polymorphisms (genotypes) associated with type 2 diabetes in distinguishing incident cases of future type 2 diabetes (discrimination), and to examine the effect of adding genetic information to previously validated non-genetic (phenotype based) models developed to estimate the absolute risk of type 2 diabetes.Design Workplace based prospective cohort study

Philippa J Talmud; Aroon D Hingorani; Jackie A Cooper; Michael G Marmot; Eric J Brunner; Meena Kumari; Mika Kivimäki; Steve E Humphries

2010-01-01

178

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

179

Vascular health, diabetes, APOE and dementia: The Aging, Demographics, And Memory Study  

E-print Network

Abstract Introduction Evidence from clinical samples and geographically limited population studies suggests that vascular health, diabetes and apolipoprotein ?4 (APOE) are associated with dementia. Methods A population-based sample of 856...

Llewellyn, David J; Lang, Iain A; Matthews, Fiona E; Plassman, Brenda L; Rogers, Mary A M; Morgenstern, Lewis B; Fisher, Gwenith G; Kabeto, Mohammed U; Langa, Kenneth M

2010-06-24

180

Weight-Loss Surgery Lowers Type 2 Diabetes Risk, Study Shows  

MedlinePLUS

... suggest that bariatric surgery may be a highly effective method of preventing the onset of new diabetes in men and women with severe obesity," study author Martin Gulliford, a professor of public health ...

181

Gene Study Finds No Proof Vitamin D Guards Against Type 2 Diabetes  

MedlinePLUS

... sharing features on this page, please enable JavaScript. Gene Study Finds No Proof Vitamin D Guards Against ... 1, 2014 Related MedlinePlus Pages Diabetes Type 2 Genes and Gene Therapy Vitamin D TUESDAY, Sept. 30, ...

182

Elevated glycosylated hemoglobin is associated with subclinical neuropathy in neurologically asymptomatic diabetic patients: a prospective study.  

PubMed

The association between poorly controlled diabetes and higher risk of polyneuropathy is well established. The American Diabetes Association recommends that glycosylated hemoglobin (HbA1c) should be less than 7%. Most previous studies, which reported HbA1c correlation with polyneuropathy, used higher HbA1c cut points and focused on neurologically symptomatic patients. This study evaluated the correlation of HbA1c levels, using the 7% cut point, with abnormal nerve conduction studies in diabetic patients in the subclinical stage of polyneuropathy. Fifty neurologically asymptomatic diabetic patients were included. HbA1c was measured at time of inclusion and 3 months later followed by nerve conduction studies. Univariate and multivariate analyses with logistic regression models were used to study the association of different patient characteristics with abnormal nerve conduction studies. Fifteen women and 35 men were studied. Half of patients had elevated HbA1c and half had HbA1c <7%. Twenty-six patients (52%) had subclinical neuropathy (18 men, 8 women). In multivariate analysis, HbA1c was the most important factor predicting higher risk of subclinical neuropathy [adjusted odds ratio 10.71 (2.49, 46.01), P < 0.005]. Therefore, nerve conduction studies abnormalities commonly exist in diabetic patients in the subclinical stages of polyneuropathy, and are highly correlated to HbA1c levels. Therapies for diabetic neuropathy should target the early stages of the disease. PMID:19151611

El-Salem, Khalid; Ammari, Fawaz; Khader, Yousef; Dhaimat, Omar

2009-02-01

183

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

184

Alcohol Consumption and the Risk of Type 2 Diabetes Mellitus: Atherosclerosis Risk in Communities Study  

Microsoft Academic Search

Evidence regarding the association between alcohol consumption and type 2 diabetes risk remains inconsistent, particularly with regard to male-female differences. The authors conducted a prospective study of type 2 diabetes risk associated with alcohol consumption in a cohort of 12,261 middle-aged participants of the Atherosclerosis Risk in Communities Study (1990-1998), who were followed between 3 and 6 years. Alcohol consumption

W. H. Linda Kao; Ian B. Puddey; Lori L. Boland; Robert L. Watson; Frederick L. Brancati

2001-01-01

185

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.

186

Diabetes Prevention Program (DPP)  

MedlinePLUS

... Statistics Research Resources Order About Us Español National Diabetes Information Clearinghouse Publications Tools and Resources E-News ... List of Topics and Titles : Diabetes Prevention Program Diabetes Prevention Program (DPP) On this page: DPP Study ...

187

Waist-to-Hip Ratio, Dyslipidemia, Glycemic Levels, Blood Pressure and Depressive Symptoms among Diabetic and Non-Diabetic Chinese Women: A Cross-Sectional Study  

PubMed Central

Objectives To explore the relationship between depressive symptoms and waist-to-hip ratio, dyslipidemia, glycemic levels or blood pressure among diabetic and non-diabetic Chinese women. Methods 11,908 women aged ?40 years were enrolled in this cross-sectional study, including 2,511 with type 2 diabetes and 9,397 without. Depressive symptoms (defined as having mild-to-severe depressive symptoms) were assessed by the Patient Health Questionnaire-9 (PHQ-9) diagnostic algorithm. The prevalence and the odds ratios (ORs) with 95% confidence intervals (CIs) for having depressive symptoms were estimated using logistic regression analysis. Results The age-adjusted prevalence of depressive symptoms was significantly higher in non-diabetic subjects with waist-to-hip ratio (WHR) ?0.9 (8.6%, age-adjusted OR 1.51 [95% CI 1.17, 1.95]), total cholesterol (TC)>6.22 mmol/L (8.8%, 1.58 [1.16, 2.15]), and Hemoglobin A1c (HbA1c) ?6.00 mmol/L (7.7%, 1.69 [1.34, 2.14]), while it was significantly lower in non-diabetic subjects with diastolic blood pressure (DBP) between 80 to 89 mmHg (6.2%, 0.78 [0.64, 0.95]). These relationships remained significant even after controlling for multiple factors (WHR ?0.9: multivariable-adjusted OR 1.39 [95% CI 1.07, 1.80]; TC>6.22 mmol/L: 1.56 [1.14, 2.12]; HbA1c ?6.00 mmol/L: 1.64 [1.30, 2.08]; DBP 80-89 mmHg: 0.78 [0.64, 0.95]). However, no significant trend between depressive symptoms and WHC, TC, HbA1c, DBP was observed in diabetic women, and no significant trend relationship between depressive symptoms and BMI, WC, TG, or SBP was observed in both non-diabetic and diabetic women. Moreover, the prevalence of depressive symptoms was significantly higher in previously-diagnosed diabetes, compared with non-diabetic subjects, while no significant differences were observed between newly-diagnosed diabetes and non-diabetic subjects. Conclusion The present study showed a relationship between WHR, TC, HbA1c, DBP and depressive symptoms among non-diabetic women, while no significant relationship between them was observed among diabetic women, even after controlling for multiple confounding factors. PMID:25314156

Zheng, Yu; Sun, Qihong; Chen, Kang; Yan, Wenhua; Pan, Changyu; Lu, Juming; Dou, Jingtao; Lu, Zhaohui; Jianming, Ba; Wang, Baoan; Mu, Yiming

2014-01-01

188

PAI-1 -675 4G/5G polymorphism in association with diabetes and diabetic complications susceptibility: a meta-analysis study.  

PubMed

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. PMID:24223897

Xu, Kuanfeng; Liu, Xiaoyun; Yang, Fan; Cui, Dai; Shi, Yun; Shen, Chong; Tang, Wei; Yang, Tao

2013-01-01

189

Knowing the ABCs: A Comparative Effectiveness Study of Two Methods of Diabetes Education  

PubMed Central

Objective To test an active-learning, empowerment approach to teaching patients about the “diabetes ABCs” (hemoglobin A1C, systolic blood pressure, and low density lipoprotein cholesterol). Methods 84 (97%) diabetic patients who participated in a randomized effectiveness trial of two clinic-based group educational methods and completed a post-intervention assessment. The empowerment arm participated in a group session that incorporated two educational innovations (a conceptual metaphor to foster understanding, and team-based learning methods to foster active learning). The traditional diabetes education arm received a didactic group session focused on self-management and educational materials about the diabetes ABCs. Participants in both arms received individual review of their current ABC values. Results A questionnaire evaluated knowledge, understanding, and recall of the diabetes ABCs was administered three months after enrollment in the study. At three months, participants in the empowerment group demonstrated greater understanding of the diabetes ABCs (P<.0001), greater knowledge of their own values (P<.0001), and greater knowledge of guideline-derived target goals for the ABCs compared with participants in the traditional arm (P<.0001). Conclusion An active-learning, empowerment-based approach applied to diabetes education can lead to greater understanding and knowledge retention. Practice Implications An empowerment approach to education can facilitate informed, activated patients and increase performance of self-management behaviors. PMID:21300516

Naik, Aanand D.; Teal, Cayla R.; Rodriguez, Elisa; Haidet, Paul

2011-01-01

190

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. PMID:24495515

2014-01-01

191

Correlation of abdominal adiposity with components of metabolic syndrome, anthropometric parameters and Insulin resistance, in obese and non obese, diabetics and non diabetics: A cross sectional observational study. (Mysore Visceral Adiposity in Diabetes Study)  

PubMed Central

Objectives: To measure Visceral Fat (VF) and Subcutaneous Fat (SCF) by ultrasound, in obese and non-obese diabetics and obese and non-obese non diabetics, in a South Indian (Asian Indian) Population and correlate them with Body Mass Index (BMI), Waist Circumference (WC), components of metabolic syndrome and Insulin Resistance (IR) Research Design and Methods: This was a prospective observational study, 80 diabetics (40 obese and 40 non obese) and 80 non diabetics (40 obese and 40 non obese) a total of 160 subjects were enrolled, out of whom 153 completed the study. The subjects were evaluated with respect to BMI, WC, Blood Pressure (BP); Fasting Blood Sugar (FBS) Fasting Insulin levels (FIL), HbA1C and Lipid profile. The SCF and VF were measured by Ultrasonography.The results were statistically analyzed. Results: WC correlated significantly with VF in all the groups. Diabetics had more VF compared to non-diabetics. Insulin resistance was significant in all the groups; however diabetics had greater levels of IR, BMI, WC, VF and SCF had no correlation with IR and had no significant correlation with metabolic parameters. Conclusions: In this study population, WC was found to be a useful surrogate measure of VF conforming to its well established applicability in other populations. Contrary to other studies elsewhere, SCF and VF were found to be poor indicators of Insulin Resistance. BMI, WC, VF and SCF were not useful in the prediction of metabolic syndrome. Ultrasound was found to be an easier and economic method of measuring abdominal adiposity and actual measurement of abdominal fat was more informative than anthropometric measurements.

Premanath, M.; Basavanagowdappa, H.; Mahesh, M.; Suresh, M.

2014-01-01

192

Nerve biopsy and conduction studies in diabetic neuropathy  

Microsoft Academic Search

Morphological findings in sural nerves were related to nerve conduction in 12 patients with diabetic neuropathy, five with mainly sensory involvement, four with severe, symmetrical sensory-motor polyneuropathy, and three with multiple mononeuropathy. All had loss of large and small myelinated and of unmyelinated fibres, even early in the disease; segmental remyelination was the most prominent myelin alteration in teased fibres,

F Behse; F Buchthal; F Carlsen

1977-01-01

193

Health according to the experiences of Iranian women with diabetes: a phenomenological study.  

PubMed

This study explores the meaning of health among Iranian women with diabetes using hermeneutic phenomenology based on Van Manen's approach. A total of 19 women with diabetes who were referred to the Diabetes Center of Imam Khomeini hospital in Ardabil, Iran were recruited using a purposive sampling method. Data were gathered through semi-structured interviews. Each interview was transcribed verbatim and analyzed simultaneously. Data analysis led to the emergence of five main themes: a God-centered life, health as a precious possession, health as wellbeing, independence, and acceptance. Patients often described coping with their illnesses and pursuing lifestyle changes by applying their spiritual and religious beliefs. The findings of this study can be used by healthcare teams to revise their opinions about patients with diabetes according to the culture of their patients. PMID:22329528

Aghamohammadi-Kalkhoran, Masoumeh; Valizadeh, Sousan; Mohammadi, Eesa; Ebrahimi, Hossein; Karimollahi, Mansoureh

2012-09-01

194

[Study on the frequency of caries and associated factors in type 1 diabetes mellitus].  

PubMed

Subjects with diabetes mellitus (DM) are more prone to certain disturbances of oral cavity but there are controversies concerning caries. This cross-sectional study investigated the frequency of caries and associated factors, in a sample of population with or without type 1 DM, including non-diabetic (53 women, 31 men) and 30 diabetic subjects (19 women, 11 men) aged 17-28 years. Diagnosis of dental caries was based on the DMF-T index (D= decay; M= miss; F= fill; T= teeth); in addition, a plaque control record (PCR) was obtained. A preponderance of female sex was found within the groups studied but such proportions did not differ when comparing diabetic and non-diabetic groups. Mean ages were 21.0 +/- 2.2 and 19.5+/-1.8 years, respectively for subjects without and with DM (p< 0.05). Education level was higher in the non-diabetic group as well as the DMF-T index (10.5 +/-5.8 vs. 6.7+/-5.7, p< 0.01). Linear regression analysis (n= 114) showed significant associations of DMF-T with age, sucrose intake, daily frequency of tooth brushing, of dental floss use, PCR and of visits to the dentist. By ANOVA model with age as a covariate the non-diabetic condition (p= 0.047), sucrose index and PCR (r(2)= 0.820) were independently associated with the DMF-T. In the diabetic-specific model, with only the diabetic subjects included and sucrose index as a covariate, DM duration, fundus abnormality and PCR were significantly associated with the presence of caries (r(2)= 0.816). The sample of type 1 diabetic subjects suggest that they are less prone to caries than non-diabetics, despite having a higher frequency of meals, less tooth brushing and dental floss use. We speculate that DM duration may contribute to the occurrence of caries and restricted sucrose consumption to lower frequency of caries in diabetic subjects. PMID:16936993

do Amaral, Fábio M Franco; Ramos, Patrícia G de A; Ferreira, Sandra Roberta G

2006-06-01

195

DCCT and EDIC Studies in Type 1 Diabetes: Lessons for Diabetic Neuropathy Regarding Metabolic Memory and Natural History  

Microsoft Academic Search

The DCCT\\/EDIC (Diabetes Control and Complications Trial\\/ Epidemiology of Diabetes Interventions and Complications) provides\\u000a a comprehensive characterization of the natural history of diabetic neuropathy in patients with type 1 diabetes and provides\\u000a insight into the impact of intensive insulin therapy in disease progression. The lessons learned about the natural history\\u000a of distal symmetrical polyneuropathy and cardiovascular autonomic neuropathy and the

Rodica Pop-Busui; William H. Herman; Eva L. Feldman; Phillip A. Low; Catherine L. Martin; Patricia A. Cleary; Barbara H. Waberski; John M. Lachin; James W. Albers

2010-01-01

196

Caffeine, diabetes, cognition, and dementia.  

PubMed

People with diabetes mellitus are at increased risk of cognitive dysfunction. This review explores the relation between caffeine intake, diabetes, cognition and dementia, focusing on type 2 diabetes (T2DM). Epidemiological studies on caffeine/coffee intake and T2DM risk are reviewed. Next, the impact of T2DM on cognition is addressed. Finally, the potential for caffeine to modulate the risk of cognitive decline in the context of diabetes is explored. The conclusion is that, although epidemiological studies indicate that coffee/caffeine consumption is associated with a decreased risk of T2DM and possibly also with a decreased dementia risk, we can at present not be certain that these associations are causal. For now, recommendations for coffee consumption in individuals with T2DM or pre-diabetic stages are therefore difficult to establish, but it should be acknowledged that caffeine does appear to have several properties that warrant further investigations in this field. PMID:20182038

Biessels, Geert Jan

2010-01-01

197

Cadmium Exposure and Incidence of Diabetes Mellitus - Results from the Malmö Diet and Cancer Study  

PubMed Central

Background Cadmium is a pollutant with multiple adverse health effects: renal dysfunction, osteoporosis and fractures, cancer, and probably cardiovascular disease. Some studies have reported associations between cadmium and impaired fasting glucose and diabetes. However, this relationship is controversial and there is a lack of longitudinal studies. Objectives To examine prospectively whether cadmium in blood is associated with incidence of diabetes mellitus. Methods The study population consists of 4585 subjects without history of diabetes (aged 46 to 67 years, 60% women), who participated in the Malmö Diet and Cancer study during 1991–1994. Blood cadmium levels were estimated from hematocrit and cadmium concentrations in erythrocytes. Incident cases of diabetes were identified from national and local diabetes registers. Results Cadmium concentrations in blood were not associated with blood glucose and insulin levels at the baseline examination. However, cadmium was positively associated with HbA1c in former smokers and current smokers. During a mean follow-up of 15.2±4.2 years, 622 (299 men and 323 women) were diagnosed with new-onset of diabetes. The incidence of diabetes was not significantly associated with blood cadmium level at baseline, neither in men or women. The hazard ratio (4th vs 1st quartile) was 1.11 (95% confidence interval 0.82–1.49), when adjusted for potential confounders. Conclusions Elevated blood cadmium levels are not associated with increased incidence of diabetes. The positive association between HbA1c and blood cadmium levels has a likely explanation in mechanisms related to erythrocyte turnover and smoking. PMID:25393737

Borné, Yan; Fagerberg, Björn; Persson, Margaretha; Sallsten, Gerd; Forsgard, Niklas; Hedblad, Bo; Barregard, Lars; Engström, Gunnar

2014-01-01

198

with Diabetes With Diabetes  

E-print Network

with Diabetes Dining A Program For People With Diabetes And Their Families Now is the time to take charge of your diabetes. What is diabetes? Diabetes is a common, serious, and costly disease. The Centers for Disease Control and Prevention (CDC) has reported that diabetes is the 6th leading cause of death

199

Beliefs about racism and health among African American women with diabetes: a qualitative study.  

PubMed

Exposure to racism has been linked to poor health outcomes. Little is known about the impact of racism on diabetes outcomes. This study explored African American women's beliefs about how racism interacts with their diabetes self-management and control. Four focus groups were conducted with a convenience sample of 28 adult African American women with type 2 diabetes who were recruited from a larger quantitative study on racism and diabetes. The focus group discussions were transcribed verbatim and analyzed by the authors. Women reported that exposure to racism was a common phenomenon, and their beliefs did in fact link racism to poor health. Specifically, women reported that exposure to racism caused physiological arousal including cardiovascular and metabolic perturbations. There was consensus that physiological arousal was generally detrimental to health. Women also described limited, and in some cases maladaptive, strategies to cope with racist events, including eating unhealthy food choices and portions. There was consensus that the subjective nature of perceiving racism and accompanying social prohibitions often made it impossible to address racism directly. Many women described anger in such situations and the tendency to internalize anger and other negative emotions, only to find that the negative emotions would be reactivated repeatedly with exposure to novel racial stressors, even long after the original racist event remitted. African American women in this study believed that racism affects their diabetes self-management and control. Health beliefs can exert powerful effects on health behaviors and may provide an opportunity for health promotion interventions in diabetes. PMID:21528110

Wagner, Julie A; Osborn, Chandra Y; Mendenhall, Emily A; Budris, Lisa M; Belay, Sophia; Tennen, Howard A

2011-03-01

200

The impact of knowledge about diabetes, resilience and depression on glycemic control: a cross-sectional study among adolescents and young adults with type 1 diabetes  

PubMed Central

Background The purpose of this study is to evaluate the relationship between glycemic control and the factors of knowledge about diabetes, resilience, depression and anxiety among Brazilian adolescents and young adults with type 1 diabetes. Methods This cross-sectional study included 85 adolescents and young adults with type 1 diabetes, aged between 11–22 years, with an average age of 17.7?±?3.72 years. Glycemic control degree was evaluated through HbA1c. To assess psychosocial factors, the following questionnaires were used: resilience (Resilience Scale, RS) and anxiety and depression (Hospital Anxiety and Depression Scale, HADS). The Diabetes Knowledge Assessment Scale (DKNA) was used to assess knowledge about diabetes. Results Significant correlations were found between HbA1c and resilience, anxiety and depression. Multiple linear regression analysis revealed that the only variable which presented significant association with the value of HbA1c was depression. Conclusions Depression has a significant association with higher HbA1c levels, as demonstrated in a regression analysis. The results suggest that depression, anxiety and resilience should be considered in the design of a multidisciplinary approach to type 1 diabetes, as these factors were significantly correlated with glycemic control. Glycemic control was not correlated with knowledge of diabetes, suggesting that theoretical or practical understanding of this disease is not by itself significantly associated with appropriate glycemic control (HbA1c???7.5%). PMID:24289093

2013-01-01

201

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. PMID:24298485

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

2013-01-01

202

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

203

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. PMID:24082980

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

2013-01-01

204

A pilot study of motivational interviewing in adolescents with diabetes  

Microsoft Academic Search

Aims: To obtain preliminary data on the impact of motivational interviewing, a counselling approach to behaviour change, on glycaemic control, wellbeing, and self-care of adolescents with diabetes.Methods: Twenty two patients aged 14–18 years participated in motivational interviewing sessions during a six month intervention. The effects of the intervention on HbA1c and a range of psychological factors were assessed.Results: Mean HbA1c

S Channon; V J Smith; J W Gregory

2003-01-01

205

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. PMID:18413171

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

2009-01-01

206

Cardiogenic diabetes.  

PubMed

It has been well established since the Framingham studies that diabetes mellitus is a risk factor for heart failure. Several recent reports suggested that the reverse is also true, and heart failure may also predispose to diabetes. We reviewed the literature and summarized the evidence of a higher incidence of new-onset diabetes in heart failure. Because a high rate of insulin resistance in heart failure is a known phenomenon, a higher incidence of diabetes in heart failure is intuitive. Although the facts confirming such connection is surprisingly scarce, we felt it was important to collect, analyze, and summarize the evidence. PMID:24174218

Guglin, Maya; Villafranca, Arnaldo; Morrison, Anthony

2014-09-01

207

Which diet for prevention of type 2 diabetes? A meta-analysis of prospective studies.  

PubMed

No specific diet is recommended to prevent type 2 diabetes. We did a meta-analysis of prospective cohort studies to assess the association between different diets and prevention of type 2 diabetes. We did a comprehensive search of multiple electronic databases (Medline, Scopus, EMBASE, and ISI web of knowledge) until August 2013 using predefined criteria. We included prospective cohort studies that evaluated the role of different diets in type 2 diabetes prevention. Studies were selected by 2 independent reviewers. We did random-effects meta-analyses to determine the relative risk (RR) of incident diabetes associated with healthful dietary patterns. A total of 21,372 cases of incident diabetes, from 18 prospective studies, with 20 cohorts, in 4 world regions were identified. In the random-effect meta-analysis of the 20 cohorts, RR was 0.80 (95 % confidence interval (CI) = 0.74-0.86, P < 0.001), with high heterogeneity (I (2) = 57 %, P = 0.001) and no evidence of publication bias (Egger's test, P = 0.653). Exclusion of two cohorts produced identical RR (0.80, 95 % CI 0.76-0.84), with nonsignificant heterogeneity (I (2) = 9 %). The risk of incident diabetes did not appreciably change considering the geography (USA, Europe, and Asia), the duration of follow-up (?10 and >10 years), and type of diets (Mediterranean and DASH, Dietary Approaches to Stop Hypertension, diets). There was a difference between at risk and general population (P = 0.0487), but the evidence was limited to two studies only. The results of our study demonstrate that several healthy diets are equally and consistently associated with a 20 % reduced risk of future type 2 diabetes. PMID:24744219

Esposito, Katherine; Chiodini, Paolo; Maiorino, Maria Ida; Bellastella, Giuseppe; Panagiotakos, Demosthenes; Giugliano, Dario

2014-09-01

208

Diabetes and Risk of Parkinson's Disease: An Updated Meta-Analysis of Case-Control Studies  

PubMed Central

Background Whether diabetes increases the risk of Parkinson's disease (PD) is still inconclusive. The objective of this updated meta-analysis is to synthesize evidence from case-control studies that evaluated the association between diabetes and the risk of PD. Methods Seven databases were searched to identify case-control studies that evaluated the association between diabetes and PD. The methodological quality of included studies was assessed using Newcastle-Ottawa scale. All data were analyzed using Review Manager 5.1 software. Subgroup analyses were also adopted, according to stratification on gender, geographic location, source of the control group, smoking, anti-diabetes drug prescription and duration of DM. Results Fourteen studies fulfilled inclusion criteria for meta-analysis, yielding a total of 21395 PD patients and 84579 control subjects. Individuals with diabetes were found to have a negative association with future PD (OR 0.75; 95% CI 0.58–0.98) in spite of significant heterogeneity. In subgroup analyses, the negative correlation was still found in studies from North America, non-PD control groups from general population, never smoking individuals, and DM ascertainment based on questionnaire or self-report. Stratification of gender and DM duration showed no significant association. No association was also found in European and Asian individuals, hospital-based controls, ever smoking subjects, DM assessment by medical record or physician diagnosis, and insulin prescription for DM. Conclusion Evidence from case-control studies suggested that diabetic individuals may have a decreased incidence of PD despite significant heterogeneity. More researches are warranted to clarify an understanding of the association between diabetes and risk of PD. PMID:24465703

Lu, Lin; Fu, Deng-lei; Li, Hui-qin; Liu, Ai-ju; Li, Ji-huang; Zheng, Guo-qing

2014-01-01

209

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. PMID:23229017

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

2012-01-01

210

Genome-wide association with diabetes-related traits in the Framingham Heart Study  

PubMed Central

Background Susceptibility to type 2 diabetes may be conferred by genetic variants having modest effects on risk. Genome-wide fixed marker arrays offer a novel approach to detect these variants. Methods We used the Affymetrix 100K SNP array in 1,087 Framingham Offspring Study family members to examine genetic associations with three diabetes-related quantitative glucose traits (fasting plasma glucose (FPG), hemoglobin A1c, 28-yr time-averaged FPG (tFPG)), three insulin traits (fasting insulin, HOMA-insulin resistance, and 0–120 min insulin sensitivity index); and with risk for diabetes. We used additive generalized estimating equations (GEE) and family-based association test (FBAT) models to test associations of SNP genotypes with sex-age-age2-adjusted residual trait values, and Cox survival models to test incident diabetes. Results We found 415 SNPs associated (at p < 0.001) with at least one of the six quantitative traits in GEE, 242 in FBAT (18 overlapped with GEE for 639 non-overlapping SNPs), and 128 associated with incident diabetes (31 overlapped with the 639) giving 736 non-overlapping SNPs. Of these 736 SNPs, 439 were within 60 kb of a known gene. Additionally, 53 SNPs (of which 42 had r2 < 0.80 with each other) had p < 0.01 for incident diabetes AND (all 3 glucose traits OR all 3 insulin traits, OR 2 glucose traits and 2 insulin traits); of these, 36 overlapped with the 736 other SNPs. Of 100K SNPs, one (rs7100927) was in moderate LD (r2 = 0.50) with TCF7L2 (rs7903146), and was associated with risk of diabetes (Cox p-value 0.007, additive hazard ratio for diabetes = 1.56) and with tFPG (GEE p-value 0.03). There were no common (MAF > 1%) 100K SNPs in LD (r2 > 0.05) with ABCC8 A1369S (rs757110), KCNJ11 E23K (rs5219), or SNPs in CAPN10 or HNFa. PPARG P12A (rs1801282) was not significantly associated with diabetes or related traits. Conclusion Framingham 100K SNP data is a resource for association tests of known and novel genes with diabetes and related traits posted at . Framingham 100K data replicate the TCF7L2 association with diabetes. PMID:17903298

Meigs, James B; Manning, Alisa K; Fox, Caroline S; Florez, Jose C; Liu, Chunyu; Cupples, L Adrienne; Dupuis, Josée

2007-01-01

211

The percutaneous permeability and absorption of dexamethasone esters in diabetic rats: a preliminary study.  

PubMed

To evaluate the influence of diabetes on the permeation of dexamethasone acetate (DA) and dexamethansone sodium phosphate (DSP), the two major dexamethansone esters in clinical practice, when applied percutaneously, histochemical staining was used to determine the skin morphology; improved Franz diffusion cells and microdialysis were used to assess the percutaneous permeation of DA and DSP in normal and diabetic rats. Histopathological examination showed that the epidermal tissue of diabetic rat was much thinner, the epidermal cell layer was less clear and the stratified arrangement of epidemic cell had almost disappeared and progressive atrophy were developed on the subcutaneous fat. In vitro studies showed that the cumulative and the penetrated DSP amount in Group DM were higher. The mean flux value and the mean depositional amount of Group DM were increased significantly compared to those of Group CTL, whereas the amount of DA penetrating was of no difference. Microdialysis indicated that there was no significant difference between Group CTL and Group DM for all the pharmacokinetic parameters of DA. In contrast, the subcutaneous AUCall values and the C(max) of DSP were significantly increased compared to the control. In conclusion, diabetic rat skin significantly increased the percutaneous permeation of DSP but had no effect on that of DA. It suggests that patients with diabetes should consider the dose of administration when using DA, DSP or other glucocorticoids topically, as different liposolubilities may play some role in the permeability of these compounds via diabetic skin. PMID:24102159

Li, Sha-Sha; Song, Zhi-Hua; Xiong, Lu-Qi; Zhang, Qing; Liu, Qiang; Li, Guo-Feng

2014-02-01

212

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. PMID:22966090

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

213

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. PMID:21292425

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

2013-01-01

214

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

215

Meats, Processed Meats, Obesity, Weight Gain and Occurrence of Diabetes among Adults: Findings from Adventist Health Studies  

Microsoft Academic Search

Aim: To examine the relation between meat intake and diabetes occurrence in adults. Methods: In a prospective cohort study we examined the relation between diet and incident diabetes recorded among 8,401 cohort members (ages 45–88 years) of the Adventist Mortality Study and Adventist Health Study (California, USA) who were non-diabetic at baseline. During the 17-year follow-up, we identified 543 incident

Arnold Vang; Pramil N. Singh; Jerry W. Lee; Ella H. Haddad; Charles H. Brinegar

2008-01-01

216

Salivary alkaline phosphatase and calcium in caries-active type II diabetes mellitus patients: An in vivo study  

PubMed Central

Background: Diabetes Mellitus is a metabolic syndrome, affecting the oral health in various ways with dental caries being one of the most common problems encountered. Saliva is one of the most abundant secretions in the human body with a variety of natural protective and defence molecules bathing the oral cavity maintaining equilibrium. Its collection is easy and non-invasive. Aims: To compare and evaluate salivary alkaline phosphatase levels and calcium ion levels between caries active type II diabetes mellitus patients and non-diabetics. Materials and Methods: This study was carried out on caries-active age and gender matched 60 non-diabetic and 60 patients with known Type II diabetes mellitus subjects of age group 25-50 years with DMFT index >10. Saliva sample was collected to analyse for alkaline phosphatase enzyme and concentration of calcium ions using Agappe kits. Statistical Analysis: Student ‘t’ test was used to correlate the salivary electrolyte concentration in non- diabetic and diabetic patients with dental caries. A ‘P’ value of 0.05 or less was considered significant. Results are presented as mean ± standard deviation (X ± SD). Results: The alkaline phosphatase (ALP) activity in saliva was higher in diabetic patients when compared to that of non-diabetic patients with salivary calcium ions were significantly higher in non-diabetic individuals. Conclusion: Diabetes Mellitus patients are more prone to dental caries, hence require intervention to improve the quality of saliva.

Hegde, Mithra N.; Tahiliani, Divya; Shetty, Shilpa; Devadiga, Darshana

2014-01-01

217

Development of diabetic retinopathy and its associated risk factors in type 2 diabetic patients in Osaka district, Japan: a long-term prospective study.  

PubMed

Incidence rates of diabetic retinopathy and its associated risk factors were studied in a long-term prospective study involving 976 type 2 (non-insulin dependent) diabetic patients that showed no retinopathy at entry to the study. 322 of the patients (one-third of the subjects studied) developed diabetic retinopathy during the observation period (average length 8.3 years). The incidence rate per 1000 person-years was 39.8. The rate was significantly related to age at onset of diabetes, to fasting plasma glucose (FPG) level at entry, and to type of treatment. The incidence rate was also related to the duration of the disease. Glycemic control clearly played a role in the occurrence of retinopathy. Patients with FPG greater than or equal to 200 mg/dl had the highest incidence rate, while patients with FPG less than 140 mg/dl showed the lowest incidence rate throughout the observation period. Furthermore, a longer period between onset of diabetes and development of retinopathy was observed in patients with FPG less than 140 mg/dl compared to patients with FPG greater than or equal to 200 mg/dl. The findings suggest that strict glycemic control may be of particular value to reduce the incidence of retinopathy and to delay its appearance in type 2 diabetic patients. PMID:2073873

Sasaki, A; Horiuchi, N; Hasewgawa, K; Uehara, M

1990-01-01

218

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. PMID:10750461

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

2000-01-01

219

The Framingham and UK Prospective Diabetes Study (UKPDS) risk equations do not reliably estimate the probability of cardiovascular events in a large ethnically diverse sample of patients with diabetes: the Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) Study  

Microsoft Academic Search

Aims\\/hypothesis  Available multivariable equations for cardiovascular risk assessment in people with diabetes have been derived either from\\u000a the general population or from populations with diabetes. Their utility and comparative performance in a contemporary group\\u000a of patients with type 2 diabetes are not well established. The aim of this study was to evaluate the performance of the Framingham\\u000a and UK Prospective Diabetes

A. P. Kengne; A. Patel; S. Colagiuri; S. Heller; P. Hamet; M. Marre; C. Y. Pan; S. Zoungas; D. E. Grobbee; B. Neal; J. Chalmers; M. Woodward

2010-01-01

220

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

221

A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population  

Microsoft Academic Search

Summary  A cross-sectional multicentre study of randomly selected diabetic patients was performed using a standardised questionnaire and examination, to establish the prevalence of peripheral neuropathy in patients attending 118 hospital diabetes clinics in the UK. Vibration perception threshold was performed in two centres to compare with the clinical scoring systems. A total of 6487 diabetic patients were studied, 53.9% male, median

M. J. Young; A. J. M. Boulton; A. F. Macleod; D. R. R. Williams; P. H. Sonksen

1993-01-01

222

Steep increase of incidence of childhood diabetes since 1999 in Austria. Time trend analysis 1979–2005. A nationwide study  

Microsoft Academic Search

In a prospective population-based incidence study all newly diagnosed type 1 diabetic patients 0–<15 years of age were registered\\u000a by the Austrian Diabetes Incidence Study Group. The nationwide incidence of type 1 diabetes between 2000–2005 was compared\\u000a with the previously published incidence rates. Long-term trends as well as seasonal trends were estimated by Poisson regression\\u000a models. A total of 3,599 incident

Edith Schober; Birgit Rami; Thomas Waldhoer

2008-01-01

223

U.K. Prospective Diabetes Study XV: Relationship of renin-angiotensin system gene polymorphisms with microalbuminuria in NIDDM  

Microsoft Academic Search

U.K. Prospective Diabetes Study XV: Relationship of renin-angiotensin system gene polymorphisms with microalbuminuria in NIDDM. We performed a case-control study to determine whether molecular variants of genes of the renin-angiotensin system were associated with the presence of albuminuria in non-insulin dependent diabetes mellitus (NIDDM). A total of 180 diabetic patients with persistent microalbuminuria [median urinary albumin (interquartile range) of 74

Christopher RK Dudley; Bernard Keavney; Irene M Stratton; Robert C Turner; Peter J Ratcliffe; CRK Dudley

1995-01-01

224

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. PMID:18044193

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

2007-01-01

225

Prevalence of diabetes in Catalonia (Spain): an oral glucose tolerance test-based population study  

Microsoft Academic Search

The goal of this study was to investigate the prevalence of diabetes mellitus and impaired glucose tolerance in the adult population of Catalonia and study their association with obesity, central obesity, hypertension and smoking habit. A random sample of 3839 subjects aged 30–89 years participated in this cross-sectional study: 2214 subjects underwent a health examination with oral glucose tolerance test

Conxa Castell; Ricard Tresserras; Jaume Serra; Albert Goday; Gonçal Lloveras; Llu??s Salleras

1999-01-01

226

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. PMID:24885699

2014-01-01

227

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. PMID:24991066

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

2013-01-01

228

Opium consumption and coronary atherosclerosis in diabetic patients: a propensity score-matched study.  

PubMed

There is a traditional belief among Eastern people that opium may have ameliorating effects on cardiovascular risk factors, especially diabetes; thus, it is widely used among diabetic patients. We attempted to investigate the association of opium consumption with coronary artery disease (CAD) in diabetic patients. A cross-sectional study was conducted on diabetic patients undergoing coronary angiography in our center. Out of 1925 diabetic patients included in the study, 228 were opium users, and the remaining 1697 non-opium users were used as a pool of potential comparators. Propensity scores were used to match the 228 opium consumers with 228 matched comparators for age, sex, and smoking status. The Gensini score and extent score were respectively used to assess the angiographic severity and extent of CAD. The mean Gensini score (86.9?±?62.7 vs. 59.6?±?43.4, p?diabetic patients than in non-opium users. After adjustment for potential confounders, a dose-response relationship was observed between dose of opium and the Gensini score ( ??=?0.27, p?=?0.04). There were no significant differences between the routes of opium administration (inhalation vs. oral) regarding the severity and extent of CAD. In conclusion, exposure to opium in diabetic patients may be positively associated with the risk of CAD, and with the angiographically determined severity and extent of the disease. Furthermore, dosage of opium consumption may correlate with severity of CAD. PMID:21800277

Hosseini, Seyed Kianoosh; Masoudkabir, Farzad; Vasheghani-Farahani, Ali; Alipour-Parsa, Saeed; Sheikh Fathollahi, Mahmood; Rahimi-Foroushani, Abbas; Hakki, Elham; Goodarzynejad, Hamidreza; Eftekhar, Hassan

2011-11-01

229

Genome-Wide Association Study of Retinopathy in Individuals without Diabetes  

PubMed Central

Background Mild retinopathy (microaneurysms or dot-blot hemorrhages) is observed in persons without diabetes or hypertension and may reflect microvascular disease in other organs. We conducted a genome-wide association study (GWAS) of mild retinopathy in persons without diabetes. Methods A working group agreed on phenotype harmonization, covariate selection and analytic plans for within-cohort GWAS. An inverse-variance weighted fixed effects meta-analysis was performed with GWAS results from six cohorts of 19,411 Caucasians. The primary analysis included individuals without diabetes and secondary analyses were stratified by hypertension status. We also singled out the results from single nucleotide polymorphisms (SNPs) previously shown to be associated with diabetes and hypertension, the two most common causes of retinopathy. Results No SNPs reached genome-wide significance in the primary analysis or the secondary analysis of participants with hypertension. SNP, rs12155400, in the histone deacetylase 9 gene (HDAC9) on chromosome 7, was associated with retinopathy in analysis of participants without hypertension, ?1.3±0.23 (beta ± standard error), p?=?6.6×10?9. Evidence suggests this was a false positive finding. The minor allele frequency was low (?2%), the quality of the imputation was moderate (r2 ?0.7), and no other common variants in the HDAC9 gene were associated with the outcome. SNPs found to be associated with diabetes and hypertension in other GWAS were not associated with retinopathy in persons without diabetes or in subgroups with or without hypertension. Conclusions This GWAS of retinopathy in individuals without diabetes showed little evidence of genetic associations. Further studies are needed to identify genes associated with these signs in order to help unravel novel pathways and determinants of microvascular diseases. PMID:23393555

Jensen, Richard A.; Sim, Xueling; Li, Xiaohui; Cotch, Mary Frances; Ikram, M. Kamran; Holliday, Elizabeth G.; Eiriksdottir, Gudny; Harris, Tamara B.; Jonasson, Fridbert; Klein, Barbara E. K.; Launer, Lenore J.; Smith, Albert Vernon; Boerwinkle, Eric; Cheung, Ning; Hewitt, Alex W.; Liew, Gerald; Mitchell, Paul; Wang, Jie Jin; Attia, John; Scott, Rodney; Glazer, Nicole L.; Lumley, Thomas; McKnight, Barbara; Psaty, Bruce M.; Taylor, Kent; Hofman, Albert; de Jong, Paulus T. V. M.; Rivadeneira, Fernando; Uitterlinden, Andre G.; Tay, Wan-Ting; Teo, Yik Ying; Seielstad, Mark; Liu, Jianjun; Cheng, Ching-Yu; Saw, Seang-Mei; Aung, Tin; Ganesh, Santhi K.; O'Donnell, Christopher J.; Nalls, Mike A.; Wiggins, Kerri L.; Kuo, Jane Z.; van Duijn, Cornelia M.; Gudnason, Vilmundur; Klein, Ronald; Siscovick, David S.; Rotter, Jerome I.; Tai, E. Shong; Vingerling, Johannes; Wong, Tien Y.

2013-01-01

230

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 PMID:24523667

Vistisen, Dorte; Witte, Daniel R.; Tabak, Adam G.; Herder, Christian; Brunner, Eric J.; Kivimaki, Mika; Faerch, Kristine

2014-01-01

231

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. PMID:24018017

2013-01-01

232

Genetic Susceptibility to Coronary Heart Disease in Type 2 Diabetes: Three Independent Studies  

PubMed Central

Objective To evaluate whether coronary heart disease (CHD)-susceptibility loci identified by genome-wide association studies of the general population also contribute to CHD in type 2 diabetes. Background No study has examined the effects of these genetic variants on CHD in diabetic patients. Methods We genotyped 15 genetic markers of 12 loci in three studies of diabetic patients: the prospective Nurses’ Health Study (309 CHD cases and 544 controls) and Health Professional Follow-up Study (345 CHD cases and 451 controls), and the cross-sectional Joslin Heart Study (422 CHD cases and 435 controls). Results Five SNPs, rs4977574 (CDKN2A/2B), rs12526453 (PHACTR1), rs646776 (CELSR2-PSRC1-SORT1), rs2259816 (HNF1A), and rs11206510 (PCSK9) showed directionally consistent associations with CHD in the three studies, with combined odds ratios (ORs) ranging from 1.17 to 1.25 (p=0.03 to 0.0002). None of the other SNPs reached significance in individual or combined analyses. A genetic risk score (GRS) was created by combining the risk alleles of the five significantly associated loci. The OR of CHD per GRS unit was 1.19 (95% confidence interval [CI] 1.13– 1.26; p<0.0001). Individuals with GRS ?8 (19% of diabetic subjects) had almost a two-fold increase in CHD risk (OR=1.94, 95% CI 1.60–2.35) as compared to individuals with GRS ?5 (30% of diabetic subjects). Prediction of CHD was significantly improved (p<0.001) when the GRS was added to a model including clinical predictors in the combined samples. Conclusions Our results illustrate the consistency and differences in the determinants of genetic susceptibility to CHD in diabetic patients and the general populations. PMID:22152955

Qi, Lu; Parast, Layla; Cai, Tianxi; Powers, Christine; Gervino, Ernest V.; Hauser, Thomas H.; Hu, Frank B.; Doria, Alessandro

2011-01-01

233

Studying fringe field effect of a field emitter array  

NASA Astrophysics Data System (ADS)

Field emitter arrays on heavy As-doped Si wafer are studied in vacuum nanoelectronics diode configuration. Different shapes of emitters are considered: cone-shaped point-emitters and cylinder-shaped sharp-edge-emitters are compared. Micro scale field enhancement factor on the edge of cylindrical emitter was calculated via home-developed Matlab application and the results are presented. Two types of anode geometry are proposed: plane anode and spherical anode. Experimental and modelling results of surface electric field distribution are presented. The spherical shape of anode allows higher voltage (and higher field emission current) without destructive arcs risk.

Sayfullin, M. F.; Nikiforov, K. A.

2014-10-01

234

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. PMID:21619571

2011-01-01

235

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

236

'I'm not a druggie, I'm just a diabetic': a qualitative study of stigma from the perspective of adults with type 1 diabetes  

PubMed Central

Objectives While health-related stigma has been the subject of considerable research in other conditions (eg, HIV/AIDS, obesity), it has not received substantial attention in diabetes. Our aim was to explore perceptions and experiences of diabetes-related stigma from the perspective of adults with type 1 diabetes mellitus (T1DM). Design A qualitative study using semistructured interviews, which were audio recorded, transcribed and subject to thematic analysis. Setting All interviews were conducted in non-clinical settings in metropolitan areas of Victoria, Australia. Participants Adults aged ?18?years with T1DM living in Victoria were eligible to take part. Participants were recruited primarily through the state consumer organisation representing people with diabetes. A total of 27 adults with T1DM took part: 15 (56%) were women; median IQR age was 42 (23) years and diabetes duration was 15 (20) years). Results Australian adults with T1DM perceive and experience T1DM-specific stigma as well as stigma-by-association with type 2 diabetes. Such stigma is characterised by blame, negative social judgement, stereotyping, exclusion, rejection and discrimination. Participants identified the media, family and friends, healthcare professionals and school teachers as sources of stigma. The negative consequences of this stigma span numerous life domains, including impact on relationships and social identity, emotional well-being and behavioural management of T1DM. This stigma also led to reluctance to disclose the condition in various environments. Adults with T1DM can be both the target and the source of diabetes-related stigma. Conclusions Stigmatisation is part of the social experience of living with T1DM for Australian adults. Strategies and interventions to address and mitigate this diabetes-related stigma need to be developed and evaluated. PMID:25056982

Browne, Jessica L; Ventura, Adriana; Mosely, Kylie; Speight, Jane

2014-01-01

237

Experiences of health care transition voiced by young adults with type 1 diabetes: a qualitative study  

PubMed Central

Objective This qualitative study aimed to explore the experience of transition from pediatric to adult diabetes care reported by posttransition emerging adults with type 1 diabetes (T1D), with a focus on preparation for the actual transfer in care. Methods Twenty-six T1D emerging adults (mean age 26.2±2.5 years) receiving adult diabetes care at a single center participated in five focus groups stratified by two levels of current glycemic control. A multidisciplinary team coded transcripts and conducted thematic analysis. Results Four key themes on the process of transfer to adult care emerged from a thematic analysis: 1) nonpurposeful transition (patients reported a lack of transition preparation by pediatric providers for the transfer to adult diabetes care); 2) vulnerability in the college years (patients conveyed periods of loss to follow-up during college and described health risks and diabetes management challenges specific to the college years that were inadequately addressed by pediatric or adult providers); 3) unexpected differences between pediatric and adult health care systems (patients were surprised by the different feel of adult diabetes care, especially with regards to an increased focus on diabetes complications); and 4) patients’ wish list for improving the transition process (patients recommended enhanced pediatric transition counseling, implementation of adult clinic orientation programs, and peer support for transitioning patients). Conclusion Our findings identify modifiable deficiencies in the T1D transition process and underscore the importance of a planned transition with enhanced preparation by pediatric clinics as well as developmentally tailored patient orientation in the adult clinic setting. PMID:25349485

Garvey, Katharine C; Beste, Margaret G; Luff, Donna; Atakov-Castillo, Astrid; Wolpert, Howard A; Ritholz, Marilyn D

2014-01-01

238

Joint relationship between renal function and proteinuria on mortality of patients with type 2 diabetes: The Taichung Diabetes Study  

PubMed Central

Background Estimated glomerular filtration rate (eGFR) is a powerful predictor of mortality in diabetic patients with limited proteinuria data. In this study, we tested whether concomitant proteinuria increases the risk of mortality among patients with type 2 diabetes. Methods Participants included 6523 patients > 30 years with type 2 diabetes who were enrolled in a management program of a medical center before 2007. Renal function was assessed by eGFR according to the Modification of Diet in Renal Disease Study equation for Chinese. Proteinuria was assessed by urine dipstick. Results A total of 573 patients (8.8%) died over a median follow-up time of 4.91 years (ranging from 0.01 year to 6.42 years). The adjusted expanded cardiovascular disease (CVD)-related mortality rates among patients with proteinuria were more than three folds higher for those with an eGFR of 60 mL/min/1.73 m2 or less compared with those with an eGFR of 90 mL/min/1.73 m2 or greater [hazard ratio, HR, 3.15 (95% confidence interval, CI, 2.0–5.1)]. The magnitude of adjusted HR was smaller in patients without proteinuria [1.98 (95% CI, 1.1–3.7)]. An eGFR of 60 mL/min/1.73 m2 to 89 mL/min/1.73 m2 significantly affected all-cause mortality and mortality from expanded CVD-related causes only in patients with proteinuria. Similarly, proteinuria affected all outcomes only in patients with an eGFR of <60 mL/min/1.73 m2. Conclusion The risks of all-cause mortality, as well as expanded and non-expanded mortality from CVD-related causes associated with proteinuria or an eGFR of 90 mL/min/1.73 m2 or greater are independently increased. Therefore, the use of proteinuria measurements with eGFR increases the precision of risk stratification for mortality. PMID:23083001

2012-01-01

239

Genome-Wide Linkage and Admixture Mapping of Type 2 Diabetes in African American Families From the American Diabetes Association GENNID (Genetics of NIDDM) Study Cohort  

PubMed Central

OBJECTIVE—We used a single nucleotide polymorphism (SNP) map in a large cohort of 580 African American families to identify regions linked to type 2 diabetes, age of type 2 diabetes diagnosis, and BMI. RESEARCH DESIGN AND METHODS—After removing outliers and problematic samples, we conducted linkage analysis using 5,914 SNPs in 1,344 individuals from 530 families. Linkage analysis was conducted using variance components for type 2 diabetes, age of type 2 diabetes diagnosis, and BMI and nonparametric linkage analyses. Ordered subset analyses were conducted ranking on age of type 2 diabetes diagnosis, BMI, waist circumference, waist-to-hip ratio, and amount of European admixture. Admixture mapping was conducted using 4,486 markers not in linkage disequilibrium. RESULTS—The strongest signal for type 2 diabetes (logarithm of odds [LOD] 4.53) was a broad peak on chromosome 2, with weaker linkage to age of type 2 diabetes diagnosis (LOD 1.82). Type 2 diabetes and age of type 2 diabetes diagnosis were linked to chromosome 13p (3–22 cM; LOD 2.42 and 2.46, respectively). Age of type 2 diabetes diagnosis was linked to 18p (66 cM; LOD 2.96). We replicated previous reports on chromosome 7p (79 cM; LOD 2.93). Ordered subset analysis did not overlap with linkage of unselected families. The best admixture score was on chromosome 12 (90 cM; P = 0.0003). CONCLUSIONS—The linkage regions on chromosomes 7 (27–78 cM) and 18p overlap prior reports, whereas regions on 2p and 13p linkage are novel. Among potential candidate genes implicated are TCF7L1, VAMP5, VAMP8, CDK8, INSIG2, IPF1, PAX8, IL18R1, members of the IL1 and IL1 receptor families, and MAP4K4. These studies provide a complementary approach to genome-wide association scans to identify causative genes for African American diabetes. PMID:18840782

Elbein, Steven C.; Das, Swapan K.; Hallman, D. Michael; Hanis, Craig L.; Hasstedt, Sandra J.

2009-01-01

240

Adherence to healthy lifestyle and risk of gestational diabetes mellitus: prospective cohort study  

PubMed Central

Objective To quantify the association between a combination of healthy lifestyle factors before pregnancy (healthy body weight, healthy diet, regular exercise, and not smoking) and the risk of gestational diabetes. Design Prospective cohort study. Setting Nurses’ Health Study II, United States. Participants 20?136 singleton live births in 14?437 women without chronic disease. Main outcome measure Self reported incident gestational diabetes diagnosed by a physician, validated by medical records in a previous study. Results Incident first time gestational diabetes was reported in 823 pregnancies. Each lifestyle factor measured was independently and significantly associated with risk of gestational diabetes. The combination of three low risk factors (non-smoker, ?150 minutes a week of moderate to vigorous physical activity, and healthy eating (top two fifths of Alternate Healthy Eating Index-2010 adherence score)) was associated with a 41% lower risk of gestational diabetes compared with all other pregnancies (relative risk 0.59, 95% confidence interval 0.48 to 0.71). Addition of body mass index (BMI) <25 before pregnancy (giving a combination of four low risk factors) was associated with a 52% lower risk of gestational diabetes compared with all other pregnancies (relative risk 0.48, 0.38 to 0.61). Compared with pregnancies in women who did not meet any of the low risk lifestyle factors, those meeting all four criteria had an 83% lower risk of gestational diabetes (relative risk 0.17, 0.12 to 0.25). The population attributable risk percentage of the four risk factors in combination (smoking, inactivity, overweight, and poor diet) was 47.5% (95% confidence interval 35.6% to 56.6%). A similar population attributable risk percentage (49.2%) was observed when the distributions of the four low risk factors from the US National Health and Nutrition Examination Survey (2007-10) data were applied to the calculation. Conclusions Adherence to a low risk lifestyle before pregnancy is associated with a low risk of gestational diabetes and could be an effective strategy for the prevention of gestational diabetes. PMID:25269649

Tobias, Deirdre K; Chavarro, Jorge E; Bao, Wei; Wang, Dong; Ley, Sylvia H; Hu, Frank B

2014-01-01

241

Regularity of preventive foot care in persons with diabetes: results from the Nord-Trøndelag Health Study.  

PubMed

The purpose of the present study was to examine the regularity of preventive care for persons with diabetes in the Nord-Trøndelag Health Study to identify associated demographic, lifestyle, and disease-related factors. Among 1,972 persons with diabetes, 1,459 (74%) answered questions related to preventive foot care. The final sample included 1,312 persons with known diabetes, but without a self-reported history of foot ulcer. Almost 85% reported receiving regular clinical diabetes examinations, 31.7% reported regular foot inspection by health care personnel, and 66.3% reported foot self-inspection. Only 58.8% reported regular clinical diabetes examination combined with foot inspection. Males, patients not using insulin, and those with shorter diabetes duration or macrovascular complications were more likely to report less regular preventive care. PMID:18481252

Iversen, Marjolein M; Ostbye, Truls; Clipp, Elizabeth; Midthjell, Kristian; Uhlving, Sverre; Graue, Marit; Hanestad, Berit R

2008-06-01

242

Comorbid Depression Is Associated with an Increased Risk of Dementia Diagnosis in Patients with Diabetes: A Prospective Cohort Study  

Microsoft Academic Search

BACKGROUND  Both depression and diabetes have been found to be risk factors for dementia. This study examined whether comorbid depression\\u000a in patients with diabetes increases the risk for dementia compared to those with diabetes alone.\\u000a \\u000a \\u000a \\u000a \\u000a METHODS  We conducted a prospective cohort study of 3,837 primary care patients with diabetes (mean age 63.2?±?13.2 years) enrolled\\u000a in an HMO in Washington State. The Patient Health

Wayne J. Katon; Elizabeth H. B. Lin; Lisa H. Williams; Paul Ciechanowski; Susan R. Heckbert; Evette Ludman; Carolyn Rutter; Paul K. Crane; Malia Oliver; Michael Von Korff

2010-01-01

243

Resources, roadblocks and turning points: a qualitative study of American Indian/Alaska Native adults with type 2 diabetes.  

PubMed

Type 2 diabetes is a worldwide health problem that has reached epidemic proportions in some communities. Alaska Native and American Indian (AN/AI) people are disproportionately diagnosed with type 2 diabetes and incidence is increasing in many Alaska communities. Developing effective interventions requires understanding the social and psychological factors that impact effective management of diabetes, yet little is known about these factors in AN/AI communities. The objective of this study was to explore perceived psychosocial needs and barriers to management of diabetes among AN/AI adults with type 2 diabetes receiving care at the Alaska Native Primary Care Center (ANPCC) to inform programmatic efforts and potential future research. We conducted three focus groups and five interviews with 13 AN/AI adults with type 2 diabetes. Interview and focus group questions elicited perceived factors that affect management of diabetes, with a focus on the psychological, social and spiritual impacts of diabetes. Data were transcribed, coded and analyzed using thematic analysis. Key themes that emerged from these data included resources and roadblocks, as well as turning points in the trajectory of diabetes. Resources are factors with a perceived positive impact on management of diabetes, including: (1) knowledge and education about diabetes, (2) social support from other people with diabetes, (3) spirituality, and (4) self-efficacy. Roadblocks are factors with a perceived negative impact on management of diabetes and include: (1) self-reported lack of knowledge about nutrition and diet, (2) social difficulties caused by dietary restrictions, and (3) co-morbid medical conditions. Finally, turning points are experiences described by participants as having transformed roadblocks in resources and thus facilitating improvement in the management of diabetes. Future programmatic interventions to improve management of diabetes with this population should focus on improving dietary education and social support opportunities for newly-diagnosed individuals. Also, educational and support opportunities for family members and friends of individuals with diabetes should also be offered to facilitate understanding and support of their loved ones' management of diabetes, especially with regard to dietary restrictions in social settings. Efforts should also focus on strengthening newly-diagnosed individuals' self-efficacy and providing ongoing support as individuals progressively adjust to the illness over time and make behavioral changes. Future research with this population should explore the effects of family support groups and the possibility of Web-based or other alternative interventions for improving psychosocial health and management of diabetes efforts. PMID:22772841

Shaw, Jennifer L; Brown, Jennifer; Khan, Burhan; Mau, Marjorie K; Dillard, Denise

2013-02-01

244

Women and Diabetes -- Diabetes Medicines  

MedlinePLUS

Women and Diabetes - Diabetes Medicines Diabetes can make it hard to control how much sugar (called glucose) is in your blood. There is ... Warning Signs Diabetes Medicines Learn More about Diabetes Diabetes Tips Talk to your doctor before you change ...

245

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

E-print Network

1 Diabetes Risk Factors, Diabetes Risk Algorithms, and the Prediction of Future Frailty of Epidemiology and Public Health, University College London, London, UK 2 Finnish Institute of Occupational Health, Helsinki, Finland 3 Inserm U 1061, Montpellier F-34000, France 4 University Montpellier I

Boyer, Edmond

246

Reliability of questionnaire information on cardiovascular disease and diabetes: cardiovascular disease study in Finnmark county  

Microsoft Academic Search

In a cardiovascular disease study in Finnmark county, Norway, which was repeated after three years (1977), 12 694 men and women twice answered a questionnaire on myocardial infarction, angina pectoris, other heart diseases, atherosclerosis obliterans, stroke, and diabetes. The reliability of these data is studied by using different indicators. These indicators suggest that questionnaire information on myocardial infarction is reliable

Steinar Tretli; Per G Lund-Larsen; Olav Per Foss

1982-01-01

247

Venlafaxine extended release in the treatment of painful diabetic neuropathy: a double-blind, placebo-controlled study  

Microsoft Academic Search

To evaluate the efficacy and safety of 6 weeks of venlafaxine extended-release (ER) (75 mg and 150–225 mg) treatment in patients with painful diabetic neuropathy. This multicenter, double-blind, randomized, placebo-controlled study included 244 adult outpatients with metabolically stable type 1 or 2 diabetes with painful diabetic neuropathy. Primary efficacy measures were scores on the daily 100 mm Visual Analog Pain

Michael C Rowbotham; Veeraindar Goli; Nadia R Kunz; Dean Lei

2004-01-01

248

Are measures of height and leg length related to incident diabetes mellitus? The ARIC (Atherosclerosis Risk in Communities) study  

Microsoft Academic Search

This study was designed to estimate the risk of developing diabetes in relation to adult height components, namely leg length\\u000a and leg length\\/height ratio. Data on 12,800 individuals without diabetes were obtained at the baseline examination from the\\u000a ARIC cohort. Cox proportional hazard models were used to estimate hazard rate ratios of diabetes for each 5-cm difference\\u000a in leg length

Shimon Weitzman; Chin-Hua Wang; James S. Pankow; Maria I. Schmidt; Frederic L. Brancati

2010-01-01

249

Health literacy issues in the care of Chinese American immigrants with diabetes: a qualitative study  

PubMed Central

Objectives To investigate why first-generation Chinese immigrants with diabetes have difficulty obtaining, processing and understanding diabetes related information despite the existence of translated materials and translators. Design This qualitative study employed purposive sampling. Six focus groups and two individual interviews were conducted. Each group discussion lasted approximately 90?min and was guided by semistructured and open-ended questions. Setting Data were collected in two community health centres and one elderly retirement village in Los Angeles, California. Participants 29 Chinese immigrants aged ?45 years and diagnosed with type 2 diabetes for at least 1?year. Results Eight key themes were found to potentially affect Chinese immigrants' capacity to obtain, communicate, process and understand diabetes related health information and consequently alter their decision making in self-care. Among the themes, three major categories emerged: cultural factors, structural barriers, and personal barriers. Conclusions Findings highlight the importance of cultural sensitivity when working with first-generation Chinese immigrants with diabetes. Implications for health professionals, local community centres and other potential service providers are discussed. PMID:25406155

Leung, Angela Yee Man; Bo, Ai; Hsiao, Hsin-Yi; Wang, Song Song; Chi, Iris

2014-01-01

250

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

251

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

PubMed Central

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

252

Knowledge, Attitudes and Practice of Diabetes in Rural Bangladesh: The Bangladesh Population Based Diabetes and Eye Study (BPDES)  

PubMed Central

Background To assess the Knowledge, Attitudes and Practice (KAP) amongst the general community regarding type 2 diabetes mellitus (DM) in rural Bangladesh. Methods Data was collected using cluster random sampling from 3104 adults residing in a rural district in Bangladesh. Participants underwent a KAP questionnaire survey regarding assessing diabetes, socio-demographic and medical history. Descriptive, Chi-square and regression analyses were performed. Results Participants were aged between 30 and 89 years (M ?=?51, SD ?=?11.8) and 65.5% were female. The prevalence of diabetes was found to be 8.3%. The majority (93%) reported to have heard of diabetes, yet only 4% knew what a glucose tolerance test was. Only 50% reported that they knew physical inactivity was a risk factor. Age, gender, level of education and socio-economic status (SES) were significantly associated with KAP. A lower proportion (41%) of older participants (aged ?65 years) reported that they knew that dietary modifications assist in diabetes control compared to those aged less than 35 years (69%), p<0.001. Males (? ?=?0.393, 95% CI?=?0.142–0.643), and any level of education compared to no schooling (? ?=?0.726, 95% CI?=?0.596, 0.857) reported significantly more knowledge, after multivariate adjustments for covariates. Participants aged under 35 years, (odds ratio (OR) ?=?1.73, 95% CI ?=?1.22–2.43) had significantly higher positive attitudes towards treatments of diabetes compared to those aged ?65 years. Of the 99 people with known diabetes, more than 50% (n?=?52) never had their blood sugar levels checked since diagnosis. Conclusions Knowledge of diabetes and its risk factors is very limited in rural Bangladesh, even in persons diagnosed with type 2 DM. The development of public health programmes to increase knowledge of diabetes and its complications is required to assist people living in rural Bangladesh to control and management of diabetes. PMID:25313643

Islam, Fakir M. Amirul; Chakrabarti, Rahul; Dirani, Mohamed; Islam, M. Tauhidul; Ormsby, Gail; Wahab, Mohamed

2014-01-01

253

Extraordinary exposed in early motherhood - a qualitative study exploring experiences of mothers with type 1 diabetes  

PubMed Central

Background Women with type 1 diabetes face several challenges during pregnancy, childbirth and in relation to breastfeeding. It is therefore of utmost importance to consider their need for specific support, early postpartum as well as in daily life after discharge from maternity care. Few studies have investigated these aspects of healthcare. The aim of this study was to explore experiences after childbirth regarding breastfeeding, glycemic control, support and well-being in women with type 1 diabetes. Methods A hermeneutic reflective life world research approach was used in this qualitative study. Data was gathered through audio-recorded focus group discussions and individual interviews with 23 women with type 1 diabetes, 6-24 months after childbirth. After verbatim transcription, the text was analyzed in order to identify themes of meaning and a conclusive interpretation of the explored phenomenon. Results Experiences of extraordinary exposure challenged the women with type 1 diabetes in their transition to early motherhood. The exposure included a struggle with breastfeeding, although with a driving force to succeed. Everyday life was filled with uncertainty and unpredictability related to one's own unstable glycemic control and the women down-prioritized their own needs in favor of the child. A feeling of being disconnected from professional care further contributed to the experiences of extraordinary exposure. Conclusion In early motherhood women with type 1 diabetes have a great need for support in managing daily life postpartum, which requires contemporary approaches to overlap insufficient linkage between health care professionals in maternity and child health care, and diabetes care. PMID:21473755

2011-01-01

254

Intentional Weight Loss and Dose Reductions of Anti-Diabetic Medications - A Retrospective Cohort Study  

PubMed Central

Background and Aim Intentional weight loss, primarily by improving insulin resistance, is known to decrease the need for anti-diabetic medications. In this study, we assess the magnitude of weight loss that resulted in dose reductions or discontinuation of anti-diabetic medications in overweight or obese patients with type 2 diabetes (DM) undergoing weight loss treatment. Methods Case records of 50 overweight or obese patients with DM who successfully decreased dosage or discontinued diabetes medications after losing weight via attendance at two University-based, outpatient weight management centers were analyzed. Follow-up visits, weight reduction interventions, and decisions for dose reductions or discontinuation of medications were individualized to patient needs by the treating physician. Results Mean starting BMI was 35 kg/m2, mean age 53.4 years, and 58% were male. All 50 used at least one anti-diabetic medication (30 metformin, 39 sulfonylureas, 31 insulin, 21 sitagliptin) to manage blood sugar. Mean duration of follow-up was 30.2 months. Mean weight loss was 10.8±4.1 kgs (11.1% of initial body weight ±4.7%). 22/50 patients (44%) discontinued anti-diabetes medications (14 sulfonylureas [36%], 7 insulin [23%], 4 sitagliptin [19%]). The mean percentage weight loss achieved at the point of successful discontinuation of medication was 11.2%±3.5% (14% for sulphonylureas, 11% for insulin, and 7.1% for sitagliptin). Mean percentage weight loss of 5.6%±2.8% (5.1% for sulphonylureas, 4.3% for insulin, and 7.1% for sitagliptin) was required for initial dose reduction. For every 5% weight loss, predicted dose reductions were sulphonylureas, 39%; insulin, 42%; and any anti-diabetic medications, 49%. Conclusion Among overweight or obese patients with type 2 diabetes, intentional weight loss of 7–14% was typically required for full discontinuation of at least one anti-diabetic medication. Discontinuation of insulin was achieved at a mean weight reduction of 11% of initial body weight. PMID:22384240

Kumar, Anita Ashok; Palamaner Subash Shantha, Ghanshyam; Kahan, Scott; Samson, Rohit Joshua; Boddu, Nelson David; Cheskin, Lawrence Jay

2012-01-01

255

Patients’ perspectives of care for type 2 diabetes in Bangladesh –a qualitative study  

PubMed Central

Background Worldwide, type 2 diabetes affects approximately 220 million people and is the cause of 1.1 million deaths each year, 80% of which occur in low and middle income countries (LMICs). Over the next 20?years, prevalence is expected to double worldwide and increase by 150% in LMICs. There is now a move towards improving care for diabetes. However no information on patients’ needs, perceptions and experiences is available, hindering effective and appropriate changes in policy and practice. We developed a study with the objective of understanding patients’ experiences of treatment for type 2 diabetes. Methods During January 2011, we conducted in-depth interviews in five sites across two administrative districts of Bangladesh, purposefully chosen to represent different geographic regions and local demographics In total, we conducted 23 (14 male, 9 female) individual interviews across the 5 sites, to gain insight into patients’ understanding of their diabetes and its management. Results Patients’ levels of knowledge and understanding about diabetes and its management is depended on where they received their initial diagnosis and care. Away from specialist centres, patients had poor understanding of the essential of diabetes and its management. No appropriate written or verbal information was available for a significant number of patients, compounded limited knowledge and understanding of diabetes by healthcare professionals. Patients felt that with improved provision of appropriate information they would be able to better understand their diabetes and improve their role in its management. Access to appropriate diagnosis and subsequent treatment was restricted by availability and costs of services. Conclusion Effective, appropriate and essential healthcare services for diabetes in Bangladesh is extremely limited, a majority of patients receive suboptimal care. Site of diagnosis will impact significantly on the quality of information provided and the quality of subsequent treatments. Although appropriate services are available at some specialist centres, the inability of patients to pay for routine tests and check-ups prevents them from receiving timely diagnoses and appropriate continuity of care. The double burden of communicable diseases and diseases is now a well-recognised. Emphasis must be placed on developing appropriate and effective preventive strategies to address this burden. PMID:25047797

2014-01-01

256

Lack of benefits for prevention of cardiovascular disease with aspirin therapy in type 2 diabetic patients - a longitudinal observational study  

Microsoft Academic Search

BACKGROUND: The risk-benefit ratio of aspirin therapy in prevention of cardiovascular disease (CVD) remains contentious, especially in type 2 diabetes. This study examined the benefit and harm of low-dose aspirin (daily dose < 300 mg) in patients with type 2 diabetes. METHODS: This is a longitudinal observational study with primary and secondary prevention cohorts based on history of CVD at

Wilson Y Leung; Wing-yee So; Derek Stewart; Augustine Lui; Peter C Tong; Gary T Ko; Alice P Kong; Ronald C Ma; Francis K Chan; Xilin Yang; Sau-chu Chiang; Juliana C Chan

2009-01-01

257

Efficacy and safety of acarbose in the treatment of Type 2 diabetes: data from a 2-year surveillance study  

Microsoft Academic Search

This 2-year surveillance study assessed the tolerability and safety of acarbose in patients with diabetes. A total of 2035 patients were enrolled; approximately 95% were classified as having Type 2 diabetes. The study was open with no control groups. Physicians had sole control of the acarbose doses prescribed. Doses of acarbose were generally low, and hence well-tolerated. The incidence of

Gabriele Mertes

1998-01-01

258

Physical activity and self-concept: the SEARCH for diabetes in youth case control study.  

PubMed

In this study, the relationship between physical activity (PA) and 3 self-concept constructs (physical abilities, physical appearance, and general self-concept) was examined. Youth with type 1 diabetes (n = 304), type 2 diabetes (n = 49), and nondiabetic controls (n = 127) aged 10-20 years wore pedometers over 7 days. Youth completed the Self-Description Questionnaire and correlation coefficients were calculated. Mean steps/day were 7413 ± 3415, 4959 ± 3474 and 6870 ± 3521 for type 1, type 2 and control youth, respectively. Significant correlations were found between steps/day and perception of physical abilities (r = .29; r = .31; r = .31) for type 1, type 2, and control youth, respectively. The other correlations were not significant. Among youth with type 2 diabetes, steps/day were significantly correlated with physical appearance (r = .46). The positive correlation between PA and physical abilities suggests a reciprocal relationship between behavior and perception. PMID:23196765

O'Neill, Jennifer R; Liese, Angela D; McKeown, Robert E; Cai, Bo; Cuffe, Steven P; Mayer-Davis, Elizabeth J; Hamman, Richard F; Dabelea, Dana

2012-11-01

259

Clinical application of fresh fibroblast allografts for the treatment of diabetic foot ulcers: a pilot study.  

PubMed

Diabetic foot ulcers often pose a difficult problem for health care professionals because of the defects associated with fibroblast functioning. Although there has been much interest recently in the use of topical growth factors for the treatment of diabetic foot ulcers, the effects are generally not very dramatic. Cryopreserved fibroblast implants, which are able to adjust to a wound's environment and provide the desired growth factors and other substances that may be lacking in a chronic wound, represent an exciting development and a major advance. These products may well provide growth factors in the right concentration and in the right sequence, something that has proved difficult to achieve with the topical application of recombinant growth factors. However, cell activities are impaired by cryopreservation. The purpose of this study was to assess the effects of fresh human allogeneic fibroblast grafting for the treatment of diabetic foot ulcers. Eight patients with diabetic foot ulcers ranging from 6 to 17 weeks in duration were treated. The size of the wounds ranged from 2.0 to 6.0 cm2, with three patients exhibiting exposed bones. A history of diabetic foot ulcers was present in five patients. Human dermal fibroblasts from healthy teenagers were cultured in Dulbecco's modified Eagle medium/Ham's F-12 supplemented with 10% autologous serum. The cultured cells were applied over the wounds immediately after debridement; fibrin was used as a cell carrier. A dressing was then applied with Tegaderm and kept moist until healing was complete. The progress and time for complete wound closure and patient satisfaction were assessed, with follow-up time ranging from 6 to 18 months. Complete wound healing occurred in all patients. Eleven to 21 days were needed for complete reepithelization of the wound, and no clinical or laboratory abnormalities were noted. Patient satisfaction was also very positive. In this study, the use of fresh human fibroblast allografts was found to be a safe and effective treatment for diabetic foot ulcers. PMID:15577349

Han, Seung-Kyu; Choi, Kyu-Jin; Kim, Woo-Kyung

2004-12-01

260

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. PMID:24991617

Akari, Sadanandam; Mateti, Uday Venkat; Kunduru, Buchi Reddy

2013-01-01

261

A hospital-based observational study of type 2 diabetic subjects from Gujarat, India.  

PubMed

The aim of this observational study was to describe the profile of subjects with type 2 diabetes mellitus from Gujarat, India. The study was performed with newly-diagnosed 622 type 2 diabetic subjects who attended the Department of Diabetology, All India Institute of Diabetes and Research and Yash Diabetes Specialties Centre (Swasthya), Ahmedabad, during August 2006-January 2009. The subjects completed an interviewer-administered questionnaire. The questionnaire included variables, such as sociodemographic factors, presenting symptoms, risk profile (hypertension, obesity, dyslipidaemia, and glycaemic status), family history of diabetes, physical activity, and behavioural profile. Blood pressure, body mass index (BMI), glycosylated haemoglobin levels, and fasting lipid profile were measured. Descriptive and bivariate analyses were carried out using the SPSS software (version 11.5). In total; 622 type 2 diabetes mellitus (T2DM) cases with mean age of 47.7 +/- 10.9 years were studied. Of the 622 subjects, 384 (62%) were male. The majority (68%) of the T2DM subjects were obese, and 67% had a positive family history of diabetes. Renal dysfunctions and vision impairment were, respectively, found in 10% (n=62) and 9% (n=57) of the 622 T2DM subjects. The mean HbAlc level was 9.02 +/- 1.67%, and good glycaemic control (HbAlc level <7%) was achieved only in 7.4% of the T2DM subjects. Results of chi-square analysis showed that higher BMI (> or =25 kg/m2) was significantly associated with hypertension among the T2DM subjects (p < 0.01). There were significant differences (p < 0.05) between male and female subjects with respect to mean age, BMI, waist- and hip-circumference, and mean low-density lipoprotein (LDL) level. The results revealed that many factors, such as obesity, family history of diabetes, dyslipidaemia, uncontrolled glycaemic status, sedentary lifestyles, and hypertension were prevalent among the T2DM subjects. The characterization of this risk profile will contribute to designing more effective and specific strategies for screening and controlling T2DM in Gujarat, India. PMID:21766562

Patel, Mayur; Patel, Ina M; Patel, Yash M; Rathi, Suresh K

2011-06-01

262

Polycystic ovary syndrome is a risk factor for type 2 diabetes: results from a long-term prospective study.  

PubMed

Polycystic ovary syndrome (PCOS) recently has been identified as a risk factor associated with type 2 diabetes. However, the evidence derives from cross-sectional observational studies, retrospective studies, or short-term prospective studies. This long-term prospective study of a large cohort of women with PCOS, followed from youth to middle age, aimed at estimating, for the first time, the incidence and potential predictors of type 2 diabetes in this population. A total of 255 women with PCOS were followed for at least 10 years (mean follow-up 16.9 years). Six women were patients with diabetes at baseline, and another 42 women developed type 2 diabetes during the follow-up. The incidence rate of type 2 diabetes in the study population was 1.05 per 100 person-years. The age-standardized prevalence of diabetes at the end of follow-up was 39.3%, which is significantly higher with respect to that of the general Italian female population of a similar age (5.8%). The likelihood of developing type 2 diabetes significantly increased as BMI, fasting glucose, and glucose area under the curve at baseline increased and significantly decreased as sex hormone-binding globulin (SHBG) levels at follow-up increased. This study demonstrates that the risk of type 2 diabetes is markedly elevated in middle-aged women with PCOS and suggests including BMI, glucose, and SHBG-circulating levels in the risk stratification. PMID:22698921

Gambineri, Alessandra; Patton, Laura; Altieri, Paola; Pagotto, Uberto; Pizzi, Carmine; Manzoli, Lamberto; Pasquali, Renato

2012-09-01

263

Evaluation of the Association between Persistent Organic Pollutants (POPs) and Diabetes in Epidemiological Studies: A National Toxicology Program Workshop Review  

PubMed Central

Background: Diabetes is a major threat to public health in the United States and worldwide. Understanding the role of environmental chemicals in the development or progression of diabetes is an emerging issue in environmental health. Objective: We assessed the epidemiologic literature for evidence of associations between persistent organic pollutants (POPs) and type 2 diabetes. Methods: Using a PubMed search and reference lists from relevant studies or review articles, we identified 72 epidemiological studies that investigated associations of persistent organic pollutants (POPs) with diabetes. We evaluated these studies for consistency, strengths and weaknesses of study design (including power and statistical methods), clinical diagnosis, exposure assessment, study population characteristics, and identification of data gaps and areas for future research. Conclusions: Heterogeneity of the studies precluded conducting a meta-analysis, but the overall evidence is sufficient for a positive association of some organochlorine POPs with type 2 diabetes. Collectively, these data are not sufficient to establish causality. Initial data mining revealed that the strongest positive correlation of diabetes with POPs occurred with organochlorine compounds, such as trans-nonachlor, dichlorodiphenyldichloroethylene (DDE), polychlorinated biphenyls (PCBs), and dioxins and dioxin-like chemicals. There is less indication of an association between other nonorganochlorine POPs, such as perfluoroalkyl acids and brominated compounds, and type 2 diabetes. Experimental data are needed to confirm the causality of these POPs, which will shed new light on the pathogenesis of diabetes. This new information should be considered by governmental bodies involved in the regulation of environmental contaminants. PMID:23651634

Novak, Raymond F.; Anderson, Henry A.; Birnbaum, Linda S.; Blystone, Chad; DeVito, Michael; Jacobs, David; Köhrle, Josef; Lee, Duk-Hee; Rylander, Lars; Rignell-Hydbom, Anna; Tornero-Velez, Rogelio; Turyk, Mary E.; Boyles, Abee L.; Thayer, Kristina A.; Lind, Lars

2013-01-01

264

Mentoring Field Directors: A National Exploratory Study  

ERIC Educational Resources Information Center

In social work field education, mentoring is underused and lacks research data. There is a paucity of research that examines the effect mentoring has on social work field directors who administer field programs at the undergraduate and/or graduate level. This exploratory study fills this void by examining the mentoring opportunities and…

Ellison, Martha L.; Raskin, Miriam S.

2014-01-01

265

Recent biophysical studies in high magnetic fields  

NASA Astrophysics Data System (ADS)

A brief overview of biophysical effects of steady magnetic fields is given. The need of high field strength is illustrated by several recent diamagnetic orientation experiments. They include rod-like viruses, purple membranes and chromosomes. Results of various studies on bees, quails, rats and pigeons exposed to fields above 7 T are also resumed.

Maret, Georg

1990-06-01

266

A longitudinal study of coping, anxiety and glycemic control in adults with type 1 diabetes  

Microsoft Academic Search

Diabetes is a unique disorder in how much it requires a high degree of individual self management strategies. Anxiety and stress can affect glycemic control, and thus management of emotions may be key to good glycemic control. This study is the first to examine how anxiety and coping style, and their interaction, can affect long-term glycemic control. We measured anxiety,

Serge Sultan; Elissa Epel; Claude Sachon; Genevieve Vaillant; Agnes Hartemann-Heurtier

2008-01-01

267

Regional Adipose Tissue Associations With Calcified Atherosclerotic Plaque: African American–Diabetes Heart Study  

Microsoft Academic Search

Coronary artery calcified atherosclerotic plaque (CP) is strongly associated with nonsubcutaneous adipose tissue, particularly pericardial adipose tissue (PAT), in community-based studies. We tested for relationships between regional adipose tissue depots and CP in African Americans with longstanding type 2 diabetes. Infrarenal aorta, coronary, and carotid artery CP and pericardial, visceral, intermuscular, and subcutaneous organ-specific adipose tissue volumes were measured using

Jasmin Divers; Lynne E. Wagenknecht; Donald W. Bowden; J. Jeffrey Carr; R. Caresse Hightower; Jingzhong Ding; Jianzhao Xu; Carl D. Langefeld; Barry I. Freedman

2010-01-01

268

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

269

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

270

Study of ACEI versus ARB in Managing Hypertensive Overt Diabetic Nephropathy: Long-Term Analysis  

Microsoft Academic Search

Background: There is, to our knowledge, no study that has directly compared angiotensin-converting enzyme inhibitor (ACEI) with angiotensin receptor blocker (ARB) in hypertensive patients with overt diabetic nephropathy (DNP). We tried to analyze the outcomes of hypertensive patients with overt type 2 DNP who used only ACEIs or ARBs. Methods: The patients who had an estimated creatinine clearance <90 ml\\/min

Savas Ozturk; Fuat Sar; Olcay Bengi-Bozkurt; Rumeyza Kazancioglu

2009-01-01

271

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

272

Serum uric acid predicts vascular complications in adults with type 1 diabetes: the coronary artery calcification in type 1 diabetes study.  

PubMed

Epidemiologic evidence supports a link between serum uric acid (SUA) and vascular complications in diabetes, but it remains unclear whether SUA improves the ability of conventional risk factor to predict complications. We hypothesized that SUA at baseline would independently predict the development of vascular complications over 6 years and that the addition of SUA to American Diabetes Association's ABC risk factors (HbA1c, BP, LDL-C) would improve vascular complication prediction over 6 years in adults with type 1 diabetes. Study participants (N = 652) were 19-56 year old at baseline and re-examined 6 years later. Diabetic nephropathy was defined as incident albuminuria or rapid GFR decline (>3.3 %/year) estimated by the CKD-EPI cystatin C. Diabetic retinopathy (DR) was based on self-reported history, and proliferative diabetic retinopathy (PDR) was defined as laser eye therapy; coronary artery calcium (CAC) was measured using electron-beam computed tomography. Progression of CAC (CACp) was defined as a change in the square-root-transformed CAC volume ?2.5. Predictors of each complication were examined in stepwise logistic regression with subjects with complications at baseline excluded from analyses. C-statistics, integrated discrimination indices and net-reclassification improvement were utilized for prediction performance analyses. SUA independently predicted development of incident albuminuria (OR 1.8, 95 % CI 1.2-2.7), rapid GFR decline (1.9, 1.1-3.3), DR (1.4, 1.1-1.9), PDR (2.1, 1.4-3.0) and CACp (1.5, 1.1-1.9). SUA improved the discrimination and net-classification risk of vascular complications over 6 years. SUA independently predicted the development of vascular complications in type 1 diabetes and also improved the reclassification of vascular complications. PMID:24929955

Bjornstad, Petter; Maahs, David M; Rivard, Christopher J; Pyle, Laura; Rewers, Marian; Johnson, Richard J; Snell-Bergeon, Janet K

2014-10-01

273

Impaired cardiac anti-oxidant activity in diabetes: human and correlative experimental studies.  

PubMed

Increased reactive oxygen species (ROS) are traditionally viewed as arising from the metabolic flux of diabetes, although reduction in the activity of anti-oxidant systems has also been implicated. Among the latter is the major thiol reducing thioredoxin system, the activity of which may be diminished by high glucose-induced expression of its endogenous inhibitor, thioredoxin interacting protein (TxnIP). We assessed TxnIP mRNA/protein expression along with thioredoxin activity in human right atrial biopsy specimens from subjects with and without diabetes undergoing coronary artery grafting. In correlative experimental studies, we examined TxnIP expression in both type 1 and type 2 rodent models of diabetic cardiomyopathy. Finally, we used in vitro gene silencing to determine the contribution of changes in TxnIP abundance to the high glucose-induced reduction in thioredoxin activity. In human right atrial biopsies, diabetes was associated with a >30-fold increase in TxnIP gene expression and a 17 % increase in TxnIP protein expression (both p < 0.05). This was associated with a 21 % reduction in thioredoxin activity when compared to human non-diabetic cardiac biopsy samples (all p < 0.05). In correlative animal studies, both type 1 and type 2 diabetic rats demonstrated a significant increase in TxnIP mRNA and reduction in thioredoxin activity when compared to non-diabetic animals (all p < 0.05). This was associated with a significant increase in ROS (p < 0.05 when compared with control). In cultured cardiac myocytes, high glucose increased ROS and TxnIP mRNA expression, in association with a reduction in thioredoxin activity (p < 0.01). These findings were abrogated by TxnIP small interfering RNA (siRNA). Scrambled siRNA had no effect upon ROS or TxnIP expression. High glucose reduces thioredoxin activity and increases ROS via TxnIP overexpression. These findings suggest that impaired thiol reductive capacity, through altered TxnIP expression, contributes to increased ROS in the diabetic heart. PMID:24925443

Connelly, Kim A; Advani, Andrew; Advani, Suzanne L; Zhang, Yuan; Kim, Young M; Shen, Vanessa; Thai, Kerri; Kelly, Darren J; Gilbert, Richard E

2014-10-01

274

Effects of diabetes and ovariectomy on rat hippocampus (a biochemical and stereological study).  

PubMed

Oxidative stress is one of the main reasons of both menopause and diabetes. So, it plays crucial role in the pathogeneses of that condition and disease. Therefore, the objective of the present study was to investigate the effects of menopause and diabetes upon the hippocampus using a rat model. Adult female Sprague Dawley rats (n?=?24) were allocated randomly as follows; control (C group) ovariectomized (O group), diabetic (D group) and ovariectomy plus diabetic groups (DO group) (n?=?6; in each group), respectively. For evaluating the results, tissue biochemistry and stereological analysis were made. Biochemistry results (lipid peroxidase (LPO); catalase (CAT); superoxide dismutase (SOD); total glutatyon (GSH); and myeloperoxidase (MPO) values) in Group C-DO were determined as 12.27, 21.88, 23.08 and 29.90 nmol/gr tissue; 59.3, 70.06, 69.7 and 78.1 mmol/min/mg tissue; 174.2, 156.4, 159.7 and 154.6 mmol/min/mg tissue; 3.63, 3.61, 4.21 and 3.97 nmol/mg tissue; and 5.05, 5.68, 5.58 and 6.19 µmol/min/mg tissue, respectively. Moreover, both menopause and diabetes led to change of lipid profiles. There were significant differences between the control and other groups (Group C and D-DO) (p??0.05). At this point, we suggested that diabetes could aggravate deleterious effects of ovariectomy. PMID:21823905

Altunkaynak, B Z; Unal, D; Altunkaynak, M E; Halici, Z; Kalkan, Y; Keles, O N; Aksak, S; Selli, J; Unal, B

2012-03-01

275

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. PMID:23898220

Smolek, Michael K; Notaroberto, Neil F; Jaramillo, Arley G; Pradillo, Lisa R

2013-01-01

276

Diabetes, diabetes treatment and breast cancer prognosis.  

PubMed

The objectives of this study are to assess the impact of pre-existing diabetes and diabetes treatment on breast cancer prognosis. 8,108 women with centrally confirmed invasive breast cancer in the Women's Health Initiative diagnosed between 1998 and 2013 were followed through the date of death or September 20, 2013. Information on diabetes and diabetes therapy were obtained via self-report and face-to-face review of current medication containers, respectively. Cox proportional hazard regression was used to estimate adjusted relative hazard ratios for overall mortality. The proportional subdistribution hazard model was used to estimate hazard ratios for breast cancer-specific mortality. Compared with women without diabetes, women with diabetes had significantly increased risk of overall mortality (HR 1.26 95 % CI 1.06-1.48), especially among those who took insulin or had longer duration of diabetes. However, diabetes was not associated with increased risk of breast cancer-specific mortality, regardless of type of treatment and duration of diabetes, despite the significant association of diabetes with unfavorable tumor characteristics. Our large prospective cohort study provides additional evidence that pre-existing diabetes increases risk of total mortality among women with breast cancer. The increased total mortality associated with diabetes was mainly driven by increased risk of dying from diseases other than breast cancer. Thus, the continuum of care for breast cancer patients with diabetes should include careful attention to CVD risk factors and other non-cancer conditions. PMID:25261292

Luo, Juhua; Virnig, Beth; Hendryx, Michael; Wen, Sijin; Chelebowski, Rowan; Chen, Chu; Rohan, Tomas; Tinker, Lesley; Wactawski-Wende, Jean; Lessin, Lawrence; Margolis, Karen

2014-11-01

277

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

278

Using dynamic pupillometry as a simple screening tool to detect autonomic neuropathy in patients with diabetes: a pilot study  

Microsoft Academic Search

BACKGROUND: Autonomic neuropathy is a common and serious complication of diabetes. Early detection is essential to enable appropriate interventional therapy and management. Dynamic pupillometry has been proposed as a simpler and more sensitive tool to detect subclinical autonomic dysfunction. The aim of this study was to investigate pupil responsiveness in diabetic subjects with and without cardiovascular autonomic neuropathy (CAN) using

Giselle L Ferrari; Jefferson LB Marques; Rajiv A Gandhi; Simon R Heller; Fábio K Schneider; Solomon Tesfaye; Humberto R Gamba

2010-01-01

279

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

280

Diabetes Insipidus  

MedlinePLUS

... Z List of Topics and Titles : Diabetes Insipidus Diabetes Insipidus On this page: What is diabetes insipidus? ... Hope through Research For More Information What is diabetes insipidus? Diabetes insipidus (DI) is a rare disease ...

281

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

PubMed Central

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), and stage 2-4 CKD (estimated glomerular filtration rate [eGFR] 15-90 mL/min/1.73 m2 with persistent proteinuria). Subjects randomized to exercise underwent thrice weekly aerobic training for 6 followed by 18 weeks of supervised home exercise. The primary outcome variable was change in proteinuria. Results Seven subjects randomized to exercise and 4 control subjects completed the study. Exercise training resulted in an increase in exercise duration during treadmill testing, which was accompanied by slight but insignificant decreases in resting systolic blood pressure and 24-hour proteinuria. Exercise did not alter GFR, hemoglobin, glycated hemoglobin, serum lipids, or C-reactive protein (CRP). Caloric intake and body weight and composition also did not change with exercise training. Conclusion Exercise training in obese diabetic patients with CKD is feasible and may have clinical benefits. A large-scale randomized controlled trial to determine the effects of exercise on renal functions, cardiovascular fitness, inflammation, and oxidative stress in diabetic patients with CKD is planned. PMID:20003224

2009-01-01

282

Take Charge of Your Diabetes (Nerve Damage)  

MedlinePLUS

... 2 Diabetes in the United States CDC Study Gestational Diabetes Diabetes in the United States Heart Disease and ... Must Not Be Shared Lifetime Risk for Diabetes Mellitus in the United States Screening for Type 2 ...

283

Effects of Diabetes on a Male  

MedlinePLUS

... 2 Diabetes in the United States CDC Study Gestational Diabetes Diabetes in the United States Heart Disease and ... Must Not Be Shared Lifetime Risk for Diabetes Mellitus in the United States Screening for Type 2 ...

284

Association of Diabetes in Pregnancy with Child Weight at Birth, Age 12 Months and 5 Years - A Population-Based Electronic Cohort Study  

PubMed Central

Background This study examines the effect of diabetes in pregnancy on offspring weight at birth and ages 1 and 5 years. Methods A population-based electronic cohort study using routinely collected linked healthcare data. Electronic medical records provided maternal diabetes status and offspring weight at birth and ages 1 and 5 years (n?=?147,773 mother child pairs). Logistic regression models were used to obtain odds ratios to describe the association between maternal diabetes status and offspring size, adjusted for maternal pre-pregnancy weight, age and smoking status. Findings We identified 1,250 (0.9%) pregnancies with existing diabetes (27.8% with type 1 diabetes), 1,358 with gestational diabetes (0.9%) and 635 (0.4%) who developed diabetes post-pregnancy. Children whose mothers had existing diabetes were less likely to be large at 12 months (OR: 0.7 (95%CI: 0.6, 0.8)) than those without diabetes. Maternal diabetes was associated with high weight at age 5 years in children whose mothers had a high pre-pregnancy weight tertile (gestational diabetes, (OR:2.1 (95%CI:1.25–3.6)), existing diabetes (OR:1.3 (95%CI:1.0 to 1.6)). Conclusion The prevention of childhood obesity should focus on mothers with diabetes with a high maternal pre-pregnancy weight. We found little evidence that diabetes in pregnancy leads to long term obesity ‘programming’. PMID:24236160

Morgan, Kelly; Rahman, Mohammed; Atkinson, Mark; Zhou, Shang-Ming; Hill, Rebecca; Khanom, Ashrafunnesa; Paranjothy, Shantini; Brophy, Sinead

2013-01-01

285

Long-term lifestyle intervention lowers the incidence of stroke in Japanese patients with type 2 diabetes: a nationwide multicentre randomised controlled trial (the Japan Diabetes Complications Study)  

Microsoft Academic Search

Aims\\/hypothesis  The aim of the study was to clarify whether a therapeutic intervention focused on lifestyle modification affected the incidence\\u000a of vascular complications in patients with established diabetes.\\u000a \\u000a \\u000a \\u000a Methods  A total of 2,033 eligible Japanese men and women aged 40–70 years with type 2 diabetes from 59 institutes were randomised\\u000a to a conventional treatment group (CON), which continued to receive the usual care,

H. Sone; S. Tanaka; S. Iimuro; K. Oida; Y. Yamasaki; S. Oikawa; S. Ishibashi; S. Katayama; H. Yamashita; H. Ito; Y. Yoshimura; Y. Ohashi; Y. Akanuma; N. Yamada

2010-01-01

286

Factors Associated with Beta-Cell Dysfunction in Type 2 Diabetes: The BETADECLINE Study  

PubMed Central

Aims Beta-cell dysfunction is an early event in the natural history of type 2 diabetes. However, its progression is variable and potentially influenced by several clinical factors. We report the baseline data of the BetaDecline study, an Italian prospective multicenter study on clinical predictors of beta-cell dysfunction in type 2 diabetes. Materials and Methods Clinical, lifestyle, and laboratory data, including circulating levels of inflammatory markers and non-esterified fatty acids, were collected in 507 type 2 diabetic outpatients on stable treatment with oral hypoglycemic drugs or diet for more than 1 year. Beta-cell dysfunction was evaluated by calculating the proinsulin/insulin ratio (P/I). Results At baseline, the subjects in the upper PI/I ratio quartile were more likely to be men and receiving secretagogue drugs; they also showed a borderline longer diabetes duration (P?=?0.06) and higher serum levels of glycated hemoglobin (HbA1c), fasting blood glucose, and triglycerides. An inverse trend across all PI/I quartiles was noted for BMI and serum levels of total cholesterol (T-C), LDL-C, HDL-C and C reactive protein (CRP), and with homeostatic model assessment (HOMA-B) and HOMA of insulin resistance (HOMA-IR) values (P<0.05 for all). At multivariate analysis, the risk of having a P/I ratio in the upper quartile was higher in the subjects on secretagogue drugs (odds ratio [OR] 4.2; 95% confidence interval [CI], 2.6–6.9) and in the males (OR 1.8; 95% CI, 1.1–2.9). Conclusions In the BetaDecline study population, baseline higher PI/I values, a marker of beta-cell dysfunction, were more frequent in men and in patients on secretagogues drugs. Follow-up of this cohort will allow the identification of clinical predictors of beta-cell failure in type 2 diabetic outpatients. PMID:25347846

Russo, Giuseppina T.; Giorda, Carlo Bruno; Cercone, Stefania; Nicolucci, Antonio; Cucinotta, Domenico

2014-01-01

287

Infrared dermal thermography on diabetic feet soles to predict ulcerations: a case study  

NASA Astrophysics Data System (ADS)

Diabetic foot ulceration is a major complication for patients with diabetes mellitus. If not adequately treated, these ulcers may lead to foot infection, and ultimately to lower extremity amputation, which imposes a major burden to society and great loss in health-related quality of life for patients. Early identification and subsequent preventive treatment have proven useful to limit the incidence of foot ulcers and lower extremity amputation. Thus, the development of new diagnosis tools has become an attractive option. The ultimate objective of our project is to develop an intelligent telemedicine monitoring system for frequent examination on patients' feet, to timely detect pre-signs of ulceration. Inflammation in diabetic feet can be an early and predictive warning sign for ulceration, and temperature has been proven to be a vicarious marker for inflammation. Studies have indicated that infrared dermal thermography of foot soles can be one of the important parameters for assessing the risk of diabetic foot ulceration. This paper covers the feasibility study of using an infrared camera, FLIR SC305, in our setup, to acquire the spatial thermal distribution on the feet soles. With the obtained thermal images, automated detection through image analysis was performed to identify the abnormal increased/decreased temperature and assess the risk for ulceration. The thermography for feet soles of patients with diagnosed diabetic foot complications were acquired before the ordinary foot examinations. Assessment from clinicians and thermography were compared and follow-up measurements were performed to investigate the prediction. A preliminary case study will be presented, indicating that dermal thermography in our proposed setup can be a screening modality to timely detect pre-signs of ulceration.

Liu, Chanjuan; van der Heijden, Ferdi; Klein, Marvin E.; van Baal, Jeff G.; Bus, Sicco A.; van Netten, Jaap J.

2013-03-01

288

Quality of Diabetes Care: A cross-sectional observational study in Oman  

PubMed Central

Objectives: The objective of this study was to evaluate the quality of diabetes care in Oman. Methods: This was a cross-sectional observational study. Fifty percent of all those attending six general health centres in June 2005 were systematically selected for the study. Descriptive statistics were used to describe the data. Results: A total of 430 diabetic subjects were included. Just over 61% percent of the subjects were female (n = 263). The overall mean age of the cohort was 52 ± 12 years ranging from 6 to 84 years. Only 40% (n = 171) and 39% (n = 169) of the diabetics had their random blood sugar (RBS) and fasting blood sugar (FBS) documented, respectively. However, 79% (n = 339) had either RBS or FBS done according to the records. Documentation for the other measurements ranged from 74% (n = 317) for HbA1c and LDL (low density lipoproteins)-cholesterol to 95% (n = 409) for systolic and diastolic blood pressure (SBP/DBP) readings. A total of 58% (n = 249) of patients had non-missing values of HbA1c, SBP/DBP, total cholesterol, LDL-cholesterol, HDL (high density lipoproteins)-cholesterol, and triglycerides. Only 2.4% (6 out of 249 diabetics) were simultaneously within goal for HbA1c (<7%), SBP/DBP (<=130/80mmHg), total cholesterol (<5.2mmol/L), LDL-cholesterol (<3.3mmol/L), HDL-cholesterol (>1.1 – <1.68mmol/L), and triglycerides (<1.8mmol/L). Conclusion: There was good documentation of values for the indicators used in the assessment of quality. However, the proportion (2.4%) of those meeting internationally recognised goals for the three diabetes-related factors was extremely low. PMID:21509272

Al-Mandhari, Ahmed; Al-Zakwani, Ibrahim; El-Shafie, Omayma; Al-Shafaee, Mohammed; Woodhouse, Nicholas

2009-01-01

289

Teleretinal Screening for Diabetic Retinopathy in Six Los Angeles Urban Safety-Net Clinics: Final Study Results  

PubMed Central

In a previous paper, we presented initial findings from a study on the feasibility and challenges of implementing teleretinal screening for diabetic retinopathy in an urban safety net setting facing eyecare specialist shortages. This paper presents some final results from that study, which involved six South Los Angeles safety net clinics. A total of 2,732 unique patients were screened for diabetic retinopathy by three ophthalmologist readers, with 1035 receiving a recommendation for referral to specialty care. Referrals included 48 for proliferative diabetic retinopathy, 115 for severe non-proliferative diabetic retinopathy (NPDR), 247 for moderate NPDR, 246 for mild NPDR, 97 for clinically significant macular edema, and 282 for a non-diabetic condition, such as glaucoma. Image quality was also assessed, with ophthalmologist readers grading 4% to 13% of retinal images taken at the different clinics as being inadequate for any diagnostic interpretation. PMID:24551394

Ogunyemi, Omolola; George, Sheba; Patty, Lauren; Teklehaimanot, Senait; Baker, Richard

2013-01-01

290

Prevalence of dyslipidemia in adult Indian diabetic patients: A cross sectional study (SOLID)  

PubMed Central

Context: India leads the world with largest number of diabetic patients and is often referred to as the diabetes capital of the world. Diabetic dyslipidemia in India is one of the main cause for Coronary Artery Disease (CAD) mortality. Although diabetes continues to be a major lifestyle condition in India, there is a lack of studies in India on whether dyslipidemia in Indian diabetics is being adequately controlled. Our study provides critical insights into the insights into proportion of diabetes patients achieving lipid goal in India. Aims: The primary objective of our study was to assess the control of dyslipidemia in the Indian diabetic population treated with lipid lowering drugs (LLDs), as per American Diabetes Association (ADA) 2010 guidelines. Settings and Design: The study was carried out in a real world Indian clinical setting involving 178 sites. This is a multicenter, noninterventional, and cross-sectional observational study. Materials and Methods: A total of 5400 adult subjects with established type-2 diabetes mellitus (T2DM) and dyslipidemia were recruited for the study. Patients in the study were on LLD at a stable dose for at least last 3 months before the designated study visit. Routine lipid profile tests were conducted for all patients. Statistical Analysis Used: Descriptive statistics was used to analyze qualitative and discrete variables. Chi-square test and t-test were conducted to assess the existence of statistically significant association between the variables. Results: A total of 5400 patients with T2DM from 178 centers across India were recruited. Out of the total population, 56.75% (N = 3065) of them were males. Primary end-point of low-density lipoprotein cholesterol (LDL-C) level below ADA 2010 target was achieved in a total of 48.74% (N = 2632) patients. Gender was significantly associated with lipid levels and age was significantly (P < 0.05) correlated with all lipid levels. Control rates of other lipid parameters like high-density lipoprotein cholesterol, triglyceride, and total cholesterol in the study were 60.48% (N = 3236), 57.54% (N = 3107), and 92.24% (N = 4981) respectively. Among those with overt cardiovascular disease (CVD), target LDL-C level of < 70 mg/dL was achieved in 22.87% (70 out of 306) patients. The LDL-C levels of 49.03% (N = 1768) patients who were on statin therapy were within target levels, while 53.46% (N = 634) patients who were on statin and their combinations with other LLDs had their LDL-C levels within the stipulated range. Conclusions: This study has reveled that dyslipidemia control in Indian T2DM patients is very poor with almost half of them not reaching their LDL -C goal. Dyslipidemia being one of the main risk factors for CVD in T2DM patients there is a need to treat dyslipidemia aggressively to reduce risk of future CV events.

Mithal, Ambrish; Majhi, Debashish; Shunmugavelu, M.; Talwarkar, Pradeep G.; Vasnawala, Hardik; Raza, Ammar S.

2014-01-01

291

Experiences of self-management support from GPs among Australian ethnically diverse diabetes patients: A qualitative study.  

PubMed

Ethnically diverse diabetes patients face significant challenges in diabetes self-management ranging from cultural expectations to inequalities in health care provision. This study explored the experiences of ethnically diverse patients with diabetes attending group diabetes education in receiving self-management support from GPs. An approach based on phenomenology was used to analyse participants' experiences in self-management support across three group interviews comprising 28 Australian ethnically diverse diabetes patients: Arabic-speaking group (n?=?11), English-speaking group (n?=?9) and Vietnamese-speaking group (n?=?8). Two themes emerged related to the poor quality of information to support self-management and challenges in negotiating traditional consultation styles. In particular, participants believed they knew more about diabetes self-management than their GPs but felt unable to influence consultation style and communicate their changing needs in self-management support. The health care and information needs of ethnically diverse patients continue to be marginalised within health systems. This small exploratory study highlights the need for further research to illuminate interactions between ethnically diverse diabetes patients and GPs in supporting long-term diabetes self-management. PMID:24678787

Rose, Vanessa K; Harris, Mark F

2015-01-01

292

Understanding the Relationship between Type 2 Diabetes Mellitus and Falls in Older Adults: A Prospective Cohort Study  

PubMed Central

Background Older adults with type 2 Diabetes Mellitus are at increased risk of falling. The current study aims to identify risk factors that mediate the relationship between diabetes and falls. Methods 199 older adults (104 with diabetes and 95 healthy controls) underwent a medical screening. Gait (GAITRite®), balance (AccuGait® force plate), grip strength (Jamar®), and cognitive status (Mini-Mental State Examination and Clock Drawing Test) were assessed. Falls were prospectively recorded during a 12-month follow-up period using monthly calendars. Results Compared to controls, diabetes participants scored worse on all physical and cognitive measures. Sixty-four participants (42 diabetes vs. 22 controls) reported at least one injurious fall or two non-injurious falls (“fallers”). Univariate logistic regression identified diabetes as a risk factor for future falls (Odds Ratio 2.25, 95%CI 1.21–4.15, p?=?0.010). Stepwise multiple regressions defined diabetes and poor balance as independent risk factors for falling. Taking more medications, slower walking speed, shorter stride length and poor cognitive performance were mediators that reduced the Odds Ratio of the relationship between diabetes and faller status relationship the most followed by reduced grip strength and increased stride length variability. Conclusions Diabetes is a major risk factor for falling, even after controlling for poor balance. Taking more medications, poorer walking performance and reduced cognitive functioning were mediators of the relationship between diabetes and falls. Tailored preventive programs including systematic medication reviews, specific balance exercises and cognitive training might be beneficial in reducing fall risk in older adults suffering from diabetes. PMID:23825617

Roman de Mettelinge, Tine; Cambier, Dirk; Calders, Patrick; Van Den Noortgate, Nele; Delbaere, Kim

2013-01-01

293

The Swedish childhood diabetes study — results from a nine year case register and a one year case-referent study indicating that Type 1 (insulin-dependent) diabetes mellitus is associated with both Type 2 (non-insulin-dependent) diabetes mellitus and autoimmune disorders  

Microsoft Academic Search

Summary  From July 1, 1977 to July 1, 1986, 3,503 incident cases of Type 1 (insulin-dependent) diabetes mellitus were registered in the Swedish childhood diabetes study. Using data from this register and from a case-referent study, including all incident Type 1 diabetic children in Sweden during one year and, for each patient, two referent children matched according to age, sex and

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

1989-01-01

294

Clinical and experimental studies on polyherbal formulations for diabetes: current status and future prospective.  

PubMed

Diabetes is a leading cause of morbidity and mortality in the world. There is currently an active search for antidiabetic drugs with greater effectiveness with fewer and less adverse side effects. Although numerous individual herbs have been experimentally or clinically reported to possess antidiabetic effects, considerably less research has been conducted on polyherbal compounds. It is believed that herbal compounds containing multiple plant products have synergistic antidiabetic effects and could enhance the desired actions. Several polyherbal formulations have been studied as therapeutic agents in diabetes management. To describe the current state of research on polyherbal compounds in the treatment of diabetes, an extensive review of literature was undertaken on several major databases. This paper presents what is known about the efficacy of these polyherbal formulations and compare their antidiabetic effects with those of current oral hypoglycemic drugs as reference. The percent decrease in blood glucose, lipids and other biochemical parameters achieved by each product in diabetic animals and patients is reported. Also, the possible mechanisms responsible for hypoglycemic action of polyherbal formulations are discussed. PMID:25074883

Ghorbani, Ahmad

2014-07-01

295

Diabetic nephropathy in a sibling and albuminuria predict early GFR decline: a prospective cohort study  

PubMed Central

Background Diabetic nephropathy is a growing clinical problem, and the cause for >40% of incident ESRD cases. Unfortunately, few modifiable risk factors are known. The objective is to examine if albuminuria and history of diabetic nephropathy (DN) in a sibling are associated with early DN progression or mortality. Methods In this longitudinal study of adults >18 yrs with diabetes monitored for up to 9 yrs (mean 4.6?±?1.7 yrs), 435 subjects at high risk (DN family history) and 400 at low risk (diabetes >10 yrs, normoalbuminuria, no DN family history) for DN progression were evaluated for rate of eGFR change using the linear mixed effects model and progression to ESRD. All-cause mortality was evaluated by Kaplan-Meier analyses while controlling for baseline covariates in a Cox proportional hazards model. Covariates included baseline eGFR, age, gender, race, diabetes duration, blood pressure, hemoglobin A1c and urine albumin:creatinine ratio. Propensity score matching was used to identify high and low risk group pairs with balanced covariates. Sensitivity analyses were employed to test for residual confounding. Results Mean baseline eGFR was 74 ml/min/1.73 m2 (86% of cohort >60 ml/min/1.73 m2). Thirty high risk and no low risk subjects developed ESRD. eGFR decline was significantly greater in high compared to low risk subjects. After controlling for confounders, change in eGFR remained significantly different between groups, suggesting that DN family history independently regulates GFR progression. Mortality was also significantly greater in high versus low risk subjects, but after controlling for baseline covariates, no significant difference was observed between groups, indicating that factors other than DN family history more strongly affect mortality. Analyses of the matched pairs confirmed change in eGFR and mortality findings. Sensitivity analyses demonstrated that the eGFR results were not due to residual confounding by unmeasured covariates of a moderate effect size in the propensity matching. Conclusions Diabetic subjects with albuminuria and family history of DN are vulnerable for early GFR decline, whereas subjects with diabetes for longer than 10 years, normoalbuminuria and negative family history, experience slower eGFR decline, and are extremely unlikely to require dialysis. Although we would not recommend that patients with low risk characteristics be neglected, scarce resources would be more sensibly devoted to vulnerable patients, such as the high risk cases in our study, and preferably prior to the onset of albuminuria or GFR decline. PMID:23773264

2013-01-01

296

Mortality in diabetic and nondiabetic patients after amputations performed from 1996 to 2005 in a tertiary hospital population: a 3-year follow-up study  

Microsoft Academic Search

AimsDiabetes is the leading cause of lower-extremity amputations worldwide. The objective of this study was to look at the survival after first amputation between subjects with and without diabetes in a sample of Greek population.

Athanasia Papazafiropoulou; Nicholas Tentolouris; Rigas-Philippos Soldatos; Christos D. Liapis; Eleftherios Dounis; Alkiviadis G. Kostakis; Elias Bastounis; Nicholas Katsilambros

2009-01-01

297

Low Socioeconomic Status is Associated with Increased Risk for Hypoglycemia in Diabetes Patients: the Diabetes Study of Northern California (DISTANCE)  

PubMed Central

Background Social risk factors for hypoglycemia are not well understood. Methods Cross-sectional analysis from the DISTANCE study, a multi-language, ethnically-stratified random sample of adults in the Kaiser Permanente Northern California diabetes registry, conducted in 2005-2006 (response rate 62%). Exposures were income and educational attainment; outcome was patient report of severe hypoglycemia. To test the association, we used multivariable logistic regression to adjust for demographic and clinical factors. Results 14,357 patients were included. Reports of severe hypoglycemia were common (11%), and higher in low-income vs. high-income (16% vs. 8.8) and low-education vs. high-education (11.9% vs. 8.9%) groups. In multivariable analysis, incomes of less than $15,000 (OR 1.51 95%CI 1.19-1.91), $15,000-$24,999 (OR 1.57 95%CI 1.27-1.94), and high school or less education (OR 1.42, 95% CI 1.24-1.63) were associated with increased hypoglycemia, similar to insulin use (OR 1.44 95%CI 1.19-1.74). Conclusions Low income and educational attainment are important risk factors for hypoglycemia. PMID:24858863

Berkowitz, Seth A.; Karter, Andrew J.; Lyles, Courtney R.; Liu, Jennifer Y.; Schillinger, Dean; Adler, Nancy E.; Moffet, Howard H.; Sarkar, Urmimala

2014-01-01

298

Comparative neurophysiological study for the diagnosis of mild polyneuropathy in patients with diabetes mellitus and glucose intolerance.  

PubMed

This article evaluates diagnostic sensitivity of minimal F-wave latency, sural/radial amplitude ratio (SRAR), dorsal sural/radial amplitude ratio (DSRAR), sympathetic skin response (SSR), and R-R interval variability (RRIV) for detecting early polyneuropathy in patients with glucose intolerance and diabetic patients. F-wave latencies were more prolonged in diabetic patients with normal and abnormal nerve conduction studies than control subjects (p < .001). SRAR was lower, SSR latency was more prolonged, and RRIV was lower in diabetic patients with abnormal nerve conduction studies than healty controls (p < .001). SSR latency was more prolonged and RRIV was lower in diabetic patients with normal nerve conduction studies than healty controls (p < .01, p < .05, respectively). DSRAR was lower in diabetic patients with normal and abnormal nerve conduction studies than control subjects (p < .001). DSRAR was also lower in patients with glucose intolerance than control subjects (p < .01). DSRAR was the most sensitive and specific test in either of diabetic patients with normal nerve conduction studies (sensitivity 66%, specificity 90%) and diabetic patients with abnormal nerve conduction studies (sensitivity 100%, specificity 90%). DSRAR is the most reliable method for detection of early nerve pathology. Patients with glucose intolerance might have subclinical neuropathy that can be demonstrated with DSRAR analysis. PMID:16753899

Turgut, Nilda; Güldiken, Sibel; Balci, Kemal; Tugrul, Armagan; Berberoglu, Ufuk; Altun, Betül Ugur

2006-06-01

299

[Experimental study on diabetes and pregnancy: with special reference to the effects of insulin treatment on fetuses of diabetic dams].  

PubMed

Through the development of treatment of diabetes mellitus, diabetic cases of pregnancy have been increasing, and the effects of maternal hyperglycemia and insulin-treated hypoglycemia on the growth and life of fetuses and newborns are becoming very important problems. However, it is difficult for us to investigate the fetuses of human diabetic mothers as experimental models. Although many reports deal with the development of newborns of diabetic mothers and about their secretory changes of insulin and C-peptide reactivity, there have been few reports concerning the effects of severe diabetes on pregnancy and the effects of insulin treatment on fetuses. Concerning experimental animals, there are also few reports about the effects of insulin treatment on diabetic pregnant animals. We conducted the present investigation to determine the effects of insulin treatment on the growth and metabolism of the fetuses of diabetic pregnant rats. Virgin female Wistar rats weighing 200 approximately 300 g were caged overnight with male rats. The mated females were isolated and the gestational age was calculated from noon of this day (zero). Seventeen of 24 pregnant rats received a rapid intravenous injection of 50 mg/kg body weight of streptozotocin (STZ) in 0.4 ml of 0.01 M citrate buffer (pH 4.5) immediately after blood samples were collected through the jugular vein under light ether anaesthesia on the 5th day of gestation. Seven pregnant rats were injected with only 0.4 ml of citrate buffer and served as the controls. These rats were divided into four groups, and each group was named as follows: Normal pregnant rats group (group I, n = 7), diabetic pregnant rats group (group II, n = 6) and insulin-treated diabetic pregnant rats group (group III: plasma glucose level 60 approximately 300 mg/dl, n = 6 and group IV: plasma glucose level below 60 mg/dl, n = 5). Group III and IV rats were treated with a subcutaneous injection of Lente Insulin (from 2 u. to 6 u.) every day from the 13th to the 19th day of gestation. Group II rats were injected with saline every day in the same way. Maternal blood samples were collected under light ether anaesthesia after feeding ad libitum on the 5th and 12th days of gestation. On the 20th day of gestation, the pregnant rats were anaesthetized by an intraperitoneal injection of sodium pentobarbital, and blood samples were collected in the manner stated above. Each fetus and placenta was taken out individually by hysterotomy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:6363146

Kawara, A; Matsuura, M; Takahata, K; Hirose, Y; Ishihara, K; Makimura, H; Utsumi, M; Doi, K; Baba, S; Yoshida, M

1983-08-20

300

Characteristics of Marshallese with Type 2 Diabetes on Oahu: A Pilot Study to Implement a Community-Based Diabetic Health Improvement Project  

PubMed Central

Objectives To determine the feasibility of a resident physician-based, culturally appropriate method of decreasing the disease burden of Type 2 Diabetes Mellitus (DM2) in a group of Pacific Islanders, Marshallese living in Hawai’i. Methods Thirty one Marshallese with diabetes who live on the island of Oahu, Hawaii were recruited. Baseline health status of the participants was characterized. Health parameters included HgbA1c, random blood sugar (RBS), lipid panels, body mass index (BMI), blood pressure, and medical history, along with qualitative information. A focus group was held with participants prior to beginning the curriculum to determine cultural views on diabetes, health, treatment, and to identify potential obstacles to health improvement. A DM2 educational curriculum culturally relevant to Marshallese populations was then started, including instruction in lifestyle modification, adherence to medication regimens, and planned quarterly assessment of health improvement. Results Baseline quantitative analysis revealed Marshallese with diabetes to be obese and hyperglycemic, with average BMI of 30 kg/m2, RBS of 285, and HgbA1c of 9.3. Qualitative analysis revealed that nearly half the participants admitted to symptoms of severe hyperglycemia. The initial focus group had a substantial turnout. Attendance rapidly declined, becoming so low that classes were eventually terminated. However, in two participants who attended more than three classes there was evidence of major improvements in HgbA1c, cholesterol, and qualitative markers, which were sustained after one year. Conclusions This pilot study of Marshallese with diabetes on Oahu showed that the majority had poor glycemic control with secondary co-morbid conditions. Although many barriers exist for successful implementation of a diabetes health improvement project in this group, the groundwork for translation of this project to the Republic of Marshall Islands (RMI) has been laid; curriculum translation and patient recruitment is currently underway to advance the project. PMID:17139336

Reddy, Ravi; Shehata, Cherie; Smith, Garrett

2006-01-01

301

Increased Risk of Acute Pancreatitis in Patients with Type 2 Diabetes: An Observational Study Using a Japanese Hospital Database  

PubMed Central

Background Increased risks of acute pancreatitis in patients with type 2 diabetes mellitus have been reported recently in several countries. We aimed to estimate the risks of acute pancreatitis in Japanese patients with diabetes mellitus. Methods/Findings We examined a large-scale hospital administrative database consisting of one million patients in 16 secondary medical care hospitals, from 2003 to 2010. The incidence rates of acute pancreatitis were estimated with cohort design; the odds ratios associated with diabetes mellitus and other comorbid risk factors were estimated with separate case-control analyses. In cohort analysis, the incidence of acute pancreatitis was higher in 14,707 diabetic patients than in 186,032 non-diabetic patients (4.75 vs. 1.65 per 1,000 patient-years) and increased in male patients and as age advanced. The adjusted odds ratio of acute pancreatitis in patients with diabetes mellitus was 1.86 (P<0.001) compared with non-diabetic patients in case-control analysis from 1,372 cases and 5,469 matched controls, which is consistent with the ones reported in previous studies. Alcoholism and gallstones were associated with a large increase in the risk of acute pancreatitis (adjusted odds ratio 13.40 and 14.29, respectively, P<0.001), although dyslipidemia was associated with significant risk reduction (adjusted odds ratio 0.62, P<0.001). Conclusions This observational study ascertained the elevated incidence rates and risk of acute pancreatitis in Japanese patients with diabetes. The risk estimates in Japanese patients with diabetes were in agreement with the ones reported in previous studies, and the elevated risk of acute pancreatitis in patients with diabetes would be generalized in different locations/populations. PMID:23300896

Urushihara, Hisashi; Taketsuna, Masanori; Liu, Ying; Oda, Eisei; Nakamura, Masaki; Nishiuma, Shinichi; Maeda, Rei

2012-01-01

302

Long term influence of insulin dependent diabetes mellitus on refraction and its components: a population based twin study  

PubMed Central

AIM—To study whether refraction of the eye, or some of its components is influenced by duration of insulin dependent diabetes mellitus.?METHODS—From the young cohort of the population based Danish Twin Register, containing 20 888 twin pairs born between 1953 and 1982, all twin pairs having one or both partners affected with IDDM were searched. Autorefraction, autokeratometry, and ultrasonic biometric measurements were carried out on 45 twin pairs: 16 monozygotic (MZ) twin pairs, 14 dizygotic twin pairs of same sex (DZss), and 15 dizygotic twin pairs of opposite sex (DZos). To obtain an estimate of the influence of duration of diabetes, the intrapair differences in duration of diabetes were correlated with intrapair differences in refraction and each of its components.?RESULTS—Refraction was statistically significantly negatively correlated with duration of diabetes in the DZss group, and axial length correspondingly positively correlated. Surprisingly, refraction and axial length in the MZ group, adjusted for confounding factors, were correlated with diabetes duration in the opposite direction than in the DZss group, although not reaching statistical significance. Lens thickness was statistically significantly positively correlated with duration of diabetes in both MZ and DZ twins. Anterior chamber depth was negatively correlated with duration of diabetes in all the zygosity groups.?CONCLUSIONS—Studies of relations between refraction and duration of diabetes show diverging results. In the MZ group, a tendency to reduced axial length and corresponding hyperopia with increasing duration of diabetes was found. However, in the DZ group of same sex the opposite tendency was found. Increasing lens thickness and decreasing anterior chamber depth with increasing duration of diabetes have been confirmed in this study.?? PMID:9227196

Logstrup, N.; Sjolie, A. K.; Kyvik, K. O.; Green, A.

1997-01-01

303

Factors Affecting Mobile Diabetes Monitoring Adoption Among Physicians: Questionnaire Study and Path Model  

PubMed Central

Background Patients with type 1 and type 2 diabetes often find it difficult to control their blood glucose level on a daily basis because of distance or physical incapacity. With the increase in Internet-enabled smartphone use, this problem can be resolved by adopting a mobile diabetes monitoring system. Most existing studies have focused on patients’ usability perceptions, whereas little attention has been paid to physicians’ intentions to adopt this technology. Objective The aim of the study was to evaluate the perceptions and user acceptance of mobile diabetes monitoring among Japanese physicians. Methods A questionnaire survey of physicians was conducted in Japan. The structured questionnaire was prepared in a context of a mobile diabetes monitoring system that controls blood glucose, weight, physical activity, diet, insulin and medication, and blood pressure. Following a thorough description of mobile diabetes monitoring with a graphical image, questions were asked relating to system quality, information quality, service quality, health improvement, ubiquitous control, privacy and security concerns, perceived value, subjective norms, and intention to use mobile diabetes monitoring. The data were analyzed by partial least squares (PLS) path modeling. Results In total, 471 physicians participated from 47 prefectures across Japan, of whom 134 were specialized in internal and gastrointestinal medicine. Nine hypotheses were tested with both the total sample and the specialist subsample; results were similar for both samples in terms of statistical significance and the strength of path coefficients. We found that system quality, information quality, and service quality significantly affect overall quality. Overall quality determines the extent to which physicians perceive the value of mobile health monitoring. However, in contrast to our initial predictions, overall quality does not have a significant direct effect on the intention to use mobile diabetes monitoring. With regard to net benefits, both ubiquitous control and health improvement are significant predictors. Net benefits in turn significantly motivate physicians to use mobile health monitoring, and has a strong influence on perceived value. Perceived value and subjective norms are predictors of intention to use. In our sample, concerns over privacy and security risk have no significant effects on intention to use mobile diabetes monitoring. Among the 3 control variables, only age significantly affected intention to use mobile diabetes monitoring, whereas experience and gender were not significant predictors of intention. Conclusions Physicians consider perceived value and net benefits as the most important motivators to use mobile diabetes monitoring. Overall quality assessment does affect their intention to use this technology, but only indirectly through perceived value. Net benefits seem to be a strong driver in both a direct and indirect manner, implying that physicians may perceive health improvement with ubiquitous control as a true utility by enhancing cost-effective monitoring, and simultaneously recognize it as a way to create value for their clinical practices. PMID:23257115

Castaneda, Jose Alberto; Sanz, Silvia; Henseler, Jorg

2012-01-01

304

Maternal age at birth and childhood type 1 diabetes: a pooled analysis of 30 observational studies  

Microsoft Academic Search

Objective: To investigate whether children born to older mothers have an increased risk of type 1 diabetes by performing a meta-analysis using individual patient data to adjust for recognised confounders.\\u000aResearch design and methods: Relevant studies published before June 2009 were identified from MEDLINE, Web of Science and EMBASE. Authors of studies were contacted and asked to provide individual patient

Chris R Cardwell; Lars C Stene; Geir Joner; Max K Bulsara; Ondrej Cinek; Joachim Rosenbauer; Johnny Ludvigsson; Mireia Jané; Jannet Svensson; Michael J Goldacre; Thomas Waldhoer; Przamyslawa Jarosz-Chobot; Suely GA Gimeno; Lee-Ming Chuang; Roger C Parslow; Emma JK Wadsworth; Amanda Chetwynd; Paolo Pozzilli; Girts Brigis; Brone Urbonait?; Sandra Sipetic; Edith Schober; Gabriele Devoti; Constantin Ionescu-Tirgoviste; Carine E de Beaufort; Denka Stoyanov; Karsten Buschard; Chris C Patterson

2010-01-01

305

Prevalence and clinical characteristics of lower limb atherosclerotic lesions in newly diagnosed patients with ketosis-onset diabetes: a cross-sectional study  

PubMed Central

Background The clinical features of atherosclerotic lesions in ketosis-onset diabetes are largely absent. We aimed to compare the characteristics of lower limb atherosclerotic lesions among type 1, ketosis-onset and non-ketotic type 2 diabetes. Methods A cross-sectional study was performed in newly diagnosed Chinese patients with diabetes, including 53 type 1 diabetics with positive islet-associated autoantibodies, 208 ketosis-onset diabetics without islet-associated autoantibodies, and 215 non-ketotic type 2 diabetics. Sixty-two subjects without diabetes were used as control. Femoral intima-media thickness (FIMT), lower limb atherosclerotic plaque and stenosis were evaluated and compared among the four groups based on ultrasonography. The risk factors associated with lower limb atherosclerotic plaque were evaluated via binary logistic regression in patients with diabetes. Results After adjusting for age and sex, the prevalence of lower limb plaque in the patients with ketosis-onset diabetes (47.6%) was significantly higher than in the control subjects (25.8%, p?=?0.013), and showed a higher trend compared with the patients with type 1 diabetes (39.6%, p?=?0.072), but no difference was observed in comparison to the patients with non-ketotic type 2 diabetes (62.3%, p?=?0.859). The mean FIMT in the ketosis-onset diabetics (0.73?±?0.17 mm) was markedly greater than that in the control subjects (0.69?±?0.13 mm, p?=?0.045) after controlling for age and sex, but no significant differences were found between the ketosis-onset diabetics and the type 1 diabetics (0.71?±?0.16 mm, p?=?0.373), and the non-ketotic type 2 diabetics (0.80?±?0.22 mm, p?=?0.280), respectively. Age and FIMT were independent risk factors for the presence of lower limb plaque in both the ketosis-onset and non-ketotic type 2 diabetic patients, while sex and age in the type 1 diabetic patients. Conclusions The prevalence and risk of lower limb atherosclerotic plaque in the ketosis-onset diabetes were remarkably higher than in the control subjects without diabetes. The features and risk factors of lower limb atherosclerotic lesions in the ketosis-onset diabetes resembled those in the non-ketotic type 2 diabetes, but different from those in the type 1 diabetes. Our findings provide further evidences to support the classification of ketosis-onset diabetes as a subtype of type 2 diabetes rather than idiopathic type 1 diabetes. PMID:24926320

2014-01-01

306

Current treatment options for type 2 diabetes mellitus in youth: today's realities and lessons from the TODAY study.  

PubMed

The incidence of type 2 diabetes in children and adolescents has increased over the last 2 decades, paralleled by an increase in obesity over the same time period. Although the value of lifestyle modification in obese youth is unquestioned, scant evidence for optimal treatment of type 2 diabetes in this age group exists. Despite recent therapeutic drug trials, metformin and insulin are the only medicines currently approved by the U.S. Food and Drug Administration for the treatment of type 2 diabetes in youth. Because of recently amended pharmaceutical regulations, however, it is likely that more antidiabetic medications soon will be added to the armamentarium of therapeutic options for youth with type 2 diabetes. Additionally, the recently published TODAY study comparing safety and efficacy of three treatment regimens in maintaining glycemic control in youth with type 2 diabetes has shed new light on the problem. PMID:23065368

George, Minu M; Copeland, Kenneth C

2013-02-01

307

Differential relationship between physical activity and progression to diabetes by glucose tolerance status: the Inter99 Study  

Microsoft Academic Search

Aims\\/hypothesis  The aim of the study was to analyse how strongly commuting and leisure-time physical activity affect progression to diabetes\\u000a and to study whether this relationship is different in individuals with isolated impaired fasting glucose (i-IFG) and isolated\\u000a impaired glucose tolerance (i-IGT).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We studied the incidence of diabetes in 4,031 individuals without diabetes at baseline who participated in the baseline and

S. Engberg; C. Glümer; D. R. Witte; T. Jørgensen; K. Borch-Johnsen

2010-01-01

308

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

PubMed Central

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 using purposive sampling in three sequential phases. Thematic analysis was used iteratively to achieve progressive focusing and to develop theory. To explore tensions in preliminary data fictional vignettes were created, which were discussed by participants in subsequent phases. The PEN-3 multilevel theoretical framework was used to inform data analysis and synthesis. Results Most lay participants accepted the concept of diabetes prevention and were more knowledgeable than expected. Practical and structural barriers to a healthy lifestyle were commonly reported. There was a strong desire to comply with cultural norms, particularly those relating to modesty. Religious leaders provided considerable support from Islamic teachings for messages about diabetes prevention. Some clinicians incorrectly perceived Bangladeshis to be poorly informed and fatalistic, although they also expressed concerns about their own limited cultural understanding. Conclusion Contrary to the views of health professionals and earlier research, poor knowledge was not the main barrier to healthy lifestyle choices. The norms and expectations of Islam offer many opportunities for supporting diabetes prevention. Interventions designed for the white population, however, need adaptation before they will be meaningful to many Bangladeshis. Religion may have an important part to play in supporting health promotion in this community. The potential for collaborative working between health educators and religious leaders should be explored further and the low cultural understanding of health professionals addressed. PMID:18984633

2008-01-01

309

Evaluation of the new ADA and WHO criteria for classification of diabetes mellitus in young adult people (15–34 yrs) in the Diabetes Incidence Study in Sweden (DISS)  

Microsoft Academic Search

Aims\\/hypothesis  We aimed to evaluate how an aetiology-based classification, as recommended in the ADA and WHO guidelines for classification of diabetes mellitus, matches clinical judgement in the Diabetes Incidence Study in Sweden (DISS), a study covering incident cases of diabetic patients aged 15 to 34 years.Methods  During a 1-year period (1998), blood samples were taken at diagnosis and 4 months (median) thereafter.

H. Borg; H. J. Arnqvist; E. Björk; J. Bolinder; J. W. Eriksson; L. Nyström; J. O. Jeppsson; G. Sundkvist

2003-01-01

310

Diabetes Mellitus and Risk of Bladder Cancer: A Meta-Analysis of Cohort Studies  

PubMed Central

Objective Diabetes is associated with increased risk of cancer at several sites, but its association with risk of bladder cancer is still controversial. We examined this association by conducting a systematic review and meta-analysis of cohort studies. Methods Studies were identified by searching PubMed, EMBASE, Scopus, Web of Science, Cochrane register, and Chinese National Knowledge Infrastructure (CNKI) databases through April 29, 2012. Summary relative risks (SRRs) with their corresponding 95% confidence intervals (CIs) were calculated using a random-effects model. Results A total of fifteen cohort studies were included in this meta-analysis. Analysis of all studies showed that diabetes was associated with a borderline statistically significant increased risk of bladder cancer (RR 1.11, 95% CI 1.00–1.23; p<0.001 for heterogeneity; I2?=?84%). When restricting the analysis to studies that had adjusted for cigarette smoking (n?=?6) or more than three confounders (n?=?7), the RRs were 1.32 (95% CI 1.18–1.49) and 1.20 (95% CI 1.02–1.42), respectively. There was no significant publication bias (p?=?0.62 for Egger’s regression asymmetry test). Conclusions Our findings support that diabetes was associated with an increased risk of bladder cancer. More future studies are warranted to get a better understanding of the association and to provide convincing evidence for clinical practice in bladder cancer prevention. PMID:23472134

Xu, Xin; Wu, Jian; Mao, Yeqing; Zhu, Yi; Hu, Zhenghui; Xu, Xianglai; Lin, Yiwei; Chen, Hong; Zheng, Xiangyi; Qin, Jie; Xie, Liping

2013-01-01

311

Clinical signature and pathogenetic factors of diabetes associated with pancreas disease (T3cDM): a prospective observational study in surgical patients.  

PubMed

To characterize the clinical signature and etiopathogenetic factors of diabetes associated with pancreas disease [type 3 diabetes mellitus (T3cDM)]. To estimate incidence and identify predictors of both diabetes onset and remission after pancreatic surgery. A prospective observational study was conducted. From January 2008 to December 2012, patients (n = 651) with new diagnosis of pancreatic disease admitted to the Pancreatic Surgery Unit of the San Raffaele Scientific Institute were evaluated. Hospital and/or outpatient medical records were reviewed. Blood biochemical values including fasting blood glucose, insulin and/or C-peptide, glycosylated hemoglobin and anti-islet antibodies were determined. Diabetes onset was assessed after surgery and during follow-up. At baseline, the prevalence of diabetes was 38 % (age of onset 64 ± 11 years). In most cases, diabetes occurred within 48 months from pancreatic disease diagnosis. Among different pancreatic diseases, minor differences were observed in diabetes characteristics, with the exception of the prevalence. Diabetes appeared associated with classical risk factors for type 2 diabetes (i.e., age, sex, family history of diabetes and body mass index), and both beta-cell dysfunction and insulin resistance appeared relevant determinants. The prevalence of adult-onset autoimmune diabetes was as previously reported within type 2 diabetes. Within a few days after surgery, either diabetes remission or new-onset diabetes was observed. In patients with pancreatic cancer, no difference in diabetes remission was observed after palliative or resective surgery. Classical risk factors for type 2 diabetes were associated with the onset of diabetes after surgery. T3cDM appeared as a heterogeneous entity strongly overlapped with type 2 diabetes. PMID:24974302

Balzano, Gianpaolo; Dugnani, Erica; Pasquale, Valentina; Capretti, Giovanni; Radaelli, Maria Grazia; Garito, Tania; Stratta, Gregorio; Nini, Alessandro; Di Fenza, Raffaele; Castoldi, Renato; Staudacher, Carlo; Reni, Michele; Scavini, Marina; Doglioni, Claudio; Piemonti, Lorenzo

2014-10-01

312

Quantitative estimation of sodium, potassium and total protein in saliva of diabetic smokers and nonsmokers: A novel study  

PubMed Central

Aims: The aim of the study was to evaluate the difference in sodium, potassium, total protein in whole saliva in diabetic smokers, diabetic nonsmokers and healthy controls. Materials and Methods: Nonstimulated saliva samples were collected from a group of diabetic smokers, diabetic nonsmokers, and controls. Supernatant after centrifugation was used to determine the levels of sodium, potassium, and total protein by using semiautomatic analyzer. Results: There exists a statistical difference in the levels of potassium and total protein between diabetic smokers, nondiabetic smokers, and controls. Difference in the levels of sodium is only significant with nondiabetic smokers and controls. Conclusion: Diabetes mellitus is known to alter the composition of saliva. The purpose of this study was to estimate and compare the levels of salivary potassium, sodium, and total protein in smoker diabetic patients and nondiabetic smokers and controls, and to explore potential of salivary electrolytes [Na+, K+] and total proteins as markers. The estimated values of salivary constituents add to the data already recorded in Indian population. However, further studies using large samples are required to evaluate the findings in our study. PMID:24082729

Kallapur, Basavaraj; Ramalingam, Karthikeyan; Bastian; Mujib, Ahmed; Sarkar, Amitabha; Sethuraman, Sathya

2013-01-01

313

Contracting and Monitoring Relationships for Adolescents with Type 1 Diabetes: A Pilot Study  

PubMed Central

Abstract Background Adolescents are developmentally in a period of transition—from children cared for by their parents to young adults capable of self-care, independent judgment, and self-directed problem solving. We wished to develop a behavioral contract for adolescent diabetes management that addresses some negotiable points of conflict within the parent–child relationship regarding self-monitoring and then assess its effectiveness in a pilot study as part of a novel cell phone–based glucose monitoring system. Methods In the first phase of this study we used semistructured interview techniques to determine the major sources of diabetes-related conflict in the adolescent–parent relationship, to identify factors that could facilitate or inhibit control, and to determine reasonable goals and expectations. These data were then used to inform development of a behavioral contract that addressed the negotiable sources of conflict between parents and their adolescent. The second phase of this research was a 3-month pilot study to measure how a novel cell phone glucose monitoring system would support the contract and have an effect on glucose management, family conflict, and quality of life. Results Interviews were conducted with 10 adolescent–caregiver pairs. The major theme of contention was nagging about diabetes management. Two additional themes emerged as points of negotiation for the behavioral contract: glucose testing and contact with the diabetes clinical team. Ten adolescent–parent pairs participated in the pilot test of the system and contract. There was a significant improvement in the Diabetes Self-Management Profile from 55.2 to 61.1 (P?study confirms previous findings that mobile technologies do offer significant potential in improving the care of adolescents with type 1 diabetes. Moreover, behavioral contracts may be an important adjunct to reduce nagging and improve outcomes with behavioral changes. PMID:21406011

DiMeglio, Linda A.; Stein, Stephanie; Marrero, David G.

2011-01-01

314

Animal models of insulin-dependent diabetes.  

PubMed

Animal models have contributed enormously to study in the field of type 1 diabetes. Perhaps the most intensively studied model is the nonobese diabetic (NOD) mouse, which develops an autoimmune-mediated spontaneous diabetes associated with the development of insulin autoantibodies and insulitis. Accurate measurement of antiislet autoantibodies by radioassay and detection of antigen-specific T cells using major histocompatibility complex tetramers are possible. Various strategies have been developed in preventing diabetes in animal models; a peptide-induced model of type 1 diabetes has been described. Finally, the development of peptide vaccines is hampered by the risk of anaphylaxis in both mouse and humans. In this chapter, methods and strategies to measure antiinsulin autoantibodies, to detect antigen-specific T cells by tetramer analysis, and to prevent diabetes using peptide vaccines are discussed. Along with these topics, a protocol of peptide-induced diabetes and peptide vaccine-induced anaphylaxis are described, serving as a reminder of the potential dangers that could exist in human trials. In summary, animal models have become necessary in the study of type 1 diabetes and provide researchers important tools to conduct studies that could not otherwise be performed in humans. PMID:15286387

Liu, Edwin; Yu, Liping; Moriyama, Hiroaki; Eisenbarth, George S

2004-01-01

315

Incidence and Predictors of Hospitalization for Bacterial Infection in Community-Based Patients with Type 2 Diabetes: The Fremantle Diabetes Study  

PubMed Central

Background The few studies that have examined the relationship between diabetes and bacterial infections have utilized administrative databases and/or have had limited/incomplete data including recognized infection risk factors. The aim of this study was to determine the incidence and associates of bacterial infection severe enough to require hospitalization in well-characterized community-based patients with type 2 diabetes. Methods and Findings We studied a cohort of 1,294 patients (mean±SD age 64.1±11.3 years) from the longitudinal observational Fremantle Diabetes Study Phase I (FDS1) and 5,156 age-, gender- and zip-code-matched non-diabetic controls. The main outcome measure was incident hospitalization for bacterial infection as principal diagnosis between 1993 and 2010. We also examined differences in statin use in 52 FDS1 pairs hospitalized with pneumonia (cases) or a contemporaneous non-infection-related cause (controls). During 12.0±5.4 years of follow-up, 251 (19.4%) patients were hospitalized on 368 occasions for infection (23.7/1,000 patient-years). This was more than double the rate in matched controls (incident rate ratio (IRR) (95% CI), 2.13 (1.88–2.42), P<0.001). IRRs for pneumonia, cellulitis, and septicemia/bacteremia were 1.86 (1.55–2.21), 2.45 (1.92–3.12), and 2.08 (1.41–3.04), respectively (P<0.001). Among the diabetic patients, older age, male sex, prior recent infection-related hospitalization, obesity, albuminuria, retinopathy and Aboriginal ethnicity were baseline variables independently associated with risk of first hospitalization with any infection (P?0.005). After adjustment for these variables, baseline statin treatment was not significant (hazard ratio (95% CI), 0.70 (0.39–1.25), P?=?0.22). Statin use at hospitalization for pneumonia among the case-control pairs was similar (23.1% vs. 13.5%, P?=?0.27). Conclusions The risk of severe infection is increased among type 2 diabetic patients and is not reduced by statin therapy. There are a number of other easily-accessible sociodemographic and clinical variables that could be used to optimize infection-related education, prevention and management in type 2 diabetes. PMID:23536910

Hamilton, Emma J.; Martin, Natalie; Makepeace, Ashley; Sillars, Brett A.; Davis, Wendy A.; Davis, Timothy M. E.

2013-01-01

316

Self-monitoring of blood glucose in type 2 diabetes and long-term outcome: an epidemiological cohort study  

Microsoft Academic Search

Aims\\/hypothesis  The aim of this study was to obtain epidemiological data on self-monitoring of blood glucose (SMBG) in type 2 diabetes and\\u000a to investigate the relationship of SMBG with disease-related morbidity and mortality.\\u000a \\u000a \\u000a \\u000a Methods  The German multicentre Retrolective Study ‘Self-monitoring of Blood Glucose and Outcome in Patients with Type 2 Diabetes’\\u000a (ROSSO) followed 3,268 patients from diagnosis of type 2 diabetes between

S. Martin; B. Schneider; L. Heinemann; V. Lodwig; H.-J. Kurth; H. Kolb; W. A. Scherbaum

2006-01-01

317

Incidence of Type 2 Diabetes by Place of Birth in the Multi-Ethnic Study of Atherosclerosis (MESA)  

PubMed Central

Incidence of diabetes among US foreign-born individuals is not well studied. Data were from the Multi Ethnic Study of Atherosclerosis. Cox proportional hazards regression was used to examine diabetes risk by race/ethnicity, place of birth, and duration of residence among foreign-born. Foreign-born Latinos had a higher risk of incident diabetes compared to US-born Latinos (hazard ratio (HR) 1.79 [95 % confidence interval (CI) 1.00–3.21]). Latinos born in Mexico (HR, 2.26 [95 % CI, 1.18–4.33]) had higher risk of incident diabetes compared to US-born Latinos. Foreign-born living in the US ?20 years had a higher adjusted risk of incident diabetes compared to those in the US for <20 years (HR, 1.60 [95 % CI, 1.05–2.55]). Incident diabetes may be higher among foreign-born compared to native born; incident diabetes may also be higher among those immigrants who have lived in the US for longer periods of time. Future studies should characterize individuals by race/ethnicity and place of birth to account for differences in biology and time spent in the US. PMID:22833256

Chan, Cheeling; Liu, Kiang; Burke, Gregory; Kanaya, Alka M.

2014-01-01

318

Study Compares Insulin Regimens for Type 1 Diabetes  

MedlinePLUS

... Dr. Andrea Tricco of St. Michael's Hospital in Toronto analyzed data from 39 studies. The studies compared ... who is assistant professor in the University of Toronto's School of Public Health. "They gained an average ...

319

Rationale, design, and method of the Diabetes & Women's Health study - a study of long-term health implications of glucose intolerance in pregnancy and their determinants.  

PubMed

Women who develop gestational diabetes mellitus or impaired glucose tolerance during pregnancy are at substantially increased risk for type 2 diabetes and comorbidities after pregnancy. Little is known about the role of genetic factors and their interactions with environmental factors in determining the transition from gestational diabetes mellitus to overt type 2 diabetes mellitus. These critical data gaps served as the impetus for this Diabetes & Women's Health study with the overall goal of investigating genetic factors and their interactions with risk factors amenable to clinical or public health interventions in relation to the transition of gestational diabetes mellitus to type 2 diabetes mellitus. To achieve the goal efficiently, we are applying a hybrid design enrolling and collecting data longitudinally from approximately 4000 women with a medical history of gestational diabetes mellitus in two existing prospective cohorts, the Nurses' Health Study II and the Danish National Birth Cohort. Women who had a medical history of gestational diabetes mellitus in one or more of their pregnancies are eligible for the present study. After enrollment, we follow study participants for an additional 2 years to collect updated information on major clinical and environmental factors that may predict type 2 diabetes mellitus risk as well as with biospecimens to measure genetic and biochemical markers implicated in glucose metabolism. Newly collected data will be appended to the relevant existing data for the creation of a new database inclusive of genetic, epigenetic and environmental data. Findings from the study are critical for the development of targeted and more effective strategies to prevent type 2 diabetes mellitus and its complications in this high-risk population. PMID:24828694

Zhang, Cuilin; Hu, Frank B; Olsen, Sjurdur F; Vaag, Allan; Gore-Langton, Robert; Chavarro, Jorge E; Bao, Wei; Yeung, Edwina; Bowers, Katherine; Grunnet, Louise G; Sherman, Seth; Kiely, Michele; Strøm, Marin; Hansen, Susanne; Liu, Aiyi; Mills, James; Fan, Ruzong

2014-11-01

320

Genetic and Genomic Studies of the BTBR ob/ob Mouse Model of Type 2 Diabetes  

E-print Network

-induced diabetes. Keywords: type 2 diabetes, BTBR, insulin resistance, obesity, pancreatic decompensation, genetics in DM2, insulin resistance is an unreliable predictor of individuals who will become diabetic.3,4 Only leading to diabetes.5 It is now becoming recognized that both insulin resistance and b-cell dysfunction

Attie, Alan D.

321

Inflammation and microalbuminuria in nondiabetic and type 2 diabetic subjects: The Insulin Resistance Atherosclerosis Study  

Microsoft Academic Search

Inflammation and microalbuminuria in nondiabetic and type 2 diabetic subjects: The Insulin Resistance Atherosclerosis Study.BackgroundMicroalbuminuria is a risk factor for cardiovascular disease, but the underlying pathomechanisms are still poorly understood. A relationship between C-reactive protein (CRP), a sensitive marker of inflammation, and atherosclerotic disease has been reported recently.MethodsWe hypothesized that microalbuminuria might be associated with chronic inflammation and investigated the

Andreas Festa; Ralph D'agostino; George Howard; Leena Mykkänen; Russell P. Tracy; Steven M. Haffner

2000-01-01

322

The role of diabetes in hepatocellular carcinoma: a case-control study among United States veterans  

Microsoft Academic Search

OBJECTIVE:Diabetes mellitus (DM) has been reported to increase the risk of hepatocellular carcinoma (HCC). We carried out a case-control study to examine the role of DM while controlling for several known risk factors of HCC.METHODS:All hospitalized patients with primary liver cancer (PLC) during 1997–1999 were identified in the computerized database of the Department of Veterans Affairs, the Patient Treatment File.

Hashem B El-Serag; Peter A Richardson; James E Everhart

2001-01-01

323

Diabetic larvae and obese flies - emerging studies of metabolism in Drosophila  

PubMed Central

Summary The past few years have seen a shift in the use of Drosophila, from studies of growth and development toward genetic characterization of carbohydrate, sterol, and lipid metabolism. This research, reviewed below, establishes a new foundation for using this simple genetic model system to define the basic regulatory mechanisms that underlie metabolic homeostasis, and holds the promise of providing new insights into the causes and treatments of critical human disorders such as diabetes and obesity. PMID:17908555

Baker, Keith D.; Thummel, Carl S.

2008-01-01

324

Menopausal bone changes and incident fractures in diabetic women: a cohort study  

Microsoft Academic Search

Summary  The purpose of this study was to evaluate the rate of bone loss and incident fractures in women with diabetes mellitus (DM)\\u000a across menopause. During menopause, DM women experienced bone mineral density (BMD) loss that was faster at hip and slower\\u000a at spine and had a higher risk of fractures, perhaps because of their earlier menopause. The increasing DM epidemic

N. Khalil; K. Sutton-Tyrrell; E. S. Strotmeyer; G. A. Greendale; M. Vuga; F. Selzer; C. J. Crandall; J. A. Cauley

2011-01-01

325

Diet quality score is a predictor of type 2 diabetes risk in women: the Australian Longitudinal Study on Women's Health.  

PubMed

The present study aimed to determine the ability of two diet quality scores to predict the incidence of type 2 diabetes in women. The study population comprised a nationally representative sample of 8370 Australian middle-aged (45-50 years) women participating in the ALSWH (Australian Longitudinal Study on Women's Health), who were free of diabetes and completed FFQ at baseline. The associations between the Australian Recommended Food Score (ARFS) and Dietary Guideline Index (DGI) with type 2 diabetes risk were assessed using multiple logistic regression models, adjusting for sociodemographic characteristics, lifestyle factors and energy intake. During 6 years of follow-up, 311 incident cases of type 2 diabetes were reported. The DGI score was inversely associated with type 2 diabetes risk (OR comparing the highest with the lowest quintile of DGI was 0·51; 95% CI 0·35, 0·76; P for trend = 0·01). There was no statistically significant association between the ARFS and type 2 diabetes risk (OR comparing the highest with the lowest quintile of ARFS was 0·99; 95% CI 0·68, 1·43; P for trend = 0·42). The results of the present prospective study indicate that the DGI score, which assesses compliance with established dietary guidelines, is predictive of type 2 diabetes risk in Australian women. The risk of type 2 diabetes among women in the highest quintile of DGI was approximately 50% lower than that in women in the lowest quintile. The ARFS was not significantly predictive of type 2 diabetes. PMID:25201303

Alhazmi, Amani; Stojanovski, Elizabeth; McEvoy, Mark; Brown, Wendy; Garg, Manohar L

2014-09-28

326

'I call it the blame and shame disease': a qualitative study about perceptions of social stigma surrounding type 2 diabetes  

PubMed Central

Objectives While health-related stigma has been the subject of considerable research in other conditions (obesity and HIV/AIDS), it has not received substantial attention in diabetes. The aim of the current study was to explore the social experiences of Australian adults living with type 2 diabetes mellitus (T2DM), with a particular focus on the perception and experience of diabetes-related stigma. Design A qualitative study using semistructured interviews, which were audio recorded, transcribed and subject to thematic analysis. Setting This study was conducted in non-clinical settings in metropolitan and regional areas in the Australian state of Victoria. Participants were recruited primarily through the state consumer organisation representing people with diabetes. Participants All adults aged ?18?years with T2DM living in Victoria were eligible to take part. Twenty-five adults with T2DM participated (12 women; median age 61?years; median diabetes duration 5?years). Results A total of 21 (84%) participants indicated that they believed T2DM was stigmatised, or reported evidence of stigmatisation. Specific themes about the experience of stigma were feeling blamed by others for causing their own condition, being subject to negative stereotyping, being discriminated against or having restricted opportunities in life. Other themes focused on sources of stigma, which included the media, healthcare professionals, friends, family and colleagues. Themes relating to the consequences of this stigma were also evident, including participants’ unwillingness to disclose their condition to others and psychological distress. Participants believed that people with type 1 diabetes do not experience similar stigmatisation. Conclusions Our study found evidence of people with T2DM experiencing and perceiving diabetes-related social stigma. Further research is needed to explore ways to measure and minimise diabetes-related stigma at the individual and societal levels, and also to explore perceptions and experiences of stigma in people with type 1 diabetes. PMID:24247325

Browne, Jessica L; Ventura, Adriana; Mosely, Kylie; Speight, Jane

2013-01-01

327

A study of the use of carbamazepine, pregabalin and alpha lipoic acid in patients of diabetic neuropathy  

PubMed Central

Background Diabetic peripheral neuropathy (DPN) is a common, symptomatic, long-term complication of diabetes mellitus. Many of the agents used to treat DN have not been compared with each other. This study was, therefore, undertaken to compare the efficacy and safety of carbamazepine, pregabalin and alpha-lipoic acid in diabetic neuropathy patients. Methods This was a prospective, observational study. The patients were categorized into three groups, Group I included those patients who were prescribed carbamazepine while group II included those on pregabalin and group III patients received alpha-lipoic acid. Each patient was followed up at every month for total duration of 6 months. Demographic details, presenting symptoms, history of diabetes, laboratory values pertaining to diabetes (Fasting blood sugar, Post prandial blood sugar and HbA1c) were recorded. Intensity of pain, using a visual analogue scale (VAS), diabetic neuropathy symptom (DNS) score and diabetic neuropathy examination (DNE) score were assessed at baseline and then at each monthly follow-up. Nerve conduction velocity (NCV) was also measured at baseline and then at the end of 3 and 6 months. Results A total of 101 patients were enrolled out of them 96 completed the study. Regarding VAS, the number of patients having pain was reduced substantially however, the speed and the quantum of this reduction were best in group II (pregabalin). Regarding DNS, also group II showed the best response in terms of number of patients as well as the speed of improvement. The results also imply that the relief from diabetic neuropathy (as per DNE score) is superior with pregabalin administration. However, no improvement in NCV was evident in any group. Conclusion Results of this study suggest that treatment with pregabalin gives faster and better improvement in diabetic neuropathy. PMID:24926454

2014-01-01

328

The Degree of Albuminuria Is Related to Left Ventricular Hypertrophy in Hypertensive Diabetics and Is Associated with Abnormal Left Ventricular Filling: A Pilot Study  

Microsoft Academic Search

The association of albuminuria and left ventricular (LV) hypertrophy (LVH) in diabetics aggra vates the prognosis. The authors studied the relation between LVH and the degree of albu minuria in diabetics and investigated the relationship of albuminuria to LV filling. A comparison was made between 30 hypertensive diabetics, 10 of whom had microalbuminuria (MIC) and 20 had macroalbuminuria (MAC), and

Abdul-Majeed Salmasi; Ewart Jepson; Ana Grenfell; Camelia Kirollos; Mark Dancy

2003-01-01

329

A cluster randomized trial to improve adherence to evidence-based guidelines on diabetes and reduce clinical inertia in primary care physicians in Belgium: study protocol [NTR 1369  

Microsoft Academic Search

BACKGROUND: Most quality improvement programs in diabetes care incorporate aspects of clinician education, performance feedback, patient education, care management, and diabetes care teams to support primary care physicians. Few studies have applied all of these dimensions to address clinical inertia. AIM: To evaluate interventions to improve adherence to evidence-based guidelines for diabetes and reduce clinical inertia in primary care physicians.

Liesbeth Borgermans; Geert Goderis; Carine Van Den Broeke; Chantal Mathieu; Bert Aertgeerts; Geert Verbeke; An Carbonez; Anna Ivanova; Richard Grol; Jan Heyrman

2008-01-01

330

The Effects and Costs of a Group-Based Education Programme for Self-Management of Patients with Type 2 Diabetes. A Community-Based Study  

ERIC Educational Resources Information Center

The worldwide epidemic of Type 2 diabetes necessitates evidence-based self-management education programmes. The purpose of this study was to investigate the effects and costs of an empowerment-based structured diabetes self-management education programme in an unselected group of patients with Type 2 diabetes. Seven hundred and two patients…

Molsted, Stig; Tribler, Jane; Poulsen, Peter B.; Snorgaard, Ole

2012-01-01

331

Risk factors for coronary artery disease in non›insulin dependent diabetes mellitus: United Kingdom prospective diabetes study (UKPDS: 23)  

Microsoft Academic Search

Objective: To evaluate baseline risk factors for coronary artery disease in patients with type 2 diabetes mellitus. Design: A stepwise selection procedure, adjusting for age and sex, was used in 2693 subjects with complete data to determine which risk factors for coronary artery disease should be included in a Cox proportional hazards model. Subjects: 3055 white patients (mean age 52)

S E Manley; D R Matthews

332

Glycometabolic State at Admission: Important Risk Marker of Mortality in Conventionally Treated Patients With Diabetes Mellitus and Acute Myocardial Infarction Long-Term Results From the Diabetes and Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) Study  

Microsoft Academic Search

Background—The Diabetes and Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) study addressed prognostic factors and the effects of concomitant treatment and glycometabolic control in diabetic patients with myocardial infarction (AMI). Methods and Results—Of 620 diabetic patients with AMI, 306 were randomly assigned to a $24-hour insulin-glucose infusion followed by multidose subcutaneous insulin. Three hundred fourteen patients were randomized as controls,

Klas Malmberg; Anna Norhammar; Hans Wedel; Lars Ryden

2010-01-01

333

Comparative Effectiveness of a Mindful Eating Intervention to a Diabetes Self-Management Intervention among Adults with Type 2 Diabetes: A Pilot Study  

PubMed Central

Mindful eating offers promise as an effective approach for weight management and glycemic control in people with diabetes. Diabetes self-management education (DSME) is an essential component of effective self-care. Yet, little research has compared the effect of mindful eating to DSME-based treatment. This study compared the impact of these two interventions in adults with type 2 diabetes mellitus (T2DM). A prospective randomized controlled trial with two parallel interventions was employed. Participants included adults aged 35–65 with T2DM for ? 1 year, body mass index (BMI) ? 27.0, and A1c ? 7.0% who were randomly assigned to a 3-month mindful eating (MB-EAT-D; n=27) or Smart Choices (SC) DSME-based (n=25) intervention. Follow-up occurred 3-months following intervention completion. Dietary intake, physical activity, weight, glycemia, and fasting insulin were assessed using repeated measures ANOVA with contrast analysis. There was no significant difference between groups in the change in weight or glycemia at study end. Significant difference occurred between groups in the change in dietary intake/1000 kcal of trans fats, total fiber, and sugars (all P<0.05). Mean (±SE) reduction in weight (?2.92 ± 0.54 kg for SC vs. ?1.53 ± 0.54 kg for MB-EAT-D) and A1c (?0.67 ± 0.24% for SC and ?0.83 ± 0.24% for MB-EAT-D) were significant (P<0.01). Significant reduction in energy intake and glycemic load occurred (all P<0.0001) for both groups. Training in mindful eating and diabetes self-management facilitate improvement in dietary intake, modest weight loss, and glycemic control. The availability of effective treatments allows diabetes patients choices in meeting their self-care needs. PMID:23102183

Miller, Carla K.; Kristeller, Jean L.; Headings, Amy; Nagaraja, Haikady; Miser, W. Fred

2012-01-01

334

Diabetes Report Card 2012: National and State Profile of Diabetes and Its Complications  

MedlinePLUS

... 2 Diabetes in the United States CDC Study Gestational Diabetes Diabetes in the United States Heart Disease and ... Must Not Be Shared Lifetime Risk for Diabetes Mellitus in the United States Screening for Type 2 ...

335

Expression of VEGF in Periodontal Tissues of Type II Diabetes Mellitus Patients with Chronic Periodontitis -an Immunohistochemical Study  

PubMed Central

Background: Vascular endothelial growth factor (VEGF) induces proliferation of endothelial cells, stimulates angiogenesis, and increases vascular permeability, but information about its role in periodontal diseases is limited. The aim of this study is to determine the association between VEGF expression in healthy and periodontally diseased tissues of healthy and diabetic patients. Materials and Methods: Seventeen systemically healthy and 17 Type 2 diabetic patients (DM), all diagnosed with periodontitis were enrolled into the study. Gingival samples were collected from both periodontal and healthy sites in all patients. Each patient served as his/her own control samples were subjected to immunohistochemical analysis. Results: The diseased sites of diabetic subjects expressed higher level of VEGF when compared to diseased sites of non diabetic subjects with chronic periodontitis, VEGF was observed in healthy periodontal tissues of both diabetic and systemically healthy people with periodontitis and VEGF was intensely present in monocytes and macrophages. Conclusion: The increased expression of VEGF in diseased sites of diabetic patients suggests that diabetes mellitus might have direct influence over VEGF expression. PMID:25302255

Kumar, Senthil

2014-01-01

336

Boulder Creek: A Virtual Field Study  

NSDL National Science Digital Library

This site presents a field lesson that is designed to enhance classroom education about urban resource management issues. The lesson consists of web materials and a self-guided field study of Boulder Creek, located in Boulder, Colorado. By completing this field lesson, students can learn about the tremendous benefits and dangers posed by an important urban-aquatic resource (Boulder Creek). The field study of Boulder Creek has three objectives: to study human-environment interactions in Boulder, CO, to learn basic techniques of fieldwork in geography, and to understand how natural hazards affect life in Boulder, CO. Although the lesson is built around a field excursion to the Boulder Creek area, the information contained in the preview link could stand on its own as an educational tool. Additionally, the information in the preview section includes questions that students can answer without going into the field. For those who are in the Boulder area and can travel to Boulder Creek, twelve stops have been chosen to supplement the online preview material. A map and questions are available for this field excursion. The web site also provides a forum for students to discuss their opinions on human-environment interactions pertaining to the Boulder Creek area.

Hill, A.; Solem, Michael

337

Body Fat Distribution and Risk of Non-lnsulin-d ependent Diabetes Mellitus in Women The Nurses' Health Study  

Microsoft Academic Search

Obesity is an established nsk factor for non-insulin-dependent diabetes mellitus (NIDDM). Anthropometric measures of overall and central obesity as predictors of NIDDM risk have not been as well studied, especially in women. Among 43,581 women enrolled in the Nurses' Health Study who in 1986 provided waist, hip, and weight information and who were initially free from diabetes and other major

Vincent J. Carey; Ellen E. Walters; Graham A. Colditz; Caren G. Solomon; Walter C. Willett; Bernard A. Rosner; Frank E. Speizer; JoAnn E. Manson

338

Safety and efficacy of acarbose in the treatment of Type 2 diabetes: data from a 5-year surveillance study  

Microsoft Academic Search

This 5-year surveillance study assessed the tolerability and safety of acarbose in patients with diabetes. A total of 2035 patients were enrolled of whom 1954 were classified as having Type 2 diabetes. The study was open with no control group. Physicians had sole control of the acarbose doses prescribed. Fasting blood glucose levels, 2-h postprandial glucose levels, HbA1 or HbA1c

Gabriele Mertes

2001-01-01

339

Assessing adolescents with insulin-dependent diabetes mellitus: A multiple perspective pilot study using visual illness narratives and interviews  

Microsoft Academic Search

This study explored the illness experiences of adolescents with insulin-dependent diabetes mellitus (IDDM) using Video Intervention\\/Prevention Assessment (VIA). Five adolescents with IDDM were asked to videotape 8 hours of their lives over a 1-month period. At the conclusion of the study, the primary investigator interviewed each adolescent and their diabetes clinician. VIA visual illness narratives and follow-up interviews provided clinically

Mara H. Buchbinder; Mark J. Detzer; Robert L. Welsch; Ann S. Christiano; Jennifer L. Patashnick; Michael Rich

2005-01-01

340

Pioglitazone hydrochloride in combination with metformin in the treatment of type 2 diabetes mellitus: A randomized, placebo-controlled study  

Microsoft Academic Search

Background: Their complimentary mechanisms of action suggest that a combination of pioglitazone hydrochloride and metformin may have clinically beneficial effects in the treatment of patients with type 2 diabetes.Objective: This study was undertaken to assess the efficacy and tolerability of pioglitazone in combination with metformin in patients with type 2 diabetes mellitus.Methods: This was a 16-week, double-blind study with the

Daniel Einhorn; Marc Rendell; James Rosenzweig; John W Egan; Annette L Mathisen; Roberta L Schneider

2000-01-01

341

The Characteristics of Chronic Inflammatory Demyelinating Polyneuropathy in Patients with and without Diabetes - An Observational Study  

PubMed Central

Introduction We aimed to determine whether the clinical characteristics and electrodiagnostic classification of nerve injury, and response to treatment differed in patients diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP) with and without diabetes. Methods CIDP patients with diabetes (CIDP+DM) (n?=?67) and without diabetes (CIDP-DM) (n?=?67) underwent clinical examination and nerve conduction studies (NCS). CIDP-DM patients were selected using age and gender matching with the existing CIDP+DM cohort. Patients treated with immunotherapies were classified as responders (R) (n?=?46) or non-responders (NR) (n?=?54) based on clinical response to treatment. The groups were compared using analysis of variance, contingency tables and Kruskal-Wallis analyses. Results CIDP+DM subjects had more severe neuropathy based on higher lower limb vibration potential thresholds (VPT)(p?=?0.004), higher Toronto Clinical Neuropathy Score (TCNS) (p?=?0.0009), more proximal weakness (p?=?0.03), more gait abnormality (p?=?0.03) and more abnormal NCS. CIDP+DM subjects had more abnormal sural NCS with lower sural sensory nerve action potential amplitudes (2.4±3.0 µV, 6.6±6.0 µV, p<0.0001) and slower sural nerve conduction velocities (38.6±5.4 m/s, 41.0±5.3 m/s, p?=?0.04). CIDP-DM subjects were more likely to receive immune therapies (93% vs 57%, p?=?<0.0001), despite no significant differences in treatment responder rates (p?=?0.71). Patients who responded to therapy had shorter duration of CIDP than non-responders (8.0±6.0 y vs 11.9±7.6 y, p?=?0.004). Discussion The clinical phenotype and electrophysiological profile of CIDP patients differs according to the presence or absence of diabetes. Despite CIDP+DM patients having more severe clinical and electrophysiological neuropathy, they are less likely to receive disease-modifying/specific therapy, yet have similar response rates to treatment as those without diabetes. Specifically, the duration of neuropathy - not diabetes status - was associated with treatment response. PMID:24586703

Dunnigan, Samantha K.; Ebadi, Hamid; Breiner, Ari; Katzberg, Hans D.; Barnett, Carolina; Perkins, Bruce A.; Bril, Vera

2014-01-01

342

Model-driven diabetes care: study protocol for a randomized controlled trial  

PubMed Central

Background People with type 1 diabetes who use electronic self-help tools register a large amount of information about their disease on their participating devices; however, this information is rarely utilized beyond the immediate investigation. We have developed a diabetes diary for mobile phones and a statistics-based feedback module, which we have named Diastat, to give data-driven feedback to the patient based on their own data. Method In this study, up to 40 participants will be given a smartphone on which is loaded a diabetes self-help application (app), the Few Touch Application (FTA). Participants will be randomized into two groups to be given access to Diastat 4 or 12 weeks, respectively after receiving the smartphone, and will use the FTA with Diastat for 8 weeks after this point. The primary endpoint is the frequency of high and low blood-glucose measurements. Discussion The study will investigate the effect of data-driven feedback to patients. Our hypothesis is that this will improve glycemic control and reduce variability. The endpoints are robust indicators that can be assembled with minimal effort by the patient beyond normal routine. Trial registration Clinicaltrials.gov: NCT01774149 PMID:23672413

2013-01-01

343

Dental students' glucometer experience and attitudes toward diabetes counseling, monitoring, and screening: a comparative study.  

PubMed

The objectives of this study were to compare glucometer experience and attitudes toward counseling, monitoring, and screening for diabetes between two classes of graduating students at one dental school to determine if there were differences by experience and year of graduation. Dental students graduating in 2010 and 2013 completed a survey about their experience with use of a glucometer as well as their attitudes toward and perceived barriers to performing glucose monitoring, screening, and counseling. Response rates for the two classes were 100 percent and 95.7 percent, respectively. Students in the two classes were in general agreement that activities related to glucose monitoring and counseling of patients with diabetes are within the scope and responsibility of the dental profession. Examination of their attitudes toward diabetes monitoring and counseling activities by level of glucometer experience indicated that students with more experience using a glucometer were more likely to consider these activities to be within the scope of dental practice and less likely to perceive barriers to such activities compared to those with little or no experience. In addition, regardless of experience, there was significantly higher endorsement for monitoring of patients who had already been diagnosed than for screening of patients who had not been diagnosed. This study suggests that any strategy to encourage dental students' and dentists' involvement in nontraditional health promotion activities should include ample direct clinical experience with these activities. PMID:25179922

Anders, Patrick L; Davis, Elaine L; McCall, W D

2014-09-01

344

Thermal Threshold: Research Study on Small Fiber Dysfunction in Distal Diabetic Polyneuropathy  

PubMed Central

Objective The most commonly used technique for diagnosis of diabetic neuropathy (DN) is nervous conduction (NC). Our hypothesis is that the use of the thermal threshold (TT) technique to evaluate small fiber damage, which precedes large fiber damage, could enable earlier diagnosis and diminish false negatives. Research Design and Methods The study involved 70 asymptomatic patients with type 2 diabetes mellitus (T2DM) all being treated with oral hypoglycemic medication, and having negative metabolic control levels with glycosylated hemoglobin A1c greater than 7% and less than 8%. Diabetic neuropathy was their only evident complication. All other complications or other causes of neuropathy were discarded. Their time of evolution was 1 to 48 months since date of diagnosis of diabetes. Both thermal threshold and sensory and motor nervous conduction were determined in upper and lower limbs. Results Nervous conduction was found normal in 81% and altered in 19% of patients (large fiber neuropathy). Thermal threshold was normal in 57% and altered in 43% of patients (small fiber neuropathy). In those with normal TTs, no case with an altered NC was found (p < 0.001). Patients with altered TTs could have normal (57%) or altered NC (43%). Thus, NC showed a high frequency of false negatives for DN (57% of 30 cases). The frequency of small fiber neuropathy found with the TT test was higher than that of large fiber neuropathy found with the NC test (p < 0.001) and was found at an earlier age. Conclusions The TT test demonstrated a higher frequency of neuropathy than the NC test in clinically asymptomatic T2DM patients. We suggest that small fiber should be studied before large fiber function to diagnosis distal and symmetrical DN. PMID:22401337

Jimenez-Cohl, Pedro; Grekin, Carlos; Leyton, Cristian; Vargas, Claudio; Villaseca, Roberto

2012-01-01

345

Fruit and vegetable intake and risk of type 2 diabetes mellitus: meta-analysis of prospective cohort studies  

PubMed Central

Objective To clarify and quantify the potential dose–response association between the intake of fruit and vegetables and risk of type 2 diabetes. Design Meta-analysis and systematic review of prospective cohort studies. Data source Studies published before February 2014 identified through electronic searches using PubMed and Embase. Eligibility criteria for selecting studies Prospective cohort studies with relative risks and 95% CIs for type 2 diabetes according to the intake of fruit, vegetables, or fruit and vegetables. Results A total of 10 articles including 13 comparisons with 24?013 cases of type 2 diabetes and 434?342 participants were included in the meta-analysis. Evidence of curve linear associations was seen between fruit and green leafy vegetables consumption and risk of type 2 diabetes (p=0.059 and p=0.036 for non-linearity, respectively). The summary relative risk of type 2 diabetes for an increase of 1 serving fruit consumed/day was 0.93 (95% CI 0.88 to 0.99) without heterogeneity among studies (p=0.477, I2=0%). For vegetables, the combined relative risk of type 2 diabetes for an increase of 1 serving consumed/day was 0.90 (95% CI 0.80 to 1.01) with moderate heterogeneity among studies (p=0.002, I2=66.5%). For green leafy vegetables, the summary relative risk of type 2 diabetes for an increase of 0.2 serving consumed/day was 0.87 (95% CI 0.81 to 0.93) without heterogeneity among studies (p=0.496, I2=0%). The combined estimates showed no significant benefits of increasing the consumption of fruit and vegetables combined. Conclusions Higher fruit or green leafy vegetables intake is associated with a significantly reduced risk of type 2 diabetes. PMID:25377009

Li, Min; Fan, Yingli; Zhang, Xiaowei; Hou, Wenshang; Tang, Zhenyu

2014-01-01

346

Telmisartan ameliorates germ cell toxicity in the STZ-induced diabetic rat: studies on possible molecular mechanisms.  

PubMed

Testicular damage is a common clinical problem in diabetic individuals that severely affects the quality of life. The present study investigates the possible protective mechanisms of telmisartan, an angiotensin II-receptor antagonist in the germ cell of diabetic rat. Male SD rats were used and randomized into six groups: control, telmisartan control, diabetic control and diabetic group treated with telmisartan at the doses of 3, 6 and 12mg/kg/day, per oral for 4 weeks. Diabetes was induced by injecting a single dose of streptozotocin (STZ), (55mg/kg) dissolved in ice-cold 10mM citrate buffer; pH 4.4 and administered i.p. immediately after preparation to the SD rats. At the end of the study, rats were sacrificed and the levels of nitrite, superoxide, malondialdehyde (MDA), glutathione (reduced and peroxidase) and superoxide dismutase (SOD) were measured. Germ cell toxicity was evaluated by using sperm count, sperm comet assay, histology of testes and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. Further to confirm the oxidative and nitrosative damage, immunohistological quantification of 8-oxo-dG (8-oxo-7,8-dihydro-2'-deoxyguanosine) and 3-nitrotyrosine were evaluated respectively. Results showed that telmisartan significantly restored the levels of nitrite, superoxide, malondialdehyde, and glutathione and superoxide dismutase in diabetic testes. Further, telmisartan significantly increased the sperm counts, reduced apoptotic cell death, sperm DNA damage, oxidative and nitrosative damage in diabetic rat. Western blot analysis showed that telmisartan reduced the testicular inflammation and cell death by down-regulating the expression of NF-?B, IL-6, TNF-?, p-ERK1/2, iNOS, caspase-3 and increasing the PPAR-? expression. Results clearly indicate that telmisartan significantly reduced the both oxidative and nitrosative stress, inflammation and cell death in diabetic testes. The present results confirmed that telmisartan exhibited beneficial role in the germ cell of diabetic rat. PMID:23648321

Kushwaha, S; Jena, G B

2013-07-01

347

SPRING: an RCT study of probiotics in the prevention of gestational diabetes mellitus in overweight and obese women  

PubMed Central

Background Obesity is increasing in the child-bearing population as are the rates of gestational diabetes. Gestational diabetes is associated with higher rates of Cesarean Section for the mother and increased risks of macrosomia, higher body fat mass, respiratory distress and hypoglycemia for the infant. Prevention of gestational diabetes through life style intervention has proven to be difficult. A Finnish study showed that ingestion of specific probiotics altered the composition of the gut microbiome and thereby metabolism from early gestation and decreased rates of gestational diabetes in normal weight women. In SPRING (the Study of Probiotics IN the prevention of Gestational diabetes), the effectiveness of probiotics ingestion for the prevention of gestational diabetes will be assessed in overweight and obese women. Methods/design SPRING is a multi-center, prospective, double-blind randomized controlled trial run at two tertiary maternity hospitals in Brisbane, Australia. Five hundred and forty (540) women with a BMI > 25.0 kg/m2 will be recruited over 2 years and receive either probiotics or placebo capsules from 16 weeks gestation until delivery. The probiotics capsules contain > 1x109 cfu each of Lactobacillus rhamnosus GG and Bifidobacterium lactis BB-12 per capsule. The primary outcome is diagnosis of gestational diabetes at 28 weeks gestation. Secondary outcomes include rates of other pregnancy complications, gestational weight gain, mode of delivery, change in gut microbiome, preterm birth, macrosomia, and infant body composition. The trial has 80% power at a 5% 2-sided significance level to detect a >50% change in the rates of gestational diabetes in this high-risk group of pregnant women. Discussion SPRING will show if probiotics can be used as an easily implementable method of preventing gestational diabetes in the high-risk group of overweight and obese pregnant women. PMID:23442391

2013-01-01

348

Low utilisation of diabetes medicines in Iran, despite their affordability (2000-2012): a time-series and benchmarking study  

PubMed Central

Objectives Diabetes is a major public health concern worldwide, particularly in low-income and middle-income countries (LMICs). Limited data exist on the status of access to diabetes medicines in LMICs. We assessed the utilisation and affordability of diabetes medicines in Iran as a middle-income country. Design We used a retrospective time-series design (2000–2012) and assessed national diabetes medicines’ utilisation using pharmaceuticals wholesale data. Methods We calculated defined daily dose consumptions per population days (DDDs/1000 inhabitants/day; DIDs) indicator. Findings were benchmarked with data from Organization for Economic Co-operation and Development (OECD) countries. We also employed Drug Utilization-90% (DU-90) method to compare DU-90s with the Essential Medicines List published by the WHO. We measured affordability using number of minimum daily wage required to purchase a treatment course for 1?month. Results Diabetes medicines’ consumption increased from 4.47 to 33.54 DIDs. The benchmarking showed that medicines’ utilisation in Iran in 2011 was only 54% of the median DIDs of 22 OECD countries. Oral hypoglycaemic agents consisted over 80% of use throughout the study period. Regular and isophane insulin (NPH), glibenclamide, metformin and gliclazide were the DU-90 drugs in 2012. Metformin, glibenclamide and regular/NPH insulin combination therapy were affordable throughout the study period (?0.4, ?0.1, ?0.3 of minimum daily wage, respectively). While the affordability of novel insulin preparations improved over time, they were still unaffordable in 2012. Conclusions The utilisation of diabetes medicines was relatively low, perhaps due to underdiagnosis and inadequate management of patients with diabetes. This had occurred despite affordability of essential diabetes medicines in Iran. Appropriate policies are required to address the underutilisation of diabetes medicines in Iran. PMID:25324322

Sarayani, Amir; Rashidian, Arash; Gholami, Kheirollah

2014-01-01

349

Diabetic Neuropathy  

MedlinePLUS

NINDS Diabetic Neuropathy Information Page Table of Contents (click to jump to sections) What is Diabetic Neuropathy? Is there any ... Trials Organizations Additional resources from MedlinePlus What is Diabetic Neuropathy? Diabetic neuropathy is a peripheral nerve disorder caused ...

350

TRANSFER OF KNOWLEDGE FROM THE SPECIALIST TO THE GENERALIST BY VIDEOCONFERENCING - POTENTIAL IMPACT ON DIABETES CARE Abrahamian, H., Schüller, A., Mauler, H., Prager, R., Irsigler, K.: Transfer of knowledge from the diabetes-specialist to the generalist by videoconferencing: effect on diabetes care. In: Journal of Telemedicine and Telecare 2002; 8, 350-355  

Microsoft Academic Search

Short running title: Telemedicine improves diabetes care in the extramural field Summary We conducted a 12 month prospective interventional study, examining the effectiveness and feasibility of Videoconferencing between primary and secondary care. The primary intention was improvement of diabetes care by means of new technologies. A treatment network consisting of a diabetes specialist and 4 general practitioners was established, using

Heidemarie Abrahamian

351

Soft drink and juice consumption and risk of physician-diagnosed incident type 2 diabetes: the Singapore Chinese Health Study.  

PubMed

Soft drinks and other sweetened beverages may contribute to risk of type 2 diabetes and obesity. However, research has not addressed higher risk and Asian populations. The authors examined the association between soft drinks and juice and the risk of type 2 diabetes among Chinese Singaporeans enrolled in a prospective cohort study of 43,580 participants aged 45-74 years and free of diabetes and other chronic diseases at baseline. The incidence of physician-diagnosed type 2 diabetes was assessed by interview and validated; 2,273 participants developed diabetes during follow-up. After adjustment for potential lifestyle and dietary confounders, participants consuming > or =2 soft drinks per week had a relative risk of type 2 diabetes of 1.42 (95% confidence interval (CI): 1.25, 1.62) compared with those who rarely consumed soft drinks. Similarly, consumption of > or =2 juice beverages per week was associated with an increased risk (relative risk (RR) = 1.29, 95% CI: 1.05, 1.58). The association was modified by 5-year weight gain for > or =2 soft drinks per week among those who gained > or =3 kg (RR = 1.70, 95% CI: 1.34, 2.16) compared with those who gained less weight (RR = 1.20, 95% CI: 1.03, 1.41). Relatively frequent intake of soft drinks and juice is associated with an increased risk for development of type 2 diabetes in Chinese men and women. PMID:20160170

Odegaard, Andrew O; Koh, Woon-Puay; Arakawa, Kazuko; Yu, Mimi C; Pereira, Mark A

2010-03-15

352

The Effects of Opiate Use and Hepatitis C Virus Infection on Risk of Diabetes Mellitus in the Women's Interagency HIV Study  

PubMed Central

Background Opiate use is common in HIV- and hepatitis C virus (HCV)-infected individuals, however its contribution to the risk of diabetes mellitus is not well understood. Methods Prospective study of 1,713 HIV-infected and 652 uninfected participants from the Women’s Interagency HIV Study between October 2000 and March 2006. Diabetes defined as fasting glucose ?126 mg/dl, or self-report of diabetes medication use or confirmed diabetes diagnosis. Opiate use determined using an interviewer-administered questionnaire. Detectable plasma HCV RNA confirmed HCV infection. Results Current opiate users had a higher prevalence of diabetes (15%) than non-users (10%, p=.03), as well as a higher risk of incident diabetes (adjusted relative hazard [RHadj] 1.58, 95% CI 1.01, 2.46), after controlling for HCV infection, HIV/antiretroviral therapy status and diabetes risk factors including age, race/ethnicity, family history of diabetes and body mass index. HCV infection was also an independent risk factor for diabetes (RHadj 1.61, 95% CI 1.02, 2.52). HCV-infected women reporting current opiate use had the highest diabetes incidence (4.83 cases/100 person-years). Conclusions Among women with or at-risk for HIV, opiate use is associated with increased diabetes risk independently of HCV infection. Diabetic screening should be part of care for opiate users, and those infected with HCV. PMID:20190642

Howard, Andrea A.; Hoover, Donald R.; Anastos, Kathryn; Wu, Xi; Shi, Qiuhu; Strickler, Howard D.; Cole, Stephen R.; Cohen, Mardge H.; Kovacs, Andrea; Augenbraun, Michael; Latham, Patricia S.; Tien, Phyllis C.

2010-01-01

353

Serum fructosamine in canine diabetes mellitus. An initial study  

Microsoft Academic Search

This study reports on a spectrophotometric assay for the determination of serum fructosamine concentration. The assay was evaluated for use in canine serum samples by assessment of the precision, accuracy, detectability and stability of serum fructosamine during storage. To evaluate the diagnostic usefulness of the assay, both the effect of acute changes in blood glucose on serum fructosamine concentration and

A. L. Jensen

1992-01-01

354

A comparative oxidative stress study--obesity with and without diabetes mellitus.  

PubMed

Oxidative stress and inflammation are involved in the initiation and progression of obesity and diabetes mellitus. The aim of our study was to find out some markers of oxidative stress in twenty obese patients with type 2 diabetes mellitus (group D) and twenty age-matched obese subjects (group O) and compare the results with the control values from twenty matched healthiy subjects (group H). Spectrophotometric methods were used. For the following plasma parameters: ceruloplasmin, d-ROM (determinable Reactive Oxygen Metabolites), alpha-dicarbonyls, the values were modified in the same way for the groups of patients versus healthy subjects. The patients had higher alpha-dicarbonyls levels than the controls (for D versus H, p<0.047 and for O versus H, p<0.043). There were not significant differences for plasma ceruloplasmin and d-ROM levels. Comparing group O versus D, all the above parameters had very close values. The antioxidant capacity (AC) was higher in group O versus group H (p<0.001) and higher in group O versus D (p<0.02). The high AC for obese patients may be due to hyperuricemia. A negative correlation between AC and d-ROM concentrations and a positive correlation between ceruloplasmin and AC levels was observed for group D. Our data underline that in type 2 diabetes mellitus and obesity, the plasma markers of oxidative stress are modified in the same way. Oxidative stress may be a "connector" between these two diseases. Probably body fat reduction (for obese individuals) diminishes oxidant formation and, in its turn, the incidence of obesity related diseases, such as diabetes mellitus. PMID:16812985

Vîrgolici, Bogdana; Mohora, Maria; Stoian, Irina; Lixandru, Dana; G?man, Laura; Paveliu, Fraga

2005-01-01

355

Functional Vascular Study in Hypertensive Subjects with Type 2 Diabetes Using Losartan or Amlodipine  

PubMed Central

Background Antihypertensive drugs are used to control blood pressure (BP) and reduce macro- and microvascular complications in hypertensive patients with diabetes. Objectives The present study aimed to compare the functional vascular changes in hypertensive patients with type 2 diabetes mellitus after 6 weeks of treatment with amlodipine or losartan. Methods Patients with a previous diagnosis of hypertension and type 2 diabetes mellitus were randomly divided into 2 groups and evaluated after 6 weeks of treatment with amlodipine (5 mg/day) or losartan (100 mg/day). Patient evaluation included BP measurement, ambulatory BP monitoring, and assessment of vascular parameters using applanation tonometry, pulse wave velocity (PWV), and flow-mediated dilation (FMD) of the brachial artery. Results A total of 42 patients were evaluated (21 in each group), with a predominance of women (71%) in both groups. The mean age of the patients in both groups was similar (amlodipine group: 54.9 ± 4.5 years; losartan group: 54.0 ± 6.9 years), with no significant difference in the mean BP [amlodipine group: 145 ± 14 mmHg (systolic) and 84 ± 8 mmHg (diastolic); losartan group: 153 ± 19 mmHg (systolic) and 90 ± 9 mmHg (diastolic)]. The augmentation index (30% ± 9% and 36% ± 8%, p = 0.025) and augmentation pressure (16 ± 6 mmHg and 20 ± 8 mmHg, p = 0.045) were lower in the amlodipine group when compared with the losartan group. PWV and FMD were similar in both groups. Conclusions Hypertensive patients with type 2 diabetes mellitus treated with amlodipine exhibited an improved pattern of pulse wave reflection in comparison with those treated with losartan. However, the use of losartan may be associated with independent vascular reactivity to the pressor effect. PMID:25014057

Pozzobon, Cesar Romaro; Gismondi, Ronaldo A. O. C.; Bedirian, Ricardo; Ladeira, Marcia Cristina; Neves, Mario Fritsch; Oigman, Wille

2014-01-01

356

A Genome-Wide Association Study Identifies Susceptibility Variants for Type 2 Diabetes in Han Chinese  

PubMed Central

To investigate the underlying mechanisms of T2D pathogenesis, we looked for diabetes susceptibility genes that increase the risk of type 2 diabetes (T2D) in a Han Chinese population. A two-stage genome-wide association (GWA) study was conducted, in which 995 patients and 894 controls were genotyped using the Illumina HumanHap550-Duo BeadChip for the first genome scan stage. This was further replicated in 1,803 patients and 1,473 controls in stage 2. We found two loci not previously associated with diabetes susceptibility in and around the genes protein tyrosine phosphatase receptor type D (PTPRD) (P?=?8.54×10?10; odds ratio [OR]?=?1.57; 95% confidence interval [CI]?=?1.36–1.82), and serine racemase (SRR) (P?=?3.06×10?9; OR?=?1.28; 95% CI?=?1.18–1.39). We also confirmed that variants in KCNQ1 were associated with T2D risk, with the strongest signal at rs2237895 (P?=?9.65×10?10; OR?=?1.29, 95% CI?=?1.19–1.40). By identifying two novel genetic susceptibility loci in a Han Chinese population and confirming the involvement of KCNQ1, which was previously reported to be associated with T2D in Japanese and European descent populations, our results may lead to a better understanding of differences in the molecular pathogenesis of T2D among various populations. PMID:20174558

Chuang, Lee-Ming; Lu, Chieh-Hsiang; Chang, Chwen-Tzuei; Wang, Tzu-Yuan; Chen, Rong-Hsing; Shiu, Chiung-Fang; Liu, Yi-Min; Chang, Chih-Chun; Chen, Pei; Chen, Chien-Hsiun; Fann, Cathy S. J.; Chen, Yuan-Tsong; Wu, Jer-Yuarn

2010-01-01

357

Pelvic floor neuropathy: a comparative study of diabetes mellitus and idiopathic faecal incontinence.  

PubMed

Twenty one patients with diabetic peripheral neuropathy, 18 with idiopathic faecal incontinence and 11 normal controls were studied with techniques of mucosal electrosensitivity, rectal distension for the quantitative assessment of anorectal sensation, and manometric and electromyographic tests for the assessment of anorectal motor function. An asymptomatic sensorimotor deficit was found in the anal canal of patients with diabetic peripheral neuropathy. Mucosal electrosensitivity thresholds in the anal canal were significantly higher (p less than 0.01 v controls) and fibre density of the external anal sphincter significantly raised (p less than 0.0001 v controls). Anal manometry and pudendal nerve terminal motor latencies were similar to controls. In patients with idiopathic faecal incontinence the tests of sensory and motor function also showed a sensorimotor neuropathy; compared with controls, mucosal electrosensitivity thresholds were significantly higher (p less than 0.002), anal canal resting and maximum squeeze pressures were significantly lower (p less than 0.05 and p less than 0.002 respectively), and pudendal nerve terminal motor latencies and fibre density of the external anal sphincter were significantly raised (both p less than 0.05). Sensory thresholds to rectal distension were similar in all groups. Pelvic floor sensorimotor neuropathy in diabetic patients has several features in common with that of patients with idiopathic faecal incontinence but its functional significance remains uncertain. PMID:3384360

Rogers, J; Levy, D M; Henry, M M; Misiewicz, J J

1988-06-01

358

HD047703, a New Promising Anti-Diabetic Drug Candidate: In Vivo Preclinical Studies  

PubMed Central

G-protein coupled receptor 119 (GPR119) has emerged as a novel target for the treatment of type 2 diabetes mellitus. GPR119 is involved in glucose-stimulated insulin secretion (GSIS) from the pancreatic ?-cells and intestinal cells. In this study, we identified a novel small-molecule GPR119 agonist, HD047703, which raises intracellular cAMP concentrations in pancreatic ?-cells and can be expected to potentiate glucose-stimulated insulin secretion from human GPR119 receptor stably expressing cells (CHO cells). We evaluated the acute efficacy of HD047703 by the oral glucose tolerance test (OGTT) in normal C57BL/6J mice. Then, chronic administrations of HD047703 were performed to determine its efficacy in various diabetic rodent models. Single administration of HD047703 caused improved glycemic control during OGTT in a dose-dependent manner in normal mice, and the plasma GLP-1 level was also increased. With respect to chronic efficacy, we observed a decline in blood glucose levels in db/db, ob/ob and DIO mice. These results suggest that HD047703 may be a potentially promising anti-diabetic agent.

Kim, SoRa; Kim, Dae Hoon; Kim, Young-Seok; Ha, Tae-Young; Yang, Jin; Park, Soo Hyun; Jeong, Kwang Won; Rhee, Jae-Keol

2014-01-01

359

Skeletal muscle magnetic resonance imaging study in a patient with diabetic lumbosacral radiculoplexus neuropathy.  

PubMed

A 63-year-old man with type 2 diabetes mellitus developed deep aching and numbness in the right hip and lower extremity with rapid body weight loss. Neurological examination revealed weakness of the right hamstrings, tibialis anterior, and peroneus longus muscles with diminished ankle tendon reflex. We diagnosed him with diabetic lumbosacral radicuoloplexus neuropathy (DLRPN) based on neurological, radiological, and neurophysiological findings. Magnetic resonance imaging (MRI) of skeletal muscles showed high intensity signals on T2-weighted images in bilateral hamstrings, adductor magnus and right tensor fasciae latae, and lower leg extensor muscles. The MRI findings suggested muscle edema caused by acute denervation. DLRPN, or diabetic amyotrophy, is known to be caused by ischemic axonal degeneration. Our patient showed good functional recovery, and abnormal MRI signals in the involved muscles mostly disappeared in parallel to the clinical course. Distribution of the denervated muscles suggested that our patient had either patchy lesions in the lumbosacaral plexus or mononeuropathy multiplex in the nerve branches. The current study highlights the potential of skeletal muscle MRI for clinical evaluation of DLRPN. PMID:25283832

Matsuda, Nozomu; Kobayashi, Shunsuke; Ugawa, Yoshikazu

2014-01-01

360

Studies of experimental hosiery in diabetic neuropathic patients with high foot pressures.  

PubMed

High plantar pressures and painless trauma are associated with the development of foot ulcers in diabetic patients. Padded hosiery has been reported to reduce plantar pressures in patients at risk of ulceration. Using the optical pedobarograph we have studied 10 patients who regularly wore experimental padded hosiery for 6 months. The hosiery continued to provide substantial and significant reduction in peak forefoot pressures at 3 months (mean reduction 15.5%, p less than 0.01) and 6 months (17.6%, p less than 0.01), although the level of reduction was less than that seen at baseline (31.3%, p less than 0.05). In addition, commercially available hosiery designed as sportswear has been tested, and compared with experimental hosiery. Although these socks (with high or medium density padding) provided significant pressure reduction versus barefoot (mean 17.4% and 10.4%, p less than 0.01), this was not as great as that seen with experimental hosiery (27%, p less than 0.05). Thus the use of socks designed to reduce pressure stress on diabetic neuropathic feet is effective, and continues to be so for a considerable period of time. Commercially available sports socks may also have a place in the management of the diabetic insensitive foot. PMID:2140084

Veves, A; Masson, E A; Fernando, D J; Boulton, A J

1990-05-01

361

The role of fibrin deposition in diabetic glomerulosclerosis: a light, electron and immunofluorescence microscopy study.  

PubMed

The possible role of fibrin deposition in the development of diabetic glomerulosclerosis has been investigated by light, immunofluorescence, and electron microscopy examination of renal tissue obtained by percutaneous biopsy from seven diabetic patients having minimal clinical evidence of renal involvement and at necropsy on nine diabetic patients. Although the biopsy specimens showed only early to moderate diffuse glomerulosclerosis without either nodular or exudative lesions, approximately 70% of glomeruli examined showed specific fluorescence for fibrinogen in a discontinuous linear pattern along the capillary basement membrane and diffusely in the mesangium. Moreover the immunofluorescence findings correlated well with the distribution patterns of material thought to be fibrin both in the light microscopy studies, by virtue of its staining properties, and by electron microscopy, because of periodicity, texture, and electron density. It is suggested that electron-dense granular deposits seen on electron microscopy may represent intermediate compounds in the fibrinogen to fibrin conversion, and that endothelial and mesangial trapping of fibrinogen or other macromolecules may initiate or accelerate mesangial enlargement, nodule formation, and irregularity of the basement membrane. PMID:4561948

Farquhar, A; MacDonald, M K; Ireland, J T

1972-08-01

362

Evaluation of a target region capture sequencing platform using monogenic diabetes as a study-model  

PubMed Central

Background Monogenic diabetes is a genetic disease often caused by mutations in genes involved in beta-cell function. Correct sub-categorization of the disease is a prerequisite for appropriate treatment and genetic counseling. Target-region capture sequencing is a combination of genomic region enrichment and next generation sequencing which might be used as an efficient way to diagnose various genetic disorders. We aimed to develop a target-region capture sequencing platform to screen 117 selected candidate genes involved in metabolism for mutations and to evaluate its performance using monogenic diabetes as a study-model. Results The performance of the assay was evaluated in 70 patients carrying known disease causing mutations previously identified in HNF4A, GCK, HNF1A, HNF1B, INS, or KCNJ11. Target regions with a less than 20-fold sequencing depth were either introns or UTRs. When only considering translated regions, the coverage was 100% with a 50-fold minimum depth. Among the 70 analyzed samples, 63 small size single nucleotide polymorphisms and indels as well as 7 large deletions and duplications were identified as being the pathogenic variants. The mutations identified by the present technique were identical with those previously identified through Sanger sequencing and Multiplex Ligation-dependent Probe Amplification. Conclusions We hereby demonstrated that the established platform as an accurate and high-throughput gene testing method which might be useful in the clinical diagnosis of monogenic diabetes. PMID:24476040

2014-01-01

363

Gene therapy for diabetes  

Microsoft Academic Search

\\u000a Diabetes mellitus is a devastating disease and the World Health Organization expects that the number of diabetic patients\\u000a will increase to 300 million by the year 2025. Intensive glycemic control with insulin therapy to both Type 1 and Type 2 diabetic\\u000a patients can reduce the risk of diabetic complications, but also increase the incidence of hypoglycemia. Many studies have\\u000a shown

Hirofumi Noguchi

364

Diabetes home monitoring project  

Microsoft Academic Search

The objective is to study the feasibility of remotely monitoring people with diabetes using low-cost technology. Using a personal computer, randomly chosen people with type I diabetes transmit their diabetes related data to their physician at Georgetown University Medical Center on a weekly basis where he analyzes it and contacts the patient every week to make safe adjustments to diet,

A. Alaoui; S. Clement; N. Khanafer; J. Collman; B. Levine; S. K. Mun

1998-01-01

365

Intensive insulin therapy justifies simplification of the diabetes diet: a prospective study in insulin-dependent diabetic patients1  

Microsoft Academic Search

Dietary and metabolic variables were investigated in 48 unselected, nonobese Type 1 (insulin-dependent) diabetic patients before and 3 mo after changing from (a) traditional insulin and diet therapy to (b) intensified insulin plus simplified diet therapy. HbA!c levels declined significantly from 9.04 ± 0.25% with therapy (a) to 8.34 ± 0.16% with therapy (b) (p <0.005). During (a), 58% of

Ernst A Chantelau; Anja Frenzen; Gaby Gosseringer; Inge Hansen; Michael Berger

366

The Field Trip Book: Study Travel Experiences in Social Studies  

ERIC Educational Resources Information Center

Looking for social studies adventures to help students find connections to democratic citizenship? Look no further! This book provides just the answer teachers need for engaging students in field trips as researching learners with emphasis on interdisciplinary social studies plus skills in collecting and reporting data gathered from field

Morris, Ronald V.

2010-01-01

367

Contribution of type 2 diabetes associated loci in the Arabic population from Tunisia: a case-control study  

Microsoft Academic Search

BACKGROUND: Candidate gene and genome-wide association studies have both reproducibly identified several common Single Nucleotide Polymorphisms (SNPs) that confer type 2 diabetes (T2D) risk in European populations. Our aim was to evaluate the contribution to T2D of five of these established T2D-associated loci in the Arabic population from Tunisia. METHODS: A case-control design comprising 884 type 2 diabetic patients and

Intissar Ezzidi; Nabil Mtiraoui; Stéphane Cauchi; Emmanuel Vaillant; Aurélie Dechaume; Molka Chaieb; Maha Kacem; Wassim Y Almawi; Philippe Froguel; Touhami Mahjoub; Martine Vaxillaire

2009-01-01

368

Prevalence of diabetic peripheral neuropathy and its relation to glycaemic control and potential risk factors: the EURODIAB IDDM Complications Study  

Microsoft Academic Search

Summary   The EURODIAB IDDM Complications Study involved the examination of 3250 randomly selected insulin-dependent diabetic patients,\\u000a from 31 centres in 16 European countries. Part of the examination included an assessment of neurological function including\\u000a neuropathic symptoms and physical signs, vibration perception threshold, tests of autonomic function and the prevalence of\\u000a impotence. The prevalence of diabetic neuropathy across Europe was 28

S. Tesfaye; L. K. Stevens; J. M. Stephenson; J. H. Fuller; M. Plater; C. Ionescu-Tirgoviste; A. Nuber; G. Pozza; J. D. Ward

1996-01-01

369

Risk factors for myocardial infarction and death in newly detected NIDDM: the Diabetes Intervention Study, 11-year follow-up  

Microsoft Academic Search

Summary   The Diabetes Intervention Study (DIS) is a prospective population-based multicentre trial of newly detected cases of non-insulin-dependent\\u000a diabetes mellitus (NIDDM). This report analyses the risk factors for subsequent coronary heart disease and all-cause death\\u000a during the 11-year follow-up. The prognostic significance of the categories of the NIDDM Policy Group was validated with respect\\u000a to the incidence of coronary heart

M. Hanefeld; S. Fischer; U. Julius; J. Schulze; U. Schwanebeck; H. Schmechel; H. J. Ziegelasch; J. Lindner

1996-01-01

370

Setbacks in diet adherence and emotional distress: A study of older patients with type 2 diabetes and their spouses  

Microsoft Academic Search

Objectives: We investigated patients’ difficulties in managing their diet (i.e. diet setbacks) and associations with change in disease-specific and general emotional distress (diabetes distress and depressive symptoms) among patients with type 2 diabetes and their spouses.Method: Data for this study were collected in couples’ homes (N?=?115 couples) using structured interviews and self-administered questionnaires at three time points: baseline (T1), six

Melissa M. Franks; Rachel C. Hemphill; Amber J. Seidel; Mary Ann Parris Stephens; Karen S. Rook; James K. Salem

2012-01-01

371

Rainfall simulator for field runoff studies  

NASA Astrophysics Data System (ADS)

SummaryRain simulators (RSs) are used in soil crusting and soil erosion laboratory and field studies. The energy flux produced by RSs is usually high in respect to the intensity of the application. The high energy flux applied on the soil surface by these RSs becomes a crucial disadvantage when low intensity rainfall is considered. Moreover, crust formation under natural field conditions is very different from crusting in disturbed soil samples. The main purpose of this study was the design and the construction of a portable RS to be used in the field for simulating rainfalls that induce soil crusting and thus lead to the generation of runoff and eventually soil erosion. A high accuracy portable RS for field rainfall simulations was designed and built. The D50 of the drops is 1.5 mm with a ground hitting velocity that nearly matches the theoretical terminal velocity without the necessity of a tower (Barros et al., 2008). The energy flux of the simulated rain is 76% of the energy flux expected for a natural rainfall of the same intensity. The spatial distribution of water is homogenous for a wide range of rain intensities. This RS can be a powerful tool for field infiltration, soil crusting and soil erosion field trials.

Abudi, I.; Carmi, G.; Berliner, P.

2012-08-01

372

Interaction Between Flames and Electric Fields Studied  

NASA Technical Reports Server (NTRS)

The interaction between flames and electric fields has long been an interesting research subject that has theoretical importance as well as practical significance. Many of the reactions in a flame follow an ionic pathway: that is, positive and negative ions are formed during the intermediate steps of the reaction. When an external electric field is applied, the ions move according to the electric force (the Coulomb force) exerted on them. The mo